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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 142 Research Studies DisplayedKim HS, Hernaez R, Sansgiry S
Comparative effectiveness of surveillance colonoscopy intervals on colorectal cancer outcomes in a national cohort of patients with inflammatory bowel disease.
The purpose of this study was to determine the comparative effectiveness of varying colonoscopy intervals on colorectal cancer (CRC) outcomes among patients with inflammatory bowel disease (IBD). Data was from the National Veterans Health Administration. Findings showed that, in a national cohort of patients with CRC-IBD, colonoscopy within 3 years prior to CRC diagnosis was associated with early tumor stage at diagnosis, and colonoscopy within 1 year was associated with a reduced all-cause mortality compared with no colonoscopy, supporting colonoscopy intervals of 1 to 3 years in patients with IBD in order to reduce late-stage CRC and all-cause mortality.
AHRQ-funded; HS024122.
Citation: Kim HS, Hernaez R, Sansgiry S .
Comparative effectiveness of surveillance colonoscopy intervals on colorectal cancer outcomes in a national cohort of patients with inflammatory bowel disease.
Clin Gastroenterol Hepatol 2022 Dec;20(12):2848-57.e2. doi: 10.1016/j.cgh.2022.02.048..
Keywords: Cancer: Colorectal Cancer, Cancer, Digestive Disease and Health, Imaging, Screening, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research
Marcaccio CL, Anjorin A, Patel PB
In-hospital outcomes after upper extremity versus transfemoral and transcarotid access for carotid stenting in the Vascular Quality Initiative.
This comparative study examined outcomes for treatment of patients at high risk of carotid endarterectomy using different approaches of carotid artery stenting (CAS). The study compared the effects of transradial or transbrachial (tr/tbCAS) versus more established transfemoral (tfCAS) or transcarotid (TCAR) CAS procedures. Patients were identified from the Quality Initiative registry from January 2016 to December 2021. Among 40,835 CAS identified patients, 962 underwent tr/tbCAS, 28,850 underwent tfCAS, and 21,033 underwent TCAR. Among matched patients who underwent tr/tbCAS versus tfCAS, there was no significant difference in the risk of stroke/death (4.1% vs 2.9), but tr/tbCAS was associated with a higher risk of death (2.4% vs 1.3). In the symptomatic subgroup, tr/tbCAS was associated with a higher risk of stroke/death (6.1% vs 3.9%) and death (3.6% vs 1.7%), but there were no differences in asymptomatic patients. After adjustment for Modified Rankin Scale in patients with preoperative stroke, there were no significant differences in stroke/death or death between groups.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, Anjorin A, Patel PB .
In-hospital outcomes after upper extremity versus transfemoral and transcarotid access for carotid stenting in the Vascular Quality Initiative.
J Vasc Surg 2022 Dec;76(6):1603-14.e7. doi: 10.1016/j.jvs.2022.05.030..
Keywords: Stroke, Cardiovascular Conditions, Outcomes, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research
Saldanha IJ, Adam GP, Bañez LL
AHRQ Author: Bañez LL
Inclusion of nonrandomized studies of interventions in systematic reviews of interventions: updated guidance from the Agency for Health Care Research and Quality Effective Health Care program.
A guidance workgroup comprised systematic review experts utilized an informal consensus generation method to develop guidelines to inform decisions regarding the inclusion of nonrandomized studies of interventions (NRSIs) in systematic reviews (SRs) of the effects of interventions. The study found that varying topics may require varying decisions regarding NRSI inclusion. The researchers identified key considerations to inform the decisions; from refinement of topics through to development of protocols. During the scoping and refinement of topics, considerations were associated with the clinical decisional dilemma, adequacy of randomized controlled trials (RCTs) to address the crucial questions, risk of bias in NRSIs, and the degree to which NRSIs are likely to complement RCTs. When NRSIs are included, during SR team formation, familiarity with topic-specific data sources and advanced analytic methods for NRSIs should be considered. During protocol development, the decision regarding NRSI inclusion or exclusion should be justified, and potential implications explained. When NRSIs are included, the protocol should describe the processes for synthesizing evidence from RCTs and NRSIs and determining the overall strength of evidence. CONCLUSION: We identified specific considerations for decisions regarding NRSI inclusion in SRs and highlight the importance of flexibility and transparency.
