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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 24 of 24 Research Studies DisplayedStrassle PD, Kinlaw AC, Chaumont N
Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change.
Gastroenterology 2019 Dec;157(6):1679-81.e11. doi: 10.1053/j.gastro.2019.08.045.
The purpose of this retrospective cohort study was to assess whether trends in elective and urgent/emergent colectomy changed after July 2006. The authors suggest that given the risks associated with elective colectomy, their findings demonstrate the need for a more evidence-based decision-making process, incorporating both patient preferences and patient-reported outcomes, for those considering elective colectomy for uncomplicated and some cases of complicated diverticulitis.
The purpose of this retrospective cohort study was to assess whether trends in elective and urgent/emergent colectomy changed after July 2006. The authors suggest that given the risks associated with elective colectomy, their findings demonstrate the need for a more evidence-based decision-making process, incorporating both patient preferences and patient-reported outcomes, for those considering elective colectomy for uncomplicated and some cases of complicated diverticulitis.
AHRQ-funded; HS026363.
Citation: Strassle PD, Kinlaw AC, Chaumont N .
Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change.
Gastroenterology 2019 Dec;157(6):1679-81.e11. doi: 10.1053/j.gastro.2019.08.045..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Healthcare Utilization, Guidelines, Shared Decision Making, Digestive Disease and Health
Leeds IL, DiBrito SR, Canner JK
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
This goal of this study was to assess the cost-effectiveness of extended prophylaxis in patients with Crohn's disease after abdominal surgery. A decision tree model was used to assess cost-effectiveness and cost-per-case averted with extended-duration venous thromboembolism prophylaxis following abdominal surgery. Results showed that extended prophylaxis in patients with Crohn's disease postoperatively is not cost-effective when the cumulative incidence of posthospital thrombosis remains less than 4.9%. These findings are driven by the low absolute risk of thrombosis in this population and the considerable cost of universal treatment.
AHRQ-funded; HS024547.
Citation: Leeds IL, DiBrito SR, Canner JK .
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
Dis Colon Rectum 2019 Nov;62(11):1371-80. doi: 10.1097/dcr.0000000000001461..
Keywords: Prevention, Digestive Disease and Health, Surgery, Healthcare Costs, Adverse Events, Patient Safety, Blood Clots, Shared Decision Making, Medication
Nguyen N, Lavery WJ, Capocelli KE, N, Lavery WJ, Capocelli
Transnasal endoscopy in unsedated children with eosinophilic esophagitis using virtual reality video goggles.
Evaluation and treatment of children with eosinophilic esophagitis (EoE) requires serial endoscopic, visual, and histologic assessment by sedated esophagogastroduodenoscopy (EGD). Unsedated transnasal endoscopy (TNE) was reported to be successful in a pilot study of children. In this study, the investigators evaluated video goggle and virtual reality-based unsedated TNE in children with EoE, collecting data on rates of completion, adverse events, and adequacy of visual and histologic findings.
AHRQ-funded; HS024599.
Citation: Nguyen N, Lavery WJ, Capocelli KE, N, Lavery WJ, Capocelli .
Transnasal endoscopy in unsedated children with eosinophilic esophagitis using virtual reality video goggles.
Clin Gastroenterol Hepatol 2019 Nov;17(12):2455-62. doi: 10.1016/j.cgh.2019.01.023..
Keywords: Children/Adolescents, Digestive Disease and Health, Care Management
Shah SC, Tepler A, Peek RM
Association between Helicobacter pylori exposure and decreased odds of eosinophilic esophagitis-a systematic review and meta-analysis.
Previous or current infection with Helicobacter pylori (exposure) has been reported to protect against eosinophilic esophagitis (EoE), perhaps owing to H pylori-induced immunomodulation. However, findings vary. In this study the investigators performed a systematic review and meta-analysis of comparative studies to define the association between H pylori exposure and EoE more clearly. The investigators found evidence for a significant association between H pylori exposure and reduced odds of EoE.
AHRQ-funded; HS026395.
Citation: Shah SC, Tepler A, Peek RM .
Association between Helicobacter pylori exposure and decreased odds of eosinophilic esophagitis-a systematic review and meta-analysis.
Clin Gastroenterol Hepatol 2019 Oct;17(11):2185-98.e3. doi: 10.1016/j.cgh.2019.01.013..
Keywords: Digestive Disease and Health, Evidence-Based Practice
Tepler A, Narula N, Peek RM
Systematic review with meta-analysis: association between Helicobacter pylori CagA seropositivity and odds of inflammatory bowel disease.
