National Healthcare Quality and Disparities Report
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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
76 to 100 of 140 Research Studies DisplayedLinden S, Bussing R, Kubilis P
Risk of suicidal events with atomoxetine compared to stimulant treatment: a cohort study.
The researchers analyzed whether the observed increased risk of suicidal ideation in clinical trials translates into an increased risk of suicidal events in pediatric patients treated with atomoxetine compared with stimulants in 26 Medicaid programs. They found that first- and second-line treatment of youths age 5 to 18 with atomoxetine compared with stimulants was not significantly associated with an increased risk of suicidal events.
AHRQ-funded; HS018506; HS016097.
Citation: Linden S, Bussing R, Kubilis P .
Risk of suicidal events with atomoxetine compared to stimulant treatment: a cohort study.
Pediatrics 2016 May;137(5):pii: e20153199. doi: 10.1542/peds.2015-3199.
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Keywords: Adverse Drug Events (ADE), Medication, Children/Adolescents, Comparative Effectiveness, Patient-Centered Outcomes Research
Ertefaie A, Small D, Flory J
Selection bias when using instrumental variable methods to compare two treatments but more than two treatments are available.
The authors discuss how instrumental variable methods may result in biased treatment effects if applied on a data set in which subjects are preselected based on their received treatments. They applied their method on The Health Improvement Network (THIN) database to estimate the comparative effect of metformin and sulfonylureas on weight gain among patients with diabetes.
AHRQ-funded; HS023898.
Citation: Ertefaie A, Small D, Flory J .
Selection bias when using instrumental variable methods to compare two treatments but more than two treatments are available.
Int J Biostat 2016 May 1;12(1):219-32. doi: 10.1515/ijb-2015-0006.
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Keywords: Research Methodologies, Comparative Effectiveness, Patient-Centered Outcomes Research
Smith LR, Earnshaw VA, Copenhaver MM
Substance use stigma: reliability and validity of a theory-based scale for substance-using populations.
The researchers aimed to advance measurement efforts of substance use stigma by drawing on stigma theory to develop and evaluate the Substance Use Stigma Mechanisms Scale (SU-SMS). Their findings support the structural and construct validity of the SU-SMS, suggesting the scale was able to capture enacted, anticipated, and internalized stigma as distinct stigma experiences, also differentiating between two distinct stigma sources, family and healthcare providers. They concluded that the SU-SMS may serve as a valuable tool for better understanding the processes through which substance use stigma serves to undermine key health behaviors and outcomes among persons with substance use disorders.
AHRQ-funded; HS022986.
Citation: Smith LR, Earnshaw VA, Copenhaver MM .
Substance use stigma: reliability and validity of a theory-based scale for substance-using populations.
Drug Alcohol Depend 2016 May 1;162:34-43. doi: 10.1016/j.drugalcdep.2016.02.019.
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Keywords: Behavioral Health, Patient-Centered Outcomes Research, Social Stigma, Substance Abuse
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
Chen Y, Cai Y, Hong C
Inference for correlated effect sizes using multiple univariate meta-analyses.
The authors selected a multivariate meta-analysis approach that used standard univariate methods for the marginal effects but also provided valid joint inference for multiple parameters. Their method can directly handle missing outcomes and can provide unbiased estimates, well-estimated standard errors, and confidence intervals with good coverage probability. The method was also found to maintain high relative efficiency compared with conventional multivariate meta-analyses where the within-study correlations are known. The authors further illustrated the proposed method through two real meta-analyses.
AHRQ-funded; HS022900.
Citation: Chen Y, Cai Y, Hong C .
Inference for correlated effect sizes using multiple univariate meta-analyses.
Stat Med 2016 Apr 30;35(9):1405-22. doi: 10.1002/sim.6789.
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Keywords: Research Methodologies, Patient-Centered Outcomes Research
Yadlapati R, Adkins C, Jaiyeola DM
Abilities of oropharyngeal pH tests and salivary pepsin analysis to discriminate between asymptomatic volunteers and subjects with symptoms of laryngeal irritation.
The researchers examined the ability of oropharyngeal pH tests and salivary pepsin tests to discriminate between asymptomatic volunteers and subjects with a combination of laryngeal and reflux symptoms. They found that oropharyngeal pH testing and salivary pepsin analysis are not able to distinguish between healthy volunteers and subjects with a combination of laryngeal and reflux symptoms.
