National Healthcare Quality and Disparities Report
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- (-) Diagnostic Safety and Quality (111)
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- Men's Health (1)
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- Outcomes (1)
- Pain (2)
- Patient-Centered Outcomes Research (1)
- Patient Experience (1)
- Patient Safety (18)
- Pneumonia (1)
- Practice Patterns (2)
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- Provider: Clinician (1)
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- Provider: Nurse (1)
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- Quality Improvement (7)
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- Racial and Ethnic Minorities (6)
- Respiratory Conditions (3)
- Risk (8)
- Screening (7)
- Sepsis (4)
- Sexual Health (1)
- Shared Decision Making (4)
- Skin Conditions (3)
- Social Determinants of Health (2)
- Stroke (4)
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- Telehealth (2)
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- Treatments (2)
- Urinary Tract Infection (UTI) (4)
- Vulnerable Populations (1)
- Women (5)
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
76 to 100 of 111 Research Studies DisplayedCifra CL, Westlund E, Ten Eyck P
An estimate of missed pediatric sepsis in the emergency department.
AHRQ-funded; HS025753.
Citation: Cifra CL, Westlund E, Ten Eyck P .
An estimate of missed pediatric sepsis in the emergency department.
Diagnosis 2021;8(2):193-98. doi: 10.1515/dx-2020-0023..
Keywords: Children/Adolescents, Sepsis, Emergency Department, Diagnostic Safety and Quality, Medical Errors, Risk
Michelson KA, Williams DN, Dart AH
Development of a rubric for assessing delayed diagnosis of appendicitis, diabetic ketoacidosis and sepsis.
This study’s objective was to create a guide for objectively grading the likelihood of delayed diagnosis of appendicitis, new-onset diabetic ketoacidosis (DKA), and sepsis. Case vignettes were constructed for each condition and then presented to expert Delphi panels for review. In each vignette, the patient had a previous emergency department visit within 7 days of the delayed diagnosis. The panels graded the likelihood of a delayed diagnosis on a five-point scale. Consensus was achieved within three Delphi rounds for all appendicitis and sepsis vignettes, and 77% of DKA vignettes. The authors created a case review guide from the consensus scores that will aid researchers and quality improvement specialists in objective case review to determine if delayed diagnosis had occurred for those three conditions.
AHRQ-funded; HS026503.
Citation: Michelson KA, Williams DN, Dart AH .
Development of a rubric for assessing delayed diagnosis of appendicitis, diabetic ketoacidosis and sepsis.
Diagnosis 2021;8(2):219-25. doi: 10.1515/dx-2020-0035..
Keywords: Diagnostic Safety and Quality, Sepsis, Medical Errors, Adverse Events, Patient Safety
Overstreet DS, Michl AN, Penn TM
Temporal summation of mechanical pain prospectively predicts movement-evoked pain severity in adults with chronic low back pain.
The objective of this study was to determine whether quantitative sensory tests of endogenous pain inhibition and facilitation prospectively predict movement-evoked pain and chronic low back pain severity self-reported on a validated questionnaire. Through surveys using the Brief Pain Inventory-Short Form, findings suggested that a pro-nociceptive pain modulatory balance characterized by enhanced pain facilitation may be an important driver of movement-evoked pain severity and poor physical function in individuals with chronic low back pain.
AHRQ-funded; HS013852.
Citation: Overstreet DS, Michl AN, Penn TM .
Temporal summation of mechanical pain prospectively predicts movement-evoked pain severity in adults with chronic low back pain.
BMC Musculoskelet Disord 2021 May 10;22(1):429. doi: 10.1186/s12891-021-04306-5..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Diagnostic Safety and Quality
Huda A, Castaño A, Niyogi A
A machine learning model for identifying patients at risk for wild-type transthyretin amyloid cardiomyopathy.
Transthyretin amyloid cardiomyopathy, an often-unrecognized cause of heart failure, is now treatable with a transthyretin stabilizer. It is therefore important to identify at-risk patients who can undergo targeted testing for earlier diagnosis and treatment, prior to the development of irreversible heart failure. In this study, the investigators showed that a random forest machine learning model could identify potential wild-type transthyretin amyloid cardiomyopathy using medical claims data.
AHRQ-funded; HS026385.
Citation: Huda A, Castaño A, Niyogi A .
