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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 107 Research Studies DisplayedChou R, Gore JL, Buckley D
Urinary biomarkers for diagnosis of bladder cancer: a systematic review and meta-analysis.
The authors systematically reviewed the evidence on the accuracy of urinary biomarkers for diagnosis of bladder cancer in adults who have signs or symptoms of the disease or are undergoing surveillance for recurrent disease. Their review concluded that urinary biomarkers miss a substantial proportion of patients with bladder cancer and are subject to false-positive results in others.
AHRQ-funded; 290201200014I.
Citation: Chou R, Gore JL, Buckley D .
Urinary biomarkers for diagnosis of bladder cancer: a systematic review and meta-analysis.
Ann Intern Med 2015 Dec 15;163(12):922-31. doi: 10.7326/m15-0997.
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Keywords: Cancer, Comparative Effectiveness, Diagnostic Safety and Quality
Roth JA, Ramsey SD, Carlson JJ
Cost-effectiveness of a biopsy-based 8-protein prostate cancer prognostic assay to optimize treatment decision making in Gleason 3 + 3 and 3 + 4 early stage prostate cancer.
A novel 8-protein prognostic assay generates a risk score at time of biopsy that is predictive of prostate cancer aggressiveness and can inform treatment decisions. The objective of this study was to evaluate the cost-effectiveness of using the assay to inform treatment decisions compared with usual care. The 8-protein assay strategy resulted in 0.04 more quality-adjusted life years and $700 less in costs compared with usual care.
AHRQ-funded; HS022982.
Citation: Roth JA, Ramsey SD, Carlson JJ .
Cost-effectiveness of a biopsy-based 8-protein prostate cancer prognostic assay to optimize treatment decision making in Gleason 3 + 3 and 3 + 4 early stage prostate cancer.
Oncologist 2015 Dec;20(12):1355-64. doi: 10.1634/theoncologist.2015-0214.
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Keywords: Cancer, Cancer: Prostate Cancer, Patient-Centered Outcomes Research, Healthcare Costs, Decision Making
Levy DE, Munshi VN, Ashburner JM
Health IT-assisted population-based preventive cancer screening: a cost analysis.
The researchers analyzed costs from a randomized trial of 2 health IT strategies to improve cancer screening compared with usual care from the perspective of a primary care network. They found that over the course of the study year, the value of reduced physician time devoted to preventive cancer screening outweighed the costs of the interventions.
AHRQ-funded; HS020308; HS018161.
Citation: Levy DE, Munshi VN, Ashburner JM .
Health IT-assisted population-based preventive cancer screening: a cost analysis.
Am J Manag Care 2015 Dec;21(12):885-91..
Keywords: Health Information Technology (HIT), Cancer, Screening, Prevention, Healthcare Costs
Guy GP, Jr., Yabroff KR, Ekwueme DU
AHRQ Author: Soni A
Healthcare expenditure burden among non-elderly cancer survivors, 2008-2012.
This study presented nationally representative estimates of annual out-of-pocket (OOP) burden among non-elderly cancer survivors and assessed the association between high OOP burden and access to care and preventive service utilization. It found that, among cancer survivors, high OOP burden was associated with being unable to obtain necessary medical care, delaying necessary medical care, and lower breast cancer screening rates among women.
AHRQ-authored.
Citation: Guy GP, Jr., Yabroff KR, Ekwueme DU .
Healthcare expenditure burden among non-elderly cancer survivors, 2008-2012.
Am J Prev Med 2015 Dec;49(6s5):S489-s97. doi: 10.1016/j.amepre.2015.09.002.
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Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Cancer, Access to Care
Keim-Malpass J, Adelstein K, Kavalieratos D
Legacy making through illness blogs: online spaces for young adults approaching the end-of-life.
The study analyzed the illness blogs of five young women (aged 25-39 years) at the end-of-life using a narrative approach. Key elements of legacy making and grief processing were explored. The women had varying experiences before their death, but uniform posthumous occurrences with the use of the blog for a space of grief for loved ones.
AHRQ-funded; HS022989.
