National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
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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 15 of 15 Research Studies DisplayedMovahedi F, Kanwar MK, Antaki JF
Timelines of adverse event journeys of LVAD patients.
The objective of this study was to investigate the timelines of adverse events (AEs) in the INTERMACS database to obtain insights into the "AE journeys" of left ventricular assist device (LVAD) patients. The characteristics of the timelines were investigated via six descriptive research questions. The analysis revealed time-related characteristics and patterns of the AE journey after LVAD, including the most common time of occurrences, duration, and time intervals between AEs. The authors concluded that the INTERMACS Event dataset is a valuable resource for research about the timeline of AE journeys of LVAD patients and noted that future studies should consider the time-related characteristics of the dataset to choose an appropriate scope of time and time granularity.
AHRQ-funded; HS027784.
Citation: Movahedi F, Kanwar MK, Antaki JF .
Timelines of adverse event journeys of LVAD patients.
Artif Organs 2023 Oct; 47(10):1604-12. doi: 10.1111/aor.14596..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Medical Devices
Zhou S, Yang G, Hou H
Infections following left ventricular assist device implantation and 1-year health-related quality of life.
This study examined number and types of infection following left ventricular assist device (LVAD) implantation and its adverse effects on patient-reported health-related quality of life (HRQOL). Participants were patients from the Society of Thoracic Surgeons' Interagency Registry for Mechanically Assisted Circulatory Support who had received a primary LVAD. The results showed that each additional infection within the first post-implantation year was associated with an incremental negative effect on patient survival free of impaired HRQOL.
AHRQ-funded; HS026003.
Citation: Zhou S, Yang G, Hou H .
Infections following left ventricular assist device implantation and 1-year health-related quality of life.
J Heart Lung Transplant 2023 Sep; 42(9):1307-15. doi: 10.1016/j.healun.2023.05.006..
Keywords: Heart Disease and Health, Medical Devices, Cardiovascular Conditions, Quality of Care
Hamer MK, DeCamp M, Bradley CJ
Adoption and value of the Medicare annual wellness visit: a mixed-methods study.
Medicare's Annual Wellness Visit (AWV) was introduced in 2011 to encourage the utilization of preventive services, but many clinicians and patients still do not participate in the visit. We qualitatively and quantitatively assessed motivations and clinical and financial value of AWVs from a primary care perspective using interviews and Medicare claims from 2012 to 2019. Primary care providers with the highest acuity patients had AWV utilization rates 11.2 percentage points lower than providers with the lowest acuity patients; utilization rates were 3.8 percentage points lower in rural counties. Adoption was motivated by patient needs and financial incentives. AWVs closed gaps in preventive care, strengthened patient-provider relationships, facilitated advance care planning, and provided an opportunity to improve quality metrics. Overall, the AWV has the potential to increase the use of high-value preventive services although not all clinics have an economic incentive to adopt the visit, which may explain some of the variability in utilization rates.
AHRQ-funded; HS026613.
Citation: Hamer MK, DeCamp M, Bradley CJ .
Adoption and value of the Medicare annual wellness visit: a mixed-methods study.
Med Care Res Rev 2023 Aug; 80(4):433-43. doi: 10.1177/10775587231166037..
Keywords: Medical Devices, Prevention
Zhou S, Yang G, Zhang M
Mortality following durable left ventricular assist device implantation by timing and type of first infection.
Researchers examined the relationship between timing and type of first infection regarding mortality following left ventricular assist device implantation. The study cohort included nearly 13,000 Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support patients at 166 centers. The results showed that patients with any post-implantation infection had an increased risk of death; ventricular assist device-related infections and infections occurring in the intermediate interval (91-180 days after implantation) were associated with the largest increase in risk. The researchers recommended that infection prevention strategies should target non-ventricular assist device infections in the first 90 days, then shift to surveillance/prevention of driveline infections after 90 days.
AHRQ-funded; HS026003.
Citation: Zhou S, Yang G, Zhang M .
