National Healthcare Quality and Disparities Report
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- Access to Care (1)
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- Rehabilitation (1)
- Research Methodologies (1)
- Respiratory Conditions (2)
- Risk (3)
- Rural Health (2)
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- Social Determinants of Health (1)
- Surgery (4)
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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 25 of 42 Research Studies DisplayedOlaya F, Brin M, Caraballo PB
A randomized controlled trial of the dissemination of an mHealth intervention for improving health outcomes: the WiseApp for Spanish-speakers living with HIV study protocol.
The purpose of this study is to test the effectiveness of an mHealth tool to improve adherence to HIV medication in Spanish-speaking people living in New York City and the Dominican Republic. The researchers developed the WiseApp study as a two-arm randomized controlled trial. The 248 participants from New York and the Dominican Republic were randomly assigned to receive a CleverCap pill bottle that is linked to the WiseApp (intervention) or to the standard of care (control). The participants completed surveys at the baseline, 3-month, 6-month, and 12-month follow-up visits. Through blood draws at each study timepoint, the study team collected HIV-1 viral load and CD4 count results. Results will be forthcoming.
AHRQ-funded; HS028523.
Citation: Olaya F, Brin M, Caraballo PB .
A randomized controlled trial of the dissemination of an mHealth intervention for improving health outcomes: the WiseApp for Spanish-speakers living with HIV study protocol.
BMC Public Health 2024 Jan 17; 24(1):201. doi: 10.1186/s12889-023-17538-y..
Keywords: Human Immunodeficiency Virus (HIV), Telehealth, Health Information Technology (HIT), Cultural Competence, Outcomes
Silverstein GD, Styke SC, Kaur S
The relationship between depressive symptoms, eHealth literacy, and asthma outcomes in the context of a mobile health intervention.
This study’s objective was to evaluate the associations between health/eHealth literacy and depressive symptoms with app usage and clinical outcomes. The authors recruited adults with persistent asthma to utilize the ASTHMAXcel PRO mobile app. Participants completed the following questionnaires: Patient Health Questionnaire-9 (PHQ-9) to assess for depressive symptoms, Asthma Control Test (ACT), Mini Asthma Quality of Life (QOL) Questionnaire, and the Newest Vital Sign (NVS) tool to measure health literacy. Subsets of participant data were available on eHealth literacy (eHeals) (n = 24) and average number of app logins across 2 months (n = 40). The average participant age was 44.0 years, with 74% identifying as female. Increased depressive symptoms were associated with worse asthma control and asthma QOL, but not eHealth literacy. Higher eHealth literacy was associated with worse asthma QOL and more app logins. NVS scores weren’t associated with any measures.
AHRQ-funded; HS025645.
Citation: Silverstein GD, Styke SC, Kaur S .
The relationship between depressive symptoms, eHealth literacy, and asthma outcomes in the context of a mobile health intervention.
Psychosom Med 2023 Sep 1; 85(7):605-11. doi: 10.1097/psy.0000000000001170..
Keywords: Health Literacy, Asthma, Telehealth, Health Information Technology (HIT), Education: Patient and Caregiver, Outcomes, Respiratory Conditions, Chronic Conditions
Krishnan JA, Margellos-Anast H, Kumar R
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
The purpose of this clinical trial was to compare an emergency-department- (ED) only intervention and home visits by community health workers for 6 months (ED-plus-home) and enhanced usual care (UC). The study enrolled children aged 5 to 11 years with uncontrolled asthma. The primary outcomes were change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers. The secondary outcomes included guideline-recommended ED discharge care and self-management. The study found that of the 373 children recruited, only 63% completed the 6-month follow-up visit. Differences in Asthma Impact Scores or caregivers' Satisfaction with Participation in Social Roles scores were not significant. However, in the intervention groups guideline-recommended ED discharge care improved significantly versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups.
AHRQ-funded; HS027804.
Citation: Krishnan JA, Margellos-Anast H, Kumar R .