Citation: Keim-Malpass J, Adelstein K, Kavalieratos D .
Legacy making through illness blogs: online spaces for young adults approaching the end-of-life.
J Adolesc Young Adult Oncol 2015 Dec;4(4):209-12. doi: 10.1089/jayao.2015.0003.
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Keywords: Cancer, Mortality, Web-Based, Young Adults
Du XL, Parikh RC, Lairson DR
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
The authors examined racial/ethnic and geographical disparities in cancer care and costs during the last 6 months of life for lung cancer decedents after the FDA's approval of bevacizumab. They found that there were substantial racial/ethnic and geographic disparities in the types of cancer care and costs in the last 6 months of life among lung cancer decedents, regardless of the length of survival times and hospice care status.
AHRQ-funded; HS018956.
Citation: Du XL, Parikh RC, Lairson DR .
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
Lung Cancer 2015 Dec;90(3):442-50. doi: 10.1016/j.lungcan.2015.09.017.
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Keywords: Cancer, Cancer: Lung Cancer, Disparities, Healthcare Costs, Medication, Palliative Care, Patient-Centered Outcomes Research, Practice Patterns, Racial and Ethnic Minorities
Kohler RE, Goyal RK, Lich KH
Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program.
The objective of this study was to examine health care utilization and expenditures as a function of patient-centered medical home (PCMH) enrollment among breast cancer patients in North Carolina’s Medicaid program. It found that PCMH enrollment was significantly associated with greater outpatient service use, but there was no difference in the probability of inpatient hospitalizations or ED visits.
AHRQ-funded; HS019468.
Citation: Kohler RE, Goyal RK, Lich KH .
Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program.
Cancer 2015 Nov 15;121(22):3975-81. doi: 10.1002/cncr.29596..
Keywords: Cancer, Cancer: Breast Cancer, Healthcare Utilization, Medicaid, Patient-Centered Healthcare
Potosky AL, O'Neill SC, Isaacs C
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
The authors evaluated the relation between gene expression profiling (GEP) testing and the use of adjuvant chemotherapy by women treated in a general oncology practice. They found that adjuvant chemotherapy use after GEP testing is generally consistent with the recommended test interpretation for women with a high or low predicted risk of recurrence. Chemotherapy use in the intermediate-risk group increased with Recurrence Score values, and evidence from ongoing randomized trials may help to clarify whether this finding reflects optimal interpretation of GEP test results.
AHRQ-funded; HS022915.
Citation: Potosky AL, O'Neill SC, Isaacs C .
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
Cancer 2015 Nov 15;121(22):4062-70. doi: 10.1002/cncr.29621.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Decision Making, Genetics, Practice Patterns, Women
El-Shami K, Oeffinger KC, Erb NL
American Cancer Society colorectal cancer survivorship care guidelines.
Communication and coordination of care between the treating oncologist and the primary care clinician is critical to effectively and efficiently manage the long-term care of colorectal cancer (CRC) survivors. The guidelines in this article are intended to assist primary care clinicians in delivering risk-based health care for CRC survivors who have completed active therapy.
AHRQ-funded; HS020937.
Citation: El-Shami K, Oeffinger KC, Erb NL .
American Cancer Society colorectal cancer survivorship care guidelines.
CA Cancer J Clin 2015 Nov-Dec;65(6):428-55. doi: 10.3322/caac.21286.
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Keywords: Cancer, Cancer: Colorectal Cancer, Care Coordination, Guidelines, Primary Care
Dinan MA, Mi X, Reed SD
Association between use of the 21-gene recurrence score assay and receipt of chemotherapy among Medicare beneficiaries with early-stage breast cancer, 2005-2009.
The researchers examined whether adoption of the 21-Gene Recurrence Score (RS) assay in a nationally representative sample of patients with early-stage breast cancer was associated with use of chemotherapy. They found that the impact of the adoption of the RS assay on receipt of chemotherapy was strongly population dependent and was associated with relatively lower chemotherapy use in groups with high-risk disease and relatively higher chemotherapy use in patients with low-risk disease.
AHRQ-funded; HS022189.
