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
1 to 19 of 19 Research Studies DisplayedTreadwell JR, Kessler SK, Wu M
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this systematic review study was to assess the effectiveness and harms of pharmacologic and dietary treatments for epilepsy in children aged 1-36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 to identify studies reporting data on children aged 1-36 months receiving pharmacologic or dietary treatments for epilepsy. Twenty-three studies met the inclusion criteria. The study found that Levetiracetam leads to seizure freedom in some infants but the data on 6 other medications (lamotrigine, phenytoin, rufinamide, stiripentol, topiramate, and vigabatrin) were too limited to allow conclusions about their effectiveness. Three medications (lamotrigine, levetiracetam, and topiramate) were rarely discontinued due to adverse effects, and severe events were also rare. In the category of diets, the ketogenic diet lead to seizure freedom in some infants and both the ketogenic diet and modified Atkins diet reduced average seizure frequency.
AHRQ-funded; 75Q80120D00002.
Citation: Treadwell JR, Kessler SK, Wu M .
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
Neurology 2023 Jan 3;100(1):e16-e27. doi: 10.1212/wnl.0000000000201026..
Keywords: Children/Adolescents, Neurological Disorders, Newborns/Infants, Medication, Nutrition, Treatments, Evidence-Based Practice
Gupta N, Patel HD, Taylor J
Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes.
The objective of this study was to perform a systematic review of plant-based diets and prostate cancer. Findings showed that interventional studies displayed generally favorable results of lifestyle modifications incorporating a plant-based diet with prostate cancer outcomes as well as improvements in nutrition and general health. Further, observational studies demonstrated either a lower risk of prostate cancer or no significant difference.
AHRQ-funded; HS026120.
Citation: Gupta N, Patel HD, Taylor J .
Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes.
Prostate Cancer Prostatic Dis 2022 Sep;25(3):444-52. doi: 10.1038/s41391-022-00553-2..
Keywords: Cancer: Prostate Cancer, Cancer, Evidence-Based Practice, Nutrition, Outcomes
Ong T, Onchiri FM, Britto MT
Impact of guideline-recommended dietitian assessments on weight gain in infants with cystic fibrosis.
This study’s purpose was to characterize nutrition management for infants with cystic fibrosis (CF) with inadequate weight gain and to assess association of dietitian assessments and center-level weight-for-age Z-scores (WAZ). Encounter data from 226 infants was used from across 28 US CF Centers from the Baby Observational Nutritional study between January 2012 through December 2017. The authors identified dietitian assessments and consensus guideline-recommended responses to inadequate weight gain: calorie increases, pancreatic enzyme replacement therapy (PERT) increases, or shortened time to next visit. They compared center assessments by funnel plot and summarized median WAZ by center. Of 2,527 visits, 808 visits had identified inadequate weight gain, distributed in 216 infants. Assessments occurred in 77% of visits but varied widely between centers (range 17% - 98%). They used funnel plot analysis to identify high-performers for frequent dietitian assessments (range 92% - 98%) and 4 under-performers (range 17% - 56%). High-performers treated inadequate weight gain more often with adequate calories (80% vs 52%) and closer follow-up (63% vs 49%) compared to underperformers. Three of 4 high-performing sites met center nutrition goals for positive median WAZ at 2 years old unlike 3 under-performers, despite similar patient characteristics.
AHRQ-funded; HS026393.
Citation: Ong T, Onchiri FM, Britto MT .
Impact of guideline-recommended dietitian assessments on weight gain in infants with cystic fibrosis.
J Cyst Fibros 2022 Jan; 21(1):115-22. doi: 10.1016/j.jcf.2021.08.005..
Keywords: Newborns/Infants, Respiratory Conditions, Chronic Conditions, Nutrition, Evidence-Based Practice, Guidelines
O'Connor EA, Evans CV, Rushkin MC
Behavioral counseling to pomote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: updated evidence report and systematic review for the US Preventive Services Task Force.
Researchers reviewed the benefits and harms of behavioral counseling interventions to improve diet and physical activity in adults with cardiovascular risk factors. They found that medium- and high-contact multisession behavioral counseling interventions to improve diet and increase physical activity for people with elevated blood pressure and lipid levels were effective in reducing cardiovascular events, blood pressure, low-density lipoproteins, and adiposity-related outcomes, with little to no risk of serious harm.
AHRQ-funded; 290201200015I.
Citation: O'Connor EA, Evans CV, Rushkin MC .
Behavioral counseling to pomote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Nov 24;324(20):2076-94. doi: 10.1001/jama.2020.17108..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Nutrition, Lifestyle Changes, Risk, Prevention, Evidence-Based Practice, Guidelines
Shah SC, Dai Zhu, X
Associations between calcium and magnesium intake and the risk of incident gastric cancer: a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study.
Gastric cancer remains a leading cause of cancer-related mortality. Identifying dietary and other modifiable disease determinants has important implications for risk attenuation in susceptible individuals. The primary aim of the investigators was to estimate the association between dietary and supplemental intakes of calcium and magnesium and the risk of incident gastric cancer. They conducted a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons Diet and Health Study.
AHRQ-funded; HS026395.
Citation: Shah SC, Dai Zhu, X .
Associations between calcium and magnesium intake and the risk of incident gastric cancer: a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study.
Int J Cancer 2020 Jun 1;146(11):2999-3010. doi: 10.1002/ijc.32659..
Keywords: Cancer, Digestive Disease and Health, Risk, Prevention, Nutrition, Patient-Centered Outcomes Research, Evidence-Based Practice
Shaw J, Tate V, Hanson J
What diet should I recommend my patient with hepatic encephalopathy?
The burden of malnutrition is high in patients with cirrhosis, especially in those with hepatic encephalopathy (HE). This has a bearing on increased morbidity and mortality. Heightened attention needs to be paid to screen the patients at high nutritional risk both in the outpatient and hospitalized settings. This review summarized the current evidence for nutritional support in HE patients and compared the recommendations about nutritional requirement as laid out by various organizations.
AHRQ-funded; HS025412.
Citation: Shaw J, Tate V, Hanson J .
What diet should I recommend my patient with hepatic encephalopathy?
Curr Hepatol Rep 2020 Mar;19(1):13-22. doi: 10.1007/s11901-020-00510-4..
Keywords: Nutrition, Guidelines, Evidence-Based Practice, Care Management
Parsons HM, Forte ML, Abdi HI
Nutrition as prevention for improved cancer health outcomes: a systematic literature review.
This systematic review examined evidence for the effectiveness of providing nutritional interventions before or during cancer therapy to improve cancer treatment outcomes. The studies examined focused primarily on non-vitamin/mineral dietary supplements, nutrition support, and route or timing of inpatient nutrition interventions for patients with gastrointestinal or head and neck cancer; most of the studies evaluated changes in body weight, adverse events from cancer treatment, length of hospital stay, or quality of life. While studies with low- or medium risk-of-bias reported mixed results on the effect of nutritional interventions, the authors concluded that the methodological limitations impair the translation of study findings into clinical practice or guidelines.
AHRQ-funded; 75Q80120D00008.
Citation: Parsons HM, Forte ML, Abdi HI .
Nutrition as prevention for improved cancer health outcomes: a systematic literature review.
JNCI Cancer Spectr 2023 May 2; 7(3):pkad035. doi: 10.1093/jncics/pkad035..
Keywords: Nutrition, Cancer, Prevention, Quality of Life, Evidence-Based Practice, Patient-Centered Outcomes Research
Hoch JM, Fatusin O, Yenokyan G
Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization.
The purpose of this paper was to identify types of feeding methods following stage 2 palliation and their influence on length of stay. Results showed that feeding methods established at admission for stage 2 palliation are not likely to change by discharge, and that length of stay is more likely to be impacted by tube feeding and intubation history than by age or weight-for-age z score at admission. Recommendations included a better understanding for selection of feeding methods and their impact on patient outcomes in order to develop evidence-based guidelines to decrease variability in clinical practice patterns and to provide appropriate counseling to caregivers.
AHRQ-funded; HS021114.
Citation: Hoch JM, Fatusin O, Yenokyan G .
Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization.
Congenit Heart Dis 2019 May;14(3):438-45. doi: 10.1111/chd.12742.
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Keywords: Nutrition, Newborns/Infants, Children/Adolescents, Hospitalization, Surgery, Heart Disease and Health, Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research
Greenhawt M
Environmental exposure to peanut and the risk of an allergic reaction.
The purpose of this review is to detail the medical evidence surrounding such potential risk of reaction to peanut in public venues, focusing on educational settings and commercial aircraft. It also reviews the medical evidence and best-practices regarding potential risk mitigating strategies.
AHRQ-funded; HS024599.
Citation: Greenhawt M .
Environmental exposure to peanut and the risk of an allergic reaction.
Ann Allergy Asthma Immunol 2018 May;120(5):476-81.e3. doi: 10.1016/j.anai.2018.03.011.
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Keywords: Evidence-Based Practice, Nutrition, Prevention, Risk
Lieberman JA, Greenhawt M, Nowak-Wegrzyn A
The environment and food allergy.
The authors argue that, with the recent global increase in non-communicable inflammatory conditions, including atopic disorders and food allergy specifically, identification of the environmental modifiers of the genetic susceptibility and deciphering their mechanism of action are of utmost importance. This knowledge will enable mitigation of the impact of lifestyle and dietary changes, pollution, and global warming on the expression of genetic susceptibility to atopic disorders.
AHRQ-funded; HS024599.
Citation: Lieberman JA, Greenhawt M, Nowak-Wegrzyn A .
The environment and food allergy.
Ann Allergy Asthma Immunol 2018 May;120(5):455-57. doi: 10.1016/j.anai.2018.01.010.
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Keywords: Evidence-Based Practice, Lifestyle Changes, Nutrition
Fiechtner L, Perkins M, Biggs V
Rationale and design of the Clinic and Community Approaches to Healthy Weight Randomized Trial.
Recent studies have demonstrated the effectiveness of family-centered, pediatric weight management programs in reducing childhood obesity. Yet, programs to optimize the care of low-income children with obesity are needed. The investigators sought to examine the comparative effectiveness of two, potentially scalable pediatric weight management programs delivered to low-income children in a clinical or community setting.
AHRQ-funded; HS024332; HS022986.
Citation: Fiechtner L, Perkins M, Biggs V .
Rationale and design of the Clinic and Community Approaches to Healthy Weight Randomized Trial.
Contemp Clin Trials 2018 Apr;67:16-22. doi: 10.1016/j.cct.2018.01.002..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Low-Income, Vulnerable Populations, Nutrition, Patient-Centered Healthcare, Family Health and History, Evidence-Based Practice, Comparative Effectiveness
Nowak-Wegrzyn A, Greenhawt M
The importance of food allergy to the practicing clinician.
This article introduces a theme issue on food allergy that brings an impressive lineup of state-of-the-art reviews, provocative commentaries, and innovative original research studies. It briefly summarizes the content of the various studies and commentaries included in the issue.
AHRQ-funded; HS024599.
Citation: Nowak-Wegrzyn A, Greenhawt M .
The importance of food allergy to the practicing clinician.
Ann Allergy Asthma Immunol 2018 Mar;120(3):227-28. doi: 10.1016/j.anai.2018.01.024.
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Keywords: Evidence-Based Practice, Provider: Health Personnel, Nutrition, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Greenhawt M, Bird JA, Nowak-Wegrzyn AH
Trends in provider management of patients with food protein-induced enterocolitis syndrome.
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy. This study sought to better understand provider-level variation in FPIES knowledge and management. It found that nearly one-third of respondents reported poor familiarity with FPIES. Considerable variation exists in the use of diagnostic tests, management, and choice of "safe" nutrition, indicating a strong need for FPIES practice guidelines.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Bird JA, Nowak-Wegrzyn AH .
Trends in provider management of patients with food protein-induced enterocolitis syndrome.
J Allergy Clin Immunol Pract 2017 Sep - Oct;5(5):1319-24.e12. doi: 10.1016/j.jaip.2016.11.036.
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Keywords: Diagnostic Safety and Quality, Evidence-Based Practice, Guidelines, Nutrition, Provider
Greenhawt M, Fleischer DM, Chan ES
LEAPing through the looking glass: secondary analysis of the effect of skin test size and age of introduction on peanut tolerance after early peanut introduction.
This study explored relationships between peanut tolerance, baseline peanut/egg sensitization, eczema severity/duration, age of introduction, gender, and race. It concluded that increasing peanut wheal size predicted peanut tolerance only in the avoidance arm. Peanut introduction between 6 and 11 months of age was associated with the highest rates of peanut tolerance, questioning the 'urgency' of introduction before 6 months.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Fleischer DM, Chan ES .
LEAPing through the looking glass: secondary analysis of the effect of skin test size and age of introduction on peanut tolerance after early peanut introduction.
Allergy 2017 Aug;72(8):1254-60. doi: 10.1111/all.13100.
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Keywords: Evidence-Based Practice, Nutrition, Skin Conditions, Patient-Centered Outcomes Research
Patnode CD, Evans CV, Senger CA
Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated evidence report and systematic review for the USPSTF
The researchers systematically reviewed the evidence on the benefits and harms of behavioral counseling for the primary prevention of cardiovascular disease in adults without known cardiovascular risk factors to inform the US Preventive Services Task Force (USPSTF). Diet and physical activity behavioral interventions were found to result in consistent modest benefits across a variety of important intermediate health outcomes across 6 to 12 months, including blood pressure, low-density lipoprotein and total cholesterol levels, and adiposity.
AHRQ-funded; 290201200015I.
Citation: Patnode CD, Evans CV, Senger CA .
Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated evidence report and systematic review for the USPSTF
JAMA 2017 Jul 11;318(2):175-93. doi: 10.1001/jama.2017.3303.
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Keywords: Behavioral Health, Cardiovascular Conditions, Evidence-Based Practice, Health Promotion, Lifestyle Changes, Nutrition, Prevention, Risk, U.S. Preventive Services Task Force (USPSTF)
Sathe N, Andrews JC, McPheeters ML
Nutritional and dietary interventions for autism spectrum disorder: a systematic review.
The objective of this study was to evaluate the effectiveness and safety of dietary interventions or nutritional supplements in autism spectrum disorder (ASD). Since the studies reviewed were small and short-term, and there were few fully categorized populations or concomitant interventions, the researchers concluded that there is little evidence to support the use of nutritional supplements or dietary therapies for children with ASD.
AHRQ-funded; 290201500003I.
Citation: Sathe N, Andrews JC, McPheeters ML .
Nutritional and dietary interventions for autism spectrum disorder: a systematic review.
Pediatrics 2017 Jun;139(6):e20170346. doi: 10.1542/peds.2017-0346.
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Keywords: Evidence-Based Practice, Nutrition, Vitamins and Supplements, Autism
Khatibzadeh S, Saheb Kashaf M, Micha R
A global database of food and nutrient consumption.
The authors conducted an empirical assessment of dietary intakes in order for evidence-based policy-making to address global health challenges. They derived The Global Dietary Database, which combines broad global coverage with estimates of food and nutrient consumption by age, sex and time. They believe that these data provide an empirical basis for global dietary surveillance, policy-making and priority setting to address diet-related burdens of disease.
AHRQ-funded; HS000062.
Citation: Khatibzadeh S, Saheb Kashaf M, Micha R .
A global database of food and nutrient consumption.
Bull World Health Organ 2016 Dec;94(12):931-34. doi: 10.2471/blt.15.156323.
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Keywords: Data, Evidence-Based Practice, Nutrition, Policy, Public Health
Hand RK, Kenne D, Wolfram TM
Assessing the viability of social media for disseminating evidence-based nutrition practice guideline through content analysis of twitter messages and health professional interviews: an observational study.
This study explored the potential for social media dissemination of the Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline (EBNPG) for Heart Failure (HF). ). It found that interview participants believed that social media was a useful way to gather professional information. They did not believe that social media was useful for communicating with patients.
AHRQ-funded; HS021953.
Citation: Hand RK, Kenne D, Wolfram TM .
Assessing the viability of social media for disseminating evidence-based nutrition practice guideline through content analysis of twitter messages and health professional interviews: an observational study.
J Med Internet Res 2016 Nov 15;18(11):e295. doi: 10.2196/jmir.5811.
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Keywords: Social Media, Evidence-Based Practice, Guidelines, Heart Disease and Health, Nutrition
Shaikh U, Nettiksimmons J, Joseph JG
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
The authors assessed the impact of participation in a virtual quality improvement (QI) learning network on adherence to clinical guidelines for childhood obesity prevention in rural clinics. They found that children who received care from clinicians who led the implementation of the intervention at their clinic showed significant improvements in nutrition and physical activity. Virtual QI learning networks in geographically dispersed clinics can significantly increase clinicians' adherence to guidelines for childhood obesity and improve access to recommended care for rural and underserved children.
AHRQ-funded; HS018567.
Citation: Shaikh U, Nettiksimmons J, Joseph JG .
Collaborative practice improvement for childhood obesity in rural clinics: the Healthy Eating Active Living Telehealth Community of Practice (HEALTH COP).
Am J Med Qual 2014 Nov-Dec;29(6):467-75. doi: 10.1177/1062860613506252.
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Keywords: Children/Adolescents, Evidence-Based Practice, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Obesity, Prevention, Quality Improvement, Rural Health, Telehealth