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- Adverse Events (2)
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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 30 Research Studies DisplayedSchroeder 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
Saldanha IJ, Cao W, Bhuma MR
Systematic reviews can guide clinical practice and new research on primary headaches in pregnancy: an editorial on the 2022 American Headache Society Members' Choice Award paper.
This article describes the systematic review paper that was done on management of primary headaches during pregnancy, postpartum, and breastfeeding, which won the 2021 American Headache Society’s Member’s Choice Award. The findings are summarized in this paper, which discusses different pharmacologic interventions and their possible effects on the fetus/child and mother. Evidence was summarized for prevention and treatment of primary headache. The authors did not find a lot of evidence for harms or benefits but called for more studies to be done.
AHRQ-funded; 290201500002I.
Citation: Saldanha IJ, Cao W, Bhuma MR .
Systematic reviews can guide clinical practice and new research on primary headaches in pregnancy: an editorial on the 2022 American Headache Society Members' Choice Award paper.
Headache 2022 Jul;62(7):774-76. doi: 10.1111/head.14332..
Keywords: Neurological Disorders, Pregnancy, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research
Kemme S, Stahl M, Brigham D
Outcomes of severe seronegative hepatitis-associated aplastic anemia: a pediatric case series.
Hepatitis-associated aplastic anemia (HAAA) is a potentially life-threatening diagnosis without clear treatment guidelines. The goal of the study was to characterize the presentation, evaluation, histopathology, and outcomes of therapy in children with HAAA to guide future research and to develop standardized care guidelines for this rare disease. The investigators found that ATG-based IST induced remission of hepatitis in patients with steroid-refractory HAAA.
AHRQ-funded; HS026510.
Citation: Kemme S, Stahl M, Brigham D .
Outcomes of severe seronegative hepatitis-associated aplastic anemia: a pediatric case series.
J Pediatr Gastroenterol Nutr 2021 Feb;72(2):194-201. doi: 10.1097/mpg.0000000000002940..
Keywords: Children/Adolescents, Hepatitis, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Guidelines
Kelly JP, DeVore AD, Wu J
Rhythm control versus rate control in patients with atrial fibrillation and heart failure with preserved ejection fraction: insights from get with the guidelines-heart failure.
Researchers analyzed the Get With The Guidelines - Heart Failure (GWTG-HF) registry linked to Medicare claims data to describe current treatments for rate versus rhythm control and subsequent outcomes in patients with heart failure with preserved ejection fraction and atrial fibrillation. They found that rhythm control in patients aged 65 and older with heart failure with preserved ejection fraction and AF was associated with a lower risk of one-year all-cause mortality. They recommended future prospective randomized studies to explore this potential benefit.
AHRQ-funded; HS021092.
Citation: Kelly JP, DeVore AD, Wu J .
Rhythm control versus rate control in patients with atrial fibrillation and heart failure with preserved ejection fraction: insights from get with the guidelines-heart failure.
J Am Heart Assoc 2019 Dec 17;8(24):e011560. doi: 10.1161/jaha.118.011560.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Guidelines, Evidence-Based Practice, Registries, Patient-Centered Outcomes Research
Greenhawt M, Shaker M
Determining levers of cost-effectiveness for screening infants at high risk for peanut sensitization before early peanut introduction.
The authors sought to identify scenarios in which current early peanut introduction guidelines would be cost-effective. They found that the current screening approach to early peanut introduction could be cost-effective at a particular health utility for an in-clinic reaction, skin prick test sensitivity and specificity, and high baseline peanut allergy prevalence among high-risk infants. However, such conditions are unlikely to be plausible to achieve realistically. They recommend further research to define the health state utility associated with reaction location.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Shaker M .
Determining levers of cost-effectiveness for screening infants at high risk for peanut sensitization before early peanut introduction.
JAMA Netw Open 2019 Dec 2;2(12):e1918041. doi: 10.1001/jamanetworkopen.2019.18041..
Keywords: Patient-Centered Outcomes Research, Newborns/Infants, Children/Adolescents, Respiratory Conditions, Skin Conditions, Screening, Healthcare Costs, Evidence-Based Practice, Guidelines
Armstrong MJ, Gronseth GS, Day GS
Patient stakeholder versus physician preferences regarding amyloid PET testing.
