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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
26 to 50 of 148 Research Studies DisplayedWhicher DM, Miller JE, Dunham KM
Gatekeepers for pragmatic clinical trials.
The authors provided a framework to help guide gatekeepers' decision-making related to the use of resources for pragmatic clinical trials. They stated that recognition of the complex set of considerations that should inform decision-making will guide gatekeepers in making justifiable choices regarding the use of limited and valuable resources.
AHRQ-funded; HS000029.
Citation: Whicher DM, Miller JE, Dunham KM .
Gatekeepers for pragmatic clinical trials.
Clin Trials 2015 Oct;12(5):442-8. doi: 10.1177/1740774515597699.
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Keywords: Shared Decision Making, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Research Methodologies
Aysola J, Rhodes KV, Polsky D
Patient-centered medical homes and access to services for new primary care patients.
The study objective was to determine whether patient-centered medical homes (PCMH) practices are associated with better access to new appointments for nonelderly adults by direct measurement. Callers to PCMH practices compared with non-PCMH practices were more likely to schedule a new appointment and be offered after-hour appointments.
AHRQ-funded; HS021706.
Citation: Aysola J, Rhodes KV, Polsky D .
Patient-centered medical homes and access to services for new primary care patients.
Med Care 2015 Oct;53(10):857-62. doi: 10.1097/mlr.0000000000000412..
Keywords: Comparative Effectiveness, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
Cochran GL, Horn SD
Potential effect of coding differences on comparisons of rural and urban outcomes.
To investigate the concern that systematic differences in coding exist, the researchers conducted a small pilot study. Their study compared rural and urban disease severity for four common diagnoses in a Midwestern urban academic medical center and eight critical access hospitals (CAHs). They found significantly fewer comorbidities (identified according to ICD-9 codes) in rural subjects, despite their being approximately 15 years older than subjects in the urban comparator group.
AHRQ-funded; HS018059.
Citation: Cochran GL, Horn SD .
Potential effect of coding differences on comparisons of rural and urban outcomes.
J Am Geriatr Soc 2015 Oct;63(10):2210-2. doi: 10.1111/jgs.13692..
Keywords: Rural Health, Urban Health, Comparative Effectiveness, Outcomes
Ogedegbe G, Shah NR, Phillips C
Comparative effectiveness of angiotensin-converting enzyme inhibitor-based treatment on cardiovascular outcomes in hypertensive Blacks versus Whites.
This study evaluated the comparative effectiveness of an ACE inhibitor–based regimen on a composite outcome of all-cause mortality, stroke, and acute myocardial infarction (AMI) in hypertensive blacks compared with whites. ACE inhibitor–based therapy was associated with poorer cardiovascular outcomes in hypertensive blacks but not in whites.
AHRQ-funded; HS018589.
Citation: Ogedegbe G, Shah NR, Phillips C .
Comparative effectiveness of angiotensin-converting enzyme inhibitor-based treatment on cardiovascular outcomes in hypertensive Blacks versus Whites.
J Am Coll Cardiol 2015 Sep 15;66(11):1224-33. doi: 10.1016/j.jacc.2015.07.021..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cardiovascular Conditions, Racial and Ethnic Minorities, Medication
Vickers BP, Shi J, Lu B
Comparative study of ED mortality risk of US trauma patients treated at level I and level II vs nontrauma centers.
The researchers used National Emergency Department Sample (NEDS) data to explore the hypothesis that severely injured trauma victims properly triaged to a level I or level II trauma center have significantly lower odds of death than those undertriaged to a non-trauma center. They found that trauma patients with Injury Severity Score of greater than 25 received most benefit from proper triage. Efforts to reduce undertriage should focus on this population.
AHRQ-funded; HS022277.
Citation: Vickers BP, Shi J, Lu B .
Comparative study of ED mortality risk of US trauma patients treated at level I and level II vs nontrauma centers.
