National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Antibiotics (1)
- Anxiety (2)
- Behavioral Health (1)
- Cardiovascular Conditions (2)
- Care Management (1)
- (-) Children/Adolescents (15)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- Critical Care (1)
- Depression (1)
- Diabetes (2)
- (-) Diagnostic Safety and Quality (15)
- Electronic Health Records (EHRs) (2)
- Emergency Medical Services (EMS) (1)
- Genetics (1)
- Guidelines (1)
- Health Information Technology (HIT) (2)
- Heart Disease and Health (2)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Implementation (1)
- Intensive Care Unit (ICU) (2)
- Medical Errors (2)
- Medication (1)
- Obesity (1)
- Obesity: Weight Management (1)
- Patient Safety (2)
- Pneumonia (1)
- Practice Patterns (1)
- Primary Care (1)
- Quality Improvement (2)
- Quality of Care (2)
- Respiratory Conditions (2)
- Screening (2)
- Sepsis (1)
- Sickle Cell Disease (1)
- Skin Conditions (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 15 of 15 Research Studies DisplayedLiu FF, Lew A, Andes E
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
The objective of this study was to share key strategies that led to successful mental health screening (MHS) implementation in one pediatric cystic fibrosis center and to report implementation and screening outcomes. Results showed that leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
AHRQ-funded; HS026393.
Citation: Liu FF, Lew A, Andes E .
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
Pediatr Pulmonol 2020 Dec;55(12):3328-36. doi: 10.1002/ppul.24951..
Keywords: Children/Adolescents, Respiratory Conditions, Chronic Conditions, Depression, Anxiety, Behavioral Health, Screening, Implementation, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Dewan M, O'Halloran A, Kleinman M
eStablish and Formalize Expert Criteria for Avoidable Resuscitation Review (SAFECARR) electronic Delphi: development of a consensus framework for classifying and reviewing cardiac arrests within the PICU.
The authors sought to develop a consensus framework to guide the process of classifying and reviewing pediatric in-hospital cardiac arrest in the PICU. A multidisciplinary group of pediatric resuscitation experts generated a consensus-based framework to classify and review pediatric in-hospital cardiac arrest in the PICU. The authors recommended that future work focus on the application of this framework and further validation of these definitions and contributing factors for in-hospital cardiac arrest both within and outside the PICU.
AHRQ-funded; HS026975.
Citation: Dewan M, O'Halloran A, Kleinman M .
eStablish and Formalize Expert Criteria for Avoidable Resuscitation Review (SAFECARR) electronic Delphi: development of a consensus framework for classifying and reviewing cardiac arrests within the PICU.
Pediatr Crit Care Med 2020 Nov;21(11):992-99. doi: 10.1097/pcc.0000000000002488..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
Dadlez NM, Adelman J, Bundy DG
Contributing factors for pediatric ambulatory diagnostic process errors: Project RedDE.
This study examined root causes of three common pediatric diagnostic errors by having 31 practices enrolled in a national QI collaborative perform monthly “mini-RCAs” (mini root cause analyses). The diagnoses errors studied were missed adolescent depression, missed elevated blood pressure, and missed actionable laboratory values. Twenty-eight practices submitted 184 mini-RCAs with the most common causes being patient volume (adolescent depression and elevated BP), inadequate staffing (adolescent depression), clinic milieu (elevated BP), written communication and provider knowledge (actionable laboratory values), and electronic health records (EHRs) – (elevated BP and actionable laboratory values). The median number of mini-RCAs submitted was 6.
AHRQ-funded; HS024538; HS024713; HS026121.
Citation: Dadlez NM, Adelman J, Bundy DG .
Contributing factors for pediatric ambulatory diagnostic process errors: Project RedDE.
Pediatr Qual Saf 2020 May-Jun;5(3):e299. doi: 10.1097/pq9.0000000000000299..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Quality Improvement, Quality of Care, Medical Errors, Adverse Events, Patient Safety
Cifra CL, Ten Eyck P, Dawson JD
Factors associated with diagnostic error on admission to a PICU: a pilot study.
This pilot retrospective cohort study examined errors in pediatric ICUs (PICUs) for children during the first 12 hours after PICU admission. A structured tool (Safer Dx) was used to identify diagnostic error in an academic tertiary institution. Out of 50 patients, 4 (8%) had diagnostic errors. The errors were in diagnoses of chronic ear infection, intracranial pressure (two cases), and Bartonella encephalitis. This pilot study will be expanded into a larger and more definitive multicenter study.
AHRQ-funded; HS022087.
Citation: Cifra CL, Ten Eyck P, Dawson JD .
Factors associated with diagnostic error on admission to a PICU: a pilot study.
