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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Antibiotics (3)
- Antimicrobial Stewardship (1)
- Children/Adolescents (5)
- Clostridium difficile Infections (1)
- Community-Acquired Infections (7)
- Comparative Effectiveness (1)
- Critical Care (1)
- Education: Patient and Caregiver (1)
- Elderly (4)
- Electronic Health Records (EHRs) (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (4)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Health Information Technology (HIT) (2)
- Health Promotion (1)
- Heart Disease and Health (1)
- Hospitalization (2)
- Hospital Readmissions (2)
- Imaging (1)
- Infectious Diseases (3)
- Influenza (1)
- Long-Term Care (1)
- Medication (4)
- Neurological Disorders (1)
- Nursing (1)
- Nursing Homes (2)
- Patient-Centered Outcomes Research (2)
- (-) Pneumonia (19)
- Prevention (2)
- Provider Performance (1)
- Respiratory Conditions (6)
- Risk (2)
- Surgery (1)
- Tobacco Use (1)
- Urinary Tract Infection (UTI) (1)
- Vaccination (5)
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 19 of 19 Research Studies DisplayedChen Z, Gleason LJ, Konetzka RT
Accuracy of infection reporting in US nursing home ratings.
The objective of this study was to assess the accuracy of publicly reported nursing home data on urinary tract infections (UTIs) and of pneumonia data, which are not publicly reported. Researchers developed a claims-based nursing home-level measure of hospitalized infections and estimated correlations between this and publicly reported ratings. Subjects were Medicare fee-for-service beneficiaries who were nursing home residents and hospitalized for UTI or pneumonia during the study period. Findings suggested that both UTI and pneumonia were substantially underreported in data used for national public reporting. The researchers concluded that alternative approaches were needed to improve surveillance of nursing home quality.
AHRQ-funded; HS026957.
Citation: Chen Z, Gleason LJ, Konetzka RT .
Accuracy of infection reporting in US nursing home ratings.
Health Serv Res 2023 Oct; 58(5):1109-18. doi: 10.1111/1475-6773.14195..
Keywords: Provider Performance, Nursing Homes, Long-Term Care, Pneumonia, Urinary Tract Infection (UTI), Elderly
Deshpande A, Walker R, Schulte R
Reducing antimicrobial overuse through targeted therapy for patients with community-acquired pneumonia: a study protocol for a cluster-randomized factorial controlled trial (CARE-CAP).
The authors described a planned cluster-randomized controlled trial in 12 hospitals in the Cleveland Clinic Health System to test two approaches to reducing the use of extended-spectrum antibiotics (ESA) in adult patients with community-acquired pneumonia (CAP): rapid diagnostic assays that provide accurate results within hours, and de-escalation after negative bacterial cultures in clinically stable patients. The purpose will be to establish whether the identification of an etiological agent early and pharmacist-led de-escalation can safely reduce the use of ESA in patients with CAP. The findings may also inform clinical guidelines on the management of CAP.
AHRQ-funded; HS028633.
Citation: Deshpande A, Walker R, Schulte R .
Reducing antimicrobial overuse through targeted therapy for patients with community-acquired pneumonia: a study protocol for a cluster-randomized factorial controlled trial (CARE-CAP).
Trials 2023 Sep 16; 24(1):595. doi: 10.1186/s13063-023-07615-3..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Community-Acquired Infections, Pneumonia, Respiratory Conditions
Metersky ML, Wang Y, Klompas M
Temporal trends in postoperative and ventilator-associated pneumonia in the United States.
The purpose of this retrospective cohort study was to assess change in rates of postoperative pneumonia and ventilator-associated pneumonia among patients hospitalized in the United States during 2009-2019. The study found that among 58,618 patients undergoing major surgical procedures between 2009 and 2019, the observed rate of postoperative pneumonia from 2009-2011 was 1.9% and decreased to 1.3% during 2017-2019. The adjusted annual risk each year, compared to the prior year, was 0.94. Among 4,007 patients hospitalized for any of the 4 conditions at risk for ventilator-associated pneumonia during 2009-2019, the researchers did not detect a significant change in observed or adjusted rates. Observed rates clustered around 10%, and adjusted annual risk compared to the prior year was 0.99.
AHRQ-funded; 290201800005C.
Citation: Metersky ML, Wang Y, Klompas M .