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
J Allergy Clin Immunol Glob 2023 Aug; 2(3). doi: 10.1016/j.jacig.2023.100100..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Emergency Department, Clinical Decision Support (CDS), Health Information Technology (HIT), Racial and Ethnic Minorities
Humbert-Droz M, Izadi Z, Schmajuk G
Development of a natural language processing system for extracting rheumatoid arthritis outcomes from clinical notes using the national rheumatology informatics system for effectiveness registry.
Researchers developed and evaluated a natural language processing pipeline for extracting outcome measures in rheumatology from free-text outpatient rheumatology notes within the ACR's Rheumatology Informatics System for Effectiveness (RISE) registry. All patients in RISE from 2015 to 2018 were included. The researchers found the pipeline to have good internal and external validity and they concluded that it could facilitate measurement of clinical and patient reported outcomes for use in both research and quality measurement.
AHRQ-funded; HS025638.
Citation: Humbert-Droz M, Izadi Z, Schmajuk G .
Development of a natural language processing system for extracting rheumatoid arthritis outcomes from clinical notes using the national rheumatology informatics system for effectiveness registry.
Arthritis Care Res 2023 Mar; 75(3):608-15. doi: 10.1002/acr.24869..
Keywords: Arthritis, Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Mohr NM, Okoro U, Harland KK
Outcomes associated with rural emergency department provider-to-provider telehealth for sepsis care: a multicenter cohort study.
The objective of this multicenter cohort study was to test the hypothesis that provider-to-provider tele-emergency department (tele-ED) care is associated with more 28-day hospital-free days and improved Surviving Sepsis Campaign (SSC) guideline adherence in rural emergency departments. Medical records of patients with sepsis were taken from rural hospitals in an established, on-demand, video tele-ED Midwestern network. Findings suggest that tele-ED cases did not have more 28-day hospital-free days or 28-day in-hospital mortality. A subgroup of patients treated by advanced practice providers suggest that mortality was lower in the cohort with tele-ED use in spite of no significant difference in complete SSC adherence. The researchers concluded that rural emergency department patients treated with provider-to-provider tele-ED care in a developed network showed similar clinical outcomes to those treated without.
AHRQ-funded; HS025753.
Citation: Mohr NM, Okoro U, Harland KK .
Outcomes associated with rural emergency department provider-to-provider telehealth for sepsis care: a multicenter cohort study.
Ann Emerg Med 2023 Jan;81(1):1-13. doi: 10.1016/j.annemergmed.2022.07.024..
Keywords: Rural Health, Emergency Department, Telehealth, Health Information Technology (HIT), Sepsis, Outcomes
Fritz B, King C, Chen Y
Protocol for the perioperative outcome risk assessment with computer learning enhancement (Periop ORACLE) randomized study.
This paper describes a protocol for an ongoing study that hypothesizes that anesthesiology clinicians can predict postoperative complications more accurately with machine learning assistance than without machine learning assistance. This investigation is a sub-study nested within the TECTONICS randomized clinical trial. Study team members who are anesthesiology clinicians working in a telemedicine setting are currently reviewing ongoing surgical cases and documenting how likely they feel the patient is to experience 30-day in-hospital death or acute kidney injury. These case reviews will be randomized to be performed with access to a display showing machine learning predictions for the postoperative complications or without access to the display, and the accuracy of the predictions will be compared across these two groups.
AHRQ-funded; HS024581.
Citation: Fritz B, King C, Chen Y .
Protocol for the perioperative outcome risk assessment with computer learning enhancement (Periop ORACLE) randomized study.
F1000Res 2022; 11:653. doi: 10.12688/f1000research.122286.2..
Keywords: Surgery, Risk, Outcomes, Health Information Technology (HIT)
Ofoma UR, Drewry AM, Maddox TM
Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care.
