National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (1)
- Cancer (12)
- (-) Cancer: Colorectal Cancer (22)
- Cancer: Lung Cancer (2)
- Cancer: Prostate Cancer (3)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Clinical Decision Support (CDS) (1)
- Colonoscopy (5)
- Cultural Competence (1)
- Diagnostic Safety and Quality (3)
- Education: Patient and Caregiver (1)
- Elderly (2)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (1)
- Family Health and History (1)
- Genetics (1)
- Guidelines (4)
- Healthcare Costs (2)
- Health Information Technology (HIT) (2)
- Health Promotion (1)
- Low-Income (2)
- Medicare (2)
- Medication (2)
- Pain (1)
- Patient-Centered Outcomes Research (4)
- Patient Adherence/Compliance (3)
- Patient Experience (1)
- Payment (1)
- Practice Patterns (2)
- Prevention (4)
- Primary Care (3)
- Quality of Care (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Risk (2)
- Rural Health (1)
- Screening (12)
- Shared Decision Making (3)
- Stress (1)
- Surgery (2)
- Treatments (1)
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 22 of 22 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
Du XL, Zhang Y
Risks of venous thromboembolism, stroke, heart disease, and myelodysplastic syndrome associated with hematopoietic growth factors in a large population-based cohort of patients with colorectal cancer.
This study sought to determine the relationship between the receipt of colony-stimulating factors (CSFs) with erythropoiesis-stimulating agents (ESAs) and the risk of developing venous thromboembolism (VTE), stroke, heart disease, and myelodysplastic syndrome (MDS) in patients with colorectal cancer. It found that the use of ESAs was significantly associated with a substantially increased risk of MDS in patients with colorectal cancer.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y .
Risks of venous thromboembolism, stroke, heart disease, and myelodysplastic syndrome associated with hematopoietic growth factors in a large population-based cohort of patients with colorectal cancer.
Clin Colorectal Cancer 2015 Dec;14(4):e21-31. doi: 10.1016/j.clcc.2015.05.007.
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Keywords: Adverse Drug Events (ADE), Cancer: Colorectal Cancer, Cardiovascular Conditions, Patient-Centered Outcomes Research, Risk
El-Shami K, Oeffinger KC, Erb NL
American Cancer Society colorectal cancer survivorship care guidelines.
Communication and coordination of care between the treating oncologist and the primary care clinician is critical to effectively and efficiently manage the long-term care of colorectal cancer (CRC) survivors. The guidelines in this article are intended to assist primary care clinicians in delivering risk-based health care for CRC survivors who have completed active therapy.
AHRQ-funded; HS020937.
Citation: El-Shami K, Oeffinger KC, Erb NL .
American Cancer Society colorectal cancer survivorship care guidelines.
CA Cancer J Clin 2015 Nov-Dec;65(6):428-55. doi: 10.3322/caac.21286.
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Keywords: Cancer, Cancer: Colorectal Cancer, Care Coordination, Guidelines, Primary Care
Murphy DR, Wu L, Thomas EJ
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
The researchers tested whether prospective use of electronic health record-based trigger algorithms to identify patients at risk of diagnostic delays could prevent delays in diagnostic evaluation for cancer. They found that electronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up.
AHRQ-funded; HS017820.
Citation: Murphy DR, Wu L, Thomas EJ .
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
J Clin Oncol 2015 Nov 1;33(31):3560-7. doi: 10.1200/jco.2015.61.1301..
Keywords: Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer: Prostate Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Liu H, Mattke S, Predmore ZS
Medicare coverage of anesthesia services during screening colonoscopies for patients at low risk of sedation-related complications.
The authors examined the costs and potential benefit of the Medicare rule change that waived patient cost sharing for anesthesia services during screening colonoscopies. Their results cast doubt on the value associated with Medicare coverage of anesthesia services during screening colonoscopies for patients at low risk of sedation-related complications. They recommended that payers create payment bundles for endoscopy procedures that include anesthesia services in a fixed fee.
AHRQ-funded; HS000029.
Citation: Liu H, Mattke S, Predmore ZS .
Medicare coverage of anesthesia services during screening colonoscopies for patients at low risk of sedation-related complications.
JAMA Intern Med 2015 Nov;175(11):1848-50. doi: 10.1001/jamainternmed.2015.4585.
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Keywords: Adverse Drug Events (ADE), Cancer: Colorectal Cancer, Colonoscopy, Medicare, Medication
Kahn B, Freeland Z, Gopal P
Predictors of guideline concordance for surveillance colonoscopy recommendations in patients at a safety-net health system.
The aim of this study was to quantify and identify predictors for guideline-concordant surveillance recommendations after adenoma polypectomy. It found that underuse recommendations were more likely in patients with C3 adenomas; overuse recommendations were more likely in patients with high-grade dysplasia or fair prep quality and less likely in those with piecemeal resection, C3 adenomas, age>65, or Hispanic ethnicity.
AHRQ-funded; HS022418.
Citation: Kahn B, Freeland Z, Gopal P .
Predictors of guideline concordance for surveillance colonoscopy recommendations in patients at a safety-net health system.
Cancer Causes Control 2015 Nov;26(11):1653-60. doi: 10.1007/s10552-015-0661-x..
Keywords: Cancer: Colorectal Cancer, Colonoscopy, Guidelines, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Baker DW, Brown T, Goldman SN
Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers.
After an earlier outreach intervention achieved 82 percent annual adherence to colorectal cancer (CRC) screening with fecal occult blood testing (FOBT), this study assessed adherence to FOBT after a second outreach. It found that a total of 88.7 percent of patients completed a fecal immunochemical test within 6 months of their second outreach.
AHRQ-funded; HS021141.
Citation: Baker DW, Brown T, Goldman SN .
Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers.
Cancer Causes Control 2015 Nov;26(11):1685-90. doi: 10.1007/s10552-015-0650-0..
Keywords: Cancer, Cancer: Colorectal Cancer, Patient Adherence/Compliance, Prevention, Screening
Abdelsattar ZM, Birkmeyer JD, Wong SL
Variation in Medicare payments for colorectal cancer surgery.
The researchers assessed the contributions of index hospitalization, physician services, readmissions, and postacute care to the overall variation in payment for colorectal cancer surgery (CRC). They concluded that Medicare spending in the first year after CRC surgery varies across hospitals even after case-mix adjustment and price standardization. Variation is largely driven by postacute care and not the index surgical hospitalization.
AHRQ-funded; HS020937; HS000053.
Citation: Abdelsattar ZM, Birkmeyer JD, Wong SL .
Variation in Medicare payments for colorectal cancer surgery.
J Oncol Pract 2015 Sep;11(5):391-5. doi: 10.1200/jop.2015.004036.
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Keywords: Cancer, Cancer: Colorectal Cancer, Payment, Medicare, Surgery
Brenner AT, Ko LK, Janz N
Race/ethnicity and primary language: health beliefs about colorectal cancer screening in a diverse, low-income population.
The purpose of this paper was to explore whether health belief model (HBM) constructs pertaining to colorectal cancer (CRC) screening differ by race/ethnicity and primary language. Understanding how different populations think about CRC screening may be critical in promoting screening in diverse populations.
AHRQ-funded; HS013853.
Citation: Brenner AT, Ko LK, Janz N .
Race/ethnicity and primary language: health beliefs about colorectal cancer screening in a diverse, low-income population.
J Health Care Poor Underserved 2015 Aug;26(3):824-38. doi: 10.1353/hpu.2015.0075.
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Keywords: Cancer: Colorectal Cancer, Cultural Competence, Low-Income, Racial and Ethnic Minorities, Screening
Kenzik K, Pisu M, Johns SA
Unresolved pain interference among colorectal cancer survivors: Implications for patient care and outcomes.
This study describes pain interference (PI) prevalence across the cancer continuum; 2) identifies demographic and clinical factors associated with PI and changes in PI; and 3) examines PI’s relationship with survivors’ job changes. It concluded that almost half of survivors with PI during the initial phase of care had continued PI into posttreatment. Comorbidities, especially cardiovascular and pulmonary conditions, contributed to continued PI.
AHRQ-funded; HS013852.
Citation: Kenzik K, Pisu M, Johns SA .
Unresolved pain interference among colorectal cancer survivors: Implications for patient care and outcomes.
Pain Med 2015 Jul;16(7):1410-25. doi: 10.1111/pme.12727..
Keywords: Cancer, Cancer: Colorectal Cancer, Quality of Life, Pain, Patient-Centered Outcomes Research
Gallego CJ, Shirts BH, Bennette CS
Next-generation sequencing panels for the diagnosis of colorectal cancer and polyposis syndromes: a cost-effectiveness analysis.
The researchers evaluated the cost effectiveness of next-generation sequencing (NGS) panels for the diagnosis of colorectal cancer and polyposis (CRCP) syndromes in patients referred to cancer genetics clinics. They concluded that the use of an NGS panel that includes genes associated with highly penetrant CRCP syndromes in addition to Lynch syndrome genes as a first-line test is likely to provide meaningful clinical benefits in a cost-effective manner.
AHRQ-funded; HS021686.
Citation: Gallego CJ, Shirts BH, Bennette CS .
Next-generation sequencing panels for the diagnosis of colorectal cancer and polyposis syndromes: a cost-effectiveness analysis.
J Clin Oncol 2015 Jun 20;33(18):2084-91. doi: 10.1200/jco.2014.59.3665..
Keywords: Cancer, Cancer: Colorectal Cancer, Shared Decision Making, Diagnostic Safety and Quality, Genetics, Healthcare Costs, Screening
Elstad EA, Sutkowi-Hemstreet A, Sheridan SL
Clinicians' perceptions of the benefits and harms of prostate and colorectal cancer screening.
The researchers sought to understand clinicians’ perceptions of the benefits and harms of two screening tests (colonoscopy and prostate-specific antigen (PSA) testing) that differ in their balance of potential benefits and harms. Clinicians perceived PSA testing to have a greater likelihood of harm as well as a lower likelihood of lengthening life relative to colonoscopy.
AHRQ-funded; HS000032; HS021133
Citation: Elstad EA, Sutkowi-Hemstreet A, Sheridan SL .
Clinicians' perceptions of the benefits and harms of prostate and colorectal cancer screening.
Med Decis Making. 2015 May;35(4):467-76. doi: 10.1177/0272989x15569780..
Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Cancer: Prostate Cancer, Screening