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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 23 of 23 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
Gephart SM, Hanson C, Wetzel CM
NEC-zero recommendations from scoping review of evidence to prevent and foster timely recognition of necrotizing enterocolitis.
The purpose of this paper is to present a scoping review with two new meta-analyses, clinical recommendations, and implementation strategies to prevent and foster timely recognition of necrotizing enterocolitis. The researchers conducted a stakeholder-engaged scoping review to classify strength of evidence and form implementation recommendations across subgroup areas: 1) promoting human milk, 2) feeding protocols and transfusion, 3) timely recognition strategies, and 4) medication stewardship.
AHRQ-funded; HS022908.
Citation: Gephart SM, Hanson C, Wetzel CM .
NEC-zero recommendations from scoping review of evidence to prevent and foster timely recognition of necrotizing enterocolitis.
Matern Health Neonatol Perinatol 2017 Dec;3:23. doi: 10.1186/s40748-017-0062-0.
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Keywords: Adverse Events, Digestive Disease and Health, Guidelines, Newborns/Infants, Prevention
Leeds IL, Canner JK, Efron JE
The independent effect of cancer on outcomes: a potential limitation of surgical risk prediction.
This study aims to compare the use of common risk models for benign versus malignant gastrointestinal disease. It found that the National Surgical Quality Improvement Program (NSQIP) prediction models less effectively evaluate the risk of death in cancer patients as compared to patients with benign disease. A diagnosis of cancer is independently associated with an increased risk of surgical complications.
AHRQ-funded; HS024736.
Citation: Leeds IL, Canner JK, Efron JE .
The independent effect of cancer on outcomes: a potential limitation of surgical risk prediction.
J Surg Res 2017 Dec;220:402-09.e6. doi: 10.1016/j.jss.2017.08.039.
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Keywords: Adverse Events, Cancer, Digestive Disease and Health, Risk, Surgery
Balbale SN, Trivedi I, O'Dwyer LC
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
In this study, the investigators conducted a systematic scoping review to describe published scientific literature on strategies to identify and reduce opioid misuse among patients with gastrointestinal (GI) symptoms and disorders. They concluded that prescription drug monitoring and self-management interventions may be promising strategies to identify and reduce opioid misuse in GI care. They suggest that rigorous, empirical research is needed to evaluate the longer-term impact of these strategies.
AHRQ-funded; HS000084.
Citation: Balbale SN, Trivedi I, O'Dwyer LC .
Strategies to identify and reduce opioid misuse among patients with gastrointestinal disorders: a systematic scoping review.
Dig Dis Sci 2017 Oct;62(10):2668-85. doi: 10.1007/s10620-017-4705-9..
Keywords: Behavioral Health, Chronic Conditions, Digestive Disease and Health, Medication, Medication: Safety, Opioids, Patient Self-Management, Prevention, Substance Abuse
Symer MM, Abelson JS, Milsom J
A mobile health application to track patients after gastrointestinal surgery: results from a pilot study.
Many surgical readmissions are preventable. Mobile health technology can identify nascent complications and potentially prevent readmission. The researchers performed a pilot study of a new mobile health application in adults undergoing major abdominal surgery and determined the app can track patient recovery from major abdominal surgery, is easy to use, and has potential to improve outcomes.
AHRQ-funded; HS000066.
Citation: Symer MM, Abelson JS, Milsom J .
A mobile health application to track patients after gastrointestinal surgery: results from a pilot study.
J Gastrointest Surg 2017 Sep;21(9):1500-05. doi: 10.1007/s11605-017-3482-2..
Keywords: Telehealth, Health Information Technology (HIT), Hospital Readmissions, Surgery, Adverse Events, Patient Safety, Digestive Disease and Health, Prevention
Feuille E, Menon NR, Huang F
Knowledge of food protein-induced enterocolitis syndrome among general pediatricians.
In this study, investigators examined knowledge of food protein-induced enterocolitis syndrome among general pediatricians. They created a 32-question survey, collecting information regarding participants’ experience with FPIES and knowledge of FPIES diagnosis and management. Investigators found that many pediatricians had a basic but incomplete understanding of FPIES diagnosis and initial management.
AHRQ-funded; HS024599.
Citation: Feuille E, Menon NR, Huang F .
Knowledge of food protein-induced enterocolitis syndrome among general pediatricians.
Ann Allergy Asthma Immunol 2017 Sep;119(3):291-92.e3. doi: 10.1016/j.anai.2017.07.001..
Keywords: Children/Adolescents, Digestive Disease and Health, Diagnostic Safety and Quality, Nutrition, Provider, Provider: Clinician, Provider: Physician
Karkar R, Schroeder J, Epstein DA
Tummytrials: a feasibility study of using self-experimentation to detect individualized food triggers.
The researchers designed, developed, and evaluated a mobile app that applies a self experimentation framework to support patients suffering from irritable bowel syndrome (IBS) in identifying their personal food triggers. In examining the feasibility of this approach in a field study with 15 IBS patients, they found that participants could use the tool to reliably undergo a self-experiment.
AHRQ-funded; HS023654.
Citation: Karkar R, Schroeder J, Epstein DA .
Tummytrials: a feasibility study of using self-experimentation to detect individualized food triggers.
Proc SIGCHI Conf Hum Factor Comput Syst 2017 May 2:6850-63. doi: 10.1145/3025453.3025480..
Keywords: Digestive Disease and Health, Health Information Technology (HIT), Nutrition, Patient Self-Management
Bounthavong M, Li M, Watanabe JH
An evaluation of health care expenditures in Crohn's disease using the United States Medical Expenditure Panel Survey from 2003 to 2013.
