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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- (-) Cancer (17)
- Cancer: Breast Cancer (5)
- Cancer: Colorectal Cancer (1)
- Cancer: Lung Cancer (1)
- Cancer: Skin Cancer (1)
- Chronic Conditions (1)
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- Decision Making (5)
- Diagnostic Safety and Quality (1)
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- (-) Elderly (17)
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- Medication (1)
- Mortality (2)
- Nursing Homes (1)
- Nutrition (1)
- Obesity (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (1)
- Prevention (2)
- Quality of Life (3)
- Racial and Ethnic Minorities (1)
- Risk (1)
- Screening (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 17 of 17 Research Studies DisplayedDalton AF, Golin CE, Morris C
Effect of a patient decision aid on preferences for colorectal cancer screening among older adults: a secondary analysis of a randomized clinical trial.
This research studied the effects of a patient decision aid on preferences for colorectal cancer (CRC) screening among adults aged 76 to 84 years. Participants were recruited from 14 community-based primary care practices who were not up to date with screening and had an appointment within 6 weeks. They were randomized to receive the intervention or control. Among the 424 participants, mean age was 76.8, 248 were women, and 333 were White. There were no statistically significant differences found in patient preferences between the health groups. Additional studies that are appropriately powered were recommended.
AHRQ-funded; HS021133.
Citation: Dalton AF, Golin CE, Morris C .
Effect of a patient decision aid on preferences for colorectal cancer screening among older adults: a secondary analysis of a randomized clinical trial.
JAMA Netw Open 2022 Dec;5(12):e2244982. doi: 10.1001/jamanetworkopen.2022.44982..
Keywords: Elderly, Decision Making, Screening, Cancer: Colorectal Cancer, Cancer
Arora S, Fowler ME, Harmon C
Differences in pretreatment frailty across gastrointestinal cancers in older adults: results from the Cancer and Aging Resilience Evaluation registry.
The purpose of this study was to explore differences in pretreatment frailty between colorectal (CRC), hepatobiliary, and pancreatic cancers. The researchers included adults aged 60 years and higher enrolled in the Cancer and Aging Resilience Evaluation registry. A 44-item Cancer and Aging Resilience Evaluation frailty index was utilized to define frailty, which included geriatric assessment impairments of functional status, cognitive complaints, health-related quality of life, comorbidities, polypharmacy, anxiety, depression, malnutrition, falls, ability to walk one block, and interference in social activities. A total of 505 patients were included in the study: 41.8% with CRC, 35.2% with pancreatic cancer, and 116 23.0% with hepatobiliary cancer. The study found the following prevalence of frailty: 40.6% pancreatic, 34.3% hepatobiliary, and 23.3% CRC. Frailty was linked with higher rates of malnutrition and instrumental activities of daily living impairments in patients with pancreatic cancer and higher number of comorbidities in patients with hepatobiliary cancer. The study concluded that adults aged 60 and over with pancreatic and hepatobiliary cancers are at high-risk of pretreatment frailty.
AHRQ-funded; HS013852.
Citation: Arora S, Fowler ME, Harmon C .
Differences in pretreatment frailty across gastrointestinal cancers in older adults: results from the Cancer and Aging Resilience Evaluation registry.
JCO Oncol Pract 2022 Nov;18(11):e1796-e806. doi: 10.1200/op.22.00270..
Keywords: Elderly, Cancer, Digestive Disease and Health
Ross RL, Rubio K, Rodriguez HP
Mammography and decision aid use for breast cancer screening in older women.
This study examines the association between practice-level decision-aid use and mammography use among older women. Physician practice responses to the 2017/2018 National Survey of Healthcare Organizations and Systems were linked to 2016-17 Medicare fee-for-service beneficiary data from eligible beneficiaries aged 65-74 years. Findings showed that health information technology-enabled automation of mammography reminders and other advanced health information technology functions may support mammography, whereas breast cancer decision aids may reduce patients' propensities to be screened through the alignment of their preferences and screening decision.
AHRQ-funded; HS022241; HS024075.
Citation: Ross RL, Rubio K, Rodriguez HP .
Mammography and decision aid use for breast cancer screening in older women.
Am J Prev Med 2022 Oct;63(4):630-35. doi: 10.1016/j.amepre.2022.04.014..