Citation: Dinan MA, Mi X, Reed SD .
Association between use of the 21-gene recurrence score assay and receipt of chemotherapy among Medicare beneficiaries with early-stage breast cancer, 2005-2009.
JAMA Oncol 2015 Nov 1;1(8):1098-109. doi: 10.1001/jamaoncol.2015.2722..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Genetics, Medicare, Women
Stuart BC, Davidoff AJ, Erten MZ
AHRQ Author: Davidoff AJ
Changes in medication management after a diagnosis of cancer among Medicare beneficiaries with diabetes.
The researchers sought to determine whether a new cancer diagnosis is associated with changes in medication adherence among Medicare beneficiaries with diabetes. They concluded that cancer diagnosis among patients with diabetes reduced adherence with evidence-based medications, particularly if patients’ life expectancy was short.
Citation: Stuart BC, Davidoff AJ, Erten MZ .
Changes in medication management after a diagnosis of cancer among Medicare beneficiaries with diabetes.
J Oncol Pract 2015 Nov;11(6):429-34. doi: 10.1200/jop.2014.003046..
Keywords: Medication, Medicare, Cancer, Diabetes, Patient Adherence/Compliance
Singal AG, El-Serag HB
Hepatocellular carcinoma from epidemiology to prevention: Translating knowledge into practice.
The effectiveness of hepatocellular carcinoma (HCC) prevention in clinical practice and at the population level has lagged behind due to patient, provider, system, and societal factors. The authors suggest that the Quality in the Continuum of Cancer Care model provides a framework for evaluating the HCC prevention processes, including potential failures that create a gap between efficacy and effectiveness.
AHRQ-funded; HS022418.
Citation: Singal AG, El-Serag HB .
Hepatocellular carcinoma from epidemiology to prevention: Translating knowledge into practice.
Clin Gastroenterol Hepatol 2015 Nov;13(12):2140-51. doi: 10.1016/j.cgh.2015.08.014.
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Keywords: Cancer, Implementation, Prevention, Social Determinants of Health
Kenzik KM, Morey MC, Cohen HJ
Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors.
This study examined how overweight long-term survivors’ symptom severity associated with comorbidity prior to a diet and exercise intervention was associated with post-intervention function. It found that symptom severity of older, overweight cancer survivors negatively affects physical function. However, greater weight loss and more physical activity were associated with higher functioning scores, regardless of symptom severity.
AHRQ-funded; HS013852.
Citation: Kenzik KM, Morey MC, Cohen HJ .
Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors.
J Geriatr Oncol 2015 Nov;6(6):424-32. doi: 10.1016/j.jgo.2015.08.004..
Keywords: Cancer, Elderly, Obesity, Nutrition
Baker DW, Brown T, Goldman SN
Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers.
After an earlier outreach intervention achieved 82 percent annual adherence to colorectal cancer (CRC) screening with fecal occult blood testing (FOBT), this study assessed adherence to FOBT after a second outreach. It found that a total of 88.7 percent of patients completed a fecal immunochemical test within 6 months of their second outreach.
AHRQ-funded; HS021141.
Citation: Baker DW, Brown T, Goldman SN .
Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers.
Cancer Causes Control 2015 Nov;26(11):1685-90. doi: 10.1007/s10552-015-0650-0..
Keywords: Cancer, Cancer: Colorectal Cancer, Patient Adherence/Compliance, Prevention, Screening
Veluswamy RR, Ezer N, Mhango G
Limited resection versus lobectomy for older patients with early-stage lung cancer: Impact of histology.
The researchers used population-based data to assess the equivalency of limited resection versus lobectomy among older patients with stage IA invasive adenocarcinoma and squamous cell carcinoma less than 2 cm in size. They found generally that limited resection is not equivalent to lobectomy in older patients with invasive non–small-cell lung cancer, although segmentectomy may be equivalent in patients with adenocarcinoma.
AHRQ-funded; HS019670.
Citation: Veluswamy RR, Ezer N, Mhango G .
Limited resection versus lobectomy for older patients with early-stage lung cancer: Impact of histology.