AHRQ-funded; HS023011.
Citation: Yadlapati R, Adkins C, Jaiyeola DM .
Abilities of oropharyngeal pH tests and salivary pepsin analysis to discriminate between asymptomatic volunteers and subjects with symptoms of laryngeal irritation.
Clin Gastroenterol Hepatol 2016 Apr;14(4):535-42.e2. doi: 10.1016/j.cgh.2015.11.017.
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Keywords: Diagnostic Safety and Quality, Digestive Disease and Health, Patient-Centered Outcomes Research
Lin LY, Sidani JE, Shensa A
Association between social media use and depression among U.S. young adults.
The authors assessed the association between social media use and depression in a nationally representative sample of young adults. They found that participants in the highest quartile of total time per day using social media had significantly increased odds of depression. They conluded that social media use was significantly associated with increased depression.
AHRQ-funded; HS022989.
Citation: Lin LY, Sidani JE, Shensa A .
Association between social media use and depression among U.S. young adults.
Depress Anxiety 2016 Apr;33(4):323-31. doi: 10.1002/da.22466.
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Keywords: Social Media, Depression, Young Adults, Behavioral Health, Patient-Centered Outcomes Research
Lavallee DC, Chenok KE, Love RM
Incorporating patient-reported outcomes into health care to engage patients and enhance care.
The authors examine the opportunities for using patient-reported outcomes to enhance care delivery and outcomes as health care information needs and technology platforms change. They highlight emerging practices in which patient-reported outcomes provide value to patients and clinicians and improve care delivery. Finally, they examine present and future challenges to maximizing the use of patient-reported outcomes in the clinic.
AHRQ-funded; HS022789.
Citation: Lavallee DC, Chenok KE, Love RM .
Incorporating patient-reported outcomes into health care to engage patients and enhance care.
Health Aff 2016 Apr;35(4):575-82. doi: 10.1377/hlthaff.2015.1362.
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Keywords: Healthcare Delivery, Shared Decision Making, Patient-Centered Outcomes Research, Patient and Family Engagement, Quality Improvement
Rising KL, Carr BG, Hess EP
Patient-centered outcomes research in emergency care: opportunities, challenges, and future directions.
The authors explored factors unique to patient-centered emergency care research and highlighted specific areas of potential alignment within each of the five national PCORI priorities.
AHRQ-funded; HS023901.
Citation: Rising KL, Carr BG, Hess EP .
Patient-centered outcomes research in emergency care: opportunities, challenges, and future directions.
Acad Emerg Med 2016 Apr;23(4):497-502. doi: 10.1111/acem.12944.
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Keywords: Emergency Department, Patient-Centered Outcomes Research, Patient-Centered Healthcare, Quality Improvement, Quality of Care, Evidence-Based Practice
Dimou FM, Adhikari D, Mehta HB
Trends in follow-up of patients presenting to the emergency department with symptomatic cholelithiasis.
To better understand underuse of cholecystectomy, the researchers examined physician follow-up patterns after emergency department (ED) visits for symptomatic gallstones. They found that fewer than half of patients were evaluated by a surgeon after an initial ED visit for symptomatic gallstones. Patients who did not have physician follow-up were most likely to require emergent cholecystectomy, suggesting inappropriate ED discharge and highlighting the need for timely follow-up.
AHRQ-funded; HS022134.
Citation: Dimou FM, Adhikari D, Mehta HB .
Trends in follow-up of patients presenting to the emergency department with symptomatic cholelithiasis.
J Am Coll Surg 2016 Apr;222(4):377-84. doi: 10.1016/j.jamcollsurg.2015.12.011.
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Keywords: Elderly, Emergency Medical Services (EMS), Patient-Centered Outcomes Research, Practice Patterns
Dev S, Hoffman TK, Kavalieratos D
Barriers to adoption of mineralocorticoid receptor antagonists in patients with heart failure: A mixed-methods study.
Mineralocorticoid receptor antagonists (MRAs) are the most underutilized pharmacotherapy for heart failure. This study sought to ascertain barriers to optimal use of MRAs. It identified eight primary barriers to MRA adoption at the provider, patient, and health system levels from the prescriber perspective. These barriers can inform the creation of multilevel interventions that will be required to close the gap in MRA adoption.
AHRQ-funded; HS022989.
Citation: Dev S, Hoffman TK, Kavalieratos D .
