National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Cancer (7)
- Cancer: Colorectal Cancer (2)
- Cancer: Lung Cancer (1)
- (-) Cancer: Prostate Cancer (20)
- Care Management (1)
- Clinician-Patient Communication (1)
- Colonoscopy (1)
- Comparative Effectiveness (5)
- Diabetes (1)
- Diagnostic Safety and Quality (2)
- Disparities (1)
- Elderly (4)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Falls (1)
- Healthcare Costs (1)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (1)
- Imaging (1)
- Medication (2)
- Men's Health (1)
- Mortality (1)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (7)
- Patient and Family Engagement (1)
- Practice Patterns (2)
- Primary Care (1)
- Quality Indicators (QIs) (1)
- Quality of Life (4)
- Racial and Ethnic Minorities (2)
- Research Methodologies (1)
- Risk (1)
- Screening (4)
- Sexual Health (1)
- Shared Decision Making (4)
- Surgery (3)
- U.S. Preventive Services Task Force (USPSTF) (2)
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 20 of 20 Research Studies DisplayedMisra-Hebert AD, Hu B, Klein EA
Prostate cancer screening practices in a large, integrated health system: 2007-2014.
The researchers assessed prostate cancer screening practices in primary care since the initial United States Preventive Services Task Force (USPSTF) recommendation against prostate-specific antigen (PSA) testing for older men. Prostate cancer screening declined from 2007 to 2014 even in higher-risk groups and follow-up screening rates were not related to previous PSA level.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Klein EA .
Prostate cancer screening practices in a large, integrated health system: 2007-2014.
BJU Int 2017 Aug;120(2):257-64. doi: 10.1111/bju.13793.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Prostate Cancer, Screening, Primary Care, Practice Patterns
Tyson MD, Alvarez J, Koyama T
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
This study tested the hypothesis that treatment-related changes in urinary, bowel, sexual, and hormonal function vary by race/ethnicity. It concluded that the effect of treatment for prostate cancer on patient-reported function did not vary dramatically by race/ethnicity. Compared to white men, African-American men experienced a somewhat more pronounced decline in urinary continence after radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Tyson MD, Alvarez J, Koyama T .
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
Eur Urol 2017 Aug;72(2):307-14. doi: 10.1016/j.eururo.2016.10.036.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Racial and Ethnic Minorities, Surgery
Winters-Stone KM, Moe E, Graff JN
Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy.
This study compared the prevalence of and association between falls and frailty of prostate cancer survivors (PCSs) who were current, past or never users of androgen deprivation therapy (ADT). It concluded that current and past exposure to ADT is linked to higher risk of falls and frailty than no treatment.
AHRQ-funded; HS022981.
Citation: Winters-Stone KM, Moe E, Graff JN .
Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy.
J Am Geriatr Soc 2017 Jul;65(7):1414-19. doi: 10.1111/jgs.14795.
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Keywords: Cancer: Prostate Cancer, Cancer, Falls, Medication, Elderly
Jayadevappa R, Chhatre S, Wong YN
Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant).
This review analyzed the comparative effectiveness of prostate cancer (PCa) treatments through systematic review and meta-analysis with a focus on outcomes that matter most to newly diagnosed localized PCa patients. The studies provided moderate data for the patient-centered outcome of mortality. Radical prostatectomy demonstrated mortality benefit compared to watchful waiting and radiation therapy.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S, Wong YN .
Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant).
Medicine 2017 May;96(18):e6790. doi: 10.1097/md.0000000000006790.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer, Cancer: Prostate Cancer
Chen RC, Basak R, Meyer AM
Association between choice of radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance and patient-reported quality of life among men with localized prostate cancer.
This study compared quality of life after radical prostatectomy, external beam radiotherapy, and brachytherapy vs active surveillance. By 24 months, mean scores between treatment groups vs active surveillance were not significantly different in most domains. However, each treatment strategy was associated with distinct patterns of adverse effects over 2 years.
AHRQ-funded; AHRQ contract (no number given).
Citation: Chen RC, Basak R, Meyer AM .
Association between choice of radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance and patient-reported quality of life among men with localized prostate cancer.
JAMA 2017 Mar 21;317(11):1141-50. doi: 10.1001/jama.2017.1652.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Surgery, Quality of Life
Barocas DA, Alvarez J, Resnick MJ
Association between radiation therapy, surgery, or observation for localized prostate cancer and patient-reported outcomes after 3 years.
This study compares functional outcomes and adverse effects associated with radical prostatectomy, external beam radiation therapy (EBRT), and active surveillance. It concluded that radical prostatectomy was associated with a greater decrease in sexual function and urinary incontinence than either EBRT or active surveillance after 3 years and was associated with fewer urinary irritative symptoms than active surveillance.
AHRQ-funded; HS019356; HS022640.
Citation: Barocas DA, Alvarez J, Resnick MJ .
Association between radiation therapy, surgery, or observation for localized prostate cancer and patient-reported outcomes after 3 years.
JAMA 2017 Mar 21;317(11):1126-40. doi: 10.1001/jama.2017.1704.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Adverse Events, Cancer: Prostate Cancer, Surgery
Eifler JB, Alvarez J, Koyama T
More judicious use of expectant management for localized prostate cancer during the last 2 decades.
Urologists have been criticized for overtreating men with low risk prostate cancer and for passively observing older men with higher risk disease. Proponents of active surveillance for low risk disease and critics of watchful waiting for higher risk disease have advocated for more judicious use of observation. In this study, the investigator compared 2 population based cohorts to determine how expectant management has evolved during the last 2 decades.
AHRQ-funded; HS019356; HS022640.
Citation: Eifler JB, Alvarez J, Koyama T .
More judicious use of expectant management for localized prostate cancer during the last 2 decades.
J Urol 2017 Mar;197(3 Pt 1):614-20. doi: 10.1016/j.juro.2016.10.067..
Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Diagnostic Safety and Quality, Men's Health
Tsai HT, Philips G, Taylor KL
Utilization and predictors of expectant management among elderly men with low-and intermediate-risk localized prostate cancer in U.S. urological practice.
Researchers assessed the use and predictors of expectant management (EM) to understand its uptake in U.S. practice. In U.S. practice, the utilization of EM steadily increased in low-risk prostate cancer and remained low in the intermediate-risk group over time. While patients with advanced age or comorbidities were more likely to receive EM, its use varied substantially by geographic region.
AHRQ-funded; HS022915.
Citation: Tsai HT, Philips G, Taylor KL .
Utilization and predictors of expectant management among elderly men with low-and intermediate-risk localized prostate cancer in U.S. urological practice.
Urol Pract 2017 Mar;4(2):132-39. doi: 10.1016/j.urpr.2016.05.005.
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Keywords: Shared Decision Making, Elderly, Healthcare Utilization, Cancer: Prostate Cancer, Practice Patterns
Scherr KA, Fagerlin A, Hofer T
Physician recommendations trump patient preferences in prostate cancer treatment decisions.
This study assessed the influence of patient preferences and urologist recommendations in treatment decisions for clinically localized prostate cancer. It found that patients' initial treatment preferences did not predict receipt of active treatment versus surveillance. Instead, receipt of active treatment was predicted primarily by urologists' recommendations.
AHRQ-funded; HS021764.
Citation: Scherr KA, Fagerlin A, Hofer T .
Physician recommendations trump patient preferences in prostate cancer treatment decisions.
Med Decis Making 2017 Jan;37(1):56-69. doi: 10.1177/0272989x16662841.
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Keywords: Cancer: Prostate Cancer, Shared Decision Making, Patient and Family Engagement, Patient-Centered Healthcare, Clinician-Patient Communication
Risko R, Merdan S, Womble PR
Clinical predictors and recommendations for staging computed tomography scan among men with prostate cancer.
This study identified clinical variables associated with a positive computed tomography (CT) scan and estimated the performance of imaging recommendations in patients with newly diagnosed prostate cancer. It found that implementation of criterion for CT imaging that includes PSA levels greater than 20, a Gleason score of 8 or higher, or locally advanced disease (interpreted as cT3/4) would ensure that CT scans are performed for almost all men who would test positive for metastases.
AHRQ-funded; HS018346
Citation: Risko R, Merdan S, Womble PR .
Clinical predictors and recommendations for staging computed tomography scan among men with prostate cancer.
Urology. 2014 Dec;84(6):1329-34. doi: 10.1016/j.urology.2014.07.051..
Keywords: Cancer: Prostate Cancer, Imaging
Roth JA, Ramsey SD, Carlson JJ
Cost-effectiveness of a biopsy-based 8-protein prostate cancer prognostic assay to optimize treatment decision making in Gleason 3 + 3 and 3 + 4 early stage prostate cancer.
A novel 8-protein prognostic assay generates a risk score at time of biopsy that is predictive of prostate cancer aggressiveness and can inform treatment decisions. The objective of this study was to evaluate the cost-effectiveness of using the assay to inform treatment decisions compared with usual care. The 8-protein assay strategy resulted in 0.04 more quality-adjusted life years and $700 less in costs compared with usual care.
AHRQ-funded; HS022982.
Citation: Roth JA, Ramsey SD, Carlson JJ .
Cost-effectiveness of a biopsy-based 8-protein prostate cancer prognostic assay to optimize treatment decision making in Gleason 3 + 3 and 3 + 4 early stage prostate cancer.
Oncologist 2015 Dec;20(12):1355-64. doi: 10.1634/theoncologist.2015-0214.
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Keywords: Cancer, Cancer: Prostate Cancer, Patient-Centered Outcomes Research, Healthcare Costs, Shared Decision Making
Morgans AK, van Bommel AC, Stowell C
Development of a standardized set of patient-centered outcomes for advanced prostate cancer: an international effort for a unified approach.
The International Consortium for Health Outcomes Measurement assembled a multidisciplinary working group to develop a standard set of outcomes relevant to men with advanced prostate cancer to follow during routine clinical care. The international multidisciplinary group identified clinical data and patient-reported outcome measures that serve as a basis for international health outcome comparisons and quality-of-care assessments. The set will be revised annually.
AHRQ-funded; HS022990.
Citation: Morgans AK, van Bommel AC, Stowell C .
Development of a standardized set of patient-centered outcomes for advanced prostate cancer: an international effort for a unified approach.
Eur Urol 2015 Nov;68(5):891-8. doi: 10.1016/j.eururo.2015.06.007.
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Keywords: Cancer: Prostate Cancer, Patient-Centered Outcomes Research, Quality of Life, Adverse Events, Quality Indicators (QIs)
Murphy DR, Wu L, Thomas EJ
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
The researchers tested whether prospective use of electronic health record-based trigger algorithms to identify patients at risk of diagnostic delays could prevent delays in diagnostic evaluation for cancer. They found that electronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up.
AHRQ-funded; HS017820.
Citation: Murphy DR, Wu L, Thomas EJ .
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
J Clin Oncol 2015 Nov 1;33(31):3560-7. doi: 10.1200/jco.2015.61.1301..
Keywords: Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer: Prostate Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Cantor SB, Deshmukh AA, Krahn MD
Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model.
The researchers sought to determine whether the forecasted assessment of how someone would feel in a future health state can be predictive of utilities (e.g. as elicited by the time-trade-off method) and also predictive of optimal decisions as determined by a decision-analytic model. They concluded that anticipated difficulty adjusting to adverse health effects were highly related to preferences and could be used as a proxy measure of utility.
AHRQ-funded; HS08992.
Citation: Cantor SB, Deshmukh AA, Krahn MD .
Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model.
Health Expect 2015 Oct;18(5):1610-20. doi: 10.1111/hex.12150.
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Keywords: Shared Decision Making, Cancer: Prostate Cancer, Elderly, Quality of Life, Screening
Chhatre S, Malkowicz SB, Schwartz JS
Understanding the racial and ethnic differences in cost and mortality among advanced stage prostate cancer patients (STROBE).
The aims of the study were to understand the racial/ethnic differences in cost of care and mortality in Medicare elderly with advanced stage prostate cancer. It found that relationship between race/ethnicity, cost of care, and mortality is intricate. For non-Hispanic black men, disparity in mortality can be attributed to treatment differences.
AHRQ-funded; HS024106.
Citation: Chhatre S, Malkowicz SB, Schwartz JS .
Understanding the racial and ethnic differences in cost and mortality among advanced stage prostate cancer patients (STROBE).
Med Health 2015 Aug;94(32):e1353. doi: 10.1097/md.0000000000001353..
