National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Cancer (1)
- Cardiovascular Conditions (1)
- Caregiving (2)
- Children/Adolescents (2)
- Clinician-Patient Communication (1)
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- COVID-19 (2)
- Digestive Disease and Health (1)
- Elderly (1)
- Evidence-Based Practice (1)
- Heart Disease and Health (1)
- Imaging (1)
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- Newborns/Infants (1)
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- Obesity: Weight Management (1)
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- Patient-Centered Outcomes Research (2)
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- Provider: Physician (2)
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- (-) Shared Decision Making (11)
- Sleep Problems (1)
- (-) Surgery (11)
- Transplantation (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 11 of 11 Research Studies DisplayedWhitebird RR, Solberg LI, Ziegenfuss JY
Personalized outcomes for hip and knee replacement: the patients point of view.
Patient reported outcome measures (PROMs) are increasingly being incorporated into clinical and surgical care for assessing outcomes. This study examined outcomes important to patients in their decision to have hip or knee replacement surgery, their perspectives on PROMs and shared decision-making, and factors they considered important for postoperative care.
AHRQ-funded; HS025618.
Citation: Whitebird RR, Solberg LI, Ziegenfuss JY .
Personalized outcomes for hip and knee replacement: the patients point of view.
J Patient Rep Outcomes 2021 Nov 4;5(1):116. doi: 10.1186/s41687-021-00393-z..
Keywords: Orthopedics, Surgery, Patient-Centered Outcomes Research, Patient Experience, Shared Decision Making
Shipe ME, Baechle JJ, Deppen SA
Modeling the impact of delaying surgery for early esophageal cancer in the era of COVID-19.
Surgical society guidelines have recommended changing the treatment strategy for early esophageal cancer during the novel coronavirus (COVID-19) pandemic. Delaying resection can allow for interim disease progression, but the impact of this delay on mortality is unknown. The COVID-19 infection rate at which immediate operative risk exceeds benefit is unknown. In this study, the investigators sought to model immediate versus delayed surgical resection in a T1b esophageal adenocarcinoma.
AHRQ-funded; HS026122.
Citation: Shipe ME, Baechle JJ, Deppen SA .
Modeling the impact of delaying surgery for early esophageal cancer in the era of COVID-19.
Surg Endosc 2021 Nov;35(11):6081-88. doi: 10.1007/s00464-020-08101-6..
Keywords: COVID-19, Cancer, Surgery, Shared Decision Making, Risk
De Roo AC, Vitous CA, Rivard SJ
High-risk surgery among older adults: not-quite shared decision-making.
This study explored surgeons’ approaches to decision-making for surgery among adults ≥65 years at high-risk of postoperative complications or death. The authors conducted semistructured in-depth interviews with 46 practicing surgeons across Michigan. They found that although shared decision-making is strongly recommended, surgeons who perform high-risk operations among older adults predominantly focused on assessing risk and setting expectations with patients and families rather than inviting them to actively participate in the decision-making process. Surgeons were also influenced by quality metrics, referrals, and personal experiences.
AHRQ-funded; HS026772; HS000053.
Citation: De Roo AC, Vitous CA, Rivard SJ .
High-risk surgery among older adults: not-quite shared decision-making.
Surgery 2021 Sep;170(3):756-63. doi: 10.1016/j.surg.2021.02.005..
Keywords: Elderly, Surgery, Shared Decision Making, Patient and Family Engagement
Lumpkin ST, Harvey E, Mihas P
Understanding patients' decisions to obtain unplanned, high-resource health care after colorectal surgery.
Researchers investigated effective strategies to reduce unplanned post-discharge health care visits following colorectal surgery (CRS). They found that interview participants voiced clear mental algorithms about when to visit an emergency department, identified facilitators and barriers to optimal health care use, and identified tangible targets for health care utilization reduction efforts. The researchers concluded that efforts should be directed at improving post-discharge communication and care coordination in order to reduce CRS patients' high-resource health care utilization.
AHRQ-funded; HS026363.
Citation: Lumpkin ST, Harvey E, Mihas P .
Understanding patients' decisions to obtain unplanned, high-resource health care after colorectal surgery.
Qual Health Res 2021 Jul;31(9):1582-95. doi: 10.1177/10497323211002479..
Keywords: Shared Decision Making, Digestive Disease and Health, Surgery
Long S, Thomas GW, Karam MD
Surgical skill can be objectively measured from fluoroscopic images using a novel image-based Decision Error Analysis (IDEA) score.
This study introduces and evaluates a novel Image-based Decision Error Analysis (IDEA) score that captures performance during fluoroscopically assisted wire navigation. Findings showed that the fluoroscopic images obtained in the course of placing a guide wire contained a rich amount of information related to surgical skill. The IDEA scoring provided a basis for evaluating the competence of a resident. The score can be used to assess skill at key timepoints throughout residency, such as when rotating onto/off of a new surgical service and before performing certain procedures in the operating room, or as a tool for debriefing/providing feedback after a procedure is completed.
AHRQ-funded; HS022077; HS025353.
Citation: Long S, Thomas GW, Karam MD .
Surgical skill can be objectively measured from fluoroscopic images using a novel image-based Decision Error Analysis (IDEA) score.
Clin Orthop Relat Res 2021 Jun;479(6):1386-94. doi: 10.1097/corr.0000000000001623..
