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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 25 of 53 Research Studies DisplayedRockova V, George EI
Fast Bayesian factor analysis via automatic rotations to sparsity.
Rotational post hoc transformations have traditionally played a key role in enhancing the interpretability of factor analysis. Regularization methods also serve to achieve this goal by prioritizing sparse loading matrices. In this work, the investigators bridge these two paradigms with a unifying Bayesian framework. Their approach deploys intermediate factor rotations throughout the learning process, greatly enhancing the effectiveness of sparsity inducing priors.
AHRQ-funded; HS021854.
Citation: Rockova V, George EI .
Fast Bayesian factor analysis via automatic rotations to sparsity.
Journal of the American Statistical Association 2016;111(516):1608-22. doi: 10.1080/01621459.2015.1100620..
Keywords: Research Methodologies
Ma X, Chen Y, Cole SR
A hybrid Bayesian hierarchical model combining cohort and case-control studies for meta-analysis of diagnostic tests: accounting for partial verification bias.
In this paper, the authors proposed a novel hybrid Bayesian hierarchical model combining cohort and case-control studies while simultaneously correcting partial verification bias. They presented two case studies on assessing the diagnostic accuracy of gadolinium-enhanced magnetic resonance imaging in detecting lymph node metastases and of adrenal fluorine-18 fluorodeoxyglucose positron emission tomography in characterizing adrenal masses.
AHRQ-funded; HS022900.
Citation: Ma X, Chen Y, Cole SR .
A hybrid Bayesian hierarchical model combining cohort and case-control studies for meta-analysis of diagnostic tests: accounting for partial verification bias.
Stat Methods Med Res 2016 Dec;25(6):3015-37. doi: 10.1177/0962280214536703.
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Keywords: Cancer, Diagnostic Safety and Quality, Imaging, Research Methodologies
Patel HD, Iyoha E, Pierorazio PM
A systematic review of research gaps in the evaluation and management of localized renal masses.
The authors conducted a systematic review to summarize research gaps for the evaluation of composite models for predicting malignancy; use of percutaneous renal sampling for diagnosis; and comparative effectiveness of surgery, thermal ablation, and active surveillance. They recommended incorporation of emerging biomarkers into validated composite models, standardization of biopsy protocols, standard reporting of clinical stage, and performance of prospective studies with objective selection criteria.
AHRQ-funded; 290201200007I.
Citation: Patel HD, Iyoha E, Pierorazio PM .
A systematic review of research gaps in the evaluation and management of localized renal masses.
Urology 2016 Dec;98:14-20. doi: 10.1016/j.urology.2016.08.013.
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Keywords: Cancer, Evidence-Based Practice, Patient-Centered Outcomes Research, Quality Indicators (QIs), Research Methodologies
Kenzik KM, Kent EE, Martin MY
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
The purpose of this study was to identify chronic condition clusters at pre- and post-cancer diagnosis, evaluate predictors of developing clusters post-cancer, and examine the impact on functional impairment among older cancer survivors. It found that distinct condition clusters of two or more chronic conditions are prevalent among older cancer survivors. Cluster prevalence increases from pre- to post-cancer diagnosis.
AHRQ-funded; HS023009; HS013852.
Citation: Kenzik KM, Kent EE, Martin MY .
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
J Cancer Surviv 2016 Dec;10(6):1096-103. doi: 10.1007/s11764-016-0553-4.
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Keywords: Chronic Conditions, Cancer, Elderly, Research Methodologies, Health Status
Flory JH, Mushlin AI, Goodman ZI
Proposals to conduct randomized controlled trials without informed consent: a narrative review.
The literature on various approaches to randomization without consent (RWOC) has never been systematically reviewed. The goal of the study was to provide a survey and narrative synthesis of published proposals for RWOC. Of all designs discussed, only cluster randomized designs and emergency research are routinely used, with the justification that informed consent is infeasible in those settings. Other designs have raised concerns that they do not appropriately respect patient autonomy.
AHRQ-funded; HS023898.
Citation: Flory JH, Mushlin AI, Goodman ZI .
Proposals to conduct randomized controlled trials without informed consent: a narrative review.
J Gen Intern Med 2016 Dec;31(12):1511-18. doi: 10.1007/s11606-016-3780-5.
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Keywords: Patient-Centered Outcomes Research, Research Methodologies
Goff SL, Youssef Y, Pekow PS
Successful strategies for practice-based recruitment of racial and ethnic minority pregnant women in a randomized controlled trial: the IDEAS for a healthy baby study.
The authors used strategies grounded in a health equity framework to address barriers to recruitment and retention in three domains: preparation, process, and patient-centeredness in the IDEAS (Information, Description, Education, Assistance, and Support) for a Healthy Baby study. They achieved higher recruitment (87.1 %) and retention rates (97.3 %) than anticipated, concluding that others seeking to recruit racial and ethnic minority pregnant women in similar settings may find the preparation, process, and patient-centered strategies used in this study applicable for their own studies.
