National Healthcare Quality and Disparities Report
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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
51 to 75 of 1430 Research Studies DisplayedLairson DR, Parikh RC, Cormier JN
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
The researchers assessed the cost-effectiveness of chemotherapy regimens by age and disease stage under "real-world" conditions for patients with breast cancer. They found that anthracycline-based chemotherapy was found cost-effective for elderly patients with early stage (stage I, II, IIIa) breast cancer considering the US threshold of $100,000 per QALY.
AHRQ-funded; HS018956.
Citation: Lairson DR, Parikh RC, Cormier JN .
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
Value Health 2015 Dec;18(8):1070-8. doi: 10.1016/j.jval.2015.08.008..
Keywords: Cancer: Breast Cancer, Treatments, Healthcare Costs, Elderly, Social Determinants of Health
Marin JR, Mills AM
Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 Academic Emergency Medicine Consensus Conference.
The 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization" was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The authors describe the specific aims of the conference and the methods used to achieve consensus.
AHRQ-funded; HS023498.
Citation: Marin JR, Mills AM .
Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 Academic Emergency Medicine Consensus Conference.
Pediatr Emerg Care 2015 Dec;31(12):876-82. doi: 10.1097/pec.0000000000000636.
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Keywords: Imaging, Emergency Department, Health Services Research (HSR), Research Methodologies
Marin JR, Mills AM
Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 Academic Emergency Medicine Consensus Conference.
The 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization" was held on May 12, 2015, with the goal of developing a high-priority research agenda on which to base future research. The authors describe the specific aims of the conference and the methods used to achieve consensus.
AHRQ-funded; HS023498.
Citation: Marin JR, Mills AM .
Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 Academic Emergency Medicine Consensus Conference.
Acad Emerg Med 2015 Dec;22(12):1363-71. doi: 10.1111/acem.12818.
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Keywords: Imaging, Emergency Department, Health Services Research (HSR), Research Methodologies
Murray MT, Neu N, Cohen B
Developing case definitions for health care-associated infections for pediatric long-term care facilities.
The researchers performed a pilot study to assess the utility of the Society for Healthcare Epidemiology of America/CDC surveillance case definitions for children in pediatric long-term care facilities (pLTCFs). They concluded that the current surveillance definitions for healthcare-acquired infections in adult long-term care appear to have limited utility for the pLTC population.
AHRQ-funded; HS021470.
Citation: Murray MT, Neu N, Cohen B .
Developing case definitions for health care-associated infections for pediatric long-term care facilities.
Clin Pediatr 2015 Dec;54(14):1380-2. doi: 10.1177/0009922815599379..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Long-Term Care, Patient Safety, Children/Adolescents
Hempel S, Shekelle PG, Liu JL
Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.
This study developed and psychometrically tested a critical appraisal instrument, the QI Minimum Quality Criteria Set (QI-MQCS) for assessing QI-specific features of quality improvement (QI) publications. The critical appraisal instrument is accompanied by a user manual detailing What to consider, Where to look, and How to rate.
AHRQ-funded; HS018139.
Citation: Hempel S, Shekelle PG, Liu JL .
Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.
BMJ Qual Saf 2015 Dec;24(12):796-804. doi: 10.1136/bmjqs-2014-003151.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Quality Improvement
Waehrer G, Deb P, Decker SL
AHRQ Author: Decker SL
Did the 2009 American Recovery and Reinvestment Act affect dietary intake of low-income individuals?
This paper examines the relationship between increased Supplemental Nutritional Assistance Program (SNAP) benefits following the 2009 American Recovery and Reinvestment Act (ARRA) and the diet quality of individuals from SNAP-eligible compared to ineligible (those with somewhat higher income). In the full sample, we find that these increases in SNAP benefits are not associated with changes in nutrient intake and diet quality.
AHRQ-authored.
Citation: Waehrer G, Deb P, Decker SL .