This study compared survival rates for inpatients who suffered in-hospital cardiac arrest (IHCA) who had access to Telemedicine Critical Care (TCC) during nights and weekends (off-hours) compared to those who did not. The authors identified 44,585 adults at 280 U.S. hospitals in the Get With The Guidelines® - Resuscitation registry who suffered IHCA in an Intensive Care Unit (ICU) or hospital ward between July 2017 and December 2019. The majority (60.6%) of IHCAs occurred in an ICU, and 32.2% participants suffered IHCA at hospitals with TCC. No difference was found in acute resuscitation survival rates or survival to discharge rates for either IHCA between TCC and non-TCC hospitals. Timing of cardiac arrest did not modify the association between TCC availability and acute resuscitation survival or survival to discharge.
AHRQ-funded; HS019455.
Citation: Ofoma UR, Drewry AM, Maddox TM .
Outcomes of in-hospital cardiac arrest among hospitals with and without telemedicine critical care.
Resuscitation 2022 Aug;177:7-15. doi: 10.1016/j.resuscitation.2022.06.008..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Telehealth, Health Information Technology (HIT), Outcomes, Critical Care, Intensive Care Unit (ICU)
Gaugler JE, Rosebush CA, Zmora R
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
The purpose of this study was to evaluate whether Remote Activity Monitoring (RAM) technology was associated with reductions in negative health transitions and service utilization for persons with Alzheimer's disease or a related dementia over an 18-month period. The researchers enrolled 88 recipients and their caregivers in a clinical trial, with 88 care recipients and their caregivers in the RAM intervention arm and 91 care recipients and their caregivers in the control arm. The treatment group had the RAM system installed in their home. The attention control group did not receive RAM technology. Baseline and follow-up surveys assessed whether the care recipient had fallen or wandered in the past 6 months (yes/no). Caregivers were also asked whether the care recipient had used any of the following healthcare services in the past 6 months: nursing home stays, assisted living stays other residential care stays, hospital stays, or emergency room visits. The study found that in adjusted models, emergency department visits were almost 50% lower in the intervention group compared with the control group. In addition, the odds of experiencing a higher frequency of falls versus a lower frequency of falls was 0.36 for those in the intervention group compared with controls. The RAM technology did not have a statistically significant effect on any other outcome. The researchers concluded that although RAM did not provide direct support for the management of behaviors for persons with AD/ADRD, the findings imply that this technology may prevent some adverse health events for people living with dementia in the community. The ongoing, unobtrusive monitoring and system alerts of RAM may have resulted in caregivers identifying activity or the lack thereof that may
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
have prevented falls and wandering events. In turn, emergency room use among persons with dementia may have been avoided.
AHRQ-funded; HS022836.
Citation: Gaugler JE, Rosebush CA, Zmora R .
Outcomes of remote activity monitoring for persons living with dementia over an 18-month period.
J Am Geriatr Soc 2022 Aug;70(8):2439-42. doi: 10.1111/jgs.17839..
Keywords: Elderly, Dementia, Neurological Disorders, Telehealth, Health Information Technology (HIT), Outcomes, Caregiving
Keeney T, Kumar A, Erler KS
Making the case for patient-reported outcome measures in big-data rehabilitation research: implications for optimizing patient-centered care.
This article discussed the potential of patient-reported outcome measures (PROMs) to transform clinical practice. It also provided examples of health systems that use PROMs to guide care and identified barriers to aggregating data from PROMs in conducting health services research. The authors proposed two priority areas which could help advance rehabilitation health services research: standardization of collecting PROMs data in electronic health records and increased partnerships between rehabilitation providers, researchers, and payors.
AHRQ-funded; HS000011.
Citation: Keeney T, Kumar A, Erler KS .
Making the case for patient-reported outcome measures in big-data rehabilitation research: implications for optimizing patient-centered care.
Arch Phys Med Rehabil 2022 May; 103(5s):S140-s45. doi: 10.1016/j.apmr.2020.12.028..
