National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (5)
- (-) Blood Clots (14)
- Blood Thinners (3)
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- Cancer: Colorectal Cancer (1)
- Care Management (1)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (1)
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- Education: Patient and Caregiver (1)
- Elderly (1)
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- Imaging (1)
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- Medication: Safety (2)
- Obesity (1)
- Obesity: Weight Management (1)
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- Patient-Centered Healthcare (1)
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- Practice Patterns (1)
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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 14 of 14 Research Studies DisplayedSchlick CJR, Merkow RP, Yang AD
Post-discharge venous thromboembolism after pancreatectomy for malignancy: predicting risk based on preoperative, intraoperative, and postoperative factors.
Extended chemoprophylaxis is recommended for high-risk patients following pancreatectomy for malignancy. However, quantifying risk remains difficult. In this study, the investigators sought to (a) identify factors associated with post-discharge venous thromboembolism (VTE) following pancreatectomy for malignancy and (b) develop a post-discharge VTE risk calculator to identify high-risk patients. The investigators concluded that preoperative, intraoperative, and postoperative factors were associated with post-discharge VTE following pancreatectomy for malignancy.
AHRQ-funded; HS026385.
Citation: Schlick CJR, Merkow RP, Yang AD .
Post-discharge venous thromboembolism after pancreatectomy for malignancy: predicting risk based on preoperative, intraoperative, and postoperative factors.
J Surg Oncol 2020 Sep 15;122(4):675-83. doi: 10.1002/jso.26046..
Keywords: Cancer, Surgery, Treatments, Blood Clots, Risk
Utter GH, Dhillon TS, Danielsen BH
Use of statewide administrative data to assess clinical outcomes: a retrospective cohort study of therapeutic anticoagulation for isolated calf vein thrombosis.
Single-center comparative effectiveness studies evaluating outcomes that can occur posthospitalization may become biased if outcomes diagnosed at other facilities are not ascertained. Administrative datasets that link patients' records across facilities may improve outcome ascertainment. The purpose of this study was to determine whether use of linked administrative data significantly augmented thromboembolic outcome ascertainment. The investigators concluded that use of linked hospital administrative data augmented detection of outcomes but imperfect linkage, nonspecific diagnoses, and documentation/coding errors introduced uncertainty regarding the accuracy of outcome ascertainment.
AHRQ-funded; HS022236.
Citation: Utter GH, Dhillon TS, Danielsen BH .
Use of statewide administrative data to assess clinical outcomes: a retrospective cohort study of therapeutic anticoagulation for isolated calf vein thrombosis.
Med Care 2020 Jul;58(7):658-62. doi: 10.1097/mlr.0000000000001347.
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Keywords: Blood Clots, Blood Thinners, Medication, Research Methodologies, Patient-Centered Outcomes Research
Yang AD, Hewitt DB, Blay E
Multi-institution evaluation of adherence to comprehensive postoperative VTE chemoprophylaxis.
The aims of this study were to: (1) measure the rate of failure to provide defect-free postoperative venous thromboembolism (VTE) chemoprophylaxis, (2) identify reasons for failure to provide defect-free VTE chemoprophylaxis, and (3) examine patient- and hospital-level factors associated with failure. The investigators concluded that in contrast to SCIP-VTE-2, their novel quality measure unmasked VTE chemoprophylaxis failures in 18% of colectomies. They found that most failures were due to patient refusals or ordering errors.
AHRQ-funded; HS024516.
Citation: Yang AD, Hewitt DB, Blay E .
Multi-institution evaluation of adherence to comprehensive postoperative VTE chemoprophylaxis.
Ann Surg 2020 Jun;271(6):1072-79. doi: 10.1097/sla.0000000000003124..
Keywords: Patient Adherence/Compliance, Guidelines, Blood Clots, Blood Thinners, Medication, Medication: Safety, Patient Safety, Adverse Events
Richardson S, Cohen S, Khan S
Higher imaging yield when clinical decision support is used.
Increased utilization of CT pulmonary angiography (CTPA) for the evaluation of pulmonary embolism has been associated with decreasing diagnostic yields and rising concerns about the harms of unnecessary testing. The objective of this study was to determine whether clinical decision support (CDS) use would be associated with increased imaging yields after controlling for selection bias.
AHRQ-funded; HS022061.
Citation: Richardson S, Cohen S, Khan S .
Higher imaging yield when clinical decision support is used.
J Am Coll Radiol 2020 Apr;17(4):496-503. doi: 10.1016/j.jacr.2019.11.021.
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Keywords: Clinical Decision Support (CDS), Imaging, Diagnostic Safety and Quality, Decision Making, Blood Clots
de Meireles A, Carlin AM, Cain-Nielsen A
Association between surgeon practice knowledge and venous thromboembolism.