Pediatr Crit Care Med 2020 May;21(5):e311-e15. doi: 10.1097/pcc.0000000000002257..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety, Critical Care, Intensive Care Unit (ICU), Hospitals
Suh TP, Ramachandran D, Patel V
Product of Investigator Global Assessment and Body Surface Area (IGAxBSA): a practice-friendly alternative to the eczema area and severity index to assess atopic dermatitis severity in children.
Accurately documenting pediatric atopic dermatitis (AD) severity is important, but research tools, such as Eczema Area and Severity Index (EASI), are too time consuming for clinical settings. The objective of this study was to evaluate an Investigator Global Assessment and body surface area product (IGA×BSA) as an easy-to-use severity measure for pediatric AD. The investigators concluded that the IGA×BSA (using the vIGA) is a simple measure that correlates well with the EASI in patients with mild to severe pediatric AD.
AHRQ-funded; HS023011.
Citation: Suh TP, Ramachandran D, Patel V .
Product of Investigator Global Assessment and Body Surface Area (IGAxBSA): a practice-friendly alternative to the eczema area and severity index to assess atopic dermatitis severity in children.
J Am Acad Dermatol 2020 May;82(5):1187-94. doi: 10.1016/j.jaad.2020.01.023.
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Keywords: Children/Adolescents, Skin Conditions, Diagnostic Safety and Quality
Reeves SL, Madden B, Wu M
Performance of ICD-10-CM diagnosis codes for identifying children with sickle cell anemia.
The purpose of this study was to develop, test, and validate the performance of ICD-10-CM claims-based case definitions for identifying children with sickle cell anemia (SCA). The investigators concluded that children with SCA could be accurately identified in administrative claims using this straightforward case definition. They asserted that this methodology could be used to monitor trends and use of health services after transition to ICD-10-CM.
AHRQ-funded; HS025292.
Citation: Reeves SL, Madden B, Wu M .
Performance of ICD-10-CM diagnosis codes for identifying children with sickle cell anemia.
Health Serv Res 2020 Apr;55(2):310-17. doi: 10.1111/1475-6773.13257..
Keywords: Children/Adolescents, Sickle Cell Disease, Diagnostic Safety and Quality
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
Johnco CJ, Salloum A, Lewin AB
Refining clinical judgment of treatment response and symptom remission identification in childhood anxiety using a signal detection analysis on the pediatric anxiety rating scale.
The purpose of this study was to determine guidelines for delineating treatment response and symptom remission for children with anxiety disorder based on the five item Pediatric Anxiety Rating Scale (PARS5), and replicate guidelines using the six item PARS (PARS6). Optimal prediction of treatment response based on gold standard criteria was achieved at 15-20 percent reduction in symptoms on the PARS5 (with 20 percent reduction achieving marginally higher accuracy), and 20 percent reduction on the PARS6.
AHRQ-funded; HS018665.
Citation: Johnco CJ, Salloum A, Lewin AB .
Refining clinical judgment of treatment response and symptom remission identification in childhood anxiety using a signal detection analysis on the pediatric anxiety rating scale.
J Child Adolesc Psychopharmacol 2015 Nov;25(9):674-83. doi: 10.1089/cap.2015.0102.
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Keywords: Children/Adolescents, Anxiety, Diagnostic Safety and Quality, Guidelines
Burns KM, Encinosa WE, Pearson GD
AHRQ Author: Encinosa WE
Electrocardiogram in preparticipation athletic evaluations among insured youths.
The researchers retrospectively characterized electrocardiogram (ECG) use among preparticipation history and examinations (PPEs). They found that thirteen percent of PPEs with ECG and 0.5 percent of PPEs alone led to a cardiology referral. After PPEs with ECG, cardiac disease was identified in 18 percent (2 percent sports-limiting); after PPEs alone, cardiac disease was identified in 0.5 percent (0.03 percent sports-limiting).
AHRQ-authored.
Citation: Burns KM, Encinosa WE, Pearson GD .
Electrocardiogram in preparticipation athletic evaluations among insured youths.
J Pediatr 2015 Oct;167(4):804-09.e1. doi: 10.1016/j.jpeds.2015.06.011..
Keywords: Children/Adolescents, Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
Eckerle MD, Namde M, Holland CK
Opportunities for earlier HIV diagnosis in a pediatric ED.
The researchers sought to determine whether there were opportunities for earlier HIV diagnosis in the PED for a cohort of young adults diagnosed with HIV. They concluded that there are opportunities for earlier diagnosis of HIV in PEDs, affirming the importance of HIV screening implementation in these settings. However, PEDs are unlikely to have the same frequency of contact with undiagnosed individuals as do adult EDs.