Mortality following durable left ventricular assist device implantation by timing and type of first infection.
J Thorac Cardiovasc Surg 2023 Aug; 166(2):570-79.e4. doi: 10.1016/j.jtcvs.2021.10.056..
Keywords: Mortality, Cardiovascular Conditions, Medical Devices, Heart Disease and Health
Montembeau SC, Merchant FM, Speight C
Patients' perspectives regarding generator exchanges of implantable cardioverter defibrillators.
This study explored how patients make implantable cardioverter defibrillator (ICD) generator exchange decisions. Fifty patients from Emory Healthcare with primary prevention ICDs implanted from 2013 to 2021 completed in-depth interviews exploring perspectives regarding generator exchanges. Patients were presented standard-gamble type hypothetical scenarios where their ICD battery was depleted but their 5-year risk of sudden cardiac death at that time varied (10%, 5%, and 1%). Among these patients, 18 had a prior generator exchange, 16 had received ICD therapy, and 17 had improved left ventricular ejection fraction. As sudden cardiac death risk decreased from 10% to 5% to 1%, the number of participants willing to undergo a generator exchange decreased from 48 to 42 to 33. Doctor recommendations were also likely to substantially impact patients’ decision making. Therapeutic inertia and common misconceptions about ICD therapy represented substantive barriers to effective shared decision-making.
AHRQ-funded; HS028558.
Citation: Montembeau SC, Merchant FM, Speight C .
Patients' perspectives regarding generator exchanges of implantable cardioverter defibrillators.
Circ Cardiovasc Qual Outcomes 2023 Aug; 16(8):509-18. doi: 10.1161/circoutcomes.122.009827..
Keywords: Medical Devices, Heart Disease and Health, Cardiovascular Conditions
MacEwan SR, Gaughan AA, Beal EW
Concerns and frustrations about the public reporting of device-related healthcare-associated infections: perspectives of hospital leaders and staff.
The purpose of this study was to explore the specific concerns of hospital leaders and staff regarding the identification and public reporting of healthcare-associated infections (HAIs). Between 2017 and 2019 the researchers conducted interviews with 471 participants including hospitals leaders and hospital staff across 18 United States hospitals. The study found that interviewees discussed concerns about public reporting of HAI data, including a lack of trust in the data and unintended consequences of its public reporting, as well as particular frustrations with the identification and accountability for publicly-reported HAIs.
AHRQ-funded; HS024958.
Citation: MacEwan SR, Gaughan AA, Beal EW .
Concerns and frustrations about the public reporting of device-related healthcare-associated infections: perspectives of hospital leaders and staff.
Am J Infect Control 2023 Jun; 51(6):633-37. doi: 10.1016/j.ajic.2022.08.003..
Keywords: Medical Devices, Healthcare-Associated Infections (HAIs), Hospitals, Provider: Health Personnel
Everhart AO
Time to publication of cost-effectiveness analyses for medical devices.
This study examined the availability of cost-effectiveness analyses for medical devices, in terms of both the number of studies and when studies are published. The longer the time between FDA approval/clearance and publication of cost-effectiveness analyses of medical devices, the longer that decision makers will not have the evidence they and their patients need when making initial decisions related to newly available medical devices. An analysis was conducted using the Tufts University Cost-Effectiveness Analysis Registry to identify studies of medical devices that were linked to FDA databases. The years between FDA approval/clearance and publication of cost-effectiveness analyses were calculated. The authors identified a total of 218 cost-effectiveness analyses of medical devices in the United States published between 2002 and 2020. Of those studies, 39.4% were linked to FDA databases. Studies examining devices approved via premarket approval were published a mean of 6.0 years after the device received FDA approval, whereas studies examining devices that were cleared via the 510(k) process were published a mean of 6.5 years after the device received FDA clearance.
AHRQ-funded; HS027522.
Citation: Everhart AO .
Time to publication of cost-effectiveness analyses for medical devices.