A machine learning model for identifying patients at risk for wild-type transthyretin amyloid cardiomyopathy.
Nat Commun 2021 May 11;12(1):2725. doi: 10.1038/s41467-021-22876-9..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Neurological Disorders, Diagnostic Safety and Quality, Risk
Campbell JI, Sandora TJ, Haberer JE
A scoping review of paediatric latent tuberculosis infection care cascades: initial steps are lacking.
This literature review looked at current studies on the diagnosis and treatment of pediatric latent tuberculosis infection (TB infection), commonly known as the TB infection care cascade. The authors conducted a systematic search of several medical databases and included articles and meeting abstracts that studied children and adolescents 21 years or younger who were screened for or diagnosed with TB infection. They identified 146 studies examining steps in the pediatric TB infection care cascade, including 31 in children living in low- and middle-income countries. Most literature described the final cascade step, which is treatment initiation to completion. Strengths and gaps were identified and future research in examining cascade steps upstream of treatment initiation was recommended.
AHRQ-funded; HS000063.
Citation: Campbell JI, Sandora TJ, Haberer JE .
A scoping review of paediatric latent tuberculosis infection care cascades: initial steps are lacking.
BMJ Glob Health 2021 May;6(5). doi: 10.1136/bmjgh-2020-004836..
Keywords: Children/Adolescents, Respiratory Conditions, Diagnostic Safety and Quality, Treatments, Care Management, Evidence-Based Practice
Sick-Samuels AC, Linz M, Bergmann J
Diagnostic stewardship of endotracheal aspirate cultures in a PICU.
This study describes the development and impact of a clinical decision support algorithm to standardize the use of endotracheal aspirate cultures (EACs) from ventilated PICU patients in the evaluation of suspected ventilator-associated infections. Bacterial growth in EACs does not distinguish bacterial colonization from infection and may lead to overtreatment with antibiotics. The rate of EACs was compared pre- and postintervention. In the preintervention year there were 557 EACs over 5092 ventilator days. After introduction of the algorithm the rate went down to 234 EACs over 3654 ventilator days. There was a 41% decrease in the monthly rate of EACs. This intervention did not affect mortality, readmissions, or length of stay in ventilated PICU patients.
AHRQ-funded; HS025642.
Citation: Sick-Samuels AC, Linz M, Bergmann J .
Diagnostic stewardship of endotracheal aspirate cultures in a PICU.
Pediatrics 2021 May;147(5). doi: 10.1542/peds.2020-1634..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Clinical Decision Support (CDS), Shared Decision Making, Healthcare-Associated Infections (HAIs), Diagnostic Safety and Quality
Lacson R, Shi J, Kapoor N
Exacerbation of inequities in use of diagnostic radiology during the early stages of reopening after COVID-19.
Researchers assessed diagnostic radiology examination utilization and associated social determinants of health during the early stages of reopening after state-mandated shutdown of nonurgent services because of COVID-19. They found that, despite resumption of nonurgent services, a marked decrease in radiology examination utilization persisted in all care settings post-shutdown, with more significantly decreased odds ratios for having examinations in inpatient and outpatient settings versus in the emergency department. Inequities worsened, with patients from communities with high rates of poverty, unemployment, and chronic disease having significantly lower odds of undergoing radiology examinations post-shutdown. Patients of Asian race and Hispanic ethnicity had significantly lower odds ratios for having examinations post-shutdown compared with White and non-Hispanic patients, respectively.
AHRQ-funded; HS024722.
Citation: Lacson R, Shi J, Kapoor N .
Exacerbation of inequities in use of diagnostic radiology during the early stages of reopening after COVID-19.
J Am Coll Radiol 2021 May;18(5):696-703. doi: 10.1016/j.jacr.2020.12.009..
Keywords: COVID-19, Disparities, Diagnostic Safety and Quality, Racial and Ethnic Minorities, Social Determinants of Health
Goldfarb N, Lowes MA, Butt M
Hidradenitis Suppurativa Area and Severity Index Revised (HASI-R): psychometric property assessment.