Temporal trends in postoperative and ventilator-associated pneumonia in the United States.
Infect Control Hosp Epidemiol 2023 Aug; 44(8):1247-54. doi: 10.1017/ice.2022.264..
Keywords: Pneumonia, Respiratory Conditions, Healthcare-Associated Infections (HAIs), Healthcare Cost and Utilization Project (HCUP)
Deshpande A, Klompas M, Guo N
Intravenous to oral antibiotic switch therapy among patients hospitalized with community-acquired pneumonia.
The purpose of this retrospective cohort study was to examine clinical practice guidelines which recommend switching from intravenous (IV) to oral antibiotics once patients are clinically stable. The researchers conducted a study of adults admitted with CAP from 2010 through 2015 and initially treated with IV antibiotics at 642 US hospitals. Switching was defined as discontinuation of IV and initiation of oral antibiotics without interrupting therapy. Patients switched by hospital day 3 were considered early switchers. The study found that of 78,041 CAP patients, 6% were switched early, most frequently to fluoroquinolones. Patients switched early had fewer days on IV antibiotics, shorter duration of inpatient antibiotic treatment, shorter LOS, and lower hospitalization costs, but no significant excesses in 14-day in-hospital mortality or late ICU admission. Patients at a greater mortality risk were less likely to be switched. However, even in hospitals with relatively high switch rates, less than 15% of very low-risk patients were switched early.
AHRQ-funded; HS029477; HS025026.
Citation: Deshpande A, Klompas M, Guo N .
Intravenous to oral antibiotic switch therapy among patients hospitalized with community-acquired pneumonia.
Clin Infect Dis 2023 Jul 26; 77(2):174-85. doi: 10.1093/cid/ciad196..
Keywords: Antibiotics, Community-Acquired Infections, Pneumonia, Respiratory Conditions, Medication
Geanacopoulos AT, Neuman MI, Lipsett SC
Association of chest radiography with outcomes in pediatric pneumonia: a population-based study.
This study’s objective was to evaluate the association of performing a chest radiograph (CXR) with 7-day hospitalization after emergency department (ED) discharge among pediatric patients with community-acquired pneumonia (CAP). This retrospective cohort study included 206,694 children aged 3 months to 17 years discharged from any ED within 8 states from 2014 to 2019. Secondary outcomes included 7-day ED revisits and a 7-day hospitalization with severe CAP. Among these children diagnosed with CAP, rates of 7-day ED revisit, hospitalization, and severe CAP were 8.9%, 1.6%, and 0.4%, respectively. After adjusting for illness severity, CXR was associated with fewer 7-day hospitalizations (1.6% vs 1.7%). CXR performance varied somewhat between EDs (median 91.5%). EDs in the highest quartile had fewer 7-day hospitalizations (1.4% vs 1.9%), ED revisits (8.5% vs 9.4%), and hospitalizations for severe CAP (0.3% vs 0.5%) as compared to EDs with the lowest quartile of CXR utilization.
AHRQ-funded; HS026503.
Citation: Geanacopoulos AT, Neuman MI, Lipsett SC .
Association of chest radiography with outcomes in pediatric pneumonia: a population-based study.
Hosp Pediatr 2023 Jul; 13(7):614-23. doi: 10.1542/hpeds.2023-007142..
Keywords: Children/Adolescents, Imaging, Pneumonia, Respiratory Conditions, Community-Acquired Infections
Rothberg MB, Haessler S, Deshpande A
Derivation and validation of a risk assessment model for drug-resistant pathogens in hospitalized patients with community-acquired pneumonia.
The purpose of this study was to develop and validate a model for risk of resistance to first-line community-acquired pneumonia (CAP) therapy. The study was conducted using data for adults hospitalized for CAP from 177 Premier Healthcare database hospitals and 11 Cleveland Clinic hospitals. The study found that among 138,762 eligible patients in the Premier database, 8.8% had positive cultures and 3.8% had organisms resistant to CAP therapy. The strongest predictor of resistance was infection with a resistant organism in the previous year. Markers of acute illness such as receipt of mechanical ventilation or vasopressors, and chronic illness such as pressure ulcer or paralysis were also related with resistant infections. The study model outperformed the Drug Resistance in Pneumonia (DRIP) model in the Premier holdout sample, the Cleveland Clinic hospitals sample. Clinicians at Premier facilities utilized broad-spectrum antibiotics for 20%-30% of their patients. In discriminating between patients with and without resistant infections, physician judgment slightly outperformed the DRIP instrument but not the study model.
AHRQ-funded; HS024277.
Citation: Rothberg MB, Haessler S, Deshpande A .
Derivation and validation of a risk assessment model for drug-resistant pathogens in hospitalized patients with community-acquired pneumonia.
Infect Control Hosp Epidemiol 2023 Jul; 44(7):1143-50. doi: 10.1017/ice.2022.229..
Keywords: Community-Acquired Infections, Pneumonia, Risk
Difazio RL, Shore BJ, Melvin P
Pneumonia after hip surgery in children with neurological complex chronic conditions.
The purpose of this retrospective cohort study was to estimate rates of postoperative pneumonia in children with neurological complex chronic conditions (CCC) undergoing hip surgery, to determine the effect of pneumonia on postoperative hospital resource use, and to identify predictors. Researchers used data from the Pediatric Health Information System for children 4 years and older with a neurological CCC who had undergone hip surgery from 2016 to 2018 in U.S. children's hospitals. Findings indicate that postoperative pneumonia in children with a neurological CCC was associated with longer length-of-stay, readmissions, and higher costs. Children who had undergone pelvic osteotomies and who had multimorbidity needed additional clinical support to prevent postoperative pneumonia and to decrease resource utilization.
AHRQ-funded; HS024453.
Citation: Difazio RL, Shore BJ, Melvin P .
Pneumonia after hip surgery in children with neurological complex chronic conditions.
Dev Med Child Neurol 2023 Feb; 65(2):232-42. doi: 10.1111/dmcn.15339..
Keywords: Children/Adolescents, Surgery, Neurological Disorders, Pneumonia, Respiratory Conditions, Hospital Readmissions, Adverse Events
Patel P, Deshpande A, Yu PC
Association of fluoroquinolones or cephalosporin plus macrolide with Clostridioides difficile infection (CDI) after treatment for community-acquired pneumonia.
The purpose of this study was to explore the relationships between the antibiotic regimens of empiric therapy with a respiratory fluoroquinolone or cephalosporin plus macrolide combination and the development of hospital-onset Clostridioides difficile infection (CDI). The researchers used data from 638 United States hospitals and included adults admitted with pneumonia and discharged from July 2010 through June 2015 with a pneumonia diagnosis code who received 3 or more days of either antibiotic regimen. The study sample included 58,060 patients treated with either cephalosporin plus macrolide (36,796 patients) or a fluoroquinolone alone (21,264 patients). 0.35% of patients who received cephalosporin plus macrolide and 0.31% who received a fluoroquinolone developed CDI, making CDI risks similar for fluoroquinolones versus cephalosporin plus macrolide.
AHRQ-funded; HS024277.
Citation: Patel P, Deshpande A, Yu PC .
Association of fluoroquinolones or cephalosporin plus macrolide with Clostridioides difficile infection (CDI) after treatment for community-acquired pneumonia.
Infect Control Hosp Epidemiol 2023 Jan; 44(1):47-54. doi: 10.1017/ice.2022.60..
Keywords: Pneumonia, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication, Infectious Diseases, Community-Acquired Infections
Albright K, Hurley LP, Lockhart S
Attitudes about adult vaccines and reminder/recall in a safety net population.
The objective of this study was to determine patient perspectives on adult vaccines generally; attitudes about Tdap, pneumococcal polysaccharide (PPSV-23), and seasonal influenza vaccines specifically; and preferences for adult reminder/recall delivery.
AHRQ-funded; HS022648.
Citation: Albright K, Hurley LP, Lockhart S .
Attitudes about adult vaccines and reminder/recall in a safety net population.
Vaccine 2017 Dec 19;35(52):7292-96. doi: 10.1016/j.vaccine.2017.11.001..
Keywords: Influenza, Pneumonia, Vaccination, Prevention, Respiratory Conditions
Ho V, Ross JS, Steiner CA
AHRQ Author: Steiner CA
A nationwide assessment of the association of smoking bans and cigarette taxes with hospitalizations for acute myocardial infarction, heart failure, and pneumonia.
