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
1 to 17 of 17 Research Studies DisplayedAnhang Price R, Quigley DD DD, Hargraves JL
A systematic review of strategies to enhance response rates and representativeness of patient experience surveys.
The purpose of this systematic review study was to explore evidence on survey administration strategies to increase response rates and representativeness of patient surveys. The researchers examined 40 peer-reviewed randomized experiments of administration protocols for patient experience surveys. The study found that when compared to mail-only or telephone-only administration of surveys, mail administration with telephone follow-up provides a median response rate benefit of 13%. Researchers also discovered that while surveys administered only by web usually result in lower response rates than those administered by mail or telephone, the limited evidence for a web-mail-telephone process suggests a potential response rate benefit over a mail-telephone process. Monetary incentives are related with substantial improvements in response rates. The study concluded that mixed-mode survey administration results in increased patient survey response rates than a single mode.
AHRQ-funded; HS025920.
Citation: Anhang Price R, Quigley DD DD, Hargraves JL .
A systematic review of strategies to enhance response rates and representativeness of patient experience surveys.
Med Care 2022 Dec;60(12):910-18. doi: 10.1097/mlr.0000000000001784..
Keywords: Patient Experience, Research Methodologies, Health Services Research (HSR)
Saldanha IJ, Adam GP, Bañez LL
AHRQ Author: Bañez LL
Inclusion of nonrandomized studies of interventions in systematic reviews of interventions: updated guidance from the Agency for Health Care Research and Quality Effective Health Care program.
A guidance workgroup comprised systematic review experts utilized an informal consensus generation method to develop guidelines to inform decisions regarding the inclusion of nonrandomized studies of interventions (NRSIs) in systematic reviews (SRs) of the effects of interventions. The study found that varying topics may require varying decisions regarding NRSI inclusion. The researchers identified key considerations to inform the decisions; from refinement of topics through to development of protocols. During the scoping and refinement of topics, considerations were associated with the clinical decisional dilemma, adequacy of randomized controlled trials (RCTs) to address the crucial questions, risk of bias in NRSIs, and the degree to which NRSIs are likely to complement RCTs. When NRSIs are included, during SR team formation, familiarity with topic-specific data sources and advanced analytic methods for NRSIs should be considered. During protocol development, the decision regarding NRSI inclusion or exclusion should be justified, and potential implications explained. When NRSIs are included, the protocol should describe the processes for synthesizing evidence from RCTs and NRSIs and determining the overall strength of evidence. CONCLUSION: We identified specific considerations for decisions regarding NRSI inclusion in SRs and highlight the importance of flexibility and transparency.
AHRQ-authored; AHRQ-funded; 290-2017-00003 -C; 75Q80120D00001- 75Q8120D00003; 75Q80120D00005 - 75Q8120D00009.
Citation: Saldanha IJ, Adam GP, Bañez LL .
Inclusion of nonrandomized studies of interventions in systematic reviews of interventions: updated guidance from the Agency for Health Care Research and Quality Effective Health Care program.
J Clin Epidemiol 2022 Dec; 152:300-06. doi: 10.1016/j.jclinepi.2022.08.015..
Keywords: Evidence-Based Practice, Research Methodologies, Health Services Research (HSR)
Holtrop JS, Davis MM
Primary care research is hard to do during COVID-19: challenges and solutions.
This study examined challenges in conducting primary care research during the COVID-19 pandemic. The authors used their experience on over 15 individual projects during the pandemic. They identified 3 key challenges to conducting primary care research: (1) practice delivery trickle-down effects, (2) limited/changing resources and procedures for research, and (3) a generally tense milieu in US society during the pandemic. They presented strategies, informed by a set of questions, to help researchers decide how to address these challenges observed during our studies. They encouraged normalization and self-compassion; and encouraged researchers and funders to embrace pragmatic and adaptive research designs as the circumstances with COVID-19 evolve over time.
AHRQ-funded; HS027080.
Citation: Holtrop JS, Davis MM .
Primary care research is hard to do during COVID-19: challenges and solutions.
Ann Fam Med 2022 Nov-Dec; 20(6):568-72. doi: 10.1370/afm.2889..