Patient and caregiver perspectives on amyloid positron emission tomography (PET) use are largely unexplored, particularly as compared with clinician views. In this study, the investigators surveyed clinicians, patients, caregivers, and dementia advocates on topics relating to an evidence-based guideline on amyloid PET use. They found that patients and caregivers emphasized the importance of having a dementia diagnosis and placed more value on testing and outcomes for asymptomatic populations than clinicians.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Gronseth GS, Day GS .
Patient stakeholder versus physician preferences regarding amyloid PET testing.
Alzheimer Dis Assoc Disord 2019 Jul-Sep;33(3):246-53. doi: 10.1097/wad.0000000000000311..
Keywords: Shared Decision Making, Dementia, Diagnostic Safety and Quality, Evidence-Based Practice, Guidelines, Imaging, Neurological Disorders, Patient-Centered Outcomes Research, Provider, Provider: Physician
Djulbegovic B, Reljic T, Elqayam S
Structured decision-making drives guidelines panels' recommendations "for" but not "against" health interventions.
This study examined the determinants of guideline panels’ recommendations and whether there is a difference between how they make recommendations for or against health interventions. They examined the factors considered by members of 8 panels convened by the American Society of Hematology (ASH) to develop guidelines using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. They found that “for” decisions were made using certainty in evidence, balance of benefits and harms, and variability in patients’ values and preferences. However there was less strength of recommendation (SOR) certainty when making “against” recommendations.
AHRQ-funded; HS024917.
Citation: Djulbegovic B, Reljic T, Elqayam S .
Structured decision-making drives guidelines panels' recommendations "for" but not "against" health interventions.
J Clin Epidemiol 2019 Jun;110:23-33. doi: 10.1016/j.jclinepi.2019.02.009..
Keywords: Shared Decision Making, Guidelines, Patient-Centered Outcomes Research, Evidence-Based Practice
Armstrong MJ
Developing the disorders of consciousness guideline and challenges of integrating shared decision-making into clinical practice.
The purpose of this study was to review methodology informing evidence-based guideline development and integration of guidelines into clinical care through shared decision-making (SDM) and to highlight challenges to SDM in disorders of consciousness. Recently published disorders of consciousness guideline recommendations provide strategies for clinicians to enhance quality care for these individuals and also to provide details helping clinicians partner with individuals with disorders of consciousness and their surrogates. Further research is recommended into many aspects of caring for individuals with disorders of consciousness and optimal strategies for partnering with surrogates in decision-making.
AHRQ-funded; HS024159.
Citation: Armstrong MJ .
Developing the disorders of consciousness guideline and challenges of integrating shared decision-making into clinical practice.
J Head Trauma Rehabil 2019 May/Jun;34(3):199-204. doi: 10.1097/htr.0000000000000496.
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Keywords: Shared Decision Making, Guidelines, Evidence-Based Practice, Neurological Disorders, Patient-Centered Outcomes Research
Magrath M, Yang E, Ahn C
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
The goal of this study was to characterize guideline adherence of surveillance recommendations after implementation of an electronic medical record (EMR)-based Colonoscopy Pathology Reporting and Clinical Decision Support System (CoRS). Results showed that an EMR-based CoRS was widely used and significantly improved guideline adherence of surveillance recommendations.
AHRQ-funded; HS022418.
Citation: Magrath M, Yang E, Ahn C .
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
J Natl Compr Canc Netw 2018 Nov;16(11):1321-28. doi: 10.6004/jnccn.2018.7050..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Colonoscopy, Cancer: Colorectal Cancer, Screening, Cancer, Guidelines, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention
Lee DJ, Barocas DA, Zhao Z
Contemporary prostate cancer radiation therapy in the United States: patterns of care and compliance with quality measures.
This study measured compliance with quality measures for radiation therapy treatment of prostate cancer. The Comparative Effectiveness Analysis of Surgery and Radiation Study enrolled men who were treated for localized prostate cancer from 2011 and 2012. Medical records were reviewed, and patients completed surveys. Researchers concluded that men who received external beam radiation therapy (EBRT) were treated more appropriately than those treated with brachytherapy (BT). White men were also more likely to receive appropriate treatment than African-American and other minorities.