Did the 2009 American Recovery and Reinvestment Act affect dietary intake of low-income individuals?
Econ Hum Biol 2015 Dec;19:170-83. doi: 10.1016/j.ehb.2015.08.006..
Keywords: Nutrition, Social Determinants of Health, Low-Income, Vulnerable Populations
Ray KN, Chari AV, Engberg J
Disparities in time spent seeking medical care in the United States.
The researchers assessed how time associated with medical visits varied across socioeconomic variables and visit characteristics. They determined that patients spent on average 123 minutes obtaining medical care, including 86 minutes of clinic time and 38 minutes travel time. Clinic time was significantly longer for racial/ethnic minorities, individuals with less education, and unemployed individuals.
AHRQ-funded; HS022989.
Citation: Ray KN, Chari AV, Engberg J .
Disparities in time spent seeking medical care in the United States.
JAMA Intern Med 2015 Dec;175(12):1983-6. doi: 10.1001/jamainternmed.2015.4468..
Keywords: Disparities, Racial and Ethnic Minorities, Social Determinants of Health, Access to Care, Quality of Care
Decker SL, Lipton BJ
AHRQ Author: Decker SL
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
This article examines the effect of Medicaid adult dental coverage on use of dental care and dental health outcomes using state-level variation in dental coverage during 2000-2012. Its findings imply that dental coverage is associated with an increase in the likelihood of a recent dental visit, with the size of the effect increasing with Medicaid payment rates to dentists, and a reduction in the likelihood of untreated dental caries.
AHRQ-authored.
Citation: Decker SL, Lipton BJ .
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health.
J Health Econ 2015 Dec;44:212-25. doi: 10.1016/j.jhealeco.2015.08.009.
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Keywords: Access to Care, Dental and Oral Health, Health Insurance, Healthcare Utilization, Medicaid, Outcomes
Kanzaria HK, Hall MK, Moore CL
Emergency department diagnostic imaging: the journey to quality.
The authors examine the current state of quality measurement as it pertains to ED imaging. They also review relevant policies and discuss both the associated challenges and the facilitators of using quality measures to help optimize ED imaging. Understanding such factors will help ensure the delivery of diagnostic imaging that is appropriate, high-quality, and patient-centered.
AHRQ-funded; HS023498.
Citation: Kanzaria HK, Hall MK, Moore CL .
Emergency department diagnostic imaging: the journey to quality.
Acad Emerg Med 2015 Dec;22(12):1380-4. doi: 10.1111/acem.12817.
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Keywords: Emergency Department, Imaging, Quality Indicators (QIs), Quality of Care
Etchegaray JM, Thomas EJ
Engaging employees: the importance of high-performance work systems for patient safety.
The researchers developed and tested survey items that measure high-performance work systems (HPWSs), reported psychometric characteristics of the survey, and examined associations between HPWSs and teamwork culture, safety culture, and overall patient safety grade. They concluded that the HPWSs survey was reliable, distinct from safety culture and teamwork culture based on a confirmatory factor analysis.
AHRQ-funded; HS017145.
Citation: Etchegaray JM, Thomas EJ .
Engaging employees: the importance of high-performance work systems for patient safety.
J Patient Saf 2015 Dec;11(4):221-7. doi: 10.1097/pts.0000000000000076.
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Keywords: Patient Safety, Quality of Care, Teams
Liang C, Gong Y
Enhancing patient safety event reporting by K-nearest neighbor classifier.
The debate on structured or unstructured data entry reveals not only a trade-off problem among data accuracy, completeness, and timeliness, but also a technical gap on text mining. The reesarchers suggested a text classification method for predicting subject categories. Their results demonstrated the feasibility of their system and indicated the advantage of such an application to raise data quality and clinical decision support in reporting patient safety events.
AHRQ-funded; HS022895.
Citation: Liang C, Gong Y .
Enhancing patient safety event reporting by K-nearest neighbor classifier.