This study’s objective was to assess the reliability and validity of the Hidradenitis suppurative (HS) Area and Severity Index Revised (HASI-R) tool to assess HS severity. This tool incorporates signs of inflammation and body surface area involved while current tools to measure severity relies on lesion counts, which are time-consuming and unreliable. Measurement properties of HASI-R were evaluated. Twenty raters evaluated 15 HS patients in a hospital-based ambulatory dermatology clinic. Inter- and intra-rater reliability of the HASI-R and its components were assessed, as well as its construct and known-groups validity. The HASI-R was found to have moderate inter-rater reliability and the highest intra-rater reliability of all HS severity assessment tools. It also had good construct validity and demonstrated known-groups validity.
AHRQ-funded; HS024585.
Citation: Goldfarb N, Lowes MA, Butt M .
Hidradenitis Suppurativa Area and Severity Index Revised (HASI-R): psychometric property assessment.
Br J Dermatol 2021 May;184(5):905-12. doi: 10.1111/bjd.19565..
Keywords: Skin Conditions, Diagnostic Safety and Quality
Woo K, Adams V, Wilson P
Identifying urinary tract infection-related information in home care nursing notes.
Urinary tract infection (UTI) is common in home care but not easily captured with standard assessment. This study aimed to examine the value of nursing notes in detecting UTI signs and symptoms in home care. The investigators found that information in nursing notes was often overlooked by stakeholders and not integrated into predictive modeling for decision-making support. They indicate that their findings highlighted the value of nursing notes in early risk identification and care guidance.
AHRQ-funded; R01 HS024723.
Citation: Woo K, Adams V, Wilson P .
Identifying urinary tract infection-related information in home care nursing notes.
J Am Med Dir Assoc 2021 May;22(5):1015-21.e2. doi: 10.1016/j.jamda.2020.12.010..
Keywords: Urinary Tract Infection (UTI), Home Healthcare, Diagnostic Safety and Quality
Ricci KB, Oslock WM, Ingraham AM
Importance of radiologists in optimizing outcomes for older Americans with acute abdomen.
Patients presenting with acute abdominal pain often undergo a computed tomography (CT) scan as part of their diagnostic workup. The authors of this study investigated the relationship between availability, timeliness, and interpretation of CT imaging and outcomes for life-threatening intra-abdominal diseases or "acute abdomen," in older Americans. The investigators concluded that delays obtaining results were associated with adverse outcomes in older patients with acute abdomen.
AHRQ-funded; HS022694.
Citation: Ricci KB, Oslock WM, Ingraham AM .
Importance of radiologists in optimizing outcomes for older Americans with acute abdomen.
J Surg Res 2021 May;261:361-68. doi: 10.1016/j.jss.2020.12.022..
Keywords: Elderly, Imaging, Diagnostic Safety and Quality
Maduekwe UN, Herb JN, Esther RJ
Pathologic nodal staging for clinically node negative soft tissue sarcoma of the extremities.
This study looked at the need for pathological nodal staging in patients with extremity synovial, clear cell, angiosarcoma, rhabdomyosarcoma, and epithelioid (SCARE) soft tissue sarcoma. Patients included were without clinical nodal involvement undergoing surgical resection in the National Cancer Database (2004-2017). The cohort included 4158 patients, with 669 patients (16%) undergoing regional lymph node surgery (RLNS). Patients with epithelioid and clear cell sarcomas were most likely to undergo RLNS. Forty-five (7%) had positive nodes with clear cell sarcoma (14%) and angiosarcoma (13%) having the highest rates of nodal positivity. Five-year survival was reduced in patients with positive nodes.
AHRQ-funded; HS000032.
Citation: Maduekwe UN, Herb JN, Esther RJ .
Pathologic nodal staging for clinically node negative soft tissue sarcoma of the extremities.
J Surg Oncol 2021 May;123(8):1792-800. doi: 10.1002/jso.26465..
Keywords: Cancer, Diagnostic Safety and Quality, Treatments
Desai S, Kapoor N, Hammer MM
RADAR: a closed-loop quality improvement initiative leveraging a safety net model for incidental pulmonary nodule management.
This study was conducted to assess whether patients with incidental pulmonary nodules (IPNs) received timely follow-up care after implementation of a quality improvement (QI) initiative between radiologists and primary care providers. A QI initiative, RADAR (Radiology Result Alert and Development of Automated Resolution), was implemented. Findings showed that the RADAR QI initiative was associated with increased timely IPN follow-up.
AHRQ-funded; HS024722.
