National Healthcare Quality and Disparities Report
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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 25 of 65 Research Studies DisplayedNadpara P, Madhavan SS, Tworek C
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study.
This study evaluated the variations in guideline-concordant timely lung cancer care and prognosis among elderly in the US. It found that the time to diagnosis and treatment varied significantly among the elderly. However, 77.5 percent received guideline-concordant timely lung cancer care. The likelihood of receiving timely care significantly decreased with early stage diagnosis, increasing age, non-white race, higher comorbidity score, and lower income.
AHRQ-funded; HS018622.
Citation: Nadpara P, Madhavan SS, Tworek C .
Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: a population-based study.
Cancer Epidemiol 2015 Dec;39(6):1136-44. doi: 10.1016/j.canep.2015.06.005.
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Keywords: Cancer: Lung Cancer, Elderly, Guidelines, Disparities, Diagnostic Safety and Quality
Probst MA, Dayan PS, Raja AS
Knowledge translation and barriers to imaging optimization in the emergency department: a research agenda.
This article outlines a research agenda to promote the dissemination and implementation (also known as knowledge translation) of evidence-based interventions for emergency department (ED) imaging, i.e., clinical pathways, clinical decision instruments, and clinical practice guidelines. A multidisciplinary group of stakeholders held online and telephone discussions over a 6-month period culminating at the 2015 Academic Emergency Medicine consensus conference. They were able to identify four overarching research questions.
AHRQ-funded; HS023498.
Citation: Probst MA, Dayan PS, Raja AS .
Knowledge translation and barriers to imaging optimization in the emergency department: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1455-64. doi: 10.1111/acem.12830.
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Keywords: Emergency Department, Evidence-Based Practice, Health Services Research (HSR), Guidelines, Imaging, Implementation
Dolor RJ, Campbell-Voytal K, Daly J
Practice-based Research Network Research Good Practices (PRGPs): summary of recommendations.
The authors summarized recommendations for improving research processes within practice-based research networks (PBRNs) to ensure research integrity. The result, the PBRN Research Good Practices (PRGPs) document, is organized into four chapters: (1) Building PBRN Infrastructure; (2) Study Development and Implementation; (3) Data Management, and (4) Dissemination Policies.
AHRQ-funded; HS021641; HS021644; HS016713; HS019601.
Citation: Dolor RJ, Campbell-Voytal K, Daly J .
Practice-based Research Network Research Good Practices (PRGPs): summary of recommendations.
Clin Transl Sci 2015 Dec;8(6):638-46. doi: 10.1111/cts.12317.
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Keywords: Guidelines, Practice-Based Research Network (PBRN), Research Methodologies, Implementation
El-Shami K, Oeffinger KC, Erb NL
American Cancer Society colorectal cancer survivorship care guidelines.
Communication and coordination of care between the treating oncologist and the primary care clinician is critical to effectively and efficiently manage the long-term care of colorectal cancer (CRC) survivors. The guidelines in this article are intended to assist primary care clinicians in delivering risk-based health care for CRC survivors who have completed active therapy.
AHRQ-funded; HS020937.
Citation: El-Shami K, Oeffinger KC, Erb NL .
American Cancer Society colorectal cancer survivorship care guidelines.
CA Cancer J Clin 2015 Nov-Dec;65(6):428-55. doi: 10.3322/caac.21286.
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Keywords: Cancer, Cancer: Colorectal Cancer, Care Coordination, Guidelines, Primary Care
Yamada NK, Yaeger KA, Halamek LP
Analysis and classification of errors made by teams during neonatal resuscitation.
This study was performed to determine and characterize common deviations from The Neonatal Resuscitation Program (NRP) algorithm during neonatal resuscitation. It concluded that errors of commission, especially when performing advanced life support interventions such as positive pressure ventilation, intubation, and chest compressions, are common during neonatal resuscitation and are sources of potential harm.
AHRQ-funded; HS012022.
Citation: Yamada NK, Yaeger KA, Halamek LP .
Analysis and classification of errors made by teams during neonatal resuscitation.
Resuscitation 2015 Nov;96:109-13. doi: 10.1016/j.resuscitation.2015.07.048.