J Clin Oncol 2015 Oct 20;33(30):3447-53. doi: 10.1200/jco.2014.60.6624..
Keywords: Cancer, Cancer: Lung Cancer, Comparative Effectiveness, Surgery
Highfield L, Rajan SS, Valerio MA
A non-randomized controlled stepped wedge trial to evaluate the effectiveness of a multi-level mammography intervention in improving appointment adherence in underserved women.
This study evaluated a theoretically based, systematically designed implementation strategy to support adoption and implementation of a patient navigation-based intervention, called Peace of Mind Program (PMP), aimed at improving breast cancer screening among underserved women.. Any potential confounding or bias will be controlled in the analysis. Outcomes such as appointment adherence, patient referral to diagnostics, time to diagnostic referral, patient referral to treatment, time to treatment referral, and budget impact of the intervention will be assessed.
AHRQ-funded; HS023255.
Citation: Highfield L, Rajan SS, Valerio MA .
A non-randomized controlled stepped wedge trial to evaluate the effectiveness of a multi-level mammography intervention in improving appointment adherence in underserved women.
Implement Sci 2015 Oct 14;10:143. doi: 10.1186/s13012-015-0334-x.
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Keywords: Cancer: Breast Cancer, Cancer, Screening, Patient Adherence/Compliance, Women, Vulnerable Populations, Prevention, Imaging
Silverberg MJ, Lau B, Achenbach CJ
Cumulative incidence of cancer among persons with HIV in North America: a cohort study.
The primary objective of the study was to compare time trends in cumulative cancer incidence in persons with and without HIV. It concluded that the high cumulative incidences by age 75 years for Kaposi sarcoma, non-Hodgkin lymphoma, and lung cancer support early and sustained antiretroviral therapy and smoking cessation.
AHRQ-funded; 90047713/PHS.
Citation: Silverberg MJ, Lau B, Achenbach CJ .
Cumulative incidence of cancer among persons with HIV in North America: a cohort study.
Ann Intern Med 2015 Oct 6;163(7):507-18. doi: 10.7326/m14-2768..
Keywords: Cancer, Human Immunodeficiency Virus (HIV), Tobacco Use
Lai JS, Yount S, Beaumont JL
A patient-centered symptom monitoring and reporting system for children and young adults with cancer (SyMon-SAYS).
This study evaluated the feasibility of implementing a patient-centered, technology-based symptom monitoring and reporting system (SyMon-SAYS) in pediatric oncology clinics using fatigue as a prototypic symptom. It concluded that the majority of patients (93 percent) and parents (78 percent) felt it was very/extremely easy to complete SyMon-SAYS; 95 percent of parents were satisfied with the system.
AHRQ-funded; HS019071.
Citation: Lai JS, Yount S, Beaumont JL .
A patient-centered symptom monitoring and reporting system for children and young adults with cancer (SyMon-SAYS).
Pediatr Blood Cancer 2015 Oct;62(10):1813-8. doi: 10.1002/pbc.25550..
Keywords: Children/Adolescents, Cancer, Health Information Technology (HIT), Children/Adolescents, Children/Adolescents
Ning J, Peng S, Ueno N
Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?
The researchers evaluated factors associated with overall, breast cancer-specific and other-cause mortalities using contemporary population data. They concluded that breast cancer-specific mortality among older women modestly improved from 2002 to 2009 across all races, but not other-cause mortality. Racial disparity in mortality persisted, but did not widen in this period.
AHRQ-funded; HS002026.
Citation: Ning J, Peng S, Ueno N .
Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?
Ann Oncol 2015 Oct;26(10):2161-8. doi: 10.1093/annonc/mdv330.
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Keywords: Cancer, Cancer: Breast Cancer, Elderly, Mortality, Racial and Ethnic Minorities
Mortel M, Rauscher GH, Murphy AM
Racial and ethnic disparity in symptomatic breast cancer awareness despite a recent screen: the role of tumor biology and mammography facility characteristics.