AHRQ-authored; AHRQ-funded; 290-2017-00003 -C; 75Q80120D00001- 75Q8120D00003; 75Q80120D00005 - 75Q8120D00009.
Citation: Saldanha IJ, Adam GP, Bañez LL .
Inclusion of nonrandomized studies of interventions in systematic reviews of interventions: updated guidance from the Agency for Health Care Research and Quality Effective Health Care program.
J Clin Epidemiol 2022 Dec; 152:300-06. doi: 10.1016/j.jclinepi.2022.08.015..
Keywords: Evidence-Based Practice, Research Methodologies, Health Services Research (HSR)
De B, Pasalic D, Barocas DA
Patient-reported outcomes after external beam radiotherapy with low dose rate brachytherapy boost vs radical prostatectomy for localized prostate cancer: five-year results from a prospective comparative effectiveness study.
The purpose of this study was to compare patient reported outcomes through 5 years following radical prostatectomy or external beam radiation therapy with low dose rate brachytherapy boost for localized prostate cancer. The researchers enrolled men 80 years of age or under who had localized prostate adenocarcinoma and followed them longitudinally from 2011 to 2012. The study found that when compared with radical prostatectomy, external beam radiation therapy with low dose rate brachytherapy boost was related with clinically meaningful worse urinary irritative/obstructive and better urinary incontinence function through 5 years. Urinary function bother was similar between groups. Treatment with external beam radiation therapy with low dose rate brachytherapy boost was associated with worse bowel function through 5 years compared to radical prostatectomy. Treatment with external beam radiation therapy with low dose rate brachytherapy boost was associated with better sexual function at 1 year compared to radical prostatectomy, but there was insufficient evidence to reject the supposition that no difference was seen at 3 or 5 years. The researcher concluded that external beam radiation therapy with low dose rate brachytherapy boost was related with clinically meaningful worse urinary irritative/obstructive and bowel functions but better urinary incontinence function through 5 years after treatment compared to radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: De B, Pasalic D, Barocas DA .
Patient-reported outcomes after external beam radiotherapy with low dose rate brachytherapy boost vs radical prostatectomy for localized prostate cancer: five-year results from a prospective comparative effectiveness study.
J Urol 2022 Dec;208(6):1226-39. doi: 10.1097/ju.0000000000002902..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Treatments
Feltnerl. C, Wallace IF, Aymes S
Screening for obstructive sleep apnea in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to examine the evidence on screening for obstructive sleep apnea (OSA) in asymptomatic adults or those with unrecognized OSA symptoms to inform the U.S. Preventive Services Task Force. The researchers utilized data from PubMed/MEDLINE, Cochrane Library, Embase, and trial registries through August 23, 2021 and surveillance data through September 23, 2022. The main outcomes were accuracy, excessive daytime sleepiness, sleep-related and general health-related quality of life (QOL), and harms. Eighty-six studies were included (N = 11,051), researchers finding that no study directly compared screening with no screening. Five studies evaluating the accuracy of other screening tools provided inconsistent results. When compared with inactive control, positive airway pressure was associated with a significant improvement in ESS score from baseline, sleep-related QOL, and general health-related QOL measured by the 36-Item Short Form Health Survey (SF-36) mental health component summary score change, and SF-36 physical health component summary score change. When compared with controls, utilization of mandibular advancement devices was also related with a significantly larger ESS score change. Reporting of other health outcomes was scarce; no trial included in the study found significant benefit related with treatment on mortality, cardiovascular events, or motor vehicle crashes. In 3 systematic reviews, positive airway pressure was significantly associated with reduced blood pressure; but the difference was relatively small. The researchers concluded that the accuracy and clinical usefulness of OSA screening tools was unclear.