Keywords: COVID-19, Primary Care, Health Services Research (HSR), Research Methodologies
Coley RY, Duan KI, Hoopes AJ
A call to integrate health equity into learning health system research training.
This paper is a call to integrate health equity into the competency domain for learning health systems (LHS) research training. In 2016, AHRQ recommended seven domains for training and mentoring researchers, but health equity was not included. Scholars in the Consortium for Applied Training to Advance the Learning health system with Scholars/Trainees (CATALyST) K12 program recommend that competency domains be extended to reflect growing demands for evidence on health inequities and interventions to alleviate them. The authors present real-life case studies in an LHS research training program that illustrate facilitators, challenges, and potential solutions at the program, funder, and research community-level to receiving training and mentorship in health equity-focused LHS science. They recommend actions in four areas for LHS research training programs: (a) integrate health equity throughout the current LHS domains; (b) develop training and mentoring in health equity; (c) establish program evaluation standards for consideration of health equity; and (d) bring forth relevant, extant expertise from the areas of health disparities research, community-based participatory research, and community-engaged health services research.
AHRQ-funded; HS026369.
Citation: Coley RY, Duan KI, Hoopes AJ .
A call to integrate health equity into learning health system research training.
Learn Health Syst 2022 Oct;6(4):e10330. doi: 10.1002/lrh2.10330..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR), Training, Disparities
Franklin PD, Drane D, Wakschlag L
Development of a learning health system science competency assessment to guide training and proficiency assessment.
This paper describes the development of the learning health systems (LHS) Competency Assessment by the AHRQ-funded ACCELERAT K12 training program. Domain experts and trainees were recruited to define and operationalize items to include in an LHS Competency Assessment to support emerging and existing LHS scientists in prioritizing and monitoring proficiency development. The method used was to conduct sequential interviews with 18 experts who iteratively defined skills and tasks to illustrate stage in proficiency and its progression for each of 42 competencies in the seven LHS expertise domains: systems science; research questions and standards of scientific evidence; research methods; informatics; ethics of research and implementation in health systems; improvement and implementation science; and engagement, leadership, and research management. The LHS Competency Assessment was reviewed, and pilot tested by current trainees and further refinement was completed using their feedback. The LHS Competency Assessment was found to offer consistent, graded criteria across the seven LHS domains.
AHRQ-funded; HS026369.
Citation: Franklin PD, Drane D, Wakschlag L .
Development of a learning health system science competency assessment to guide training and proficiency assessment.
Learn Health Syst 2022 Oct;6(4):e10343. doi: 10.1002/lrh2.10343..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR), Training, Education: Curriculum
O'Malley AJ, Landon BE, Zaborski LA
Weak correlations in health services research: weak relationships or common error?
This study examined whether the correlation between a provider's effect on one population of patients and the same provider's effect on another population is underestimated if the effects for each population are estimated separately as opposed to being jointly modeled as random effects, and characterized how the impact of the estimation procedure varies with sample size. The authors used Medicare claims and enrollment data on emergency department (ED) visits, including patient characteristics, the patient’s hospitalization status, and identification of the doctor responsible for the decision to hospitalize the patient. The simulation analysis demonstrated that the joint modeling approach is generally close to unbiased, whereas the stratified approach can be severely biased in small samples. Correlations included 0.98 for female and male patients and only 0.38 using stratified estimation. Correlations for White and non-White patients are 0.99 and 0.28, and for Medicaid dual-eligible and non-dual-eligible patients 0.99 and 0.31, respectively.
AHRQ-funded; HS025408.
Citation: O'Malley AJ, Landon BE, Zaborski LA .
Weak correlations in health services research: weak relationships or common error?
Health Serv Res 2022 Feb;57(1):182-91. doi: 10.1111/1475-6773.13882..
Keywords: Health Services Research (HSR), Research Methodologies
Jensen JD, Krakow M, John KK
Against conventional wisdom: when the public, the media, and medical practice collide.
In 2009, the U.S. Preventive Services Task Force released new mammography screening guidelines that sparked a torrent of criticism. The goal of this article is to articulate how conflicts of this type arise and to review possible means of redress. The authors concluded that science is routinely simplified as it is prepared for public consumption. In line with the model of information overload, this practice may increase short-term adherence to recommendations at the expense of long-term message consistency and trust in science.
AHRQ-funded; 290200810015C
Citation: Jensen JD, Krakow M, John KK .
Against conventional wisdom: when the public, the media, and medical practice collide.
BMC Med Inform Decis Making 2013;13 Suppl 3:S4. doi: 10.1186/1472-6947-13-s3-s4..
Keywords: Communication, Evidence-Based Practice, Guidelines, Health Services Research (HSR), U.S. Preventive Services Task Force (USPSTF)
Miller WL, Crabtree BF, Harrison MI
AHRQ Author: Harrison MI
Integrating mixed methods in health services and delivery system research.
The authors introduced this AHRQ-sponsored issue of Health Services Research, describing the papers and briefly indicating where they fit into the emerging mixed methods mosaic. They then provided some suggestions about what may be missing and anticipated a future state of a more integrated approach to health services research and richer dialogue between researchers and those engaged in health care.
AHRQ-authored.
Citation: Miller WL, Crabtree BF, Harrison MI .
Integrating mixed methods in health services and delivery system research.
Health Serv Res 2013 Dec;48(6 Pt 2):2125-33. doi: 10.1111/1475-6773.12123.
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Keywords: Healthcare Delivery, Health Services Research (HSR), Research Methodologies
Chen J, Liu L, Zhang D
A flexible model for the mean and variance functions, with application to medical cost data.
The authors considered an extension to generalized linear models by assuming nonlinear associations of covariates in the mean function and allowing the variance to be an unknown but smooth function of the mean. They discussed their application of the model to the annual medical costs of heart failure patients in the clinical data repository at the University of Virginia Hospital System.
AHRQ-funded; HS020263.
Citation: Chen J, Liu L, Zhang D .
A flexible model for the mean and variance functions, with application to medical cost data.
Stat Med 2013 Oct 30;32(24):4306-18. doi: 10.1002/sim.5838.
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Keywords: Healthcare Delivery, Healthcare Costs, Health Services Research (HSR)
Chambers DA, Haim A, Mullican CA
AHRQ Author: Mullican CA
Health information technology and mental health services research: a path forward.
This article reports on the AHRQ- and NIMH-organized November 2010 workshop, “Health Information Technology and Mental Health: The Way Forward.” The primary workshop goal was to bring together experts in mental health services and interventions research, practitioners, consumers, and technologists to discuss emerging opportunities in uniting all aspects of health IT and mental health research. The workshop resulted in a four-paper series, envisioning a future mental health system in which health IT is fully integrated within mental health service systems, for patient, clinician, and system levels.
AHRQ-authored.
Citation: Chambers DA, Haim A, Mullican CA .
Health information technology and mental health services research: a path forward.
Gen Hosp Psychiatry 2013 Jul-Aug;35(4):329-31. doi: 10.1016/j.genhosppsych.2013.03.006.
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Keywords: Access to Care, Health Information Technology (HIT), Health Services Research (HSR), Health Information Technology (HIT), Behavioral Health
Clancy CM, Margolis PA, Miller M
AHRQ Author: Clancy CM
Collaborative networks for both improvement and research.
The authors discuss collaborative improvement networks, which can serve as large-scale, health system laboratories to engage clinicians, researchers, patients, and parents in testing approaches to translate research into practice. Creation of total population registries in collaborative network sites provides large, representative study samples with high-quality data which can be used to generate evidence and to inform clinical decision-making. Collaborative networks for improvement and research offer the opportunity not only to make improvements but also to study improvements to determine which interventions and combination of strategies work best in which settings.
AHRQ-authored; AHRQ-funded; HS021114.
Citation: Clancy CM, Margolis PA, Miller M .
Collaborative networks for both improvement and research.
Pediatrics 2013 Jun;131 Suppl 4:S210-4. doi: 10.1542/peds.2012-3786H.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Patient-Centered Outcomes Research, Children/Adolescents, Implementation
Pylypchuk Y, Sarpong EM
AHRQ Author: Sarpong EM
Comparison of health care utilization: United States versus Canada.
The purpose of this paper was to compare health care utilization between Canadian and U.S. residents. Findings showed that the poor and less educated were more likely to utilize health care in Canada than in the United States, while health care use for residents with high incomes and higher levels of education were not markedly different between the two countries and often higher for U.S residents. Also, foreign-born residents were more likely to use health care in Canada than in the United States.
