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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 13 of 13 Research Studies DisplayedMcGinn T, Cohen S, Khan S
The high cost of low value care.
The main focus of this study was bridging the "evidence gap" between frontline decision-making in health care and the actual evidence, with the hope of reducing unnecessary diagnostic testing and treatments. From their work in pulmonary embolism (PE) and over ordering of computed tomography pulmonary angiography, the investigators integrated the highly validated Wells' criteria into the electronic health record at two of their major academic tertiary hospitals.
AHRQ-funded; HS022061.
Citation: McGinn T, Cohen S, Khan S .
The high cost of low value care.
Trans Am Clin Climatol Assoc 2019;130:60-70..
Keywords: Healthcare Costs, Evidence-Based Practice, Patient-Centered Outcomes Research, Shared Decision Making, Comparative Effectiveness
Skrivankova V, Heagerty PJ
Single index methods for evaluation of marker-guided treatment rules based on multivariate marker panels.
Answering the scientific challenge to identify and validate the factors that can reliably be used to target treatment and to quantify the expected treatment benefit as a function of candidate markers, the authors of this article propose to focus on a smooth, non-parametric evaluation of a canonical single-index score that estimates the expected treatment benefit associated with patient characteristics. Their methods decouple the model used to generate the treatment benefit score from the methods adopted in order to evaluate the performance of the resulting single-index score. They also demonstrate that the canonical single-index treatment benefit score can be used for selecting subsets of patients with enriched expected treatment response.
AHRQ-funded; HS019222.
Citation: Skrivankova V, Heagerty PJ .
Single index methods for evaluation of marker-guided treatment rules based on multivariate marker panels.
Biometrics 2018 Jun;74(2):663-72. doi: 10.1111/biom.12752..
Keywords: Comparative Effectiveness, Shared Decision Making, Outcomes, Treatments
Semenkovich TR, Panni RZ, Hudson JL
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
This study examined comparative effectiveness and survival rates for upfront esophagectomy versus induction chemoradiation in patients with clinical stage T2N20 esophageal cancer. A decision analysis model was created for the two treatment strategies. Results showed comparable median survival rates for both strategies. The optimal treatment strategy depended on the accuracy of endoscopic ultrasound staging.
AHRQ-funded; HS022330.
Citation: Semenkovich TR, Panni RZ, Hudson JL .
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
J Thorac Cardiovasc Surg 2018 May;155(5):2221-30.e1. doi: 10.1016/j.jtcvs.2018.01.006..
Keywords: Treatments, Cancer, Surgery, Comparative Effectiveness, Shared Decision Making, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes, Medication
LeBlanc A, Herrin J, Williams MD
Shared decision making for antidepressants in primary care: a cluster randomized trial.
The researchers estimated the effect of the Depression Medication Choice (DMC) encounter decision aid on quality of the decision‐making process and depression outcomes. They found that the DMC decision aid helped primary care clinicians and patients with moderate to severe depression select antidepressants together, improving the decision-making process without extending the visit.
AHRQ-funded; HS019214.
Citation: LeBlanc A, Herrin J, Williams MD .
Shared decision making for antidepressants in primary care: a cluster randomized trial.
JAMA Intern Med 2015 Nov;175(11):1761-70. doi: 10.1001/jamainternmed.2015.5214..
Keywords: Medication, Comparative Effectiveness, Shared Decision Making, Primary Care
Whicher DM, Miller JE, Dunham KM
Gatekeepers for pragmatic clinical trials.
The authors provided a framework to help guide gatekeepers' decision-making related to the use of resources for pragmatic clinical trials. They stated that recognition of the complex set of considerations that should inform decision-making will guide gatekeepers in making justifiable choices regarding the use of limited and valuable resources.
AHRQ-funded; HS000029.
Citation: Whicher DM, Miller JE, Dunham KM .
Gatekeepers for pragmatic clinical trials.
Clin Trials 2015 Oct;12(5):442-8. doi: 10.1177/1740774515597699.
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Keywords: Shared Decision Making, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Research Methodologies
Fischer MA, Allen-Coleman C, Farrell SF
Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.
Because children, pregnant women and people with mental illness have generally been underrepresented in research discussions, comparative effectiveness rsearch (CER) questions for these groups may be understudied. To address this problem, AHRQ commissioned a team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, they developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide.
AHRQ-funded; 290200500161.
Citation: Fischer MA, Allen-Coleman C, Farrell SF .
Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.
J Comp Eff Res 2015 Sep;4(5):465-71. doi: 10.2217/cer.15.26.
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Keywords: Comparative Effectiveness, Medicaid, Research Methodologies, Shared Decision Making, Vulnerable Populations
Parmar AD, Sheffield KM, Adhikari D
PREOP-Gallstones: a prognostic nomogram for the management of symptomatic cholelithiasis in older patients.
The objective of this study was to develop and validate a risk prediction model that would identify older patients who are at highest risk for recurrent episodes. It concluded that surgeons can use a prognostic nomogram to accurately provide patients with their 2-year risk of developing gallstone-related complications, allowing patients and physicians to make informed decisions in the context of their symptom severity and its impact on their quality of life.
AHRQ-funded; HS022134
Citation: Parmar AD, Sheffield KM, Adhikari D .
PREOP-Gallstones: a prognostic nomogram for the management of symptomatic cholelithiasis in older patients.
