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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 178 Research Studies DisplayedAsher GN, Gartlehner G, Gaynes BN
Comparative benefits and harms of complementary and alternative medicine therapies for initial treatment of major depressive disorder: systematic review and meta-analysis.
The objective of this study was to report the comparative benefits and harms of exercise and complementary and alternative medicine (CAM) treatments with second-generation antidepressants (SGA) for major depressive disorder (MDD). The investigators indicated that although they found little difference in the comparative efficacy of most CAM therapies or exercise and SGAs, the overall poor quality of the available evidence base tempers any conclusions that they might draw from those trials.
AHRQ-funded; 290201200008I.
Citation: Asher GN, Gartlehner G, Gaynes BN .
Comparative benefits and harms of complementary and alternative medicine therapies for initial treatment of major depressive disorder: systematic review and meta-analysis.
Journal Altern Complement Med 2017 Dec;23(12):907-19. doi: 10.1089/acm.2016.0261..
Keywords: Comparative Effectiveness, Complementary and Alternative Medicine, Depression, Evidence-Based Practice, Behavioral Health
Lou Y, Cao J, Zhang S
Sample size calculations for time-averaged difference of longitudinal binary outcomes.
In this study, the researchers investigated sample size calculation for the comparison of time-averaged responses between treatment groups in clinical trials with longitudinally observed binary outcomes. Their simulation showed that the nominal power and type I error are well preserved over a wide range of design parameters. The researchers believe that theirs is the first study to consider the mixture of missing patterns in sample size calculation.
AHRQ-funded; HS022418.
Citation: Lou Y, Cao J, Zhang S .
Sample size calculations for time-averaged difference of longitudinal binary outcomes.
Commun Stat Theory Methods 2017;46(1):344-53. doi: 10.1080/03610926.2014.991040.
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Keywords: Research Methodologies, Comparative Effectiveness, Outcomes
Wang Z, Whiteside SPH, Sim L
Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: a systematic review and meta-analysis.
This review evaluated the comparative effectiveness and adverse events of cognitive behavioral therapy (CBT) and pharmacotherapy for childhood anxiety disorders. Evidence supports the effectiveness of CBT and selective serotonin reuptake inhibitors (SSRIs) for reducing childhood anxiety symptoms. Serotonin-norepinephrine reuptake inhibitors also appear to be effective based on less consistent evidence.
AHRQ-funded; 290201500013I.
Citation: Wang Z, Whiteside SPH, Sim L .
Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: a systematic review and meta-analysis.
JAMA Pediatr 2017 Nov;171(11):1049-56. doi: 10.1001/jamapediatrics.2017.3036.
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Keywords: Anxiety, Behavioral Health, Children/Adolescents, Comparative Effectiveness, Medication
Borah BJ, Yao X, Laughlin-Tommaso SK
Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database.
The objective of this retrospective analysis of administrative claims from a large U.S. commercial insurance database, was to compare risk of reintervention, long-term clinical outcomes, and health care utilization among women who have bulk symptoms from leiomyoma and who underwent the following procedures: hysterectomy, myomectomy, uterine artery embolization, and magnetic resonance-guided, focused ultrasound surgery.
AHRQ-funded; HS023418.
Citation: Borah BJ, Yao X, Laughlin-Tommaso SK .
Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database.
Obstet Gynecol 2017 Nov;130(5):1047-56. doi: 10.1097/AOG.0000000000002331..
Keywords: Cancer, Comparative Effectiveness, Health Insurance, Outcomes, Patient-Centered Outcomes Research, Surgery, Women
Chopra R, Vakharia PP, Sacotte R
Efficacy of bleach baths in reducing severity of atopic dermatitis: a systematic review and meta-analysis.
This study sought to determine the efficacy of bleach vs water baths at decreasing atopic dermatitis (AD) severity. In pooled analyses, there were no significant differences observed between bleach vs water baths at 4 weeks vs baseline for the Eczema Area and Severity Index. Although bleach baths are effective in decreasing AD severity, they do not appear to be more effective than water baths alone.
AHRQ-funded; HS023011.
Citation: Chopra R, Vakharia PP, Sacotte R .
Efficacy of bleach baths in reducing severity of atopic dermatitis: a systematic review and meta-analysis.
Ann Allergy Asthma Immunol 2017 Nov;119(5):435-40. doi: 10.1016/j.anai.2017.08.289.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Skin Conditions
Zeitler EP, Al-Khatib SM, Friedman DJ
Predicting appropriate shocks in patients with heart failure: patient level meta-analysis from SCD-HeFT and MADIT II.
The study authors sought to identify characteristics predictive of appropriate shocks in patients with a primary prevention implantable cardioverter defibrillator (ICD). In this meta-analysis of patient level data from Multicenter Automatic Defibrillator Implantation Trial II and Sudden Cardiac Death in Heart Failure Trial, higher NYHA class, lower LVEF, no beta-blocker therapy, and single chamber ICD (vs. dual chamber) were significant predictors of appropriate shocks.
AHRQ-funded; HS018505.
Citation: Zeitler EP, Al-Khatib SM, Friedman DJ .
Predicting appropriate shocks in patients with heart failure: patient level meta-analysis from SCD-HeFT and MADIT II.
J Cardiovasc Electrophysiol 2017 Nov;28(11):1345-51. doi: 10.1111/jce.13307.
Keywords: Comparative Effectiveness, Heart Disease and Health, Medical Devices, Medical Devices, Risk
Linder JA, Meeker D, Fox CR
Effects of behavioral interventions on inappropriate antibiotic prescribing in primary care 12 months after stopping interventions.
This study examines the persistence of effects 12 months after stopping behavioral interventions on inappropriate antibiotic prescribing. In the 12 months after removing behavioral interventions, inappropriate antibiotic prescribing for acute respiratory infections (ARIs) increased relative to control practices—whose inappropriate prescribing rates continued to decrease.
AHRQ-funded; HS019913.
Citation: Linder JA, Meeker D, Fox CR .
Effects of behavioral interventions on inappropriate antibiotic prescribing in primary care 12 months after stopping interventions.
JAMA 2017 Oct 10;318(14):1391-92. doi: 10.1001/jama.2017.11152.
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Keywords: Antibiotics, Practice Patterns, Primary Care, Comparative Effectiveness, Respiratory Conditions
Butler M, Epstein RA, Totten A
AHRQ series on complex intervention systematic reviews-paper 3: adapting frameworks to develop protocols.
This article identifies and describes elements of frameworks and how they can be adapted to inform the protocol and conduct of systematic reviews of complex interventions. Possible approaches to analytic frameworks for complex interventions that illustrate causal and associative linkages are outlined, including time elements, which systematic reviews of complex interventions may need to address.
AHRQ-funded; 290201200004C; 290201500008I; 290201500005I; 290201500006I; 290201500010I.
Citation: Butler M, Epstein RA, Totten A .
AHRQ series on complex intervention systematic reviews-paper 3: adapting frameworks to develop protocols.
J Clin Epidemiol 2017 Oct;90:19-27. doi: 10.1016/j.jclinepi.2017.06.013.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Braun D, Gorfine M, Parmigiani G
Propensity scores with misclassified treatment assignment: a likelihood-based adjustment.
The researchers show that misclassification of treatment assignment can impact three distinct stages of a propensity score analysis. They examine how error in the treatment assignment impacts each stage in the context of three common propensity score implementations: subclassification, matching, and inverse probability of treatment weighting (IPTW). They propose a two-step likelihood-based approach which fully adjusts for treatment misclassification bias under subclassification
AHRQ-funded; HS021991.
Citation: Braun D, Gorfine M, Parmigiani G .
Propensity scores with misclassified treatment assignment: a likelihood-based adjustment.
Biostatistics 2017 Oct 1;18(4):695-710. doi: 10.1093/biostatistics/kxx014.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Nelson HD, Denneson LM, Low AR
Suicide risk assessment and prevention: a systematic review focusing on veterans.
This article reviews studies of the accuracy of methods to identify individuals at increased risk of suicide and the effectiveness and adverse effects of health care interventions relevant to U.S. veteran and military populations in reducing suicide and suicide attempts. It concludes that risk assessment methods have been shown to be sensitive predictors of suicide and suicide attempts, but the frequency of false positives limits their clinical utility.
AHRQ-funded; HS019456.
Citation: Nelson HD, Denneson LM, Low AR .
Suicide risk assessment and prevention: a systematic review focusing on veterans.
Psychiatr Serv 2017 Oct;68(10):1003-15. doi: 10.1176/appi.ps.201600384.
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Keywords: Comparative Effectiveness, Behavioral Health, Prevention, Risk
Landsittel DP, Kessler L, Schmid CH
Training in patient-centered outcomes research for specific researcher communities.
A number of publications have discussed approaches to training the scientific workforce in comparative effectiveness research (CER) and patient-centered outcomes research (PCOR). To extend these efforts into specific researcher communities, the AHRQ developed a Funding Opportunity Announcement that called for training for a specific researcher community in collaboration with associated program partners. This paper describes the strategies developed by the 5 subsequently funded programs, and the challenges associated with developing in-person and online programs.
AHRQ-funded; HS023214; HS023199; HS023299; HS023207; HS023185.
Citation: Landsittel DP, Kessler L, Schmid CH .
Training in patient-centered outcomes research for specific researcher communities.
J Clin Transl Sci 2017 Oct;1(5):278-84. doi: 10.1017/cts.2017.307.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies, Training
Ong TC, Kahn MG, Kwan BM
Dynamic-ETL: a hybrid approach for health data extraction, transformation and loading.
The researchers designed and implemented a health data transformation and loading approach, which we refer to as Dynamic ETL (Extraction, Transformation and Loading) (D-ETL), that automates part of the process through use of scalable, reusable and customizable code. Their results showed that ETL rule composition methods and the D-ETL engine offer a scalable solution for health data transformation via automatic query generation to harmonize source datasets.
AHRQ-funded; HS019908; HS022956.
Citation: Ong TC, Kahn MG, Kwan BM .
Dynamic-ETL: a hybrid approach for health data extraction, transformation and loading.
BMC Med Inform Decis Mak 2017 Sep 13;17(1):134. doi: 10.1186/s12911-017-0532-3.
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Keywords: Comparative Effectiveness, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research
Singal AG, Gupta S, Skinner CS
Effect of colonoscopy outreach vs fecal immunochemical test outreach on colorectal cancer screening completion: a randomized clinical trial.
Researchers compared the effectiveness of fecal immunochemical test (FIT) outreach and colonoscopy outreach to increase completion of the colorectal cancer (CRC) screening process (screening initiation and follow-up) within 3 years. Among persons aged 50 to 64 years receiving primary care at a safety-net institution, mailed outreach invitations offering FIT or colonoscopy compared with usual care increased the proportion completing CRC screening process within 3 years.
AHRQ-funded; HS022418.
Citation: Singal AG, Gupta S, Skinner CS .
Effect of colonoscopy outreach vs fecal immunochemical test outreach on colorectal cancer screening completion: a randomized clinical trial.
JAMA 2017 Sep 5;318(9):806-15. doi: 10.1001/jama.2017.11389.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Comparative Effectiveness, Patient-Centered Outcomes Research
Qian F, Zhong Y, Hannan EL
Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York.
Endeavor zotarolimus-eluting stents (E-ZES) and everolimus-eluting stents (EES) as second-generation stents were approved for use in percutaneous coronary interventions (PCIs) in 2008. The researchers aimed to evaluate the long-term outcomes of E-ZES vs. EES. They concluded that compared with patients receiving EES, patients receiving E-ZES had a significantly higher rate of 6-year all-cause mortality.
AHRQ-funded; HS022289.
Citation: Qian F, Zhong Y, Hannan EL .
Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York.
Int J Cardiol 2017 Aug 15;241:437-43. doi: 10.1016/j.ijcard.2017.03.095.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Medication, Patient-Centered Outcomes Research, Heart Disease and Health
Balk EM, Lichtenstein AH
Omega-3 fatty acids and cardiovascular disease: summary of the 2016 Agency of Healthcare Research and Quality evidence review.
The authors summarize the 2016 update of the 2004 Agency of Healthcare Research and Quality's evidence review of omega-3 fatty acids and cardiovascular disease (CVD). The overall findings for the effects of marine oil supplements on intermediate CVD outcomes remain largely unchanged. The strongest effect of marine oils is on triglyceride concentrations.
AHRQ-funded; 290201500002I.
Citation: Balk EM, Lichtenstein AH .
Omega-3 fatty acids and cardiovascular disease: summary of the 2016 Agency of Healthcare Research and Quality evidence review.
Nutrients 2017 Aug 11;9(8). doi: 10.3390/nu9080865.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention
Caldieraro MA, Sylvia LG, Dufour S
Clinical correlates of acute bipolar depressive episode with psychosis.
The aim of this study was to identify the characteristics of depressed bipolar patients with current psychosis compared to those without psychosis. Results showed that psychosis was present in 10.6% of the studied depressed patients. Psychotic patients had less education, lower income, and were more frequently single and unemployed. Psychosis was also associated with a more severe depressive episode, higher suicidality, more comorbid conditions and worse functioning. Most group differences disappeared when controlling for depression severity.
AHRQ-funded; HS019371.
Citation: Caldieraro MA, Sylvia LG, Dufour S .
Clinical correlates of acute bipolar depressive episode with psychosis.
J Affect Disord 2017 Aug 1;217:29-33. doi: 10.1016/j.jad.2017.03.059.
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Keywords: Comparative Effectiveness, Diagnostic Safety and Quality, Behavioral Health, Patient-Centered Healthcare
Chen Y, Lairson DR, Chan W
Cost-effectiveness of novel agents in medicare patients with multiple myeloma: findings from a U.S. payer's perspective.
The researchers sought to determine the cost-effectiveness (measured as cost per life-year saved) of front-line novel agent-based therapy use among a cohort of elderly patients with multiple myeloma (MM) in a real-world setting. They concluded that, given the most common treatment practices in the United States, the use of novel agent-based therapy is not cost-effective at its current level of cost and effectiveness.
AHRQ-funded; HS018956.
Citation: Chen Y, Lairson DR, Chan W .
Cost-effectiveness of novel agents in medicare patients with multiple myeloma: findings from a U.S. payer's perspective.
J Manag Care Spec Pharm 2017 Aug;23(8):831-43. doi: 10.18553/jmcp.2017.23.8.831.
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Keywords: Healthcare Costs, Cancer, Comparative Effectiveness, Healthcare Costs, Medication
Reid MC, Henderson CR, Jr., Trachtenberg MA
Implementing a pain self-management protocol in home care: a cluster-randomized pragmatic trial.
The researchers sought to determine the effectiveness of a cognitive-behavioral pain self-management protocol delivered by physical therapists for use by older adults with activity-limiting pain receiving home care. Their real-world pragmatic trial found no effect of implementation of a pain self-management intervention in a home care setting.
AHRQ-funded; HS020648.
Citation: Reid MC, Henderson CR, Jr., Trachtenberg MA .
Implementing a pain self-management protocol in home care: a cluster-randomized pragmatic trial.
J Am Geriatr Soc 2017 Aug;65(8):1667-75. doi: 10.1111/jgs.14836.
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Keywords: Home Healthcare, Patient Self-Management, Pain, Elderly, Comparative Effectiveness
Tyson MD, Alvarez J, Koyama T
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
This study tested the hypothesis that treatment-related changes in urinary, bowel, sexual, and hormonal function vary by race/ethnicity. It concluded that the effect of treatment for prostate cancer on patient-reported function did not vary dramatically by race/ethnicity. Compared to white men, African-American men experienced a somewhat more pronounced decline in urinary continence after radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Tyson MD, Alvarez J, Koyama T .
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
Eur Urol 2017 Aug;72(2):307-14. doi: 10.1016/j.eururo.2016.10.036.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Racial and Ethnic Minorities, Surgery
Murtaugh CM, Deb P, Zhu C
Reducing readmissions among heart failure patients discharged to home health care: effectiveness of early and intensive nursing services and early physician follow-up.
This study compared the effectiveness of two "treatments"-early, intensive home health nursing and physician follow-up within a week-versus less intense and later postacute care in reducing readmissions among heart failure patients discharged to home health care. Neither treatment by itself had a statistically significant effect on hospital readmission. In combination, however, they reduced the probability of readmission by roughly 8 percentage points.
AHRQ-funded; HS020257.
Citation: Murtaugh CM, Deb P, Zhu C .
Reducing readmissions among heart failure patients discharged to home health care: effectiveness of early and intensive nursing services and early physician follow-up.
Health Serv Res 2017 Aug;52(4):1445-72. doi: 10.1111/1475-6773.12537.
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Keywords: Comparative Effectiveness, Heart Disease and Health, Home Healthcare, Hospital Readmissions, Patient-Centered Outcomes Research
Ferrada P, Callcut R, Zielinski MD
Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: an Eastern Association for the Surgery of Trauma multicenter trial.
The objective of this study was to compare loop ileostomy (LI) and total colectomy (TC) procedures in a multicentric approach to help the surgeon decide what procedure was best suited for the patient in need. In this study, the investigators found that LI carried less mortality than TC.
AHRQ-funded; HS024547.
Citation: Ferrada P, Callcut R, Zielinski MD .
Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: an Eastern Association for the Surgery of Trauma multicenter trial.
J Trauma Acute Care Surg 2017 Jul;83(1):36-40. doi: 10.1097/ta.0000000000001498..
Keywords: Clostridium difficile Infections, Comparative Effectiveness, Infectious Diseases, Surgery, Treatments
Ong T, Pradhananga R, Holve E
A framework for classification of electronic health data extraction-transformation-loading challenges in data network participation.
The researchers conducted key-informant interviews with data partner representatives to survey the Extract, Transform, Load (ETL) process challenges faced in clinical data research networks (CDRNs) and registries. The paper concluded that overcoming ETL technical challenges requires significant investments in a broad array of information technologies and human resources. Identifying these technical obstacles can inform optimal resource allocation to minimize the barriers and cost of entry for new data partners into extant networks, which in turn can expand data networks' inclusiveness and diversity.
AHRQ-funded; HS019564.
Citation: Ong T, Pradhananga R, Holve E .
A framework for classification of electronic health data extraction-transformation-loading challenges in data network participation.
eGEMS 2017 Jun 13;5(1):10. doi: 10.5334/egems.222..
Keywords: Comparative Effectiveness, Data, Health Information Technology (HIT), Patient-Centered Outcomes Research, Registries
Weitlauf AS, Sathe N, McPheeters ML
Interventions targeting sensory challenges in autism spectrum disorder: a systematic review.
This review evaluated the effectiveness and safety of interventions targeting sensory challenges in ASD. It concluded that some interventions may yield modest short-term (<6 months) improvements in sensory- and ASD symptom severity-related outcomes; the evidence base is small, and the durability of the effects is unclear. Although some therapies may hold promise, substantial needs exist for continuing improvements in methodologic rigor.
AHRQ-funded; 290201500003I.
Citation: Weitlauf AS, Sathe N, McPheeters ML .
Interventions targeting sensory challenges in autism spectrum disorder: a systematic review.
Pediatrics 2017 Jun;139(6):e20170347. doi: 10.1542/peds.2017-0347.
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Keywords: Patient-Centered Outcomes Research, Evidence-Based Practice, Comparative Effectiveness, Children/Adolescents, Autism
Halbert CH, Bellamy S, Briggs V
A comparative effectiveness education trial for lifestyle health behavior change in African Americans.
The authors of this study compared the effects of alternate behavioral interventions on obesity-related health behaviors by conducting a comparative effectiveness education trial in a community-based sample of 530 adult African Americans. The investigators suggest that education about risk factors for chronic disease and evidence-based strategies for health behavior change may be useful for addressing obesity-related behaviors among African Americans.
AHRQ-funded; HS019339.
Citation: Halbert CH, Bellamy S, Briggs V .
A comparative effectiveness education trial for lifestyle health behavior change in African Americans.
Health Educ Res 2017 Jun 1;32(3):207-18. doi: 10.1093/her/cyx039..
Keywords: Comparative Effectiveness, Education: Patient and Caregiver, Lifestyle Changes, Lifestyle Changes, Obesity, Racial and Ethnic Minorities
Mehta HB, Vargas GM, Adhikari D
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
The objectives were to determine trends in the use of chemotherapy as the initial treatment and to evaluate the comparative effectiveness of initial chemotherapy vs resection of the primary tumor on survival (intention-to-treat analysis) in Stage IV colorectal cancer (CRC). Instrumental variable analysis found that, compared with resection, chemotherapy as the initial treatment offers similar or better 2-year survival in patients with Stage IV CRC.
AHRQ-funded; HS022134.
Citation: Mehta HB, Vargas GM, Adhikari D .
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
Colorectal Dis 2017 Jun;19(6):O210-o18. doi: 10.1111/codi.13659.
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Keywords: Cancer: Colorectal Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Surgery