The goal of this study was to update cost estimates of Crohn's disease based on a representative sample of the US population from the most recent 11 years (2003-2013) of the Medical Expenditure Panel Survey (MEPS). A secondary aim was to describe expenditure trends in respondents with and without Crohn's disease pre-post FDA approvals of new biologics and the American College of Gastroenterology Crohn's disease treatment guidelines.
AHRQ-funded; HS013853.
Citation: Bounthavong M, Li M, Watanabe JH .
An evaluation of health care expenditures in Crohn's disease using the United States Medical Expenditure Panel Survey from 2003 to 2013.
Res Social Adm Pharm 2017 May-Jun;13(3):530-38. doi: 10.1016/j.sapharm.2016.05.042..
Keywords: Healthcare Costs, Digestive Disease and Health, Medical Expenditure Panel Survey (MEPS)
Stone B, Hester G, Jackson D
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Gastroesophageal reflux (GER), aspiration, and secondary complications lead to morbidity and mortality in children with neurologic impairment (NI), dysphagia, and gastrostomy feeding. Fundoplication and gastrojejunal (GJ) feeding can reduce risk. A comparison of GJ to fundoplication using first-year postprocedure reflux-related hospitalization (RRH) rates found that in children with NI, GER, and dysphagia,:fundoplication and GJ feeding have similar RRH outcomes.
AHRQ-funded; HS019862.
Citation: Stone B, Hester G, Jackson D .
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Hosp Pediatr 2017 Mar;7(3):140-48. doi: 10.1542/hpeds.2016-0126.
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Keywords: Children/Adolescents, Digestive Disease and Health, Neurological Disorders, Nutrition, Outcomes, Treatments
Predmore Z, Nie X, Main R
Anesthesia service use during outpatient gastroenterology procedures continued to increase from 2010 to 2013 and potentially discretionary spending remained high.
Previous studies have identified an increasing number of gastroenterology (GI) procedures using anesthesia services to provide sedation, with a majority of these services delivered to low-risk patients. The aim of this study was to update these trends with the most recent years of data. It found that during 2010 to 2013, anesthesia service use in GI procedures continued to increase and the proportion of these services rendered for low-risk patients remained high.
AHRQ-funded; HS000029.
Citation: Predmore Z, Nie X, Main R .
Anesthesia service use during outpatient gastroenterology procedures continued to increase from 2010 to 2013 and potentially discretionary spending remained high.
Am J Gastroenterol 2017 Feb;112(2):297-302. doi: 10.1038/ajg.2016.266.
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Keywords: Digestive Disease and Health, Ambulatory Care and Surgery, Healthcare Costs
Banerjee T, Meyer TW, Shafi T
Free and total p-cresol sulfate levels and infectious hospitalizations in hemodialysis patients in CHOICE and HEMO.
P-cresol sulfate (PCS), a prototype protein-bound uremic retention solute, has been shown to exert toxic effects in vitro. The researchers explored the relationship between free and total PCS and indoxyl sulfate (IS) with infection-related hospitalizations (IH) and septicemia in 2 cohorts. Their results suggest an association between higher concentrations of free PCS and infection-related and sepsis-related hospitalizations in hemodialysis patients.
AHRQ-funded; HS008365.
Citation: Banerjee T, Meyer TW, Shafi T .
Free and total p-cresol sulfate levels and infectious hospitalizations in hemodialysis patients in CHOICE and HEMO.
Medicine 2017 Feb;96(6):e5799. doi: 10.1097/md.0000000000005799.
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Keywords: Hospitalization, Kidney Disease and Health, Kidney Disease and Health, Digestive Disease and Health, Sepsis
Schroeder J, Hoffswell J, Chung CF
Supporting patient-provider collaboration to identify individual triggers using food and symptom journals.
The researchers examined patient-provider collaboration to interpret patient-generated data. Irritable bowel syndrome (IBS) management often requires patient-provider collaboration using a patient's food and symptom journal to identify the patient's triggers. Drawing upon individual and collaborative interviews with patients and providers, the researchers found that collaborative review helps improve data comprehension and build mutual trust.
AHRQ-funded; HS023654.
Citation: Schroeder J, Hoffswell J, Chung CF .
Supporting patient-provider collaboration to identify individual triggers using food and symptom journals.
CSCW 2017 Feb 25;2017:1726-39. doi: 10.1145/2998181.2998276.
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Keywords: Digestive Disease and Health, Health Information Technology (HIT), Nutrition, Clinician-Patient Communication, Patient Self-Management
Zia JK, Chung CF, Schroeder J
The feasibility, usability, and clinical utility of traditional paper food and symptom journals for patients with irritable bowel syndrome.
The primary aim of this study was to evaluate the feasibility, usability, and clinical utility of paper food and gastrointestinal symptom journals as a data collection tool. Over half of the 17 participants perceived paper journaling of food and symptoms as feasible, usable, and clinically useful. Thirteen participants demonstrated a strong association with at least one symptom and meal nutrient.
AHRQ-funded; HS023654.
Citation: Zia JK, Chung CF, Schroeder J .
The feasibility, usability, and clinical utility of traditional paper food and symptom journals for patients with irritable bowel syndrome.
Neurogastroenterol Motil 2017 Feb;29(2). doi: 10.1111/nmo.12935.
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Keywords: Digestive Disease and Health, Nutrition, Patient Experience, Patient Self-Management