Venous thromboembolism (VTE) is the most common cause of mortality following bariatric surgery. This study aimed to determine practice patterns of VTE chemoprophylaxis among bariatric surgeons participating in a large statewide quality collaborative and compare the results of surgeon self-reported chemoprophylaxis prescription practices versus actual data from abstracted charts. They administered a 13-question survey to 66 surgeons to reveal VTE practice patterns such as medication type, dosage, timing, duration, and level of trainee involvement. They also examined the charts of all patients who had developed VTE during the study period and 15 other randomly selected patient charts per site. There was found to be a greater discordance between surgeon self-reported and actual perioperative VTE prophylaxis, but there was no significant discordance postoperatively. Greater perioperative discordance is associated with significantly increased risk of VTE.
AHRQ-funded; HS02362; HS024403.
Citation: de Meireles A, Carlin AM, Cain-Nielsen A .
Association between surgeon practice knowledge and venous thromboembolism.
Obes Surg 2020 Feb 16;30(6):2274-79. doi: 10.1007/s11695-020-04468-6..
Keywords: Surgery, Obesity: Weight Management, Obesity, Blood Clots, Practice Patterns, Provider: Physician, Provider
Abraham NS, Noseworthy PA, Inselman J
Risk of gastrointestinal bleeding increases with combinations of antithrombotic agents and patient age.
This study investigated whether age of patient and time frame increased the risk of gastrointestinal bleeding (GIB) in elderly patients being treated with anticoagulants, antiplatelets, or a combination of both therapies. This retrospective analysis used nationwide claims data from privately insured and Medicare Advantage enrollees who received anticoagulant and/or antiplatelet agents from October 1, 2010, through May 31, 2017. The final cohort included 311,211 patients who had a primary diagnosis of atrial fibrillation, ischemic heart disease, or venous thromboembolism. There was no significant different in the proportion of patients with GIB after anticoagulant or antiplatelet monotherapy, but combination therapy increased GIB risk. Advancing age was also associated with increasing 1-year probability of FIB, especially patients older than 75 years taking combination therapy.
AHRQ-funded; HS025402.
Citation: Abraham NS, Noseworthy PA, Inselman J .
Risk of gastrointestinal bleeding increases with combinations of antithrombotic agents and patient age.
Clin Gastroenterol Hepatol 2020 Feb;18(2):337-46.e19. doi: 10.1016/j.cgh.2019.05.017..
Keywords: Adverse Drug Events (ADE), Medication, Adverse Events, Medication: Safety, Elderly, Blood Thinners, Blood Clots, Digestive Disease and Health
Owodunni OP, Haut ER, Shaffer DL
Using electronic health record system triggers to target delivery of a patient-centered intervention to improve venous thromboembolism prevention for hospitalized patients: is there a differential effect by race?
Venous thromboembolism (VTE) is a leading cause of preventable harm, and disparities observed in prevention practices. In this study, the investigators examined the impact of a patient-centered VTE education bundle on the non-administration of preventive prophylaxis by race. The investigators found that the patient education materials, developed collaboratively with a diverse group of patients, improved patient's understanding and the importance of VTE prevention through prophylaxis.
AHRQ-funded; HS024547.
Citation: Owodunni OP, Haut ER, Shaffer DL .
Using electronic health record system triggers to target delivery of a patient-centered intervention to improve venous thromboembolism prevention for hospitalized patients: is there a differential effect by race?
PLoS One 2020 Jan 16;15(1):e0227339. doi: 10.1371/journal.pone.0227339..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Healthcare, Blood Clots, Prevention, Inpatient Care, Health Literacy, Education: Patient and Caregiver
Schlick CJR, Liu JY, Yang AD
Pre-operative, intra-operative, and post-operative factors associated with post-discharge venous thromboembolism following colorectal cancer resection.
Venous thromboembolism (VTE) is the most common preventable cause of 30-day post-operative mortality, with many events occurring after hospital discharge. High-level evidence supports post-discharge VTE chemoprophylaxis following abdominal/pelvic cancer resection; however, some studies support a more tailored approach. The objectives of this study were to (1) identify risk factors associated with post-discharge VTE in a large cohort of patients undergoing colorectal cancer resection and (2) develop a post-discharge VTE risk calculator.
AHRQ-funded; HS024516; HS026385.
Citation: Schlick CJR, Liu JY, Yang AD .
Pre-operative, intra-operative, and post-operative factors associated with post-discharge venous thromboembolism following colorectal cancer resection.
J Gastrointest Surg 2020 Jan;24(1):144-54. doi: 10.1007/s11605-019-04354-2..