Accumulating data support a protective role of Helicobacter pylori against inflammatory bowel diseases (IBD), which might be mediated by strain-specific constituents, specifically cagA expression. The aim of this study was to perform a systematic review and meta-analysis to more clearly define the association between CagA seropositivity and IBD. The investigators found evidence for a significant association between CagA seropositive H pylori exposure and reduced odds of IBD, particularly CD, but not for CagA seronegative H pylori exposure.
AHRQ-funded; HS026395.
Citation: Tepler A, Narula N, Peek RM .
Systematic review with meta-analysis: association between Helicobacter pylori CagA seropositivity and odds of inflammatory bowel disease.
Aliment Pharmacol Ther 2019 Jul;50(2):121-31. doi: 10.1111/apt.15306..
Keywords: Digestive Disease and Health, Evidence-Based Practice
Quinn CC, Chard S, Roth EG
The Telemedicine for Patients With Inflammatory Bowel Disease (TELE-IBD) clinical trial: qualitative assessment of participants' perceptions.
This qualitative clinical trial examined the use of telemedicine for managing patients with inflammatory bowel disease (IBD). The study called TELE-IBD, enrolled 348 patients, with 259 completing the study. Patients completing the study were interviewed after and results were positive in improving quality of life (QOL) by improving patient education and self-management.
AHRQ-funded; HS018975.
Citation: Quinn CC, Chard S, Roth EG .
The Telemedicine for Patients With Inflammatory Bowel Disease (TELE-IBD) clinical trial: qualitative assessment of participants' perceptions.
J Med Internet Res 2019 Jun 3;21(6):e14165. doi: 10.2196/14165..
Keywords: Telehealth, Digestive Disease and Health, Health Information Technology (HIT), Care Management
Law AC, Stevens JP, Walkey AJ
Gastrostomy tube use in the critically ill, 1994-2014.
This study used AHRQ’s Healthcare Cost and Utilization Project’s (HCUP’s) National Inpatient Sample to evaluate trends in gastrostomy tube use among critically ill adults from 1994 to 2014. Patients with dementia were excluded from the study. It was found that tube use more than doubled during that time period. Most patients were discharged to long-term care facilities after tube placement. Population-based rates went from 11.9 to 28.8 gastrostomies per 100,000 adults which is an increase of 142%.
AHRQ-funded; HS024288.
Citation: Law AC, Stevens JP, Walkey AJ .
Gastrostomy tube use in the critically ill, 1994-2014.
Ann Am Thorac Soc 2019 Jun;16(6):724-30. doi: 10.1513/AnnalsATS.201809-638OC..
Keywords: Critical Care, Digestive Disease and Health, Healthcare Cost and Utilization Project (HCUP), Outcomes, Patient-Centered Outcomes Research, Surgery
Shah SC, Nakata C, Polydorides AD
Upper endoscopy up to 3 years prior to a diagnosis of gastric cancer is associated with lower stage of disease in a USA multiethnic urban population, a retrospective study.
This study focused on the feasibility of earlier diagnosis of non-cardia gastic cancer (NCGC) for high-risk populations in the US who include multiracial and ethnic populations. A retrospective study was conducted with patients who were positively identified endoscopically with NCGC at Mount Sinai Hospital in New York City. The primary outcome was an increased frequency of patients diagnosed with stage 0-Ia (38%) as opposed to stage Ib-III (34%) and stage IV (20.3%). For patients with stage 0-Ia if they had a prior negative endoscopy there was a 94% higher likelihood of the NCGC being in a curable stage.
AHRQ-funded; HS026395.
Citation: Shah SC, Nakata C, Polydorides AD .
Upper endoscopy up to 3 years prior to a diagnosis of gastric cancer is associated with lower stage of disease in a USA multiethnic urban population, a retrospective study.
J Prev Med Public Health 2019 May;52(3):179-87. doi: 10.3961/jpmph.18.262..
Keywords: Cancer, Diagnostic Safety and Quality, Digestive Disease and Health, Imaging, Racial and Ethnic Minorities, Urban Health
Chung CF, Wang Q, Schroeder J
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
This study examined if the use of a photo-based food diary app will help patients with irritable bowel syndrome (IBS) help gather food and symptom data to help their doctors with disease management. The investigators designed and developed Foodprint which includes a mobile and web app and pre-visit note to go to experts which communicate an individual’s expectations and questions. A control group and a group with IBS were used to determine the effectiveness of Foodprint.
AHRQ-funded; HS023654.
Citation: Chung CF, Wang Q, Schroeder J .
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
Proc ACM Interact Mob Wearable Ubiquitous Technol 2019 Mar;3(1). doi: 10.1145/3314394..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Digestive Disease and Health, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Patient Self-Management
Faye AS, Polubriaginof F, Green PHR
Low rates of screening for celiac disease among family members.
This study determined how many family members of patients diagnosed with celiac disease were screened. Even among those patients with a family history, nearly 30% of symptomatic first-degree relatives were not tested. These tests are recommended in guidelines for all relatives with a documented family history.
AHRQ-funded; HS021816.
Citation: Faye AS, Polubriaginof F, Green PHR .
Low rates of screening for celiac disease among family members.
Clin Gastroenterol Hepatol 2019 Feb;17(3):463-68. doi: 10.1016/j.cgh.2018.06.016..
Keywords: Diagnostic Safety and Quality, Digestive Disease and Health, Family Health and History, Screening
Daniel VT, Ayturk D, Ward DV
The influence of payor status on outcomes associated with surgical repair of upper gastrointestinal perforations due to peptic ulcer disease in the United States.
An association between lack of insurance and inferior outcomes has been well described for a number of surgical emergencies, yet little is known about the relationship of payor status and outcomes of patients undergoing emergent surgical repair for upper gastrointestinal (UGI) perforations. In this study, the investigators evaluated the association of payor status and in-hospital mortality for patients undergoing emergency surgery for UGI perforations in the United States.
AHRQ-funded; HS022694.
Citation: Daniel VT, Ayturk D, Ward DV .
The influence of payor status on outcomes associated with surgical repair of upper gastrointestinal perforations due to peptic ulcer disease in the United States.
Am J Surg 2019 Jan;217(1):121-25. doi: 10.1016/j.amjsurg.2018.06.025..
Keywords: Adverse Events, Digestive Disease and Health, Health Insurance, Healthcare Cost and Utilization Project (HCUP), Mortality, Outcomes, Patient Safety, Surgery, Uninsured
Almario CV, Chey WD, Iriana S
Computer versus physician identification of gastrointestinal alarm features.
This study's objective was to compare the number of alarms documented by physicians during usual care vs. that collected by a computer algorithm called Automated Evaluation of Gastrointestinal Symptoms (AEGIS). AEGIS identified more patients with positive alarm features compared to physicians and also documented more positive alarms. Moreover, clinicians documented only 30% of the positive alarms self-reported by patients through AEGIS.
AHRQ-funded; HS000046.
Citation: Almario CV, Chey WD, Iriana S .
Computer versus physician identification of gastrointestinal alarm features.
Int J Med Inform 2015 Dec;84(12):1111-7. doi: 10.1016/j.ijmedinf.2015.07.006.
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Keywords: Clinical Decision Support (CDS), Diagnostic Safety and Quality, Digestive Disease and Health, Electronic Health Records (EHRs), Patient Safety
Krouse RS, You YN
Prospective comparative effectiveness trial for malignant bowel obstruction: SWOG S1316.
This paper is an update on the status of the Prospective Comparative Effectiveness Trial for Malignant Bowel Obstruction trial (S1316), the aim of which is to assess the quality of life outcome of “good days” for patients with malignant bowel obstruction (MBO) who receive surgical intervention in comparison with patients who undergo nonsurgical intervention.
AHRQ-funded; HS021491.
Citation: Krouse RS, You YN .
Prospective comparative effectiveness trial for malignant bowel obstruction: SWOG S1316.
Bull Am Coll Surg 2015 Dec;100(12):49-50.
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Keywords: Comparative Effectiveness, Digestive Disease and Health, Patient-Centered Outcomes Research, Quality of Life
Johnson SL, Bartels CM, Palta M
Biological and steroid use in relationship to quality measures in older patients with inflammatory bowel disease: a US Medicare cohort study.
The researchers examined the frequency and predictors of antitumour necrosis factor (TNF) use, among US patients with inflammatory bowel disease (IBD) aged 65 years and older prior to the publication of a new Medicare quality measure calling for the use of anti-TNFs and other steroid-sparing agents. They found that anti-TNF use was very low in this population of older patients with IBD.
AHRQ-funded; HS022786.
Citation: Johnson SL, Bartels CM, Palta M .
Biological and steroid use in relationship to quality measures in older patients with inflammatory bowel disease: a US Medicare cohort study.
BMJ Open 2015 Sep 07;5(9):e008597. doi: 10.1136/bmjopen-2015-008597.