Keywords: Rehabilitation, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Health Information Technology (HIT), Outcomes
Ferucci ED, Day GM, Choromanski TL
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
This study’s objective was to evaluate outcomes and quality of care for rheumatoid arthritis (RA) in patients seen by video telemedicine compared to in-person only. Individuals in the Alaska Tribal Health System who were diagnosed with RA were recruited when seeing a rheumatologist either in person or by video telemedicine. Participants completed a Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire and a telephone medicine perception survey at the start of the survey. They also agreed to medical record review. The authors repeated the surveys by telephone and at 6 and 12 months, and medical record abstraction was performed at 12 months for quality measures. By the end of the 12-month period, about half of the 122 RA participants (52%) had ever used telemedicine for RA. Higher RAPID3 score and functional status were associated with the telemedicine group, with no statistically significant change over the 12-month period. The only quality measure that differed between the two groups at 12 months was the proportion of visits in which disease activity was documented, but it was not significantly after multivariate analysis.
AHRQ-funded; HS024540.
Citation: Ferucci ED, Day GM, Choromanski TL .
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
Arthritis Care Res 2022 Mar;74(3):484-92. doi: 10.1002/acr.24485..
Keywords: Arthritis, Chronic Conditions, Telehealth, Health Information Technology (HIT), Quality of Care, Outcomes
Coley RY, Boggs JM, Beck A
Predicting outcomes of psychotherapy for depression with electronic health record data.
This study evaluated models for predicting outcomes of psychotherapy for depression in a clinical practice setting. Findings showed that prediction models did not accurately predict depression treatment outcomes despite using rich electronic health record data and advanced analytic techniques. Recommendations included caution when considering prediction models for psychiatric outcomes using baseline intake information and transparent research to evaluate performance of any model intended for clinical use.
AHRQ-funded; HS026369.
Citation: Coley RY, Boggs JM, Beck A .
Predicting outcomes of psychotherapy for depression with electronic health record data.
J Affect Disord Rep 2021 Dec;6:100198. doi: 10.1016/j.jadr.2021.100198..
Keywords: Depression, Behavioral Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research, Outcomes
Austin EJ, LeRouge C, Lee JR
A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.
The authors reported on their effort to develop generalizable learnings that can support the integration of electronic patient-reported outcome measures into clinical practice within a learning health system (LHS) framework. They concluded that the guidelines produced from this work highlighted the complex, multidisciplinary nature of implementing change within LHS contexts, as well as the value of action research approaches to enable rapid, iterative learning that leverages the knowledge and experience of communities of practice.
AHRQ-funded; HS023785.
Citation: Austin EJ, LeRouge C, Lee JR .
A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.
Learn Health Syst 2021 Oct;5(4):e10263. doi: 10.1002/lrh2.10263..
Keywords: Learning Health Systems, Health Information Technology (HIT), Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Jacobs M, Ellis C
Estimating the cost and value of functional changes in communication ability following telepractice treatment for aphasia.
This study assessed the cost, cost-effectiveness, and perceived value associated with improved functional communication in individuals receiving telerehabilitation treatment for aphasia. Twenty persons with aphasia completed between 5 and 12 telehealth sessions of 45-60 minutes within a 6-week timeframe using a Language-Oriented Treatment (LOT). Measures were used to obtain baseline and treatment status using the National Outcomes Measures (NOMS) comprehension and verbal expression and the ASHA Quality of Communication Life (QCL). African Americans were twice as likely as Whites to experience improvement after treatment. The likelihood of improvement also increased with each additional year of education but decreased with age. The average cost of treatment varied between $540 and $1,296. However, on average the monetary equivalent in patient’s improved QCL was between $1,790 to $3,912, showing the QCL far exceeded the financial cost of treatment.
AHRQ-funded; HS025043.
Citation: Jacobs M, Ellis C .
Estimating the cost and value of functional changes in communication ability following telepractice treatment for aphasia.
PLoS One 2021 Sep 17;16(9):e0257462. doi: 10.1371/journal.pone.0257462..
