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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 46 Research Studies DisplayedMcGinty EE, Presskreischer R, Anderson KE
Psychological distress and COVID-19-related stressors reported in a longitudinal cohort of US adults in April and July 2020.
The authors investigated how psychological distress has changed over the course of the COVID-19 pandemic. They found that more than 60% of adults with serious distress reported that pandemic-related disruptions to education, employment, and finances negatively affected their mental health. Thirty-five percent of adults with serious distress cited inability to obtain health care as a contributing factor, highlighting the need to facilitate safe and affordable health care access during the pandemic and beyond.
AHRQ-funded; HS000029.
Citation: McGinty EE, Presskreischer R, Anderson KE .
Psychological distress and COVID-19-related stressors reported in a longitudinal cohort of US adults in April and July 2020.
JAMA 2020 Dec 22;324(24):2555-57. doi: 10.1001/jama.2020.21231..
Keywords: COVID-19, Behavioral Health, Stress
Fisher KA, Bloomstone SJ, Walder J
Attitudes toward a potential SARS-CoV-2 vaccine: a survey of U.S. adults.
The authors assessed the intent to be vaccinated against COVID-19 among a representative sample of adults in the United States and identified predictors of and reasons for vaccine hesitancy. They found that approximately 3 in 10 adults were not sure they would accept vaccination and 1 in 10 did not intend to be vaccinated against COVID-19. They recommended targeted and multipronged efforts to increase acceptance of a COVID-19 vaccine.
AHRQ-funded; HS024596.
Citation: Fisher KA, Bloomstone SJ, Walder J .
Attitudes toward a potential SARS-CoV-2 vaccine: a survey of U.S. adults.
Ann Intern Med 2020 Dec 15;173(12):964-73. doi: 10.7326/m20-3569..
Keywords: COVID-19, Vaccination, Public Health, Patient Adherence/Compliance
Byrnes ME, Varlamos CJ, Rivard SJ
"You're used to being the one that can fix things…": a qualitative snapshot of colorectal surgeons during COVID-19.
This viewpoint article reflects the narratives of 58 colorectal surgeons who engaged in an in-depth qualitative interview during the COVID-19 shutdown of elective surgeries. The goal for reporting these findings is to offer a snapshot of surgeon perspectives on the delays of elective surgeries and to give voice to surgeons who were unable to perform most or all their duties as a surgeon.
AHRQ-funded; HS025365; HS000053.
Citation: Byrnes ME, Varlamos CJ, Rivard SJ .
"You're used to being the one that can fix things…": a qualitative snapshot of colorectal surgeons during COVID-19.
Dis Colon Rectum 2020 Dec;63(12):1575-78. doi: 10.1097/dcr.0000000000001818..
Keywords: Surgery, Provider: Physician, Provider, COVID-19, Public Health, Infectious Diseases
Temkin-Greener H, Guo W, Mao Y
COVID-19 pandemic in assisted living communities: results from seven states.
The purpose of this observational study was to describe variations in COVID-19 confirmed cases and deaths among assisted living (AL) residents and examine their associations with key AL characteristics. The investigators concluded that ALs with a higher proportion of minorities had more COVID-19 cases. Many of the previously identified individual risk factors were also present in this vulnerable population.
AHRQ-funded; HS024923; HS026893; HS026893.
Citation: Temkin-Greener H, Guo W, Mao Y .
COVID-19 pandemic in assisted living communities: results from seven states.
J Am Geriatr Soc 2020 Dec;68(12):2727-34. doi: 10.1111/jgs.16850..
Keywords: Elderly, Public Health, COVID-19, Nursing Homes, Vulnerable Populations, Risk
Shappell CN, Klompas M, Rhee C
Does severe acute respiratory syndrome coronavirus 2 cause sepsis?
Although some experts have unequivocally asserted that multiple organ failure arising from COVID-19 is sepsis, other case series of severe COVID-19 infections have not labeled the disease as sepsis despite the fact that patients have proven infection and organ dysfunction and therefore meet the formal definition of sepsis. In this study, the authors explore why this is the case, and whether or not it truly serves patients.
