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 21 of 21 Research Studies DisplayedMagrath M, Yang E, Ahn C
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
The goal of this study was to characterize guideline adherence of surveillance recommendations after implementation of an electronic medical record (EMR)-based Colonoscopy Pathology Reporting and Clinical Decision Support System (CoRS). Results showed that an EMR-based CoRS was widely used and significantly improved guideline adherence of surveillance recommendations.
AHRQ-funded; HS022418.
Citation: Magrath M, Yang E, Ahn C .
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
J Natl Compr Canc Netw 2018 Nov;16(11):1321-28. doi: 10.6004/jnccn.2018.7050..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Colonoscopy, Cancer: Colorectal Cancer, Screening, Cancer, Guidelines, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention
Predmore Z, Pannikottu J, Sharma R
Factors associated with the overuse of colorectal cancer screening: a systematic review.
The purpose of this systematic review was to examine factors associated with overuse of colorectal cancer (CRC) screening, using studies that were in English, used a U.S. population, and contained original data. The review indicates that overuse of CRC screening was greater in the Northeast/Mid-Atlantic regions and in urban areas, but was lower in academically affiliated centers. The authors conclude that, although the literature supports important overuse of CRC screening, what drives these practices remains unclear and that future research should explore these factors thoroughly.
AHRQ-funded; HS000029.
Citation: Predmore Z, Pannikottu J, Sharma R .
Factors associated with the overuse of colorectal cancer screening: a systematic review.
Am J Med Qual 2018 Sep/Oct;33(5):472-80. doi: 10.1177/1062860618764302..
Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Prevention, Screening
Lewis CL, Kistler CE, Dalton AF
A decision aid to promote appropriate colorectal cancer screening among older adults: a randomized controlled trial.
The purpose of this study was to test a patient decision aid (PtDA) to promote CRC screening in older adults. The PtDA was designed to facilitate individual decision-making to help patients understand the potential risks and benefit of CRC screening. 424 patients aged 70 – 84 who were not up to date with CRC screening participated in a double-blinded randomized controlled trial, using the PtDA or an attention control. Two outcomes - appropriate CRC screening behavior at 6 months following the initial visit or appropriate screening intent immediately after the visit - were defined as completed screening or intent for patients in good health, discussion about screening with their provider for patients in intermediate health, or no screening or intent for patients in poor health. Appropriate screening behavior at 6 months was higher in the intervention group; appropriate screening intent following the provider visit was also higher. The authors conclude that the PtDA for older adults promoted appropriate CRC screening behavior.
AHRQ-funded; HS021133.
Citation: Lewis CL, Kistler CE, Dalton AF .
A decision aid to promote appropriate colorectal cancer screening among older adults: a randomized controlled trial.
Med Decis Making 2018 Jul;38(5):614-24. doi: 10.1177/0272989x18773713..
Keywords: Cancer, Cancer: Colorectal Cancer, Shared Decision Making, Education: Patient and Caregiver, Elderly, Prevention, Screening
Kanters AE, Morris AM, Albrahamse PH
The effect of peer support on colorectal cancer patients' adherence to guideline-concordant multidisciplinary care.
Dis Colon Rectum 2018 Jul;61(7):817-23. doi: 10.1097/dcr.0000000000001067.
The purpose of this study was to evaluate the effect of peer support on the attitudes of patients with colorectal cancer toward chemotherapy and their adherence to it. The study demonstrated that exposure to peer support is associated with higher adjuvant chemotherapy adherence.
The purpose of this study was to evaluate the effect of peer support on the attitudes of patients with colorectal cancer toward chemotherapy and their adherence to it. The study demonstrated that exposure to peer support is associated with higher adjuvant chemotherapy adherence.
AHRQ-funded; HS000053.
Citation: Kanters AE, Morris AM, Albrahamse PH .
The effect of peer support on colorectal cancer patients' adherence to guideline-concordant multidisciplinary care.