AHRQ-funded; HS021864; HS021879.
Citation: Goff SL, Youssef Y, Pekow PS .
Successful strategies for practice-based recruitment of racial and ethnic minority pregnant women in a randomized controlled trial: the IDEAS for a healthy baby study.
J Racial Ethn Health Disparities 2016 Dec;3(4):731-37. doi: 10.1007/s40615-015-0192-x.
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Keywords: Racial and Ethnic Minorities, Pregnancy, Racial and Ethnic Minorities, Research Methodologies
Sockolow P, Dowding D, Randell R
Using mixed methods in health information technology evaluation.
The authors illustrated some of the benefits and challenges of using mixed methods in evaluation. The diversity of the informatics scholars' research experience provides a broad overview of approaches in combining robust analysis of outcome data with qualitative methods that provide an understanding of the processes through which, and the contexts in which, those outcomes are achieved.
AHRQ-funded; HS021008.
Citation: Sockolow P, Dowding D, Randell R .
Using mixed methods in health information technology evaluation.
Stud Health Technol Inform 2016;225:83-7.
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Keywords: Health Information Technology (HIT), Health Services Research (HSR), Research Methodologies
Hallas J, Pottegard A, Wang S
Persistent user bias in case-crossover studies in pharmacoepidemiology.
The authors aimed to assess the occurrence of an upward-biased odds ratio of studying chronic medication exposure and to evaluate whether it is remedied by including a control group. They found that, in case-crossover studies of medications, contamination by persistent users confers a moderate bias upward, which is partly remedied by using a control group.
AHRQ-funded; HS022193.
Citation: Hallas J, Pottegard A, Wang S .
Persistent user bias in case-crossover studies in pharmacoepidemiology.
Am J Epidemiol 2016 Nov 15;184(10):761-69. doi: 10.1093/aje/kww079.
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Keywords: Medication, Research Methodologies
Liu Y, Chen Y, Scheet P
A meta-analytic framework for detection of genetic interactions.
The researchers propose a new procedure for detecting gene-by-gene interactions through heterogeneity in estimated low-order (e.g., marginal) effect sizes by leveraging population structure, or ancestral differences, among studies in which the same phenotypes were measured. They implement this approach in a meta-analytic framework, which offers numerous advantages, such as robustness and computational efficiency, and is necessary when data-sharing limitations restrict joint analysis.
AHRQ-funded; HS022900.
Citation: Liu Y, Chen Y, Scheet P .
A meta-analytic framework for detection of genetic interactions.
Genet Epidemiol 2016 Nov;40(7):534-43. doi: 10.1002/gepi.21996.
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Keywords: Genetics, Research Methodologies, Health Information Technology (HIT)
Ferrante JM, Friedman A, Shaw EK
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
In this paper, the authors comprehensively describe their experiences, from start to finish, of designing and using an asynchronous online discussion forum for collecting and analyzing information elicited from care coordinators in Patient-Centered Medical Homes across the United States. They conclude that an asynchronous online discussion forum is a feasible, efficient, and effective method to conduct a qualitative study, particularly when subjects are health professionals.
AHRQ-funded; HS020682.
Citation: Ferrante JM, Friedman A, Shaw EK .
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
Qual Health Res 2016 Nov;26(13):1851-61. doi: 10.1177/1049732315609567..
Keywords: Care Coordination, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Research Methodologies
Pezold ML, Pusic AL, Cohen WA
Defining a research agenda for patient-reported outcomes in surgery: using a Delphi survey of stakeholders.
The authors sought to create a research agenda to help determine future directions and advance cross-disciplinary collaboration on the use of patient-reported outcomes (PROs) in surgery. They concluded that the Patient-Reported Outcomes in Surgery Conference research agenda was created using a modified Delphi survey of stakeholders that will help researchers, surgeons, and funders identify crucial areas of future PROs research in surgery.
AHRQ-funded; HS023357; HS000066.
Citation: Pezold ML, Pusic AL, Cohen WA .
Defining a research agenda for patient-reported outcomes in surgery: using a Delphi survey of stakeholders.
JAMA Surg 2016 Oct;151(10):930-36. doi: 10.1001/jamasurg.2016.1640.
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Keywords: Patient-Centered Outcomes Research, Research Methodologies, Surgery, Quality Indicators (QIs)
Schweizer ML, Braun BI, Milstone AM
Research methods in healthcare epidemiology and antimicrobial stewardship-quasi-experimental designs.
The authors highlighted key considerations for quasi-experimental studies in healthcare epidemiology and antimicrobial stewardship, including study design and analytic approaches to avoid selection bias and other common pitfalls of quasi-experimental studies.
AHRQ-funded; HS022872.
Citation: Schweizer ML, Braun BI, Milstone AM .
Research methods in healthcare epidemiology and antimicrobial stewardship-quasi-experimental designs.
Infect Control Hosp Epidemiol 2016 Oct;37(10):1135-40. doi: 10.1017/ice.2016.117.
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Keywords: Antimicrobial Stewardship, Patient Safety, Research Methodologies
Folch DC, Arribas-Bel D, Koschinsky J
Spatial variation in the quality of American Community Survey estimates.
The authors use a series of multivariate spatial regression models to describe the patterns of association between uncertainty in estimates and economic, demographic, and geographic factors, controlling for the number of responses in the American Community Survey. They find that these demographic and geographic patterns in estimate quality persist even after accounting for the number of responses, and they present advice for data users and potential solutions to the challenges identified.
AHRQ-funded; HS021752.
Citation: Folch DC, Arribas-Bel D, Koschinsky J .
Spatial variation in the quality of American Community Survey estimates.
Demography 2016 Oct;53(5):1535-54. doi: 10.1007/s13524-016-0499-1.
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Keywords: Data, Research Methodologies, Social Determinants of Health
Fu R, Holmer HK
Change score or follow-up score? Choice of mean difference estimates could impact meta-analysis conclusions.
This study assessed the impact of using change score vs. follow-up score on the conclusions of meta-analyses. It concluded that using the change vs. the follow-up score could lead to important discrepancies in conclusions. Sensitivity analyses should be conducted to check the robustness of results to the choice of mean difference estimates.
AHRQ-funded; 290200710057I.
Citation: Fu R, Holmer HK .
Change score or follow-up score? Choice of mean difference estimates could impact meta-analysis conclusions.
J Clin Epidemiol 2016 Aug;76:108-17. doi: 10.1016/j.jclinepi.2016.01.034.
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Keywords: Research Methodologies, Data, Outcomes
Ma X, Nie L, Cole SR
Statistical methods for multivariate meta-analysis of diagnostic tests: an overview and tutorial.
The researchers presented an overview and tutorial of statistical methods for meta-analysis of diagnostic tests under two scenarios: (1) when the reference test can be considered a gold standard and (2) when the reference test cannot be considered a gold standard. They introduced a number of case studies with detailed annotated SAS code in MIXED and NLMIXED procedures to facilitate the implementation of these approaches.
AHRQ-funded; HS020666.
Citation: Ma X, Nie L, Cole SR .
Statistical methods for multivariate meta-analysis of diagnostic tests: an overview and tutorial.
Stat Methods Med Res 2016 Aug;25(4):1596-619. doi: 10.1177/0962280213492588.
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Keywords: Research Methodologies
Dagne GA, Brown CH, Howe G
Testing moderation in network meta-analysis with individual participant data.
The authors extended existing network methods for main effects to examining moderator effects. They further studied how the use of individual participant data may increase the sensitivity of network meta-analysis (NMA) for detecting moderator effects. They proposed a new NMA diagram and applied it to data from a classroom-based randomized study that involved two sub-trials, each comparing interventions that were contrasted with separate control groups.
AHRQ-funded; HS020263.
Citation: Dagne GA, Brown CH, Howe G .
Testing moderation in network meta-analysis with individual participant data.
Stat Med 2016 Jul 10;35(15):2485-502. doi: 10.1002/sim.6883.
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Keywords: Comparative Effectiveness, Data, Research Methodologies
Sjoding MW, Cooke CR, Iwashyna TJ
Acute respiratory distress syndrome measurement error. Potential effect on clinical study results.
This study investigated how the degree of variability in acute respiratory distress syndrome (ARDS) measurement commonly reported in clinical studies affects study power, the accuracy of treatment effect estimates, and the measured strength of risk factor associations. It found that lower reliability measurement of ARDS during patient enrollment in randomized controlled trials seriously degraded study power and effect size estimates of clinical studies.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Cooke CR, Iwashyna TJ .
Acute respiratory distress syndrome measurement error. Potential effect on clinical study results.
Ann Am Thorac Soc 2016 Jul;13(7):1123-8. doi: 10.1513/AnnalsATS.201601-072OC.
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Keywords: Diagnostic Safety and Quality, Research Methodologies, Respiratory Conditions
Linder SK, Kamath GR, Pratt GF
Citation searches are more sensitive than keyword searches to identify studies using specific measurement instruments.
This study compared the effectiveness of two search methods in identifying studies that used the Control Preferences Scale (CPS), a health care decision-making instrument commonly used in clinical settings. It found that keyword searches in bibliographic databases yielded high average precision (90%) but low average sensitivity (16%). PubMed was the most precise, followed closely by Scopus and WOS.
AHRQ-funded; HS022134.
Citation: Linder SK, Kamath GR, Pratt GF .
