National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (8)
- (-) Blood Clots (22)
- Blood Thinners (2)
- Cancer: Breast Cancer (1)
- Cancer: Ovarian Cancer (1)
- Cardiovascular Conditions (2)
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- Children/Adolescents (1)
- Comparative Effectiveness (2)
- Critical Care (1)
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- Hospitalization (3)
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- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (1)
- Medication (2)
- Mortality (1)
- Outcomes (2)
- Patient Safety (8)
- Payment (2)
- Prevention (7)
- Provider Performance (2)
- Public Reporting (1)
- Quality Improvement (4)
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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 22 of 22 Research Studies DisplayedBeckman MG, Abe K, Barnes K
AHRQ Author: Brady PJ
Strategies and partnerships toward prevention of healthcare-associated venous thromboembolism.
This issue of the Journal of Hospital Medicine showcases the initiatives of several of the CDC’s healthcare-associated venous thromboembolism (HA-VTE) prevention champions. The CDC and AHRQ are partnering to disseminate and promote these best practices. In addition to this challenge, the CDC, AHRQ and the Joint Commission Center for Transforming Healthcare are working on activities and programs dedicated to improving prevention of HA-VTE. They are summarized in the article.
AHRQ-authored.
Citation: Beckman MG, Abe K, Barnes K .
Strategies and partnerships toward prevention of healthcare-associated venous thromboembolism.
J Hosp Med 2016 Dec;11 Suppl 2:S5-s7. doi: 10.1002/jhm.2659.
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Keywords: Prevention, Blood Clots, Quality Improvement, Guidelines, Adverse Events
Lau BD, Haut ER, Hobson DB
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Suboptimal prevention practices have prompted payers to consider hospital-associated Venous thromboembolism (VTE) as a potentially preventable condition for which financial incentives or penalties exist to drive practice improvement. The authors reviewed a subset of hospital-associated VTE that were identified by ICD-9 codes used by a state-run pay-for-performance quality improvement program and discuss their findings.
AHRQ-funded; HS017952.
Citation: Lau BD, Haut ER, Hobson DB .
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Am J Med Qual 2016 Sep;31(5):448-53. doi: 10.1177/1062860615583547.
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Keywords: Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Prevention, Hospitals, Quality Improvement, Blood Clots, Payment, Provider Performance
Farrow NE, Lau BD, JohnBull EA
Is the meaningful use venous thromboembolism VTE-6 measure meaningful? A retrospective analysis of one hospital's VTE-6 cases.
The researchers assessed the validity of the Meaningful Use VTE-6 measure by reviewing the quality of venous thromboembolism (VTE) prophylaxis provided to patients. Sixty percent of the patients identified as having sustained potentially preventable VTE were false positives. For the remaining forty percent, VTE was considered to be truly potentially preventable and those patients therefore provided targets for quality improvement measures.
AHRQ-funded; HS017952.
Citation: Farrow NE, Lau BD, JohnBull EA .
Is the meaningful use venous thromboembolism VTE-6 measure meaningful? A retrospective analysis of one hospital's VTE-6 cases.
Jt Comm J Qual Patient Saf 2016 Sep;42(9):410-6.
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Keywords: Blood Clots, Quality Improvement, Quality Measures, Quality Measures, Electronic Health Records (EHRs)
Poonawalla IB, Piller LB, Lairson DR
Use of hematopoietic growth factors and risk of thromboembolic and pulmonary toxicities in elderly patients with advanced ovarian cancer.
This study evaluated the risk of thromboembolic and pulmonary toxicities associated with hematopoietic growth factor (HGF) use (i.e., erythropoietin-stimulating agent [ESA] and/or colony-stimulating factor [CSF]) in a community-dwelling cohort of elderly patients with advanced ovarian cancer. An increased risk of thromboembolic events was observed in elderly patients with ovarian cancer who received ESA + CSF.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Piller LB, Lairson DR .
Use of hematopoietic growth factors and risk of thromboembolic and pulmonary toxicities in elderly patients with advanced ovarian cancer.
Womens Health Issues 2016 Sep-Oct;26(5):574-83. doi: 10.1016/j.whi.2016.05.007.
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Keywords: Adverse Events, Blood Clots, Elderly, Cancer: Ovarian Cancer, Risk
Wang SV, Franklin JM, Glynn RJ
Prediction of rates of thromboembolic and major bleeding outcomes with dabigatran or warfarin among patients with atrial fibrillation: new initiator cohort study.
The authors compared stratified event rates from randomized controlled trials with predicted event rates from models developed in observational data and assessed their ability to accurately capture observed rates of thromboembolism and major bleeding for patients treated with dabigatran or warfarin as part of routine care. They found that estimated rates of thromboembolism under dabigatran or warfarin treatment in randomized controlled trials were close to observed rates in routine care patients, but that rates of major bleeding were underestimated. They concluded that models developed in routine care patients can provide accurate, tailored estimates of risk and benefit under alternative treatment to enhance patient centered care.
AHRQ-funded; HS022193.
Citation: Wang SV, Franklin JM, Glynn RJ .
Prediction of rates of thromboembolic and major bleeding outcomes with dabigatran or warfarin among patients with atrial fibrillation: new initiator cohort study.
BMJ 2016 May 24;353:i2607. doi: 10.1136/bmj.i2607.
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Keywords: Blood Thinners, Adverse Drug Events (ADE), Blood Clots, Patient Safety, Medication
Jindai K, Sterkel AK, Reed KD
Limb embolism in a 52-year-old woman.
In response to a photo quiz, the authors make the following diagnosis: arterial thrombus caused by Histoplasma capsulatum deriving from native valve endocarditis caused by the same organism. Various aspects of the case are discussed.
AHRQ-funded; HS022465; HS023779.
Citation: Jindai K, Sterkel AK, Reed KD .
Limb embolism in a 52-year-old woman.
Clin Infect Dis 2016 May 15;62(10):1320-1. doi: 10.1093/cid/ciw081.
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Keywords: Blood Clots, Care Management, Case Study, Diagnostic Safety and Quality, Patient Safety
Grant PJ, Greene MT, Chopra V
Assessing the Caprini score for risk assessment of venous thromboembolism in hospitalized medical patients.
The authors examined how well the Caprini risk assessment model predicts venous thromboembolism in hospitalized medical patients. They concluded that the Caprini risk assessment model was unable to identify a subset of medical patients who benefit from pharmacologic prophylaxis.
AHRQ-funded; HS022835.
Citation: Grant PJ, Greene MT, Chopra V .
Assessing the Caprini score for risk assessment of venous thromboembolism in hospitalized medical patients.
Am J Med 2016 May;129(5):528-35. doi: 10.1016/j.amjmed.2015.10.027.
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Keywords: Adverse Events, Blood Clots, Hospitalization, Risk, Patient Safety
Du XL, Zhang Y, Hardy D
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
The researchers sought to determine the risk of venous thromboembolism (VTE), stroke, ischemic heart disease, and myelodysplastic syndrome (MDS) in association with the receipt of colony-stimulating factors (CSFs) and/or erythropoiesis-stimulating agents (ESAs) in women with breast cancer. They found that receipts of CSFs and ESAs were significantly associated with an increased risk of VTE in women with breast cancer.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Hardy D .
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
Cancer Causes Control 2016 May;27(5):695-707. doi: 10.1007/s10552-016-0742-5.
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Keywords: Blood Clots, Cancer: Breast Cancer, Cardiovascular Conditions, Risk, Stroke
Yen J, Van Arendonk KJ, Streiff MB
Risk factors for venous thromboembolism in pediatric trauma patients and validation of a novel scoring system: the risk of clots in kids with trauma score.
The researchers identified risk factors for venous thromboembolism and developed venous thromboembolism risk assessment models for pediatric trauma patients. They found that venous thromboembolism is infrequent after trauma in pediatric patients, and they developed weighted scoring systems to stratify pediatric trauma patients at risk.
AHRQ-funded; HS017952.
Citation: Yen J, Van Arendonk KJ, Streiff MB .
Risk factors for venous thromboembolism in pediatric trauma patients and validation of a novel scoring system: the risk of clots in kids with trauma score.
Pediatr Crit Care Med 2016 May;17(5):391-9. doi: 10.1097/pcc.0000000000000699.
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Keywords: Blood Clots, Children/Adolescents, Risk, Risk, Trauma
Siegler JE, Samai A, Albright KC
Factoring in factor VIII with acute ischemic stroke.
This review summarized the molecular role of factor VIII in thrombogenesis and its clinical use in the diagnosis and prognosis of acute ischemic stroke. It also discussed the utility of screening for serum factor VIII levels among patients at risk for, or those who have experienced, ischemic stroke.
AHRQ-funded; HS013852.
Citation: Siegler JE, Samai A, Albright KC .
Factoring in factor VIII with acute ischemic stroke.
Clin Appl Thromb Hemost 2015 Oct;21(7):597-602. doi: 10.1177/1076029615571630.
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Keywords: Stroke, Blood Clots, Cardiovascular Conditions
Hemmila MR, Osborne NH, Henke PK
Prophylactic inferior vena cava filter placement does not result in a survival benefit for trauma patients.
The researchers examined the relationship between prophylactic inferior vena cava (IVC) filter use, mortality, and venous thromboembolic events (VTE). They found that high rates of prophylactic IVC filter placement have no effect on reducing trauma patient mortality and are associated with an increase in deep venous thromboembolism (DVT) events.
AHRQ-funded; HS018728.
Citation: Hemmila MR, Osborne NH, Henke PK .
Prophylactic inferior vena cava filter placement does not result in a survival benefit for trauma patients.
Ann Surg 2015 Oct;262(4):577-85. doi: 10.1097/sla.0000000000001434..
Keywords: Blood Clots, Outcomes, Mortality, Injuries and Wounds, Prevention
Greene MT, Flanders SA, Woller SC
The association between PICC use and venous thromboembolism in upper and lower extremities.
The researchers examined the risk of venous thromboembolism in deep veins of the arm, leg, and chest after peripherally inserted central catheter placement (PICC). They found that PICC use is associated with upper- and lower-extremity deep vein thrombosis.
AHRQ-funded; HS022835.
Citation: Greene MT, Flanders SA, Woller SC .
The association between PICC use and venous thromboembolism in upper and lower extremities.
Am J Med 2015 Sep;128(9):986-93.e1. doi: 10.1016/j.amjmed.2015.03.028..
Keywords: Adverse Events, Blood Clots, Patient Safety, Risk
Fallouh N, McGuirk HM, Flanders SA
Peripherally inserted central catheter-associated deep vein thrombosis: a narrative review.
To better guide clinicians, the researchers performed a comprehensive literature review to summarize best practices for peripherally inserted central catheter-related deep vein thrombosis (PICC-DVT). They concluded that centrally positioned, otherwise functional and clinically necessary PICCs need not be removed despite concomitant DVT. Anticoagulation with low-molecular-weight heparin or warfarin for at least 3 months represents the mainstay of treatment.
AHRQ-funded; HS022835.
Citation: Fallouh N, McGuirk HM, Flanders SA .
Peripherally inserted central catheter-associated deep vein thrombosis: a narrative review.
Am J Med 2015 Jul;128(7):722-38. doi: 10.1016/j.amjmed.2015.01.027..
Keywords: Adverse Events, Blood Clots, Evidence-Based Practice, Patient Safety
Chopra V, Fallouh N, McGuirk H
Patterns, risk factors and treatment associated with PICC-DVT in hospitalized adults: a nested case-control study.
The purpose of this study was to determine patterns, risk factors and treatment related to peripherally inserted central catheters-deep vein thrombosis (PICC-DVT) in hospitalized patients. It found that treatment for PICC-DVT varied and included heparin bridging, low molecular weight heparin only and device removal only; the average duration of treatment also varied across these groups.
AHRQ-funded; HS022835.
Citation: Chopra V, Fallouh N, McGuirk H .
Patterns, risk factors and treatment associated with PICC-DVT in hospitalized adults: a nested case-control study.
Thromb Res 2015 May;135(5):829-34. doi: 10.1016/j.thromres.2015.02.012..
Keywords: Patient Safety, Blood Clots, Blood Thinners, Risk, Hospitalization
Chung JW, Ju MH, Kinnier CV
Postoperative venous thromboembolism outcomes measure: analytic exploration of potential misclassification of hospital quality due to surveillance bias.
The authors discuss problems associated with AHRQ’s Patient Safety Indicator (PS112), Postoperative Venous Thromboembolism such as identifying truly poor-quality hospitals from those that only seem to be poor-quality because of hospital-to-hospital variations in imaging rates for venous thromboembolism (VTE). They call for the development of administrative codes that enable reliable identification and exclusion of sub-clinical VTE from the measure numerator.
AHRQ-funded; HS021857
Citation: Chung JW, Ju MH, Kinnier CV .
Postoperative venous thromboembolism outcomes measure: analytic exploration of potential misclassification of hospital quality due to surveillance bias.
Ann Surg. 2015 Mar;261(3):443-4. doi: 10.1097/sla.0000000000000850..
Keywords: Quality Indicators (QIs), Blood Clots, Quality of Care, Adverse Events
Michtalik HJ, Carolan HT, Haut ER
Use of provider-level dashboards and pay-for-performance in venous thromboembolism prophylaxis.
The researchers sequentially examined an individualized physician dashboard and pay-for-performance program to improve venous thromboembolism (VTE) prophylaxis rates among hospitalists. They found that direct feedback using dashboards was associated with significantly improved compliance, with further improvement after incorporating an individual physician pay-for-performance program.
AHRQ-funded; HS017952; HS022331.
Citation: Michtalik HJ, Carolan HT, Haut ER .
Use of provider-level dashboards and pay-for-performance in venous thromboembolism prophylaxis.
J Hosp Med 2015 Mar;10(3):172-8. doi: 10.1002/jhm.2303..
Keywords: Provider Performance, Payment, Blood Clots, Prevention, Quality Improvement, Quality of Care, Hospitals, Patient Safety
Wong A, Kraus PS, Lau BD
Patient preferences regarding pharmacologic venous thromboembolism prophylaxis.
The purpose of this study was to assess patient preferences regarding pharmacological venous thromboembolism prophylaxis. It found that a majority preferred an oral route of administration for prophylaxis. Also, patients preferring subcutaneous injections were less likely to refuse doses of ordered pharmacologic prophylaxis.
AHRQ-funded; HS017952.
Citation: Wong A, Kraus PS, Lau BD .
Patient preferences regarding pharmacologic venous thromboembolism prophylaxis.
J Hosp Med 2015 Feb;10(2):108-11. doi: 10.1002/jhm.2282..
Keywords: Comparative Effectiveness, Blood Clots, Medication, Prevention
Admon AJ, Seymour CW, Gershengorn HB
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
The researchers examined the relationship between intensive care unit (ICU) use for patients with pulmonary embolism (PE) and cost, mortality, readmission, and procedure use in 263 hospitals. They found wide variations in ICU admission rates for acute PE without a detectable impact on mortality, cost, or readmission.
AHRQ-funded; HS020672
Citation: Admon AJ, Seymour CW, Gershengorn HB .
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
Chest. 2014 Dec;146(6):1452-61. doi: 10.1378/chest.14-0059..
Keywords: Blood Clots, Care Management, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU)
Ju MH, Chung JW, Kinnier CV
Association between hospital imaging use and venous thromboembolism events rates based on clinical data.
This study assessed the presence and extent of venous thromboembolism (VTE) surveillance bias using high-quality clinical data from 208 hospitals. It concluded that hospitals may be unfairly deemed poor performers for the outcome VTE measure if they have increased vigilance for VTE by performing more VTE imaging studies that result in higher VTE event rates.
AHRQ-funded; HS021857
Citation: Ju MH, Chung JW, Kinnier CV .
Association between hospital imaging use and venous thromboembolism events rates based on clinical data.
Ann Surg. 2014 Sep; 260(3):558-64; discussion 64-6. doi: 10.1097/sla.0000000000000897..
Keywords: Blood Clots, Public Reporting, Adverse Events, Outcomes, Quality of Care
Chopra V, Ratz D, Kuhn L
Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors.
This study was designed to determine patient, provider, and device outcome of deep vein thrombosis (DVT) associated with peripherally inserted central catheters (PICCs). Larger PICC gauge, especially in the use of recently diagnosed cancer patients, increases the likelihood of DVT.
AHRQ-funded; HS022835
Citation: Chopra V, Ratz D, Kuhn L .
Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors.
J Thromb Haemost 2014 Jun;12(6):847-54. doi: 10.1111/jth.12549..
Keywords: Adverse Events, Blood Clots, Patient Safety, Risk
Streiff MB, Brady JP, Grant AM
AHRQ Author: Brady JP
CDC Grand Rounds: preventing hospital-associated venous thromboembolism.
Approximately half of new venous thromboembolism (VTE) cases occur during a hospital stay or within 90 days of an inpatient admission or surgical procedure, and many are not diagnosed until after discharge. Prevention of VTE can be complicated as physicians must balance the risk for thrombosis with the risk for bleeding from anticoagulants. A collaborative, team-based approach to care is needed for significant and sustained improvement, and it also offers efficiency and capacity to tackle other patient safety problems.
AHRQ-authored.
Citation: Streiff MB, Brady JP, Grant AM .
CDC Grand Rounds: preventing hospital-associated venous thromboembolism.
MMWR Morb Mortal Wkly Rep 2014 Mar 7;63(9):190-3.
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Keywords: Blood Clots, Healthcare-Associated Infections (HAIs), Hospitalization, Prevention, Teams
Lau BD, Haut ER
Practices to prevent venous thromboembolism: a brief review.
The purpose of this review is to provide an update on the most effective interventions aimed at improving adherence to guidelines on the use of venous thromboembolism (VTE) prevention strategies. After reviewing sixteen studies, the researchers concluded that the greatest and most sustained improvements were those that combined education with computerised tools.
AHRQ-funded; 290200710.
Citation: Lau BD, Haut ER .
Practices to prevent venous thromboembolism: a brief review.
BMJ Qual Saf 2014 Mar;23(3):187-95. doi: 10.1136/bmjqs-2012-001782..
Keywords: Comparative Effectiveness, Blood Clots, Prevention, Decision Making, Guidelines