AHRQ-funded; HS025008.
Citation: Shappell CN, Klompas M, Rhee C .
Does severe acute respiratory syndrome coronavirus 2 cause sepsis?
Crit Care Med 2020 Dec;48(12):1707-09. doi: 10.1097/ccm.0000000000004601..
Keywords: COVID-19, Sepsis, Respiratory Conditions
Gelfand JM, Armstrong AW, Bell S
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
This article describes the process that was used to create the first version of a guidance document for management of psoriatic disease during the COVID-19 pandemic developed by the National Psoriasis Foundation. A task force of 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care was created with supplementation by nonvoting members. A Delphi process was created, out of which 22 guidance statements were approved. All guidance statements were recommended, with 9 of them high consensus, and the remaining 13 were moderate consensus. Topics covered included how COVID-19 can impact patients, how medical care can be optimized during the pandemic, and what patients can do to lower their risk of getting infected with COVID-19. This guidance will be updated by the TF as new data emerges.
AHRQ-funded; HS026372.
Citation: Gelfand JM, Armstrong AW, Bell S .
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
J Am Acad Dermatol 2020 Dec;83(6):1704-16. doi: 10.1016/j.jaad.2020.09.001..
Keywords: Skin Conditions, Chronic Conditions, Care Management, Evidence-Based Practice, Guidelines, COVID-19
Barry CL, Han H, Presskreischer R
Public support for social safety-net policies for COVID-19 in the United States, April 2020.
Researchers examined public support for health insurance, income support, and unemployment policies during the initial phase of disease transmission and economic distress following the COVID-19 outbreak and assessed varying public support based on beliefs about the role of government. They fielded a nationally representative survey of US adults from April 7-13, 2020. Their results indicate that, during the initial phase of the COVID-19 pandemic in early April 2020, most US adults favored a range of safety-net policies to ameliorate its negative health and economic consequences, with public support being the highest among those favoring a stronger governmental role in society.
AHRQ-funded; HS000029.
Citation: Barry CL, Han H, Presskreischer R .
Public support for social safety-net policies for COVID-19 in the United States, April 2020.
Am J Public Health 2020 Dec;110(12):1811-13. doi: 10.2105/ajph.2020.305919..
Keywords: Public Health, Policy, COVID-19
Soares WE, Schoenfeld EM, Visintainer P
Safety assessment of a noninvasive respiratory protocol for adults with COVID-19.
As evidence emerged supporting noninvasive strategies for coronavirus disease 2019 (COVID-19)-related respiratory distress, the investigators implemented a noninvasive COVID-19 respiratory protocol (NCRP) that encouraged high-flow nasal cannula (HFNC) and self-proning across our healthcare system. To assess safety, the investigators conducted a retrospective chart review evaluating mortality and other patient safety outcomes after implementation of the NCRP protocol (April 3, 2020, to April 15, 2020) for adult patients hospitalized with COVID-19, compared with preimplementation outcomes (March 15, 2020, to April 2, 2020).
AHRQ-funded; HS025701.
Citation: Soares WE, Schoenfeld EM, Visintainer P .
Safety assessment of a noninvasive respiratory protocol for adults with COVID-19.
J Hosp Med 2020 Dec;15(12):734-38. doi: 10.12788/jhm.3548..
Keywords: Patient Safety, COVID-19, Respiratory Conditions, Inpatient Care, Infectious Diseases
Feldman AG, Adams MA, Wachs ME
Successful non-directed living liver donor transplant for an infant with biliary atresia during the COVID-19 pandemic.
This case study describes a successful non-directed living liver donor transplant for an infant with biliary atresia that occurred during the COVID-19 pandemic. Careful preoperative planning was used to prevent infection pre- and post-cooperatively, and robust telehealth technology use both in and out of the hospital.
AHRQ-funded; HS026510.
Citation: Feldman AG, Adams MA, Wachs ME .
Successful non-directed living liver donor transplant for an infant with biliary atresia during the COVID-19 pandemic.