Keywords: Telehealth, Health Information Technology (HIT), Healthcare Costs, Outcomes
Kutney-Lee A, Brooks Carthon M, Sloane DM
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Researchers examined associations between electronic health record (EHR) usability and nurse job and surgical patient outcomes. Data from the American Hospital Association, state patient discharges, and nurse surveys were linked in a cross-sectional analysis. The researchers found that employing EHR systems with suboptimal usability was associated with higher odds of adverse nurse job outcomes and surgical patient mortality and readmission.
AHRQ-funded; HS023805.
Citation: Kutney-Lee A, Brooks Carthon M, Sloane DM .
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Med Care 2021 Jul;59(7):625-31. doi: 10.1097/mlr.0000000000001536..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery, Outcomes, Nursing, Provider: Nurse
Aiyegbusi OL, Nair D, Peipert JD
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
This review discusses and summarizes evidence of the impact of electronic patient-reported outcomes measures (ePROMs) on clinical parameters and outcomes relevant to chronic diseases. Various studies have demonstrated the feasibility of ePROMs in routine clinical practice with patients increasing expressing a preference for an electronic mode of administration. These ePROMs could have significant impacts on outcomes valued by patients, healthcare providers, and researchers. Recently published literature.
AHRQ-funded; HS026395.
Citation: Aiyegbusi OL, Nair D, Peipert JD .
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
Ther Adv Chronic Dis 2021 May 24;12:20406223211015958. doi: 10.1177/20406223211015958..
Keywords: Chronic Conditions, Patient Experience, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Evidence-Based Practice
Presley C, Agne A, Shelton T
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
This study compared the effectiveness of a community-based diabetes self-management education (DSME) plus mobile health (mHealth)-enhanced peer support intervention to community-based DSME alone for African American adults with poorly controlled type 2 diabetes. This randomized controlled trial took place in Jefferson County, Alabama within a safety-net healthcare system with a group diagnosed with type 2 diabetes and hemoglobin A1C ≥ 7.5%. The intervention group reviewed community-based DSME plus 6 months of mHealth-enhanced peer support, including 12 weekly phone calls, then 3 monthly calls from community health workers. The control group received community based DSME only. Primary outcomes were lower A1C and secondary outcomes were lower diabetes distress, depressive symptoms, self-efficacy or confidence in their ability to manage diabetes, and social support. Of 120 participants selected, 97 completed the study. Both groups experienced clinical meaning reduction in A1C. Participants in the intervention group experienced a significantly larger reduction in diabetes distress compared to the control group.
AHRQ-funded; HS019465.
Citation: Presley C, Agne A, Shelton T .
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
J Gen Intern Med 2020 Oct;35(10):2889-96. doi: 10.1007/s11606-020-06011-w..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Education: Patient and Caregiver
Dorsch MP, Cornellier ML, Poggi AD
Effects of a novel contextual just-in-time mobile app intervention (LowSalt4Life) on sodium intake in adults with hypertension: pilot randomized controlled trial.
Researchers evaluated the effect of a just-in-time adaptive mobile application intervention, LowSalt4Life, on reducing sodium intake. They found that, in a randomized controlled pilot study in adults with hypertension, a contextual just-in-time mobile application intervention demonstrated a greater reduction in dietary sodium intake over 8 weeks compared to controls. There was not a statistically significant difference in self-confidence following a low sodium diet, 24-hour urinary sodium excretion, or dietary intake of sodium measured by 24-hour dietary recall compared to control over 8 weeks. They recommended a larger clinical trial is to elucidate further the effects of the LowSalt4Life intervention on sodium intake and blood pressure.
AHRQ-funded; HS024567.
Citation: Dorsch MP, Cornellier ML, Poggi AD .
Effects of a novel contextual just-in-time mobile app intervention (LowSalt4Life) on sodium intake in adults with hypertension: pilot randomized controlled trial.
JMIR Mhealth Uhealth 2020 Aug 10;8(8). doi: 10.2196/16696..
Keywords: Blood Pressure, Telehealth, Health Information Technology (HIT), Outcomes
Burnham JP, Fritz SA, Yaeger LH
Telemedicine infectious diseases consultations and clinical outcomes: a systematic review.
