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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 48 Research Studies DisplayedSchmajuk G, Yazdany J
Leveraging the electronic health record to improve quality and safety in rheumatology.
In the coming years, developing and leveraging tools within the electronic health record (EHR) will be the key to making the next big strides in improving the health of patients with rheumatoid arthritis and other rheumatic diseases, including building EHR infrastructure to capture patient outcomes and developing automated methods to retrieve information from free text of clinical notes.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Yazdany J .
Leveraging the electronic health record to improve quality and safety in rheumatology.
Rheumatol Int 2017 Oct;37(10):1603-10. doi: 10.1007/s00296-017-3804-4.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Patient Safety, Quality Improvement, Arthritis
Pellegrini CA, Song J, Semanik PA
Patients less likely to lose weight following a knee replacement: results from the osteoarthritis initiative.
The purpose of this study was to examine weight change patterns preoperatively and postoperatively among overweight/obese knee replacement patients. Overweight and obese patients initially lost weight during the interval including knee replacement; however, they were less likely to lose more than 2.5% of their weight in the 1 to 2 years immediately after the surgery.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Song J, Semanik PA .
Patients less likely to lose weight following a knee replacement: results from the osteoarthritis initiative.
J Clin Rheumatol 2017 Oct;23(7):355-60. doi: 10.1097/rhu.0000000000000579..
Keywords: Obesity: Weight Management, Arthritis, Patient-Centered Outcomes Research, Surgery
Herbert MS, Goodin BR, Bulls HW
Ethnicity, cortisol, and experimental pain responses among persons with symptomatic knee osteoarthritis.
This study aimed to examine the relationship between cortisol and pain responses during a cold-pressor task (CPT) among African American (AA) and non-Hispanic White (NHW) adults with knee osteoarthritis (OA). Consistent with previous findings in young healthy adults, cold-pressor pain responses are related to pre-CPT cortisol concentrations in NHW persons with knee OA but not in their AA counterparts.
AHRQ-funded; HS013852.
Citation: Herbert MS, Goodin BR, Bulls HW .
Ethnicity, cortisol, and experimental pain responses among persons with symptomatic knee osteoarthritis.
Clin J Pain 2017 Sep;33(9):820-26. doi: 10.1097/ajp.0000000000000462.
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Keywords: Arthritis, Pain, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Treatments
Li W, Ayers DC, Lewis CG
Functional gain and pain relief after total joint replacement according to obesity status.
The researchers examined the changes between preoperative and postoperative function and pain in a large representative U.S. cohort to determine if there was a relationship to obesity status. They found that six months after total joint replacement, severely or morbidly obese patients reported excellent pain relief and substantial functional gain that was similar to the findings in other patients.
AHRQ-funded; HS018910.
Citation: Li W, Ayers DC, Lewis CG .
Functional gain and pain relief after total joint replacement according to obesity status.
J Bone Joint Surg Am 2017 Jul 19;99(14):1183-89. doi: 10.2106/jbjs.16.00960.
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Keywords: Obesity, Surgery, Pain, Arthritis, Patient-Centered Outcomes Research
Gandek B, Ware JE, Jr.
Validity and responsiveness of the knee injury and osteoarthritis outcome score: a comparative study among total knee replacement patients.
The researchers evaluated validity and responsiveness of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in relation to other patient-reported outcome measures before and after total knee replacement (TKR). They concluded that KOOS scales were valid and responsive in a cohort of 1,143 US TKR patients. KOOS QOL performed particularly well in capturing aggregate knee-specific outcomes.
AHRQ-funded; HS018910; HS024632.
Citation: Gandek B, Ware JE, Jr. .
Validity and responsiveness of the knee injury and osteoarthritis outcome score: a comparative study among total knee replacement patients.
Arthritis Care Res 2017 Jun;69(6):817-25. doi: 10.1002/acr.23193.
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Keywords: Arthritis, Surgery, Patient-Centered Outcomes Research, Outcomes, Injuries and Wounds
Singh JA, Hossain A, Mudano AS
Biologics or tofacitinib for people with rheumatoid arthritis naive to methotrexate: a systematic review and network meta-analysis.
The researchers performed a systematic review to compare the benefits and harms of biologics and small molecule tofacitinib versus comparator (methotrexate (MTX) and other disease-modifying antirheumatic drugs) in patients with rheumatoid arthritis (RA) who are naive to methotrexate. They concluded that in MTX-naive RA participants, there was moderate-quality evidence that, compared with MTX alone, biologics with MTX were associated with absolute and relative clinically meaningful benefits in three of the efficacy outcomes.