Citation: Desai S, Kapoor N, Hammer MM .
RADAR: a closed-loop quality improvement initiative leveraging a safety net model for incidental pulmonary nodule management.
Jt Comm J Qual Patient Saf 2021 May;47(5):275-81. doi: 10.1016/j.jcjq.2020.12.006..
Keywords: Quality Improvement, Quality of Care, Diagnostic Safety and Quality, Imaging
Srivastava S, Clark B, Landy-Schmitt C
Repetitive and self-injurious behaviors in children with Cornelia de Lange syndrome.
AHRQ-funded; HS023000.
Citation: Srivastava S, Clark B, Landy-Schmitt C .
Repetitive and self-injurious behaviors in children with Cornelia de Lange syndrome.
J Autism Dev Disord 2021 May;51(5):1748-58. doi: 10.1007/s10803-020-04617-x..
Keywords: Children/Adolescents, Neurological Disorders, Diagnostic Safety and Quality
Gleason K, Harkless G, Stanley J
The critical need for nursing education to address the diagnostic process.
In this paper, the authors reviewed the history and current state of diagnostic education in pre-licensure registered nurse preparation, introduced interprofessional individual- and team-based competencies to improve diagnostic safety, and discussed the next steps for nursing education.
AHRQ-funded; HS027198.
Citation: Gleason K, Harkless G, Stanley J .
The critical need for nursing education to address the diagnostic process.
Nurs Outlook 2021 May-Jun;69(3):362-69. doi: 10.1016/j.outlook.2020.12.005..
Keywords: Diagnostic Safety and Quality, Provider: Nurse, Education: Curriculum
Asti L, Hopley C, Avelis C
The potential clinical and economic value of a human papillomavirus primary screening test that additionally identifies genotypes 31, 45, 51, and 52 individually.
This study looked at the potential clinical and economic value of a human papillomavirus (HPV) primary screening test that additionally identified genotypes 31,45,51, and 52 along with genotypes 16 and 18. The authors developed a Markov model of the HPV disease course and evaluated the clinical and economic value of HPV primary screening with Onclarity. Currently HPV primary screening results in 25,194 invasive procedures and 48 invasive cervical cancer (ICC) cases per 100,000 women. Screening with extended genotyping and later screening women with certain genotypes averted 903 to 3163 invasive procedures and results in 0 to 3 more ICC cases compared with current primary screening tests. Extended genotyping was cost effective when costing $75 and cost saving when costing $43. When the probabilities of disease progression increased 2-4 times, it was not cost-effective because it resulted in more ICC cases and accrued fewer quality-adjusted life-years.
AHRQ-funded; HS023317.
Citation: Asti L, Hopley C, Avelis C .
The potential clinical and economic value of a human papillomavirus primary screening test that additionally identifies genotypes 31, 45, 51, and 52 individually.
Sex Transm Dis 2021 May;48(5):370-80. doi: 10.1097/olq.0000000000001327.
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Keywords: Sexual Health, Infectious Diseases, Screening, Diagnostic Safety and Quality, Genetics, Cancer: Cervical Cancer, Cancer, Women
Wayne MT, Molling D, Wang XQ
Measurement of sepsis in a national cohort using three different methods to define baseline organ function.
In 2017, the U.S. Centers for Disease Control and Prevention (CDC) developed a new surveillance definition of sepsis, the adult sepsis event (ASE), to better track sepsis epidemiology. The objective of this study was to understand how sepsis identification and outcomes differed when using the best laboratory values during hospitalization versus methods that used historical lookbacks to define baseline organ function.
AHRQ-funded; HS026725.
Citation: Wayne MT, Molling D, Wang XQ .
Measurement of sepsis in a national cohort using three different methods to define baseline organ function.
Ann Am Thorac Soc 2021 Apr;18(4):648-55. doi: 10.1513/AnnalsATS.202009-1130OC..
Keywords: Sepsis, Diagnostic Safety and Quality
Davis K, Wilbur K, Metzger S
Symptom and needs assessment screening in oncology patients: alternate outreach methods during COVID-19.