Researchers reviewed the current evidence for clinical effectiveness of telemedicine infectious diseases consultations. They found that the outcomes tracked were heterogeneous, precluding meta-analysis, and the majority of studies were of poor quality. Overall, clinical outcomes with telemedicine infectious diseases consultation seem comparable to in-person infectious diseases consultation. They concluded that, although in widespread use, the clinical effectiveness of telemedicine infectious diseases consultations has yet to be sufficiently studied.
AHRQ-funded; R01 HS024269.
Citation: Burnham JP, Fritz SA, Yaeger LH .
Telemedicine infectious diseases consultations and clinical outcomes: a systematic review.
Open Forum Infect Dis 2019 Dec 5;6(12):ofz517. doi: 10.1093/ofid/ofz517..
Keywords: Telehealth, Infectious Diseases, Health Information Technology (HIT), Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research
Vakkalanka JP, Harland KK, Wittrock A
Telemedicine is associated with rapid transfer and fewer involuntary holds among patients presenting with suicidal ideation in rural hospitals: a propensity matched cohort study.
The purpose of this retrospective propensity-matched cohort study was to evaluate the impact of telemedicine in clinical management and patient outcomes of patients presenting to rural critical access hospital emergency departments (EDs) with suicidal ideation or attempt. The authors suggest that the role of telemedicine in influencing access, quality and efficiency of care in underserved rural hospitals is critically important as these networks become more prevalent in rural healthcare environments.
AHRQ-funded; HS025753.
Citation: Vakkalanka JP, Harland KK, Wittrock A .
Telemedicine is associated with rapid transfer and fewer involuntary holds among patients presenting with suicidal ideation in rural hospitals: a propensity matched cohort study.
J Epidemiol Community Health 2019 Nov;73(11):1033-39. doi: 10.1136/jech-2019-212623..
Keywords: Telehealth, Rural Health, Access to Care, Behavioral Health, Health Information Technology (HIT), Healthcare Delivery, Care Management, Outcomes, Emergency Department
Hinson JS, Martinez DA, Cabral S
Triage performance in emergency medicine: a systematic review.
The authors synthesized existing emergency department (ED) triage literature by using a framework that enables performance comparisons and benchmarking across triage systems, with respect to clinical outcomes and reliability. They found that a substantial proportion of ED patients who die post-encounter or who are critically ill are not designated as high acuity at triage. They suggested that the opportunity exists to improve interrater reliability and triage performance in identifying patients at risk of adverse outcome.
AHRQ-funded; HS023641.
Citation: Hinson JS, Martinez DA, Cabral S .
Triage performance in emergency medicine: a systematic review.
Ann Emerg Med 2019 Jul;74(1):140-52. doi: 10.1016/j.annemergmed.2018.09.022..
Keywords: Emergency Department, Shared Decision Making, Critical Care, Outcomes, Health Information Technology (HIT)
Burnham JP, Fritz SA, Yaeger LH
Telemedicine infectious diseases consultations and clinical outcomes: a systematic review and meta-analysis protocol.
This article describes a proposed systematic review that will evaluate the current evidence on the effect of telemedicine infectious diseases consultation within a range of clinical outcomes, including mortality, hospital readmission, antimicrobial use, and cost. Standard systematic review methodology will be used. Data will be grouped by outcome. Primary outcome will be 30-day all-cause mortality. Secondary outcomes will include: readmission within 30 days after discharge from an initial hospitalization with an infection; patient compliance/adherence; patient satisfaction; cost effectiveness; hospital length of stay, use of antimicrobials and antimicrobial stewardship. The findings of this review will add to the established literature regarding feasibility of telemedicine consultation.
AHRQ-funded; HS024269.
Citation: Burnham JP, Fritz SA, Yaeger LH .
Telemedicine infectious diseases consultations and clinical outcomes: a systematic review and meta-analysis protocol.
Syst Rev 2019 Jun 7;8(1):135. doi: 10.1186/s13643-019-1056-y..
