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)
- Asthma (1)
- Brain Injury (1)
- Children/Adolescents (3)
- Clinical Decision Support (CDS) (7)
- Communication (2)
- Comparative Effectiveness (1)
- Data (1)
- Diabetes (1)
- Education: Patient and Caregiver (3)
- Electronic Health Records (EHRs) (8)
- Emergency Department (1)
- Genetics (2)
- Guidelines (1)
- Health Information Exchange (HIE) (1)
- (-) Health Information Technology (HIT) (20)
- Imaging (1)
- Medical Errors (1)
- Medication (3)
- Outcomes (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (1)
- Patient Safety (3)
- Practice Patterns (1)
- Pregnancy (1)
- Primary Care (2)
- Provider (1)
- Provider: Nurse (1)
- Provider: Physician (1)
- Quality of Care (1)
- (-) Shared Decision Making (20)
- Social Determinants of Health (1)
- Surgery (1)
- Transplantation (1)
- Web-Based (2)
- Women (1)
- Workflow (1)
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 20 of 20 Research Studies DisplayedMelnick ER, Hess EP, Guo G
Patient-centered decision support: formative usability evaluation of integrated clinical decision support with a patient decision aid for minor head injury in the emergency department.
The study’s objective was to formatively evaluate an electronic tool that not only helps clinicians at the bedside to determine the need for CT use based on the Canadian CT Head Rule but also promotes evidence-based conversations between patients and clinicians regarding patient-specific risk and patients' specific concerns. It concluded that the Concussion or Brain Bleed app is a useful and usable final product integrating clinical decision support with a patient decision aid.
AHRQ-funded; HS021271.
Citation: Melnick ER, Hess EP, Guo G .
Patient-centered decision support: formative usability evaluation of integrated clinical decision support with a patient decision aid for minor head injury in the emergency department.
J Med Internet Res 2017 May 19;19(5):e174. doi: 10.2196/jmir.7846.
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Keywords: Brain Injury, Shared Decision Making, Emergency Department, Health Information Technology (HIT), Patient-Centered Healthcare
Zikmund-Fisher BJ, Scherer AM, Witteman HO
Graphics help patients distinguish between urgent and non-urgent deviations in laboratory test results.
Most electronic health record systems provide laboratory test results to patients in table format. Researchers tested whether presenting such results in visual displays (number lines) could improve understanding. They found that visual displays reduced respondents' perceived urgency and desire to contact health care providers immediately for near-normal test results compared to tables but did not affect their perceptions of extreme values.
AHRQ-funded; HS021681.
Citation: Zikmund-Fisher BJ, Scherer AM, Witteman HO .
Graphics help patients distinguish between urgent and non-urgent deviations in laboratory test results.
J Am Med Inform Assoc 2017 May 1;24(3):520-28. doi: 10.1093/jamia/ocw169.
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Keywords: Communication, Education: Patient and Caregiver, Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT)
LeRouge C, Hasselquist MB, Kellogg L
Using heuristic evaluation to enhance the visual display of a provider dashboard for patient-reported outcomes.
A human-centered design (HCD) approach to understanding the data visualization needs for patient-reported outcomes (PRO) in clinical practice can optimize the visual design of an interactive PRO system. Beyond iterative methods, the authors explored the additive value of other HCD methods such as heuristic evaluation. Their evaluation led to several recommendations to improve the display, accessibility, and interpretability of the dashboard’s data.
AHRQ-funded; HS023785.
Citation: LeRouge C, Hasselquist MB, Kellogg L .
Using heuristic evaluation to enhance the visual display of a provider dashboard for patient-reported outcomes.
eGEMS 2017 Apr 20;5(2):Article 6. doi: 10.13063/2327-9214.1283.
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Keywords: Patient-Centered Healthcare, Patient-Centered Outcomes Research, Health Information Technology (HIT), Data, Shared Decision Making
Zheng H, Tulu B, Choi W
Using mHealth app to support treatment decision-making for knee arthritis: patient perspective.