Barriers to adoption of mineralocorticoid receptor antagonists in patients with heart failure: A mixed-methods study.
J Am Heart Assoc 2016 Mar 31;5(3). doi: 10.1161/jaha.115.002493.
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Keywords: Heart Disease and Health, Medication, Patient-Centered Outcomes Research, Practice Patterns
Abdelsattar ZM, Wong SL, Regenbogen SE
Colorectal cancer outcomes and treatment patterns in patients too young for average-risk screening.
The researchers investigated the national treatment patterns and outcomes of patients younger than 50 with colorectal cancer (CRC). They found that patients with CRC diagnosed at age <50 years are more likely to present with advanced-stage disease. However, they receive more aggressive therapy and achieve longer disease-specific survival, despite the greater percentage of patients with advanced-stage disease.
AHRQ-funded; HS000053; HS020937.
Citation: Abdelsattar ZM, Wong SL, Regenbogen SE .
Colorectal cancer outcomes and treatment patterns in patients too young for average-risk screening.
Cancer 2016 Mar 15;122(6):929-34. doi: 10.1002/cncr.29716.
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Keywords: Cancer: Colorectal Cancer, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Risk, Screening
Subramaniam RM, Suarez-Cuervo C, Wilson RF
Effectiveness of prevention strategies for contrast-induced nephropathy: a systematic review and meta-analysis.
N-acetylcysteine, sodium bicarbonate, statins, and ascorbic acid have been studied for reducing contrast-induced nephropathy (CIN). This study evaluated the comparative effectiveness of interventions to reduce CIN in adults receiving contrast media. It concluded that the greatest reduction in CIN was seen with N-acetylcysteine plus IV saline in patients receiving LOCM and with statins plus N-acetylcysteine plus IV saline.
AHRQ-funded; 290201200007I.
Citation: Subramaniam RM, Suarez-Cuervo C, Wilson RF .
Effectiveness of prevention strategies for contrast-induced nephropathy: a systematic review and meta-analysis.
Ann Intern Med 2016 Mar 15;164(6):406-16. doi: 10.7326/m15-1456.
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Keywords: Adverse Events, Comparative Effectiveness, Kidney Disease and Health, Patient-Centered Outcomes Research, Prevention
Lyons EJ, Baranowski T, Basen-Engquist KM
Testing the effects of narrative and play on physical activity among breast cancer survivors using mobile apps: study protocol for a randomized controlled trial.
This paper described a study to determine the effectiveness of an intervention that combines narrative and gaming to encourage sustained physical activity in postmenopausal breast cancer survivors. The primary outcome of the study is minutes of moderate to vigorous physical activity at six months. Other objectively measured outcomes include fitness and physical function. Self-reported outcomes include quality of life, depression, and motivation.
AHRQ-funded; HS022134.
Citation: Lyons EJ, Baranowski T, Basen-Engquist KM .
Testing the effects of narrative and play on physical activity among breast cancer survivors using mobile apps: study protocol for a randomized controlled trial.
BMC Cancer 2016 Mar 9;16:202. doi: 10.1186/s12885-016-2244-y.
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Keywords: Cancer: Breast Cancer, Comparative Effectiveness, Lifestyle Changes, Patient-Centered Outcomes Research, Telehealth
Sanders RC, Jr., Nett ST, Davis KF
Family presence during pediatric tracheal intubations.
The researchers described the current practice of family presence (FP) during tracheal intubation (TI) and evaluated the association with procedural and clinician (including physician, respiratory therapist, and nurse practitioner) outcomes across multiple pediatric intensive care units (PICUs). They found that FP was not associated with first attempt success, adverse TI-associated events, oxygen desaturation (<80%), or higher team stress level.
AHRQ-funded; HS022464; HS022469; HS021583.
Citation: Sanders RC, Jr., Nett ST, Davis KF .
Family presence during pediatric tracheal intubations.
JAMA Pediatr 2016 Mar 7;170(3):e154627. doi: 10.1001/jamapediatrics.2015.4627.
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Keywords: Newborns/Infants, Children/Adolescents, Critical Care, Adverse Events, Patient-Centered Outcomes Research
Kamal AH, Bull J, Ritchie CS
Adherence to measuring what matters measures using point-of-care data collection across diverse clinical settings.
