National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 85 Research Studies DisplayedSolberg LI, Ziegenfuss JY, Rivard RL
Is there room for individual patient-specified preferences in the patient-reported outcome measurement revolution?
The goal of this study was to test the feasibility of collecting qualitative patient-preferred goals and its feasibility as an addition to a standardized process for collecting quantitative composite patient-reported outcome measures (PROMs) from patients undergoing knee joint replacement. The study found that joint replacement patients who responded to quantitative PROMS were willing to report on their other preferred outcomes.
AHRQ-funded; HS025618.
Citation: Solberg LI, Ziegenfuss JY, Rivard RL .
Is there room for individual patient-specified preferences in the patient-reported outcome measurement revolution?
J Patient Cent Res Rev 2023 Fall; 10(4):210-18. doi: 10.17294/2330-0698.2017..
Keywords: Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Neerland C, Slaughter-Acey J, Behrens K
An evidence map for social and structural determinants for maternal morbidity and mortality: a systematic review.
The study aimed to identify social and structural determinants of maternal morbidity and mortality during prenatal and postpartum periods in the U.S. Out of 8,378 references screened, 118 studies were included, covering domains like identity, socioeconomic factors, violence, and trauma. Findings revealed mixed patterns between risk factors and outcomes, with notable attention to depression and mental health. Advancing the field long-term should involve developing comprehensive datasets to thoroughly investigate intersections with biological and medical risk factors.
AHRQ-funded; 75Q80120D00008.
Citation: Neerland C, Slaughter-Acey J, Behrens K .
An evidence map for social and structural determinants for maternal morbidity and mortality: a systematic review.
Obstet Gynecol 2024 Mar; 143(3):383-92. doi: 10.1097/aog.0000000000005489.
Keywords: Social Determinants of Health, Maternal Care, Mortality, Evidence-Based Practice, Risk, Women, Outcomes
Wu J, Yuan CT, Moyal-Smith R
Electronic health record-supported implementation of an evidence-based pathway for perioperative surgical care.
This study examines the role of electronic health records (EHRs) in implementing enhanced recovery pathways (ERPs) for perioperative surgical care. Interviews with informaticians and clinicians from eight US hospitals revealed three thematic clusters: "EHR difficulties," "EHR enablers," and "EHR barriers." Researchers concluded that high performers and improvers successfully integrated ERPs into EHRs with dedicated multidisciplinary teams, while others faced challenges. Early involvement of informatics expertise benefited ERP implementation and sustainability.
AHRQ-funded; 2332015000201.
Citation: Wu J, Yuan CT, Moyal-Smith R .
Electronic health record-supported implementation of an evidence-based pathway for perioperative surgical care.
J Am Med Inform Assoc 2024 Feb 16; 31(3):591-99. doi: 10.1093/jamia/ocad237.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery, Evidence-Based Practice, Hospitals
Hernandez SE, Solomon D, Moon J
Understanding clinical implementation coordinators' experiences in deploying evidence-based interventions.
Researchers described their fluoroquinolone restriction for the prevention of Clostridioides difficile infection (FIRST) trial, a multisite clinical study which used an electronic health record-based best-practice alert to optimize the use of fluoroquinolone antibiotics in acute care settings. Their goals were to describe the roles and responsibilities of clinical implementation coordinators within antibiotic stewardship teams and to identify facilitators and barriers coordinators experienced within the implementation process. The researchers conducted directed content analysis of semistructured interviews, implementation diaries, and check-in meetings. Their results indicated that clinical implementation coordinators facilitated the implementation process via their roles and responsibilities and acted as strategic partners in the improvement of adoption and sustainability of a fluoroquinolone preauthorization protocol.
AHRQ-funded; HS026226.
Citation: Hernandez SE, Solomon D, Moon J .
Understanding clinical implementation coordinators' experiences in deploying evidence-based interventions.
Am J Health Syst Pharm 2024 Feb 8; 81(4):120-28. doi: 10.1093/ajhp/zxad272.
Keywords: Evidence-Based Practice, Implementation, COVID-19
Al Hussein Al Awamlh B, Wallis CJD, Penson DF
Functional outcomes after localized prostate cancer treatment.