Am J Emerg Med 2015 Sep;33(9):1158-65. doi: 10.1016/j.ajem.2015.05.010..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Trauma, Comparative Effectiveness, Mortality
Tilden EL, Lee VR, Allen AJ
Cost-effectiveness analysis of latent versus active labor hospital admission for medically low-risk, term women.
The purpose of this study was to assess the outcomes and costs of hospital admission during the latent versus active phase of labor. It found that delaying admission until active labor would result in 672,000 fewer epidurals, 67,232 fewer cesarean deliveries, and 9.6 fewer maternal deaths in our theoretic cohort as compared to admission during latent labor.
AHRQ-funded; HS017582.
Citation: Tilden EL, Lee VR, Allen AJ .
Cost-effectiveness analysis of latent versus active labor hospital admission for medically low-risk, term women.
Birth 2015 Sep;42(3):219-26. doi: 10.1111/birt.12179..
Keywords: Labor and Delivery, Comparative Effectiveness, Healthcare Costs, Patient-Centered Outcomes Research, Hospitalization
Bannuru RR, McAlindon TE, Sullivan MC
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
The researchers evaluated the effects of alternative placebo types on pain outcomes in knee osteoarthritis. Their review concluded that all placebos are not equal, and some can trigger clinically relevant responses. Differential placebo effects can substantially alter estimates of the relative efficacies of active treatments.
AHRQ-funded; HS021396.
Citation: Bannuru RR, McAlindon TE, Sullivan MC .
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
Ann Intern Med 2015 Sep 1;163(5):365-72. doi: 10.7326/m15-0623..
Keywords: Comparative Effectiveness, Arthritis, Medication, Pain, Outcomes
Bannuru RR, McAlindon TE, Sullivan MC
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
The researchers evaluated the effects of alternative placebo types on pain outcomes in knee osteoarthritis. Their review concluded that all placebos are not equal, and some can trigger clinically relevant responses. Differential placebo effects can substantially alter estimates of the relative efficacies of active treatments.
AHRQ-funded; HS021396.
Citation: Bannuru RR, McAlindon TE, Sullivan MC .
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
Ann Intern Med 2015 Sep 1;163(5):365-72. doi: 10.7326/m15-0623..
Keywords: Comparative Effectiveness, Arthritis, Medication, Pain, Outcomes
Chou R, Hashimoto R, Friedly J
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
The researchers reviewed evidence on the benefits and harms of epidural corticosteroid injections in adults with radicular low back pain or spinal stenosis of any duration. They concluded that epidural corticosteroid injections for radiculopathy were associated with immediate reductions in pain and function. However, benefits were small and not sustained, and there was no effect on long-term surgery risk.
AHRQ-funded; 290201200014I.
Citation: Chou R, Hashimoto R, Friedly J .
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
Ann Intern Med 2015 Sep 1;163(5):373-81. doi: 10.7326/m15-0934.
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Keywords: Medication, Back Health and Pain, Chronic Conditions, Comparative Effectiveness, Evidence-Based Practice
Wyss R, Ellis AR, Brookhart MA
Matching on the disease risk score in comparative effectiveness research of new treatments.
The researchers used simulations and an empirical example to evaluate the performance of disease risk score (DRS) matching compared with propensity score (PS) matching when controlling large numbers of covariates in settings involving newly introduced treatments. When PS distributions are separated, DRS matching can improve the precision of effect estimates and allow researchers to evaluate the treatment effect in a larger proportion of the treated population.
AHRQ-funded; HS017950.
Citation: Wyss R, Ellis AR, Brookhart MA .
Matching on the disease risk score in comparative effectiveness research of new treatments.
Pharmacoepidemiol Drug Saf 2015 Sep;24(9):951-61. doi: 10.1002/pds.3810.
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Keywords: Comparative Effectiveness, Research Methodologies, Blood Thinners, Medication
Swanson SA, Hernandez-Diaz S, Palmsten K
Methodological considerations in assessing the effectiveness of antidepressant medication continuation during pregnancy using administrative data.