AHRQ-funded; HS021749.
Citation: Eckerle MD, Namde M, Holland CK .
Opportunities for earlier HIV diagnosis in a pediatric ED.
Am J Emerg Med 2015 Jul;33(7):917-9. doi: 10.1016/j.ajem.2015.04.006..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Screening, Children/Adolescents, Emergency Medical Services (EMS)
Carmody D, Lindauer KL, Naylor RN
Adolescent non-adherence reveals a genetic cause for diabetes.
Glucokinase related maturity-onset diabetes of the young (GCK-MODY) is frequently unrecognized or misdiagnosed as Type 1 or Type 2 diabetes, resulting in unnecessary pharmacologic therapy. The authors recommend considering a genetic cause when evaluating every person with new-onset hyperglycaemia or those with atypical diabetes. Testing costs for the most common MODY causing genes may be offset by savings made in therapeutic costs. They suggest that it is important that all clinicians supervising diabetes care recognize the cardinal features that distinguish GCK-MODY from other forms of diabetes.
AHRQ-funded; HS023007.
Citation: Carmody D, Lindauer KL, Naylor RN .
Adolescent non-adherence reveals a genetic cause for diabetes.
Diabet Med 2015 Jun;32(6):e20-3. doi: 10.1111/dme.12669.
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Keywords: Children/Adolescents, Diabetes, Diagnostic Safety and Quality, Genetics, Medication
Kelly MS, Smieja M, Luinstra K
Association of respiratory viruses with outcomes of severe childhood pneumonia in Botswana.
The authors examined whether detection of respiratory viruses predicts acute lower respiratory tract infection (ALRI) outcomes in low- and middle-income countries. They found that respiratory viruses were detected from most children hospitalized with ALRI in Botswana, but only respiratory syncytial virus (RSV) and human metapneumovirus were more frequent than among children without ALRI. Further, detection of RSV from children with ALRI predicted a protracted illness course but lower mortality compared with non-RSV viruses.
AHRQ-funded; HS020939.
Citation: Kelly MS, Smieja M, Luinstra K .
Association of respiratory viruses with outcomes of severe childhood pneumonia in Botswana.
PLoS One 2015 May 14;10(5):e0126593. doi: 10.1371/journal.pone.0126593.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Pneumonia, Respiratory Conditions
Shaikh U, Berrong J, Nettiksimmons J
Impact of electronic health record clinical decision support on the management of pediatric obesity.
The investigators assessed the impact of electronic health record-based clinical decision support in improving the diagnosis and management of pediatric obesity. They found a statistically significant increase in the diagnosis of overweight/obesity, scheduling of follow-up appointments, frequency of ordering recommended laboratory investigations, and assessment and counseling for nutrition and physical activity.
AHRQ-funded; HS018567.
Citation: Shaikh U, Berrong J, Nettiksimmons J .
Impact of electronic health record clinical decision support on the management of pediatric obesity.
Am J Med Qual 2015 Jan-Feb;30(1):72-80. doi: 10.1177/1062860613517926.
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Keywords: Care Management, Children/Adolescents, Clinical Decision Support (CDS), Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Obesity, Obesity: Weight Management
Fierro JL, Prasad PA, Localio AR
Variability in the diagnosis and treatment of group a streptococcal pharyngitis by primary care pediatricians.
The researchers compared practice patterns regarding the diagnosis and management of streptococcal pharyngitis across 25 pediatric primary care practices sharing an electronic health record. They found that only 18 of 222 clinicians wrote 50 percent of all broad-spectrum antibiotic prescriptions for children with group a streptococcus pharyngitis. They suggested targeted interventions to improve adherence to prescribing guidelines.
AHRQ-funded; 290200710013
Citation: Fierro JL, Prasad PA, Localio AR .
Variability in the diagnosis and treatment of group a streptococcal pharyngitis by primary care pediatricians.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S79-85. doi: 10.1086/677820..
Keywords: Antibiotics, Children/Adolescents, Diagnostic Safety and Quality, Primary Care, Practice Patterns
Lawrence JM, Black MH, Zhang JL
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
The researchers explored the utility of different algorithms for diabetes case identification by using electronic health records. They found that case identification accuracy was highest in 75% of bootstrapped samples for those who had 1 or more outpatient diabetes diagnoses or 1 or more insulin prescriptions and in 25% of samples for those who had 2 or more outpatient diabetes diagnoses and 1 or more antidiabetic medications.
AHRQ-funded; HS019859.
Citation: Lawrence JM, Black MH, Zhang JL .
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
Am J Epidemiol 2014 Jan;179(1):27-38. doi: 10.1093/aje/kwt230..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality