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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 4 of 4 Research Studies DisplayedSong J, Min SH, Chae S
Uncovering hidden trends: identifying time trajectories in risk factors documented in clinical notes and predicting hospitalizations and emergency department visits during home health care.
The purpose of this study was to characterize risk factor patterns documented in home health care (HHC) clinical notes and explore their relationships with hospitalizations or emergency department (ED) visits. The researchers analyzed data for 73,350 episodes of care from one large HHC organization utilizing dynamic time warping and hierarchical clustering analysis to characterize the patterns of risk factors over time documented in clinical notes. The study found that six temporal clusters emerged, reflecting varying patterns in how risk factors were documented. Patients with a sharp increase in documented risk factors over time had a 3 times greater probability of hospitalization or ED visit than patients with no documented risk factors. The majority of risk factors were found in the physiological domain, and a minority were found in the environmental domain.
AHRQ-funded; HS027742.
Citation: Song J, Min SH, Chae S .
Uncovering hidden trends: identifying time trajectories in risk factors documented in clinical notes and predicting hospitalizations and emergency department visits during home health care.
J Am Med Inform Assoc 2023 Oct 19; 30(11):1801-10. doi: 10.1093/jamia/ocad101..
Keywords: Emergency Department, Hospitalization, Home Healthcare, Risk
Herzig SJ, Anderson TS, Urman RD
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
The purpose of this retrospective cohort study was to identify risk factors for opioid-related adverse drug events (ORADEs) after hospital discharge following orthopedic procedures. The participants of this study included a national sample of Medicare beneficiaries who underwent major orthopedic surgery during hospitalization in 2016 and had an opioid prescription filled within 2 days of discharge. The study found that among 30,514 hospitalizations with a major orthopedic procedure and an opioid claim, a potential ORADE requiring hospital revisit occurred in 2.5%. After adjustment for patient characteristics, prior opioid use, co-prescribed sedating medications, and opioid prescription characteristics were not related with ORADEs. Independent risk factors did include age of 80 years or older, female sex, and clinical conditions, including heart failure, respiratory illness, kidney disease, dementia/delirium, anxiety disorder, and musculoskeletal/nervous system injuries.
AHRQ-funded; HS026215.
Citation: Herzig SJ, Anderson TS, Urman RD .
Risk factors for opioid-related adverse drug events among older adults after hospitalization for major orthopedic procedures.
J Patient Saf 2023 Oct 1; 19(6):379-85. doi: 10.1097/pts.0000000000001144..
Keywords: Elderly, Opioids, Adverse Drug Events (ADE), Adverse Events, Hospitalization, Orthopedics, Surgery, Medication, Risk, Medication: Safety, Patient Safety
Chae S, Davoudi A, Song J
Predicting emergency department visits and hospitalizations for patients with heart failure in home healthcare using a time series risk model.
This study’s objective was to develop a time series risk model for predicting emergency department (ED) visits and hospitalizations in patients with heart failure (HF) using longitudinal electronic health record data. The authors explored which data sources yield the best-performing models over various time windows. They used data collected from 9362 patients from a large home healthcare (HHC) agency and iteratively developed risk models using both structured and unstructured data. They developed seven specific sets of variables including: (1) the Outcome and Assessment Information Set, (2) vital signs, (3) visit characteristics, (4) rule-based natural language processing-derived variables, (5) term frequency-inverse document frequency variables, (6) Bio-Clinical Bidirectional Encoder Representations from Transformers variables, and (7) topic modeling. Risk models for 18 time windows (1-15, 45, and 60 days) before an ED visit or hospitalization were developed. They compared risk prediction performances using recall, precision, accuracy, F1, and area under the receiver operating curve (AUC). The best-performing model was built using a combination of all 7 sets of variables and the time window of 4 days before an ED visit or hospitalization.
AHRQ-funded; HS027742.
Citation: Chae S, Davoudi A, Song J .
Predicting emergency department visits and hospitalizations for patients with heart failure in home healthcare using a time series risk model.
J Am Med Inform Assoc 2023 Sep 25; 30(10):1622-33. doi: 10.1093/jamia/ocad129..
Keywords: Hospitalization, Emergency Department, Risk
Song J, Chae S, Bowles KH
The identification of clusters of risk factors and their association with hospitalizations or emergency department visits in home health care.
The purpose of this retrospective cohort study was to identify risk factor clusters in home health care and assess whether the clusters are related with hospitalizations or emergency department visits. The researchers included 61,454 patients associated with 79,079 episodes receiving home health care from one of the largest home health care organizations in the U.S. The study found that a total of 11.6% of home health episodes resulted in hospitalizations or emergency department visits. Three clusters were formed by the risk factors: 1) Cluster 1- a combination of risk factors related to situations where patients may experience increased pain ("impaired physical comfort with pain"). 2) Cluster 2 - characterized by multiple comorbidities or other risks for hospitalization (e.g., prior falls, called "high comorbidity burden"). 3) Cluster 3 - "impaired cognitive/psychological and skin integrity" which includes dementia or skin ulcer. The risk of hospitalizations or emergency department visits increased by 1.95 times for Cluster 2 and by 2.12 times for Cluster 3 when compared to cluster 1. The study concluded that Varying combinations of risk factors affected the likelihood of negative outcomes.
AHRQ-funded; HS027742.
Citation: Song J, Chae S, Bowles KH .
The identification of clusters of risk factors and their association with hospitalizations or emergency department visits in home health care.
J Adv Nurs 2023 Feb; 79(2):593-604. doi: 10.1111/jan.15498..
Keywords: Emergency Department, Hospitalization, Home Healthcare, Risk