The goal of this study is to evaluate whether standard administrative claims data can be used to evaluate the effectiveness of antidepressants. Its findings suggest that either antidepressant medications do not reduce the risk of depression relapse in pregnant women, or that administrative data alone could not be used to validly estimate the effectiveness of psychotropic medications during pregnancy.
AHRQ-funded; HS018533.
Citation: Swanson SA, Hernandez-Diaz S, Palmsten K .
Methodological considerations in assessing the effectiveness of antidepressant medication continuation during pregnancy using administrative data.
Pharmacoepidemiol Drug Saf 2015 Sep;24(9):934-42. doi: 10.1002/pds.3798..
Keywords: Medication, Comparative Effectiveness, Pregnancy
Kuo YF, Chen NW, Baillargeon J
Potentially preventable hospitalizations in Medicare patients with diabetes: a comparison of primary care provided by nurse practitioners versus physicians.
The researchers compared the rates of potentially preventable hospitalizations in older diabetic patients who received primary care from nurse practitioners (NPs) only versus those who received care from primary care physicians only. Using potentially preventable hospitalizations as a quality indicator, they found that primary care provided by NPs was at least comparable with that provided by generalist physicians.
AHRQ-funded; HS020642; HS022134.
Citation: Kuo YF, Chen NW, Baillargeon J .
Potentially preventable hospitalizations in Medicare patients with diabetes: a comparison of primary care provided by nurse practitioners versus physicians.
Med Care 2015 Sep;53(9):776-83. doi: 10.1097/mlr.0000000000000406..
Keywords: Hospitalization, Primary Care, Comparative Effectiveness, Diabetes
Fischer MA, Allen-Coleman C, Farrell SF
Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.
Because children, pregnant women and people with mental illness have generally been underrepresented in research discussions, comparative effectiveness rsearch (CER) questions for these groups may be understudied. To address this problem, AHRQ commissioned a team to work with Medicaid Medical Directors and other stakeholders to identify relevant CER questions. Through an iterative process of topic identification and refinement, they developed relevant, feasible and actionable questions based on issues affecting Medicaid programs nationwide.
AHRQ-funded; 290200500161.
Citation: Fischer MA, Allen-Coleman C, Farrell SF .
Stakeholder assessment of comparative effectiveness research needs for Medicaid populations.
J Comp Eff Res 2015 Sep;4(5):465-71. doi: 10.2217/cer.15.26.
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Keywords: Comparative Effectiveness, Medicaid, Research Methodologies, Shared Decision Making, Vulnerable Populations
Bewtra M, Newcomb CW, Wu Q
Mortality associated with medical therapy versus elective colectomy in ulcerative colitis: a cohort study.
This study sought to determine whether patients with advanced ulcerative colitis (UC) treated with elective colectomy have improved survival compared with those treated with medical therapy. It found that elective colectomy was associated with improved survival compared with long-term medical therapy, although this result did not remain statistically significant in all sensitivity analyses.
AHRQ-funded; HS018517.
Citation: Bewtra M, Newcomb CW, Wu Q .
Mortality associated with medical therapy versus elective colectomy in ulcerative colitis: a cohort study.
Ann Intern Med 2015 Aug 18;163(4):262-70. doi: 10.7326/m14-0960..
Keywords: Comparative Effectiveness, Mortality, Outcomes, Surgery, Digestive Disease and Health
Marsolo K, Margolis PA, Forrest CB
A digital architecture for a network-based learning health system: integrating chronic care management, quality improvement, and research.
The authors collaborated with the ImproveCareNow Network to create a proof-of-concept architecture for a network-based Learning Health System. This collaboration involved transitioning an existing registry to one that is linked to the electronic health record (EHR), enabling a “data in once” strategy. This required automating a series of reports that support care improvement while also demonstrating the use of observational registry data for comparative effectiveness research.
AHRQ-funded; HS020024; HS022974.
Citation: Marsolo K, Margolis PA, Forrest CB .