Am J Manag Care 2023 May; 29(5):265-68. doi: 10.37765/ajmc.2023.89359..
Keywords: Medical Devices, Healthcare Costs
Weiner M, Adeoye P, Boeh MJ
Continuous glucose monitoring and other wearable devices to assess hypoglycemia among older adult outpatients with diabetes mellitus.
The purpose of this study was to assess whether vulnerable older adults could use wearable devices, and explore Hypoglycemia frequency over a two week period. The researchers recruited 10 participants with diabetes mellitus to pilot test a continuous glucometer, physical activity monitor, electronic medication bottles, and smartphones which that provided prompts about medications, behaviors, and symptoms. A sample of 70 then wore glucometers and activity monitors and used the smartphone and bottles for a duration of 2 weeks and provided feedback. The study found that patients were interested in assistance with the interpretation of graphs, had challenges with keeping the glucometers attached. Nearly 23% of respondents indicated that they never check their blood sugars. In two weeks of monitoring, 73% had HG and 42% had serious, clinically significant HG.
AHRQ-funded; HS024384.
Citation: Weiner M, Adeoye P, Boeh MJ .
Continuous glucose monitoring and other wearable devices to assess hypoglycemia among older adult outpatients with diabetes mellitus.
Appl Clin Inform 2023 Jan; 14(1):37-44. doi: 10.1055/a-1975-4136..
Keywords: Elderly, Diabetes, Chronic Conditions, Ambulatory Care and Surgery, Patient Self-Management, Medical Devices
Chrisinger BW, Grossestreuer AV, Laguna MC
Characteristics of automated external defibrillator coverage in Philadelphia, PA, based on land use and estimated risk.
The authors investigated how well the likelihood of out-of-hospital cardiac arrest was met by the supply of automated external defibrillators (AED) in a dense urban environment. This article offers one method by which local officials can use spatial data to prioritize attention for AED placement and coverage.
AHRQ-funded; HS018362.
Citation: Chrisinger BW, Grossestreuer AV, Laguna MC .
Characteristics of automated external defibrillator coverage in Philadelphia, PA, based on land use and estimated risk.
Resuscitation 2016 Dec;109:9-15. doi: 10.1016/j.resuscitation.2016.09.021.
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Keywords: Medical Devices, Health Insurance, Urban Health, Cardiovascular Conditions
Krishnamurthy Y, Cooper LB, Parikh KS
Pulmonary hypertension in the era of mechanical circulatory support.
The researchers summarized the literature available to highlight the definition, pathogenesis, and prognosis of pulmonary hypertension (PH) due to left heart disease (LHD). Additionally, they discussed the use of mechanical circulatory support (MCS) in this population. Then, they provided recommendations regarding the management and reassessment of PH due to LHD in the specific context of MCS.
AHRQ-funded; HS021092.
Citation: Krishnamurthy Y, Cooper LB, Parikh KS .
Pulmonary hypertension in the era of mechanical circulatory support.
ASAIO J 2016 Sep-Oct;62(5):505-12. doi: 10.1097/mat.0000000000000408.
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Keywords: Comparative Effectiveness, Heart Disease and Health, Medical Devices, Respiratory Conditions
Khazanie P, Hammill BG, Patel CB
Use of heart failure medical therapies among patients with left ventricular assist devices: insights from INTERMACS.
The authors examined the use of heart failure medications before and after left ventricular assist devices (LVAD) implant in adult patients enrolled in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). They found that overall use of neurohormonal antagonists was low after LVAD implant, whereas use of loop diuretics and amiodarone remained high, and concluded that heart failure medication use is highly variable, but appears to generally increase after LVAD implantation.
AHRQ-funded; HS021092.
Citation: Khazanie P, Hammill BG, Patel CB .
Use of heart failure medical therapies among patients with left ventricular assist devices: insights from INTERMACS.
J Card Fail 2016 Sep;22(9):672-9. doi: 10.1016/j.cardfail.2016.02.004.
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Keywords: Comparative Effectiveness, Heart Disease and Health, Medical Devices, Medication, Patient-Centered Outcomes Research
Kostick KM, Minard CG, Wilhelms LA
Development and validation of a patient-centered knowledge scale for left ventricular assist device placement.
The authors presented a comprehensive and valid methodology for developing a clinically informed and patient-centered measure of knowledge about left ventricular assist device (LVAD) therapy to facilitate discussion and measure candidate understanding of treatment options. They concluded that the LVAD knowledge scale may be useful in clinical settings to identify gaps in knowledge among patient candidates considering LVAD treatment; to better tailor education and discussion with patients and their caregivers; and to enhance informed decision-making before treatment decisions are made.
AHRQ-funded; HS024849.
Citation: Kostick KM, Minard CG, Wilhelms LA .
Development and validation of a patient-centered knowledge scale for left ventricular assist device placement.
J Heart Lung Transplant 2016 Jun;35(6):768-76. doi: 10.1016/j.healun.2016.01.015.
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Keywords: Shared Decision Making, Heart Disease and Health, Medical Devices, Patient and Family Engagement, Patient-Centered Outcomes Research
Zhu Y, Chen CY, Matsuyama Y
Comparative validity of methods to select appropriate cutoff weight for probabilistic linkage without unique personal identifiers.
The researchers aimed to assess the validity of probabilistic linkage in the absence of unique personal identifiers (UPI) and the methods of cutoff weight selection. They found that probabilistic linkage without UPI generated valid linkages when an optimal cutoff was chosen and concluded that histogram inspection, the duplicate method, and the odds formula method can be used in conjunction when a gold standard is not available.
AHRQ-funded; 29020050016I.
Citation: Zhu Y, Chen CY, Matsuyama Y .
Comparative validity of methods to select appropriate cutoff weight for probabilistic linkage without unique personal identifiers.
Pharmacoepidemiol Drug Saf 2016 Apr;25(4):444-52. doi: 10.1002/pds.3832.
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Keywords: Data, Medical Devices, Registries
Zeitler EP, Hellkamp AS, Schulte PJ
Comparative effectiveness of implantable cardioverter defibrillators for primary prevention in women.
The researchers examined clinical practice data to compare survival rates among women with heart failure with or without a primary prevention implantable cardioverter defibrillator (ICD). Theyn found that among patients with heart failure with reduced left ventricular ejection fraction, a primary prevention ICD was associated with a significant survival advantage among women and among men.
AHRQ-funded; HS021092.
Citation: Zeitler EP, Hellkamp AS, Schulte PJ .
Comparative effectiveness of implantable cardioverter defibrillators for primary prevention in women.
Circ Heart Fail 2016 Jan;9(1):e002630. doi: 10.1161/circheartfailure.115.002630.
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Keywords: Medical Devices, Comparative Effectiveness, Prevention, Heart Disease and Health, Mortality
Green AR, Leff B, Wang Y
Geriatric conditions in patients undergoing defibrillator implantation for prevention of sudden cardiac death: prevalence and impact on mortality.
The researchers sought to determine the prevalence of frailty and dementia among older adults receiving primary prevention implantable cardioverter-defibrillators (ICDs) and to determine the impact of multimorbidity on mortality within 1 year of ICD implantation. They concluded that more than 10 percent of Medicare beneficiaries with heart failure receiving primary prevention ICDs have frailty or dementia. These patients had significantly higher 1-year mortality than those with other common chronic conditions.
AHRQ-funded; HS019814; 290201200007I.
Citation: Green AR, Leff B, Wang Y .
Geriatric conditions in patients undergoing defibrillator implantation for prevention of sudden cardiac death: prevalence and impact on mortality.
Circ Cardiovasc Qual Outcomes 2016 Jan;9(1):23-30. doi: 10.1161/circoutcomes.115.002053.
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Keywords: Elderly, Medical Devices, Mortality, Prevention, Dementia