Citation: Feltnerl. C, Wallace IF, Aymes S .
Screening for obstructive sleep apnea in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Nov 15;328(19):1951-71. doi: 10.1001/jama.2022.18357..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sleep Problems, Screening, Evidence-Based Practice, Prevention
Schroeder MC, Chapman CG, Chrischilles EA
Generating practice-based evidence in the use of guideline-recommended combination therapy for secondary prevention of acute myocardial infarction.
This study’s goal was to determine if variation in real-world practice of guideline-recommended combination therapy for secondary prevention of acute myocardial infarction (AMI) reflects poor quality-of-care or a balance of outcome tradeoffs among patients. Medicare fee-for-service beneficiaries hospitalized 2007-2008 for AMI were included. Treatment within 30-days post-discharge was grouped into one of eight possible combinations for the three drug classes: beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers, and statins. Outcomes looked at included one-year overall survival, one-year cardiovascular-event-free survival, and 90-day adverse events. Results were found that each drug combination was observed in the final sample (N = 124,695), with 35.7% having all three, and 13.5% having none. There were both treatment benefits and harms in patients with AMIs with higher rates of guideline-recommended treatment.
AHRQ-funded; HS018381.
Citation: Schroeder MC, Chapman CG, Chrischilles EA .
Generating practice-based evidence in the use of guideline-recommended combination therapy for secondary prevention of acute myocardial infarction.
Pharmacy 2022 Nov 3;10(6). doi: 10.3390/pharmacy10060147..
Keywords: Evidence-Based Practice, Guidelines, Heart Disease and Health, Cardiovascular Conditions, Comparative Effectiveness, Patient-Centered Outcomes Research, Prevention
Shah SC, Tarassishin L, Eisele C
Breastfeeding is associated with lower likelihood of Helicobacter pylori colonization in babies, based on a prospective USA maternal-infant cohort.
The authors evaluated maternal and baby factors associated with likelihood of H. pylori colonization in the babies. They found that H. pylori prevalence was 31.8% in mothers and 19.7% in their babies. Dominant breastfeeding and maternal IBD were associated with significantly lower likelihood of H. pylori colonization among babies; no other clinical factors were associated with H. pylori colonization in the babies. They concluded that dominant breastfeeding may protect against early H. pylori colonization.
AHRQ-funded; HS026395.
Citation: Shah SC, Tarassishin L, Eisele C .
Breastfeeding is associated with lower likelihood of Helicobacter pylori colonization in babies, based on a prospective USA maternal-infant cohort.
Dig Dis Sci 2022 Nov;67(11):5149-57. doi: 10.1007/s10620-021-07371-x..
Keywords: Newborns/Infants, Breast Feeding, Evidence-Based Practice
Gartlehner G, Patel SV, Reddy S
Hormone therapy for the primary prevention of chronic conditions in postmenopausal persons: updated evidence report and systematic review for the US Preventive Services Task Force.
This US Preventive Services Task Force (USPSTF) recommendation is an updated evidence report and systematic review on the use of hormone therapy in postmenopausal persons for the primary prevention of chronic conditions. The reviewers included 20 trials (N = 39,145) and 3 cohort studies (N = 1,155,410) from a dual review of abstracts, full-text articles, and study quality. Harms and benefits were compared for participants using estrogen only compared with estrogen plus progestin. Participants using estrogen only compared with placebo had significantly lower risks for diabetes and fractures, but increased for gallbladder disease over 7.1 years, stroke over 7.2 years, venous thromboembolism over 7.2 years and urinary incontinence over 1 year. For participants using estrogen plus progestin some benefits were found, but there was also an increased risk of harms significantly for invasive breast cancer, gallbladder disease, venous thromboembolism, probable dementia, and urinary incontinence.
AHRQ-funded; 75Q80120D00007.
Citation: Gartlehner G, Patel SV, Reddy S .