A digital architecture for a network-based learning health system: integrating chronic care management, quality improvement, and research.
eGEMS 2015 Aug 17;3(1):1168. doi: 10.13063/2327-9214.1168..
Keywords: Electronic Health Records (EHRs), Registries, Patient-Centered Outcomes Research, Comparative Effectiveness, Health Information Technology (HIT)
Chung H, Kim J, Askew RL
Assessing measurement invariance of three depression scales between neurologic samples and community samples.
The purpose of this study was to test measurement invariance of three patient-reported measures of depressive symptoms between neurologic and community samples. Its results suggest that depressive symptoms as measured by three different outcome measures have the same meaning across clinical and community samples. Thus, the use of these measures for group comparisons is supported.
AHRQ-funded; HS020700.
Citation: Chung H, Kim J, Askew RL .
Assessing measurement invariance of three depression scales between neurologic samples and community samples.
Qual Life Res 2015 Aug;24(8):1829-34. doi: 10.1007/s11136-015-0927-5..
Keywords: Depression, Outcomes, Comparative Effectiveness
Rundell SD, Gellhorn AC, Comstock BA
Clinical outcomes of early and later physical therapist services for older adults with back pain.
The purpose of this study was to compare clinical outcomes of patients receiving early or later PT services with those not receiving PT among older adults presenting to primary care for a new visit for back pain. It found that among older adults early referral to PT resulted in no or minimal differences in pain, function, or health-related quality at 3, 6, or 12 months compared with a matched group that did not receive early PT.
AHRQ-funded; HS019222.
Citation: Rundell SD, Gellhorn AC, Comstock BA .
Clinical outcomes of early and later physical therapist services for older adults with back pain.
Spine J 2015 Aug;15(8):1744-55. doi: 10.1016/j.spinee.2015.04.001..
Keywords: Back Health and Pain, Elderly, Primary Care, Comparative Effectiveness, Patient-Centered Outcomes Research
Du XL, Zhang Y, Parikh RC
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
The purpose of this study was to compare the effectiveness of chemotherapy in prolonging survival according to age in breast and colon cancer. It found that the effectiveness of chemotherapy decreased with age in participants with breast cancer, in whom chemotherapy appears to be effective until age 79 except for the doxorubicin-cyclophosphamide combination, which was effective in participants aged 80 to 84.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Parikh RC .
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
J Am Geriatr Soc 2015 Aug;63(8):1570-82. doi: 10.1111/jgs.13523..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research
Goldman SN, Liss DT, Brown T
Comparative effectiveness of multifaceted outreach to initiate colorectal cancer screening in community health centers: a randomized controlled trial.
The researchers sought to determine whether outreach increases fecal immune-chemical test (FIT) uptake among patients with no CRC screening history compared to usual care. They found that patients who received outreach were more likely to complete FIT than those in usual care (36.7 percent vs. 14.8 percent).
AHRQ-funded; HS021141.
Citation: Goldman SN, Liss DT, Brown T .
Comparative effectiveness of multifaceted outreach to initiate colorectal cancer screening in community health centers: a randomized controlled trial.
J Gen Intern Med 2015 Aug;30(8):1178-84. doi: 10.1007/s11606-015-3234-5..
Keywords: Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Prevention, Screening
FitzHenry F, Resnic FS, Robbins SL
Creating a common data model for comparative effectiveness with the observational medical outcomes partnership.
This case study describes the challenges and opportunities of a study specific use of the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM) by two health systems and describe three comparative effectiveness use cases developed from the CDM. It concluded that the data transformation to the CDM was time consuming and resources required were substantial, beyond requirements for collecting native source data.
AHRQ-funded; HS019913.
Citation: FitzHenry F, Resnic FS, Robbins SL .
Creating a common data model for comparative effectiveness with the observational medical outcomes partnership.
Appl Clin Inform 2015 Aug 26;6(3):536-47. doi: 10.4338/aci-2014-12-cr-0121..