Citation searches are more sensitive than keyword searches to identify studies using specific measurement instruments.
J Clin Epidemiol 2015 Apr;68(4):412-7. doi: 10.1016/j.jclinepi.2014.10.008..
Keywords: Research Methodologies, Shared Decision Making, Evidence-Based Practice
Cato KD, Bockting W, Larson E
Did I tell you that? Ethical issues related to using computational methods to discover non-disclosed patient characteristics.
Using the Belmont Report's principles of respect for persons, beneficence, and justice as a framework, the authors examined the ethical issues posed by electronic phenotyping. Ethical issues identified include the ability of the patient to consent for the use of their information, the ability to suppress pediatric information, and ensuring that the potential benefits justify the risks of harm to patients.
AHRQ-funded; HS022961.
Citation: Cato KD, Bockting W, Larson E .
Did I tell you that? Ethical issues related to using computational methods to discover non-disclosed patient characteristics.
J Empir Res Hum Res Ethics 2016 Jul;11(3):214-9. doi: 10.1177/1556264616661611.
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Keywords: Clinician-Patient Communication, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research, Registries, Research Methodologies
Cohen DJ, Balasubramanian BA, Gordon L
A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.
This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness.
AHRQ-funded; HS022981; HS023940.
Citation: Cohen DJ, Balasubramanian BA, Gordon L .
A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.
Implement Sci 2016 Jun 29;11(1):86. doi: 10.1186/s13012-016-0449-8.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Primary Care, Research Methodologies
Grob R, Schlesinger M, Parker AM
Breaking narrative ground: Innovative methods for rigorously eliciting and assessing patient narratives.
The researchers sought to design a methodology for rigorously eliciting narratives about patients' experiences with clinical care that is potentially useful for public reporting and quality improvement. They demonstrated that a five-question protocol that has been tested and refined yields three- to sixfold increases in completeness and four- to tenfold increases in meaningfulness, compared to a single open-ended question. It performs equally well for healthy and sick patients.
AHRQ-funded; HS021858; HS016980; HS016978.
Citation: Grob R, Schlesinger M, Parker AM .
Breaking narrative ground: Innovative methods for rigorously eliciting and assessing patient narratives.
Health Serv Res 2016 Jun;51 Suppl 2:1248-72. doi: 10.1111/1475-6773.12503.
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Keywords: Patient Experience, Patient and Family Engagement, Research Methodologies
Terza JV
Inference using sample means of parametric nonlinear data transformations.
AHRQ-funded; HS017434.
Citation: Terza JV .
Inference using sample means of parametric nonlinear data transformations.
Health Serv Res 2016 Jun;51(3):1109-13. doi: 10.1111/1475-6773.12494.
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Keywords: Research Methodologies, Health Services Research (HSR), Data
Desai RJ, Glynn RJ, Wang S
Performance of disease risk score matching in nested case-control studies: a simulation study.
The authors investigate whether or not matching on a disease risk score (DRS), which includes many confounders, results in greater precision than matching on only a few confounders. Their results suggest that DRS matching might increase the statistical efficiency of case-control studies, particularly when the outcome is rare.
AHRQ-funded; HS022193.
Citation: Desai RJ, Glynn RJ, Wang S .
Performance of disease risk score matching in nested case-control studies: a simulation study.
Am J Epidemiol 2016 May 15;183(10):949-57. doi: 10.1093/aje/kwv269.
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Keywords: Research Methodologies, Risk, Patient-Centered Outcomes Research
Goedken AM, Lund BC, Cook EA
Application of a framework for determining number of drugs.
The purpose of the study was to propose a framework and illustrate how that framework can be used to create and succinctly describe various approaches to counting the number of drugs used by patients and to examine the impact of varying individual components of the framework on the resulting drug count.
AHRQ-funded; HS018381.
Citation: Goedken AM, Lund BC, Cook EA .
Application of a framework for determining number of drugs.
BMC Res Notes 2016 May 13;9:272. doi: 10.1186/s13104-016-2076-5.
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Keywords: Medication, Research Methodologies, Heart Disease and Health, Medicare
Kahwati L, Viswanathan M, Golin CE
Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.
The researchers aimed to extend the results from an existing systematic review of interventions to improve medication adherence by using qualitative comparative analysis (QCA) to identify necessary or sufficient configurations of behavior change techniques among effective interventions. They were able to identify seven configurations of behavior change techniques sufficient for improving adherence, which together accounted for 26 (76 percent) of the effective studies.
AHRQ-funded; HS022563.
Citation: Kahwati L, Viswanathan M, Golin CE .
Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.
Syst Rev 2016 May 4;5:83. doi: 10.1186/s13643-016-0255-z.
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Keywords: Medication, Patient Adherence/Compliance, Research Methodologies, Comparative Effectiveness, Behavioral Health