Hormone therapy for the primary prevention of chronic conditions in postmenopausal persons: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Nov 1;328(17):1747-65. doi: 10.1001/jama.2022.18324..
Keywords: U.S. Preventive Services Task Force (USPSTF), Prevention, Evidence-Based Practice, Guidelines, Chronic Conditions, Women
Tracer H, Justus M
AHRQ Author: Tracer H
Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer.
This Putting Prevention into Practice case study is used to increase understanding of the USPSTF final recommendation on vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer. A case study was presented using a 53-year-old-patient with no significant history presenting for a wellness visit. The patient’s 10-year cardiovascular risk and BMI are described. Three multiple-choice questions are presented regarding harms and benefits, and recommendations not to use supplementation to prevent cardiovascular disease and cancer.
AHRQ-authored.
Citation: Tracer H, Justus M .
Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer.
Am Fam Physician 2022 Nov;106(5):565-66..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Cancer, Prevention, Evidence-Based Practice, Guidelines
Ko H, Pelt CE, Martin BI
Patient-reported outcomes following cemented versus cementless primary total knee arthroplasty: a comparative analysis based on propensity score matching.
The purpose of this study was to compare baseline and early post-operative global and condition-specific patient reported outcomes (PROs) between patients undergoing cemented versus cementless total knee arthroplasty (TKA). The researchers prospectively collected PROs through the Comparative Effectiveness Pulmonary Embolism Prevention After Hip and Knee Replacement (PEPPER) trial using the short-form of the Knee Injury and Osteoarthritis Outcome Score (KOOS-Jr.), the Patient-Reported Outcomes Measurement Information System Physical Health (PROMIS-PH), and the Numeric Pain Rating Scale (NPRS). Pre- and post-operative outcomes in 5,961 patients undergoing primary TKA between December 2016 and August 2021 were examined. The study found that significant pre to- post-operative were observed in both groups. The researchers concluded that patients with cemented TKA reported early benefit in KOOS-Jr. over those with cementless TKA.
AHRQ-funded; HS024714.
Citation: Ko H, Pelt CE, Martin BI .
Patient-reported outcomes following cemented versus cementless primary total knee arthroplasty: a comparative analysis based on propensity score matching.
BMC Musculoskelet Disord 2022 Oct 27;23(1):934. doi: 10.1186/s12891-022-05899-1..
Keywords: Orthopedics, Surgery, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Viswanathan M, Wallace IF, Cook Middleton J
Screening for depression and suicide risk in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors sought to review the evidence on screening for depression or suicide risk in children and adolescents to inform the US Preventive Services Task Force. They found indirect evidence that suggested some screening instruments were reasonably accurate for detecting depression. Further, psychotherapy and pharmacotherapy were associated with some benefits and no statistically significant harms for depression, but the evidence was limited for suicide risk screening instruments and interventions.
AHRQ-funded; 290201500011I.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for depression and suicide risk in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 18;328(15):1543-56. doi: 10.1001/jama.2022.16310..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Depression, Behavioral Health, Screening, Primary Care, Guidelines, Evidence-Based Practice, Prevention
Kuzel AJ, Cuellar A, Nichols L
The EvidenceNOW practice support initiative: the Heart of Virginia Healthcare.
The purpose of this study was for The Heart of Virginia Health care (HVH) collaborative (one of the Agency for Healthcare Research and Quality's (AHRQ) Evidence Now project’s 7 collaboratives) to test different ways to improve performance and outcomes on ABCS clinical quality measures (appropriate Aspirin use, Blood pressure control, Cholesterol control, and Smoking cessation counseling) within small primary care practices. The researchers recruited 264 eligible practices and randomized them to 3 cohorts in a stepped wedge design, with 173, utilizing 16 different EHRs, participated through the entire initiative. Trained coaches delivered the practice support curriculum to improve performance on the ABCS measures. The program included an initial kickoff meeting, 3 months of focused support, 9 months of continued support, and access to online materials and faculty. The intervention phase was shortened due to difficulty in recruiting a sufficient number of practices. The study found that the short HVH intervention had a small but statistically significant positive average effects on appropriate use of aspirin and other anti-thrombotics, small negative effects on blood pressure control, except for those practices which did not attend the kickoff, and small negative effects on smoking cessation counseling. The researchers concluded that the truncation of the intervention contributed to the lack of substantial improvements in the ABCS.