Dis Colon Rectum 2018 Jul;61(7):817-23. doi: 10.1097/dcr.0000000000001067..
Keywords: Cancer: Colorectal Cancer, Treatments, Guidelines, Medication, Patient Adherence/Compliance
Abelson JS, Chait A, Shen MJ
Sources of distress among patients undergoing surgery for colorectal cancer: a qualitative study.
The objective of this qualitative study was to explore sources of distress among colorectal cancer patients undergoing surgery. The investigators found that patients identified sources of stress at preoperative, in-hospital recovery and postoperative stages. Sources of stress included, but were not limited to: emotional reaction to diagnosis, negative emotional reaction to having a surgery, dealing with distressing physical symptoms and complications after surgery.
AHRQ-funded; HS000066.
Citation: Abelson JS, Chait A, Shen MJ .
Sources of distress among patients undergoing surgery for colorectal cancer: a qualitative study.
J Surg Res 2018 Jun;226:140-49. doi: 10.1016/j.jss.2018.01.017..
Keywords: Adverse Events, Cancer, Cancer: Colorectal Cancer, Stress, Surgery
Kistler CE, Vu M, Sutkowi-Hemstreet A
Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening.
This study sought to examine circumstances under which primary-care providers would discuss and recommend two types of cancer screening services across a spectrum of net benefit and other factors known to influence screening. While most providers' reported practice patterns aligned with net benefit, some providers would discuss and recommend low-value cancer screening, particularly when faced with a patient request.
AHRQ-funded; HS019468; HS021133.
Citation: Kistler CE, Vu M, Sutkowi-Hemstreet A .
Exploring factors that might influence primary-care provider discussion of and recommendation for prostate and colon cancer screening.
Int J Gen Med 2018 May 17;11:179-90. doi: 10.2147/ijgm.s153887..
Keywords: Cancer: Colorectal Cancer, Cancer: Prostate Cancer, Primary Care, Practice Patterns, Screening
Singal AG, Corley DA, Kamineni A
Patterns and predictors of repeat fecal immunochemical and occult blood test screening in four large health care systems in the United States.
The objectives of this study were to characterize screening patterns and identify factors associated with repeat screening among patients who completed an index guaiac fecal occult blood test (gFOBT) or fecal immunochemical test (FIT). The investigators found that screening patterns varied substantially across healthcare systems, with consistent screening proportions ranging from 1 to 54.3% and no repeat screening proportions ranging from 6.9 to 42.8%. Consistent screening increased with older age but was less common among racial/ethnic minorities and patients with more comorbidities.
AHRQ-funded; HS022418.
Citation: Singal AG, Corley DA, Kamineni A .
Patterns and predictors of repeat fecal immunochemical and occult blood test screening in four large health care systems in the United States.
Am J Gastroenterol 2018 May;113(5):746-54. doi: 10.1038/s41395-018-0023-x..
Keywords: Screening, Cancer: Colorectal Cancer, Cancer, Practice Patterns, Diagnostic Safety and Quality
Roydhouse JK, Gutman R, Keating NL
Differences between proxy and patient assessments of cancer care experiences and quality ratings.
This study assessed the impact of proxy survey responses on cancer care experience reports and quality ratings. Adjusted proxy scores were modestly higher for medical care experiences but lower for nursing care and care coordination experiences. There were no significant differences between adjusted patient and proxy ratings of quality.
AHRQ-funded; HS000011.
Citation: Roydhouse JK, Gutman R, Keating NL .
Differences between proxy and patient assessments of cancer care experiences and quality ratings.
Health Serv Res 2018 Apr;53(2):919-43. doi: 10.1111/1475-6773.12672.
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Keywords: Cancer, Cancer: Colorectal Cancer, Cancer: Lung Cancer, Quality of Care, Patient Experience
Davis MM, Freeman M, Shannon J
A systematic review of clinic and community intervention to increase fecal testing for colorectal cancer in rural and low-income populations in the United States - how, what and when?
