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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 250 Research Studies DisplayedBateni SB, Gingrich AA, Stewart SL
Hospital utilization and disposition among patients with malignant bowel obstruction: a population-based comparison of surgical to medical management.
In this study, the investigators sought to compare clinically meaningful outcomes in malignant bowel obstruction (MBO) patients treated with surgical versus medical management using population-based data. In this population-based analysis, medical management was associated with less hospital utilization at 30- and 90-days, fewer in-hospital deaths, and more frequent discharges to home. The authors suggest that these data underscore the potential benefits of medical management for MBO patients at the end-of-life.
AHRQ-funded; HS022236.
Citation: Bateni SB, Gingrich AA, Stewart SL .
Hospital utilization and disposition among patients with malignant bowel obstruction: a population-based comparison of surgical to medical management.
BMC Cancer 2018 Nov 26;18(1):1166. doi: 10.1186/s12885-018-5108-9..
Keywords: Cancer, Comparative Effectiveness, Hospitalization, Palliative Care, Patient-Centered Outcomes Research, Surgery
Ancker JS, Stabile C, Carter J
Informing, reassuring, or alarming? Balancing patient needs in the development of a postsurgical symptom reporting system in cancer.
After ambulatory surgeries, patients who recover at home have multiple questions about wound healing, symptoms and medication side effects, and recovery expectations. In this study, the investigators conducted user testing and rapid application development of a symptom reporting system that supports home-based recovery by inviting patients to self-report symptoms in the days after surgery and receive an immediate feedback report giving context for their reported symptoms.
AHRQ-funded; HS021531.
Citation: Ancker JS, Stabile C, Carter J .
Informing, reassuring, or alarming? Balancing patient needs in the development of a postsurgical symptom reporting system in cancer.
AMIA Annu Symp Proc 2018 Dec 5;2018:166-74..
Keywords: Adverse Events, Ambulatory Care and Surgery, Cancer, Education: Patient and Caregiver, Health Information Technology (HIT), Patient Safety, Surgery
Greenzang KA, Cronin AM, Kang TI
Parental distress and desire for information regarding long-term implications of pediatric cancer treatment.
In this study, the authors evaluated parental distress associated with information regarding future limitations, and the extent to which distress is associated with information preferences. The investigators concluded that although information regarding future limitations caused by cancer treatment is upsetting to many parents, the majority of them desire this information, and those who are distressed are more likely to value this information.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Cronin AM, Kang TI .
Parental distress and desire for information regarding long-term implications of pediatric cancer treatment.
Cancer 2018 Dec 1;124(23):4529-37. doi: 10.1002/cncr.31772..
Keywords: Cancer, Caregiving, Children/Adolescents, Communication, Children/Adolescents
Grover S, Desir F, Jing Y
Reduced cancer survival among adults with HIV and AIDS-defining illnesses despite no difference in cancer stage at diagnosis.
A cohort of persons with HIV (PWH) who had AIDS-defining illness (ADI) at the time of cancer diagnosis were compared to those without HIV and ADI with cancer diagnosis at the same stages. Those with ADI had a higher mortality rate (30-70%) with lung cancer statistically significant. This finding is related with HIV-related immune suppression.
AHRQ-funded; 90047713.
Citation: Grover S, Desir F, Jing Y .
Reduced cancer survival among adults with HIV and AIDS-defining illnesses despite no difference in cancer stage at diagnosis.
J Acquir Immune Defic Syndr 2018 Dec 1;79(4):421-29. doi: 10.1097/qai.0000000000001842..
Keywords: Cancer, Diagnostic Safety and Quality, Human Immunodeficiency Virus (HIV), Outcomes
Wang SY, Hsu SH, Huang S
Regional practice patterns and racial/ethnic differences in intensity of end-of-life care.
The purpose of this study was to examine whether regional practice patterns impact racial/ethnic differences in intensity of end-of-life care for cancer decedents. The investigators found that there was greater variation in intensity of end-of-life care among Hispanics, Asians, and whites in high-expenditure hospital referral regions (HRRs) than in low-expenditure HRRs.
AHRQ-funded; HS023900.
Citation: Wang SY, Hsu SH, Huang S .
Regional practice patterns and racial/ethnic differences in intensity of end-of-life care.
Health Serv Res 2018 Dec;53(6):4291-309. doi: 10.1111/1475-6773.12998..
Keywords: Cancer, Palliative Care, Practice Patterns, Racial and Ethnic Minorities
Magrath M, Yang E, Ahn C
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
The goal of this study was to characterize guideline adherence of surveillance recommendations after implementation of an electronic medical record (EMR)-based Colonoscopy Pathology Reporting and Clinical Decision Support System (CoRS). Results showed that an EMR-based CoRS was widely used and significantly improved guideline adherence of surveillance recommendations.
