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 25 of 2092 Research Studies DisplayedScally CP, Yin H, Birkmeyer JD
Comparing perioperative processes of care in high and low mortality centers performing pancreatic surgery.
The researchers compared high and low mortality hospitals in order to identify differences in patient care impacting safety. They concluded that high and low mortality hospitals both have high compliance with common quality measures; however, high mortality hospitals performed worse in other areas of perioperative care, indicating possible targets for quality improvement efforts.
AHRQ-funded; HS020937.
Citation: Scally CP, Yin H, Birkmeyer JD .
Comparing perioperative processes of care in high and low mortality centers performing pancreatic surgery.
J Surg Oncol 2015 Dec;112(8):866-71. doi: 10.1002/jso.24085.
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Keywords: Surgery, Mortality, Quality Improvement, Outcomes, Patient Safety
Chen R, Strait KM, Dharmarajan K
Hospital variation in admission to intensive care units for patients with acute myocardial infarction.
This study investigates how contemporary hospitals use this resource-intensive setting of intensive care units (ICUs) and whether higher use is associated with better outcomes. It found that rates of ICU admission for patients with AMI vary substantially across hospitals and were not associated with differences in mortality, but were associated with greater use of critical care therapies.
AHRQ-funded; HS020672.
Citation: Chen R, Strait KM, Dharmarajan K .
Hospital variation in admission to intensive care units for patients with acute myocardial infarction.
Am Heart J 2015 Dec;170(6):1161-9. doi: 10.1016/j.ahj.2015.09.003.
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Keywords: Hospitalization, Intensive Care Unit (ICU), Heart Disease and Health
Balamuth F, Weiss SL, Hall M
Identifying pediatric severe sepsis and septic shock: accuracy of diagnosis codes.
The purpose of this study was to evaluate accuracy of 2 established administrative methods of identifying children with sepsis using a medical record review reference standard. It concluded that sepsis specific International Classification of Diseases, Ninth Revision, Clinical Modification codes identify pediatric patients with severe sepsis in administrative data more accurately than a combination of codes for infection plus organ dysfunction.
AHRQ-funded; K08-HS023827.
Citation: Balamuth F, Weiss SL, Hall M .
Identifying pediatric severe sepsis and septic shock: accuracy of diagnosis codes.
J Pediatr 2015 Dec;167(6):1295-300.e4. doi: 10.1016/j.jpeds.2015.09.027.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Sepsis
Boles RE, Yun L, Hambidge SJ, et al.
Influencing the home food and activity environment of families of preschool children receiving home-based treatment for obesity.
The goal of this study was to characterize the home food and activity environments of overweight and obese preschool-aged children from low socioeconomic status Latino families. It showed that despite a small, but significant reduction in preschool BMI for a subsample, families showed little change in the home food and activity environment.
AHRQ-funded; HS021138.
Citation: Boles RE, Yun L, Hambidge SJ, et al..
Influencing the home food and activity environment of families of preschool children receiving home-based treatment for obesity.
Clin Pediatr 2015 Dec;54(14):1387-90. doi: 10.1177/0009922815570614..
Keywords: Obesity, Children/Adolescents, Nutrition, Obesity: Weight Management, Family Health and History
Sabbatini AK, Merck LH, Froemming AT
Optimizing patient-centered communication and multidisciplinary care coordination in emergency diagnostic imaging: a research agenda.
This article summarizes findings reached during the patient-centered outcomes session of the 2015 Academic Emergency Medicine consensus conference "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The primary objective was to develop a research agenda focused on 1) defining component parts of the emergency diagnostic imaging care coordination process, 2) identifying gaps in communication that affect emergency diagnostic imaging, and 3) defining optimal methods of communication.
AHRQ-funded; HS022982.
Citation: Sabbatini AK, Merck LH, Froemming AT .
Optimizing patient-centered communication and multidisciplinary care coordination in emergency diagnostic imaging: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1427-34. doi: 10.1111/acem.12826.
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Keywords: Communication, Emergency Department, Health Services Research (HSR), Imaging, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Rodrigue JR, Fleishman A, Fitzpatrick S
Organ donation video messaging in motor vehicle offices: results of a randomized trial.