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Keywords: Medical Errors, Newborns/Infants, Newborns/Infants, Guidelines
Callaghan BC, Kerber KA, Pace RJ
Headache neuroimaging: routine testing when guidelines recommend against them.
The aim of this article was to determine the patient-level factors associated with headache neuroimaging in outpatient practice. It concluded that neuroimaging is routinely ordered in outpatient headache patients including populations where guidelines specifically recommend against their use (migraines, chronic headaches, no red flags).
AHRQ-funded; HS017690.
Citation: Callaghan BC, Kerber KA, Pace RJ .
Headache neuroimaging: routine testing when guidelines recommend against them.
Cephalalgia 2015 Nov;35(13):1144-52. doi: 10.1177/0333102415572918.
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Keywords: Neurological Disorders, Imaging, Decision Making, Guidelines, Diagnostic Safety and Quality
Kahn B, Freeland Z, Gopal P
Predictors of guideline concordance for surveillance colonoscopy recommendations in patients at a safety-net health system.
The aim of this study was to quantify and identify predictors for guideline-concordant surveillance recommendations after adenoma polypectomy. It found that underuse recommendations were more likely in patients with C3 adenomas; overuse recommendations were more likely in patients with high-grade dysplasia or fair prep quality and less likely in those with piecemeal resection, C3 adenomas, age>65, or Hispanic ethnicity.
AHRQ-funded; HS022418.
Citation: Kahn B, Freeland Z, Gopal P .
Predictors of guideline concordance for surveillance colonoscopy recommendations in patients at a safety-net health system.
Cancer Causes Control 2015 Nov;26(11):1653-60. doi: 10.1007/s10552-015-0661-x..
Keywords: Cancer: Colorectal Cancer, Colonoscopy, Guidelines, Patient Adherence/Compliance, Patient-Centered Outcomes Research
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
Kramer RD, Cooke CR, Liu V
Variation in the contents of sepsis bundles and quality measures. a systematic review.
The researchers sought to determine the degree of agreement on component elements of sepsis bundles and the associated timing goals for completion of each element. They also evaluated the amount of variation between metrics associated with bundles. They found that no bundle included metrics evaluating timeliness or completeness of sepsis recognition. Also, there was a lack of consensus on component elements and timing goals across highly recognized sepsis bundles.
AHRQ-funded; HS020672.
Citation: Kramer RD, Cooke CR, Liu V .
Variation in the contents of sepsis bundles and quality measures. a systematic review.
Ann Am Thorac Soc 2015 Nov;12(11):1676-84. doi: 10.1513/AnnalsATS.201503-163BC.
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Keywords: Sepsis, Mortality, Guidelines, Antimicrobial Stewardship, Outcomes
Huang ES, Davis AM
Glycemic control in older adults with diabetes mellitus.
These comprehensive guidelines emphasize an individualized approach to diabetes care goals and treatment among adults. The glycemic control recommendations suggest a general goal for glycated hemoglobin (HbA1c) in older adults of 7.5 percent to 8.0 percent (level IA evidence). A target HbA1c level between 7.0 percent and 7.5 percent may be appropriate if it can be safely achieved in healthy older adults.
AHRQ-funded; HS018542.
Citation: Huang ES, Davis AM .
Glycemic control in older adults with diabetes mellitus.
JAMA 2015 Oct 13;314(14):1509-10. doi: 10.1001/jama.2015.8345..
Keywords: Diabetes, Guidelines, Patient-Centered Outcomes Research, Elderly, Quality Improvement
Chopra V, Flanders SA, Saint S
The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results from a multispecialty panel using the RAND/UCLA Appropriateness Method.
The authors organized and conducted a multidisciplinary meeting of national and international experts to develop appropriateness criteria for use, care, and management of peripherally inserted central catheters (PICCs) and related ventricular assist devices (VADs) in hospitalized patients. Among the objectives were developing a list of appropriate indications for use of PICCs in relation to other VADs, and defining the appropriateness of practices associated with the insertion and care of PICCs.
AHRQ-funded; HS022835.
Citation: Chopra V, Flanders SA, Saint S .
The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results from a multispecialty panel using the RAND/UCLA Appropriateness Method.