Researchers conducted this systematic review to determine how implementation strategies and contextual factors influenced the uptake of interventions to increase fecal testing for colorectal cancer in rural and low-income populations. They found that provision of kits through the mail, use of pre-addressed stamped envelopes, client reminders and in-clinic distribution appeared most frequently in the highly effective/effective clinic-based study arms. Few studies described contextual factors or implementation strategies.
AHRQ-funded; HS022981.
Citation: Davis MM, Freeman M, Shannon J .
A systematic review of clinic and community intervention to increase fecal testing for colorectal cancer in rural and low-income populations in the United States - how, what and when?
BMC Cancer 2018 Jan 6;18(1):40. doi: 10.1186/s12885-017-3813-4.
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Keywords: Cancer: Colorectal Cancer, Health Promotion, Low-Income, Rural Health, Screening
Naber SK, Kuntz KM, Henrikson NB
AHRQ Author: Ganiats TG
Cost effectiveness of age-specific screening intervals for people with family histories of colorectal cancer.
Despite relative risk of colorectal cancer (CRC) decreasing with age among individuals with a family history of CRC, no screening recommendations specify less frequent screening. Researchers found that for individuals with a family history of CRC, it is cost effective to gradually increase the screening interval if several subsequent screening colonoscopies have negative results and no new cases of CRC are found in family members.
AHRQ-authored.
Citation: Naber SK, Kuntz KM, Henrikson NB .
Cost effectiveness of age-specific screening intervals for people with family histories of colorectal cancer.
Gastroenterology 2018 Jan;154(1):105-16.e20. doi: 10.1053/j.gastro.2017.09.021.
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Keywords: Cancer: Colorectal Cancer, Healthcare Costs, Family Health and History, Risk, Screening
Kistler CE, Golin C, Sundaram A
Individualized colorectal cancer screening discussions between older adults and their primary care providers: a cross-sectional study.
The aim of this study was to describe colorectal cancer (CRC) screening discussions and explore their associations with patient characteristics and screening intentions. The investigators found that CRC screening discussions varied by type of participant and content. They assert that future work is needed to determine if interventions focused on specific domains alters the appropriateness of participants' colorectal cancer screening intentions.
AHRQ-funded; HS021133.
Citation: Kistler CE, Golin C, Sundaram A .
Individualized colorectal cancer screening discussions between older adults and their primary care providers: a cross-sectional study.
MDM Policy Pract 2018 Jan-Jun;3(1):2381468318765172. doi: 10.1177/2381468318765172..
Keywords: Cancer: Colorectal Cancer, Shared Decision Making, Elderly, Primary Care, Screening
Elstad EA, Sheridan SL, Lee JG
Have screening harms become newsworthy? News coverage of prostate and colorectal cancer screening since the 2008 USPSTF recommendation changes.
The researchers aimed to determine whether newspapers portrayed screening for prostate and colorectal cancers differently after the 2008 USPSTF recommendation changes. In US newspapers from 2005 to 2012, they found that benefits in prostate cancer screening articles and harms and benefits in colonoscopy articles did not change over time, but mentions of prostate cancer screening harms increased after 2008. They concluded that consumers, especially lay consumers, are receiving unbalanced information on cancer screening.
AHRQ-funded; HS021133; HS000032.
Citation: Elstad EA, Sheridan SL, Lee JG .
Have screening harms become newsworthy? News coverage of prostate and colorectal cancer screening since the 2008 USPSTF recommendation changes.
J Behav Med 2014 Dec;37(6):1242-51. doi: 10.1007/s10865-014-9572-7.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Cancer: Prostate Cancer, Screening, U.S. Preventive Services Task Force (USPSTF)
Abdelsattar ZM, Wong SL, Birkmeyer NJ
Multi-institutional assessment of sphincter preservation for rectal cancer.