Stud Health Technol Inform 2015;218:40603.
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Keywords: Adverse Events, Medical Errors, Patient Safety, Public Reporting, Clinical Decision Support (CDS), Health Information Technology (HIT), Data
Whicher D, Wu AW
Ethics review of survey research: a mandatory requirement for publication?
The authors provided guidance for journals to consider when making determinations about the necessity of ethical review for survey research projects. They stated that in situations where there is greater than minimal risk of informational or psychological harms, the survey research should have received institutional ethics oversight. They also specified that survey research projects that enroll vulnerable individuals with diminished autonomy should receive institutional ethics oversight.
AHRQ-funded; HS000029.
Citation: Whicher D, Wu AW .
Ethics review of survey research: a mandatory requirement for publication?
Patient 2015 Dec;8(6):477-82. doi: 10.1007/s40271-015-0141-0.
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Keywords: Evidence-Based Practice, Policy, Patient Safety, Research Methodologies
Johnson SL, Palta M, Bartels CM
Examining systemic steroid use in older inflammatory bowel disease patients using hurdle models: a cohort study.
In order to evaluate the relationship between patient characteristics and the frequency and duration of incident steroid use, the researchers applied a 2-part hurdle model to Medicare data. Their study identified differences in predictors of frequency and duration of medication use and suggests the utility of two-part models to examine drug utilization patterns.
AHRQ-funded; HS022786.
Citation: Johnson SL, Palta M, Bartels CM .
Examining systemic steroid use in older inflammatory bowel disease patients using hurdle models: a cohort study.
BMC Pharmacol Toxicol 2015 Dec 8;16:34. doi: 10.1186/s40360-015-0034-9..
Keywords: Elderly, Medicare, Medication
Swain MJ, Kharrazi H
Feasibility of 30-day hospital readmission prediction modeling based on health information exchange data.
The researchers conducted a semi-systematic review of readmission predictive factors published prior to March 2013. They found that mapping of these variables with common HL7 segments resulted in an 89.2 percent total coverage, with the DG1 (diagnosis) segment having the highest coverage of 39.4 percent. The PID (patient identification) and OBX (observation results) segments cover 13.9 percent and 9.1 percent of the variables.
AHRQ-funded; HS022578.
Citation: Swain MJ, Kharrazi H .
Feasibility of 30-day hospital readmission prediction modeling based on health information exchange data.
Int J Med Inform 2015 Dec;84(12):1048-56. doi: 10.1016/j.ijmedinf.2015.09.003.
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Keywords: Health Information Exchange (HIE), Hospital Readmissions, Health Information Technology (HIT), Data
Cherney AR, Marin JR, Brown J
AHRQ Author: Henriksen K
Funding research in emergency diagnostic imaging: summary of a panel discussion at the 2015 Academic Emergency Medicine Consensus Conference.
As part of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization," a panel of representatives from several Federal agencies and organizations including AHRQ was assembled to discuss future opportunities for funding research in this particular area of interest. Representatives from these agencies and organizations discussed their missions and priorities and how they distribute funding.
AHRQ-authored.
Citation: Cherney AR, Marin JR, Brown J .
Funding research in emergency diagnostic imaging: summary of a panel discussion at the 2015 Academic Emergency Medicine Consensus Conference.
Acad Emerg Med 2015 Dec;22(12):1400-5. doi: 10.1111/acem.12825.
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Keywords: Imaging, Emergency Department, Health Services Research (HSR), Healthcare Utilization
McCabe AM, Kuppermann N
Generation of evidence and translation into practice: Lessons learned and future directions.
This article describes the experience of the Pediatric Emergency Care Applied Research Network (PECARN) in deriving and validating the traumatic brain injury prediction rules and how PECARN is translating these prediction rules into clinical practice. Furthermore, it discusses the potential for patient/parent shared decision-making with a focus on patient-centered outcomes in Emergency department research.