Keywords: Orthopedics, Surgery, Shared Decision Making, Medical Errors, Adverse Events, Imaging
Links AR, Callon W, Wasserman C
Treatment recommendations to parents during pediatric tonsillectomy consultations: a mixed methods analysis of surgeon language.
A deeper understanding of the dialogue clinicians use to relay treatment recommendations is needed to fully understand their influence on patient decisions about surgery. In this study, the authors characterize how otolaryngologists provide treatment recommendations and suggest a classification framework. The investigators concluded that clinicians provide treatment recommendations in a variety of ways that may introduce more or less certainty and choice to parental treatment decisions.
AHRQ-funded; HS022932.
Citation: Links AR, Callon W, Wasserman C .
Treatment recommendations to parents during pediatric tonsillectomy consultations: a mixed methods analysis of surgeon language.
Patient Educ Couns 2021 Jun;104(6):1371-79. doi: 10.1016/j.pec.2020.11.015..
Keywords: Children/Adolescents, Surgery, Caregiving, Shared Decision Making, Clinician-Patient Communication, Communication, Provider: Physician, Provider
Leu GR, Links AR, Ryan MA
Assessment of parental choice predisposition for tonsillectomy in children.
The decision to proceed with tonsillectomy to treat pediatric obstructive sleep-disordered breathing (OSDB) often falls on individual families. Despite emphasis on shared decision-making between parents and surgeons about tonsillectomy for OSDB, the extent to which parents have already decided about surgery prior to the child's consultation is not known. The objective of this study was to identify predictors of parent choice predisposition for surgical treatment of OSDB with tonsillectomy and describe its association with parent-clinician communication.
AHRQ-funded; HS022932.
Citation: Leu GR, Links AR, Ryan MA .
Assessment of parental choice predisposition for tonsillectomy in children.
JAMA Otolaryngol Head Neck Surg 2021 Mar;147(3):263-70. doi: 10.1001/jamaoto.2020.5031..
Keywords: Children/Adolescents, Caregiving, Shared Decision Making, Surgery, Sleep Problems, Respiratory Conditions
Shipe ME, Beeghly-Fadiel A, Deppen SA
Modeling the impact of delaying bariatric surgery due to COVID-19: a decision analysis.
In this study, the investigators developed a decision analysis model to evaluate risks and benefits of delaying scheduled bariatric surgery during the novel coronavirus disease (COVID-19) pandemic. Their base case was a 45-year-old female with diabetes and a body mass index of 45 kg/m(2). They compared immediate with delayed surgery after 6 months to allow for COVID-19 prevalence to decrease. The investigators found that immediate and delayed bariatric surgeries after 6 months resulted in similar 20-year overall survival.
AHRQ-funded; HS026122.
Citation: Shipe ME, Beeghly-Fadiel A, Deppen SA .
Modeling the impact of delaying bariatric surgery due to COVID-19: a decision analysis.
Obes Surg 2021 Mar;31(3):1387-91. doi: 10.1007/s11695-020-05054-6..
Keywords: Obesity: Weight Management, Obesity, COVID-19, Surgery, Shared Decision Making
Vemulakonda VM, Kempe A A, Hamer MK
Physician perspectives on discussions with parents of infants with suspected ureteropelvic junction obstruction.
The purpose of this study was to understand pediatric urologists' perceived role of patient characteristics on discussions about treatment of infants with suspected UPJ obstruction. The investigators found that physicians recognized a gap in data to guide surgical decisions and utilized personal experience to augment this gap. Physicians also recognized the influence of educational and language barriers on discussions with families and considered risk of loss to follow up when making recommendations, suggesting an implicit consideration of demographics.
AHRQ-funded; HS024597.
Citation: Vemulakonda VM, Kempe A A, Hamer MK .
Physician perspectives on discussions with parents of infants with suspected ureteropelvic junction obstruction.
J Pediatr Surg 2021 Mar;56(3):620-25. doi: 10.1016/j.jpedsurg.2020.04.016..
Keywords: Newborns/Infants, Surgery, Shared Decision Making, Provider: Physician
McKinney WT, Schaffhausen CR, Schladt D
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
The Scientific Registry of Transplant Recipients provides transplant program-specific information, but it is unclear what patients and stakeholders need to know. Acceptance criteria for the candidate waitlist and donor organs vary by program and region, but there is no means to search for programs by the clinical profiles of recipients and donors. The authors examined variability in program-specific characteristics that could influence access to transplantation.
AHRQ-funded; HS026379; HS024527.
Citation: McKinney WT, Schaffhausen CR, Schladt D .
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
Clin Transplant 2021 Feb;35(2):e14183. doi: 10.1111/ctr.14183..
Keywords: Transplantation, Surgery, Heart Disease and Health, Cardiovascular Conditions, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice, Shared Decision Making
Valentine KD, Vo H, Fowler FJ
Development and evaluation of the shared decision making process scale: a short patient-reported measure.
The Shared Decision Making (SDM) Process scale is a short patient-reported measure of the amount of SDM that occurs around a medical decision. SDM Process items have been used previously in studies of surgical decision making and exhibited discriminant and construct validity. In this study, the investigators conducted secondary data analysis across 8 studies of 11 surgical conditions with 3965 responses.
AHRQ-funded; HS025718.
Citation: Valentine KD, Vo H, Fowler FJ .
Development and evaluation of the shared decision making process scale: a short patient-reported measure.
Med Decis Making 2021 Feb;41(2):108-19. doi: 10.1177/0272989x20977878..
Keywords: Shared Decision Making, Surgery