The objective of this observational cohort study was to compare rates of adverse functional outcomes between specific treatments for localized prostate cancer. Researchers used data from five U.S. Surveillance, Epidemiology, and End Results Program registries. Participants were patients treated for localized prostate cancer in 2011-2012. The results indicated that radical prostatectomy was associated with worse urinary incontinence, but not with worse sexual function, at 10-year followup when compared with radiotherapy or surveillance. Among patients with unfavorable-prognosis disease, external beam radiotherapy with androgen deprivation therapy was associated with worse bowel and hormone function at 10-year followup compared with radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Al Hussein Al Awamlh B, Wallis CJD, Penson DF .
Functional outcomes after localized prostate cancer treatment.
JAMA 2024 Jan 23; 331(4):302-17. doi: 10.1001/jama.2023.26491.
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Keywords: Cancer: Prostate Cancer, Cancer, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Feltner C, Wallace IF, Nowell SW
Screening for speech and language delay and disorders in children 5 years or younger: evidence report and systematic review for the US Preventive Services Task Force.
This evidence report and systematic review reviewed the evidence on screening for speech and language delay or disorders in children 5 years or younger to inform the US Preventive Services Task Force. This literature review looked at English-language studies of screening test accuracy, trials or cohort studies comparing screening vs no screening; randomized clinical trials (RCTs) of interventions. Main outcomes and measures were screening test accuracy, speech and language outcomes, school performance, function, quality of life, and harms. A total of 38 studies in 41 articles were included (N = 9006). There were 21 studies (n = 7489) that assessed the accuracy of 23 different screening tools that varied with regard to whether they were designed to be completed by parents vs trained examiners, and to screen for global (any) language problems vs specific skills (e.g., expressive language). Three studies assessing parent-reported tools for expressive language skills had consistently high sensitivity (range, 88%-93%) and specificity (range, 88%-85%). Other screening tools had widely varying accuracy. Seventeen RCTs (n = 1517) evaluated interventions for speech and language delay or disorders. There were no RCTs included on the harms of interventions.
AHRQ-funded; 75Q80120D00006.
Citation: Feltner C, Wallace IF, Nowell SW .
Screening for speech and language delay and disorders in children 5 years or younger: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2024 Jan 23; 331(4):335-51. doi: 10.1001/jama.2023.24647..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Screening, Prevention, Evidence-Based Practice
Cantor AG, Jungbauer RM, Skelly AC
Respectful maternity care : a systematic review.
The purpose of this systematic review was to collect information on definitions and valid measurements of respectful maternity care (RMC), its effectiveness for improving pregnant and postpartum maternal and infant health outcomes, and strategies for implementation. Frameworks for RMC were found to be well described but varied in definition. Evidence was lacking on the effectiveness of implementing RMC to improve any maternal or infant health outcome. Tools to measure RMC demonstrated consistency but lacked a gold standard; the authors conclude that further evaluation was needed before implementation in U.S. settings.
AHRQ-funded; 75Q80120D00006
Citation: Cantor AG, Jungbauer RM, Skelly AC .
Respectful maternity care : a systematic review.
Ann Intern Med 2024 Jan; 177(1):50-64. doi: 10.7326/m23-2676..
Keywords: Maternal Care, Women, Patient-Centered Outcomes Research, Evidence-Based Practice
Peaker B, Dooley C B, Peaker B, Dooley C C
AHRQ Author: Peaker B
Screening for syphilis in nonpregnant adolescents and adults.
This case study described a 42-year-old male presenting at the clinic with low back pain that had been radiating down his right leg for one week. Case study questions related to the USPSTF recommendation on Screening for Syphilis in Nonpregnant Adolescents and Adults addressed why this patient was at increased risk, whether screening should take place, and why the USPSTF does not recommend screening for all people.
AHRQ-authored.
Citation: Peaker B, Dooley C B, Peaker B, Dooley C C .
Screening for syphilis in nonpregnant adolescents and adults.
Am Fam Physician 2024 Jan; 109(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Evidence-Based Practice, Sexual Health, Children/Adolescents
Hartling L, Guise JM, Kato E
AHRQ Author: Kato, E, Berliner E
A taxonomy of rapid reviews links report types and methods to specific decision-making contexts.
The researchers described characteristics of rapid reviews and examined the impact of methodological variations on their reliability and validity. They concluded that rapid products have tremendous methodological variation and that categorization based on timeframe or type of synthesis reveals patterns. The similarity across rapid products lies in the close relationship with the end user to meet time-sensitive decision-making needs.
AHRQ-authored; AHRQ-funded; 290201200013I; 290201200010I; 290201200011I; 290201200015I; 290201200007I; 290201200004C.
Citation: Hartling L, Guise JM, Kato E .
A taxonomy of rapid reviews links report types and methods to specific decision-making contexts.
J Clin Epidemiol 2015 Dec;68(12):1451-62.e3. doi: 10.1016/j.jclinepi.2015.05.036.
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Keywords: Shared Decision Making, Evidence-Based Practice, Data, Research Methodologies
Hempel S, Shekelle PG, Liu JL
Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.
This study developed and psychometrically tested a critical appraisal instrument, the QI Minimum Quality Criteria Set (QI-MQCS) for assessing QI-specific features of quality improvement (QI) publications. The critical appraisal instrument is accompanied by a user manual detailing What to consider, Where to look, and How to rate.
AHRQ-funded; HS018139.
Citation: Hempel S, Shekelle PG, Liu JL .
Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.
BMJ Qual Saf 2015 Dec;24(12):796-804. doi: 10.1136/bmjqs-2014-003151.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Quality Improvement
Whicher D, Wu AW
Ethics review of survey research: a mandatory requirement for publication?
The authors provided guidance for journals to consider when making determinations about the necessity of ethical review for survey research projects. They stated that in situations where there is greater than minimal risk of informational or psychological harms, the survey research should have received institutional ethics oversight. They also specified that survey research projects that enroll vulnerable individuals with diminished autonomy should receive institutional ethics oversight.
AHRQ-funded; HS000029.
Citation: Whicher D, Wu AW .
Ethics review of survey research: a mandatory requirement for publication?
Patient 2015 Dec;8(6):477-82. doi: 10.1007/s40271-015-0141-0.
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Keywords: Evidence-Based Practice, Policy, Patient Safety, Research Methodologies
McCabe AM, Kuppermann N
Generation of evidence and translation into practice: Lessons learned and future directions.
This article describes the experience of the Pediatric Emergency Care Applied Research Network (PECARN) in deriving and validating the traumatic brain injury prediction rules and how PECARN is translating these prediction rules into clinical practice. Furthermore, it discusses the potential for patient/parent shared decision-making with a focus on patient-centered outcomes in Emergency department research.
AHRQ-funded; HS023498.
Citation: McCabe AM, Kuppermann N .
Generation of evidence and translation into practice: Lessons learned and future directions.
Acad Emerg Med 2015 Dec;22(12):1372-9. doi: 10.1111/acem.12819.
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Keywords: Implementation, Evidence-Based Practice, Emergency Medical Services (EMS), Brain Injury, Children/Adolescents
Nkoy F, Fassl B, Stone B
Improving pediatric asthma care and outcomes across multiple hospitals.
This study aimed to assess the impact of an evidence-based care process model 5 years after implementation at Primary Children's Hospital, a tertiary care facility, and after its dissemination to 7 community hospitals. The intervention resulted in sustained, long-term improvement in asthma care and outcomes at the tertiary care hospital and successful dissemination to community hospitals.
AHRQ-funded; HS018166; HS018678.
Citation: Nkoy F, Fassl B, Stone B .
Improving pediatric asthma care and outcomes across multiple hospitals.
Pediatrics 2015 Dec;136(6):e1602-10. doi: 10.1542/peds.2015-0285..
Keywords: Children/Adolescents, Asthma, Hospitalization, Evidence-Based Practice, Patient-Centered Outcomes Research
Probst MA, Dayan PS, Raja AS
Knowledge translation and barriers to imaging optimization in the emergency department: a research agenda.
This article outlines a research agenda to promote the dissemination and implementation (also known as knowledge translation) of evidence-based interventions for emergency department (ED) imaging, i.e., clinical pathways, clinical decision instruments, and clinical practice guidelines. A multidisciplinary group of stakeholders held online and telephone discussions over a 6-month period culminating at the 2015 Academic Emergency Medicine consensus conference. They were able to identify four overarching research questions.
AHRQ-funded; HS023498.
Citation: Probst MA, Dayan PS, Raja AS .