AHRQ-funded; HS023913.
Citation: Kuzel AJ, Cuellar A, Nichols L .
The EvidenceNOW practice support initiative: the Heart of Virginia Healthcare.
J Am Board Fam Med 2022 Oct 18;35(5):979-89. doi: 10.3122/jabfm.2022.05.210021..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Evidence-Based Practice, Primary Care, Patient-Centered Outcomes Research, Quality Improvement, Quality of Care, Healthcare Delivery
Viswanathan M, Wallace IF, Cook Middleton J
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this paper was to review the evidence on screening for anxiety in children and adolescents to inform the US Preventive Services Task Force. Indirect evidence of findings suggested that some screening instruments were reasonably accurate. Cognitive behavioral therapy and pharmacotherapy were associated with benefits; no statistically significant association with harms was reported.
AHRQ-funded; 290201500011I, 75Q80120D00007.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 11;328(14):1445-55. doi: 10.1001/jama.2022.16303..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Anxiety, Behavioral Health, Primary Care, Screening, Guidelines, Evidence-Based Practice, Prevention
Scott Scott, Kempe A, Bajaj L
"These are our kids": qualitative interviews with clinical leaders in general emergency departments on motivations, processes, and guidelines in pediatric sepsis care.
Researchers sought to identify barriers and facilitators to pediatric sepsis care in general emergency departments (EDs), including care processes, the role of guidelines, and incentivized metrics. They interviewed medical directors, nurse managers, and quality coordinators. They found that leaders in general EDs were motivated to provide high-quality pediatric sepsis care but disagreed on whether reportable metrics would drive improvements. Leaders universally sought direct support from their nearest children's hospitals and actionable guidelines.
AHRQ-funded; HS025696.
Citation: Scott Scott, Kempe A, Bajaj L .
"These are our kids": qualitative interviews with clinical leaders in general emergency departments on motivations, processes, and guidelines in pediatric sepsis care.
Ann Emerg Med 2022 Oct;80(4):347-57. doi: 10.1016/j.annemergmed.2022.05.030..
Keywords: Children/Adolescents, Emergency Department, Sepsis, Guidelines, Evidence-Based Practice
Adam GP, Pappas D, Papageorgiou H
A novel tool that allows interactive screening of PubMed citations showed promise for the semi-automation of identification of biomedical literature.
This study looked at a novel tool named Pythia that allows interactive screening of PubMed citations to provide semi-automation of identification of biomedical literature for use with systematic reviews. Pythia incorporates a set of natural-language questions with machine-learning algorithms to rank all PubMed citations based on relevance, returning the 100 top-ranked citations. Of the seven systematic reviews conducted, the number of abstracts reviewed per relevant abstract number needed to read was lower than in the manually screened project in four reviews, higher in two, and had mixed results in one. The reviews that had greater overall sensitivity retrieved more relevant citations in early batches, but retrieval was generally unaffected by other aspects, such as study design, study size, and specific key question.
AHRQ-funded; HS027247.
Citation: Adam GP, Pappas D, Papageorgiou H .
A novel tool that allows interactive screening of PubMed citations showed promise for the semi-automation of identification of biomedical literature.
J Clin Epidemiol 2022 Oct;150:63-71. doi: 10.1016/j.jclinepi.2022.06.007..
Keywords: Research Methodologies, Evidence-Based Practice
Adhia AH, Feinglass JM, Schlick CJR
Hospital volume predicts guideline-concordant care in stage III esophageal cancer.