No national study using complete hospitalization counts by area that accounts for contemporaneous controls including state cigarette taxes has been conducted. This study in 28 states found that smoking bans lowered pneumonia hospitalization rates for persons ages 60 to 74 years and higher cigarette taxes were associated with lower heart failure hospitalizations for all ages and fewer pneumonia hospitalizations for adults aged 60 to 74.
AHRQ-authored.
Citation: Ho V, Ross JS, Steiner CA .
A nationwide assessment of the association of smoking bans and cigarette taxes with hospitalizations for acute myocardial infarction, heart failure, and pneumonia.
Med Care Res Rev 2017 Dec;74(6):687-704. doi: 10.1177/1077558716668646.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Hospitalization, Pneumonia, Tobacco Use
Haessler S, Lagu T, Lindenauer PK
Treatment trends and outcomes in healthcare-associated pneumonia.
This retrospective cohort study assessed changes in hospital rates of concordant antibiotic use over time and their correlation with outcomes related to management of healthcare-associated pneumonia (HCAP). The study concluded that only 1 in 5 patients with risk factors for HCAP received treatment that was fully in accordance with guidelines, and many received community-acquired pneumonia (CAP) therapy instead.
AHRQ-funded; HS018723.
Citation: Haessler S, Lagu T, Lindenauer PK .
Treatment trends and outcomes in healthcare-associated pneumonia.
J Hosp Med 2017 Nov;12(11):886-91. doi: 10.12788/jhm.2877..
Keywords: Antibiotics, Elderly, Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Pneumonia
McFarland M, Szasz TP, Zhou JY
Colonization with 19F and other pneumococcal conjugate vaccine serotypes in children in St. Louis, Missouri, USA.
The primary goal of this study was to determine the vaccine-type (VT) serotype prevalence of nasopharyngeal (NP) pneumococcal colonization of children residing in the St. Louis, MO, USA metropolitan area following introduction of the 13-valent pneumococcal conjugate vaccine in 2010. It concluded that children in St. Louis exhibit a higher prevalence of VT serotypes among pneumococcal carriage isolates than has been reported in other areas in the US.
AHRQ-funded; HS021736; HS024269.
Citation: McFarland M, Szasz TP, Zhou JY .
Colonization with 19F and other pneumococcal conjugate vaccine serotypes in children in St. Louis, Missouri, USA.
Vaccine 2017 Aug 3;35(34):4389-95. doi: 10.1016/j.vaccine.2017.06.047.
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Keywords: Vaccination, Children/Adolescents, Pneumonia, Infectious Diseases
Boltey E, Yakusheva O, Costa DK
5 nursing strategies to prevent ventilator-associated pneumonia.
This article reviews the top five evidence-based nursing practices for reducing ventilator-associated pneumonia (VAP) risk in critically ill adults.
AHRQ-funded; HS024552.
Citation: Boltey E, Yakusheva O, Costa DK .
5 nursing strategies to prevent ventilator-associated pneumonia.
Am Nurse Today 2017 Jun;12(6):42-43..
Keywords: Critical Care, Healthcare-Associated Infections (HAIs), Nursing, Prevention, Pneumonia
Meystre S, Gouripeddi R, Tieder J
Enhancing comparative effectiveness research with automated pediatric pneumonia detection in a multi-institutional clinical repository: a PHIS+ pilot study.
The aim of this study was to develop an automated, scalable, and accurate method to determine the presence or absence of pneumonia in children using chest imaging reports. It found that, when compared with each of the domain experts manually annotating these reports, the new Natural Language Processing (NLP) application developed by the researchers allowed for significantly higher sensitivity (.71 vs .527) and similar positive predictive value and specificity.
AHRQ-funded; HS019862.
Citation: Meystre S, Gouripeddi R, Tieder J .
Enhancing comparative effectiveness research with automated pediatric pneumonia detection in a multi-institutional clinical repository: a PHIS+ pilot study.
J Med Internet Res 2017 May 15;19(5):e162. doi: 10.2196/jmir.6887.
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Keywords: Children/Adolescents, Community-Acquired Infections, Comparative Effectiveness, Health Information Technology (HIT), Pneumonia
Brown T, Goldman SN, Persell SD
Development and evaluation of a patient education video promoting pneumococcal vaccination.