The purpose of this paper was to evaluate the implementation of Measuring What Matters (MWM) measures by exploring documentation of quality measure adherence across six diverse clinical settings inherent to palliative care practice. The authors found that the lowest adherence involved comprehensive assessments during the first visit in hospitalized patients in the intensive care unit and that the highest adherence across all settings involved documentation of management of moderate to severe pain. They recommended additional studies for better understanding of benchmarks and acceptable ranges for adherence tailored to various clinical settings.
AHRQ-funded; HS023681; HS022763.
Citation: Kamal AH, Bull J, Ritchie CS .
Adherence to measuring what matters measures using point-of-care data collection across diverse clinical settings.
J Pain Symptom Manage 2016 Mar;51(3):497-503. doi: 10.1016/j.jpainsymman.2015.12.313.
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Keywords: Quality Measures, Palliative Care, Patient-Centered Outcomes Research, Quality of Care, Patient Safety
Stevens VJ, Solberg LI, Bailey SR
Assessing trends in tobacco cessation in diverse patient populations.
This study examined change in tobacco use over 4 years among the general population of patients in six diverse health care organizations using electronic medical record data. It found that among smokers who regularly used these care systems, one in seven had achieved long-term cessation after 4 years. The study shows the practicality of using electronic medical records for monitoring patient smoking status over time.
AHRQ-funded; HS019828.
Citation: Stevens VJ, Solberg LI, Bailey SR .
Assessing trends in tobacco cessation in diverse patient populations.
Nicotine Tob Res 2016 Mar;18(3):275-80. doi: 10.1093/ntr/ntv092.
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Keywords: Tobacco Use, Electronic Health Records (EHRs), Patient-Centered Outcomes Research, Healthcare Delivery, Lifestyle Changes
Fonarow GG, Liang L, Thomas L
Assessment of home-time after acute ischemic stroke in Medicare beneficiaries.
The researchers evaluated home-time as a patient-centered outcome in Medicare beneficiaries with ischemic stroke in comparison with modified Rankin Scale (mRS) score at 90 days and at 1 year post event. They concluded that in a population of older patients with ischemic stroke, home-time was readily available from administrative data and associated with mRS at 90 days and 1 year.
AHRQ-funded; HS019479; HS016964.
Citation: Fonarow GG, Liang L, Thomas L .
Assessment of home-time after acute ischemic stroke in Medicare beneficiaries.
Stroke 2016 Mar;47(3):836-42. doi: 10.1161/strokeaha.115.011599.
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Keywords: Medicare, Stroke, Elderly, Home Healthcare, Patient-Centered Outcomes Research
Fakih MG, Gould CV, Trautner BW
Beyond infection: device utilization ratio as a performance measure for urinary catheter harm.
As multiple definitions for measuring catheter-associated urinary tract infections exist, the authors advocate use of the device utilization ratio (DUR) as an additional performance measure for potential urinary catheter harm. The DUR is currently captured as part of National Healthcare Safety Network reporting, and the data are readily obtainable from electronic medical records. This method also provides a more direct reflection of improvement efforts focused on reducing inappropriate urinary catheter use.
AHRQ-funded; 290201000025I.
Citation: Fakih MG, Gould CV, Trautner BW .
Beyond infection: device utilization ratio as a performance measure for urinary catheter harm.
Infect Control Hosp Epidemiol 2016 Mar;37(3):327-33. doi: 10.1017/ice.2015.287.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Prevention, Patient-Centered Outcomes Research
Vora AN, Peterson ED, Hellkamp AS
Care transitions after acute myocardial infarction for transferred-in versus direct-arrival patients.
Many patients in the United States require transfer from one hospital to another for acute myocardial infarction (MI) care. How well these transferred-in patients are transitioned back to their local community is unknown. This study found that transferred-in patients with acute MI are less likely to have outpatient clinic follow-up within 30 days and more likely to be readmitted within the first 30 days post discharge compared with direct-arrival patients.
AHRQ-funded; HS021092.
Citation: Vora AN, Peterson ED, Hellkamp AS .
Care transitions after acute myocardial infarction for transferred-in versus direct-arrival patients.
Circ Cardiovasc Qual Outcomes 2016 Mar;9(2):109-16. doi: 10.1161/circoutcomes.115.002108.
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Keywords: Transitions of Care, Hospital Readmissions, Cardiovascular Conditions, Patient-Centered Outcomes Research, Hospital Discharge
Wancata LM, Banerjee M, Muenz DG
Conditional survival in advanced colorectal cancer and surgery.
The authors evaluated the impact of cancer-directed surgery on long-term survival in patients with advanced colorectal cancer (CRC). They found that five-year disease-specific conditional survival improves dramatically over time for selected patients with advanced CRC who undergo cancer-directed surgery.
AHRQ-funded; HS020937.
Citation: Wancata LM, Banerjee M, Muenz DG .
Conditional survival in advanced colorectal cancer and surgery.
J Surg Res 2016 Mar;201(1):196-201. doi: 10.1016/j.jss.2015.10.021.
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Keywords: Cancer: Colorectal Cancer, Mortality, Outcomes, Patient-Centered Outcomes Research, Surgery
DeVore AD, Hammill BG, Hardy NC
Has public reporting of hospital readmission rates affected patient outcomes?: Analysis of Medicare claims data.
Following the implementation of Centers for Medicare & Medicaid Services (CMS) public reporting, this study assessed trends of 30-day readmission rates and post-discharge care for patients discharged with acute myocardial infarction (MI), heart failure (HF), or pneumonia. It found that the release of the CMS public reporting of hospital readmission rates did not change 30-day readmission trends for MI, HF, or pneumonia, but it was associated with less hospital-based acute care for HF.
AHRQ-funded; HS021092.
Citation: DeVore AD, Hammill BG, Hardy NC .
Has public reporting of hospital readmission rates affected patient outcomes?: Analysis of Medicare claims data.
J Am Coll Cardiol 2016 Mar 1;67(8):963-72. doi: 10.1016/j.jacc.2015.12.037.
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Keywords: Public Reporting, Hospital Readmissions, Outcomes, Medicare, Patient-Centered Outcomes Research
Harris JG, Bingham CA, Morgan EM
Improving care delivery and outcomes in pediatric rheumatic diseases.
This article highlights efforts in pediatric rheumatology related to optimizing the care provided to patients with pediatric rheumatic diseases and describes various approaches to improve health outcomes. It summarizes the current efforts to improve care delivery and outcomes in pediatric rheumatic diseases through a learning health system approach that harnesses knowledge from the clinical encounter to serve quality improvement, research, and discovery.
AHRQ-funded; HS021114.
Citation: Harris JG, Bingham CA, Morgan EM .
Improving care delivery and outcomes in pediatric rheumatic diseases.
Curr Opin Rheumatol 2016 Mar;28(2):110-6. doi: 10.1097/bor.0000000000000257.
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Keywords: Healthcare Delivery, Patient-Centered Outcomes Research, Children/Adolescents, Children/Adolescents
Raol N, Zogg CK, Boss EF
Inpatient pediatric tonsillectomy: Does hospital type affect cost and outcomes of care?
The researchers ascertained whether hospital type is associated with differences in total cost and outcomes for inpatient tonsillectomy. They found that significant differences in costs, outcomes, and patient factors exist for inpatient tonsillectomy based on hospital type. Reasons for these differences are not discernable using isolated claims data.
AHRQ-funded; HS022932.
Citation: Raol N, Zogg CK, Boss EF .
Inpatient pediatric tonsillectomy: Does hospital type affect cost and outcomes of care?
Otolaryngol Head Neck Surg 2016 Mar;154(3):486-93. doi: 10.1177/0194599815621739..
Keywords: Healthcare Cost and Utilization Project (HCUP), Patient-Centered Outcomes Research, Healthcare Costs, Surgery, Children/Adolescents
Ma J, Rosas LG, Lv N
Precision lifestyle medicine: a new frontier in the science of behavior change and population health.
The precision medicine movement heralds targeted and proactive treatments for precisely characterized disease phenotypes and endotypes to achieve optimal health for individual patients. Precision lifestyle medicine represents a departure from traditional lifestyle intervention models and calls for innovative tools and transformative mechanism-driven strategies to support this new paradigm. The authors further argue that precision lifestyle medicine supports the diversity of individuals in the adoption and maintenance of healthy lifestyles.
AHRQ-funded; HS022702.
Citation: Ma J, Rosas LG, Lv N .
Precision lifestyle medicine: a new frontier in the science of behavior change and population health.
Am J Prev Med 2016 Mar;50(3):395-7. doi: 10.1016/j.amepre.2015.09.035.
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Keywords: Patient-Centered Outcomes Research, Lifestyle Changes, Lifestyle Changes