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- Access to Care (2)
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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 12 of 12 Research Studies DisplayedPatel KR, Justiz AM, Ahmed AM
Association of vitiligo and inflammatory arthropathy in hospitalized US adults.
The purpose of this study was to explore the relationships between vitiligo and autoimmune arthropathies. The researchers analyzed data from the 2002-2016 Nationwide Inpatient Sample (NIS) according to Healthcare Cost and Utilization Project (HCUP) policies. Between 2002 and 2016, 96,970,768 admissions were captured, including 18,231 (0.02%) with vitiligo. The study found that vitiligo was significantly associated with higher odds of any inflammatory arthritis, psoriatic arthritis, rheumatoid arthritis, and other inflammatory arthritis, with a trend toward significance with reactive arthritis and ankylosing spondylitis.
AHRQ-funded; HS023011.
Citation: Patel KR, Justiz AM, Ahmed AM .
Association of vitiligo and inflammatory arthropathy in hospitalized US adults.
J Am Acad Dermatol 2023 Dec; 89(6):1256-57. doi: 10.1016/j.jaad.2023.07.1015..
Keywords: Arthritis, Chronic Conditions, Skin Conditions
Erickson T, Daftary K, Quan VL
Capturing the diversity of dermatology-what's in a name?
This article discusses the use of the term skin of color (SOC) in dermatology and how certain individuals with less skin pigment may socially consider themselves to be SOC, while the inverse is true. The authors sought to highlight strengths and weaknesses of the current terminology used in SOC dermatology and recommend a more holistic understanding of reported differences, including a framework reflective of upstream socioeconomic, environmental, and historical factors that may be most relevant to reported associations.
AHRQ-funded; HS026385.
Citation: Erickson T, Daftary K, Quan VL .
Capturing the diversity of dermatology-what's in a name?
Am J Clin Dermatol 2023 Sep; 24(5):675-80. doi: 10.1007/s40257-023-00800-9..
Keywords: Skin Conditions, Racial and Ethnic Minorities
Smith JH, Silverberg JI
Correlation of clinician-reported outcomes with patient-reported outcomes by race and ethnicity in patients with atopic dermatitis.
This study examined the correlation of clinician-reported outcome measures (ClinROMs) with patient-reported outcomes by race and ethnicity in patients with atopic dermatitis (AD). A prospective, dermatology practice-based study was conducted with children and adults with AD for patients enrolled January 2014 through September 2019. Electronic surveys were completed by patients or caregivers, including self-identified race and Hispanic ethnicity, Numerical Rating Scale (NRS) for average itch in the past 7 days, and Patient Oriented Eczema Measure (POEM). Different severity indexes including Ezcema Area and Severity Index (EASI), and objective-SCORing Atopic Dermatitis Index (SCORAD) were used by a dermatologist to perform total body skin assessments. Spear correlations were performed for POEM and NRS-itch versus objective-SCORAD and EASI. Overall, 1987 patients were included in the study (age less than 18 years: 101 [5.08%], age greater or equal to 18 years: 1886 [94.92%]), including 198 (9.96%) Black, 360 (18.12%) Asian, 8 (0.40%) Multiracial/Other, 1313 (66.08%) White, and 108 (5.44%) Hispanic. Black patients had a moderate correlation for POEM with objective-SCORAD and EASI, while NRS average-itch had a weak-moderate correlation. In White patients there were strong correlations for both measures. Patients who were Asian/Pacific Islander had numerically weaker correlations of POEM but strong or very strong correlations of NRS average-itch with objective-SCORAD and EASI compared to White patients while patients with Hispanic ethnicity also showed numerically weaker correlations for POEM with objective-SCORAD and EASI, and weaker correlations of NRS average-itch with EASI.
AHRQ-funded; HS023011.
Citation: Smith JH, Silverberg JI .
Correlation of clinician-reported outcomes with patient-reported outcomes by race and ethnicity in patients with atopic dermatitis.
J Am Acad Dermatol 2023 Sep; 89(3):579-80. doi: 10.1016/j.jaad.2023.04.050..
Keywords: Racial and Ethnic Minorities, Skin Conditions, Outcomes
Jackson-Cowan L, Silverberg JI
Longitudinal course of cognitive impairment in patients with atopic dermatitis.