This initiative’s goal was to develop alternate outreach methods to cancer patients without access to an electronic portal during COVID-19. The authors implemented a standardized telephone outreach process targeting patients without active electronic portal accounts to improve remote symptom monitoring. A total of 172 screens were completed, identifying 110 needs for 63 individuals. Twenty-eight patients completed patient enrollment, with outreach calls capturing a higher percentage of Black patients (34%) and older adults age 61-80 years old (69%) compared to portal users.
AHRQ-funded; HS026170.
Citation: Davis K, Wilbur K, Metzger S .
Symptom and needs assessment screening in oncology patients: alternate outreach methods during COVID-19.
J Psychosoc Oncol 2021;39(3):452-60. doi: 10.1080/07347332.2021.1890663..
Keywords: COVID-19, Cancer, Access to Care, Telehealth, Health Information Technology (HIT), Diagnostic Safety and Quality
Rauscher GH, Murphy AM, Qiu Q
The "sweet spot" revisited: optimal recall rates for cancer detection with 2D and 3D digital screening mammography in the Metro Chicago Breast Cancer Registry.
The authors examined the trade-offs for higher recall rates in terms of biopsy recommendations and cancer detection in mammography in a single large health care organization. 2D analog, 2D digital, and 3D digital mammography screenings among women 40-79 years old with cancer follow-up were examined. They found that the results of their investigation were in contrast to those of a recent study suggesting appropriateness of higher recall rates. They concluded that optimal cancer detection appeared to be in the recall rate range of 7-9% for both 2D digital mammography and 3D tomosynthesis.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Murphy AM, Qiu Q .
The "sweet spot" revisited: optimal recall rates for cancer detection with 2D and 3D digital screening mammography in the Metro Chicago Breast Cancer Registry.
AJR Am J Roentgenol 2021 Apr;216(4):894-902. doi: 10.2214/ajr.19.22429.
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Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Diagnostic Safety and Quality, Women, Prevention
Vemulakonda VM
Ureteropelvic junction obstruction: diagnosis and management.
Ureteropelvic junction obstruction (UPJO) is the most common cause of prenatally diagnosed hydronephrosis. Although associated with obstruction of the kidney, the natural history is variable, ranging from spontaneous resolution to progressive loss of function over the first few years of life. The purpose of this article is to review recent literature focused on the prenatal and postnatal evaluation of infants with prenatally diagnosed hydronephrosis suspicious for UPJO.
AHRQ-funded; HS024597.
Citation: Vemulakonda VM .
Ureteropelvic junction obstruction: diagnosis and management.
Curr Opin Pediatr 2021 Apr 1;33(2):227-34. doi: 10.1097/mop.0000000000000994..
Keywords: Newborns/Infants, Pregnancy, Diagnostic Safety and Quality
Jones OT, Calanzani N, Saji S
Artificial intelligence techniques that may be applied to primary care data to facilitate earlier diagnosis of cancer: systematic review.
This study’s objective was a systematic review of artificial intelligence (AI) techniques that might facilitate earlier diagnosis of cancer and could be applied to primary care electronic health record (EHR) data. Findings showed that AI techniques have been applied to EHR-type data to facilitate early diagnosis of cancer, but their use in primary care settings is still at an early stage of maturity. Further evidence is needed on their performance using primary care data, implementation barriers, and cost-effectiveness before widespread adoption into routine primary care clinical practice can be recommended.
AHRQ-funded; HS027363.
Citation: Jones OT, Calanzani N, Saji S .
Artificial intelligence techniques that may be applied to primary care data to facilitate earlier diagnosis of cancer: systematic review.
J Med Internet Res 2021 Mar 3;23(3):e23483. doi: 10.2196/23483..
Keywords: Cancer, Diagnostic Safety and Quality, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT)
Schoenfeld EM, Poronsky KE, Westafer LM
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Both ultrasound and CT scan can be used for diagnosis of ureterolithiasis (or renal colic, the pain from an obstructing kidney stone), but the majority of patients receive a CT scan. Diagnostic pathways utilizing ultrasound have been shown to decrease radiation exposure to patients but are potentially less accurate. The investigators developed a decision aid to facilitate SDM in this scenario. The objective of this study was to determine the effects of this decision aid, as compared to usual care, on patient knowledge, radiation exposure, engagement, safety, and healthcare utilization.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Poronsky KE, Westafer LM .
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Trials 2021 Mar 10;22(1):201. doi: 10.1186/s13063-021-05140-9..
