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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 549 Research Studies DisplayedNeerland 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
Sneed NM, Heerman WJ, Shaw PA
Associations between gestational weight gain, gestational diabetes, and childhood obesity incidence.
Excessive maternal gestational weight gain (GWG) and gestational diabetes mellitus (GDM) have been linked to childhood obesity. This cohort study explored the association between maternal weight gain during pregnancy, GDM, and early childhood obesity. Findings revealed that excessive weight gain during the second and third trimesters increased the risk of childhood obesity by age 6. However, GDM was associated with a lower risk. No significant interaction between GWG and GDM was observed.
AHRQ-funded; HS026122.
Citation: Sneed NM, Heerman WJ, Shaw PA .
Associations between gestational weight gain, gestational diabetes, and childhood obesity incidence.
Matern Child Health J 2024 Feb; 28(2):372-81. doi: 10.1007/s10995-023-03853-8.
Keywords: Maternal Care, Women, Children/Adolescents, Obesity
Pozzar RA, Wall JA, Tavormina A
Experiences of patients with peritoneal carcinomatosis-related complex care needs and their caregivers.
The study explored the needs of patients with peritoneal carcinomatosis (PC) and caregivers during care transitions. Findings showed limited prognostic understanding and advance care planning among patients, with most caregivers providing daily care without proper training. Many participants experienced anxiety and depression. Interviewees emphasized the lack of guidance and called for health system changes. The study concluded that interventions providing clinical training, facilitating serious illness conversations, and offering psychosocial support are necessary.
AHRQ-funded; HS013852.
Citation: Pozzar RA, Wall JA, Tavormina A .
Experiences of patients with peritoneal carcinomatosis-related complex care needs and their caregivers.
Gynecol Oncol 2024 Feb; 181:68-75. doi: 10.1016/j.ygyno.2023.12.013.
Keywords: Cancer, Caregiving, Palliative Care, Women
Moniz MH, Stout MJ, Kolenic GE
Association of childbirth with medical debt.
The purpose of this study was to assess the relationship between childbirth and having medical debt in collections and explored variations by neighborhood socioeconomic status. The study found that among a statewide cohort (n=26,717) of commercially insured pregnant and postpartum adults, having medical debt in collections was more likely among postpartum individuals compared with pregnant individuals and those in lowest-income neighborhoods compared with all others. Postpartum adults in the lowest-income neighborhoods also had the greatest predicted probabilities of having medical debt in collections, followed by pregnant adults in the lowest-income neighborhoods, followed by all other postpartum and pregnant adults.
AHRQ-funded; HS025465; HS028672; HS027788.
Citation: Moniz MH, Stout MJ, Kolenic GE .
Association of childbirth with medical debt.
Obstet Gynecol 2024 Jan; 143(1):11-13. doi: 10.1097/aog.0000000000005381..
Keywords: Maternal Care, Women, Healthcare Costs
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
Danan ER, Than C, Chawla N
Abnormal cervical cancer screening results among US veteran and non-veteran participants in the National Health Interview Survey (NHIS).
Researchers tested whether Veterans with a recent cervical cancer screening test were more likely than non-Veterans to have received an abnormal result. Data was taken from the National Health Interview Survey (NHIS). An adjusted regression model of the date indicated that a previously observed association between Veteran status and abnormal screening result was explained by differences in sociodemographic and health factors between Veterans and non-Veterans. The researchers concluded that clinicians should address modifiable risk factors and provide evidence-based follow-up for abnormal results.
AHRQ-funded; HS026379.
Citation: Danan ER, Than C, Chawla N .
Abnormal cervical cancer screening results among US veteran and non-veteran participants in the National Health Interview Survey (NHIS).
Prev Med Rep 2023 Dec; 36:102472. doi: 10.1016/j.pmedr.2023.102472..
Keywords: Cancer: Cervical Cancer, Cancer, Screening, Women, Prevention
Fingar KR, Weiss AJ, Roemer M
AHRQ Author: Roemer M, Reid LD
Effects of the COVID-19 early pandemic on delivery outcomes among women with and without COVID-19 at birth.
This AHRQ-authored paper examined the early pandemic-related changes in birth outcomes for pregnant women with and without a COVID-19 diagnosis at delivery. They compared four delivery outcomes-preterm delivery (PTD), severe maternal morbidity (SMM), stillbirth, and cesarean birth-between 2017 and 2019 (prepandemic) and between April and December 2020 (early pandemic) using interrupted time series models on 11.8 million deliveries, stratified by COVID-19 infection status at birth with entropy weighting for historical controls, from the HCUP across 43 states and the District of Columbia. Relative to 2017-2019, women without COVID-19 at delivery in 2020 had lower odds of PTD (OR = 0.93) and SMM (OR = 0.88) but increased odds of stillbirth (OR = 1.04). COVID-19 deliveries had an excess of each outcome, by factors of 1.07-1.46 for outcomes except SMM at 4.21. The effect for SMM was more pronounced for Asian/Pacific Islander non-Hispanic (API; OR = 10.51) and Hispanic (OR = 5.09) pregnant women than for White non-Hispanic (OR = 3.28) women.
AHRQ-authored; AHRQ-funded; 290201800001C.
Citation: Fingar KR, Weiss AJ, Roemer M .
Effects of the COVID-19 early pandemic on delivery outcomes among women with and without COVID-19 at birth.
Birth 2023 Dec; 50(4):996-1008. doi: 10.1111/birt.12753..
Keywords: Healthcare Cost and Utilization Project (HCUP), COVID-19, Maternal Care, Women, Outcomes
Danilack VA, Siegel-Reamer L, Lum L
From "disappointing" to "fantastic": women's experiences with labor induction in a U.S. tertiary hospital.
This study examined women’s expectations and experiences regarding labor induction. Labor induction patients were recruited in a US tertiary care hospital's postpartum mother-baby unit and invited to participate in semi-structured qualitative interviews. From April to September 2018, 26 women were interviewed about expectations and experiences of the labor induction process, side effects and health outcomes of concern, reflections on personal tolerance of different interventions, and thoughts about an ideal process. A wide range of experiences were described- with characterizations from horrible, frustrating, and terrifying to simple, fast and smooth. The Foley balloon catheter was the most polarizing induction method. Other concerns centered on the health of their baby, and an ideal induction involved fewer interventions.
AHRQ-funded; HS025013.
Citation: Danilack VA, Siegel-Reamer L, Lum L .
From "disappointing" to "fantastic": women's experiences with labor induction in a U.S. tertiary hospital.
Birth 2023 Dec; 50(4):959-67. doi: 10.1111/birt.12750..
Keywords: Women, Maternal Care, Hospitals, Patient Experience
Goyal N, Gannon M, Sood E
Group well child care for mothers with opioid use disorder: framework for implementation.
The purpose of this study was to utilize an implementation science framework to examine barriers and facilitators to group well child care (WCC) interventions for parents with opioid use disorder and their children. The researchers conducted a qualitative study using structured phone interviews as a component of the planning phase of a trial of group WCC. Eligible parents were English speaking and had a child less than two years old. Thirty-one parents and 13 pediatric clinicians participated in the interviews. 68% of parents reported that they would be likely or very likely to bring their child to the OUD treatment center for WCC. The researchers found 6 themes emerged describing perceived implementation barriers, including intervention difficulty, complexity, and potential negative outcomes including loss of privacy. Six themes emerged as implementation facilitators: 1. focus on parental OUD and recovery, 2. peer support, 3. accessibility and coordination of care, 4. clinician skill and expertise in parental OUD, 5. increased time for patient care, and 6. continuity of care.
AHRQ-funded; HS027399.
Citation: Goyal N, Gannon M, Sood E .
Group well child care for mothers with opioid use disorder: framework for implementation.
Matern Child Health J 2023 Dec; 27(suppl 1):75-86. doi: 10.1007/s10995-023-03762-w..
Keywords: Children/Adolescents, Women, Substance Abuse, Opioids, Behavioral Health
Dullabh P, Heaney-Huls KK, Chiao AB
Implementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection.
This paper describes a pilot intervention of a smartphone app for postpartum monitoring of hypertensive disorders of pregnancy (HDP) that integrates patient-contributed data into electronic health records (EHRs) to support monitoring and clinical decision-making. Results from the pilot evaluation highlighted the resources needed when implementing the app, challenges for integrating an app into the EHR, and the usability and utility of the HDP monitoring app for patient and clinician users. Key observations of the implementation team included the importance of a local clinical champion, more robust patient involvement and support for the remote patient monitoring program, an impetus for EHR developers to adopt data integration standards, and a need to expand the capabilities of the standards to support interventions using patient-contributed data.
AHRQ-funded; 233201500023I.
Citation: Dullabh P, Heaney-Huls KK, Chiao AB .
Implementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection.
JAMIA Open 2023 Dec; 6(4):ooad098. doi: 10.1093/jamiaopen/ooad098..
Keywords: Electronic Health Records (EHRs), Maternal Care, Blood Pressure, Telehealth, Health Information Technology (HIT), Women
Schulte A, Biggs MA
Association between facility and clinician characteristics and family planning services provided during U.S. outpatient care visits.
The purpose of this study was to characterize the provision of family planning services in outpatient care settings and evaluate variation by facility and clinician characteristics. The researchers utilized National Ambulatory Medical Care Survey data, to evaluate family planning service provision by facility location, facility type, physician specialty, types of clinicians seen, and if the patient was seen by their primary care provider. The sample used for analysis included 53,489 patient visits between 2011 and 2019 with reproductive-age (15-49 years) individuals. Family planning services were provided at 8% of total sampled visits and were more likely to be provided in urban compared with rural areas and at community health centers compared with private physician practices. Family planning services were also more likely to be provided when the patient saw a physician assistant or nurse compared with only a physician. After controlling for observed covariates, measures of between-clinician heterogeneity demonstrated broad variation in which clinicians offered family planning services.
AHRQ-funded; HS022241.
Citation: Schulte A, Biggs MA .
Association between facility and clinician characteristics and family planning services provided during U.S. outpatient care visits.
Womens Health Issues 2023 Nov-Dec; 33(6):573-81. doi: 10.1016/j.whi.2023.06.008..
Keywords: Ambulatory Care and Surgery, Maternal Care, Women, Sexual Health
DiMeo A, Karlage A, Schoenherr K
Cultural brokering in pregnancy care: a critical review.
This study is a literature review of cultural brokering during pregnancy. The authors identified 33 articles in their literature search. They found that cultural brokering is not clearly defined in the current literature. Only a few articles provided information about language concordance between cultural brokers and patients or clinicians, with no articles describing the impact of cultural brokering on health outcomes. Cultural broker facilitating was described as providing information about language concordance between cultural brokers and patients or clinicians. Barriers included misunderstanding the responsibilities, difficulty maintaining personal boundaries, and limited availability and accessibility of cultural brokers. They propose cultural brokering as interactions that cover four key aims: (1) language support; (2) bridging cultural differences; (3) social support and advocacy; and (4) navigation of the healthcare system.
AHRQ-funded; HS026370.
Citation: DiMeo A, Karlage A, Schoenherr K .
Cultural brokering in pregnancy care: a critical review.
Int J Gynaecol Obstet 2023 Nov; 163(2):357-66. doi: 10.1002/ijgo.15063..
Keywords: Maternal Care, Women, Clinician-Patient Communication, Cultural Competence
Salinas KE, Bazan M, Rivera L
Experiences and communication preferences in pregnancy care among patients with a Spanish language preference: a qualitative study.
The purpose of this study was to explore Spanish-speaking patients' experiences and preferences regarding communication during pregnancy care with specific attention to language barriers. The researchers conducted focus groups with patients with a Spanish language preference who gave birth between July 2022 and February 2023 at an academic medical center. A total of seven focus groups with 27 total participants were held. The study identified three key themes regarding preferences in patient experiences and communication when seeking pregnancy care: 1. language discordance and concordance between patients and clinicians exist on a spectrum and are not binary; 2. language-discordant care presents communication challenges, even when interpreters are present; and 3. language discordance can be effectively addressed with positive interpersonal engagements between clinicians and patients.
AHRQ-funded; HS026370.
Citation: Salinas KE, Bazan M, Rivera L .
Experiences and communication preferences in pregnancy care among patients with a Spanish language preference: a qualitative study.
Obstet Gynecol 2023 Nov 1; 142(5):1227-36. doi: 10.1097/aog.0000000000005369..
Keywords: Maternal Care, Women, Communication, Cultural Competence, Racial and Ethnic Minorities
Kerlikowske K, Bissell MCS, Sprague BL
Impact of BMI on prevalence of dense breasts by race and ethnicity.
Researchers evaluated differences in body mass index (BMI) in relation to differences in dense breasts prevalence by race/ethnicity. Their results indicated that dense breasts were most prevalent among Asian women followed by non-Hispanic White, Hispanic, and Black women. Clinically important differences in breast density prevalence are present across racial/ethnic groups after accounting for age, menopausal status, and BMI. IMPACT: If breast density is the sole criterion used to notify women of dense breasts and discuss supplemental screening it may result in implementing inequitable screening strategies across racial/ethnic groups.
AHRQ-funded; HS018366.
Citation: Kerlikowske K, Bissell MCS, Sprague BL .
Impact of BMI on prevalence of dense breasts by race and ethnicity.
Cancer Epidemiol Biomarkers Prev 2023 Nov; 32(11):1524-30. doi: 10.1158/1055-9965.Epi-23-0049..
Keywords: Obesity, Women, Racial and Ethnic Minorities, Cancer: Breast Cancer, Cancer, Imaging
Shields AD, Vidosh J, Thomson BA
Validation of a simulation-based resuscitation curriculum for maternal cardiac arrest.
The purpose of this study was to evaluate the knowledge, skills, and self-efficacy of health care participants completing a simulation-based blended learning training curriculum on managing maternal medical emergencies and maternal cardiac arrest. The study included a formative assessment of the Obstetric Life Support curriculum. The training consisted of self-guided pre-course work and an instructor-led simulation course using a customized low-fidelity simulator. Eighty-five participants consented to participation in the training (out of 88 invited); 77 participants completed the training over eight sessions. The study found that at baseline, less than 50% of participants were able to achieve a passing score on the cognitive assessment. After the course, mean cognitive assessment scores improved by 13 points, from 69.4% at baseline to 82.4% after the course. The researchers observed significant improvements in participant self-efficacy, and 92.6% of participants agreed or strongly agreed that the course met its educational objectives.
AHRQ-funded; HS026169.
Citation: Shields AD, Vidosh J, Thomson BA .
Validation of a simulation-based resuscitation curriculum for maternal cardiac arrest.
Obstet Gynecol 2023 Nov 1; 142(5):1189-98. doi: 10.1097/aog.0000000000005349..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Maternal Care, Simulation, Training, Education: Continuing Medical Education, Women
Beck D, Hall S, Costa DK
Leveraging population health datasets to advance maternal health research.
Researchers reviewed a sample of population health datasets and highlighted recommended changes to the datasets to identify existing gaps in maternal health research and help address maternal morbidity and mortality. Their findings showed insufficient representation of pregnant and postpartum individuals across all datasets. They recommended that pregnant and postpartum individuals should be oversampled in population health data to facilitate rapid policy and program evaluation and that individuals with pregnancies resulting in outcomes other than livebirth be included or asked about their experiences.
AHRQ-funded; HS027640.
Citation: Beck D, Hall S, Costa DK .
Leveraging population health datasets to advance maternal health research.
Matern Child Health J 2023 Oct; 27(10):1683-88. doi: 10.1007/s10995-023-03695-4..
Keywords: Maternal Care, Women, Social Determinants of Health
Truong S, Foley OW, Fallah P
Transcending language barriers in obstetrics and gynecology: a critical dimension for health equity.
This article discusses the issue of language barriers in obstetrics and gynecology. The authors present two cases of language-discordant care and a framework for addressing language as a critical lens for health inequities in obstetrics and gynecology, which includes a variety of clinical settings such as labor and delivery, perioperative care, outpatient clinics, and inpatient services, as well as sensitivity around reproductive health topics. Drivers of language-related inequities at the clinician, health system, and societal level are explored in the proposed framework. They end with actionable recommendations for enhancing equitable care for patients experiencing language barriers.
AHRQ-funded; HS026370.
Citation: Truong S, Foley OW, Fallah P .
Transcending language barriers in obstetrics and gynecology: a critical dimension for health equity.
Obstet Gynecol 2023 Oct 1; 142(4):809-17. doi: 10.1097/aog.0000000000005334..
Keywords: Cultural Competence, Women, Maternal Care, Disparities
Henderson JT, Webber EM, Thomas RG
Screening for hypertensive disorders of pregnancy: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to conduct a systematic review to update the evidence on the effectiveness of screening for hypertensive disorders of pregnancy with the purpose of informing the U.S. Preventive Services Task Force. The main outcome was Morbidity or mortality, with measures of health-related quality of life. The review included 6 fair-quality studies comparing changes in prenatal screening practices with routine screening at in-person office visits (usual care). This systematic review did not find evidence that any alternate screening strategies for hypertensive disorders of pregnancy had increased effectiveness over routine blood pressure measurement at in-person prenatal visits. No harms of the different screening strategies were identified.
AHRQ-funded; 75Q80120D00004.
Citation: Henderson JT, Webber EM, Thomas RG .
Screening for hypertensive disorders of pregnancy: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Sep 19; 330(11):1083-91. doi: 10.1001/jama.2023.4934..
Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Screening, Prevention, Evidence-Based Practice, Guidelines, Maternal Care, Women
Akintunde T, Howard J, Wilson D
Racial and ethnic disparities in long-term contraception use among the birthing population at an academic hospital in the Southeastern United States.
This paper discusses racial and ethnic disparities in long-term contraception among the birthing population at an academic hospital in the Southeastern US. The authors used data from 5011 patients who delivered at a large academic hospital to determine the effect of race/ethnicity and social vulnerability index (SVI) on the odds of undergoing a long-term contraceptive procedure. SVI substantially affects the odds of long-term contraception for non-Hispanic White women and birthing people. In contrast, Hispanic and non-Hispanic Black women and birthing people have significantly higher odds of undergoing a long-term contraceptive procedure. These disparities may be attributed to factors including healthcare providers, organizational and external policies.
AHRQ-funded; HS027680.
Citation: Akintunde T, Howard J, Wilson D .
Racial and ethnic disparities in long-term contraception use among the birthing population at an academic hospital in the Southeastern United States.
Proc Hum Factors Ergon Soc Annu Meet 2023 Sep; 67(1):609-13. doi: 10.1177/21695067231192873..
Keywords: Racial and Ethnic Minorities, Disparities, Maternal Care, Women
Darney BG, Biel FM, Oakley J
Contraceptive method switching and long-acting reversible contraception removal in U.S. safety net clinics, 2016-2021.
The objective of this retrospective cohort study was to describe patterns of contraceptive method switching and long-acting reversible contraception (LARC) removal in a large network of community health centers. Data was taken from individual-level electronic health record data from clinics in 20 states. Contraceptive switching and LARC removal were found to be common in community health centers. The authors recommended that clinicians normalize switching and LARC removal among patients.
AHRQ-funded; HS025155.
Citation: Darney BG, Biel FM, Oakley J .
Contraceptive method switching and long-acting reversible contraception removal in U.S. safety net clinics, 2016-2021.
Obstet Gynecol 2023 Sep; 142(3):669-78. doi: 10.1097/aog.0000000000005277..
Keywords: Women, Sexual Health
Saldanha IJ, Adam GP, Kanaan G
Delivery strategies for postpartum care: a systematic review and meta-analysis.
This systematic review examined the effects of postpartum health care-delivery strategies on health care utilization and maternal outcomes. The authors searched medical databases from inception to November 16, 2022. They found 64 eligible studies (50 randomized controlled trials, 14 nonrandomized comparative studies; N=543,480). The review found that for general postpartum care, care location (clinic, at home, by telephone) did not affect depression or anxiety symptoms (low strength of evidence), and care integration (by multiple types of health care professionals) did not affect depression symptoms or substance use (low strength of evidence). Providing contraceptive care earlier (compared with later) was associated with greater implant use at 6 months (moderate strength of evidence). Low strength of evidence was found for location of breastfeeding affecting hospitalization, other unplanned care utilization, or mental health symptoms. Peer support was associated with higher rates of any or exclusive breastfeeding at 1 month and any breastfeeding at 3-6 months but not other breastfeeding measures (all moderate strength of evidence). Care by a lactation consultant was associated with higher breastfeeding rates at 6 months but not exclusive breastfeeding (all moderate strength of evidence). Moderate strength of evidence was found for the association of use and nonuse of information technology for breastfeeding care with comparable rates of breastfeeding. Moderate strength of evidence was found for the association of testing reminders for screening or preventive care and greater adherence to oral glucose tolerance testing but not random glucose or hemoglobin A1c testing.
AHRQ-funded; 75Q80120D00001; 75Q80121F32007.
Citation: Saldanha IJ, Adam GP, Kanaan G .
Delivery strategies for postpartum care: a systematic review and meta-analysis.
Obstet Gynecol 2023 Sep 1; 142(3):529-42. doi: 10.1097/aog.0000000000005293..
Keywords: Maternal Care, Women, Healthcare Delivery, Evidence-Based Practice, Patient-Centered Outcomes Research
Offit LR, Chikarmane SA, Lacson RC
Frequency and outcomes of BI-RADS category 3 assessments in patients with a personal history of breast cancer: full-field digital mammography versus digital breast tomosynthesis.
The purpose of this article was to compare the frequency, outcomes, and additional characteristics of BI-RADS category 3 assessments between full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in patients with a personal history of breast cancer (PHBC). This retrospective study examined electronic health records from 14,845 mammograms in 10,118 patients (mean age, 63 years) with PHBC who had undergone mastectomy and/or lumpectomy. Of these, 8422 examinations were performed by FFDM from October 2014 to October 2016 and the rest examinations by FFDM with DBT from February 2017 to December 2018. The frequency of category 3 assessment was lower for DBT than FFDM (5.6% vs 6.4%). DBT, compared with FFDM, showed a lower malignancy rate for category 3 lesions (1.8% vs 5.0%), higher malignancy rate for category 4 lesions (32.0% vs 23.2%), and no difference in malignancy rate for category 5 lesions (100.0% vs 75.0%). An analysis of index category 3 lesions included 438 lesions for FFDM and 274 lesions for DBT. For category 3 lesions, DBT, compared with FFDM, showed lower PPV3 (13.9% vs 36.1%) and a more frequent mammographic finding of mass (33.2% vs 23.1%).
AHRQ-funded; HS028616.
Citation: Offit LR, Chikarmane SA, Lacson RC .
Frequency and outcomes of BI-RADS category 3 assessments in patients with a personal history of breast cancer: full-field digital mammography versus digital breast tomosynthesis.
AJR Am J Roentgenol 2023 Sep; 221(3):313-22. doi: 10.2214/ajr.23.29067..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Women
Anchan RM, Spies JB, Zhang S
Long-term health-related quality of life and symptom severity following hysterectomy, myomectomy, or uterine artery embolization for the treatment of symptomatic uterine fibroids.
This study compared the different surgical procedures used for uterine fibroids with respect to long-term health-related quality of life outcomes and symptom improvement. The authors examined differences in change from baseline to 1-, 2-, and 3-year follow-up in health-related quality of life and symptom severity among patients who underwent abdominal myomectomy, laparoscopic or robotic myomectomy, abdominal hysterectomy, laparoscopic or robotic hysterectomy, or uterine artery embolization. A subset of the COMPARE-UF registry, a multiinstitutional prospective observational cohort study of women undergoing treatment for uterine fibroids was used. A subset of 1384 women aged 31 to 45 years who underwent either abdominal myomectomy (n=237), laparoscopic myomectomy (n=272), abdominal hysterectomy (n=177), laparoscopic hysterectomy (n=522), or uterine artery embolization (n=176) were included. They obtained demographics, fibroid history, and symptoms using questionnaires at enrollment and at 1, 2, and 3 years posttreatment. The Uterine Fibroid Symptom and Quality of Life (UFS-QoL) questionnaire was used to ascertain symptom severity and health-related quality of life scores among participants. Those undergoing hysterectomy and uterine artery embolization reported the longest duration of fibroid symptoms with a mean of 6.3 years. The most common fibroid symptoms were heavy bleeding (menorrhagia) (75.3%), bulk symptoms (74.2%), and bloating (73.2%), with more than half (54.9%) of participants reported anemia, and 9.4% women reported a history of blood transfusion. Across all modalities, total health-related quality of life and symptom severity score markedly improved from baseline to 1-year with the largest improvement in the laparoscopic hysterectomy group. Those undergoing abdominal myomectomy, laparoscopic myomectomy, and uterine artery embolization also demonstrated significant improvement in health-related quality of life and symptom severity at 1 year, and the improvement persisted from baseline for uterine-sparing procedures during second and third year, posttreatment intervals, however with a trend toward decline in degree of improvement from years 1 and 2.
AHRQ-funded; HS023418.
Citation: Anchan RM, Spies JB, Zhang S .
Long-term health-related quality of life and symptom severity following hysterectomy, myomectomy, or uterine artery embolization for the treatment of symptomatic uterine fibroids.
Am J Obstet Gynecol 2023 Sep; 229(3):275.e1-75.e17. doi: 10.1016/j.ajog.2023.05.020..
Keywords: Quality of Life, Women, Surgery
MacDougall H, Hanson S, Interrante JD
Rural-urban differences in health care unaffordability during the postpartum period.
The purpose of this cross-sectional study was to explore health care unaffordability for rural and urban residents and by postpartum status. The study found that postpartum people reported statistically significantly higher rates of inability to pay medical bills when compared with non-postpartum people. Rural residents also reported higher rates of inability to pay their medical bills and having problems paying medical bills as compared with urban residents. In adjusted models, the predicted probability of being unable to pay medical bills among postpartum respondents was 12.8%, which was higher than among non-postpartum respondents. Similarly, postpartum respondents had higher predicted probabilities of reporting problems paying medical bills (18.4%) than compared with non-postpartum respondents. IN adjusted models, residency in a rural area was not significantly related with the health care unaffordability outcome measures.
AHRQ-funded; HS000011.
Citation: MacDougall H, Hanson S, Interrante JD .
Rural-urban differences in health care unaffordability during the postpartum period.
Med Care 2023 Sep; 61(9):595-600. doi: 10.1097/mlr.0000000000001888..
Keywords: Rural Health, Urban Health, Rural/Inner-City Residents, Maternal Care, Healthcare Costs, Women, Access to Care
Sprague BL, Ichikawa L, Eavey J
Breast cancer risk characteristics of women undergoing whole-breast ultrasound screening versus mammography alone.
This study evaluated mammography screening failure risk among women undergoing supplemental ultrasound screening in clinical practice in comparison with women undergoing mammography alone. Screening ultrasounds and screening mammograms without supplemental screening were identified within three Breast Cancer Surveillance Consortium registries. A clinically significant proportion of women who had undergone mammography screening alone were at high mammography screening failure risk. Ultrasound screening was highly targeted to women with dense breasts, but only a small proportion were high mammography screening failure risk.
AHRQ-funded; HS018366.
Citation: Sprague BL, Ichikawa L, Eavey J .
Breast cancer risk characteristics of women undergoing whole-breast ultrasound screening versus mammography alone.
Cancer 2023 Aug 15; 129(16):2456-68. doi: 10.1002/cncr.34768..
Keywords: Cancer: Breast Cancer, Cancer, Women, Imaging, Screening, Risk