This study sought to identify whether variation in sphincter preservation surgery (SPS) rates for patients with rectal cancer can be explained by patient, tumor, or treatment-related factors across hospitals. It found that SPS rates vary by hospital, even after accounting for clinical characteristics using detailed chart review.
AHRQ-funded; HS000053
Citation: Abdelsattar ZM, Wong SL, Birkmeyer NJ .
Multi-institutional assessment of sphincter preservation for rectal cancer.
Ann Surg Oncol. 2014 Dec;21(13):4075-80. doi: 10.1245/s10434-014-3882-4..
Keywords: Cancer: Colorectal Cancer, Quality of Care, Surgery
Pignone MP, Crutchfield TM, Brown PM
Using a discrete choice experiment to inform the design of programs to promote colon cancer screening for vulnerable populations in North Carolina.
This study used a discrete choice experiment (DCE) to learn about how vulnerable individuals in North Carolina value different aspects of CRC screening programs. It found that follow-up cost coverage was most frequently found to be the most important attribute from the DCE (47 percent); followed by test reward/copayment (33 percent).
AHRQ-funded; HS019468.
Citation: Pignone MP, Crutchfield TM, Brown PM .
Using a discrete choice experiment to inform the design of programs to promote colon cancer screening for vulnerable populations in North Carolina.
BMC Health Serv Res 2014 Nov 30;14:611. doi: 10.1186/s12913-014-0611-4..
Keywords: Cancer: Colorectal Cancer, Health Promotion, Rural Health, Screening, Social Determinants of Health
Rabin BA, Ellis JL, Steiner JF
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
The authors described health service utilization patterns of subgroups of prostate cancer and colorectal cancer (CRC) patients with different relative probabilities of dying of their cancer or other conditions. They found that although a new diagnosis of cancer increased utilization of cancer-related services for an extended time period, the timing of cancer diagnosis did not appear to affect other types of utilization.
AHRQ-funded; HS019520.
Citation: Rabin BA, Ellis JL, Steiner JF .
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
J Natl Cancer Inst Monogr 2014 Nov;2014(49):275-81. doi: 10.1093/jncimonographs/lgu023.
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Keywords: Cancer: Prostate Cancer, Cancer: Colorectal Cancer, Cancer, Healthcare Utilization, Mortality, Healthcare Delivery
Thompson CA, Gomez SL, Chan A
Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.
The researchers performed multivariable modeling to evaluate potential predictors (at the provider- and patient-level) of screening completion among Asian patients. They concluded that language- and gender-concordant primary care providers and culturally tailored online health resources may help improve preventive cancer screening in Asian patient populations.
AHRQ-funded; HS019815.
Citation: Thompson CA, Gomez SL, Chan A .
Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.
Cancer Epidemiol Biomarkers Prev 2014 Nov;23(11):2208-17. doi: 10.1158/1055-9965.epi-14-0487..
Keywords: Cancer: Breast Cancer, Cancer: Cervical Cancer, Cancer: Colorectal Cancer, Healthcare Utilization, Screening
Feuer EJ, Rabin BA, Zou Z
The Surveillance, Epidemiology, and End Results Cancer Survival Calculator SEER*CSC: validation in a managed care setting.
The researchers externally validate the nomograms for prostate and colorectal cancer using data from Kaiser Permanente Colorado. Their results indicated that the colorectal and prostate cancer nomograms are reliable tools for physicians and patients to use to obtain information on prognosis and assist in establishing priorities for both treatment of the cancer and other conditions, particularly when a patient is elderly and/or has significant comorbidities.
AHRQ-funded; HS019520.
Citation: Feuer EJ, Rabin BA, Zou Z .
The Surveillance, Epidemiology, and End Results Cancer Survival Calculator SEER*CSC: validation in a managed care setting.
J Natl Cancer Inst Monogr 2014 Nov;2014(49):265-74. doi: 10.1093/jncimonographs/lgu021.