AHRQ-authored.
Citation: Pylypchuk Y, Sarpong EM .
Comparison of health care utilization: United States versus Canada.
Health Serv Res 2013 Apr;48(2 Pt 1):560-81. doi: 10.1111/j.1475-6773.2012.01466.x.
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Keywords: Health Services Research (HSR), Healthcare Utilization, Medical Expenditure Panel Survey (MEPS), Social Determinants of Health
Lee SY, Weiner BJ, Harrison MI
AHRQ Author: Harrison MI
Organizational transformation: a systematic review of empirical research in health care and other industries.
The investigators reported findings from a systematic review of empirical research on transformational change in the health care and non-health care literature, with a focus on the antecedents, processes, and outcomes of transformational change. They found that available research documents the multiplicity of factors affecting change and the complexity of their interactions, but less information is available about the processes of transformational change than about its antecedents and consequences. They discussed research and practice implications.
AHRQ-authored.
Citation: Lee SY, Weiner BJ, Harrison MI .
Organizational transformation: a systematic review of empirical research in health care and other industries.
Med Care Res Rev 2013 Apr;70(2):115-42. doi: 10.1177/1077558712458539.
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Keywords: Healthcare Delivery, Health Services Research (HSR), Organizational Change
Kleinman LC, Dougherty D
AHRQ Author: Dougherty D
Assessing quality improvement in health care: theory for practice.
The authors reviewed the role of theory as a means to enhance the practice of quality improvement (QI) research and to propose a novel conceptual model focused on the operations of health care. They concluded that such a theory can promote opportunities for moving the field forward and organizing the planning and interpretation of comparable studies.
AHRQ-authored.
Citation: Kleinman LC, Dougherty D .
Assessing quality improvement in health care: theory for practice.
Pediatrics 2013 Mar;131 Suppl 1:S110-9. doi: 10.1542/peds.2012-1427n.
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Keywords: Quality Improvement, Healthcare Delivery, Organizational Change, Quality of Care, Health Services Research (HSR)
Fleurence R, Selby JV, Odom-Walker K
AHRQ Author: Slutsky JR
How the Patient-Centered Outcomes Research Institute is engaging patients and others in shaping its research agenda.
This article describes PCORI's approach to generating topics for research and how it is being used in selection of research that PCORI will fund. It further describes challenges facing this approach, including a lack of common language and training on the part of patients and resistance on the part of researchers to questions that are not researcher generated.
AHRQ-authored.
Citation: Fleurence R, Selby JV, Odom-Walker K .
How the Patient-Centered Outcomes Research Institute is engaging patients and others in shaping its research agenda.
Health Aff 2013 Feb;32(2):393-400. doi: 10.1377/hlthaff.2012.1176.
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Keywords: Health Services Research (HSR), Patient and Family Engagement, Patient-Centered Outcomes Research, Research Methodologies
Koh HK, Baur C, Brach C
AHRQ Author: Brach C
Toward a systems approach to health literacy research.
The authors discuss a call for research exploring how health care organizations can effectively address health literacy and patient-centered care. Topics include AHRQ's Health Literacy Universal Precautions Toolkit, Accountable Care Organizations, and Patient Centered Medical Homes.
AHRQ-authored.
Citation: Koh HK, Baur C, Brach C .
Toward a systems approach to health literacy research.
J Health Commun 2013;18(1):1-5. doi: 10.1080/10810730.2013.759029.
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Keywords: Healthcare Delivery, Health Literacy, Health Services Research (HSR), Patient-Centered Healthcare, Tools & Toolkits
Siegel JE, Heeringa JW, Carman KL
AHRQ Author: Siegel JE
Public deliberation in decisions about health research.
This paper provides a brief overview of public deliberation and describes its emerging role in health and health care research.
AHRQ-authored.
Citation: Siegel JE, Heeringa JW, Carman KL .
Public deliberation in decisions about health research.
Virtual Mentor 2013 Jan;15(1):56-64. doi: 10.1001/virtualmentor.2013.15.1.pfor2-1301.
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Keywords: Decision Making, Healthcare Delivery, Health Services Research (HSR), Policy