Ann Surg. 2015 Jun;261(6):1184-90. doi: 10.1097/sla.0000000000000868..
Keywords: Comparative Effectiveness, Risk, Elderly, Shared Decision Making
Carman KL, Mallery C, Maurer M
Effectiveness of public deliberation methods for gathering input on issues in healthcare: results from a randomized trial.
The researchers conducted a 5-arm randomized controlled trial, assigning participants to one of four deliberative methods or to a reading materials only control group. They found that participating in deliberation increased participants' knowledge of evidence and comparative effectiveness research and shifted participants' attitudes regarding the role of evidence in decision-making.
AHRQ-funded; 290201000005C.
Citation: Carman KL, Mallery C, Maurer M .
Effectiveness of public deliberation methods for gathering input on issues in healthcare: results from a randomized trial.
Soc Sci Med 2015 May;133:11-20. doi: 10.1016/j.socscimed.2015.03.024..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Research Methodologies, Shared Decision Making
Samwald M, Minarro Gimenez JA, Boyce RD
Pharmacogenomic knowledge representation, reasoning and genome-based clinical decision support based on OWL 2 DL ontologies.
The authors developed Web Ontology Language (OWL) ontologies and automated reasoning methodologies to meet various goals such as providing a simple and concise formalism for representing pharmacogenomic knowledge. Their ontology-based framework can be used to represent, organize and reason over the growing wealth of pharmacogenomic knowledge, as well as to identify errors, inconsistencies and insufficient definitions in source data sets or individual patient data.
AHRQ-funded; HS019461.
Citation: Samwald M, Minarro Gimenez JA, Boyce RD .
Pharmacogenomic knowledge representation, reasoning and genome-based clinical decision support based on OWL 2 DL ontologies.
BMC Med Inform Decis Mak 2015 Feb 22;15:12. doi: 10.1186/s12911-015-0130-1..
Keywords: Comparative Effectiveness, Health Information Technology (HIT), Shared Decision Making, Medication, Genetics
Patel MB, Humble SS, Cullinane DC
Cervical spine collar clearance in the obtunded adult blunt trauma patient: a systematic review and practice management guideline from the Eastern Association for the Surgery of Trauma.
The authors’ aims were to perform a systematic review and to develop evidence-based recommendations that might be used to direct decision making in the removal of a cervical collar from adult obtunded blunt trauma patients. In conclusion, they conditionally recommended cervical collar removal after a negative high-quality C-spine CT scan result alone.
AHRQ-funded; HS017952.
Citation: Patel MB, Humble SS, Cullinane DC .
Cervical spine collar clearance in the obtunded adult blunt trauma patient: a systematic review and practice management guideline from the Eastern Association for the Surgery of Trauma.
J Trauma Acute Care Surg 2015 Feb;78(2):430-41. doi: 10.1097/ta.0000000000000503..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Guidelines, Trauma, Shared Decision Making
Concannon TW, Fuster M, Saunders T
A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research.
This study reviewed 70 articles on methods of stakeholder engagement in comparative effectiveness research and patient-centered outcomes research. The authors found frequent engagement with patients, modestly frequent engagement with clinicians, and infrequent engagement with other stakeholders.The roles and activities of stakeholders were highly variable across research and program reports.
AHRQ-funded; HS017726
Citation: Concannon TW, Fuster M, Saunders T .
A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research.
J Gen Intern Med. 2014 Dec;29(12):1692-701. doi: 10.1007/s11606-014-2878-x..
Keywords: Comparative Effectiveness, Clinician-Patient Communication, Shared Decision Making
Tang DH, Warholak TL, Hines LE
Evaluation of Pharmacy and Therapeutic (P&T) Committee member knowledge, attitudes and ability regarding the use of comparative effectiveness research (CER) in health care decision-making.
This study was conducted to evaluate changes in CER knowledge, attitudes, and ability among Pharmacy and Therapeutics (P&T) Committee members and support staff after attending a tailored educational program. It found that the CER educational program was effective in increasing participants’ CER knowledge and self-perceived ability to evaluate relevant evidence.
AHRQ-funded; HS019220.
Citation: Tang DH, Warholak TL, Hines LE .
Evaluation of Pharmacy and Therapeutic (P&T) Committee member knowledge, attitudes and ability regarding the use of comparative effectiveness research (CER) in health care decision-making.
Res Social Adm Pharm 2014 Sep-Oct;10(5):768-80. doi: 10.1016/j.sapharm.2013.11.008..
Keywords: Comparative Effectiveness, Shared Decision Making, Evidence-Based Practice
Lau BD, Haut ER
Practices to prevent venous thromboembolism: a brief review.
The purpose of this review is to provide an update on the most effective interventions aimed at improving adherence to guidelines on the use of venous thromboembolism (VTE) prevention strategies. After reviewing sixteen studies, the researchers concluded that the greatest and most sustained improvements were those that combined education with computerised tools.
AHRQ-funded; 290200710.
Citation: Lau BD, Haut ER .
Practices to prevent venous thromboembolism: a brief review.
BMJ Qual Saf 2014 Mar;23(3):187-95. doi: 10.1136/bmjqs-2012-001782..
Keywords: Comparative Effectiveness, Blood Clots, Prevention, Shared Decision Making, Guidelines