The authors explored patient preferences on content and design of a mobile health app to facilitate daily symptom capture and summary feedback reporting, in order to inform treatment decisions, including use of total knee replacement surgery (TKR). The authors suggest that user input can inform the design and implementation of mHealth technology to meet patient needs for their treatment decisions. Patient priorities must be considered through patient-centered app design.
AHRQ-funded; HS018910.
Citation: Zheng H, Tulu B, Choi W .
Using mHealth app to support treatment decision-making for knee arthritis: patient perspective.
eGEMS 2017 Apr 20;5(2):7. doi: 10.13063/2327-9214.1284..
Keywords: Arthritis, Shared Decision Making, Health Information Technology (HIT), Surgery
Ancker JS, Edwards A, Nosal S
Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system.
In this study, the investigators tested hypotheses arising from two possible alert fatigue mechanisms: (A) cognitive overload associated with amount of work, complexity of work, and effort distinguishing informative from uninformative alerts, and (B) desensitization from repeated exposure to the same alert over time. The investigators found that clinicians became less likely to accept alerts as they received more of them, particularly more repeated alerts. There was no evidence of an effect of workload per se, or of desensitization over time for a newly deployed alert.
AHRQ-funded; HS021531.
Citation: Ancker JS, Edwards A, Nosal S .
Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system.
BMC Med Inform Decis Mak 2017 Apr 10;17(1):1-9. doi: 10.1186/s12911-017-0430-8..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider, Provider: Nurse, Provider: Physician
Horsky J, Aarts J, Verheul L
Clinical reasoning in the context of active decision support during medication prescribing.
The purpose of this study was to describe and analyze reasoning patterns of clinicians responding to drug-drug interaction alerts in order to understand the role of patient-specific information in the decision-making process about the risks and benefits of medication therapy. The investigators found that declining an alert suggestion was preceded by sometimes brief but often complex reasoning, prioritizing different aspects of care quality and safety, especially when the perceived risk was higher.
AHRQ-funded; HS021094.
Citation: Horsky J, Aarts J, Verheul L .
Clinical reasoning in the context of active decision support during medication prescribing.
Int J Med Inform 2017 Jan;97:1-11. doi: 10.1016/j.ijmedinf.2016.09.004..
Keywords: Adverse Drug Events (ADE), Adverse Events, Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Medication, Patient Safety
Wright A, Sittig DF, Ash JS
Lessons learned from implementing service-oriented clinical decision support at four sites: a qualitative study.
This study identified challenges, lessons learned and best practices for service-oriented clinical decision support, based on the results of the Clinical Decision Support Consortium, a multi-site study which developed, implemented and evaluated clinical decision support services in a diverse range of electronic health records. Based on the challenges and lessons learned, there were eight best practices for developers and implementers of service-oriented clinical decision support.
AHRQ-funded; 290200810010.
Citation: Wright A, Sittig DF, Ash JS .
Lessons learned from implementing service-oriented clinical decision support at four sites: a qualitative study.
Int J Med Inform 2015 Nov;84(11):901-11. doi: 10.1016/j.ijmedinf.2015.08.008.
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Keywords: Clinical Decision Support (CDS), Electronic Health Records (EHRs), Shared Decision Making, Health Information Technology (HIT)
Fumo DE, Kapoor V, Reece LJ
Historical matching strategies in kidney paired donation: the 7-year evolution of a web-based virtual matching system.
Failure to convert computer-identified possible kidney paired donation (KPD) exchanges into transplants has prohibited KPD from reaching its full potential. This study analyzes the progress of exchanges in moving from "offers" to completed transplants. The "offer" and 1-way success rates were 21.9 and 15.5 percent, respectively. Three reasons for failure were found that could be prospectively prevented by changes in protocol or software.
AHRQ-funded; HS020610.
Citation: Fumo DE, Kapoor V, Reece LJ .
Historical matching strategies in kidney paired donation: the 7-year evolution of a web-based virtual matching system.
Am J Transplant 2015 Oct;15(10):2646-54. doi: 10.1111/ajt.13337.