AHRQ-funded; HS019356; HS022640.
Citation: Lee DJ, Barocas DA, Zhao Z .
Contemporary prostate cancer radiation therapy in the United States: patterns of care and compliance with quality measures.
Pract Radiat Oncol 2018 Sep-Oct;8(5):307-16. doi: 10.1016/j.prro.2018.04.009..
Keywords: Cancer, Cancer: Prostate Cancer, Comparative Effectiveness, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, Practice Patterns, Quality Measures
Greenhawt M, Chan ES, Fleischer DM
Caregiver and expecting caregiver support for early peanut introduction guidelines.
This study investigates caregiver preferences for early peanut introduction (EPI) recommendations. The study concluded that among new and expecting caregivers, there is poor current willingness and questionable support for early allergenic solid food recommendations, including in-office allergy risk assessment before introduction. Willingness was better among expecting vs current caregivers.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Chan ES, Fleischer DM .
Caregiver and expecting caregiver support for early peanut introduction guidelines.
Ann Allergy Asthma Immunol 2018 Jun;120(6):620-25. doi: 10.1016/j.anai.2018.03.001..
Keywords: Caregiving, Children/Adolescents, Guidelines, Newborns/Infants, Patient-Centered Outcomes Research
Armstrong MJ, Mullins CD, Gronseth GS
Impact of patient involvement on clinical practice guideline development: a parallel group study.
The aim of this study was to investigate the effect of patient and public involvement (PPI) on guideline question formation and validate a conceptual model of patient and public contributions to guidelines. The qualitative analysis of the discussions occurring during guideline question development demonstrated key differences in group conduct and validated the proposed conceptual model of patient and public contributions to guidelines.
AHRQ-funded; HS024159; HS022135.
Citation: Armstrong MJ, Mullins CD, Gronseth GS .
Impact of patient involvement on clinical practice guideline development: a parallel group study.
Implement Sci 2018 Apr 16;13(1):55. doi: 10.1186/s13012-018-0745-6.
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Keywords: Evidence-Based Practice, Guidelines, Patient and Family Engagement, Patient-Centered Outcomes Research, Research Methodologies
Swaminathan L, Flanders S, Rogers M
Improving PICC use and outcomes in hospitalised patients: an interrupted time series study using MAGIC criteria.
This study tested whether implementation of the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) can improve inappropriate peripherally inserted central catheter (PICC) use and patient outcomes. It concluded that, in a multihospital quality improvement project, implementation of MAGIC improved PICC appropriateness and reduced complications to a modest extent.
AHRQ-funded; HS022835.
Citation: Swaminathan L, Flanders S, Rogers M .
Improving PICC use and outcomes in hospitalised patients: an interrupted time series study using MAGIC criteria.
BMJ Qual Saf 2018 Apr;27(4):271-78. doi: 10.1136/bmjqs-2017-007342.
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Keywords: Adverse Events, Guidelines, Hospitalization, Patient-Centered Outcomes Research, Quality Improvement
Kemper AR, Krist AH, Tseng CW
AHRQ Author: Mabry-Hernandez IR, Wolff TA
Challenges in developing U.S. Preventive Services Task Force child health recommendations.
In March 2016, the USPSTF convened an expert panel to discuss its portfolio of child and adolescent recommendations and identify unique methodologic issues when evaluating evidence regarding children and adolescents. The panel identified key domains of challenges, including measuring patient-centered health outcomes; identifying intermediate outcomes predictive of important health outcomes and evaluating the long time horizon needed to assess the balance of benefits and harms.
AHRQ-authored.
Citation: Kemper AR, Krist AH, Tseng CW .
Challenges in developing U.S. Preventive Services Task Force child health recommendations.
Am J Prev Med 2018 Jan;54(1s1):S63-s69. doi: 10.1016/j.amepre.2017.08.023.
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Keywords: Children/Adolescents, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, U.S. Preventive Services Task Force (USPSTF)
Dykewicz MS, Wallace DV, Baroody F
Treatment of seasonal allergic rhinitis: an evidence-based focused 2017 guideline update.