Knowledge translation and barriers to imaging optimization in the emergency department: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1455-64. doi: 10.1111/acem.12830.
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Keywords: Emergency Department, Evidence-Based Practice, Health Services Research (HSR), Guidelines, Imaging, Implementation
Lemke AA, Harris-Wai JN
Stakeholder engagement in policy development: challenges and opportunities for human genomics.
The purpose of this paper is to examine how stakeholder engagement is used to develop policies in genomics research and public health areas, as well as to identify future priorities for conducting evidence-based stakeholder engagements. It concluded that several challenges of using stakeholder engagement as a tool for genomics policy development remain, and little evidence regarding how to best incorporate stakeholder feedback into policy-making processes is currently available.
AHRQ-funded; HS023547.
Citation: Lemke AA, Harris-Wai JN .
Stakeholder engagement in policy development: challenges and opportunities for human genomics.
Genet Med 2015 Dec;17(12):949-57. doi: 10.1038/gim.2015.8.
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Keywords: Evidence-Based Practice, Genetics, Patient and Family Engagement, Policy, Public Health
O'Brien EC, Simon DN, Thomas LE
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
The researchers sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based in atrial fibrillation (AF) population. They concluded that their five-element ORBIT bleeding risk score had better ability to predict major bleeding in AF patients when compared with HAS-BLED and ATRIA risk scores.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Simon DN, Thomas LE .
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
Eur Heart J 2015 Dec 7;36(46):3258-64. doi: 10.1093/eurheartj/ehv476.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Adverse Drug Events (ADE), Adverse Events, Risk, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice
Lee KC, Payne CB
AHRQ Author: Lee KC
Screening for speech and language delay and disorders in children five years and younger.
This case study involves a two-year-old girl presenting for a well-child visit. The three multiple choice questions concern risk factors and interventions for children with language delays and disorders.
AHRQ-authored.
Citation: Lee KC, Payne CB .
Screening for speech and language delay and disorders in children five years and younger.
Am Fam Physician 2015 Nov 15;92(10):923-4.
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Keywords: Case Study, Children/Adolescents, Evidence-Based Practice, Screening, U.S. Preventive Services Task Force (USPSTF)
Weiner BJ, Pignone MP, DuBard CA
Advancing heart health in North Carolina primary care: the Heart Health NOW study protocol.
The objective of Heart Health NOW (HHN) is to determine if primary care practice support a comprehensive evidence-based quality improvement strategy involving practice facilitation, academic detailing, technology support, and regional learning collaboratives—accelerates widespread dissemination and implementation of evidence-based guidelines for cardiovascular disease (CVD) prevention in small- to medium-sized primary care practices.
AHRQ-funded; HS023912.
Citation: Weiner BJ, Pignone MP, DuBard CA .
Advancing heart health in North Carolina primary care: the Heart Health NOW study protocol.
Implement Sci 2015 Nov 14;10:160. doi: 10.1186/s13012-015-0348-4..
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Prevention, Primary Care
Berkman ND, Lohr KN, Ansari MT
Grading the strength of a body of evidence when assessing health care interventions: an EPC update.
The authors discussed the state of revision of 2010 guidance on grading the strength of evidence (SOE) of the effectiveness of drugs, devices, and other preventive and therapeutic interventions in systematic reviews produced by AHRQ's Evidence-based Practice Center (EPC) program. They concluded that EPC working groups will consider ongoing challenges and modify guidance as needed, on issues such as combining trials and observational studies in bodies of evidence, weighting domains, and combining qualitative and quantitative syntheses.
AHRQ-funded; 290200710056I.
Citation: Berkman ND, Lohr KN, Ansari MT .
Grading the strength of a body of evidence when assessing health care interventions: an EPC update.
J Clin Epidemiol 2015 Nov;68(11):1312-24. doi: 10.1016/j.jclinepi.2014.11.023.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Quality of Care, Patient-Centered Outcomes Research, Research Methodologies
Berkman ND, Lohr KN, Ansari MT, et al.
AHRQ Author: Chang S
Grading the strength of a body of evidence when assessing health care interventions: an EPC update.
The purpose of this article is to revise the 2010 guidance on grading the strength of evidence (SOE) of the effectiveness of drugs, devices, and other preventive and therapeutic interventions produced by AHRQ’s Evidence-based Practice Center program. It concluded that no single approach for grading SOE suits all reviews, but a more consistent and transparent approach to reporting summary information will make reviews more useful.