The researchers aimed to develop and refine a patient education video about pneumococcal polysaccharide vaccination (PPSV23) and to assess patient perceptions regarding video content and receipt of video during a clinic visit. They found that focus group participants had positive reactions to the video but suggested reducing the intensity of messages about pneumonia severity. Participants shown the revised video during a clinic visit perceived it to be easy to understand and informative.
AHRQ-funded; HS021141.
Citation: Brown T, Goldman SN, Persell SD .
Development and evaluation of a patient education video promoting pneumococcal vaccination.
Patient Educ Couns 2017 May;100(5):1024-27. doi: 10.1016/j.pec.2016.12.025.
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Keywords: Education: Patient and Caregiver, Health Promotion, Pneumonia, Vaccination
Iroh Tam PY, Thielen BK, Obaro SK
Childhood pneumococcal disease in Africa - a systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility.
This study provided updated estimates of the incidence, serotype distribution, and antimicrobial susceptibility profile of Streptococcus pneumoniae causing disease in Africa. It concluded that, although the incidence of invasive pneumococcal disease (IPD) in young children in Africa is substantial, currently available conjugate vaccines are estimated to cover the majority of invasive disease-causing pneumococcal serotypes.
AHRQ-funded; HS020666.
Citation: Iroh Tam PY, Thielen BK, Obaro SK .
Childhood pneumococcal disease in Africa - a systematic review and meta-analysis of incidence, serotype distribution, and antimicrobial susceptibility.
Vaccine 2017 Apr 4;35(15):1817-27. doi: 10.1016/j.vaccine.2017.02.045.
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Keywords: Children/Adolescents, Infectious Diseases, Medication, Pneumonia, Vaccination
Makam AN, Nguyen OK, Clark C
Predicting 30-day pneumonia readmissions using electronic health record data.
The objective of this study was to develop pneumonia-specific readmission risk-prediction models using EHR data from the first day and from the entire hospital stay ("full stay"). The investigators concluded that EHR data collected from the entire hospitalization can accurately predict readmission risk among patients hospitalized for pneumonia. They suggest that this approach outperforms a first-day pneumonia-specific model, the Centers for Medicare and Medicaid Services pneumonia model, and 2 commonly used pneumonia severity of illness scores.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Clark C .
Predicting 30-day pneumonia readmissions using electronic health record data.
J Hosp Med 2017 Apr;12(4):209-16. doi: 10.12788/jhm.2711..
Keywords: Pneumonia, Hospital Readmissions, Hospitalization, Electronic Health Records (EHRs), Health Information Technology (HIT)
Frei CR, Rehani S, Lee GC
Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy.
The researchers assessed the impact of empiric Pseudomonas pharmacotherapy on 30-day mortality in hospitalized patients with community-onset pneumonia stratified according to their risk (low, medium, or high) of drug-resistant pathogens. By using a risk score, they found that empiric Pseudomonas therapy was associated with lower 30-day mortality in the high-risk group but not the low- or medium-risk groups.
AHRQ-funded; HS022418.
Citation: Frei CR, Rehani S, Lee GC .
Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy.
Pharmacotherapy 2017 Feb;37(2):195-203. doi: 10.1002/phar.1891.
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Keywords: Elderly, Community-Acquired Infections, Pneumonia, Patient-Centered Outcomes Research, Risk
Nace DA, Archbald-Pannone LR, Ashraf MS
Pneumococcal vaccination guidance for post-acute and long-term care settings: recommendations from AMDA's infection advisory committee.
Sorting out the indications and timing for 13 pneumococcal serotypes and 23 pneumococcal serotypes administration is complex. The authors discuss the importance of pneumococcal vaccination for older adults, detail AMDA-The Society for Post-Acute and Long-Term Care Medicine (The Society)'s recommendations for pneumococcal vaccination practice and procedures, and offer guidance to postacute and long-term care providers supporting the development and effective implementation of pneumococcal vaccine policies.
AHRQ-funded; HS023779.
Citation: Nace DA, Archbald-Pannone LR, Ashraf MS .
Pneumococcal vaccination guidance for post-acute and long-term care settings: recommendations from AMDA's infection advisory committee.
J Am Med Dir Assoc 2017 Feb;18(2):99-104. doi: 10.1016/j.jamda.2016.11.010.
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Keywords: Elderly, Guidelines, Nursing Homes, Pneumonia, Vaccination