AHRQ-funded; HS023498.
Citation: McCabe AM, Kuppermann N .
Generation of evidence and translation into practice: Lessons learned and future directions.
Acad Emerg Med 2015 Dec;22(12):1372-9. doi: 10.1111/acem.12819.
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Keywords: Implementation, Evidence-Based Practice, Emergency Medical Services (EMS), Brain Injury, Children/Adolescents
Ahuja V, Sohn MW, Birge JR
Geographic variation in rosiglitazone use surrounding FDA warnings in the Department of Veterans Affairs.
The purpose of this study was to document variation in the use of rosiglitazone and other glucose- lowering drugs across 21 Veterans Integrated Service Networks. It found that aggregate rosiglitazone use increased monotonically from 7.7 percent, in the quarter it was added to the VA formulary, to a peak of 15.3 percent in the quarter when the FDA issued the safety alert.
AHRQ-funded; HS018542.
Citation: Ahuja V, Sohn MW, Birge JR .
Geographic variation in rosiglitazone use surrounding FDA warnings in the Department of Veterans Affairs.
J Manag Care Spec Pharm 2015 Dec;21(12):1214-34. doi: 10.18553/jmcp.2015.21.12.1214.
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Keywords: Adverse Drug Events (ADE), Medication: Safety, Medication, Practice Patterns
Nadpara P, Madhavan SS, Tworek C
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study.
This study evaluated the variations in guideline-concordant timely lung cancer care and prognosis among elderly in the US. It found that the time to diagnosis and treatment varied significantly among the elderly. However, 77.5 percent received guideline-concordant timely lung cancer care. The likelihood of receiving timely care significantly decreased with early stage diagnosis, increasing age, non-white race, higher comorbidity score, and lower income.
AHRQ-funded; HS018622.
Citation: Nadpara P, Madhavan SS, Tworek C .
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study.
Cancer Epidemiol 2015 Dec;39(6):1136-44. doi: 10.1016/j.canep.2015.06.005.
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Keywords: Cancer: Lung Cancer, Elderly, Guidelines, Disparities, Diagnostic Safety and Quality
Levy DE, Munshi VN, Ashburner JM
Health IT-assisted population-based preventive cancer screening: a cost analysis.
The researchers analyzed costs from a randomized trial of 2 health IT strategies to improve cancer screening compared with usual care from the perspective of a primary care network. They found that over the course of the study year, the value of reduced physician time devoted to preventive cancer screening outweighed the costs of the interventions.
AHRQ-funded; HS020308; HS018161.
Citation: Levy DE, Munshi VN, Ashburner JM .
Health IT-assisted population-based preventive cancer screening: a cost analysis.
Am J Manag Care 2015 Dec;21(12):885-91..
Keywords: Health Information Technology (HIT), Cancer, Screening, Prevention, Healthcare Costs
Guy GP, Jr., Yabroff KR, Ekwueme DU
AHRQ Author: Soni A
Healthcare expenditure burden among non-elderly cancer survivors, 2008-2012.
This study presented nationally representative estimates of annual out-of-pocket (OOP) burden among non-elderly cancer survivors and assessed the association between high OOP burden and access to care and preventive service utilization. It found that, among cancer survivors, high OOP burden was associated with being unable to obtain necessary medical care, delaying necessary medical care, and lower breast cancer screening rates among women.
AHRQ-authored.
Citation: Guy GP, Jr., Yabroff KR, Ekwueme DU .
Healthcare expenditure burden among non-elderly cancer survivors, 2008-2012.
Am J Prev Med 2015 Dec;49(6s5):S489-s97. doi: 10.1016/j.amepre.2015.09.002.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Cancer, Access to Care
Layton TJ, Ryan AM
Higher incentive payments in Medicare Advantage's pay-for-performance program did not improve quality but did increase plan offerings.