This study developed quality measures for management of stage III esophageal cancer including: utilization of neoadjuvant therapy, surgical sampling of at least 15 lymph nodes, resection within 60 days of chemotherapy or radiation, and completeness of resection to determine whether hospital volume varies measure adherence of published guidelines. A total of 1345 hospitals participating in the National Cancer Database from 2004 to 2016 were included. The authors examined association of volume, program accreditation, safety net status, geographic region, and patient travel distance on adequate adherence (≥85% of patients are adherent) using logistic regression modeling. The rate of adequate adherence was worst in nodal staging at 12.6% and highest for utilization of neoadjuvant therapy at 84.8%. Academic programs had the highest rate of adequate adherence for induction therapy (77.2%), timing of surgery (56.6%), and completeness of resection (78.5%) but lowest for nodal staging at only 4.4%. Every additional esophagectomy performed per year increased the odds of adequate adherence for induction therapy and completeness of resection but decreased for nodal staging.
AHRQ-funded; HS026385.
Citation: Adhia AH, Feinglass JM, Schlick CJR .
Hospital volume predicts guideline-concordant care in stage III esophageal cancer.
Ann Thorac Surg 2022 Oct;114(4):1176-82. doi: 10.1016/j.athoracsur.2021.07.092..
Keywords: Hospitals, Cancer, Guidelines, Evidence-Based Practice
Leland NE, Lekovitch C, Martínez J
Optimizing post-acute care patient safety: a scoping review of multifactorial fall prevention interventions for older adults.
The purpose of this scoping review was to describe the evidence for multifactorial post-acute care (PAC) fall prevention interventions for older patients. The researchers included 33 studies and characterized common intervention domains including: evaluating patient-specific fall risk factors, developing an individualized risk profile and treatment plan that targets each patient's fall risk factors, and implementing facility-based strategies such as staff education. There was not consensus across studies in how the domains were addressed and to what extent. The researchers concluded that health system efforts to prevent accidental falls in PAC should consider a patient-centered multifactorial approach.
AHRQ-funded; HS022907.
Citation: Leland NE, Lekovitch C, Martínez J .
Optimizing post-acute care patient safety: a scoping review of multifactorial fall prevention interventions for older adults.
J Appl Gerontol 2022 Oct;41(10):2187-96. doi: 10.1177/07334648221104375..
Keywords: Elderly, Falls, Prevention, Patient Safety, Evidence-Based Practice
Holcomb J, Ferguson GM, Sun J
Stakeholder engagement in adoption, implementation, and sustainment of an evidence-based intervention to increase mammography adherence among low-income women.
The purpose of this document review study was to create a conceptual framework to guide stakeholder engagement in an evidence-based intervention to increase mammography appointment adherence in underserved and low-income women. The document review results were aligned with the constructs of the conceptual framework and an application of stakeholder engagement in an evidence-based mammography intervention. The researchers concluded that both the conceptual framework constructs and the stakeholder engagement strategies can be utilized across a range of organizations, programs, and settings.
AHRQ-funded; HS023255.
Citation: Holcomb J, Ferguson GM, Sun J .
Stakeholder engagement in adoption, implementation, and sustainment of an evidence-based intervention to increase mammography adherence among low-income women.
J Cancer Educ 2022 Oct;37(5):1486-95. doi: 10.1007/s13187-021-01988-2..
Keywords: Evidence-Based Practice, Screening, Imaging, Women, Low-Income, Patient Adherence/Compliance
Lozano PM, Lane-Fall M, Franklin PD
AHRQ Author: Chesley FD
Training the next generation of learning health system scientists.
The purpose of this paper was to describe the approaches developed by 11 Agency for Healthcare Research and Quality (AHRQ)- and Patient-Centered Outcomes Research Institute- funded Centers of Excellence (COEs) to grow the number of learning health systems (LHS) scientists. Program directors for each COE have provided descriptive program data since 2018. The authors found that since the program began, the 11 COEs have partnered with health systems to train 110 scholars. Nine programs partner with a Veterans Affairs health system and 9 partner with safety net providers. Clinically trained scholars include 70 physicians and 17 scholars in other clinical disciplines. Non-clinicians represent diverse fields, with most representing population health sciences. Challenges include guiding scholars through issues that can disrupt or delay projects during already-limited program time, such as delays in accessing data, organizational changes, pandemic impacts and others. The researchers concluded that the program documentation provides evidence of scholars' academic accomplishments and career-trajectory achievements.
AHRQ-authored; AHRQ-funded; HS026369; HS026370; HS026372; HS026379; HS026383; HS026385; HS026390; HS026393; HS026395; HS026396; HS026407
Citation: Lozano PM, Lane-Fall M, Franklin PD .
Training the next generation of learning health system scientists.
Learn Health Syst 2022 Oct;6(4):e10342. doi: 10.1002/lrh2.10342..
Keywords: Learning Health Systems, Health Systems, Patient-Centered Outcomes Research, Evidence-Based Practice, Training, Workforce
Henninger ML, Bean SI, Lin JS
Screening for syphilis infection in nonpregnant adults and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this systematic review was to summarize the available published evidence on the potential benefits and harms of screening for syphilis infection in non-pregnant, asymptomatic adults and adolescents at increased risk for syphilis infection, for the purpose of supporting the 2022 United States Prevention Services Task Force recommendations statement on screening for syphilis infection.
AHRQ-funded; 75Q80120D00004.
Citation: Henninger ML, Bean SI, Lin JS .
Screening for syphilis infection in nonpregnant adults and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Sep 27;328(12):1250-52. doi: 10.1001/jama.2022.8612..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Prevention, Sexual Health, Infectious Diseases, Evidence-Based Practice
Jonas DE, Vander Schaaf EB, Riley S
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to explore the evidence on the benefits and harms of screening children and adolescents for prediabetes and type 2 diabetes to inform the US Preventive Services Task Force (USPSTF). The researchers utilized references; experts; literature surveillance, and PubMed/MEDLINE, Cochrane Library, and trial registries. The final review included 8 publications with 856 participants with a mean age of 14 years. The researchers found that none of the eligible studies directly assessed the benefits or harms of preventive screening. The limited eligible clinical trials reported few health outcomes and found no difference between groups.
AHRQ-funded; 290201500007I.
Citation: Jonas DE, Vander Schaaf EB, Riley S .
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Sep 13;328(10):968-79. doi: 10.1001/jama.2022.7957..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Prevention, Evidence-Based Practice, Guidelines
Tracer H, Newhouse CN
AHRQ Author: Tracer H
Aspirin use to prevent cardiovascular disease.
This Putting Prevention into Practice case study involves a 56-year-old man, a wellness visit, and aspirin usage to prevent cardiovascular disease. Three questions based on U.S. Preventative Serices Task Force recommendations are presented, followed by the answers.
AHRQ-authored.
Citation: Tracer H, Newhouse CN .
Aspirin use to prevent cardiovascular disease.
Am Fam Physician 2022 Sep;106(3):327-28..
Keywords: Medication, Cardiovascular Conditions, Prevention, Guidelines, Evidence-Based Practice
Oatis CA, Konnyu KJ, Franklin PD
Generating consistent longitudinal real-world data to support research: lessons from physical therapists.
The purpose of this study was to evaluate whether clinicians can generate consistent and standardized real-world data (RWD) to enhance data quality in the course of routine patient care. The researchers collaborated with PT clinicians and experts to generate a web-based comprehensive system to quantify the total dose of PT interventions with type of modality, quantity, intensity, and progressions over time. The system was designed to be implemented in outpatient PT clinics capable of residing alongside or within a clinic’s existing EHR. The study goal was to collect routine clinical data in a format useable by the general population of outpatient physical therapists treating patients post Total Knee Replacement (TKR) and in a structure that would allow easy quantification and analysis across patients, therapists, and sites. Uniform and efficient documentation of real-world PT practice following TKR is essential for the necessary comparative effectiveness research demanded by the currently unexplained practice variation. Over a period of 2 years, physical therapists and PT assistants located in three US states entered data for a total of 161 patients post TKR with 2615 patient visits. No technical problems with the data capture system were reported, and physical therapists noted that data entry was efficient and simple. The researchers concluded that the results demonstrate that routine PT interventions can be captured thoroughly in an efficient, systematic, and consistent manner across real-world therapists and sites.
