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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 278 Research Studies DisplayedNorton WE, Zwarenstein M, Czajkowski S
AHRQ Author: Kato E
Building internal capacity in pragmatic trials: a workshop for program scientists at the US National Cancer Institute.
This article describes a workshop put together by the authors for program scientists at the National Cancer Institute (NCI) to help them become better researchers and stewards of research funds. The workshop got good reviews from the attendees and many felt it will help them develop funding opportunities and advise grantees.
AHRQ-authored.
Citation: Norton WE, Zwarenstein M, Czajkowski S .
Building internal capacity in pragmatic trials: a workshop for program scientists at the US National Cancer Institute.
Trials 2019 Dec 27;20(1):779. doi: 10.1186/s13063-019-3934-y..
Keywords: Research Methodologies, Health Services Research (HSR), Cancer, Healthcare Delivery
Tracer H, Sanou A
AHRQ Author: Tracer H
Screening for pancreatic cancer.
This “Putting Prevention into Practice: An Evidence Based Approach” case study, is based on the U.S. Preventive Services Task Force (USPSTF) recommendation for pancreatic cancer screening. It describes a patient scenario and poses questions.
AHRQ-authored.
Citation: Tracer H, Sanou A .
Screening for pancreatic cancer.
Am Fam Physician 2019 Dec 15;100(12):771-72..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Prevention, Cancer, Case Study, Primary Care
Xu X, Lin H, Wright JD
Association between power morcellation and mortality in women with unexpected uterine cancer undergoing hysterectomy or myomectomy.
Despite concerns that power morcellation may adversely affect prognosis of patients with occult uterine cancer, empirical evidence has been limited and inconclusive. In this study, the investigators aimed to determine whether uncontained power morcellation at the time of hysterectomy or myomectomy was associated with increased mortality risk in women with occult uterine cancer.
AHRQ-funded; HS024702.
Citation: Xu X, Lin H, Wright JD .
Association between power morcellation and mortality in women with unexpected uterine cancer undergoing hysterectomy or myomectomy.
J Clin Oncol 2019 Dec 10;37(35):3412-24. doi: 10.1200/jco.19.00562..
Keywords: Cancer, Mortality, Women, Surgery, Risk, Adverse Events
Aneja S, Chang E, Omuro A
Applications of artificial intelligence in neuro-oncology.
This article explores the promise that artificial intelligence algorithms has for improving understanding of brain tumors and help drive future innovations in neuro-oncology.
AHRQ-funded; HS023000.
Citation: Aneja S, Chang E, Omuro A .
Applications of artificial intelligence in neuro-oncology.
Curr Opin Neurol 2019 Dec;32(6):850-56. doi: 10.1097/wco.0000000000000761.
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Keywords: Health Information Technology (HIT), Cancer, Diagnostic Safety and Quality, Imaging
Chapman CH, Caram MEV, Radhakrishnan A
Association between PSA values and surveillance quality after prostate cancer surgery.
This study examined the association between PSA values and posttreatment surveillance after prostate cancer surgery. Normally the treatment cutoff rate is 0.2 ng/mL but 4.0 ng/mL may be more appropriate. Data from the US Veterans Health Administration was used to perform a retrospective longitudinal cohort study for men diagnosed with nonmetastatic prostate cancer from 2005 to 2008 who underwent radical prostatectomy. Guideline concordance was high at year 1 (95%) but decreased to 79% in year 7. After adjustment, guideline concordance was lowered for the youngest and oldest, Black, and unmarried men.
AHRQ-funded; HS018726.
Citation: Chapman CH, Caram MEV, Radhakrishnan A .
Association between PSA values and surveillance quality after prostate cancer surgery.
Cancer Med 2019 Dec;8(18):7903-12. doi: 10.1002/cam4.2663..