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Keywords: Elderly, Digestive Disease and Health, Medication, Quality Measures
Siegel CA, Lofland JH, Naim A
Gastroenterologists' views of shared decision making for patients with inflammatory bowel disease.
The researchers examined gastroenterologists' perspectives about shared decision making (SDM) with patients with inflammatory bowel disease (IBD). They found three key barriers to practicing SDM were lack of time, reimbursement, and tools. They concluded that gastroenterologists lack the systematic approaches and tools for implementing SDM within their IBD practices.
AHRQ-funded; HS021747.
Citation: Siegel CA, Lofland JH, Naim A .
Gastroenterologists' views of shared decision making for patients with inflammatory bowel disease.
Dig Dis Sci 2015 Sep;60(9):2636-45. doi: 10.1007/s10620-015-3675-z.
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Keywords: Shared Decision Making, Digestive Disease and Health, Patient and Family Engagement, Practice Patterns
Chung CF, Cook K, Bales E
More than telemonitoring: Health provider use and nonuse of life-log data in irritable bowel syndrome and weight management.
The researchers sought to develop an in-depth understanding of providers’ facilitators and barriers to successfully integrating life-log data into their practices and creating better experiences. Providers reported using self-monitoring data to enhance provider-patient communication, develop personalized treatment plans, and to motivate and educate patients, in addition to using them as diagnostic and adherence tools. Barriers included a lack of time to review detailed records and questions about providers' expertise to review it.
AHRQ-funded; HS023654.
Citation: Chung CF, Cook K, Bales E .
More than telemonitoring: Health provider use and nonuse of life-log data in irritable bowel syndrome and weight management.
J Med Internet Res 2015 Aug 21;17(8):e203. doi: 10.2196/jmir.4364..
Keywords: Digestive Disease and Health, Health Information Technology (HIT), Telehealth, Obesity, Clinician-Patient Communication
Bewtra M, Newcomb CW, Wu Q
Mortality associated with medical therapy versus elective colectomy in ulcerative colitis: a cohort study.
This study sought to determine whether patients with advanced ulcerative colitis (UC) treated with elective colectomy have improved survival compared with those treated with medical therapy. It found that elective colectomy was associated with improved survival compared with long-term medical therapy, although this result did not remain statistically significant in all sensitivity analyses.
AHRQ-funded; HS018517.
Citation: Bewtra M, Newcomb CW, Wu Q .
Mortality associated with medical therapy versus elective colectomy in ulcerative colitis: a cohort study.
Ann Intern Med 2015 Aug 18;163(4):262-70. doi: 10.7326/m14-0960..
Keywords: Comparative Effectiveness, Mortality, Outcomes, Surgery, Digestive Disease and Health
Lo Re V, Carbonari DM, Forde KA
Validity of diagnostic codes and laboratory tests of liver dysfunction to identify acute liver failure events.
The researchers examined positive predictive values (PPVs) of hospital ICD-9 diagnoses and laboratory tests of liver dysfunction for identifying acute liver failure (ALF) within a large, community-based integrated care organization. They found that algorithms comprising relevant hospital diagnoses, laboratory evidence of liver dysfunction, and prescriptions for hepatic encephalopathy treatment had low PPVs for confirmed (ALF) events. Studies of ALF will need to rely on medical records to confirm this outcome.
AHRQ-funded; HS018372.
Citation: Lo Re V, Carbonari DM, Forde KA .
Validity of diagnostic codes and laboratory tests of liver dysfunction to identify acute liver failure events.
Pharmacoepidemiol Drug Saf 2015 Jul;24(7):676-83. doi: 10.1002/pds.3774..
Keywords: Diagnostic Safety and Quality, Digestive Disease and Health
Khalil D, Boktor M, Mortensen EM
Comparison of frequency of inflammatory bowel disease and noninfectious gastroenteritis among statin users versus nonusers.
The objective of this study was to examine the association of statin use on the prevalence of IBD and noninfectious gastroenteritis (NI-GE) in a cohort of patients who were followed longitudinally in a military health care system, where patients had similar access and availability of health care. It found that statin use was not associated with either an increased or decreased risk of IBD or NI-GE diagnoses.
AHRQ-funded; HS022418.
Citation: Khalil D, Boktor M, Mortensen EM .
Comparison of frequency of inflammatory bowel disease and noninfectious gastroenteritis among statin users versus nonusers.
Am J Cardiol 2015 May 15;115(10):1396-401. doi: 10.1016/j.amjcard.2015.02.035..