AHRQ-funded; 75Q80120D00001.
Citation: Oatis CA, Konnyu KJ, Franklin PD .
Generating consistent longitudinal real-world data to support research: lessons from physical therapists.
ACR Open Rheumatol 2022 Sep;4(9):771-74. doi: 10.1002/acr2.11465..
Keywords: Research Methodologies, Patient-Centered Outcomes Research, Evidence-Based Practice
Calcaterra SL, Martin M, Bottner R
Management of opioid use disorder and associated conditions among hospitalized adults: a consensus statement from the Society of Hospital Medicine.
This paper discusses the findings of a Society of Hospital Medicine working group convened to develop a Consensus Statement on the management of opioid use disorder (OUD) and associated conditions among hospitalized adults. The statement is intended for clinicians practicing medicine in the inpatient setting (e.g., hospitalists, primary care physicians, family physicians, advanced practice nurses, and physician assistants) and is intended to apply to hospitalized adults at risk for, or diagnosed with, OUD. The first step of the working group to develop the statement was to conduct a systematic review of relevant guidelines and compose a draft statement based on extracted recommendations. In the next step the working group obtained feedback on the draft statement from external experts in addiction medicine, SHM members, professional societies, harm reduction organizations and advocacy groups, and peer reviewers. This iterative development process resulted in a final Consensus Statement consisting of 18 recommendations covering the following topics: (1) identification and treatment of OUD and opioid withdrawal, (2) perioperative and acute pain management in patients with OUD, and (3) methods to optimize care transitions at hospital discharge for patients with OUD.
AHRQ-funded; HS026215.
Citation: Calcaterra SL, Martin M, Bottner R .
Management of opioid use disorder and associated conditions among hospitalized adults: a consensus statement from the Society of Hospital Medicine.
J Hosp Med 2022 Sep;17(9):744-56. doi: 10.1002/jhm.12893..
Keywords: Opioids, Substance Abuse, Behavioral Health, Evidence-Based Practice, Guidelines, Inpatient Care
Calcaterras SL, Bottner R, Martin M
Management of opioid use disorder, opioid withdrawal, and opioid overdose prevention in hospitalized adults: a systematic review of existing guidelines.
This study evaluated the quality and content of existing guidelines for in-hospital opioid use disorder (OUD) treatment and management. A literature search was done on several databases, websites of relevant societies and advocacy organizations, and selected international search engines. Nineteen guidelines published between January 2010 and June 2020 met the selection criteria. The majority of guidelines were based on observational studies or expert consensus. They recommended the use of nonstigmatizing language among patients with OUD; to assess patients with unhealthy opioid use for OUD using the Diagnostic Statistical Manual of Diseases-5th Edition criteria; use of methadone or buprenorphine to treat OUD and opioid withdrawal; use of multimodal, nonopioid therapy, and when needed, short-acting opioid analgesics in addition to buprenorphine or methadone, for acute pain management; ensuring linkage to ongoing methadone or buprenorphine treatment; referring patients to psychosocial treatment; and ensuring access to naloxone for opioid overdose reversal.
AHRQ-funded; HS026215.
Citation: Calcaterras SL, Bottner R, Martin M .
Management of opioid use disorder, opioid withdrawal, and opioid overdose prevention in hospitalized adults: a systematic review of existing guidelines.
J Hosp Med 2022 Sep;17(9):679-92. doi: 10.1002/jhm.12908..
Keywords: Opioids, Substance Abuse, Behavioral Health, Evidence-Based Practice, Guidelines, Inpatient Care