Keywords: Cancer: Prostate Cancer, Cancer, Surgery, Screening, Guidelines, Prevention, Evidence-Based Practice
Sheetz KH, Dimick JB, Nathan H
Centralization of high-risk cancer surgery within existing hospital systems.
Centralization is often proposed as a strategy to improve the quality of certain high-risk health care services. In this study, the investigators evaluated the extent to which existing hospital systems centralize high-risk cancer surgery and whether centralization is associated with short-term clinical outcomes. The investigators concluded that greater centralization of complex cancer surgery within existing hospital systems was associated with better outcomes.
AHRQ-funded; HS023597.
Citation: Sheetz KH, Dimick JB, Nathan H .
Centralization of high-risk cancer surgery within existing hospital systems.
J Clin Oncol 2019 Dec 1;37(34):3234-42. doi: 10.1200/jco.18.02035..
Keywords: Surgery, Cancer, Risk, Hospitals, Health Systems, Quality Improvement, Quality Indicators (QIs), Quality of Care, Outcomes
Hassmiller Lich K, O'Leary MC, Nambiar S
Estimating the impact of insurance expansion on colorectal cancer and related costs in North Carolina: a population-level simulation analysis.
Researchers used microsimulation to estimate the health and financial effects of insurance expansion and reduction scenarios in North Carolina (NC) for colorectal cancer screening (CRC). The full lifetime of a simulated population of residents age-eligible for CRC screening (aged 50-75) during a 5-year period were simulated. Findings indicate that the estimated cost savings--balancing increased CRC screening/testing costs against decreased cancer treatment costs--were approximately $30 M and $970 M for Medicaid expansion and Medicare-for-all scenarios, respectively, compared to status quo. The researchers concluded that insurance expansion will likely improve CRC screening both overall and in underserved populations while saving money, with the largest savings realized by Medicare.
AHRQ-funded; HS022981.
Citation: Hassmiller Lich K, O'Leary MC, Nambiar S .
Estimating the impact of insurance expansion on colorectal cancer and related costs in North Carolina: a population-level simulation analysis.
Prev Med 2019 Dec;129s:105847. doi: 10.1016/j.ypmed.2019.105847..
Keywords: Health Insurance, Cancer: Colorectal Cancer, Cancer, Healthcare Costs, Screening, Prevention, Medicaid, Medicare, Policy, Access to Care
Fuzesi S, Becetti K, Klassen AF
Expectations of breast-conserving therapy: a qualitative study.
The goal of this study was to describe expectations of breast-conserving therapy (BCT) among patients with early breast cancer and aimed to inform preoperative patient education and improve the patient experience through knowledge. The researchers identified themes related to patient expectations of BCT and found that patients had a clear knowledge gap regarding BCT. This data may be used to enhance preoperative discussions aimed at preparing patients for surgery and treatment.
AHRQ-funded; T32HS00066.
Citation: Fuzesi S, Becetti K, Klassen AF .
Expectations of breast-conserving therapy: a qualitative study.
J Patient Rep Outcomes 2019 Dec 27;3(1):73. doi: 10.1186/s41687-019-0167-5..
Keywords: Cancer: Breast Cancer, Cancer, Education: Patient and Caregiver, Surgery
Esfandiari NH, Hughes DT, Reyes-Gastelum D
Factors associated with diagnosis and treatment of thyroid microcarcinomas.
The authors sought to determine diagnostic pathways for microcarcinomas versus larger cancers. Surveying patients from the Georgia and Los Angeles Surveillance, Epidemiology, and End Results (SEER) registries with differentiated thyroid cancer, they found that thyroid microcarcinomas are more likely to be detected by ultrasound and less likely to be associated with surgery scheduled for known thyroid cancer. They concluded that understanding diagnostic pathways allows for targeted interventions to decrease overdiagnosis and overtreatment.
AHRQ-funded; HS024512.
Citation: Esfandiari NH, Hughes DT, Reyes-Gastelum D .
Factors associated with diagnosis and treatment of thyroid microcarcinomas.