Keywords: Comparative Effectiveness, Outcomes, Data
Pine M, Kowlessar NM, Salemi JL
Enhancing clinical content and race/ethnicity data in statewide hospital administrative databases: obstacles encountered, strategies adopted, and lessons learned.
Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases. The authors concluded that creation of enhanced administrative databases to support comparative effectiveness research is difficult, particularly in the face of numerous challenges with recruiting data partners such as competing demands on information technology resources.
AHRQ-funded
Citation: Pine M, Kowlessar NM, Salemi JL .
Enhancing clinical content and race/ethnicity data in statewide hospital administrative databases: obstacles encountered, strategies adopted, and lessons learned.
Health Serv Res 2015 Aug;50 Suppl 1:1300-21. doi: 10.1111/1475-6773.12330..
Keywords: Healthcare Cost and Utilization Project (HCUP), Comparative Effectiveness, Patient-Centered Outcomes Research, Data
Conover MM, Howell JO, Wu JM
Incidence of opioid-managed pelvic pain after hysteroscopic sterilization versus laparoscopic sterilization, US 2005-2012.
The researchers compared the incidence of opioid-managed pelvic pain within 12 months after hysteroscopic and laparoscopic sterilization. They found that among women without recent history of childbirth, there was no compelling evidence of a clinically meaningful increase in the incidence of pelvic pain requiring opioids during the year after hysteroscopic sterilization.
AHRQ-funded; HS017950.
Citation: Conover MM, Howell JO, Wu JM .
Incidence of opioid-managed pelvic pain after hysteroscopic sterilization versus laparoscopic sterilization, US 2005-2012.
Pharmacoepidemiol Drug Saf 2015 Aug;24(8):875-84. doi: 10.1002/pds.3766..
Keywords: Comparative Effectiveness, Medication, Opioids, Pain, Women
Fingar KR, Smith MW, Davies S
AHRQ Author: Stocks C
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
This study examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine States in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. It found that county-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for.
AHRQ-authored; AHRQ-funded; 290201200003I; HS021700.
Citation: Fingar KR, Smith MW, Davies S .
Medicaid dental coverage alone may not lower rates of dental emergency department visits.
Health Aff 2015 Aug;34(8):1349-57. doi: 10.1377/hlthaff.2015.0223..
Keywords: Dental and Oral Health, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Comparative Effectiveness, Medicaid
Shah ED, Siegel CA, Chong K
Patients with Crohn's disease are more likely to remain on biologics than immunomodulators: a meta-analysis of treatment durability.
The researchers aimed to clarify treatment durability by assessing subject discontinuations from clinical trials in the context of treatment efficacy. They found that for patients with Crohn’s disease, biologic therapies had higher durability than immunomodulators for induction and maintenance therapy.
AHRQ-funded; HS021747.
Citation: Shah ED, Siegel CA, Chong K .
Patients with Crohn's disease are more likely to remain on biologics than immunomodulators: a meta-analysis of treatment durability.
Dig Dis Sci 2015 Aug;60(8):2408-18. doi: 10.1007/s10620-015-3618-8..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions, Comparative Effectiveness
Salemi JL, Salinas-Miranda AA, Wilson RE
Transformative use of an improved all-payer hospital discharge data infrastructure for community-based participatory research: a sustainability pathway.
The researchers describe the use of a clinically enhanced maternal and child health (MCH) database to strengthen community-engaged research activities, and to support the sustainability of data infrastructure initiatives. The population-based, longitudinal database was used to supplement data collected from focus groups and community surveys with epidemiological and health care cost data on important MCH disparity issues in the target community.
AHRQ-funded; HS019997.
Citation: Salemi JL, Salinas-Miranda AA, Wilson RE .
Transformative use of an improved all-payer hospital discharge data infrastructure for community-based participatory research: a sustainability pathway.
Health Serv Res 2015 Aug;50 Suppl 1:1322-38. doi: 10.1111/1475-6773.12309..
Keywords: Maternal Care, Comparative Effectiveness, Hospital Discharge, Data, Quality Improvement