AHRQ-funded; HS021110.
Citation: Singh JA, Hossain A, Mudano AS .
Biologics or tofacitinib for people with rheumatoid arthritis naive to methotrexate: a systematic review and network meta-analysis.
Cochrane Database Syst Rev 2017 May 8;5:CD012657. doi: 10.1002/14651858.cd012657.
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Keywords: Comparative Effectiveness, Medication, Arthritis, Patient-Centered Outcomes Research, Evidence-Based Practice
Zheng H, Tulu B, Choi W
Using mHealth app to support treatment decision-making for knee arthritis: patient perspective.
The authors explored patient preferences on content and design of a mobile health app to facilitate daily symptom capture and summary feedback reporting, in order to inform treatment decisions, including use of total knee replacement surgery (TKR). The authors suggest that user input can inform the design and implementation of mHealth technology to meet patient needs for their treatment decisions. Patient priorities must be considered through patient-centered app design.
AHRQ-funded; HS018910.
Citation: Zheng H, Tulu B, Choi W .
Using mHealth app to support treatment decision-making for knee arthritis: patient perspective.
eGEMS 2017 Apr 20;5(2):7. doi: 10.13063/2327-9214.1284..
Keywords: Arthritis, Decision Making, Health Information Technology (HIT), Surgery
Kathuria P, Gordon KB, Silverberg JI
Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures.
This study investigated whether psoriasis (Pso) and psoriatic arthritis (PsA) are associated with osteoporosis and fractures in US adults. Using records of 183,725 persons with Pso and 28,765 with PsA from the 2006-2012 National Emergency Department Sample, including 20 percent of the emergency care visits throughout the United States, it found that Pso and PsA were associated with osteopenia, osteoporosis, ankylosing spondylitis, and pathologic fractures.
AHRQ-funded; HS023011.
Citation: Kathuria P, Gordon KB, Silverberg JI .
Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures.
J Am Acad Dermatol 2017 Mar 14;76(6):1045-53.e3. doi: 10.1016/j.jaad.2016.11.046.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Osteoporosis, Injuries and Wounds, Arthritis
Singh JA, Hossain A, Tanjong Ghogomu E
Biologics or tofacitinib for people with rheumatoid arthritis unsuccessfully treated with biologics: a systematic review and network meta-analysis.
This review is focused on biologic or tofacitinib therapy in people with rheumatoid arthritis (RA) who had previously been treated unsuccessfully with biologics. Biologic (with or without methotrexate (MTX)) or tofacitinib (with MTX) use was associated with clinically meaningful and statistically significant benefits compared to placebo or an active comparator (MTX/other traditional disease-modifying anti-rheumatic drugs) among people with RA previously unsuccessfully treated with biologics.
AHRQ-funded; HS021110.
Citation: Singh JA, Hossain A, Tanjong Ghogomu E .
Biologics or tofacitinib for people with rheumatoid arthritis unsuccessfully treated with biologics: a systematic review and network meta-analysis.
Cochrane Database Syst Rev 2017 Mar 10;3:CD012591. doi: 10.1002/14651858.cd012591.
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Keywords: Comparative Effectiveness, Medication, Arthritis, Patient-Centered Outcomes Research, Evidence-Based Practice
Curtis JR, Chen L, Greenberg JD
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights.
Treat to target guidelines recommend achieving remission or low disease activity in rheumatoid arthritis (RA). However, the reduction in adverse events and costs associated with lower disease activity is unclear. This study found that leveraging the benefits of linking registry and administrative data together, lower disease activity in RA was associated with incrementally reduced risks of all-cause hospitalization, ED visits, mortality, and medical costs in a dose-dependent fashion.
AHRQ-funded; HS021694.
Citation: Curtis JR, Chen L, Greenberg JD .
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights.
Pharmacoepidemiol Drug Saf 2017 Mar;26(3):310-19. doi: 10.1002/pds.4126.
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Keywords: Patient-Centered Outcomes Research, Registries, Arthritis, Healthcare Costs, Guidelines
Franklin PD, Miozzari H, Christofilopoulos P
Important patient characteristics differ prior to total knee arthroplasty and total hip arthroplasty between Switzerland and the United States.
The researchers compared preoperative patient and clinical characteristics from two large cohorts who underwent either total knee (TKA) or hip (THA) arthroplasty, one in Switzerland, the other in the US. They found substantial differences between US and Swiss cohorts in pre-operative patient characteristics and pain levels, which has potentially important implications for cross-cultural comparison of TKA/THA outcomes.
AHRQ-funded; HS018910.
Citation: Franklin PD, Miozzari H, Christofilopoulos P .
Important patient characteristics differ prior to total knee arthroplasty and total hip arthroplasty between Switzerland and the United States.
BMC Musculoskelet Disord 2017 Jan 11;18(1):14. doi: 10.1186/s12891-016-1372-5.
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Keywords: Surgery, Pain, Patient-Centered Outcomes Research, Osteoporosis, Arthritis
Charles-Schoeman C, Yin Lee Y, Shahbazian A
Improvement of high-density lipoprotein function in patients with early rheumatoid arthritis treated with methotrexate monotherapy or combination therapies in a randomized controlled trial.
This study was undertaken to evaluate changes in HDL function and HDL-associated proteins over 2 years of follow-up in patients with early rheumatoid arthritis receiving either methotrexate (MTX) monotherapy, MTX + etanercept (ETN) combination therapy, or MTX + sulfasalazine (SSZ) + hydroxychloroquine (HCQ) triple therapy. It found that reduced disease activity in patients with any of the 3 therapies in the trial was associated with improvements in the HDL function profile.
AHRQ-funded; HS018517.
Citation: Charles-Schoeman C, Yin Lee Y, Shahbazian A .
Improvement of high-density lipoprotein function in patients with early rheumatoid arthritis treated with methotrexate monotherapy or combination therapies in a randomized controlled trial.
Arthritis Rheumatol 2017 Jan;69(1):46-57. doi: 10.1002/art.39833.
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Keywords: Arthritis, Medication, Comparative Effectiveness
Schmajuk G, Tonner C, Miao Y
Folic acid supplementation is suboptimal in a national cohort of older veterans receiving low dose oral methotrexate.
The authors aimed to determine the prevalence, predictors of, and persistence of folic acid use in a population-based cohort of methotrexate (MTX) users with rheumatic diseases. They found that patients who did not see a rheumatologist were 23% less likely to receive folic acid compared to patients who did have a rheumatologist visit during the baseline period, and after 20 months, only 50% of patients continued to receive folic acid. The authors recommend improving patient safety for users of MTX by standardizing workflows for folic acid supplementation.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Tonner C, Miao Y .
Folic acid supplementation is suboptimal in a national cohort of older veterans receiving low dose oral methotrexate.
PLoS One 2016 Dec 15;11(12):e0168369. doi: 10.1371/journal.pone.0168369.
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Keywords: Elderly, Healthcare Utilization, Medication, Arthritis
Herrinton LJ, Harrold L, Salman C
Population variations in rheumatoid arthritis treatment and outcomes, Northern California, 1998-2009.
This study assessed variations in rheumatoid arthritis treatment and outcomes at the community level from 1998 through 2009. It found that disease-modifying anti-rheumatic drug use increased in the typical patient from 38 to 63 percent of the time, and oral prednisone use declined from 23 to 15 percent of the time, whereas opioid use initially rose but then fell to 23 percent of the time.
AHRQ-funded; HS019912; HS010391; HS021590; HS018517; HS017919.
Citation: Herrinton LJ, Harrold L, Salman C .
Population variations in rheumatoid arthritis treatment and outcomes, Northern California, 1998-2009.
Perm J 2016 Winter;20(1):4-12. doi: 10.7812/tpp/15-028.
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Keywords: Arthritis, Medication, Comparative Effectiveness, Outcomes
Yazdany J, Bansback N, Clowse M
Rheumatology informatics system for effectiveness: a national informatics-enabled registry for quality improvement.
The authors reported on the Rheumatology Informatics System for Effectiveness (RISE) registry's architecture and initial data and demonstrated how RISE is being used to improve care quality. They concluded that RISE provides critical infrastructure for improving care quality in rheumatology and is a unique data source to generate new knowledge.
AHRQ-funded; HS024412.
Citation: Yazdany J, Bansback N, Clowse M .
Rheumatology informatics system for effectiveness: a national informatics-enabled registry for quality improvement.
Arthritis Care Res 2016 Dec;68(12):1866-73. doi: 10.1002/acr.23089.
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Keywords: Quality of Care, Health Information Technology (HIT), Quality Improvement, Registries, Arthritis
Ware JE, Jr., Gandek B, Allison J
The validity of disease-specific quality of life attributions among adults with multiple chronic conditions.
The objective of this study was to evaluate the convergent and discriminant validity of QOL attributions to specific diseases among adults with multiple chronic conditions (MCC). It concluded that, collectively, convergent and discriminant test results support the construct validity of disease-specific QOL impact attributions across MCC within the eight pre-identified conditions.
AHRQ-funded; HS023117.
Citation: Ware JE, Jr., Gandek B, Allison J .
The validity of disease-specific quality of life attributions among adults with multiple chronic conditions.
Int J Stat Med Res 2016;5(1):17-40..
Keywords: Quality of Life, Chronic Conditions, Arthritis, Kidney Disease and Health, Heart Disease and Health
Rolfson O, Wissig S, van Maasakkers L
Defining an international standard set of outcome measures for patients with hip or knee osteoarthritis: consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group.
The researchers defined a minimum Standard Set of outcome measures and case-mix factors for monitoring, comparing, and improving healthcare for patients with clinically diagnosed hip or knee osteoarthritis (OA) with a focus on defining the outcomes that matter most to patients. The Working Group reached consensus on a concise set of outcome measures to evaluate patients' joint pain, physical functioning, health-related quality of life, work status, mortality, reoperations, readmissions, and overall satisfaction with treatment result.
AHRQ-funded; HS018910.
Citation: Rolfson O, Wissig S, van Maasakkers L .
Defining an international standard set of outcome measures for patients with hip or knee osteoarthritis: consensus of the International Consortium for Health Outcomes Measurement Hip and Knee Osteoarthritis Working Group.
Arthritis Care Res 2016 Nov;68(11):1631-39. doi: 10.1002/acr.22868.
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Keywords: Arthritis, Care Management, Chronic Conditions, Patient-Centered Outcomes Research
Yazdany J, Robbins M, Schmajuk G
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
The researchers sought to develop and test electronic clinical quality measures for rheumatoid arthritis. Disease activity assessment, functional status assessment, disease-modifying antirheumatic durg use, and tuberculosis screening measures have achieved national endorsement and are recommended for use in federal quality reporting programs.
AHRQ-funded; HS024412.
Citation: Yazdany J, Robbins M, Schmajuk G .
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
Arthritis Care Res 2016 Nov;68(11):1579-90. doi: 10.1002/acr.22984.
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Keywords: Electronic Health Records (EHRs), Medication, Quality Measures, Arthritis, Outcomes
Nguyen UD, Ayers DC, Li W
Preoperative pain and function: profiles of patients selected for total knee arthroplasty.
The researchers examined patient-reported preoperative pain and function profiles to understand symptom severity at the time of total knee arthroplasty (TKA) decision. Of 6,936 patients, 77 percent had high pain and poor function (group 4), 19 percent had high pain "or" poor function (groups 2-3), and 5 percent had little pain and high function before TKA (group 1).
AHRQ-funded; HS018910.
Citation: Nguyen UD, Ayers DC, Li W .
Preoperative pain and function: profiles of patients selected for total knee arthroplasty.
J Arthroplasty 2016 Nov;31(11):2402-07.e2. doi: 10.1016/j.arth.2016.04.015.
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Keywords: Pain, Surgery, Arthritis, Comparative Effectiveness, Patient-Centered Outcomes Research
Suter LG, Barber CE, Herrin J
American College of Rheumatology white paper on performance outcome measures in rheumatology.
The objective of this study was to highlight the opportunities and challenges of developing and implementing performance outcome measures in rheumatology for accountability purposes. The authors' hypothetical outcome measure was a measure of rheumatoid arthritis disease activity intended for evaluating Accountable Care Organization performance. They provided a summary table of key take-home points for clinicians and policymakers. The authors concluded that the most effective and meaningful measures can only be created through the close collaboration of patients, providers, measure developers, and policymakers.
AHRQ-funded; HS024412.
Citation: Suter LG, Barber CE, Herrin J .
American College of Rheumatology white paper on performance outcome measures in rheumatology.
Arthritis Care Res 2016 Oct;68(10):1390-401. doi: 10.1002/acr.22936.
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Keywords: Quality of Care, Quality Measures, Outcomes, Arthritis
Mamtani R, Clark AS, Scott FI
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
The researchers examined the rates of breast cancer recurrence in patients with immune-mediated disease and treated breast cancer who received therapy with methotrexate, thiopurines, or anti-tumor necrosis factor (anti-TNF). They found that the risk of breast cancer recurrence in patients who received methotrexate, thiopurine, or anti-TNF therapy was not statistically significantly increased, although they did not rule out a 2-fold or greater increased risk in those treated with thiopurines.
AHRQ-funded; HS021110; HS018517.
Citation: Mamtani R, Clark AS, Scott FI .
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
Arthritis Rheumatol 2016 Oct;68(10):2403-11. doi: 10.1002/art.39738.
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Keywords: Cancer: Breast Cancer, Digestive Disease and Health, Medication, Patient-Centered Outcomes Research, Arthritis
Mannion ML, Xie F, Baddley J
Analysis of health care claims during the peri-transfer stage of transition from pediatric to adult care among juvenile idiopathic arthritis patients.
This study investigated the utilization of health care services before and after transfer from pediatric to adult rheumatology care in clinical practice. It found that individuals with juvenile idiopathic arthritis (JIA) who transferred to adult care were more likely receive a diagnosis of rheumatoid arthritis instead of juvenile rheumatoid arthritis and were less likely to receive NSAIDs, but had no significant immediate changes to other medication use.
AHRQ-funded; HS021110.
Citation: Mannion ML, Xie F, Baddley J .
Analysis of health care claims during the peri-transfer stage of transition from pediatric to adult care among juvenile idiopathic arthritis patients.
Pediatr Rheumatol Online J 2016 Sep 5;14(1):49. doi: 10.1186/s12969-016-0107-3.
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Keywords: Healthcare Utilization, Arthritis, Children/Adolescents
Yun H, Yang S, Chen L
Risk of herpes zoster in autoimmune and inflammatory diseases: implications for vaccination.
This study was undertaken to evaluate the age-stratified incidence of herpes zoster (HZ) in patients with autoimmune or inflammatory (AI) diseases as compared to older adults for whom the HZ vaccine is currently recommended by the US Centers for Disease Control and Prevention. The researchers found that systemic lupus erythematosus, inflammatory bowel disease, and rheumatoid arthritis are AI diseases associated with a higher risk of HZ compared to that in older adults for whom vaccination is currently recommended, suggesting that individuals with these conditions who are as young as age 40 years could potentially benefit from the HZ vaccine.
AHRQ-funded; HS021694; HS018517.
Citation: Yun H, Yang S, Chen L .
Risk of herpes zoster in autoimmune and inflammatory diseases: implications for vaccination.
Arthritis Rheumatol 2016 Sep;68(9):2328-37. doi: 10.1002/art.39670.
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Keywords: Infectious Diseases, Prevention, Arthritis, Risk, Sexual Health, Vaccination
Sieberts SK, Zhu F, Garcia-Garcia J
Crowdsourced assessment of common genetic contribution to predicting anti-TNF treatment response in rheumatoid arthritis.
A rigorous community-based assessment of the utility of SNP data for predicting anti-TNF treatment efficacy in RA patients was performed in the context of an open challenge framework which enabled the comparative evaluation of predictions developed by 73 research groups using the most comprehensive available data and covering a wide range of state-of-the-art modelling methodologies.
AHRQ-funded; HS018517.
Citation: Sieberts SK, Zhu F, Garcia-Garcia J .
Crowdsourced assessment of common genetic contribution to predicting anti-TNF treatment response in rheumatoid arthritis.
Nat Commun 2016 Aug 23;7:12460. doi: 10.1038/ncomms12460..
Keywords: Genetics, Arthritis
Fitzgerald GK, Fritz JM, Childs JD
Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial.
The purposes of this paper are to determine if (1) treatment effects differ between participants receiving manual therapy (MT) with exercise compared to subjects who don't, and if (2) treatment effects are better sustained when participants receive booster sessions compared to those who don't over a one year period in subjects with knee osteoarthritis. The researchers found that MT or use of boosters with exercise did not result in additive improvement in the primary outcome at 1 year. Also, secondary outcomes suggest MT may have some short term benefit, and booster sessions may improve responder status and knee pain at 1 year.
AHRQ-funded; HS019624.
Citation: Fitzgerald GK, Fritz JM, Childs JD .
Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial.
Osteoarthritis Cartilage 2016 Aug;24(8):1340-9. doi: 10.1016/j.joca.2016.03.001.
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Keywords: Arthritis, Comparative Effectiveness, Patient-Centered Outcomes Research, Treatments