In a racially and ethnically diverse sample of recently diagnosed urban patients with breast cancer, the researchers examined associations of patient, tumor biology, and mammography facility characteristics on the probability of symptomatic discovery of their breast cancer despite a recent prior screening mammogram. They concluded that facility resources and tumor aggressiveness explain much of the racial/ethnic disparity in symptomatic breast cancer among recently screened patients.
AHRQ-funded; HS018366.
Citation: Mortel M, Rauscher GH, Murphy AM .
Racial and ethnic disparity in symptomatic breast cancer awareness despite a recent screen: the role of tumor biology and mammography facility characteristics.
Cancer Epidemiol Biomarkers Prev 2015 Oct;24(10):1599-606. doi: 10.1158/1055-9965.epi-15-0305.
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Keywords: Cancer: Breast Cancer, Cancer, Disparities, Women, Racial and Ethnic Minorities, Screening, Prevention
Parikh ND, Waljee AK, Singal AG
Downstaging hepatocellular carcinoma: a systematic review and pooled analysis.
The researchers aimed to characterize rates of successful downstaging to within Milan criteria and post-liver transplantation recurrence and survival among patients who underwent downstaging. They concluded that the success rate of downstaging hepatocellular carcinoma to within Milan criteria exceeds 40 percent; however, posttransplant HCC recurrence rates are high at 16 percent.
AHRQ-funded; HS022418.
Citation: Parikh ND, Waljee AK, Singal AG .
Downstaging hepatocellular carcinoma: a systematic review and pooled analysis.
Liver Transpl 2015 Sep;21(9):1142-52. doi: 10.1002/lt.24169..
Keywords: Cancer, Risk, Transplantation
Abdelsattar ZM, Birkmeyer JD, Wong SL
Variation in Medicare payments for colorectal cancer surgery.
The researchers assessed the contributions of index hospitalization, physician services, readmissions, and postacute care to the overall variation in payment for colorectal cancer surgery (CRC). They concluded that Medicare spending in the first year after CRC surgery varies across hospitals even after case-mix adjustment and price standardization. Variation is largely driven by postacute care and not the index surgical hospitalization.
AHRQ-funded; HS020937; HS000053.
Citation: Abdelsattar ZM, Birkmeyer JD, Wong SL .
Variation in Medicare payments for colorectal cancer surgery.
J Oncol Pract 2015 Sep;11(5):391-5. doi: 10.1200/jop.2015.004036.
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Keywords: Cancer, Cancer: Colorectal Cancer, Payment, Medicare, Surgery
Kenzik KM, Ganz PA, Martin MY
How much do cancer-related symptoms contribute to health-related quality of life in lung and colorectal cancer patients? A report from the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium.
The objective of this study was to examine associations of symptoms with physical and mental health-related quality of life (HRQOL) in patients with colorectal cancer (CRC) and in patients with lung cancer. It found that physical component summary scores for patients with CRC and lung cancer were below the general population norm of 50 (43 and 37, respectively), and mental component summary scores were at the population norm.
AHRQ-funded; HS013852.
Citation: Kenzik KM, Ganz PA, Martin MY .
How much do cancer-related symptoms contribute to health-related quality of life in lung and colorectal cancer patients? A report from the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium.
Cancer 2015 Aug 15;121(16):2831-9. doi: 10.1002/cncr.29415..
Keywords: Quality of Life, Cancer, Cancer: Lung Cancer, Outcomes
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
Morgans AK, Schapira L
Confronting therapeutic failure: a conversation guide.
The authors review the classic six-step SPIKES (setting, perception, invitation for information, knowledge, empathy, summarize and strategize) protocol for giving bad news that has been widely adopted since it was first published in this journal in 2005. They also offer practical tips derived from a thorough review of the evidence and our clinical experience.
AHRQ-funded; HS022990.
Citation: Morgans AK, Schapira L .
Confronting therapeutic failure: a conversation guide.
Oncologist 2015 Aug;20(8):946-51. doi: 10.1634/theoncologist.2015-0050..
Keywords: Cancer, Clinician-Patient Communication, Communication, Patient-Centered Healthcare, Patient-Centered Outcomes Research