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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 4 of 4 Research Studies DisplayedMeyer AND, Giardina TD, Khawaja L
Patient and clinician experiences of uncertainty in the diagnostic process: current understanding and future directions,.
The purpose of this study was to provide a comprehensive overview of the current literature on diagnosis-related uncertainty in patients and clinicians. The researchers describe 1) where patients and clinicians encounter uncertainty within the diagnostic process, 2) how uncertainty affects the diagnostic process, 3) origins of uncertainty related to probability/risk, ambiguity, or complexity, and 4) strategies for managing uncertainty. The study found that every step in the diagnostic process involves uncertainty. The researchers’ recommendations of strategies for general management included: acknowledging uncertainty, obtaining more information from patients, creating diagnostic safety nets such as educating patients about observing red flags, utilizing worst/ best case scenario planning, and communicating diagnostic uncertainty to patients, families, and colleagues. The study also delineated possible strategies specific to various aspects of diagnostic uncertainty.
AHRQ-funded; HS025474.
Citation: Meyer AND, Giardina TD, Khawaja L .
Patient and clinician experiences of uncertainty in the diagnostic process: current understanding and future directions,.
Patient Educ Couns 2021 Nov;104(11):2606-15. doi: 10.1016/j.pec.2021.07.028..
Keywords: Diagnostic Safety and Quality, Clinician-Patient Communication, Communication
Cifra Cifra, CL Dukes, KC Ayres, et al.
Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: a pilot ethnography.
This pilot study’s goal was to determine the feasibility of using focused ethnography to understand the relationship between referral communication and the diagnostic process for critically ill children. Findings showed that focused ethnography in the pediatric intensive care unit is feasible to investigate relationships between clinician referral communication and the diagnostic process for critically ill children.
AHRQ-funded; HS026965.
Citation: Cifra Cifra, CL Dukes, KC Ayres, et al..
Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: a pilot ethnography.
J Crit Care 2021 Jun;63:246-49. doi: 10.1016/j.jcrc.2020.09.011..
Keywords: Children/Adolescents, Communication, Critical Care, Intensive Care Unit (ICU), 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