National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Arthritis (1)
- (-) Cancer (16)
- Cancer: Breast Cancer (4)
- Cancer: Colorectal Cancer (1)
- Cancer: Prostate Cancer (1)
- Cancer: Skin Cancer (1)
- Comparative Effectiveness (3)
- Decision Making (1)
- Disparities (3)
- Elderly (3)
- Genetics (2)
- Healthcare Costs (2)
- Healthcare Delivery (2)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (2)
- Health Insurance (1)
- Medicare (2)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (3)
- Patient Safety (3)
- Practice Patterns (1)
- Quality of Care (1)
- Risk (1)
- Surgery (4)
- (-) Treatments (16)
- Women (2)
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 16 of 16 Research Studies DisplayedGiordano SH, Niu J, Chavez-MacGregor M
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
The objective of the current study was to generate cost estimates for guideline-concordant adjuvant chemotherapy regimens from payers' and patients' perspectives in a large, insured US population. It concluded that the costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden.
AHRQ-funded; HS020263.
Citation: Giordano SH, Niu J, Chavez-MacGregor M .
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
Cancer 2016 Nov 15; 122(2):3447-3455. doi: 10.1002/cncr.30274.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Healthcare Costs
Liu S, Mazur T, Li H
SU-F-T-275: A correlation study on 3D fluence-based QA and 2D dose measurement-based QA.
The aim of this paper was to demonstrate the feasibility and creditability of computing and verifying 3D fluencies to assure IMRT and VMAT treatment deliveries, by correlating the passing rates of the 3D fluence-based QA (P(alpha)) to the passing rates of 2D dose measurement based QA (P(Dm)). It concluded that the demonstrated correlations improve the creditability of using 3D fluence-based QA for assuring treatment deliveries for IMRT/VMAT plans.
AHRQ-funded; HS022888.
Citation: Liu S, Mazur T, Li H .
SU-F-T-275: A correlation study on 3D fluence-based QA and 2D dose measurement-based QA.
Med Phys 2016 Jun;43(6 Part 17):3525-26. doi: 10.1118/1.4956415.
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Keywords: Cancer, Healthcare Delivery, Treatments, Patient Safety, Health Information Technology (HIT)
Liu S, Wu Y, Chang X
TU-FG-201-03: Automatic pre-delivery verification using statistical analysis of consistencies in treatment plan parameters by the treatment site and modality.
A novel computer software system, namely APDV (Automatic Pre-Delivery Verification), was developed for verifying patient treatment plan parameters right prior to treatment deliveries in order to automatically detect and prevent catastrophic errors. This study implemented APDV as a stand-alone program to ensure required real time performance. It concluded that APDV could be useful in detecting and preventing catastrophic errors immediately before treatment deliveries.
AHRQ-funded; HS022888.
Citation: Liu S, Wu Y, Chang X .
TU-FG-201-03: Automatic pre-delivery verification using statistical analysis of consistencies in treatment plan parameters by the treatment site and modality.
Med Phys 2016 Jun;43(6 Part 35):3753. doi: 10.1118/1.4957526.
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Keywords: Cancer, Healthcare Delivery, Treatments, Patient Safety, Health Information Technology (HIT)
Ellis CT, Samuel CA, Stitzenberg KB
National trends in nonoperative management of rectal adenocarcinoma.
The researchers examined the use of non-operative management (NOM) for rectal cancer over time and the patient- and facility-level factors associated with its use. They found evidence of increasing NOM use, with this increase occurring more frequently in black and uninsured/Medicaid patients, raising concern that increased NOM use may actually represent increasing disparities in rectal cancer care rather than innovation. They recommended further studies to assess survival differences by treatment strategy.
AHRQ-funded; HS000032.
Citation: Ellis CT, Samuel CA, Stitzenberg KB .
National trends in nonoperative management of rectal adenocarcinoma.
J Clin Oncol 2016 May 10;34(14):1644-51. doi: 10.1200/jco.2015.64.2066.
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Keywords: Cancer, Cancer: Colorectal Cancer, Disparities, Patient-Centered Healthcare, Treatments
Yang D, Wooten HO, Green O
A software tool to automatically assure and report daily treatment deliveries by a Cobalt-60 radiation therapy device.
The researchers developed a method for verification of treatment delivery after each treatment fraction in order to detect and correct errors, and they developed a comprehensive daily report. The end result has been integrated into a commercial version of the treatment delivery system, and it has been in clinical use for over one year.
AHRQ-funded; HS022888.
Citation: Yang D, Wooten HO, Green O .
A software tool to automatically assure and report daily treatment deliveries by a Cobalt-60 radiation therapy device.
J Appl Clin Med Phys 2016 May 8;17(3):6001.
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Keywords: Treatments, Cancer, Quality of Care, Patient Safety
Healy MA, Yin H, Wong SL
Multimodal cancer care in poor prognosis cancers: resection drives long-term outcomes.
The researchers compared effects of resection with other therapies on long-term outcomes across U.S. hospitals. They examined claims in the Surveillance, Epidemiology, and End Results (SEER) Medicare dataset for patients with esophageal and pancreatic cancers and found that a significant association exists between long-term survival and rates of cancer-directed surgery across hospitals, without variation in rates of other therapies.
AHRQ-funded; HS020937.
Citation: Healy MA, Yin H, Wong SL .
Multimodal cancer care in poor prognosis cancers: resection drives long-term outcomes.
J Surg Oncol 2016 May;113(6):599-604. doi: 10.1002/jso.24217.
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Keywords: Cancer, Outcomes, Surgery, Treatments, Disparities
Scott FI, Mamtani R, Brensinger CM
Risk of nonmelanoma skin cancer associated with the use of immunosuppressant and biologic agents in patients with a history of autoimmune disease and nonmelanoma skin cancer.
The study objective was to determine the relative hazard of a second nonmelanoma skin cancer (NMSC) in patients with rheumatoid arthritis and inflammatory bowel disease who use methotrexate, anti-tumor necrosis factor (anti-TNF) therapy, or thiopurines after an initial NMSC. It concluded that methotrexate use is associated with an increased risk of a second NMSC.
AHRQ-funded; HS018517.
Citation: Scott FI, Mamtani R, Brensinger CM .
Risk of nonmelanoma skin cancer associated with the use of immunosuppressant and biologic agents in patients with a history of autoimmune disease and nonmelanoma skin cancer.
JAMA Dermatol 2016 Feb;152(2):164-72. doi: 10.1001/jamadermatol.2015.3029.
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Keywords: Cancer, Arthritis, Risk, Comparative Effectiveness, Treatments
Mohanty S, Rajaram R, Bilimoria KY
Assessment of non-surgical versus surgical therapy for localized hepatocellular carcinoma.
Hypothesizing that non-surgical techniques have expanded to localized disease, the researchers examined treatment patterns, factors associated with surgical therapy, and the impact of modality on survival for patients with hepatocellular carcinoma (HCC). They concluded that non-surgical therapy has become as common as surgery in the treatment of non-cirrhotic, localized HCC.
AHRQ-funded; HS000078.
Citation: Mohanty S, Rajaram R, Bilimoria KY .
Assessment of non-surgical versus surgical therapy for localized hepatocellular carcinoma.
J Surg Oncol 2016 Feb;113(2):175-80. doi: 10.1002/jso.24113.
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Keywords: Cancer, Surgery, Treatments
Shen C, Tina Shih YC
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
The authors studied the impact of the fast diffusion of robotic surgical systems on the overall treatment pattern of localized prostate cancer. They found that the density of robotic systems at state-level had a significantly positive impact on the rate of surgery and a significantly negative impact on the rate of radiation therapy. They concluded that part of the increase in the rate of surgery was driven by substitution across treatment types with a large proportion originating from the younger population.
AHRQ-funded; HS018535; HS020263.
Citation: Shen C, Tina Shih YC .
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
Soc Sci Med 2016 Feb;151:110-20. doi: 10.1016/j.socscimed.2016.01.016.
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Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Healthcare Costs, Treatments
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
Gupta A, Long JB, Chen J
Risk of vascular toxicity with platinum based chemotherapy in elderly patients with bladder cancer.
The researchers evaluated the short-term (less than 1 year) and intermediate-term (2 to 5 years) vascular toxicity of platinum agents in older patients with bladder cancer. They found that patients receiving platinum based chemotherapy were at higher risk for thromboembolism but not other vascular events, particularly in the first year after diagnosis. This risk of thromboembolism is similar for cisplatin and carboplatin.
AHRQ-funded; HS018781.
Citation: Gupta A, Long JB, Chen J .
Risk of vascular toxicity with platinum based chemotherapy in elderly patients with bladder cancer.
J Urol 2016 Jan;195(1):33-40. doi: 10.1016/j.juro.2015.08.088..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cancer, Treatments, Elderly
Potosky AL, O'Neill SC, Isaacs C
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
The authors evaluated the relation between gene expression profiling (GEP) testing and the use of adjuvant chemotherapy by women treated in a general oncology practice. They found that adjuvant chemotherapy use after GEP testing is generally consistent with the recommended test interpretation for women with a high or low predicted risk of recurrence. Chemotherapy use in the intermediate-risk group increased with Recurrence Score values, and evidence from ongoing randomized trials may help to clarify whether this finding reflects optimal interpretation of GEP test results.
AHRQ-funded; HS022915.
Citation: Potosky AL, O'Neill SC, Isaacs C .
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
Cancer 2015 Nov 15;121(22):4062-70. doi: 10.1002/cncr.29621.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Decision Making, Genetics, Practice Patterns, Women
Dinan MA, Mi X, Reed SD
Association between use of the 21-gene recurrence score assay and receipt of chemotherapy among Medicare beneficiaries with early-stage breast cancer, 2005-2009.
The researchers examined whether adoption of the 21-Gene Recurrence Score (RS) assay in a nationally representative sample of patients with early-stage breast cancer was associated with use of chemotherapy. They found that the impact of the adoption of the RS assay on receipt of chemotherapy was strongly population dependent and was associated with relatively lower chemotherapy use in groups with high-risk disease and relatively higher chemotherapy use in patients with low-risk disease.
AHRQ-funded; HS022189.
Citation: Dinan MA, Mi X, Reed SD .
Association between use of the 21-gene recurrence score assay and receipt of chemotherapy among Medicare beneficiaries with early-stage breast cancer, 2005-2009.
JAMA Oncol 2015 Nov 1;1(8):1098-109. doi: 10.1001/jamaoncol.2015.2722..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Genetics, Medicare, Women
Du XL, Zhang Y, Parikh RC
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
The purpose of this study was to compare the effectiveness of chemotherapy in prolonging survival according to age in breast and colon cancer. It found that the effectiveness of chemotherapy decreased with age in participants with breast cancer, in whom chemotherapy appears to be effective until age 79 except for the doxorubicin-cyclophosphamide combination, which was effective in participants aged 80 to 84.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Parikh RC .
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
J Am Geriatr Soc 2015 Aug;63(8):1570-82. doi: 10.1111/jgs.13523..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research
Huo J, Du XL, Lairson DR
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
The authors examined the patterns of utilization of radiation therapy, chemotherapy, surgery, and hospice at the end-of-life care for patients diagnosed with metastatic melanoma. They found that surgery and hospice care use increased over the 8 years of this study, whereas the use of chemotherapy and radiation therapy remained consistent for patients diagnosed with metastatic melanoma.
AHRQ-funded; HS018956.
Citation: Huo J, Du XL, Lairson DR .
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
Am J Clin Oncol 2015 Jun;38(3):235-41. doi: 10.1097/COC.0b013e31829378f9.
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Keywords: Cancer, Cancer: Skin Cancer, Treatments, Elderly, Healthcare Utilization, Palliative Care, Patient-Centered Outcomes Research, Surgery
Koroukian SM
Dual-eligibility status: a marker of vulnerability and cancer-related disparities.
This editorial discusses a study by Warren et al that highlights important differences in receipt of chemotherapy across subgroups of the Medicare population according to type of supplemental insurance. It explores the important questions raised by the findings, especially the individual factors that may have contributed to the observed disparities.
AHRQ-funded; HS023113.
Citation: Koroukian SM .
Dual-eligibility status: a marker of vulnerability and cancer-related disparities.
J Clin Oncol 2015 Feb 1;33(4):297-8. doi: 10.1200/jco.2014.59.1933..
Keywords: Medicare, Cancer, Health Insurance, Treatments, Disparities