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Keywords: Cancer: Colorectal Cancer, Cancer: Prostate Cancer, Cancer, Mortality
Lairson DR, Parikh RC, Cormier JN
Cost-utility analysis of chemotherapy regimens in elderly patients with stage III colon cancer.
The authors investigated community-level evidence on the effectiveness and cost effectiveness of treatment for stage III colon cancer for elderly patients among those receiving no chemotherapy, 5-fluorouracil (5-FU), and FOLFOX (5-FU + oxaliplatin). They concluded that FOLFOX appears more effective and cost effective than other strategies for colon cancer treatment of older patients, with results being sensitive to age.
AHRQ-funded; HS018956.
Citation: Lairson DR, Parikh RC, Cormier JN .
Cost-utility analysis of chemotherapy regimens in elderly patients with stage III colon cancer.
Pharmacoeconomics 2014 Oct;32(10):1005-13. doi: 10.1007/s40273-014-0180-8.
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Keywords: Cancer: Colorectal Cancer, Comparative Effectiveness, Healthcare Costs, Elderly, Patient-Centered Outcomes Research
Zhang Y, Fu SS, Du XL
Increasing utilization and predictors of hematopoietic growth factors in patients diagnosed with colorectal cancer: findings from a large national population-based cohort in the USA, 1992-2009.
The authors examined the temporal trend and predictors of receiving hematopoietic growth factors in a large nationwide and population-based cohort of patients with colorectal cancer in the USA from 1992 to 2009. They found that gender, marital status, comorbidity scores, geographic area, year of diagnosis, tumor stage, number of lymph nodes, and risk profile for febrile neutropenia were statistically significant predictors of using colony-stimulating factors and erythropoiesis-stimulating agents.
AHRQ-funded; HS018956.
Citation: Zhang Y, Fu SS, Du XL .
Increasing utilization and predictors of hematopoietic growth factors in patients diagnosed with colorectal cancer: findings from a large national population-based cohort in the USA, 1992-2009.
Med Oncol 2014 Oct;31(10):242. doi: 10.1007/s12032-014-0242-y.
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Keywords: Cancer: Colorectal Cancer, Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Wheeler SB, Kuo TM, Goyal RK
Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population.
The researchers examined colorectal cancer (CRC) testing across regions of North Carolina by using population-based Medicare and Medicaid claims data from disabled individuals who turned 50 years of age during 2003-2008. They found that fewer than 50% of eligible individuals had evidence of CRC testing; men, African-Americans, Medicaid beneficiaries, and those living furthest away from endoscopy facilities had significantly lower odds of CRC testing, with significant regional variation.
AHRQ-funded; HS019468.
Citation: Wheeler SB, Kuo TM, Goyal RK .
Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population.
Health Place 2014 Sep;29:114-23. doi: 10.1016/j.healthplace.2014.07.001.
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Keywords: Access to Care, Cancer: Colorectal Cancer, Disparities, Screening, Social Determinants of Health
Pruitt SL, Leonard T, Zhang S
Physicians, clinics, and neighborhoods: multiple levels of influence on colorectal cancer screening.
The researchers described variability in colorectal cancer (CRC) test use across multiple levels, including physician, clinic, and neighborhood; and (ii) compared the performance of novel cross-classified models versus traditional hierarchical models. Significant variability was observed across all levels in both hierarchical and cross-classified models that was unexplained by measured covariates. For colonoscopy, variance was similar across all levels.
AHRQ-funded; HS022418.
Citation: Pruitt SL, Leonard T, Zhang S .
Physicians, clinics, and neighborhoods: multiple levels of influence on colorectal cancer screening.
Cancer Epidemiol Biomarkers Prev 2014 Jul;23(7):1346-55. doi: 10.1158/1055-9965.epi-13-1130..
Keywords: Cancer: Colorectal Cancer, Diagnostic Safety and Quality, Screening