J Clin Endocrinol Metab 2019 Dec;104(12):6060-68. doi: 10.1210/jc.2019-01219..
Keywords: Cancer, Diagnostic Safety and Quality
Wong MS, Arnold CM, Roberts ET
The relationship between federal housing assistance and uptake of cancer screening among low-income adults.
The primary aim of this study was to examine the relationship between participation in federal housing assistance programs and self-reported cancer screening among low-income adults. The investigators concluded that their results reinforced the need to improve rates of screening and suggested that providing housing assistance, in and of itself, may be insufficient to overcome the multiple access barriers that low-income populations face.
AHRQ-funded; HS000029.
Citation: Wong MS, Arnold CM, Roberts ET .
The relationship between federal housing assistance and uptake of cancer screening among low-income adults.
J Gen Intern Med 2019 Dec;34(12):2714-16. doi: 10.1007/s11606-019-05037-z..
Keywords: Cancer, Screening, Low-Income, Vulnerable Populations, Access to Care, Healthcare Utilization, Social Determinants of Health
Wang S, Lai S, von Itzstein MS
Type and case volume of health care facility influences survival and surgery selection in cases with early-stage non-small cell lung cancer.
With the expansion of non-small cell lung cancer (NSCLC) screening methods, the percentage of cases with early-stage NSCLC is anticipated to increase. Yet it remains unclear how the type and case volume of the health care facility at which treatment occurs may affect surgery selection and overall survival for cases with early-stage NSCLC. In this study, the investigators examine how type and case volume of health care facility influenced survival and surgery selection in cases with early-stage non-small cell lung cancer.
AHRQ-funded; HS022418.
Citation: Wang S, Lai S, von Itzstein MS .
Type and case volume of health care facility influences survival and surgery selection in cases with early-stage non-small cell lung cancer.
Cancer 2019 Dec 1;125(23):4252-59. doi: 10.1002/cncr.32377..
Keywords: Cancer: Lung Cancer, Surgery, Cancer, Patient-Centered Outcomes Research, Outcomes, Mortality
Rhodes RL, Ukoha NCE, Williams KA
Understanding underuse of advance care planning among a cohort of African American patients with advanced cancer: formative research that examines gaps in intent to discuss options for care.
Advance care planning (ACP), palliative care (PC), and hospice are often underutilized by African Americans. This study assessed the impact of stage of intent to discuss ACP options as key potential barriers. The investigators concluded that despite being hospitalized with advanced cancer and having poor prognosis, intent to discuss ACP options, PC, and hospice in this population was variable, and completion of these activities was low.
AHRQ-funded; HS022418.
Citation: Rhodes RL, Ukoha NCE, Williams KA .
Understanding underuse of advance care planning among a cohort of African American patients with advanced cancer: formative research that examines gaps in intent to discuss options for care.
Am J Hosp Palliat Care 2019 Dec;36(12):1057-62. doi: 10.1177/1049909119843276..
Keywords: Cancer, Palliative Care, Patient-Centered Healthcare, Racial and Ethnic Minorities
Evensen CT, Yost KJ, Keller S
Development and testing of the CAHPS Cancer Care Survey.
In order to develop the CAHPS Cancer Care Survey instrument, the authors conducted cognitive tests of the instrument as well as field tests at six cancer centers and four community oncology practices; the survey was then finalized and obtained the CAHPS trademark. The authors recommend mail-only, mail-telephone mixed-mode, and Web-mail mixed-mode data collection methods.
AHRQ-funded; 290200600019I.
Citation: Evensen CT, Yost KJ, Keller S .
Development and testing of the CAHPS Cancer Care Survey.
J Oncol Pract 2019 Nov;15(11):e969-e78. doi: 10.1200/jop.19.00039..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Cancer, Patient Experience, Quality of Care
Montgomery KB, Holder AM, Burgan CM
Is it time for synoptic reporting in melanoma nodal surveillance ultrasonography?
Previous qualitative research has identified a potential gap between surgeons’ and radiologists’ awareness of Second Multicenter Selective Lymphadenectomy Trial (MSLT-II) criteria. The purpose of this study was to explore how these criteria have been adopted and reported outside of clinical trial settings or utilized by surgical teams when interpreting ultrasound results. The study found that of the 269 nodal ultrasounds performed in 78 patients, 81.0% reported normal findings versus 19% abnormal findings. Researchers indicated that only 15% of normal ultrasounds had one or more MSLT-II criteria reported versus 88.9% abnormal ultrasounds. While 37% of abnormal ultrasounds had only one MSLT-II criterion reported, 27.8% had two criteria and 24.1% had three criteria. Of the eight abnormal ultrasounds with biopsy recommendation, 75% had two or more MSLT-II criteria reported. Clinically actionable recommendations were provided in 94.9% of normal ultrasounds compared with 64.8% of abnormal ultrasounds.
AHRQ-funded; HS013852.
Citation: Montgomery KB, Holder AM, Burgan CM .
Is it time for synoptic reporting in melanoma nodal surveillance ultrasonography?
Ann Surg Oncol 2023 Sep; 30(9):5327-28. doi: 10.1245/s10434-023-13749-0..
Keywords: Cancer: Skin Cancer, Cancer, Skin Conditions, Imaging
Parsons HM, Forte ML, Abdi HI
Nutrition as prevention for improved cancer health outcomes: a systematic literature review.
This systematic review examined evidence for the effectiveness of providing nutritional interventions before or during cancer therapy to improve cancer treatment outcomes. The studies examined focused primarily on non-vitamin/mineral dietary supplements, nutrition support, and route or timing of inpatient nutrition interventions for patients with gastrointestinal or head and neck cancer; most of the studies evaluated changes in body weight, adverse events from cancer treatment, length of hospital stay, or quality of life. While studies with low- or medium risk-of-bias reported mixed results on the effect of nutritional interventions, the authors concluded that the methodological limitations impair the translation of study findings into clinical practice or guidelines.
AHRQ-funded; 75Q80120D00008.
Citation: Parsons HM, Forte ML, Abdi HI .
Nutrition as prevention for improved cancer health outcomes: a systematic literature review.
JNCI Cancer Spectr 2023 May 2; 7(3):pkad035. doi: 10.1093/jncics/pkad035..
Keywords: Nutrition, Cancer, Prevention, Quality of Life, Evidence-Based Practice, Patient-Centered Outcomes Research
Papaleontiou M, Chen DW, Banerjee M
Thyrotropin suppression for papillary thyroid cancer: a physician survey study.
AHRQ-funded; HS024512.
Citation: Papaleontiou M, Chen DW, Banerjee M .
Thyrotropin suppression for papillary thyroid cancer: a physician survey study.
Thyroid 2021 Sep;31(9):1383-90. doi: 10.1089/thy.2021.0033..
Keywords: Cancer, Diagnostic Safety and Quality
Ellis RJ, Zhang LM, Ko CY
Variation in hospital utilization of minimally invasive distal pancreatectomy for localized pancreatic neoplasms.
The objectives of this study were to identify factors associated with use of minimally invasive distal pancreatectomy (MIDP) for localized neoplasms and to assess hospital variation in MIDP utilization. Results showed that utilization of MIDP for localized pancreatic neoplasms is highly variable; while some patient-level factors are associated with MIDP use, hospital adoption of MIDP appears to be the primary driver of utilization. Monitoring hospital-level use of MIDP may be a useful quality measure to monitor uptake of emerging techniques in pancreatic surgery.
AHRQ-funded; HS026385; HS000078.
Citation: Ellis RJ, Zhang LM, Ko CY .
Variation in hospital utilization of minimally invasive distal pancreatectomy for localized pancreatic neoplasms.
J Gastrointest Surg 2020 Dec;24(12):2780-88. doi: 10.1007/s11605-019-04414-7..
Keywords: Cancer, Surgery, Hospitals, Quality of Care
Sheetz KH, Chhabra KR, Smith ME
Association of discretionary hospital volume standards for high-risk cancer surgery with patient outcomes and access, 2005-2016.
Various clinical societies and patient advocacy organizations continue to encourage minimum volume standards at hospitals that perform certain high-risk operations. Although many clinicians and quality and safety experts believe this can improve outcomes, the extent to which hospitals have responded to these discretionary standards remains unclear. The purpose of this study was to evaluate the association between short-term clinical outcomes and hospitals' adherence to the Leapfrog Group's minimum volume standards for high-risk cancer surgery.
AHRQ-funded; HS000053; HS023597; HS024763.
Citation: Sheetz KH, Chhabra KR, Smith ME .
Association of discretionary hospital volume standards for high-risk cancer surgery with patient outcomes and access, 2005-2016.
JAMA Surg 2019 Nov;154(11):1005-12. doi: 10.1001/jamasurg.2019.3017..
Keywords: Patient Safety, Hospitals, Outcomes, Surgery, Cancer
Cole AL, Jazowski SA, Dusetzina SB
Initiation of generic imatinib may improve medication adherence for patients with chronic myeloid leukemia.
Investigators compared adherence to tyrosine kinase inhibitors (TKIs) between patients with chronic myeloid leukemia (CML) who initiated branded or generic imatinib using MarketScan commercial claims data. They found that patients initiating generic imatinib achieved clinically significant improvements in adherence to TKI therapy relative to branded drug users, presumably due to lower out-of-pocket costs. Given the importance of optimal adherence in CML, considering barriers to adherence when selecting initial treatment may improve long-term medication adherence.
AHRQ-funded; HS000032.
Citation: Cole AL, Jazowski SA, Dusetzina SB .
Initiation of generic imatinib may improve medication adherence for patients with chronic myeloid leukemia.
Pharmacoepidemiol Drug Saf 2019 Nov;28(11):1529-33. doi: 10.1002/pds.4893..
Keywords: Patient Adherence/Compliance, Medication, Chronic Conditions, Cancer
Murphy CC, Lee SJC, Gerber DE
Patient and provider perspectives on delivery of oral cancer therapies.
Investigators conducted a qualitative study exploring the range of patient and provider perspectives on oral cancer therapies. Through semi-structured interviews with patients and providers at a tertiary referral center and a county safetynet hospital in Dallas, Texas, they found that nearly all providers described challenges engaging with and educating patients about oral cancer therapies. Despite their initial hypothesis, the researchers also found that safetynet patients encountered few barriers accessing oral therapies when compared to patients receiving care in the tertiary referral center.
AHRQ-funded; HS022418.
Citation: Murphy CC, Lee SJC, Gerber DE .
Patient and provider perspectives on delivery of oral cancer therapies.
Patient Educ Couns 2019 Nov;102(11):2102-09. doi: 10.1016/j.pec.2019.06.019..
Keywords: Cancer, Healthcare Delivery, Access to Care, Patient-Centered Outcomes Research, Care Management
Crossnohere NL, Richardson DR, Reinhart C
Side effects from acute myeloid leukemia treatment: results from a national survey.
Acute myeloid leukemia (AML) is experiencing a therapeutic renaissance due to the heightened biomedical understanding of AML and patient-focused drug development (PFDD). Many AML patients now live long-term with the side effects of treatment. This study documents the prevalence and severity of AML treatment-related side effects. This study documents the prevalence and severity of AML treatment-related side effects.
AHRQ-funded; HS000032.
Citation: Crossnohere NL, Richardson DR, Reinhart C .
Side effects from acute myeloid leukemia treatment: results from a national survey.