Keywords: Cancer: Prostate Cancer, Mortality, Racial and Ethnic Minorities, Elderly, Disparities
Tsai HT, Keating NL, Van Den Eeden SK
Risk of diabetes among patients receiving primary androgen deprivation therapy for clinically localized prostate cancer.
The researchers sought to determine if primary androgen deprivation therapy increases the risk of diabetes and to determine the susceptibility factors. They found that primary androgen deprivation therapy may increase diabetes risk by 60% and recommended using caution when managing localized prostate cancer. They further recommended routine screening and lifestyle interventions to reduce the risk of diabetes in men receiving androgen deprivation therapy.
AHRQ-funded; HS022915.
Citation: Tsai HT, Keating NL, Van Den Eeden SK .
Risk of diabetes among patients receiving primary androgen deprivation therapy for clinically localized prostate cancer.
J Urol 2015 Jun;193(6):1956-62. doi: 10.1016/j.juro.2014.12.027.
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Keywords: Adverse Drug Events (ADE), Diabetes, Medication, Cancer: Prostate Cancer, Risk
Resnick MJ, Barocas DA, Morgans AK
The evolution of self-reported urinary and sexual dysfunction over the last two decades: implications for comparative effectiveness research.
This study evaluated differences in pretreatment urinary and sexual function in two population-based cohorts of men with prostate cancer enrolled nearly 20 yrs. apart. It concluded that reporting of pretreatment urinary incontinence and erectile dysfunction has increased over the past two decades. These findings may reflect sociological changes including heightened media attention and direct-to-consumer marketing, among other potential explanations.
AHRQ-funded; HS019356; HS022640; HS022990.
Citation: Resnick MJ, Barocas DA, Morgans AK .
The evolution of self-reported urinary and sexual dysfunction over the last two decades: implications for comparative effectiveness research.
Eur Urol 2015 Jun;67(6):1019-25. doi: 10.1016/j.eururo.2014.08.035..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer, Cancer: Prostate Cancer, Sexual Health
Elstad EA, Sutkowi-Hemstreet A, Sheridan SL
Clinicians' perceptions of the benefits and harms of prostate and colorectal cancer screening.
The researchers sought to understand clinicians’ perceptions of the benefits and harms of two screening tests (colonoscopy and prostate-specific antigen (PSA) testing) that differ in their balance of potential benefits and harms. Clinicians perceived PSA testing to have a greater likelihood of harm as well as a lower likelihood of lengthening life relative to colonoscopy.
AHRQ-funded; HS000032; HS021133
Citation: Elstad EA, Sutkowi-Hemstreet A, Sheridan SL .
Clinicians' perceptions of the benefits and harms of prostate and colorectal cancer screening.
Med Decis Making. 2015 May;35(4):467-76. doi: 10.1177/0272989x15569780..
Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Cancer: Prostate Cancer, Screening
Gilbert SM, Dunn RL, Wittmann D
Quality of life and satisfaction among prostate cancer patients followed in a dedicated survivorship clinic.
The researchers integrated quality of lifer (QOL) assessments into a prostate cancer survivorship clinic and compared recovery and satisfaction among men managed in the survivorship clinic with those followed with more routine care. They concluded that patient QOL and satisfaction were higher among men managed in a survivorship program.
AHRQ-funded; HS020927.
Citation: Gilbert SM, Dunn RL, Wittmann D .
Quality of life and satisfaction among prostate cancer patients followed in a dedicated survivorship clinic.
Cancer 2015 May 1;121(9):1484-91. doi: 10.1002/cncr.29215..
Keywords: Cancer: Prostate Cancer, Quality of Life, Outcomes, Cancer
DeFrank JT, Barclay C, Sheridan S
The psychological harms of screening: the evidence we have versus the evidence we need.
The study’s purpose was to understand the extent of evidence on psychological harms. The researchers reviewed 68 studies and developed an evidence map that quantifies the distribution of evidence on psychological harms for five adult screening services. They found that the evidence for psychological harms of screening is inadequate in number of studies and in research design and measures.
AHRQ-funded; HS021133.
Citation: DeFrank JT, Barclay C, Sheridan S .
The psychological harms of screening: the evidence we have versus the evidence we need.
J Gen Intern Med 2015 Feb;30(2):242-8. doi: 10.1007/s11606-014-2996-5..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Cancer: Prostate Cancer, Evidence-Based Practice, Research Methodologies