AHRQ-funded; HS022418.
Citation: Magrath M, Yang E, Ahn C .
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
J Natl Compr Canc Netw 2018 Nov;16(11):1321-28. doi: 10.6004/jnccn.2018.7050..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Colonoscopy, Cancer: Colorectal Cancer, Screening, Cancer, Guidelines, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention
Lee CI, Zhu W, Onega TL
The effect of digital breast tomosynthesis adoption on facility-level breast cancer screening volume.
This study examined whether adoption of digital breast tomosynthesis (DBT) was associated with a decrease in screening mammography capacity across Breast Cancer Screening Consortium facilities. Facility characteristics and examination volume data were collected from facilities that adopted DBT from 2011 and 2014. The majority of facilities had no academic affiliation (73%), were nonprofit (80%) and were general radiology practices (66.7%). Monthly screening volumes were slightly higher after the adoption period but otherwise remained relatively stable before and after adoption of DBT.
AHRQ-funded; HS018366.
Citation: Lee CI, Zhu W, Onega TL .
The effect of digital breast tomosynthesis adoption on facility-level breast cancer screening volume.
AJR Am J Roentgenol 2018 Nov;211(5):957-63. doi: 10.2214/ajr.17.19350..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Women
Kenzik KM, Mehta A, Richman JS
Congestive heart failure in older adults diagnosed with follicular lymphoma: a population-based study.
This population-based study examined congestive heart failure in older adults diagnosed with follicular lymphoma. The investigators concluded that patients with follicular lymphoma who were exposed to anthracyclines between the ages of 66 years and 75 years were found to be at an increased risk of new-onset CHF; preexisting hypertension and diabetes appeared to increase this risk.
AHRQ-funded; HS023009.
Citation: Kenzik KM, Mehta A, Richman JS .
Congestive heart failure in older adults diagnosed with follicular lymphoma: a population-based study.
Cancer 2018 Nov 1;124(21):4221-30. doi: 10.1002/cncr.31695..
Keywords: Cancer, Elderly, Heart Disease and Health
Murray KS, Prunty M, Henderson A
Functional status in patients requiring nursing home stay after radical cystectomy.
The objective of this study was to evaluate the ability to perform activities of daily living (ADLs) in patients who required nursing home (NH) care after radical cystectomy (RC), as this surgery can impair patients' ability to perform ADLs in the post-operative period. The investigators found that ADLs, as measured by the Minimum Data Set (MDS)-ADL Long Form score, worsen after RC. They suggest this should be an important part of the risks and benefits conversation with patients, their families, and caregivers.
AHRQ-funded; HS022140.
Citation: Murray KS, Prunty M, Henderson A .
Functional status in patients requiring nursing home stay after radical cystectomy.
Urology 2018 Nov;121:39-43. doi: 10.1016/j.urology.2018.07.030..
Keywords: Cancer, Nursing Homes, Outcomes, Patient-Centered Outcomes Research
Lee SC, Higashi RT, Sanders JM
Effects of program scale-up on time to resolution for patients with abnormal screening mammography results.
Effects of geographic program expansion to rural areas on mammogram screening program outcomes are understudied. The authors of this study sought to determine whether time-to-resolution (TTR) varied significantly by service delivery time period, location, and participant characteristics across 19 North Texas counties.
AHRQ-funded; HS022418.
Citation: Lee SC, Higashi RT, Sanders JM .
Effects of program scale-up on time to resolution for patients with abnormal screening mammography results.
Cancer Causes Control 2018 Oct;29(10):995-1005. doi: 10.1007/s10552-018-1074-4..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Women, Rural Health, Access to Care, Prevention
Modi PK, Kaufman SR, Qi J
National trends in active surveillance for prostate cancer: validation of medicare claims-based algorithms.
This study analyzed the use of active surveillance of low-risk prostate cancer among a wide variety of health care practices. Researchers identified men with prostate cancer from 2012-2014 using a 100% sample of Michigan Medicare data and linked them with the Michigan Urologic Surgery Improvement Collaborative (MUSIC) registry. They analyzed the performance of 8 claims-based algorithms that were used and selected 3 of them to apply to a 20% national Medicare sample. The 3 algorithms were determined to be either the most sensitive, the most specific, and a balanced algorithm incorporating age and comorbidity. They found that use of surveillance for men increased from 2007 to 2014 but there was a large decrease in the rate of prostate cancer diagnosis. The rate of active surveillance either increased or remained stable depending on the algorithm used.