The researchers evaluated the effects of the size of financial bonuses on quality of care and the number of plan offerings in the Medicare Advantage Quality Bonus Payment Demonstration. They concluded that at great expense to Medicare, double bonuses in the Medicare Advantage Quality Bonus Payment Demonstration were not associated with improved quality but were associated with more plan offerings.
AHRQ-funded; HS018546.
Citation: Layton TJ, Ryan AM .
Higher incentive payments in Medicare Advantage's pay-for-performance program did not improve quality but did increase plan offerings.
Health Serv Res 2015 Dec;50(6):1810-28. doi: 10.1111/1475-6773.12409..
Keywords: Medicare, Payment, Provider Performance, Health Services Research (HSR), Quality Improvement, Quality of Care
Parker SH
Human factors science: Brief history and applications to healthcare.
This section will define the science of human factors, its origins, its impact on safety in other domains, and its impact and potential for impact on patient safety.
Patient Safety, Medical Errors, Health Care Quality
Citation: Parker SH .
Human factors science: Brief history and applications to healthcare.
Curr Probl Pediatr Adolesc Health Care 2015 Dec;45(12):390-4. doi: 10.1016/j.cppeds.2015.10.002.
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Keywords: Patient Safety, Medical Errors, Quality of Care
Kronman MP, Hersh AL, Gerber JS
Identifying antimicrobial stewardship targets for pediatric surgical patients.
The authors examined the collective pool of all systemic antibiotics prescribed to children hospitalized for surgical conditions and identified common surgical conditions with highly variable and potentially unnecessary antibiotic use. They concluded that the use of vancomycin for pediatric cardiothoracic and neurosurgical patients, and broad-spectrum antipseudomonal agents for gastrointestinal surgery patients, represent potentially high-yield targets for stewardship efforts to reduce unnecessary antimicrobial use.
AHRQ-funded; HS023320.
Citation: Kronman MP, Hersh AL, Gerber JS .
Identifying antimicrobial stewardship targets for pediatric surgical patients.
J Pediatric Infect Dis Soc 2015 Dec;4(4):e100-8. doi: 10.1093/jpids/piv022.
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Keywords: Antibiotics, Antimicrobial Stewardship, Children/Adolescents, Children/Adolescents, Surgery
Grainger R, Dalbeth N, Keen H
Imaging as an outcome measure in gout studies: Report from the OMERACT Gout Working Group.
Discussion in the Outcome Measures in Rheumatology (OMERACT) working group was focused to consider (1) features of gout that should be recorded using imaging, (2) best methods of measuring these features, and (3) joints that should be imaged. The working group identified 3 relevant domains for imaging in gout studies: urate deposition (tophus burden), joint inflammation, and structural joint damage.
AHRQ-funded; HS021110.
Citation: Grainger R, Dalbeth N, Keen H .
Imaging as an outcome measure in gout studies: Report from the OMERACT Gout Working Group.
J Rheumatol 2015 Dec;42(12):2460-4. doi: 10.3899/jrheum.141164..
Keywords: Imaging, Patient-Centered Outcomes Research, Outcomes, Chronic Conditions
Eaton EF, Kulczycki A, Saag M
Immunization costs and programmatic barriers at an urban HIV clinic.
This study estimated costs of providing Gardasil, Prevnar, and Zostavax to eligible patients at a US Ryan White Part C academically affiliated HIV clinic in 2013. Its cost analysis of 3 vaccines showed great variation in insurance coverage, with potential losses of almost $100 000 for one HIV clinic if eligible patients received vaccinations in one calendar year.
AHRQ-funded; HS013852.
Citation: Eaton EF, Kulczycki A, Saag M .
Immunization costs and programmatic barriers at an urban HIV clinic.
Clin Infect Dis 2015 Dec;61(11):1726-31. doi: 10.1093/cid/civ637.
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Keywords: Human Immunodeficiency Virus (HIV), Healthcare Costs, Medication, Vaccination