Pediatr Transplant 2020 Dec;24(8):e13816. doi: 10.1111/petr.13816..
Keywords: Newborns/Infants, COVID-19, Transplantation, Surgery, Case Study
Kang M, Gurbani SS, Kempker JA
The published scientific literature on COVID-19: an analysis of PubMed abstracts.
This article describes a PubMed search done on the published scientific literature on COVID-19 from first reporting of the virus in late December 2019 through Nov. 9, 2020. A total of 57,263 articles were included, with 34% ahead of print, 25.1% e-published, and 40.9% print published at the time of data extraction. There was a peak of 2277 articles the week of May 11. The origin countries of publication were United States (35.7%), followed by England (27%), and the Netherlands (8.7%). Most publications (98%) were in English followed by less than 1% each in Spanish, German, and French.
AHRQ-funded; HS025240.
Citation: Kang M, Gurbani SS, Kempker JA .
The published scientific literature on COVID-19: an analysis of PubMed abstracts.
J Med Syst 2020 Nov 25;45(1):3. doi: 10.1007/s10916-020-01678-4..
Keywords: COVID-19, Public Health, Research Methodologies, Health Services Research (HSR)
Selden TM, Berdahl TA, Fang Z
AHRQ Author: Selden TM, Berdahl TA, Fang Z
The risk of severe COVID-19 within households of school employees and school-age children.
Across the United States, school districts are grappling with questions of whether and how to reopen elementary and secondary schools in the 2020-21 academic year. Using pre-pandemic household data, the authors examined how often persons at risk of severe coronavirus disease 2019 (COVID-19) were connected to schools, either as employees or by living in the same households as school employees or school-age children.
AHRQ-authored.
Citation: Selden TM, Berdahl TA, Fang Z .
The risk of severe COVID-19 within households of school employees and school-age children.
Health Aff 2020 Nov;39(11):2002-09. doi: 10.1377/hlthaff.2020.01536..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, COVID-19, Public Health, Risk, Infectious Diseases
Yang J, Landrum MB, Zhou L
Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts.
The purpose of this study was to examine changes in outpatient visits for mental health and/or substance use disorders (MH/SUD) in an integrated healthcare organization during the initial Massachusetts COVID-19 surge and partial state reopening. The investigators concluded that MH/SUD visit volume increased during the COVID surge and was supported by rapidly-scaled telemedicine.
AHRQ-funded; HS025375.
Citation: Yang J, Landrum MB, Zhou L .
Disparities in outpatient visits for mental health and/or substance use disorders during the COVID surge and partial reopening in Massachusetts.
Gen Hosp Psychiatry 2020 Nov-Dec;67:100-06. doi: 10.1016/j.genhosppsych.2020.09.004..
Keywords: Behavioral Health, Substance Abuse, COVID-19, Disparities, Access to Care, Ambulatory Care and Surgery, Telehealth, Health Information Technology (HIT)
Misra-Hebert AD, Ji X, Nowacki AS
Impact of the COVID-19 pandemic on healthcare workers' risk of infection and outcomes in a large, integrated health system.
Researchers assessed healthcare workers (HCW) risk for COVID-19 infection, hospitalization, and intensive care unit (ICU) admission. Participants were individuals who had tested for SARS-CoV-2 infection in a large academic healthcare system. The study found that, in a large healthcare system, HCW had similar odds for testing positive, but lower odds of hospitalization, compared to non-HCW. Patient-facing HCW had higher odds of a positive test.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Ji X, Nowacki AS .
Impact of the COVID-19 pandemic on healthcare workers' risk of infection and outcomes in a large, integrated health system.
J Gen Intern Med 2020 Nov;35(11):3293-301. doi: 10.1007/s11606-020-06171-9..
Keywords: COVID-19, Risk, Provider: Health Personnel, Public Health, Healthcare Delivery, Infectious Diseases
Chou R, Dana T, Jungbauer R
Masks for prevention of respiratory virus infections, including SARS-CoV-2, in health care and community settings : a living rapid review.
This study examined the effectiveness of N95, surgical, and cloth masks in community and health care settings for preventing respiratory virus infections, including coronavirus. The effects of reuse or extended use of N95 masks was also studied. The authors used multiple electronic databases, including the World Health Organization COVID-19 database and medRxiv preprint server (2003 through 2020), and reference lists. Randomized trials of masks and risks for respiratory virus infection were included. The studies were abstracted and methodological limitations were assessed by one reviewer, with a second reviewer providing verification. Thirty-nine studies with 33,867 participants were included. No studies were found that evaluated reuse or extended use of N95 masks. The studies showed that COVID-19 and MERS probably decreased with use versus nonuse and possibly decreased with N95 versus surgical mask use. Random trials in community settings found not much difference between N95 versus surgical masks. The studies’ findings were not definitive.
AHRQ-funded; 290201500009I.
Citation: Chou R, Dana T, Jungbauer R .
Masks for prevention of respiratory virus infections, including SARS-CoV-2, in health care and community settings : a living rapid review.
Ann Intern Med 2020 Oct 6;173(7):542-55. doi: 10.7326/m20-3213..
Keywords: COVID-19, Respiratory Conditions, Infectious Diseases, Prevention, Public Health, Evidence-Based Practice
Lara OD, O'Cearbhaill RE, Smith MJ
COVID-19 outcomes of patients with gynecologic cancer in New York City.
Researchers studied clinical characteristics and outcomes of vulnerable populations with gynecologic cancer who developed COVID-19 infections. Among patients from six New York City area hospital systems with known gynecologic cancer and a COVID-19 diagnosis, the researchers found a case fatality rate of 14 percent, with no association between cytotoxic chemotherapy and cancer-directed surgery and COVID-19 severity or death. They recommended that patients be counseled regarding the safety of continued anticancer treatments during the pandemic, as the ability to continue cancer therapies for cancer control and cure is critical.
AHRQ-funded; HS026120.
Citation: Lara OD, O'Cearbhaill RE, Smith MJ .
COVID-19 outcomes of patients with gynecologic cancer in New York City.
Cancer 2020 Oct 1;126(19):4294-303. doi: 10.1002/cncr.33084..
Keywords: COVID-19, Respiratory Conditions, Cancer, Women, Vulnerable Populations, Outcomes, Urban Health
Gold JA, Becton J, Ash JS
Do you know what your scribe did last spring? The impact of COVID-19 on medical scribe workflow.
This study assessed the impact of COVID-19 on the workflow of medical scribes. This prospective observational study was conducted at an academic medical center in the United States. A total of 74 scribes working in ambulatory practices were recruited, with 57 scribes completing the survey. Overall, 42% of scribes transitioned to remote scribing with 97% serving as remote scribes for telehealth visits. These scribes worked at home and used personal equipment. Of those no longer working as scribes, 46% worked in preclinic support, with a wide range of EHR-related activities reported. The remainder were either redeployed or furloughed.
AHRQ-funded; HS025141.
Citation: Gold JA, Becton J, Ash JS .
Do you know what your scribe did last spring? The impact of COVID-19 on medical scribe workflow.
Appl Clin Inform 2020 Oct;11(5):807-11. doi: 10.1055/s-0040-1721396..
Keywords: COVID-19, Workflow, Electronic Health Records (EHRs), Telehealth, Health Information Technology (HIT)
Glass M, Rana S, Coghlan R
Global palliative care education in the time of COVID-19.
This paper describes the Global Palliative Education Collaborative (GPEC), which is a training partnership between Harvard, University of California San Francisco, and Tulane medical schools in the U.S., and international palliative care (PC) programs in Uganda and India. U.S.-based fellowships are offered by GPEC to learn about resource-limited PC provision, gain perspectives on global challenges to caring for patients at the end of life, and cultivate resiliency. They also offer a novel educational project that the GPEC faculty and fellows are participating in called the Resilient Inspirational Storytelling Empathy Project. Palliative care has become even more important during the COVID-19 pandemic.
AHRQ-funded; HS026383.
Citation: Glass M, Rana S, Coghlan R .
Global palliative care education in the time of COVID-19.
J Pain Symptom Manage 2020 Oct;60(4):e14-e19. doi: 10.1016/j.jpainsymman.2020.07.018..
Keywords: Palliative Care, COVID-19, Education: Continuing Medical Education, Training
DePuccio MJ, Di Tosto G, Walker DM
Patients' perceptions about medical record privacy and security: implications for withholding of information during the COVID-19 pandemic.
Researchers explored how patients’ concerns about the privacy and security of their medical information may lead to information-withholding behaviors. They found that many hospitalized patients were concerned about who had access to their medical information, and they found an association between these concerns and patients’ reported information-withholding behavior. They recommended reinforcing technological safeguards and clearly communicating about how patients’ medical information is accessed, stored, and used in order to honor patient privacy preferences and potentially address patients’ concerns in this area.
AHRQ-funded; HS024091; HS024767.
Citation: DePuccio MJ, Di Tosto G, Walker DM .
Patients' perceptions about medical record privacy and security: implications for withholding of information during the COVID-19 pandemic.
J Gen Intern Med 2020 Oct;35(10):3122-25. doi: 10.1007/s11606-020-05998-6..
Keywords: COVID-19, Electronic Health Records (EHRs), Health Information Technology (HIT)
Bartsch SM, O'Shea KJ, Ferguson MC
Vaccine efficacy needed for a COVID-19 coronavirus vaccine to prevent or stop an epidemic as the sole intervention.
This study examined the needed efficacy and coverage of a COVID-19 vaccine to prevent or stop the pandemic. Simulation experiments were conducted at 60-80% efficacy rates. At 60% efficacy, vaccination coverage needs to be 100%. If the coverage rate is reduced to 75%, the efficacy needs to be 70% and up to 80% when coverage drops to 60%. These findings show that the vaccine needs to have at least an efficacy rate of 70% to prevent an epidemic and at least 80% to extinguish an epidemic without any other measures such as social distancing.
AHRQ-funded; HS023317.
Citation: Bartsch SM, O'Shea KJ, Ferguson MC .
Vaccine efficacy needed for a COVID-19 coronavirus vaccine to prevent or stop an epidemic as the sole intervention.
Am J Prev Med 2020 Oct;59(4):493-503. doi: 10.1016/j.amepre.2020.06.011..
Keywords: Vaccination, COVID-19, Public Health, Prevention, Evidence-Based Practice, Infectious Diseases
White EM, Kosar CM, Feifer RA
Variation in SARS-CoV-2 prevalence in U.S. skilled nursing facilities.
The objective of this study was to identify county and facility factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks in skilled nursing facilities (SNFs). The investigators concluded that larger SNFs and SNFs in areas of high SARS-CoV-2 prevalence were at high risk for outbreaks and must have access to universal testing to detect cases, implement mitigation strategies, and prevent further potentially avoidable cases and related complications.
AHRQ-funded; HS000011.
Citation: White EM, Kosar CM, Feifer RA .
Variation in SARS-CoV-2 prevalence in U.S. skilled nursing facilities.
J Am Geriatr Soc 2020 Oct;68(10):2167-73. doi: 10.1111/jgs.16752..
Keywords: COVID-19, Elderly, Nursing Homes, Long-Term Care, Public Health, Infectious Diseases
Auger KA, Shah SS, Richardson T
Association between statewide school closure and COVID-19 incidence and mortality in the US.
This study examined whether school closures between March and May due to the beginning of the COVID-19 pandemic was associated with decreased COVID-19 incidence and mortality. States were examined in quartiles using the number of cases per 100,000 population. States with the lowest cumulative incidence had the most significant decline (-72%) in cases compared to states with the highest incidence (-49%). States that closed schools earlier had the largest reduction in incidence and mortality.
AHRQ-funded; HS024735, HS026763, HS025138.
Citation: Auger KA, Shah SS, Richardson T .
Association between statewide school closure and COVID-19 incidence and mortality in the US.