Ann Intern Med 2015 Sep 15;163(6 Suppl):S1-40. doi: 10.7326/m15-0744..
Keywords: Adverse Events, Guidelines, Inpatient Care, Patient Safety
Traino HM, Nonterah CW, Cyrus JW
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
This review will catalogue disparities in the steps to transplantation as well as the barriers and facilitators to completion of each step identified in the extant literature. The results of the review will be used to generate recommendations for future research to improve equity in access to kidney transplantation.
AHRQ-funded; HS018113.
Citation: Traino HM, Nonterah CW, Cyrus JW .
Disparities in the completion of steps to kidney transplantation: protocol for a systematic review.
BMJ Open 2015 Sep 08;5(9):e008677. doi: 10.1136/bmjopen-2015-008677.
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Keywords: Disparities, Transplantation, Kidney Disease and Health, Access to Care, Guidelines
Grossman DC, Elder RW
Aligning the work of two U.S. Task Forces on behavioral counseling recommendations.
This paper highlights the collaboration and alignment between topics and recommendations related to behavioral counseling interventions from the U.S. Preventive Services Task Force (USPSTF) and Community Preventive Services Task Force (CPSTF). It also explores opportunities for greater alignment between the two Task Forces and compares and contrasts the groups and their current approaches to making recommendations that involve behavioral counseling interventions.
AHRQ-funded; 290201000004I.
Citation: Grossman DC, Elder RW .
Aligning the work of two U.S. Task Forces on behavioral counseling recommendations.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S174-83. doi: 10.1016/j.amepre.2015.06.003.
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Keywords: Behavioral Health, Evidence-Based Practice, Guidelines, Health Promotion, U.S. Preventive Services Task Force (USPSTF)
Curry SJ, McNellis RJ
AHRQ Author: McNellis RJ
Behavioral counseling in primary care: perspectives in enhancing the evidence base.
This article introduces a special issue containing eight articles that were written for a behavioral counseling interventions (BCI) Expert Forum convened in November 2013 by the US Preventive Services Task Force. The authors briefly discuss each of the papers. The forum brought together experienced behavioral counseling researchers, senior leaders in NIH and CDC, members of the USPSTF, and senior members of the AHRQ team supporting the USPSTF.
AHRQ-authored.
Citation: Curry SJ, McNellis RJ .
Behavioral counseling in primary care: perspectives in enhancing the evidence base.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S125-8. doi: 10.1016/j.amepre.2015.06.004..
Keywords: Behavioral Health, Evidence-Based Practice, Guidelines, U.S. Preventive Services Task Force (USPSTF)
Curry SJ, Whitlock EP
Behavioral counseling interventions expert forum: overview and primer on U.S. Preventive Services Task Force methods.
In November 2013, the U.S. Preventive Services Task Force convened an expert forum on behavioral counseling interventions. The forum brought together NIH, CDC, and AHRQ leaders, leading behavioral counseling researchers, and members of the U.S. preventive Services Task Force to discuss issues related to optimizing evidence-based behavioral counseling recommendations. This paper provides an overview of the methods used by the Task Force to develop counseling recommendations.
AHRQ-funded; 290201000004I.
Citation: Curry SJ, Whitlock EP .
Behavioral counseling interventions expert forum: overview and primer on U.S. Preventive Services Task Force methods.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S129-37. doi: 10.1016/j.amepre.2015.04.017.
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Keywords: Behavioral Health, Evidence-Based Practice, Guidelines, Prevention, U.S. Preventive Services Task Force (USPSTF)
Moehring RW, Hazen KC, Hawkins MR
Challenges in preparation of cumulative antibiogram reports for community hospitals.
This descriptive cohort study of antibiogram reporting practices included community hospitals enrolled in the Duke Infection Control Outreach Network. Survey respondents’ self-assessment of full or partial compliance with Clinical and Laboratory Standards Institute (CLSI) guidelines was 50 percent and 15 percent, respectively; 33 percent reported uncertainty with CLSI guidelines. Full adherence to CLSI guidelines for hospital antibiograms was uncommon.
AHRQ-funded; HS023866.
Citation: Moehring RW, Hazen KC, Hawkins MR .
Challenges in preparation of cumulative antibiogram reports for community hospitals.