This study’s objective was to investigate the longitudinal course predictors of cognitive impairment (CI) in atopic dermatitis (AD). A prospective dermatology practice-based study was performed using questionnaires and evaluation by a dermatologist (n = 210). Patients with 2 or more visits were included, and cognitive function was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function 8-item Short-Form. At baseline, 20.85% of patients had PROMIS T scores greater or equal to 45, indicating CI. Among patients with baseline CI, 34.09% had persistent CI, 47.72% had a fluctuating course, and 18.18% had sustained improvement of cognitive function. In repeated-measures regression models, cognitive function scores declined overtime in patients with worse AD severity [SCORing Atopic Dermatitis (SCORAD), Atopic Dermatitis Severity Index:, increased itch, skin pain, and sleep disturbance. Persistent CI was associated with female gender and depressive symptoms. Two classes of cognitive dysfunction were identified using latent class analysis: normal cognition (77.23%), moderate dysfunction (16.21%) and severe impairment (6.55%). Black/African-American race, moderate-to-severe SCORAD, dermatology life quality index, Patient Health Questionnaire-9 (PHQ9), itch and skin pain were more likely to experience moderate dysfunction or severe cognitive impairment.
AHRQ-funded; HS023011.
Citation: Jackson-Cowan L, Silverberg JI .
Longitudinal course of cognitive impairment in patients with atopic dermatitis.
Arch Dermatol Res 2023 Aug; 315(6):1553-60. doi: 10.1007/s00403-023-02536-2..
Keywords: Skin Conditions
Pagani K, Lukac D, Olbricht SM
Urgent referrals from primary care to dermatology for lesions suspicious for skin cancer: patterns, outcomes, and need for systems improvement.
The purpose of this study was to explore primary care and dermatology triaging and processing of urgent dermatology referrals. The researchers conducted chart reviews of all dermatology referrals designated by primary care as urgent for evaluation of a lesion concerning for skin cancer. Dermatology encounters for patients occurred on or before 30 days for 50.6% of referrals and on or after 31 days for 38.4% of referrals, with 10.9% never completed. The rate of non-English languages in the delayed group was 7.1% greater than in the timely group. The rate of all races excluding whites, non-Hispanic in the delayed appointment group (31 days or more) was 15.1% greater than in the timely appointment group (30 days or less). Overall, 15.8% of referrals yielded malignancy diagnoses, while 76.8% and 7.4% resulted in benign and pre-malignant diagnoses, respectively. The primary care team documented completed, incomplete, or pending referral status during their subsequent visits with the patients in only 37.5% of the referrals.
AHRQ-funded; HS027282.
Citation: Pagani K, Lukac D, Olbricht SM .
Urgent referrals from primary care to dermatology for lesions suspicious for skin cancer: patterns, outcomes, and need for systems improvement.
Arch Dermatol Res 2023 Jul; 315(5):1397-400. doi: 10.1007/s00403-022-02456-7..
Keywords: Cancer: Skin Cancer, Cancer, Primary Care, Skin Conditions, Access to Care
Chatrath S, Silverberg JI
Phenotypic differences of atopic dermatitis stratified by age.
Atopic dermatitis (AD) is a prevalent condition affecting individuals of all age groups. A deeper understanding of the diverse age-related phenotypes can enhance AD treatment strategies. The purpose of this study was to identify clinical phenotypes of AD associated with different age groups. A prospective study involving 380 participants was conducted in a dermatology practice setting. AD severity was assessed through questionnaires and comprehensive physical examinations. The study included 23 (6.1%) pediatric patients (<18 years), 176 (46.3%) young adults (18-39 years), and 181 (47.6%) older adults (≥ 40 years). The study found that both young and older adults displayed a lower likelihood of AD on the ankles, moderate to severe AD on flexures, pityriasis alba, weeping lesions, moderate to severe excoriations, and intense itching in comparison to pediatric patients. Young adults had more AD around the eyes. Older adults exhibited increased AD on elbows, nipples, knees, keratosis pilaris, and lichenification. Four distinct classes were identified regarding AD distribution and related signs.
AHRQ-funded; HS023011
Citation: Chatrath S, Silverberg JI .
Phenotypic differences of atopic dermatitis stratified by age.
JAAD Int 2023 Jun;11:1-7. doi: 10.1016/j.jdin.2022.08.026.
Keywords: Skin Conditions
Fishbein AB, Lor J, Penedo FJ
Patient-reported outcomes for measuring sleep disturbance in pediatric atopic dermatitis: cross-sectional study of the patient reported outcomes measurement information system pediatric sleep measures and actigraphy.
The purposes of this cross-sectional study were to test the Patient-Reported Outcomes Measurement Information System (PROMIS) sleep measures in pediatric atopic dermatitis (AD) and to develop an algorithm to screen, evaluate, and intervene to reduce sleep disturbances. Participants were children with AD aged 5 to 17 and one parent who completed sleep, itch, and AD-specific questionnaires. Clinicians assessed disease severity. PROMIS sleep disturbance parent proxy reliability was high and was differentiated among Patient-Oriented Eczema Measure (POEM)-determined disease severity groups. The authors concluded that sleep disturbance in pediatric AD should be screened using the POEM sleep question, and further assessment using the PROMIS sleep disturbance measure or objective sleep monitoring if it is needed.
AHRQ-funded; HS023011.
Citation: Fishbein AB, Lor J, Penedo FJ .
Patient-reported outcomes for measuring sleep disturbance in pediatric atopic dermatitis: cross-sectional study of the patient reported outcomes measurement information system pediatric sleep measures and actigraphy.
J Am Acad Dermatol 2023 Feb; 88(2):348-56. doi: 10.1016/j.jaad.2020.05.138..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice
Silverberg JI, Patel N, Immaneni S
Assessment of atopic dermatitis using self-report and caregiver report: a multicentre validation study.
The researchers sought to validate the assessment of self- and caregiver-reported eczema. They performed a prospective multicentre dermatology-practice-based study (three sites) to determine the validity of caregiver- and self-reported ever having eczema and 1-year history of eczema. Their conclusion was that self- and caregiver-reported diagnosis of eczema ever or in the past year based on a single question demonstrated sufficient validity for the epidemiological study of eczema.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Patel N, Immaneni S .
Assessment of atopic dermatitis using self-report and caregiver report: a multicentre validation study.
Br J Dermatol 2015 Dec;173(6):1400-4. doi: 10.1111/bjd.14031.
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Keywords: Skin Conditions, Diagnostic Safety and Quality, Caregiving
Yu SH, Silverberg JI
Association between atopic dermatitis and depression in US adults.
The researchers sought to determine the prevalence of depression in US adults with atopic dermatitis (AD). They concluded that approximately one in three US adults with AD reported any symptoms of depression and one in three adults with AD met diagnostic criteria for major depressive disorder.
AHRQ-funded; HS023011.
Citation: Yu SH, Silverberg JI .
Association between atopic dermatitis and depression in US adults.
J Invest Dermatol 2015 Dec;135(12):3183-6. doi: 10.1038/jid.2015.337..
Keywords: Depression, Behavioral Health, Risk, Skin Conditions
Li JC, Silverberg JI
Varicella infection is not associated with increasing prevalence of eczema: a U.S. population-based study.
The investigators sought to understand the impact of declining rates of chickenpox infection on the prevalence of eczema. Using National Health Interview Survey data, they found that eczema was inversely associated with chickenpox. They concluded that lower rates of chickenpox infection secondary to widespread vaccination against varicella zoster virus are not contributing to higher rates of childhood eczema in the U.S.
AHRQ-funded; HS023011.
Citation: Li JC, Silverberg JI .
Varicella infection is not associated with increasing prevalence of eczema: a U.S. population-based study.
Br J Dermatol 2015 Nov;173(5):1169-74. doi: 10.1111/bjd.14028.
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Keywords: Infectious Diseases, Skin Conditions, Skin Conditions, Vaccination
Silverberg JI
Health care utilization, patient costs, and access to care in US adults with eczema: a population-based study.
This study examined the out-of-pocket costs, health care access and utilization in adult eczema in the United States. It found that adults with eczema had $371 to $489 higher out-of-pocket costs per person-year compared with those without eczema, with higher odds of increased out-of-pocket costs.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Health care utilization, patient costs, and access to care in US adults with eczema: a population-based study.
JAMA Dermatol 2015 Jul;151(7):743-52. doi: 10.1001/jamadermatol.2014.5432.
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Keywords: Access to Care, Healthcare Costs, Healthcare Utilization, Skin Conditions
Balachandra S, Pardos de la Gandara M, Salvato S
Recurrent furunculosis caused by a community-acquired Staphylococcus aureus strain belonging to the USA300 clone.
This study is a clinical history of a patient with recurrent skin infections caused by a strain of CA-MRSA belonging to the USA300 clone. The strain was recovered repeatedly from wounds and lower body sites but never from the nostrils. The clinical history of recurrence strongly suggests the existence of a common environmental source of the MRSA strain.
AHRQ-funded; HS021667.
Citation: Balachandra S, Pardos de la Gandara M, Salvato S .
Recurrent furunculosis caused by a community-acquired Staphylococcus aureus strain belonging to the USA300 clone.
Microb Drug Resist 2015 Apr;21(2):237-43. doi: 10.1089/mdr.2014.0283..
Keywords: Skin Conditions, Methicillin-Resistant Staphylococcus aureus (MRSA), Injuries and Wounds, Community-Acquired Infections