JAMA 2020 Sep;324(9):859-70. doi: 10.1001/jama.2020.14348..
Keywords: COVID-19, Public Health, Children/Adolescents, Policy, Mortality
Selden TM, Berdahl TA
AHRQ Author: Selden TM, Berdahl TA
COVID-19 and racial/ethnic disparities in health risk, employment, and household composition.
In this study, the investigators used data from the Medical Expenditure Panel Survey to explore potential explanations for racial-ethnic disparities in coronavirus disease 2019 (COVID-19) hospitalizations and mortality. The authors found that black adults in every age group were more likely than whites to have health risks associated with severe COVID-19 illness. However, whites were older on average than blacks.
AHRQ-authored.
Citation: Selden TM, Berdahl TA .
COVID-19 and racial/ethnic disparities in health risk, employment, and household composition.
Health Aff 2020 Sep;39(9):1624-32. doi: 10.1377/hlthaff.2020.00897..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Disparities, Racial and Ethnic Minorities, Risk
Li Y, Temkin-Greener H, Shan G
COVID-19 infections and deaths among Connecticut nursing home residents: facility correlates.
This study looked at the relationship between higher registered nurse (RN) staffing, quality ratings, the concentration of Medicaid residents or racial/ethnic minorities; and the number of COVID-19 confirmed cases and deaths at nursing homes. All Connecticut nursing homes (n = 215) were included in the study. As of April 16, 2020, the average number of confirmed cases was 8 per nursing home (zero in 107 facilities) and the number of confirmed deaths was 1.7 per nursing (zero in 131 facilities). In nursing homes with at least one death, every 20-minute increase in RN staffing significantly predicted 26% fewer COVID-19 deaths and was associated with 22% fewer confirmed cases. Facilities with a high concentration of Medicaid residents or racial/ethnic minority residents had 16% and 15% more confirmed cases.
AHRQ-funded; HS024923; HS026893.
Citation: Li Y, Temkin-Greener H, Shan G .
COVID-19 infections and deaths among Connecticut nursing home residents: facility correlates.
J Am Geriatr Soc 2020 Sep;68(9):1899-906. doi: 10.1111/jgs.16689..
Keywords: Elderly, COVID-19, Nursing Homes, Long-Term Care, Mortality, Racial and Ethnic Minorities
Rhee C, Baker M, Vaidya V
Incidence of nosocomial COVID-19 in patients hospitalized at a large US academic medical center.
Some patients are avoiding essential care for fear of contracting coronavirus disease 2019 (COVID-19) in hospitals. The purpose of this study was to assess the incidence of COVID-19 among patients hospitalized at a large US academic medical center in the 12 weeks after the first inpatient case was identified. The investigators concluded that in this cohort study of patients in a large academic medical center with rigorous infection control measures, nosocomial COVID-19 was rare during the height of the pandemic in the region.
AHRQ-funded; K08 HS025008.
Citation: Rhee C, Baker M, Vaidya V .
Incidence of nosocomial COVID-19 in patients hospitalized at a large US academic medical center.
JAMA Netw Open 2020 Sep;3(9):e2020498. doi: 10.1001/jamanetworkopen.2020.20498..
Keywords: COVID-19, Hospitalization, Hospitals, Public Health
Pantell MS, Shields-Zeeman L
Maintaining social connections in the setting of COVID-19 social distancing: a call to action.
The COVID-19 pandemic is an unprecedented public health crisis, with substantial health, social, and economic implications. The devastating direct medical consequences of COVID-19 have been accompanied by far reaching economic and social consequences, including increased risk of social isolation and loneliness. The authors discuss the need to remember that “social distancing” should refer to physical distancing and isolation, but not social isolation as changes to social routines impact the country.
AHRQ-funded; HS019264.
Citation: Pantell MS, Shields-Zeeman L .
Maintaining social connections in the setting of COVID-19 social distancing: a call to action.
Health Educ Behav 2020 Aug;47(4):569-80. doi: 10.1177/1090198120920529..
Keywords: COVID-19, Public Health