Since nearly all registered organ donors in the United States signed up via a driver's license transaction, motor vehicle (MV) offices represent an important venue for organ donation education. The researchers evaluated the impact of organ donation video messaging in MV offices. There was a relatively low uptake of the video intervention by customers that most likely contributed to the negative trial finding.
HS022061; HS024204
Citation: Rodrigue JR, Fleishman A, Fitzpatrick S .
Organ donation video messaging in motor vehicle offices: results of a randomized trial.
Prog Transplant 2015 Dec;25(4):332-8. doi: 10.7182/pit2015166..
Keywords: Transplantation, Health Promotion, Education: Patient and Caregiver
Desai NR, Parzynski CS, Krumholz HM
Patterns of institutional review of percutaneous coronary intervention appropriateness and the effect on quality of care and clinical outcomes.
The researchers sought to determine whether internal review of percutaneous coronary intervention (PCI) appropriateness using appropriate use criteria is associated with differences in procedural appropriateness, quality of care, and patient outcomes. They concluded that there was a modest association between procedural appropriateness and clinical outcomes and a similarly modest correlation between nonacute PCI volume and procedural appropriateness.
AHRQ-funded; HS023000
Citation: Desai NR, Parzynski CS, Krumholz HM .
Patterns of institutional review of percutaneous coronary intervention appropriateness and the effect on quality of care and clinical outcomes.
JAMA Intern Med. 2015 Dec;175(12):1988-90.
Keywords: Cardiovascular Conditions, Patient-Centered Outcomes Research, Heart Disease and Health, Registries
Rundell SD, Goode AP, Friedly JL
Role of health services research in producing high-value rehabilitation care.
The overall purpose of this article is to present a framework to help clinicians, researchers, educators, and policy makers better understand the role of health services research in developing and evaluating evidence on value in rehabilitation. The authors believe that rehabilitation professionals have a great opportunity to increase their engagement in describing, evaluating, delivering, and disseminating high-value care, but there are several barriers they need to consider to be most successful.
AHRQ-Funded HS022982.
Citation: Rundell SD, Goode AP, Friedly JL .
Role of health services research in producing high-value rehabilitation care.
Phys Ther 2015 Dec;95(12):1703-11. doi: 10.2522/ptj.20150033..
Keywords: Health Services Research (HSR), Rehabilitation, Patient-Centered Outcomes Research, Comparative Effectiveness
Campbell-Voytal K, Daly JM, Nagykaldi ZJ
Team science approach to developing consensus on research good practices for practice-based research networks: A case study.
Using peer learning strategies, seven experienced practice-based research networks (PBRNs) working in collaborative teams articulated procedures for PBRN Research Good Practices (PRGPs). The PRGPs is a PBRN-specific resource to facilitate PBRN management and staff training, to promote adherence to study protocols, and to increase validity and generalizability of study findings. This paper describes the team science processes which culminated in the PRGPs.
AHRQ-funded; HS016713; HS019601.
Citation: Campbell-Voytal K, Daly JM, Nagykaldi ZJ .
Team science approach to developing consensus on research good practices for practice-based research networks: A case study.
Clin Transl Sci 2015 Dec;8(6):632-7. doi: 10.1111/cts.12363.
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Keywords: Primary Care: Models of Care, Practice-Based Research Network (PBRN), Primary Care, Teams, Implementation
Bennette CS, Ramsey SD, McDermott CL
Predicting low accrual in the National Cancer Institute's cooperative group clinical trials.
The study’s objective was to evaluate the empirical relationship and predictive properties of putative risk factors for low accrual in the National Cancer Institute's (NCI's) Cooperative Group Program, now the National Clinical Trials Network (NCTN). It identified multiple characteristics of NCTN-sponsored trials associated with low accrual and developed a prediction model that can provide a useful estimate of accrual risk based on these factors.
AHRQ-funded; HS023340.
Citation: Bennette CS, Ramsey SD, McDermott CL .
Predicting low accrual in the National Cancer Institute's cooperative group clinical trials.
J Natl Cancer Inst 2016 Feb;108(2). doi: 10.1093/jnci/djv324.
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Keywords: Research Methodologies, Risk
Lewis MW, Khodneva Y, Redmond N
The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study.
The authors investigated the association between income-education groups and incident coronary heart disease (CHD) in a national prospective cohort study. They found that, for younger individuals, low income, regardless of education, was associated with higher risk of CHD; however, this was not observed for those 65 years of age or older.
AHRQ-funded; HS023009.
Citation: Lewis MW, Khodneva Y, Redmond N .
The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study.
BMC Public Health 2015 Dec 29;15:1312. doi: 10.1186/s12889-015-2630-4.
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Keywords: Cardiovascular Conditions, Racial and Ethnic Minorities, Social Determinants of Health, Stroke
Calo WA, Cubillos L, Breen J
Experiences of Latinos with limited English proficiency with patient registration systems and their interactions with clinic front office staff: an exploratory study to inform community-based translational research in North Carolina.
This study explored Latino patients with limited English proficiency (LEP) experiences with, and expectations for, interactions with patient registration systems and front office staff. It found that Latino patients in North Carolina experienced health services barriers unique to their LEP background. Participants identified ways in which the lack of cultural and linguistic competence of front office staff negatively affect their experiences seeking health services.
AHRQ-funded; HS000032.
Citation: Calo WA, Cubillos L, Breen J .
Experiences of Latinos with limited English proficiency with patient registration systems and their interactions with clinic front office staff: an exploratory study to inform community-based translational research in North Carolina.
BMC Health Serv Res 2015 Dec 23;15:570. doi: 10.1186/s12913-015-1235-z.
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Keywords: Access to Care, Communication, Health Services Research (HSR), Clinician-Patient Communication, Racial and Ethnic Minorities
Finnerty NM, Rodriguez RM, Carpenter CR
Clinical decision rules for diagnostic imaging in the emergency department: a research agenda.
The objective of this working group and article was to generate a consensus-based research agenda for the development and implementation of clinical decision rules (CDRs) for diagnostic imaging in the emergency department. A research agenda was developed, prioritizing a number of questions, including: what are the optimal methods to justify the derivation and validation of diagnostic imaging CDRs?
AHRQ-funded; HS023498.
Citation: Finnerty NM, Rodriguez RM, Carpenter CR .
Clinical decision rules for diagnostic imaging in the emergency department: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1406-16. doi: 10.1111/acem.12828.
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Keywords: Decision Making, Emergency Department, Health Services Research (HSR), Imaging
Murugiah K, Wang Y, Desai NR
Hospital variation in outcomes for transcatheter aortic valve replacement among Medicare beneficiaries, 2011 to 2013.
The researchers studied hospital performance on transcatheter aortic valve replacement (TAVR) using data from all Medicare fee-for-service (FFS) beneficiaries 65 years of age and older who underwent TAVR from January 1, 2011, to December 31, 2013. They found that for an individual patient, the between-hospital variation translates to a great than 2-fold higher risk of dying within 30 days for a patient undergoing TAVR at a hospital 1 SD above the national average compared with undergoing TAVR at a hospital 1 SD below; the between-hospital variation was
AHRQ-funded; HS023000.
Citation: Murugiah K, Wang Y, Desai NR .
Hospital variation in outcomes for transcatheter aortic valve replacement among Medicare beneficiaries, 2011 to 2013.
J Am Coll Cardiol 2015 Dec 15;66(23):2678-79. doi: 10.1016/j.jacc.2015.10.008.
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Keywords: Cardiovascular Conditions, Hospitals, Medicare, Patient-Centered Outcomes Research, Surgery
Chen SI, Wang Y, Dreyer R
Insurance and prehospital delay in patients </=55 years with acute myocardial infarction.
The authors assessed whether gender differences in health insurance help explain gender differences in delay in seeking care for patients with acute myocardial infarction (AMI) in the US and in Spain. They concluded that in the US, women were more likely than men to delay, although it was not explained by differences in insurance status. Further, the lack of gender differences in prehospital delays in Spain suggests that these differences may vary by health care system and culture.
AHRQ-funded; HS023000.
Citation: Chen SI, Wang Y, Dreyer R .
Insurance and prehospital delay in patients </=55 years with acute myocardial infarction.
Am J Cardiol 2015 Dec 15;116(12):1827-32. doi: 10.1016/j.amjcard.2015.09.018.
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Keywords: Healthcare Delivery, Emergency Medical Services (EMS), Health Insurance, Heart Disease and Health, Sex Factors
Chou R, Gore JL, Buckley D
Urinary biomarkers for diagnosis of bladder cancer: a systematic review and meta-analysis.
The authors systematically reviewed the evidence on the accuracy of urinary biomarkers for diagnosis of bladder cancer in adults who have signs or symptoms of the disease or are undergoing surveillance for recurrent disease. Their review concluded that urinary biomarkers miss a substantial proportion of patients with bladder cancer and are subject to false-positive results in others.
AHRQ-funded; 290201200014I.
Citation: Chou R, Gore JL, Buckley D .
Urinary biomarkers for diagnosis of bladder cancer: a systematic review and meta-analysis.
Ann Intern Med 2015 Dec 15;163(12):922-31. doi: 10.7326/m15-0997.
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Keywords: Cancer, Comparative Effectiveness, Diagnostic Safety and Quality
Herring B, Trish E
Explaining the growth in US health care spending using state-level variation in income, insurance, and provider market dynamics.
The authors estimated a regression model for state personal health care spending for 1991-2009, then used the results to produce state-level projections of health care spending for 2010-2013 and compared those average projected state values with actual national spending for 2010-2013. They found that at least 70% of the recent slowdown in health care spending can likely be explained by long-standing patterns.
AHRQ-funded; HS000046.
Citation: Herring B, Trish E .
Explaining the growth in US health care spending using state-level variation in income, insurance, and provider market dynamics.
Inquiry 2015 Dec 9;52. doi: 10.1177/0046958015618971.
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Keywords: Healthcare Costs, Health Insurance, Provider: Health Personnel, Policy, Policy
Spatz ES, Jiang X, Lu J
Qingdao Port Cardiovascular Health Study: a prospective cohort study.
The Qingdao Port Cardiovascular Health Study was designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. Early findings reveal a significant increase in cardiovascular risk factors (hypertension, diabetes, hyperlipidemia, and body mass index) from 2000 to 2010.
AHRQ-funded; HS023000.
Citation: Spatz ES, Jiang X, Lu J .
Qingdao Port Cardiovascular Health Study: a prospective cohort study.
BMJ Open 2015 Dec 9;5(12):e008403. doi: 10.1136/bmjopen-2015-008403.
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Keywords: Cardiovascular Conditions, Risk, Social Determinants of Health, Patient-Centered Outcomes Research, Prevention
Amick HR, Gartlehner G, Gaynes BN
Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis.
This systematic review sought to identify the benefits and harms of second generation antidepressants and cognitive behavioral therapies (CBTs) in the initial treatment of a current episode of major depressive disorder in adults. It concluded that the available evidence suggests no difference in treatment effects of second generation antidepressants and CBT, either alone or in combination, although small numbers may preclude detection of small but clinically meaningful differences.
AHRQ-funded; 290-2012-00008I
Citation: Amick HR, Gartlehner G, Gaynes BN .
Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis.
BMJ 2015 Dec 8;351:h6019. doi: 10.1136/bmj.h6019..
Keywords: Medication, Behavioral Health, Comparative Effectiveness, Depression
McCoy RG, Van Houten HK, Ross JS
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
The researchers sought to determine the extent and effect of excessive testing for glycated hemoglobin (HbA1c) among adults with controlled type 2 diabetes. They found that in a US cohort of adults with stable and controlled type 2 diabetes, more than 60% received too many HbA1c tests, a practice associated with potential overtreatment with hypoglycemic drugs.
AHRQ-funded; HS018339.
Citation: McCoy RG, Van Houten HK, Ross JS .
HbA1c overtesting and overtreatment among US adults with controlled type 2 diabetes, 2001-13: observational population based study.
BMJ 2015 Dec 8;351:h6138. doi: 10.1136/bmj.h6138..
Keywords: Chronic Conditions, Diabetes, Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Tieu L, Sarkar U, Schillinger D
Barriers and facilitators to online portal use among patients and caregivers in a safety net health care system: a qualitative study.
The researchers explored patient and caregiver perspectives on online patient portal use before its implementation at San Francisco General Hospital. Despite concerns about security, difficulty understanding medical information, and satisfaction with current communication processes, respondents generally expressed enthusiasm about portal use. Their findings suggest a strong need for training and support to assist vulnerable patients with portal registration and use, particularly those with limited health literacy.
AHRQ-funded; HS022561; HS022047; HS022408.
Citation: Tieu L, Sarkar U, Schillinger D .
Barriers and facilitators to online portal use among patients and caregivers in a safety net health care system: a qualitative study.
J Med Internet Res 2015 Dec 03;17(12):e275. doi: 10.2196/jmir.4847.
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Keywords: Web-Based, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Literacy
DeLia D, Wang HE, Kutzin J
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
This study provides a real world evaluation of the effectiveness of post-arrest care in therapeutic hypothermia (TH) centers during a time of growing TH dissemination in the state of New Jersey. It concluded that post-arrest outcomes are more favorable at TH centers but these improved outcomes are not apparent until after hospital discharge.
AHRQ-funded; HS020097.
Citation: DeLia D, Wang HE, Kutzin J .
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
BMC Health Serv Res 2015 Dec 2;15:533. doi: 10.1186/s12913-015-1199-z.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Emergency Medical Services (EMS), Outcomes
Shah MN, Wasserman EB, Gillespie SM
High-intensity telemedicine decreases emergency department use for ambulatory care sensitive conditions by older adult senior living community residents.
The aim of this study was to assess the effect of a high-intensity telemedicine program for senior living community (SLC) residents on the rate of Emergency department (ED) visits for ambulatory care sensitive conditions (ACSCs). It found that providing acute illness care by high-intensity telemedicine to older adults residing in SLCs significantly decreases the rate of ED use for ACSCs over 1 year.
AHRQ-funded; HS018047.
Citation: Shah MN, Wasserman EB, Gillespie SM .
High-intensity telemedicine decreases emergency department use for ambulatory care sensitive conditions by older adult senior living community residents.
J Am Med Dir Assoc 2015 Dec;16(12):1077-81. doi: 10.1016/j.jamda.2015.07.009..
Keywords: Elderly, Telehealth, Health Information Technology (HIT), Emergency Department, Healthcare Utilization, Long-Term Care
Prey JE, Polubriaginof F, Kuperman GJ
A global analysis of approaches to sharing clinical data with patients.
The authors investigated the current state of approaches for providing patients with access to their own clinical information. They found that efforts to improve patient access to data are active on a global-scale; however, there are many open questions about best practices and much can be learned by adopting an international perspective to guide future implementation efforts.
AHRQ-funded; HS021816.
Citation: Prey JE, Polubriaginof F, Kuperman GJ .
A global analysis of approaches to sharing clinical data with patients.
Stud Health Technol Inform 2015;216:907.
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Keywords: Education: Continuing Medical Education, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement
Hartling L, Guise JM, Kato E
AHRQ Author: Kato, E, Berliner E
A taxonomy of rapid reviews links report types and methods to specific decision-making contexts.
The researchers described characteristics of rapid reviews and examined the impact of methodological variations on their reliability and validity. They concluded that rapid products have tremendous methodological variation and that categorization based on timeframe or type of synthesis reveals patterns. The similarity across rapid products lies in the close relationship with the end user to meet time-sensitive decision-making needs.
AHRQ-authored; AHRQ-funded; 290201200013I; 290201200010I; 290201200011I; 290201200015I; 290201200007I; 290201200004C.
Citation: Hartling L, Guise JM, Kato E .
A taxonomy of rapid reviews links report types and methods to specific decision-making contexts.
J Clin Epidemiol 2015 Dec;68(12):1451-62.e3. doi: 10.1016/j.jclinepi.2015.05.036.
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Keywords: Decision Making, Evidence-Based Practice, Data, Research Methodologies