Keywords: Imaging, Screening, Decision Making, Cancer: Breast Cancer, Women, Prevention, Cancer, Elderly
Jiang Y, Mason M, Cho Y
Tolerance to oral anticancer agent treatment in older adults with cancer: a secondary analysis of data from electronic health records and a pilot study of patient-reported outcomes.
The purpose of this study was to explore the tolerance of capecitabine oral chemotherapy among older adults with cancer and investigate factors associated with related side effects and treatment changes. The researchers combined data from electronic health records and a pilot study of patient-reported outcomes, and found that older adults were more likely to experience fatigue and experienced more severe fatigue and hand-foot syndrome (HFS) than younger adults. The severity of fatigue and HFS were associated with the number of outpatient medications and the duration of treatment respectively. Female sex, breast cancer diagnosis, capecitabine monotherapy, and severe HFS were found to be associated with subsequent dose reductions. The study concluded that older adults were less likely to tolerate capecitabine treatment and had different co-occurring side effects compared to younger adults.
AHRQ-funded; HS027846.
Citation: Jiang Y, Mason M, Cho Y .
Tolerance to oral anticancer agent treatment in older adults with cancer: a secondary analysis of data from electronic health records and a pilot study of patient-reported outcomes.
BMC Cancer 2022 Sep 3;22(1):950. doi: 10.1186/s12885-022-10026-3..
Keywords: Elderly, Cancer, Medication, Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT)
Bredbeck BC, Mott NM, Wang T
Facility-level variation of low-value breast cancer treatments in older women with early-stage breast cancer: analysis of a statewide claims registry.
The goal of this retrospective cohort study was to determine facility-level variation of sentinel lymph node biopsy (SLNB) and adjuvant radiotherapy in older women with early-stage, hormone receptor-positive (HR+) breast cancer who were undergoing breast-conserving surgery (BCS). Researchers used a statewide registry of claims data and included a cohort of women aged 70 or older who were diagnosed with breast cancer and who underwent BCS at 80 hospitals in the Michigan Value Collaborative. They concluded that SLNB and radiotherapy rates remain high with significant variation in utilization at the facility level, and that high utilizers of SLNB are also likely to be high utilizers of radiotherapy.
AHRQ-funded; HS026030.
Citation: Bredbeck BC, Mott NM, Wang T .
Facility-level variation of low-value breast cancer treatments in older women with early-stage breast cancer: analysis of a statewide claims registry.
Ann Surg Oncol 2022 Jul; 29(7):4155-64. doi: 10.1245/s10434-022-11631-z..
Keywords: Cancer: Breast Cancer, Cancer, Elderly, Women
Tsang M, DeBoer RJ, Garrett SB
Decision-making about clinical trial options among older patients with metastatic cancer who have exhausted standard therapies.
The purpose of this study was to examine the potential reasons for and responses to older adults’ under enrollment in phase 1 cancer clinical trials. The researchers conducted 101 in-depth qualitative interviews with 39 adults aged 65 and older with advanced cancer and asked about their experiences with the trials. The data was analyzed to identify the participants’ understanding of clinical research, their perceptions of early phase trials, and their experiences with enrollment in the trials. The study found that participants over the age of 70 were less enthusiastic about participation in clinical trials, although they did not mention age as a limitation to participation. Findings indicated that participation in clinical trials was an interactive, ongoing process, in which older adults relied on their oncologist for guidance and discussion. The researchers concluded that older adults rely on their oncologist to navigate the perceived complexities of phase 1 trial enrollment, and that acknowledgement of those complexities via shared decision-making can help prevent under-enrollment.
AHRQ-funded; HS022241.
Citation: Tsang M, DeBoer RJ, Garrett SB .
Decision-making about clinical trial options among older patients with metastatic cancer who have exhausted standard therapies.
J Geriatr Oncol 2022 Jun;13(5):594-99. doi: 10.1016/j.jgo.2022.01.012..
Keywords: Elderly, Cancer, Decision Making, Quality of Life
Liu MA, Keeney T, Papaila A
Functional status and survival in older nursing home residents with advanced non-small-cell lung cancer: a SEER-Medicare analysis.
The purpose of this study was to examine the association between activities of daily living (ADL) impairment and overall survival in patients 65 and older with advanced non-small-cell lung cancer (NSCLC) receiving care in nursing homes from 2011 to 2015. The researchers examined the association between ADL scores and overall survival among 3,174 patients who received systemic cancer chemotherapy or immunotherapy within 3 months of NSCLC diagnosis; and among patients who did not receive any treatment. The study found that the ADL score was associated with increased risk of death. One standard deviation increase in the ADL score was associated with lower overall survival rate among treated and untreated patients The median overall survival was 3.1 months for patients with an ADL score of less than 14, 2.8 months for patients with an ADL score between 14 and 17, 2.3 months for patients with ADL score between 18-19, and 1.8 months for patients with ADL score of 20+. The researchers concluded that the ADL assessment may be a useful clinical tool in nursing home adults aged 65 and older with advanced non-small-cell lung cancer.
AHRQ-funded; HS000011.
Citation: Liu MA, Keeney T, Papaila A .
Functional status and survival in older nursing home residents with advanced non-small-cell lung cancer: a SEER-Medicare analysis.
JCO Oncol Pract 2022 Jun;18(6):e886-e95. doi: 10.1200/op.21.00460..
Keywords: Elderly, Nursing Homes, Cancer: Lung Cancer, Cancer
Di M, Keeney T, Belanger E
Global risk indicator and therapy for older patients with diffuse large B-cell lymphoma: a population-based study.
The objective of this study was to examine the impact of global risk on treatment selection and outcomes among older home care recipients with diffuse large B-cell lymphoma. Researchers selected patients diagnosed with diffuse large B-cell lymphoma who had pretreatment Outcome and Assessment Information Set (OASIS) evaluations from SEER-Medicare. High-risk patients were less likely to receive chemotherapy and were more likely to experience acute mortality, emergency department visits, hospitalization or intensive care unit admission, and had inferior overall survival rates. The researchers concluded that global risk on the basis of OASIS was easily available and offered a potential way to improve patient selection for curative treatment and institution of preventive measures.
AHRQ-funded; HS000011.
Citation: Di M, Keeney T, Belanger E .
Global risk indicator and therapy for older patients with diffuse large B-cell lymphoma: a population-based study.
JCO Oncol Pract 2022 Mar; 18(3):e383-e402. doi: 10.1200/op.21.00513..
Keywords: Elderly, Cancer, Risk
Dossett LA, Mott NM, Bredbeck BC
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
The purpose of this study was to examine the role that an individual’s maximizing-minimizing trait, an inherent preference for more or less medical care, may influence the preference for low-value care in the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women 70 years of age or higher with early-stage, hormone-receptor positive invasive breast cancer. The researchers recruited women 70 years of age or higher (n=1600) who were maximizers (515), minimizers (550), or neutral (535), and presented them with a hypothetical breast cancer diagnosis and then randomized exposure to one of three follow-up messages. Messages included: 1) maximizer-tailored, 2) minimizer-tailored, or 3) neutral. The study reported that higher maximizing tendency correlated positively with electing both SLNB and radiotherapy on logistic regression. Any maximizer- or minimizer-tailoring decreased preference for SLNB in maximizing and neutral women but had no effect in minimizing women. Tailoring had no impact on radiotherapy decision, except for an increased probability of minimizers electing radiotherapy when presented with maximizer-tailored messaging. The study concluded that among women facing a hypothetical breast cancer diagnosis, tendencies for maximizing-minimizing are correlated with preferences for treatment.
AHRQ-funded; HS026030.
Citation: Dossett LA, Mott NM, Bredbeck BC .
Using tailored messages to target overuse of Low-Value breast cancer care in older women.
J Surg Res 2022 Feb;270:503-12. doi: 10.1016/j.jss.2021.10.005..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Decision Making, Clinician-Patient Communication, Communication
Kenzik KM, Morey MC, Cohen HJ
Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors.
This study examined how overweight long-term survivors’ symptom severity associated with comorbidity prior to a diet and exercise intervention was associated with post-intervention function. It found that symptom severity of older, overweight cancer survivors negatively affects physical function. However, greater weight loss and more physical activity were associated with higher functioning scores, regardless of symptom severity.
AHRQ-funded; HS013852.
Citation: Kenzik KM, Morey MC, Cohen HJ .
Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors.
J Geriatr Oncol 2015 Nov;6(6):424-32. doi: 10.1016/j.jgo.2015.08.004..
Keywords: Cancer, Elderly, Obesity, Nutrition
Ning J, Peng S, Ueno N
Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?
The researchers evaluated factors associated with overall, breast cancer-specific and other-cause mortalities using contemporary population data. They concluded that breast cancer-specific mortality among older women modestly improved from 2002 to 2009 across all races, but not other-cause mortality. Racial disparity in mortality persisted, but did not widen in this period.
AHRQ-funded; HS002026.
Citation: Ning J, Peng S, Ueno N .
Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?
Ann Oncol 2015 Oct;26(10):2161-8. doi: 10.1093/annonc/mdv330.
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Keywords: Cancer, Cancer: Breast Cancer, Elderly, Mortality, Racial and Ethnic Minorities
Vemana G, Vetter J, Chen L
Sources of variation in follow-up expenditure after radical cystectomy.
Follow-up care after radical cystectomy is poorly defined, with extensive variation in practice patterns. The researchers sought to determine sources of these variations in care as well as examine the economic effect of standardization of care on guideline-recommended care. The most variation in expenditure on follow-up care was at the patient level, largely based on node positivity, chemotherapy status, and final cancer stage.
AHRQ-funded; HS019455.
Citation: Vemana G, Vetter J, Chen L .
Sources of variation in follow-up expenditure after radical cystectomy.
Urol Oncol 2015 Jun;33(6):267.e31-7. doi: 10.1016/j.urolonc.2015.03.009..
Keywords: Cancer, Surgery, Healthcare Costs, Elderly
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
Pergolotti M, Cutchin MP
The Possibilities for Activity Scale (PActS): Development, validity, and reliability.
This study aimed to develop and validate a measure of perceived occupational possibilities: the Possibilities for Activity Scale (PActS). The PActS demonstrated promising internal consistency reliability and construct-related structural and known-groups validity. The PActS appears to be a useful measure of internalized occupational possibilities for participation in activity for older adults with cancer.
AHRQ-funded; HS000032.
Citation: Pergolotti M, Cutchin MP .
The Possibilities for Activity Scale (PActS): Development, validity, and reliability.
Can J Occup Ther 2015 Apr;82(2):85-92..
Keywords: Cancer, Quality of Life, Elderly
Gross CP, Fried TR, Tinetti ME
Decision-making and cancer screening: a qualitative study of older adults with multiple chronic conditions.
The researchers sought to understand how older persons with multiple chronic conditions (MCC) approach decisions about cancer screenings. They found that some older persons with MCC employ heuristics which circumvent the traditional quantitative comparison of risks and benefits, providing an important challenge to informed decision making.
AHRQ-funded; HS018598.
Citation: Gross CP, Fried TR, Tinetti ME .
Decision-making and cancer screening: a qualitative study of older adults with multiple chronic conditions.
J Geriatr Oncol 2015 Mar;6(2):93-100. doi: 10.1016/j.jgo.2014.12.001..
Keywords: Cancer, Chronic Conditions, Decision Making, Elderly, Screening
Vyas A, Madhavan S, Sambamoorthi U
Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.
The objective of this study is to determine the association between persistence with mammography screening and stage at breast cancer (BC) diagnosis among elderly women. It found that, as compared to women who were not persistent with mammography screening, women who were persistent with mammography screening were significantly more likely to be diagnosed at earlier stages of BC.
AHRQ-funded; HS018622.
Citation: Vyas A, Madhavan S, Sambamoorthi U .
Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.
Breast Cancer Res Treat 2014 Dec;148(3):645-54. doi: 10.1007/s10549-014-3204-3..
Keywords: Cancer, Cancer: Breast Cancer, Diagnostic Safety and Quality, Elderly, Prevention, Screening, Women
Arvold ND, Wang Y, Zigler C
Hospitalization burden and survival among older glioblastoma patients.
The researchers performed a retrospective cohort study among patients aged 65 years and older with glioblastoma diagnosed between 1999 and 2007. They found that higher comorbidity score and black race were associated with an increased risk of being hospitalized for at least 25% of remaining life, whereas radiation, temozolomide, and extensive surgery were associated with a decreased risk.
AHRQ-funded; HS021991.
Citation: Arvold ND, Wang Y, Zigler C .
Hospitalization burden and survival among older glioblastoma patients.
Neuro Oncol 2014 Nov;16(11):1530-40. doi: 10.1093/neuonc/nou060.
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Keywords: Cancer, Elderly, Hospitalization, Mortality, Quality of Life