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Keywords: Health Information Technology (HIT), Transplantation, Shared Decision Making, Clinical Decision Support (CDS)
Shorten A, Fagerlin A, Illuzzi J
Developing an Internet-based decision aid for women choosing between vaginal birth after cesarean and planned repeat cesarean.
This article is part of a series that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. The authors outlined a framework and process used to create an Internet-based decision aid about birth choices after previous cesarean. They transformed a paper-based decision aid into a secure, interactive Web site to meet the diverse needs of women and providers.
AHRQ-funded; HS022114.
Citation: Shorten A, Fagerlin A, Illuzzi J .
Developing an Internet-based decision aid for women choosing between vaginal birth after cesarean and planned repeat cesarean.
J Midwifery Womens Health 2015 Jul-Aug;60(4):390-400. doi: 10.1111/jmwh.12298.
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Keywords: Shared Decision Making, Health Information Technology (HIT), Pregnancy, Web-Based, Women
Fiks AG, Mayne SL, Karavite DJ
Parent-reported outcomes of a shared decision-making portal in asthma: a practice-based RCT.
This study evaluated the feasibility, acceptability, and impact of MyAsthma, an EHR-linked patient portal supporting shared decision-making for pediatric asthma. It found that parents of children with moderate to severe persistent asthma used the portal more than others; 92 percent were satisfied with MyAsthma. Parents reported that use improved their communication with the office, ability to manage asthma, and awareness of the importance of ongoing attention to treatment.
AHRQ-funded; HS021645.
Citation: Fiks AG, Mayne SL, Karavite DJ .
Parent-reported outcomes of a shared decision-making portal in asthma: a practice-based RCT.
Pediatrics 2015 Apr;135(4):e965-73. doi: 10.1542/peds.2014-3167..
Keywords: Asthma, Children/Adolescents, Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT)
Burgess JF, Jones EA, Morgan JR
Capsule commentary on Tannenbaum et al., nudging physician prescription decisions by partitioning the order set: results of a vignette-based study.
Users of computerized provider order entry (CPOE)s employ a variety of “shortcuts” to increase efficiency and reduce search costs. The authors comment on a study suggesting that new ordering could be a shortcut for signaling which choices are “common or appropriate”. They argue that future research on inappropriate use should grapple directly with when and why providers employ shortcuts.
AHRQ-funded; HS022242.
Citation: Burgess JF, Jones EA, Morgan JR .
Capsule commentary on Tannenbaum et al., nudging physician prescription decisions by partitioning the order set: results of a vignette-based study.
J Gen Intern Med 2015 Mar;30(3):343. doi: 10.1007/s11606-014-3095-3..
Keywords: Health Information Technology (HIT), Shared Decision Making, Medication
Samwald M, Minarro Gimenez JA, Boyce RD
Pharmacogenomic knowledge representation, reasoning and genome-based clinical decision support based on OWL 2 DL ontologies.
The authors developed Web Ontology Language (OWL) ontologies and automated reasoning methodologies to meet various goals such as providing a simple and concise formalism for representing pharmacogenomic knowledge. Their ontology-based framework can be used to represent, organize and reason over the growing wealth of pharmacogenomic knowledge, as well as to identify errors, inconsistencies and insufficient definitions in source data sets or individual patient data.
AHRQ-funded; HS019461.
Citation: Samwald M, Minarro Gimenez JA, Boyce RD .
Pharmacogenomic knowledge representation, reasoning and genome-based clinical decision support based on OWL 2 DL ontologies.
BMC Med Inform Decis Mak 2015 Feb 22;15:12. doi: 10.1186/s12911-015-0130-1..
Keywords: Comparative Effectiveness, Health Information Technology (HIT), Shared Decision Making, Medication, Genetics
Butler KA, Mercer E, Bahrami A
Model checking for verification of interactive health IT systems.
The authors proposed to formalize the relationship between HIT and the conceptual work that increasingly typifies modern care. They demonstrated the method on a patient contact system to show that model checking is effective for interactive systems and that much of it can be automated.
AHRQ-funded; HS021233.
Citation: Butler KA, Mercer E, Bahrami A .
Model checking for verification of interactive health IT systems.
AMIA Annu Symp Proc 2015;2015:349-58.
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Keywords: Shared Decision Making, Health Information Technology (HIT), Health Information Technology (HIT), Patient Safety, Workflow
Heisler M, Choi H, Palmisano G
Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
This study compared outcomes between community health worker (CHW) use of a tailored, interactive, Web-based, tablet computer-delivered tool specifically developed for the study and use of printed educational materials. In a population of low-income Latino and African American adults with diabetes and relatively low levels of formal education, participants in both CHW-led interventions reported mostly similar improvements in outcomes over 3 months.
AHRQ-funded; HS019256
Citation: Heisler M, Choi H, Palmisano G .
Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
Ann Intern Med. 2014 Nov 18;161(10 Suppl):S13-22. doi: 10.7326/m13-3012..
Keywords: Health Information Technology (HIT), Diabetes, Shared Decision Making, Outcomes, Social Determinants of Health
Lacson R, Prevedello LM, Andriole KP
Four-year impact of an alert notification system on closed-loop communication of critical test results.
The authors evaluated the impact of an alert notification system on policy adherence for communicating critical imaging test results to referring providers and assessed system adoption over the first 4 years after implementation. They concluded that an automated alert notification system for communicating critical imaging results was successfully adopted and was associated with increased adherence to institutional policy for communicating critical test results and with reduced workflow interruptions.
AHRQ-funded; HS019635.
Citation: Lacson R, Prevedello LM, Andriole KP .
Four-year impact of an alert notification system on closed-loop communication of critical test results.
AJR Am J Roentgenol 2014 Nov;203(5):933-8. doi: 10.2214/ajr.14.13064.
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Keywords: Communication, Shared Decision Making, Guidelines, Health Information Technology (HIT), Imaging
Welch BM, Eilbeck K, Del Fiol G
Technical desiderata for the integration of genomic data with clinical decision support.
The objective of this study is to develop and validate a guiding set of technical desiderata for supporting the clinical use of the whole genome sequence (WGS) through clinical decision support (CDS). A panel of domain experts in genomics and CDS developed a proposed set of seven additional requirements. These additional desiderata provide important guiding principles for the technical development of CDS capabilities for the clinical use of WGS information.
AHRQ-funded; HS018352.
Citation: Welch BM, Eilbeck K, Del Fiol G .
Technical desiderata for the integration of genomic data with clinical decision support.
J Biomed Inform 2014 Oct;51:3-7. doi: 10.1016/j.jbi.2014.05.014..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Genetics, Electronic Health Records (EHRs), Shared Decision Making
Longo DR, Woolf HS
Rethinking the information priorities of patients.
Efforts have intensified to provide consumers with online data tools and consumer reports that offer profiles and statistics for evaluating specialists, hospitals, and other clinical facilities. In this article, the authors examine two key questions: what should these resources look like and do patients really want them?
AHRQ-funded; HS021902
Citation: Longo DR, Woolf HS .
Rethinking the information priorities of patients.
JAMA. 2014 May 14;311(18):1857-8. doi: 10.1001/jama.2014.3038..
Keywords: Education: Patient and Caregiver, Shared Decision Making, Quality of Care, Health Information Technology (HIT), Web-Based
Del Fiol G, Workman TE, Gorman PN
Clinical questions raised by clinicians at the point of care: a systematic review.
The researchers conducted a systematic review of studies examining the questions that clinicians raise in the context of patient care decisionmaking. They concluded that clinicians frequently raise questions about patient care in their practice. Although they are effective at finding answers to questions they pursue, roughly half of the questions are never pursued.
AHRQ-funded; HS018352.
Citation: Del Fiol G, Workman TE, Gorman PN .
Clinical questions raised by clinicians at the point of care: a systematic review.
JAMA Intern Med. 2014 May;174(5):710-8. doi: 10.1001/jamainternmed.2014.368..
Keywords: Education: Patient and Caregiver, Shared Decision Making, Health Information Exchange (HIE), Health Information Technology (HIT), Practice Patterns
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care