J Clin Microbiol 2015 Sep;53(9):2977-82. doi: 10.1128/jcm.01077-15..
Keywords: Hospitals, Patient Safety, Guidelines
Alcantara C, Klesges LM, Resnicow K
Enhancing the evidence for behavioral counseling: a perspective from the society of behavioral medicine.
The members of the Society of Behavioral Medicine (SBM)-a multidisciplinary scientific organization committed to improving population health through behavior change- review the USPSTF mandate and current recommendations for behavioral counseling interventions and provide a perspective for the future that calls for concerted and coordinated efforts among SBM, USPSTF, and other organizations invested in the rapid and wider uptake of beneficial, feasible, and referable primary care-focused behavioral counseling interventions.
AHRQ-funded; 290201000004I.
Citation: Alcantara C, Klesges LM, Resnicow K .
Enhancing the evidence for behavioral counseling: a perspective from the society of behavioral medicine.
Am J Prev Med 2015 Sep;49(3 Suppl 2):S184-93. doi: 10.1016/j.amepre.2015.05.015.
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Keywords: Behavioral Health, Evidence-Based Practice, Guidelines, Health Promotion, Primary Care, U.S. Preventive Services Task Force (USPSTF)
Mussa FF
Screening for abdominal aortic aneurysm.
Consensus exists across guidelines on one-time screening of elderly men to detect and treat abdominal aortic aneurysm (AAA) larger than 5.5 cm. However, the recommendations regarding other age groups, imaging intervals for small AAAs, inclusion of women, and cost-effectiveness have not been universally adopted. As many countries are considering the initiation of an AAA screening program, this is an overview on the current status of such programs.
AHRQ-funded; HS019473.
Citation: Mussa FF .
Screening for abdominal aortic aneurysm.
J Vasc Surg 2015 Sep;62(3):774-8. doi: 10.1016/j.jvs.2015.05.035..
Keywords: Screening, Evidence-Based Practice, Guidelines
Narayanaswami P, Gronseth G, Dubinsky R
The impact of social media on dissemination and implementation of clinical practice guidelines: a longitudinal observational study.
The researchers’ aim was to develop and evaluate an innovative dissemination strategy by adding social media-based dissemination methods to traditional methods for the clinical practice guidelines (CPGs) “Complementary and alternative medicine in multiple sclerosis.” They found that social media-based dissemination methods did not confer additional benefit over print-, email-, and Internet-based methods in increasing CPG awareness and changing intent in physicians or patients.
AHRQ-funded; HS022004.
Citation: Narayanaswami P, Gronseth G, Dubinsky R .
The impact of social media on dissemination and implementation of clinical practice guidelines: a longitudinal observational study.
J Med Internet Res 2015 Aug 13;17(8):e193. doi: 10.2196/jmir.4414..
Keywords: Communication, Complementary and Alternative Medicine, Evidence-Based Practice, Guidelines, Social Media, Implementation
Wang D, Le XH, Luque AE
Identifying effective approaches for dissemination of clinical evidence--correlation analyses on promotional activities and usage of a guideline-driven interactive case simulation tool in a statewide HIV-HCV-STD clinical education program.
The investigators analyzed correlations between promotional activities and usage of a guideline-driven interactive case simulation tool (ICST) for insomnia screening and treatment in a statewide HIV-HCV-STD clinical education program. They found that promotional activities were strongly correlated with the number of audience as well as the intensity of use of the target resource, with strong correlations identified between the sending of email newsletters and the intensity of resource use by promotion recipients, by new users, and through the most convenient access channel associated with the promotion.
AHRQ-funded; HS022057.
Citation: Wang D, Le XH, Luque AE .
Identifying effective approaches for dissemination of clinical evidence--correlation analyses on promotional activities and usage of a guideline-driven interactive case simulation tool in a statewide HIV-HCV-STD clinical education program.
Stud Health Technol Inform 2015;216:515-9.
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Keywords: Human Immunodeficiency Virus (HIV), Education: Continuing Medical Education, Simulation, Guidelines, Evidence-Based Practice, Health Promotion, Screening, Sleep Problems, Training
Ho T, Dukhovny D, Zupancic JA
Choosing Wisely in newborn medicine: five opportunities to increase value.
This report describes the identification of 5 tests and treatments in newborn medicine. The expert panel achieved consensus on the top 5 items. The first item was to avoid routine use of antireflux medications for treatment of symptomatic gastroesophageal reflux disease or for treatment of apnea and desaturation in preterm infants.
AHRQ-funded; HS000063.
Citation: Ho T, Dukhovny D, Zupancic JA .
Choosing Wisely in newborn medicine: five opportunities to increase value.
Pediatrics 2015 Aug;136(2):e482-9. doi: 10.1542/peds.2015-0737..
Keywords: Newborns/Infants, Prevention, Patient-Centered Outcomes Research, Guidelines
Smith-Bindman R, Moghadassi M, Griffey RT
Computed tomography radiation dose in patients with suspected urolithiasis.
The researchers determined the radiation doses of CT scans for suspected urolithiasis in the emergency department setting. They found that less than 8 percent of patients received appropriately low-dose CT for suspected urolithiasis. Furthermore, they found a 200-fold variation in dose between patients and a 5-fold variation in median dose across hospitals.
AHRQ-funded; HS019312.
Citation: Smith-Bindman R, Moghadassi M, Griffey RT .
Computed tomography radiation dose in patients with suspected urolithiasis.
JAMA Intern Med 2015 Aug;175(8):1413-6. doi: 10.1001/jamainternmed.2015.2697..
Keywords: Emergency Department, Guidelines, Imaging, Emergency Medical Services (EMS)
Morrato EH, Rabin B, Proctor J
Bringing it home: expanding the local reach of dissemination and implementation training via a university-based workshop.
The Colorado Research in Implementation Science Program (CRISP) developed and delivered an introductory D&I workshop adapted from national programs to extend training reach and foster a local learning community for D&I. This paper describes the context of the local training environment, findings from a pre-workshop needs assessment survey, training design and structure, and post-workshop evaluation. Lessons learned may inform others intending to develop local D&I training workshop.
AHRQ-funded; HS021138.
Citation: Morrato EH, Rabin B, Proctor J .
Bringing it home: expanding the local reach of dissemination and implementation training via a university-based workshop.
Implement Sci 2015 Jul 4;10:94. doi: 10.1186/s13012-015-0281-6..
Keywords: Communication, Education: Continuing Medical Education, Evidence-Based Practice, Guidelines, Quality of Care, Quality Improvement, Training, Implementation
Williams DJ, Edwards KM, Self WH
Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines.
The 2011 national guidelines for the management of childhood community-acquired pneumonia (CAP) recommended narrow-spectrum antibiotics (e.g., ampicillin) for most children hospitalized with CAP. The researchers assessed the impact of these guidelines on antibiotic prescribing at 3 children’s hospitals. They found that, after publication of national guidelines, third-generation cephalosporin use declined and penicillin/ampicillin use increased among children hospitalized with CAP.
AHRQ-authored; HS022342.
Citation: Williams DJ, Edwards KM, Self WH .
Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines.
Pediatrics 2015 Jul;136(1):44-52. doi: 10.1542/peds.2014-3047..
Keywords: Children/Adolescents, Hospitalization, Guidelines, Medication, Practice Patterns
Tjia J, Field T, Mazor K
Dissemination of evidence-based antipsychotic prescribing guidelines to nursing homes: a cluster randomized trial.
This study evaluated the effectiveness of efforts to translate and disseminate evidence-based guidelines about atypical antipsychotic use to nursing homes (NHs). It found that RE-AIM indicators suggest some success in disseminating the toolkit and differences in reach, adoption, and implementation according to dissemination strategy but no measurable effect on antipsychotic prescribing trends.
AHRQ-funded; HS019351.
Citation: Tjia J, Field T, Mazor K .
Dissemination of evidence-based antipsychotic prescribing guidelines to nursing homes: a cluster randomized trial.
J Am Geriatr Soc 2015 Jul;63(7):1289-98. doi: 10.1111/jgs.13488..
Keywords: Communication, Evidence-Based Practice, Guidelines, Long-Term Care, Medication, Nursing Homes, Practice Patterns, Tools & Toolkits, Implementation