This article provides an evidence-based focused 2017 guideline update for the treatment of seasonal allergic rhinitis.
AHRQ-funded; HS024599
Citation: Dykewicz MS, Wallace DV, Baroody F .
Treatment of seasonal allergic rhinitis: an evidence-based focused 2017 guideline update.
Ann Allergy Asthma Immunol 2017 Dec;119(6):489-511.e41. doi: 10.1016/j.anai.2017.08.012..
Keywords: Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research
Guise JM, Butler ME, Chang C
AHRQ series on complex intervention systematic reviews-paper 6: PRISMA-CI extension statement and checklist.
This paper provides a stand-alone extension to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting tool for complex interventions-PRISMA-CI-to help authors, publishers, and readers understand and apply to systematic reviews of complex interventions. PRISMA-CI development followed the Enhancing the QUAlity and Transparency Of health Research Network guidance for extensions and focused on adding or modifying only essential items.
AHRQ-funded; 290201200004C; 290201200016I; 290201500011I.
Citation: Guise JM, Butler ME, Chang C .
AHRQ series on complex intervention systematic reviews-paper 6: PRISMA-CI extension statement and checklist.
J Clin Epidemiol 2017 Oct;90:43-50. doi: 10.1016/j.jclinepi.2017.06.016.
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Keywords: Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, Research Methodologies
Wasserman S, Avilla E, Ben-Shoshan M
Epinephrine autoinjectors: new data, new problems.
This paper reviews new data, and new problems in recently published literature on epinephrine autoinjectors. The authors emphasize that existing gaps in anaphylaxis management remain unaddressed. Patient needs are largely unmet, and very few studies are being designed to clarify and instill best practice, and to determine how to increase adherence to existing anaphylaxis guidelines through integrated knowledge translation strategies.
AHRQ-funded; HS024599.
Citation: Wasserman S, Avilla E, Ben-Shoshan M .
Epinephrine autoinjectors: new data, new problems.
J Allergy Clin Immunol Pract 2017 Sep - Oct;5(5):1180-91. doi: 10.1016/j.jaip.2017.06.027.
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Keywords: Evidence-Based Practice, Guidelines, Medication, Patient-Centered Outcomes Research, Patient Self-Management
Singal AG, Tiro J, Li X
Hepatocellular carcinoma surveillance among patients with cirrhosis in a population-based integrated health care delivery system.
This study characterized guideline-concordant hepatocellular carcinoma (HCC) surveillance rates and patient-level factors associated with surveillance among a population-based cohort of patients with cirrhosis. It concluded that, although one third of patients undergo inconsistent HCC surveillance, less than 2 percent of patients receive guideline-concordant biannual HCC surveillance.
AHRQ-funded; HS022418.
Citation: Singal AG, Tiro J, Li X .
Hepatocellular carcinoma surveillance among patients with cirrhosis in a population-based integrated health care delivery system.
J Clin Gastroenterol 2017 Aug;51(7):650-55. doi: 10.1097/mcg.0000000000000708.
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Keywords: Cancer, Guidelines, Healthcare Delivery, Patient-Centered Outcomes Research, Practice Patterns
Dimou FM, Adhikari D, Mehta HB
Outcomes in older patients with grade III cholecystitis and cholecystostomy tube placement: a propensity score analysis.
The Tokyo Guidelines recommend initial cholecystostomy tube drainage, antibiotics, and delayed cholecystectomy in patients with grade III cholecystitis. The researchers compared mortality, readmission, and complication rates with and without cholecystostomy tube placement in a cohort of patients with grade III cholecystitis. Cholecystostomy tube placement was associated with lower rates of definitive treatment with cholecystectomy, higher mortality, and higher readmission rates.
AHRQ-funded; HS022134.
Citation: Dimou FM, Adhikari D, Mehta HB .
Outcomes in older patients with grade III cholecystitis and cholecystostomy tube placement: a propensity score analysis.
J Am Coll Surg 2017 Apr;224(4):502-11.e1. doi: 10.1016/j.jamcollsurg.2016.12.021.
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Keywords: Elderly, Patient-Centered Outcomes Research, Surgery, Guidelines, Practice Patterns
Curtis JR, Chen L, Greenberg JD
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights.
Treat to target guidelines recommend achieving remission or low disease activity in rheumatoid arthritis (RA). However, the reduction in adverse events and costs associated with lower disease activity is unclear. This study found that leveraging the benefits of linking registry and administrative data together, lower disease activity in RA was associated with incrementally reduced risks of all-cause hospitalization, ED visits, mortality, and medical costs in a dose-dependent fashion.
AHRQ-funded; HS021694.
Citation: Curtis JR, Chen L, Greenberg JD .
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights.
Pharmacoepidemiol Drug Saf 2017 Mar;26(3):310-19. doi: 10.1002/pds.4126.
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Keywords: Patient-Centered Outcomes Research, Registries, Arthritis, Healthcare Costs, Guidelines
Armstrong MJ, Rueda JD, Gronseth GS
Framework for enhancing clinical practice guidelines through continuous patient engagement.
The authors propose a ten-step framework outlining steps and options for patient engagement in guideline development with the goal of highlighting steps for patient engagement and methods by which this can be achieved. This framework can serve as a resource for guideline developers desiring to increase patient engagement and reference for researchers investigating engagement methodology at different steps of the clinical practice guideline lifecycle.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Rueda JD, Gronseth GS .
Framework for enhancing clinical practice guidelines through continuous patient engagement.
Health Expect 2017 Feb;20(1):3-10. doi: 10.1111/hex.12467.
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Keywords: Evidence-Based Practice, Guidelines, Patient and Family Engagement, Patient-Centered Outcomes Research, Quality Improvement
Burstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Shelley DR, Ogedegbe G, Anane S
Testing the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC.
The long-term goal of the HealthyHearts NYC trial is to create a robust infrastructure for implementing and disseminating evidence-based practice guidelines in primary care practices. The authors hypothesized that practice facilitation will result in superior clinical outcomes compared to usual care and that the effects of practice facilitation will be mediated by greater adoption of system changes in accord with patient-centered medical homes and the chronic care model.
AHRQ-funded; HS023922.
Citation: Shelley DR, Ogedegbe G, Anane S .
Testing the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC.
Implement Sci 2016 Jul 4;11(1):88. doi: 10.1186/s13012-016-0450-2.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, Primary Care
Roberts ET, DuGoff EH, Heins SE
Evaluating clinical practice guidelines based on their association with return to work in administrative claims data.
The researchers examined the association between non-adherence to clinical practice guidelines (CPGs) and time to return to work (RTW) for patients with workplace injuries. They found that early receipt of care and getting less than the recommended amount of care were correlated with faster RTW, while excessive physical therapy, bracing, and injections were associated with slower RTW. They recommended that CPGs supported by observational studies or randomized trials may have a more certain relationship to health outcomes.
AHRQ-funded; HS000029.
Citation: Roberts ET, DuGoff EH, Heins SE .
Evaluating clinical practice guidelines based on their association with return to work in administrative claims data.
Health Serv Res 2016 Jun;51(3):953-80. doi: 10.1111/1475-6773.12360.
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Keywords: Guidelines, Injuries and Wounds, Patient-Centered Outcomes Research
Gaither JR, Goulet JL, Becker WC
The association between receipt of guideline-concordant long-term opioid therapy and all-cause mortality.
The researchers' objective was to determine the association between receipt of guideline-concordant long-term opioid therapy (LtOT) and 1-year all-cause mortality. They found no association between all-cause mortality and primary care visits or urine drug testing and recommended that providers use caution in initiating LtOT in conjunction with benzodiazepines and untreated substance use disorders.
AHRQ-funded; HS021112.
Citation: Gaither JR, Goulet JL, Becker WC .
The association between receipt of guideline-concordant long-term opioid therapy and all-cause mortality.
J Gen Intern Med 2016 May;31(5):492-501. doi: 10.1007/s11606-015-3571-4.
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Keywords: Guidelines, Mortality, Opioids, Patient-Centered Outcomes Research, Substance Abuse