AHRQ-funded; HS025707.
Citation: Modi PK, Kaufman SR, Qi J .
National trends in active surveillance for prostate cancer: validation of medicare claims-based algorithms.
Urology 2018 Oct;120:96-102. doi: 10.1016/j.urology.2018.06.037..
Keywords: Cancer, Cancer: Prostate Cancer, Medicare, Men's Health, Payment
Roydhouse JK, Gutman R, Keating NL
The association of proxy care engagement with proxy reports of patient experience and quality of life.
The purpose of this study was to assess the association of proxy-specific covariates with proxy-reported patient cancer care experience, quality rating, and quality of life. The investigators concluded that collecting data on proxy engagement in care is warranted if proxy responses are used.
AHRQ-funded; HS000011.
Citation: Roydhouse JK, Gutman R, Keating NL .
The association of proxy care engagement with proxy reports of patient experience and quality of life.
Health Serv Res 2018 Oct;53(5):3809-24. doi: 10.1111/1475-6773.12980..
Keywords: Cancer, Patient Experience, Patient and Family Engagement, Quality of Life
Symer MM, Yeo HL
Recent advances in the management of anal cancer.
The incidence of anal cancer is gradually increasing. This article discusses the epidemiology and pathogenesis of anal cancer, and the prevention of human papilloma virus (HPV) infection as an important management principle. Screening recommendations from various sources are reviewed, and the authors note that screening for individuals at risk of anal cancer should include anal cytology and anoscopy. Current treatments and special cases are also reviewed; the authors conclude that treatments such biological therapies, therapeutic vaccination, and immunotherapy are likely to improve outcomes in patients with anal cancer.
AHRQ-funded; HS000066.
Citation: Symer MM, Yeo HL .
Recent advances in the management of anal cancer.
F1000Res 2018 Sep 28;7. doi: 10.12688/f1000research.14518.1..
Keywords: Cancer, Care Management, Diagnostic Safety and Quality, Screening
Skinner D, Franz B, Howard J
The politics of primary care expansion: lessons from cancer survivorship and substance abuse.
The purpose of this study was to understand the perspectives of primary care innovators treating patient populations not traditionally considered to be within the purview of primary care. The authors indicated that their study findings suggested that the politics surrounding entrenched professional identities contributed to barriers faced by conference participants in their efforts to provide innovative care for these nontraditional populations. Specifically, obstacles surfaced in relation to sharing patients across disciplinary boundaries, which resulted in issues of possessiveness, a questioning of provider qualifications, and a lack of interprofessional trust.
AHRQ-funded; HS021287.
Citation: Skinner D, Franz B, Howard J .
The politics of primary care expansion: lessons from cancer survivorship and substance abuse.
J Healthc Manag 2018 Sep-Oct;63(5):323-36. doi: 10.1097/jhm-d-16-00030..
Keywords: Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Cancer, Substance Abuse, Policy, Healthcare Delivery, Organizational Change, Quality of Care
Johnson AM, Spaete JP, Jowell PS
Top ten tips palliative care clinicians should know about interventional symptom management options when caring for patients with gastrointestinal malignancies.
In this article, the researchers brought together a team of interventional gastroenterologists and palliative care experts to collate practical pearls for the types of endoscopic interventions used for symptom management in patients with GI malignancies.
AHRQ-funded; HS023681.
Citation: Johnson AM, Spaete JP, Jowell PS .
Top ten tips palliative care clinicians should know about interventional symptom management options when caring for patients with gastrointestinal malignancies.
J Palliat Med 2018 Sep;21(9):1339-43. doi: 10.1089/jpm.2018.0251..
Keywords: Palliative Care, Education: Continuing Medical Education, Cancer
Lee DJ, Barocas DA, Zhao Z
Contemporary prostate cancer radiation therapy in the United States: patterns of care and compliance with quality measures.
This study measured compliance with quality measures for radiation therapy treatment of prostate cancer. The Comparative Effectiveness Analysis of Surgery and Radiation Study enrolled men who were treated for localized prostate cancer from 2011 and 2012. Medical records were reviewed, and patients completed surveys. Researchers concluded that men who received external beam radiation therapy (EBRT) were treated more appropriately than those treated with brachytherapy (BT). White men were also more likely to receive appropriate treatment than African-American and other minorities.
AHRQ-funded; HS019356; HS022640.
Citation: Lee DJ, Barocas DA, Zhao Z .
Contemporary prostate cancer radiation therapy in the United States: patterns of care and compliance with quality measures.
Pract Radiat Oncol 2018 Sep-Oct;8(5):307-16. doi: 10.1016/j.prro.2018.04.009..
Keywords: Cancer, Cancer: Prostate Cancer, Comparative Effectiveness, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, Practice Patterns, Quality Measures
Predmore Z, Pannikottu J, Sharma R
Factors associated with the overuse of colorectal cancer screening: a systematic review.
The purpose of this systematic review was to examine factors associated with overuse of colorectal cancer (CRC) screening, using studies that were in English, used a U.S. population, and contained original data. The review indicates that overuse of CRC screening was greater in the Northeast/Mid-Atlantic regions and in urban areas, but was lower in academically affiliated centers. The authors conclude that, although the literature supports important overuse of CRC screening, what drives these practices remains unclear and that future research should explore these factors thoroughly.
AHRQ-funded; HS000029.
Citation: Predmore Z, Pannikottu J, Sharma R .
Factors associated with the overuse of colorectal cancer screening: a systematic review.
Am J Med Qual 2018 Sep/Oct;33(5):472-80. doi: 10.1177/1062860618764302..
Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Prevention, Screening
Murff HJ, Roumie CL, Greevy RA
Metformin use and incidence cancer risk: evidence for a selective protective effect against liver cancer.
Several observational studies suggest that metformin reduces incidence cancer risk; however, many of these studies suffer from time-related biases and several cancer outcomes have not been investigated due to small sample sizes. In this large cohort study that accounted for time-related biases, the researchers observed no association between the use of metformin and most cancers; however, they found a strong inverse association between metformin and liver cancer.
AHRQ-funded; 290050042.
Citation: Murff HJ, Roumie CL, Greevy RA .
Metformin use and incidence cancer risk: evidence for a selective protective effect against liver cancer.
Cancer Causes Control 2018 Sep;29(9):823-32. doi: 10.1007/s10552-018-1058-4..
Keywords: Cancer, Medication, Risk
Krishnan N, Li B, Jacobs BL
The fate of radical cystectomy patients after hospital discharge: understanding the black box of the pre-readmission interval.
This study looked at reasons why bladder cancer patients who had undergone radical cystectomy surgery were readmitted to the hospital within 30 days. A retrospective cohort study was conducted for patients from 2005 to 2012. Researchers found that fever or difficulty with eating or maintaining their weight had the highest chance of being readmitted. Patients who had a higher pain tolerance or had noninfectious wounds or urinary concerns were less likely to be readmitted.
AHRQ-funded; HS018726.
Citation: Krishnan N, Li B, Jacobs BL .
The fate of radical cystectomy patients after hospital discharge: understanding the black box of the pre-readmission interval.
Eur Urol Focus 2018 Sep;4(5):711-17. doi: 10.1016/j.euf.2016.07.004..
Keywords: Adverse Events, Cancer, Hospital Discharge, Hospital Readmissions, Surgery
Beg MS, Gupta A, Sher D
Impact of concurrent medication use on pancreatic cancer survival-SEER-Medicare analysis.
Researchers examined the association of several medication classes on pancreatic cancer survival, using data from the Surveillance, Epidemiology, and End Results-Medicare database. They found that the use of beta-blockers, heparin, insulin, and warfarin were associated with improved survival in patients with pancreatic cancer, whereas metformin, thiazolidinedione, statin, and combination therapies were not. The authors recommended additional studies to validate these findings in the clinical setting.
AHRQ-funded; HS022418.
Citation: Beg MS, Gupta A, Sher D .
Impact of concurrent medication use on pancreatic cancer survival-SEER-Medicare analysis.
Impact of concurrent medication use on pancreatic cancer survival-SEER-Medicare analysis..
Keywords: Cancer, Medication, Mortality, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Mian HS, Wildes TM, Fiala MA
Development of a Medicare health outcomes survey deficit-accumulation frailty index and its application to older patients with newly diagnosed multiple myeloma.
JCO Clinical Cancer Informatics 2018; 2):1-13. doi: 10.1200/cci.18.00043.
This study’s objective was to develop a frailty index for older patients and apply it to a subset of patients newly diagnosed with multiple myeloma. The study used the Rockwood Accumulation of Deficits approach for the Medicare Health Outcomes Study (MHOS). Data from over 2 million patients without cancer older than 66 years of age from SEER-MHOS linked databases were compared to the cohort with multiple myeloma. It was found that among patients without cancer, each 10% increase in the frailty index was associated with a 40% increased risk of death. For the multiple myeloma cohort, each 10% increase in the frailty index was associated with a 16% increased risk for death. Median time for overall survival was only 26.8 months for patients considered frail, compared with 43.7 months for those who were not. This frailty index could be used a predictor of overall survival in older multiple myeloma patients.
This study’s objective was to develop a frailty index for older patients and apply it to a subset of patients newly diagnosed with multiple myeloma. The study used the Rockwood Accumulation of Deficits approach for the Medicare Health Outcomes Study (MHOS). Data from over 2 million patients without cancer older than 66 years of age from SEER-MHOS linked databases were compared to the cohort with multiple myeloma. It was found that among patients without cancer, each 10% increase in the frailty index was associated with a 40% increased risk of death. For the multiple myeloma cohort, each 10% increase in the frailty index was associated with a 16% increased risk for death. Median time for overall survival was only 26.8 months for patients considered frail, compared with 43.7 months for those who were not. This frailty index could be used a predictor of overall survival in older multiple myeloma patients.
AHRQ-funded; HS019455.
Citation: Mian HS, Wildes TM, Fiala MA .
Development of a Medicare health outcomes survey deficit-accumulation frailty index and its application to older patients with newly diagnosed multiple myeloma.
JCO Clin Cancer Inform 2018;2. doi: 10.1200/cci.18.00043..
Keywords: Cancer, Diagnostic Safety and Quality, Elderly, Health Status, Medicare
Wolff T, Chevinsky J
AHRQ Author: Wolff T
Behavioral counseling to prevent skin cancer.
This paper presents a case study, along with questions and answers, related to the U.S. Preventive Services Task Force (USPSTF) recommendations for behavioral counseling to prevent skin cancer.
AHRQ-authored.
Citation: Wolff T, Chevinsky J .
Behavioral counseling to prevent skin cancer.
Am Fam Physician 2018 Jul 15;98(2):105-06..
Keywords: Cancer, Cancer: Skin Cancer, Case Study, Prevention, U.S. Preventive Services Task Force (USPSTF)
Davies L, Petitti DB, Martin L
Defining, estimating, and communicating overdiagnosis in cancer screening.
Overdiagnosis represents one harm of too much medicine, but the concept can be confusing. Because the U.S. Preventive Services Task Force (USPSTF) issues screening recommendations aimed largely at healthy persons, it has a particular interest in understanding harms related to screening, especially but not limited to overdiagnosis. In support of the USPSTF, the authors summarize the knowledge and provide guidance on defining, estimating, and communicating overdiagnosis in cancer screening.
AHRQ-funded; 290201200015I; 290201600006C.
Citation: Davies L, Petitti DB, Martin L .
Defining, estimating, and communicating overdiagnosis in cancer screening.
Ann Intern Med 2018 Jul 3;169(1):36-43. doi: 10.7326/m18-0694..
Keywords: Cancer, Communication, Diagnostic Safety and Quality, Screening, U.S. Preventive Services Task Force (USPSTF)
Rhoten BA, Murphy BA, Dietrich MS
Depressive symptoms, social anxiety, and perceived neck function in patients with head and neck cancer.
This study examined the relationships of depressive symptoms and social anxiety with perceived neck function in patients treated for head and neck cancer. Significant associations were found between membership in the neck disability index trajectories and membership in the longitudinal patterns of depressive symptoms and social anxiety. The investigators concluded that impaired physical function and psychological distress are intertwined for patients with head and neck cancer long after completing treatment.
AHRQ-funded; HS022990.
Citation: Rhoten BA, Murphy BA, Dietrich MS .
Depressive symptoms, social anxiety, and perceived neck function in patients with head and neck cancer.
Head Neck 2018 Jul;40(7):1443-52. doi: 10.1002/hed.25129..
Keywords: Anxiety, Cancer, Depression, Behavioral Health
Bateni SB, Canter RJ, Meyers FJ
Palliative care training and decision-making for patients with advanced cancer: a comparison of surgeons and medical physicians.
Surgical decision-making in patients with advanced cancer requires careful thought and deliberation to balance the high risks with the potential palliative benefits. In this study, the investigators sought to compare surgical decision-making and palliative care training among surgeons and medical physicians who commonly treat advanced cancer patients. The investigators concluded that substantial deficiencies in palliative care training persised among surgeons and were associated with more aggressive recommendations for treatment for the selected scenarios presented in patients with advanced cancer.
AHRQ-funded; HS022236.
Citation: Bateni SB, Canter RJ, Meyers FJ .
Palliative care training and decision-making for patients with advanced cancer: a comparison of surgeons and medical physicians.
Surgery 2018 Jul;164(1):77-85. doi: 10.1016/j.surg.2018.01.021..
Keywords: Decision Making, Palliative Care, Cancer, Surgery, Education: Continuing Medical Education, Training