AHRQ authored; AHRQ-funded 290200710056I
Citation: Berkman ND, Lohr KN, Ansari MT, et al..
Grading the strength of a body of evidence when assessing health care interventions: an EPC update.
J Clin Epidemiol. 2015 Nov;68(11):1312-24. doi: 10.1016/j.jclinepi.2014.11.023..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Research Methodologies, Quality Measures
Bangalore S, Ogedegbe G, Gyamfi J
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
The study’s objective was to evaluate the effectiveness of angiotensin-converting enzyme inhibitors when compared with other antihypertensive agents in hypertensive blacks. It found that in a large cohort of hypertensive blacks, angiotensin-converting enzyme inhibitors were associated with less benefit when compared with calcium channel blockers or thiazide diuretics.
AHRQ-funded; HS018589.
Citation: Bangalore S, Ogedegbe G, Gyamfi J .
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
Am J Med 2015 Nov;128(11):1195-203. doi: 10.1016/j.amjmed.2015.04.034..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Medication, Outcomes, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Comparative Effectiveness
Patnode CD, Henderson JT, Thompson JH
Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the U.S. Preventive Services Task Force.
The researchers reviewed the effectiveness and safety of pharmacotherapy and behavioral interventions for tobacco cessation. They concluded that behavioral and pharmacotherapy interventions improve rates of smoking cessation among the general adult population, alone or in combination. Data on the effectiveness and safety of electronic nicotine delivery systems are limited.
AHRQ-funded; 290201200015I.
Citation: Patnode CD, Henderson JT, Thompson JH .
Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: a review of reviews for the U.S. Preventive Services Task Force.
Ann Intern Med 2015 Oct 20;163(8):608-21. doi: 10.7326/m15-0171..
Keywords: Behavioral Health, Evidence-Based Practice, Medication, Pregnancy, Prevention, Tobacco Use, U.S. Preventive Services Task Force (USPSTF), Women
Rangachari P, Madaio M, Rethemeyer RK
Cumulative impact of periodic top-down communications on infection prevention practices and outcomes in two units.
The authors investigated the challenge of consistent implementation of evidence-based infection prevention practices at the unit level. Their results showed that the interventions cumulatively had a significant desired impact on central catheter use and helped validate the theoretical literature and identify evidence-based management strategies for practice change at the unit level. Further, periodic top-down communications have the potential to modify interprofessional knowledge exchanges and enable practice change at the unit level, leading to significantly improved outcomes and reduced costs.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
Cumulative impact of periodic top-down communications on infection prevention practices and outcomes in two units.
Health Care Manage Rev 2015 Oct-Dec;40(4):324-36. doi: 10.1097/hmr.0000000000000038.
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Keywords: Communication, Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Children/Adolescents, Prevention
Gephart SM
Fostering best practice: strategies for writing evidence-based practice briefs.
In this editorial, the author provides instructions to make the task of writing a brief manageable for even the newest of authors. From asking a compelling clinical question to telling the story of a critical appraisal of evidence to making recommendations, the overall goal of writing such a brief is to support best practice care in the neonatal intensive care unit.
AHRQ-funded; HS022908.
Citation: Gephart SM .
Fostering best practice: strategies for writing evidence-based practice briefs.
Adv Neonatal Care 2015 Oct;15(5):299-306. doi: 10.1097/anc.0000000000000222.
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Keywords: Evidence-Based Practice, Nursing, Research Methodologies, Neonatal Intensive Care Unit (NICU)
Whicher DM, Miller JE, Dunham KM
Gatekeepers for pragmatic clinical trials.
The authors provided a framework to help guide gatekeepers' decision-making related to the use of resources for pragmatic clinical trials. They stated that recognition of the complex set of considerations that should inform decision-making will guide gatekeepers in making justifiable choices regarding the use of limited and valuable resources.
AHRQ-funded; HS000029.
Citation: Whicher DM, Miller JE, Dunham KM .
Gatekeepers for pragmatic clinical trials.
Clin Trials 2015 Oct;12(5):442-8. doi: 10.1177/1740774515597699.
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Keywords: Shared Decision Making, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Research Methodologies