Keywords: Cancer: Colorectal Cancer, Cancer, Surgery, Blood Clots, Adverse Events, Risk, Hospital Discharge
Admon AJ, Seymour CW, Gershengorn HB
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
The researchers examined the relationship between intensive care unit (ICU) use for patients with pulmonary embolism (PE) and cost, mortality, readmission, and procedure use in 263 hospitals. They found wide variations in ICU admission rates for acute PE without a detectable impact on mortality, cost, or readmission.
AHRQ-funded; HS020672
Citation: Admon AJ, Seymour CW, Gershengorn HB .
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
Chest. 2014 Dec;146(6):1452-61. doi: 10.1378/chest.14-0059..
Keywords: Blood Clots, Care Management, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU)
Ju MH, Chung JW, Kinnier CV
Association between hospital imaging use and venous thromboembolism events rates based on clinical data.
This study assessed the presence and extent of venous thromboembolism (VTE) surveillance bias using high-quality clinical data from 208 hospitals. It concluded that hospitals may be unfairly deemed poor performers for the outcome VTE measure if they have increased vigilance for VTE by performing more VTE imaging studies that result in higher VTE event rates.
AHRQ-funded; HS021857
Citation: Ju MH, Chung JW, Kinnier CV .
Association between hospital imaging use and venous thromboembolism events rates based on clinical data.
Ann Surg. 2014 Sep; 260(3):558-64; discussion 64-6. doi: 10.1097/sla.0000000000000897..
Keywords: Blood Clots, Public Reporting, Adverse Events, Outcomes, Quality of Care
Chopra V, Ratz D, Kuhn L
Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors.
This study was designed to determine patient, provider, and device outcome of deep vein thrombosis (DVT) associated with peripherally inserted central catheters (PICCs). Larger PICC gauge, especially in the use of recently diagnosed cancer patients, increases the likelihood of DVT.
AHRQ-funded; HS022835
Citation: Chopra V, Ratz D, Kuhn L .
Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors.
J Thromb Haemost 2014 Jun;12(6):847-54. doi: 10.1111/jth.12549..
Keywords: Adverse Events, Blood Clots, Patient Safety, Risk
Streiff MB, Brady JP, Grant AM
AHRQ Author: Brady JP
CDC Grand Rounds: preventing hospital-associated venous thromboembolism.
Approximately half of new venous thromboembolism (VTE) cases occur during a hospital stay or within 90 days of an inpatient admission or surgical procedure, and many are not diagnosed until after discharge. Prevention of VTE can be complicated as physicians must balance the risk for thrombosis with the risk for bleeding from anticoagulants. A collaborative, team-based approach to care is needed for significant and sustained improvement, and it also offers efficiency and capacity to tackle other patient safety problems.
AHRQ-authored.
Citation: Streiff MB, Brady JP, Grant AM .
CDC Grand Rounds: preventing hospital-associated venous thromboembolism.
MMWR Morb Mortal Wkly Rep 2014 Mar 7;63(9):190-3.
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Keywords: Blood Clots, Healthcare-Associated Infections (HAIs), Hospitalization, Prevention, Teams
Lau BD, Haut ER
Practices to prevent venous thromboembolism: a brief review.
The purpose of this review is to provide an update on the most effective interventions aimed at improving adherence to guidelines on the use of venous thromboembolism (VTE) prevention strategies. After reviewing sixteen studies, the researchers concluded that the greatest and most sustained improvements were those that combined education with computerised tools.
AHRQ-funded; 290200710.
Citation: Lau BD, Haut ER .
Practices to prevent venous thromboembolism: a brief review.
BMJ Qual Saf 2014 Mar;23(3):187-95. doi: 10.1136/bmjqs-2012-001782..
Keywords: Comparative Effectiveness, Blood Clots, Prevention, Decision Making, Guidelines
Radecki RP
Letter by Radecki regarding article, "safety of thrombolysis in stroke mimics: results from a multicenter cohort study".
In this letter commenting on an article on the treatment of stroke mimics, the author asserts that the difficult question of the acceptable rate of misdiagnosis remains. He suggests that patients undergoing thrombolytic therapy for acute ischemic stroke have confirmatory testing such as an MRI with diffusion-weighted sequences and that the incidence of neuroimaging negative events be reported.
AHRQ-funded; HS017586
Citation: Radecki RP .
Letter by Radecki regarding article, "safety of thrombolysis in stroke mimics: results from a multicenter cohort study".
Stroke. 2013 Sep;44(9):e105. doi: 10.1161/STROKEAHA.113.002040..
Keywords: Stroke, Decision Making, Patient Safety, Blood Clots