Curr Med Res Opin 2019 Nov;35(11):1965-70. doi: 10.1080/03007995.2019.1631149..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cancer, Medication, Quality of Life
Mullins BT, Basak R, Broughman JR
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
This study compares the effects of different types of radical prostatectomy and radiotherapy on sexual function. A population-based cohort of 835 men with newly diagnosed prostate cancer from 2011 through 2013 was recruited in collaboration with the Rapid Case Ascertainment system of the North Carolina Central Cancer Registry. They were enrolled prior to treatment and followed retrospectively using the validated Prostate Cancer Symptom Indices (PCSI) instrument. The sexual function scores were compared among patients who received the following treatment types: external-beam RT (EBRT), EBRT with androgen deprivation therapy (ADT), brachytherapy, nerve-sparing radical prostatectomy (RP), and non-nerve-sparing RP. The cohort was surveyed at 24 months post-therapy, and RT alone was found to result in the best preservation of sexual function with brachytherapy, RT with ADT, and nerve-sparing RP yielding similar outcomes. Patients treated with non-nerve-sparing RP experienced the worst sexual function outcome.
AHRQ-funded.
Citation: Mullins BT, Basak R, Broughman JR .
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
Cancer 2019 Oct 15;125(20):3657-65. doi: 10.1002/cncr.32288..
Keywords: Quality of Life, Sexual Health, Surgery, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Cancer: Prostate Cancer, Cancer, Evidence-Based Practice
Kunst NR, Alarid-Escudero F, Paltiel AD
A value of information analysis of research on the 21-gene assay for breast cancer management.
The authors aimed to quantify the value of conducting further research to reduce decision uncertainty in the use of the 21-gene assay Oncotype DX (21-GA). They found that current evidence strongly supports the use of the 21-GA in intermediate- and high-risk women and recommended that further research focus on low-risk women.
AHRQ-funded; HS023900.
Citation: Kunst NR, Alarid-Escudero F, Paltiel AD .
A value of information analysis of research on the 21-gene assay for breast cancer management.
Value Health 2019 Oct;22(10):1102-10. doi: 10.1016/j.jval.2019.05.004..
Keywords: Genetics, Cancer: Breast Cancer, Cancer, Decision Making, Research Methodologies
Chang X, Li HH, Kalet AM
Development and validation of a bayesian network method to detect external beam radiation therapy physician order errors.
This study investigated using a Bayesian network (BN)-based method to detect physician order errors in external beam radiation therapy. The authors extracted data from 4331 total external beam radiation orders written from 2008 to 2017 at their institution of origin. The cohort was divided into 3 groups: single prescription, concurrent boost, and sequential boost. True-positive (TPR) and false-positive (FPR) rates were determined. The investigators saw good results using the BN method.
AHRQ-funded; HS022888.
Citation: Chang X, Li HH, Kalet AM .
Development and validation of a bayesian network method to detect external beam radiation therapy physician order errors.
Int J Radiat Oncol Biol Phys 2019 Oct 1;105(2):423-31. doi: 10.1016/j.ijrobp.2019.05.034..
Keywords: Medical Errors, Patient Safety, Cancer, Treatments
Modi PK, Kaufman SR, Herrel LA
Practice-level adoption of conservative management for prostate cancer.
In this study, the authors describe the longitudinal adoption of conservative management (ie, the absence of treatment) for prostate cancer among urology group practices in the United States and identify group practice features that influence this adoption. The investigators found that there was increasing variation among group practices in the use of conservative management for prostate cancer. They indicated that this underscores the need for a better understanding of practice-level factors that influence prostate cancer management.
AHRQ-funded; HS025707.
Citation: Modi PK, Kaufman SR, Herrel LA .
Practice-level adoption of conservative management for prostate cancer.
J Oncol Pract 2019 Oct;15(10):e863-e69. doi: 10.1200/jop.19.00088.
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Keywords: Cancer: Prostate Cancer, Cancer, Practice Patterns, Care Management