Keywords: Digestive Disease and Health, Patient-Centered Outcomes Research, Risk, Medication, Cardiovascular Conditions
Cross RK, Jambaulikar G, Langenberg P
TELEmedicine for Patients with Inflammatory Bowel Disease (TELE-IBD): design and implementation of randomized clinical trial.
This study compares disease activity and quality of life over 1 year in a randomized trial of IBD patients receiving standard care versus telemedicine. If effective, telemedicine should decrease symptoms, improve quality of life, and decrease health care utilization. The burden associated with use of telemedicine for patients and providers needs to be assessed. This trial is ongoing and will be completed in July 2016.
AHRQ-funded; HS018975.
Citation: Cross RK, Jambaulikar G, Langenberg P .
TELEmedicine for Patients with Inflammatory Bowel Disease (TELE-IBD): design and implementation of randomized clinical trial.
Contemp Clin Trials 2015 May;42:132-44. doi: 10.1016/j.cct.2015.03.006..
Keywords: Comparative Effectiveness, Digestive Disease and Health, Health Information Technology (HIT), Patient-Centered Outcomes Research, Telehealth
Hazelwood GS, Rezaie A, Borman M
Comparative effectiveness of immunosuppressants and biologics for inducing and maintaining remission in Crohn's disease: a network meta-analysis.
The authors compared therapies for induction and maintenance of remission in patients with Crohn's disease. They found that adalimumab and infliximab + azathioprine are the most effective therapies for induction and maintenance of remission of Crohn's disease.
AHRQ-funded; HS021747.
Citation: Hazelwood GS, Rezaie A, Borman M .
Comparative effectiveness of immunosuppressants and biologics for inducing and maintaining remission in Crohn's disease: a network meta-analysis.
Gastroenterology 2015 Feb;148(2):344-54.e5; quiz e14-5. doi: 10.1053/j.gastro.2014.10.011.
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Keywords: Comparative Effectiveness, Digestive Disease and Health, Medication, Patient-Centered Outcomes Research, Treatments
Goyette P, Boucher G, Mallon D
High-density mapping of the MHC identifies a shared role for HLA-DRB1*01:03 in inflammatory bowel diseases and heterozygous advantage in ulcerative colitis.
Studies in inflammatory bowel diseases (IBD) have indicated that multiple independent associations exist at human leukocyte antigen (HLA) and non-HLA genes, but they have lacked the statistical power to define the architecture of association and causal alleles. To address this, the researchers performed high-density single nucleotide polymorphism (SNP) typing of the major histocompatibility complex in >32,000 individuals with IBD.
AHRQ-funded; HS021747.
Citation: Goyette P, Boucher G, Mallon D .
High-density mapping of the MHC identifies a shared role for HLA-DRB1*01:03 in inflammatory bowel diseases and heterozygous advantage in ulcerative colitis.
Nat Genet 2015 Feb;47(2):172-9. doi: 10.1038/ng.3176..
Keywords: Chronic Conditions, Genetics, Digestive Disease and Health
Norman JM, Handley SA, Baldridge MT
Disease-specific alterations in the enteric virome in inflammatory bowel disease.
The researchers show that the enteric virome is abnormal in Crohn's disease (CD) and ulcerative colitis (UC) patients. Their data support a model in which changes in the virome may contribute to intestinal inflammation and bacterial dysbiosis. They conclude that the virome is a candidate for contributing to, or being a biomarker for, human inflammatory bowel disease and speculate that the enteric virome may play a role in other diseases.
AHRQ-funded; HS021747.
Citation: Norman JM, Handley SA, Baldridge MT .
Disease-specific alterations in the enteric virome in inflammatory bowel disease.
Cell 2015 Jan 29;160(3):447-60. doi: 10.1016/j.cell.2015.01.002.
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Keywords: Digestive Disease and Health, Chronic Conditions
Dorn SD, Palsson OS, Woldeghebriel M
Development and pilot testing of an integrated, web-based self-management program for irritable bowel syndrome (IBS).
The researchers developed, assessed, and refined an integrated IBS self-management program (IBS Self-care) and then conducted a 12-week pilot test. They found that the IBS Self-Care program was well received by users who after 12 weeks reported improved knowledge about IBS, but no significant changes in self-efficacy or quality of life.
AHRQ-funded; HS019468.
Citation: Dorn SD, Palsson OS, Woldeghebriel M .
Development and pilot testing of an integrated, web-based self-management program for irritable bowel syndrome (IBS).
Neurogastroenterol Motil 2015 Jan;27(1):128-34. doi: 10.1111/nmo.12487..
Keywords: Patient Self-Management, Health Literacy, Education: Patient and Caregiver, Digestive Disease and Health