Keywords: Emergency Department, Shared Decision Making, Kidney Disease and Health, Imaging, Diagnostic Safety and Quality
Cook A, Quinn ED, Rowland C
Exploring expressive communication skills in a cross-sectional sample of individuals with a dual diagnosis of autism spectrum disorder and down syndrome.
The authors hypothesized that individuals with a comorbid diagnosis of Down syndrome (DS) and autism spectrum disorder would have significantly lower Communication Matrix scores and specifically social communication scores than individuals with DS alone. They found that, in a sample of 4,782 individuals with DS, scores for individuals with a comorbid diagnosis were on average 18.01 points and 7.26 points lower for total score and social score, respectively, as compared to individuals with DS alone.
AHRQ-funded; K12 HS026370; 1013200.
Citation: Cook A, Quinn ED, Rowland C .
Exploring expressive communication skills in a cross-sectional sample of individuals with a dual diagnosis of autism spectrum disorder and down syndrome.
Am J Intellect Dev Disabil 2021 Mar 1;126(2):97-113. doi: 10.1352/1944-7558-126.2.97..
Keywords: Autism, Communication, Diagnostic Safety and Quality
Fenton JJ, Jerant A, Franks P
Watchful waiting as a strategy to reduce low-value spinal imaging: study protocol for a randomized trial.
This paper describes the protocol that will be used for an upcoming randomized control trial to determine the effectiveness of teaching clinicians how to advise watchful waiting when patients request low-value spinal imaging for acute low back pain. The authors will recruit 8-10 primary care and urgent care clinics in Sacramento, California. The study will last 3-6 months and during this time clinicians in the intervention group with receive 3 visits with standardized patient instructors (SPIs) portraying patients with acute back pain. The SPIs will instruct clinicians in a 3-step model emphasizing trust, empathic communication, and negotiation of a watchful waiting approach. The primary outcome looked for will a decreased post-intervention rate of spinal imaging among actual patients with acute back pain compared to the rate of imaging during the baseline period. Secondary outcomes will include use of targeted communication techniques during a follow-up visit with an SP.
AHRQ-funded; HS026415.
Citation: Fenton JJ, Jerant A, Franks P .
Watchful waiting as a strategy to reduce low-value spinal imaging: study protocol for a randomized trial.
Trials 2021 Feb 27;22(1):167. doi: 10.1186/s13063-021-05106-x..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Imaging, Diagnostic Safety and Quality, Clinician-Patient Communication, Communication
Miller AC, Arakkal AT, Koeneman S
Incidence, duration and risk factors associated with delayed and missed diagnostic opportunities related to tuberculosis: a population-based longitudinal study.
Missed opportunities to diagnose tuberculosis are costly to patients and society. In this retrospective cohort study, the investigators (1) estimated the frequency and duration of diagnostic delays among patients with active pulmonary tuberculosis and (2) determined the risk factors for experiencing a diagnostic delay. The investigators found that many patients with tuberculosis experience multiple missed diagnostic opportunities prior to diagnosis.
AHRQ-funded; HS027375.
Citation: Miller AC, Arakkal AT, Koeneman S .
Incidence, duration and risk factors associated with delayed and missed diagnostic opportunities related to tuberculosis: a population-based longitudinal study.
BMJ Open 2021 Feb 18;11(2):e045605. doi: 10.1136/bmjopen-2020-045605..
Keywords: Respiratory Conditions, Diagnostic Safety and Quality, Risk
Shah NR, Eisman AS, Winchester DE
E-consult protocoling to improve the quality of cardiac stress tests.
Rarely appropriate cardiac stress tests remain prevalent in the range of 10% to 20% and unnecessarily prolong wait times. To address this ongoing problem, the investigators designed the EPIQ-Stress workflow, which included a structured electronic consult (“econsult”) with all outpatient stress test orders. In this study, the investigators assessed whether EPIQ-Stress implementation was associated with a reduction in rarely appropriate testing and in order-to-report wait times.
AHRQ-funded; HS022998.
Citation: Shah NR, Eisman AS, Winchester DE .
E-consult protocoling to improve the quality of cardiac stress tests.
JACC Cardiovasc Imaging 2021 Feb;14(2):512-14. doi: 10.1016/j.jcmg.2020.08.009..
Keywords: Telehealth, Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality