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
101 to 125 of 140 Research Studies DisplayedWang SY, Hall J, Pollack CE
Trends in end-of-life cancer care in the Medicare program.
The researchers sought to examine contemporary trends in end-of-life cancer care and geographic variation of end-of-life care aggressiveness among Medicare beneficiaries. They found that the proportion of beneficiaries receiving at least one potentially aggressive end-of-life intervention increased in repeated hospitalization, repeated ED visits, ICU admissions, and late hospice enrollment but declined in in-hospital death. End-of-life chemotherapy use did not change significantly over time. They concluded that despite growing focus on providing appropriate end-of-life care, there has not been an improvement in aggressive end-of-life cancer care in the Medicare program.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Trends in end-of-life cancer care in the Medicare program.
J Geriatr Oncol 2016 Mar;7(2):116-25. doi: 10.1016/j.jgo.2015.11.007.
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Keywords: Cancer, Care Management, Elderly, Medicare, Palliative Care, Outcomes, Patient-Centered Outcomes Research, Practice Patterns
Palmsten K, Schatz M, Chan PH
Validation of the pregnancy asthma control test.
The researchers sought to validate telephone administration of a modified version of the Asthma Control Test (ACT) during pregnancy. They found that the Pregnancy Asthma Control Test (p-ACT) demonstrated good internal consistency, varied in the expected direction by impairment level, and was responsive to changes in asthma course. Telephone administration of the p-ACT was reliable and valid for assessing asthma control during pregnancy.
AHRQ-funded; HS018474.
Citation: Palmsten K, Schatz M, Chan PH .
Validation of the pregnancy asthma control test.
J Allergy Clin Immunol Pract 2016 Mar-Apr;4(2):310-15.e1. doi: 10.1016/j.jaip.2015.11.019.
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Keywords: Pregnancy, Asthma, Diagnostic Safety and Quality, Patient-Centered Outcomes Research
Agarwal A, Zhang W, Kuo Y
Process and outcome measures among COPD patients with a hospitalization cared for by an advance practice provider or primary care physician.
This study examined the process and outcomes of care of chronic obstructive pulmonary disease (COPD) patients by Advanced Practice Providers (APPs) and primary care physicians. It found that, compared to patients cared for by physicians, patients cared for by APPs were more likely to receive short acting bronchodilator, oxygen therapy and have been referred to a pulmonologist; however they had lower rates of vaccination probably due to lower age group.
AHRQ-funded; HS020642; HS022134.
Citation: Agarwal A, Zhang W, Kuo Y .
Process and outcome measures among COPD patients with a hospitalization cared for by an advance practice provider or primary care physician.
PLoS One 2016 Feb 24;11(2):e0148522. doi: 10.1371/journal.pone.0148522..
Keywords: Primary Care, Patient-Centered Outcomes Research, Outcomes, Respiratory Conditions
Sabbatini AK, Kocher KE, Basu A
In-hospital outcomes and costs among patients hospitalized during a return visit to the emergency department.
This study examined in-hospital clinical outcomes and resource use among patients who are hospitalized during an unscheduled return visit to the ED.It found that, compared with adult patients who were hospitalized during the index ED visit and did not have a return visit to the ED, patients who were initially discharged during an ED visit and admitted during a return visit to the ED had lower in-hospital mortality.
AHRQ-funded; HS024160; HS022982.
Citation: Sabbatini AK, Kocher KE, Basu A .
In-hospital outcomes and costs among patients hospitalized during a return visit to the emergency department.
JAMA 2016 Feb 16;315(7):663-71. doi: 10.1001/jama.2016.0649.
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Keywords: Patient-Centered Outcomes Research, Hospital Readmissions, Emergency Department, Hospitalization
Bhatia N, Santos M, Jones LW
Cardiovascular effects of androgen deprivation therapy for the treatment of prostate cancer: ABCDE steps to reduce cardiovascular disease in patients with prostate cancer.
Since cardiovascular disease risk may be increased by the use of androgen deprivation therapy (ADT), the researchers have adapted the five-step "ABCDE" algorithm for prostate cancer survivors. Its treatment recommendations come under the following headings: awareness and aspirin, blood pressure, cholesterol and cigarettes, diet and diabetes, and exercise. The algorithm is illustrated by a hypothetical case study.
AHRQ-funded; HS022990.
Citation: Bhatia N, Santos M, Jones LW .
Cardiovascular effects of androgen deprivation therapy for the treatment of prostate cancer: ABCDE steps to reduce cardiovascular disease in patients with prostate cancer.
Circulation 2016 Feb 2;133(5):537-41. doi: 10.1161/circulationaha.115.012519.
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Keywords: Cardiovascular Conditions, Cancer: Prostate Cancer, Diagnostic Safety and Quality, Medication, Patient-Centered Outcomes Research
Hollis RH, Singletary BA, McMurtrie JT
Blood transfusion and 30-day mortality in patients with coronary artery disease and anemia following noncardiac surgery.
The researchers evaluated the association between postoperative blood transfusion and mortality in patients with coronary artery disease and postoperative MI following noncardiac surgery. Their findings support a restrictive postoperative transfusion strategy in patients with stable coronary artery disease following noncardiac surgery.
AHRQ-funded; HS013852.
Citation: Hollis RH, Singletary BA, McMurtrie JT .
Blood transfusion and 30-day mortality in patients with coronary artery disease and anemia following noncardiac surgery.
JAMA Surg 2016 Feb;151(2):139-45. doi: 10.1001/jamasurg.2015.3420.
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Keywords: Mortality, Surgery, Heart Disease and Health, Patient-Centered Outcomes Research
Singh JA, Ramachandaran R
Does rural residence impact total ankle arthroplasty utilization and outcomes?
The objective of this study was to compare total ankle arthroplasty (TAA) utilization and outcomes by patient residence. It demonstrated an absence of any evidence of rural-urban differences in TAA outcomes. The rural-urban differences in TAA utilization noted in 2003 were no longer significant in 2011.
AHRQ-funded; HS021110.
Citation: Singh JA, Ramachandaran R .
Does rural residence impact total ankle arthroplasty utilization and outcomes?
Clin Rheumatol 2016 Feb;35(2):381-6. doi: 10.1007/s10067-015-2908-z.
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Keywords: Centers for Education and Research on Therapeutics (CERTs), Rural Health, Surgery, Patient-Centered Outcomes Research, Healthcare Utilization
Farias AJ, Du XL
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
The aim of this study was to determine whether there are racial/ethnic differences in initiation and timing of adjuvant endocrine therapy (AET) after Medicare Part D drug coverage. After controlling for all variables, only Asian women were found to have a greater odds of initiation of overall AET compared to non-Hispanic white women. Hispanic Mexicans and non-Hispanic black patients had a significantly lower odds of tamoxifen initiation.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
Med Oncol 2016 Feb;33(2):19. doi: 10.1007/s12032-016-0732-1.
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Keywords: Cancer: Breast Cancer, Treatments, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Chinnadurai S, Fonnesbeck C, Snyder KM
Pharmacologic interventions for infantile hemangioma: a meta-analysis.
The objective of this report was to meta-analyze studies of pharmacologic interventions for children with infantile hemangiomas (IH). It concluded that propranolol was effective at reducing IH size compared with placebo, observation, and other treatments including steroids in most studies. Corticosteroids demonstrated moderate effectiveness at reducing IH size/volume.
AHRQ-funded; 290201200009I.
Citation: Chinnadurai S, Fonnesbeck C, Snyder KM .
Pharmacologic interventions for infantile hemangioma: a meta-analysis.
Pediatrics 2016 Feb;137(2):e20153896. doi: 10.1542/peds.2015-3896.
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Keywords: Medication, Children/Adolescents, Newborns/Infants, Comparative Effectiveness, Patient-Centered Outcomes Research
Tamirisa NP, Parmar AD, Vargas GM
Relative contributions of complications and failure to rescue on mortality in older patients undergoing pancreatectomy.
This study evaluated the relative contribution of overall postoperative complications and failure to rescue rates on the observed increased mortality in older patients undergoing pancreatic resection at specialized centers. In experienced hands, the rates of complications after pancreatectomy in patients 80 years or older compared to patients younger than 80 years were similar. However, when complications occurred, older patients were more likely to die.
AHRQ-funded; HS022134.
Citation: Tamirisa NP, Parmar AD, Vargas GM .
Relative contributions of complications and failure to rescue on mortality in older patients undergoing pancreatectomy.
Ann Surg 2016 Feb;263(2):385-91. doi: 10.1097/sla.0000000000001093..
Keywords: Elderly, Mortality, Surgery, Adverse Events, Patient-Centered Outcomes Research
Dinan MA, Li Y, Zhang Y
Resource use in the last year of life among patients who died with versus of prostate cancer.
The researchers conducted a retrospective analysis of Surveillance, Epidemiology, and End Results-Medicare data of men with prostate cancer. Patients who died of prostate cancer rather than from other causes had more hospice and outpatient use, less inpatient and ICU use, and lower overall costs. Efforts to shift care toward outpatient settings might provide more efficient and judicious care for patients during the end of life.
AHRQ-funded; HS022189.
Citation: Dinan MA, Li Y, Zhang Y .
Resource use in the last year of life among patients who died with versus of prostate cancer.
Clin Genitourin Cancer 2016 Feb;14(1):28-37.e2. doi: 10.1016/j.clgc.2015.07.006.
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Keywords: Cancer, Cancer: Prostate Cancer, Healthcare Costs, Healthcare Utilization, Men's Health, Mortality, Palliative Care, Patient-Centered Outcomes Research
Mandl LA, Zhu R, Huang WT
Short-term total hip arthroplasty outcomes in patients with psoriatic arthritis or psoriatic skin disease compared to patients with osteoarthritis.
This study was undertaken to assess whether patients with psoriatic arthritis (PsA) or those with cutaneous psoriasis (PsC) without evidence of inflammatory joint disease are at an increased risk for worse outcomes after total hip arthroplasty (THA) as compared to patients with osteoarthritis (OA). It concluded that neither PsA nor PsC are risk factors for poor outcomes after THA.
AHRQ-funded; HS016075.
Citation: Mandl LA, Zhu R, Huang WT .
Short-term total hip arthroplasty outcomes in patients with psoriatic arthritis or psoriatic skin disease compared to patients with osteoarthritis.
Arthritis Rheumatol 2016 Feb;68(2):410-7. doi: 10.1002/art.39431.
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Keywords: Arthritis, Surgery, Registries, Patient-Centered Outcomes Research
O'Neil B, Koyama T, Alvarez J
The comparative harms of open and robotic prostatectomy in population based samples.
Using population cohort data,the researchers examined sexual and urinary function in men undergoing open radical prostatectomy vs those undergoing robotic assisted radical prostatectomy. They found that men undergoing robotic assisted radical prostatectomy likely experience less decline in early urinary continence and sexual function than those undergoing open radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: O'Neil B, Koyama T, Alvarez J .
The comparative harms of open and robotic prostatectomy in population based samples.
J Urol 2016 Feb;195(2):321-9. doi: 10.1016/j.juro.2015.08.092.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Surgery, Adverse Events
Marshall DA, Burgos-Liz L, Pasupathy KS
Transforming healthcare delivery: integrating dynamic simulation modelling and big data in health economics and outcomes research.
The authors discussed the synergies between big data and dynamic simulation modelling (DSM), practical considerations and challenges, and how integrating big data and DSM can be useful to decision makers to address complex, systemic health economics and outcomes questions and to transform healthcare delivery.
AHRQ-funded; HS023710.
Citation: Marshall DA, Burgos-Liz L, Pasupathy KS .
Transforming healthcare delivery: integrating dynamic simulation modelling and big data in health economics and outcomes research.
Pharmacoeconomics 2016 Feb;34(2):115-26. doi: 10.1007/s40273-015-0330-7.
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Keywords: Data, Shared Decision Making, Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Strom MA, Silverberg JI
Utilization of preventive health care in adults and children with eczema.
This study examined associations of eczema with vaccination, disease screening, health maintenance, and healthcare utilization. Childhood eczema was associated with higher rates of vaccination for influenza; well child checkups; and interaction with most types of healthcare providers . Adult eczema was associated with higher odds of vaccination for various diseases. It was also associated with increased measurement of blood glucose; cholesterol; blood pressure and HIV infection.
AHRQ-funded; HS023011.
Citation: Strom MA, Silverberg JI .
Utilization of preventive health care in adults and children with eczema.
Am J Prev Med 2016 Feb;50(2):e33-44. doi: 10.1016/j.amepre.2015.07.029.
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Keywords: Vaccination, Prevention, Screening, Healthcare Utilization, Patient-Centered Outcomes Research
Lyons TW, Johnson KB, Michelson KA
Yield of emergent neuroimaging in children with new-onset seizure and status epilepticus.
The purpose of this paper was to determine the yield of emergent neuroimaging among children with new-onset seizures presenting with status epilepticus. The authors found that a substantial minority of children with new-onset seizures presenting with status epilepticus have urgent or emergent intracranial pathology identified on neuroimaging and that magnetic resonance imaging is the preferred imaging modality when available and safe.
AHRQ-funded; HS000063.
Citation: Lyons TW, Johnson KB, Michelson KA .
Yield of emergent neuroimaging in children with new-onset seizure and status epilepticus.
Seizure 2016 Feb;35:4-10. doi: 10.1016/j.seizure.2015.12.009.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Imaging, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research
Albright KC, Boehme AK, Tanner RM
Addressing stroke risk factors in black and white Americans: Findings from the National Health and Nutrition Examination Survey, 2009-2010.
The authors examined racial differences in risk factors being addressed among stroke survivors and those at risk for stroke. They found that addressed hypertension and hyperlipidemia in stroke-naïve participants were significantly lower in blacks than in whites. They concluded that a better understanding of this information is critical to preventing stroke and other vascular diseases.
AHRQ-funded; HS023009; HS013852.
Citation: Albright KC, Boehme AK, Tanner RM .
Addressing stroke risk factors in black and white Americans: Findings from the National Health and Nutrition Examination Survey, 2009-2010.
Ethn Dis 2016 Jan 21;26(1):9-16. doi: 10.18865/ed.26.1.9.
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Keywords: Disparities, Racial and Ethnic Minorities, Patient-Centered Outcomes Research, Prevention, Stroke
Wang TY, Vora AN, Peng SA
Effectiveness and safety of aldosterone antagonist therapy use among older patients with reduced ejection fraction after acute myocardial infarction.
The purpose of this paper is to describe how aldosterone antagonist treatment is used among older myocardial infarction (MI) patients in routine practice. They found that aldosterone antagonist use was not associated with lower mortality except in symptomatic HF patients, and risks of hyperkalemia were low at 30 days, but significantly higher among patients prescribed aldosterone antagonists, as was risk of acute renal failure compared with patients not prescribed aldosterone antagonists. They concluded that these results underscore the importance of close post-discharge monitoring of this patient population.
AHRQ-funded; HS021092.
Citation: Wang TY, Vora AN, Peng SA .
Effectiveness and safety of aldosterone antagonist therapy use among older patients with reduced ejection fraction after acute myocardial infarction.
J Am Heart Assoc 2016 Jan 21;5(1). doi: 10.1161/jaha.115.002612.
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Keywords: Comparative Effectiveness, Elderly, Medication, Heart Disease and Health, Patient-Centered Outcomes Research
Johnson KE, Neta G, Dember LM
Use of PRECIS ratings in the National Institutes of Health (NIH) health care systems research collaboratory.
This analysis applied the PRECIS-2 pragmatic trial criteria to five NIH Collaboratory pragmatic trials to better understand 1) the pragmatic aspects of the design and implementation of treatments delivered in real world settings and 2) the usability of the PRECIS-2 criteria for assessing pragmatic features across studies and across time. All five trials were rated to be more pragmatic than explanatory.
AHRQ-funded; HS022982.
Citation: Johnson KE, Neta G, Dember LM .
Use of PRECIS ratings in the National Institutes of Health (NIH) health care systems research collaboratory.
Trials 2016 Jan 16;17:32. doi: 10.1186/s13063-016-1158-y.
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Keywords: Research Methodologies, Patient-Centered Outcomes Research, Healthcare Delivery
Brown DW, Mangeot C, Anderson JB
Digoxin use is associated with reduced interstage mortality in patients with no history of arrhythmia after stage I palliation for single ventricle heart disease.
The researchers sought to determine whether digoxin use post-S1P is associated with reduced interstage mortality (IM), utilizing the multicenter database of the National Pediatric Cardiology Quality Improvement Collaborative (NPCQIC). They found that among infants with single vetricle defects in the NPCQIC database discharged post-S1P with no history of arrhythmia, use of digoxin at discharge was associated with reduced IM.
AHRQ-funded; HS021114.
Citation: Brown DW, Mangeot C, Anderson JB .
Digoxin use is associated with reduced interstage mortality in patients with no history of arrhythmia after stage I palliation for single ventricle heart disease.
J Am Heart Assoc 2016 Jan 11;5(1). doi: 10.1161/jaha.115.002376.
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Keywords: Medication, Mortality, Cardiovascular Conditions, Patient-Centered Outcomes Research
Deckersbach T, Nierenberg AA, McInnis MG
Baseline disability and poor functioning in bipolar disorder predict worse outcomes: results from the Bipolar CHOICE study.
This study examined the effects of treatment on functioning impairments and quality of life and assessed baseline functioning and employment status as predictors of treatment response in symptomatic individuals from the Bipolar Clinical Health Outcomes Initiative in Comparative Effectiveness (Bipolar CHOICE) study. It found that prior disability status was associated with a worse treatment response and prospective illness course.
AHRQ-funded; HS019371.
Citation: Deckersbach T, Nierenberg AA, McInnis MG .
Baseline disability and poor functioning in bipolar disorder predict worse outcomes: results from the Bipolar CHOICE study.
J Clin Psychiatry 2016 Jan;77(1):100-8. doi: 10.4088/JCP.14m09210.
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Keywords: Behavioral Health, Comparative Effectiveness, Patient-Centered Outcomes Research, Medication
Nierenberg AA, McElroy SL, Friedman ES
Bipolar CHOICE (Clinical Health Outcomes Initiative in Comparative Effectiveness): a pragmatic 6-month trial of lithium versus quetiapine for bipolar disorder.
The purpose of this trial was to compare lithium and second-generation antipsychotics. The investigators found that outcomes with lithium + APT and quetiapine + APT were not significantly different across 6 months of treatment for bipolar disorder.
AHRQ-funded; HS019371.
Citation: Nierenberg AA, McElroy SL, Friedman ES .
Bipolar CHOICE (Clinical Health Outcomes Initiative in Comparative Effectiveness): a pragmatic 6-month trial of lithium versus quetiapine for bipolar disorder.
J Clin Psychiatry 2016 Jan;77(1):90-9. doi: 10.4088/JCP.14m09349.
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Keywords: Adverse Drug Events (ADE), Comparative Effectiveness, Medication, Behavioral Health, Patient-Centered Outcomes Research
Cummings DM, Kirian K, Howard G
Consequences of comorbidity of elevated stress and/or depressive symptoms and incident cardiovascular outcomes in diabetes: results from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.
The authors evaluated the impact of comorbid depressive symptoms and/or stress on adverse cardiovascular (CV) outcomes in individuals with diabetes compared with those without diabetes. They concluded that comorbid stress and/or depressive symptoms are common in individuals with diabetes and together are associated with progressively increased risks for adverse CV outcomes.
AHRQ-funded; HS023009.
Citation: Cummings DM, Kirian K, Howard G .
Consequences of comorbidity of elevated stress and/or depressive symptoms and incident cardiovascular outcomes in diabetes: results from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.
Diabetes Care 2016 Jan;39(1):101-9. doi: 10.2337/dc15-1174.
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Keywords: Cardiovascular Conditions, Depression, Diabetes, Patient-Centered Outcomes Research, Stress
Chimenti PC, Drinkwater CJ, Li W
Factors associated with early improvement in low back pain after total hip arthroplasty: A multi-center prospective cohort analyses.
This study identified factors associated with an improvement in low back pain (LBP) at six-month follow-up after total hip arthroplasty (THA). It found that among patients reporting severe or moderate LBP preoperatively, 56 percent improved 6 months after surgery. Patients without improvement were more likely to be on Medicare, have a high school education or less, have household income less than $45,000 and have one or more comorbid conditions.
AHRQ-funded; HS018910.
Citation: Chimenti PC, Drinkwater CJ, Li W .
Factors associated with early improvement in low back pain after total hip arthroplasty: A multi-center prospective cohort analyses.
J Arthroplasty 2016 Jan;31(1):176-9. doi: 10.1016/j.arth.2015.07.028.
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Keywords: Back Health and Pain, Arthritis, Surgery, Patient-Centered Outcomes Research, Registries
Poonawalla IB, Piller LB, Lairson DR
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
The researchers sought to determine the effectiveness of erythropoietin-stimulating agent (ESA) and granulocyte colony-stimulating factor (CSF) in reducing blood transfusion needs and neutropenia incidence in community-dwelling elderly ovarian cancer patients. They found that erythropoietin-stimulating agents were effective in reducing blood transfusion need. Granulocyte colony-stimulating factors were effective in lowering neutropenia incidence and also were associated with improved survival in elderly ovarian cancer patients.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Piller LB, Lairson DR .
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
Int J Gynecol Cancer 2016 Jan;26(1):95-103. doi: 10.1097/igc.0000000000000564.
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Keywords: Cancer, Treatments, Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research