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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 21 of 21 Research Studies DisplayedIngraham NE, King S, Proper J
Morbidity and mortality trends of pancreatitis: an observational study.
The authors assessed temporal trends of incidence, complications, management, and outcomes for acute pancreatitis in hospitalized patients at the national level. Using HCUP data, they found that the incidence of pancreatitis, from 2008 to 2015, has increased whereas inpatient mortality has decreased.
AHRQ-funded; HS026732.
Citation: Ingraham NE, King S, Proper J .
Morbidity and mortality trends of pancreatitis: an observational study.
Surg Infect 2021 Dec;22(10):1021-30. doi: 10.1089/sur.2020.473..
Keywords: Healthcare Cost and Utilization Project (HCUP), Digestive Disease and Health, Mortality
Bajaj JS, Shamsaddini A, Acharya C
Multiple bacterial virulence factors focused on adherence and biofilm formation associate with outcomes in cirrhosis.
This study’s goal was to define the association of bacterial virulence factors (VFs) with cirrhosis severity and infections, their linkage with outcomes, and impact of fecal microbiota transplant (FMT). This case-control study followed 233 subjects (40 controls, 43 compensated, 30 HE-only (hepatic encephalopathy), 20 ascites-only, 70 both, and 30 infected. Stool samples were collected before and after a 90-day FMT trial. Bacterial species and VFs for all species and selected pathogens (Escherichia, Klebsiella, Pseudomonas, Staphylococcus, Streptococcus, and Enterococcus species) were compared between groups. Decompensated patients, especially those with infections, had higher VFs coding versus the rest. Biofilm and adhesion VFs from Enterobacteriaceae and Enterococcus species were associated with death and hospitalizations independent of clinical factors regardless of when all VFs or selected pathogens were analyzed. FMT was associated with reduced VF post-FMT versus pre-FMT and post-placebo.
AHRQ-funded; HS025412.
Citation: Bajaj JS, Shamsaddini A, Acharya C .
Multiple bacterial virulence factors focused on adherence and biofilm formation associate with outcomes in cirrhosis.
Gut Microbes 2021 Jan-Dec;13(1):1993584. doi: 10.1080/19490976.2021.1993584..
Keywords: Digestive Disease and Health
Bajaj JS, Shamsaddini A, Fagan A
Distinct gut microbial compositional and functional changes associated with impaired inhibitory control in patients with cirrhosis.
The authors sought to assess the impact of inhibitory control versus traditional cirrhosis-related cognitive performance on gut microbial composition and function. They found that the gut microbial signature of impaired inhibitory control, which is associated with addictive disorders that can lead to cirrhosis, is distinct from cirrhosis-related cognitive impairment.
AHRQ-funded; HS025412.
Citation: Bajaj JS, Shamsaddini A, Fagan A .
Distinct gut microbial compositional and functional changes associated with impaired inhibitory control in patients with cirrhosis.
Gut Microbes 2021 Jan-Dec;13(1):1953247. doi: 10.1080/19490976.2021.1953247..
Keywords: Digestive Disease and Health
Lumpkin ST, Harvey E, Mihas P
Understanding patients' decisions to obtain unplanned, high-resource health care after colorectal surgery.
Researchers investigated effective strategies to reduce unplanned post-discharge health care visits following colorectal surgery (CRS). They found that interview participants voiced clear mental algorithms about when to visit an emergency department, identified facilitators and barriers to optimal health care use, and identified tangible targets for health care utilization reduction efforts. The researchers concluded that efforts should be directed at improving post-discharge communication and care coordination in order to reduce CRS patients' high-resource health care utilization.
AHRQ-funded; HS026363.
Citation: Lumpkin ST, Harvey E, Mihas P .
Understanding patients' decisions to obtain unplanned, high-resource health care after colorectal surgery.
Qual Health Res 2021 Jul;31(9):1582-95. doi: 10.1177/10497323211002479..
Keywords: Shared Decision Making, Digestive Disease and Health, Surgery
Dos Santos Marques IC, Theiss LM, Wood LN
Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease.
The authors hypothesized that racial disparities exist for Hispanic and Asian patients undergoing surgery for inflammatory bowel disease (IBD). Data from the American College of Surgeons National Surgical Quality Improvement Program (ACS- NSQIP) was used. They found that racial disparities do exist among IBD patients undergoing surgery. Black, Hispanic, and Asian IBD patients experience major disparities in post-operative complications, readmissions, and length of stay, respectively, when compared to White patients with IBD. They recommended future research to better understand the mechanisms of these disparities including evaluation of social determinants of health.
AHRQ-funded; HS023009.
Citation: Dos Santos Marques IC, Theiss LM, Wood LN .
Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease.
Am J Surg 2021 Apr;221(4):668-74. doi: 10.1016/j.amjsurg.2020.12.010..
Keywords: Disparities, Racial and Ethnic Minorities, Surgery, Digestive Disease and Health, Outcomes
Shah SC, Zhu X, Dai Q
Magnesium intake is associated with a reduced risk of incident liver cancer, based on an analysis of the NIH-American Association of Retired Persons (NIH-AARP) Diet and Health Study prospective cohort.
Liver cancer incidence and mortality are escalating globally. Magnesium intake has been studied extensively in nonmalignant liver pathology, but the association between dietary intake of magnesium and primary liver malignancy has not been previously evaluated. In this study, investigators aimed to determine the association between total magnesium intake and primary liver cancer risk. The investigators concluded that based on their prospective cohort analysis, magnesium intake was associated with a lower risk of primary liver cancer, which was more pronounced among moderate and heavy alcohol users.
AHRQ-funded; HS026395.
Citation: Shah SC, Zhu X, Dai Q .
Magnesium intake is associated with a reduced risk of incident liver cancer, based on an analysis of the NIH-American Association of Retired Persons (NIH-AARP) Diet and Health Study prospective cohort.
Am J Clin Nutr 2021 Mar 11;113(3):630-38. doi: 10.1093/ajcn/nqaa326..
Keywords: Cancer, Risk, Digestive Disease and Health, Prevention
Fischer CP, Knapp L, Cohen ME
Feasibility of enhanced recovery in emergency colorectal operation.
This study examines the feasibility of using enhanced recovery pathways (ERPs) in emergency colorectal operations. It has been successfully used with elective surgical care but has not been examined for emergency procedures. A total of 31,511 patients who underwent colorectal operations at 235 hospitals were identified from a national ERP collaborative. Most were elective surgeries (28,425), with 3,086 emergencies. For emergency cases, rates of early Foley removal and venous thromboembolism prophylaxis were highest. Rates of multimodal pain control, early mobilization, and early liquid intake were modest. Patients younger than age 65 years, those with independent functional status, American Society of Anesthesiologists Physical Status Classification 1 to 3, and without physiologic derangement had the most nonadherence. Lack of mobilization or liquid intake was independently associated with increased odds of ileus and prolonged length of stay.
AHRQ-funded; 233201500020I.
Citation: Fischer CP, Knapp L, Cohen ME .
Feasibility of enhanced recovery in emergency colorectal operation.
J Am Coll Surg 2021 Feb;232(2):178-85. doi: 10.1016/j.jamcollsurg.2020.10.004..
Keywords: Surgery, Digestive Disease and Health, Emergency Department, Patient-Centered Outcomes Research, Outcomes
Diaz A, Ricci KB, Rushing AP
Re-examining "never letting the sun rise or set on a bowel obstruction" in the era of acute care surgery.
This study looked at factors linked to emergency surgery practices for small bowel obstruction (SBO) as opposed to non-operative treatment. Data from adult SBO patients from 17 Statewide Inpatient Databases (SIDS) was linked to the authors’ 2015 survey on emergency general surgery (EGS) practices including queries on operating room (OR) availability and surgical staffing. Of the 32,422 SBO patients identified, 83% were treated non-operatively. Operative patients tended to be older, had more comorbidities (53% vs. 46% with 3 or greater), and experienced more systemic complications (36% vs. 23%), higher mortality (2.8% vs. 1.4%), and longer length of stay (median 10 vs. 4 days). Patients had higher odds of operation if they were treated at hospitals with surgeons sometimes or rarely/never covering EGS at more than one location compared to always.
AHRQ-funded; HS022694.
Citation: Diaz A, Ricci KB, Rushing AP .
Re-examining "never letting the sun rise or set on a bowel obstruction" in the era of acute care surgery.
J Gastrointest Surg 2021 Feb;25(2):512-22. doi: 10.1007/s11605-019-04496-3..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Digestive Disease and Health
Lumpkin ST, Mihas P, Baldwin X
Surgical patient values frame and modify the impact of risk factors for non-routine postdischarge care: a mixed-methods study.
This mixed methods study looked at patient perspectives on risk factors of non-routine postdischarge care (emergency department visit or rehospitalization) for adult colorectal surgery patients. Surgery patients were identified from hospital records from 2017 to 2018. The authors enrolled 258 participants, surveyed 167, and interviewed 18. Depressive symptoms were found to be one of the many risk factors confirmed to increase non-routine health utilization.
AHRQ-funded; HS026363.
Citation: Lumpkin ST, Mihas P, Baldwin X .
Surgical patient values frame and modify the impact of risk factors for non-routine postdischarge care: a mixed-methods study.
Am J Surg 2021 Jan;221(1):195-203. doi: 10.1016/j.amjsurg.2020.05.016..
Keywords: Digestive Disease and Health, Surgery, Risk, Hospital Readmissions, Emergency Department
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