Keywords: Evidence-Based Practice, Health Information Technology (HIT), Infectious Diseases, Outcomes, Patient Safety
Patel MR, Smith A, Leo H
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
This study assessed the effectiveness of providing physicians who use electronic health records (EHRs) education for communication strategies and its impact on patient outcomes. The evidence-based Physician Asthma Care Education (PACE) program was extended in a pilot program using 18 providers and 126 adult patients with persistent asthma. Outcomes were assessed at baseline and 3- and 6-month postintervention intervals. Providers who completed the EHR-PACE program felt more confident in communicating with their patients, but there was no significant changes in patient asthma outcomes or their perceptions of their provider’s communication skills.
AHRQ-funded; HS023786.
Citation: Patel MR, Smith A, Leo H .
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
Health Educ Behav 2019 Jun;46(3):484-93. doi: 10.1177/1090198118796879..
Keywords: Asthma, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Evidence-Based Practice, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Hannan EL, Barrett SC, Samadashvili Z
Retooling of paper-based outcome measures to electronic format: comparison of the NY State public risk model and EHR-derived risk models for CABG mortality.
This study assessed the feasibility of retooling the paper-based New York State coronary artery bypass graft (CABG) surgery statistical model for mortality and readmission into a model for electronic health records (EHRs). Researchers found that only 6 data elements could be extracted from the EHR, and outlier hospitals differed for readmission but was usable for mortality. They concluded that the EHR model was inferior to the NYS model, and that simplifying the EHR risk model couldn’t capture most of the risk factors in the NYS model.
AHRQ-funded; HS022647.
Citation: Hannan EL, Barrett SC, Samadashvili Z .
Retooling of paper-based outcome measures to electronic format: comparison of the NY State public risk model and EHR-derived risk models for CABG mortality.
Med Care 2019 May;57(5):377-84. doi: 10.1097/mlr.0000000000001104..
Keywords: Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Mortality, Outcomes, Risk, Cardiovascular Conditions
Bassett SM, Cohn M, Cotten P
Feasibility and acceptability of an online positive affect intervention for those living with comorbid HIV depression.
Positive affect has unique beneficial effects on psychological and physical health, independent of the effects of negative affect. Interventions that explicitly target positive affect show promise for improving health outcomes in a number of chronic illnesses. In this article, the investigators present pilot data on the acceptability and feasibility of an online intervention to increase positive affect in those living with comorbid human immunodeficiency virus (HIV) and depression.
AHRQ-funded; HS000084.
Citation: Bassett SM, Cohn M, Cotten P .
Feasibility and acceptability of an online positive affect intervention for those living with comorbid HIV depression.
AIDS Behav 2019 Mar;23(3):753-64. doi: 10.1007/s10461-019-02412-z..
Keywords: Human Immunodeficiency Virus (HIV), Depression, Behavioral Health, Chronic Conditions, Telehealth, Health Information Technology (HIT), Outcomes
Norgeot B, Glicksberg BS, Trupin L
Assessment of a deep learning model based on electronic health record data to forecast clinical outcomes in patients with rheumatoid arthritis.
This study researched the use of artificial intelligence learning models to predict clinical outcomes in patients with rheumatoid arthritis (RA). Patients from a university hospital (UH) and a public safety-net hospital (SNH). The populations were quite different from each other. A total of 578 UH patients and 242 SNH patients were included in the study. Patients at the UH were seen more frequently than the SNH patients and were often prescribed high-class medications (63% vs. 28.9%). The model that was used showed a statistically random performance based on each patients’ most recent disease activity score.
AHRQ-funded; HS024412.
Citation: Norgeot B, Glicksberg BS, Trupin L .
Assessment of a deep learning model based on electronic health record data to forecast clinical outcomes in patients with rheumatoid arthritis.
JAMA Netw Open 2019 Mar;2(3):e190606. doi: 10.1001/jamanetworkopen.2019.0606..
Keywords: Arthritis, Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes