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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 DisplayedReimer T, Lee SJC, Garcia S
Cancer center clinic and research team perceptions of identity and interactions.
The purpose of this study was to determine perceptions of roles of cancer center clinic and research teams. The researchers developed and administered survey to research and clinic staff at a National Cancer Institute-designated comprehensive cancer center. Although there are many similarities between clinic and research teams, the researchers also identified key differences, including perceptions of goal clarity and sharing, understanding and alignment with cancer center goals, and importance of outcomes.
AHRQ-funded; HS022418.
Citation: Reimer T, Lee SJC, Garcia S .
Cancer center clinic and research team perceptions of identity and interactions.
J Oncol Pract 2017 Dec;13(12):e1021-e29. doi: 10.1200/jop.2017.024349..
Keywords: Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Research Methodologies
Crawford J, Beaton D, Almad F
AHRQ Author: Bierman AS
Cross-cultural survey development: the colon cancer screening behaviors survey for South Asian populations.
The objective of this work was to develop a survey that considered cultural relevance and diversity of South Asian populations, with the aim of describing or predicting factors that influence colorectal cancer screening intention and adherence. The initial development of the Colon Cancer Screening Behaviours Survey for South Asian populations was completed using a number of steps. This initial survey was later cross-culturally translated and adapted into the Urdu language.
AHRQ-authored.
Citation: Crawford J, Beaton D, Almad F .
Cross-cultural survey development: the colon cancer screening behaviors survey for South Asian populations.
BMC Res Notes 2017 Dec 28;10(1):770. doi: 10.1186/s13104-017-3098-3.
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Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Patient Adherence/Compliance, Racial and Ethnic Minorities, Screening
Kistler CE, Golin C, Morris C
Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults.
This paper reports on the design of a randomized clinical trial to understand the effects of a patient decision aid on appropriate colorectal cancer screening. The study aims to determine the ability of a patient decision aid to increase individualized and appropriate colorectal cancer screening.
AHRQ-funded; HS021133.
Citation: Kistler CE, Golin C, Morris C .
Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults.
Clin Trials 2017 Dec;14(6):648-58. doi: 10.1177/1740774517725289..
Keywords: Cancer, Cancer: Colorectal Cancer, Decision Making, Elderly, Prevention, Screening
Adams AS, Madden JM, Zhang F
Effects of transitioning to Medicare Part D on access to drugs for medical conditions among dual enrollees with cancer.
This study evaluated the impact of transitioning from Medicaid to Medicare Part D drug coverage on the use of noncancer treatments among dual enrollees with cancer. Its findings suggest that the removal of drug caps under Part D had a modest impact on the treatment of hypercholesterolemia overall and may have reduced white-black gaps in the use of lipid-lowering and antidepressant therapies.
AHRQ-funded; HS018577.
Citation: Adams AS, Madden JM, Zhang F .
Effects of transitioning to Medicare Part D on access to drugs for medical conditions among dual enrollees with cancer.
Value Health 2017 Dec;20(10):1345-54. doi: 10.1016/j.jval.2017.05.023.
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Keywords: Access to Care, Cancer, Medicare, Medication, Racial and Ethnic Minorities
Pak K, Uno H, Kim DH
Interpretability of cancer clinical trial results using restricted mean survival time as an alternative to the hazard ratio.
To discuss issues of conventional trial design and analysis and to present alternatives to the hazard ratio (HR) using a recent immunotherapy study as an illustrative example. The investigators suggest that the design and analysis of a conventional cancer clinical trial can be improved by adopting a robust statistical procedure that enables clinically meaningful interpretations of the treatment effect.
AHRQ-funded; HS022193.
Citation: Pak K, Uno H, Kim DH .
Interpretability of cancer clinical trial results using restricted mean survival time as an alternative to the hazard ratio.
JAMA Oncol 2017 Dec;3(12):1692-96. doi: 10.1001/jamaoncol.2017.2797..
Keywords: Cancer, Research Methodologies
Childers CP, Childers KK, Maggard-Gibbons M
National estimates of genetic testing in women with a history of breast or ovarian cancer.
In the United States, 3.8 million women have a history of breast (BC) or ovarian cancer (OC). Up to 15 percent of cases are attributable to heritable mutations, which, if identified, provide critical knowledge for treatment and preventive care. This study found that fewer than one in five individuals with a history of BC or OC meeting select National Cancer Comprehensive Network criteria have undergone genetic testing.
AHRQ-funded; HS025079.
Citation: Childers CP, Childers KK, Maggard-Gibbons M .
National estimates of genetic testing in women with a history of breast or ovarian cancer.
J Clin Oncol 2017 Dec 1;35(34):3800-06. doi: 10.1200/jco.2017.73.6314.
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Keywords: Cancer, Cancer: Breast Cancer, Cancer: Ovarian Cancer, Family Health and History, Genetics, Quality of Care, Screening, Women
Tamirisa NP, Goodwin JS, Kandalam A
Patient and physician views of shared decision making in cancer.
The aim of the study was to explore patient and physician perceptions of shared decision making in clinical encounters for cancer care. Among the study’s multiple conclusions was that most physicians reported providing patients with written information, however, most patients reported that written information was too detailed and felt that the physicians did not assess the level of information they wished to receive.
AHRQ-funded; HS022134.
Citation: Tamirisa NP, Goodwin JS, Kandalam A .
Patient and physician views of shared decision making in cancer.
Health Expect 2017 Dec;20(6):1248-53. doi: 10.1111/hex.12564..
Keywords: Cancer, Decision Making, Patient-Centered Healthcare, Patient Experience, Clinician-Patient Communication
Leeds IL, Canner JK, Efron JE
The independent effect of cancer on outcomes: a potential limitation of surgical risk prediction.
This study aims to compare the use of common risk models for benign versus malignant gastrointestinal disease. It found that the National Surgical Quality Improvement Program (NSQIP) prediction models less effectively evaluate the risk of death in cancer patients as compared to patients with benign disease. A diagnosis of cancer is independently associated with an increased risk of surgical complications.
AHRQ-funded; HS024736.
Citation: Leeds IL, Canner JK, Efron JE .
The independent effect of cancer on outcomes: a potential limitation of surgical risk prediction.
J Surg Res 2017 Dec;220:402-09.e6. doi: 10.1016/j.jss.2017.08.039.
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Keywords: Adverse Events, Cancer, Digestive Disease and Health, Risk, Surgery
Kruser JM, Rakhra SS, Sacotte RM
Intensive care unit outcomes among patients with cancer after palliative radiation therapy.
To inform goals of care discussions at the time of palliative radiation therapy (RT) consultation, researchers sought to characterize intensive care unit (ICU) outcomes for patients treated with palliative RT compared to all other patients with metastatic cancer admitted to the ICU. They found that prior treatment with palliative RT is associated with increased in-hospital mortality after ICU admission.
AHRQ-funded; HS000078.
Citation: Kruser JM, Rakhra SS, Sacotte RM .
Intensive care unit outcomes among patients with cancer after palliative radiation therapy.
Int J Radiat Oncol Biol Phys 2017 Nov 15;99(4):854-58. doi: 10.1016/j.ijrobp.2017.06.2463.
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Keywords: Cancer, Intensive Care Unit (ICU), Palliative Care, Patient-Centered Outcomes Research
Gustafson DH, DuBenske LL, Atwood AK
Reducing symptom distress in patients with advanced cancer using an e-alert system for caregivers: Pooled analysis of two randomized clinical trials.
The aim of this paper was to assess the effects on cancer patient symptom distress of an eHealth system that alerts clinicians to significant changes in the patient's symptoms, as reported by a family caregiver. It found that when severe caregiver-reported symptoms were shared with clinicians, the symptoms were more likely to be subsequently reported as improved than when the symptoms were not shared with clinicians.
AHRQ-funded; HS019917.
Citation: Gustafson DH, DuBenske LL, Atwood AK .
Reducing symptom distress in patients with advanced cancer using an e-alert system for caregivers: Pooled analysis of two randomized clinical trials.
J Med Internet Res 2017 Nov 14;19(11):e354. doi: 10.2196/jmir.7466.
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Keywords: Cancer, Caregiving, Communication, Telehealth, Web-Based
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
Kelly G, Wang SY, Lucas G
Facilitating meaningful engagement on community advisory committees in patient-centered outcome research.
In this study, the investigators conducted a process evaluation of ongoing activities of a Patient Advisory Committee (PAC) formed around the development of an individualized decision aid for older women with early stage breast cancer. They indicated that their results suggested that engaging committee members in a process of evaluation and collective reflection during a research collaboration can break down barriers to collaboration, build relationships, create opportunities for co-learning and strengthen researchers' capacity to engage meaningfully with stakeholders.
AHRQ-funded; HS023900.
Citation: Kelly G, Wang SY, Lucas G .
Facilitating meaningful engagement on community advisory committees in patient-centered outcome research.
Prog Community Health Partnersh 2017;11(3):243-51. doi: 10.1353/cpr.2017.0029..
Keywords: Cancer, Cancer: Breast Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Research Methodologies
Rauscher GH, Dabbous F, Dolecek TA
Absence of an anticipated racial disparity in interval breast cancer within a large health care organization.
The researchers sought to estimate the extent of an anticipated racial disparity in interval breast cancer (IBC) within a single, large health care organization. Contrary to expectation, in patient-adjusted models, there was no IBC racial disparity. The sorting of patients by race across facilities appears to have mitigated an otherwise anticipated disparity in IBC.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Dabbous F, Dolecek TA .
Absence of an anticipated racial disparity in interval breast cancer within a large health care organization.
Ann Epidemiol 2017 Oct;27(10):654-58. doi: 10.1016/j.annepidem.2017.09.002.
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Keywords: Cancer: Breast Cancer, Cancer, Disparities, Racial and Ethnic Minorities, Women, Screening, Screening, Imaging
Gingrich AA, Bateni SB, Monjazeb AM
Neoadjuvant radiotherapy is associated with R0 resection and improved survival for patients with extremity soft tissue sarcoma undergoing surgery: a national cancer database analysis.
Neoadjuvant radiotherapy (RT) is increasingly advocated for the management of soft tissue sarcoma (STS). This study sought to characterize the impact of neoadjuvant RT on rates of R0 resection and overall survival (OS) in extremity STS patients undergoing surgery. The authors concluded that preoperative RT independently predicts higher rates of R0 resection for patients with extremity STS undergoing surgical resection. Negative surgical margins and pre- or postoperative RT are associated with improved OS.
AHRQ-funded; HS022236.
Citation: Gingrich AA, Bateni SB, Monjazeb AM .
Neoadjuvant radiotherapy is associated with R0 resection and improved survival for patients with extremity soft tissue sarcoma undergoing surgery: a national cancer database analysis.
Ann Surg Oncol 2017 Oct;24(11):3252-63. doi: 10.1245/s10434-017-6019-8..
Keywords: Adverse Events, Cancer, Mortality, Patient-Centered Outcomes Research, Patient Safety
Fisher KA, Mazor KM
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
This paper comments on the Mack et al. article “Evaluation of Patient and Family Outpatient Complaints as a Strategy to Prioritize Efforts to Improve Cancer Care Delivery”, published in 2017 in The Joint Commission Journal on Quality and Patient Safety, in which Mack et al. categorized all complaints filed at a large outpatient cancer center during a two-year period, put forth a preliminary rating system for assessing complaint severity, and catalogued the actions taken in response to the complaints.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Mazor KM .
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
Jt Comm J Qual Patient Saf 2017 Oct;43(10):495-97. doi: 10.1016/j.jcjq.2017.07.003..
Keywords: Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient Experience, Patient Safety, Quality of Care, Quality Improvement
Kamal AH
Redesigning oncology care delivery: Early wins, lessons learned, and a roadmap.
This editorial, discusses oncology care delivery and comments on an article by Colligan, et al., published, in 2017, in Medical Care, entitled “Two innovative cancer care programs have potential to reduce utilization and spending.”
AHRQ-funded; HS023681.
Citation: Kamal AH .
Redesigning oncology care delivery: Early wins, lessons learned, and a roadmap.
Med Care 2017 Oct;55(10):871-72. doi: 10.1097/mlr.00000000000.
Keywords: Cancer, Healthcare Delivery, Patient-Centered Outcomes Research
Rhoten BA
Conceptual issues surrounding body image for oncology nurses.
This paper discusses conceptual issues surrounding cancer survivors’ body image. It targets oncology nurses so they may have a better understanding of the historic overview of body image conceptualization, as well as a more contemporary, cancer-specific approach to understanding how this population of patients may be particularly affected.
AHRQ-funded; HS022990.
Citation: Rhoten BA .
Conceptual issues surrounding body image for oncology nurses.
Oncol Nurs Forum 2017 Sep 1;44(5):534-36. doi: 10.1188/17.onf.534-536..
Keywords: Cancer, Patient-Centered Healthcare, Provider, Quality of Life
Park JS, Bateni SB, Bold RJ
The modified frailty index to predict morbidity and mortality for retroperitoneal sarcoma resections.
The researchers performed a retrospective analysis of patients with a diagnosis of primary malignant retroperitoneal neoplasm who underwent surgical resection. The modified frailty index (mFI) was calculated according to standard published methods. Their data demonstrate that the majority of patients undergoing retroperitoneal sarcoma resections have few, if any, comorbidities. The mFI was a limited predictor of overall and serious complications and was not a significant predictor of mortality.
AHRQ-funded; HS022236.
Citation: Park JS, Bateni SB, Bold RJ .
The modified frailty index to predict morbidity and mortality for retroperitoneal sarcoma resections.
J Surg Res 2017 Sep;217:191-97. doi: 10.1016/j.jss.2017.05.025.
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Keywords: Cancer, Elderly, Health Status, Mortality, Risk
Haymart MR, Esfandiari NH, Stang MT
Controversies in the management of low-risk differentiated thyroid cancer.
This article addresses the controversy that exists over optimal management of low-risk differentiated thyroid cancer. It discusses the fact that lack of physician consensus results in wide variation in patient care, with some patients at risk for over- or under-treatment and highlights the need to design and implement studies to address current knowledge gaps.
AHRQ-funded; HS024512.
Citation: Haymart MR, Esfandiari NH, Stang MT .
Controversies in the management of low-risk differentiated thyroid cancer.
Endocr Rev 2017 Aug 1;38(4):351-78. doi: 10.1210/er.2017-00067..
Keywords: Cancer, Care Management, Health Services Research (HSR)
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
Singal AG, Tiro J, Li X
Hepatocellular carcinoma surveillance among patients with cirrhosis in a population-based integrated health care delivery system.
This study characterized guideline-concordant hepatocellular carcinoma (HCC) surveillance rates and patient-level factors associated with surveillance among a population-based cohort of patients with cirrhosis. It concluded that, although one third of patients undergo inconsistent HCC surveillance, less than 2 percent of patients receive guideline-concordant biannual HCC surveillance.
AHRQ-funded; HS022418.
Citation: Singal AG, Tiro J, Li X .
Hepatocellular carcinoma surveillance among patients with cirrhosis in a population-based integrated health care delivery system.
J Clin Gastroenterol 2017 Aug;51(7):650-55. doi: 10.1097/mcg.0000000000000708.
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Keywords: Cancer, Guidelines, Healthcare Delivery, Patient-Centered Outcomes Research, Practice Patterns
Shih YT, Xu Y, Liu L
Rising prices of targeted oral anticancer medications and associated financial burden on Medicare beneficiaries.
This study examined trends in targeted oral anticancer medication (TOAM) prices and patient out-of-pocket (OOP) payments in Medicare Part D and estimated the actual effects on patient OOP payments of partial filling of the coverage gap by 2012. It concluded that rising TOAM prices threaten the financial relief patients have begun to experience under closure of the coverage gap in Medicare Part D.
AHRQ-funded; HS020263.
Citation: Shih YT, Xu Y, Liu L .
Rising prices of targeted oral anticancer medications and associated financial burden on Medicare beneficiaries.
J Clin Oncol 2017 Aug 1;35(22):2482-89. doi: 10.1200/jco.2017.72.3742.
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Keywords: Cancer, Medication, Healthcare Costs, Medicare, Elderly
Smith AB, Basch E
Role of patient-reported outcomes in postsurgical monitoring in oncology.
This article describes the benefits of electronic patient-reported outcomes (ePROs) in postsurgical symptom monitoring for surgical oncology patients; ePROs can identify at-risk patients, provide closer monitoring, and provide a mechanism to identify and treat complications before they worsen. The article also summarizes the literature of ePRO use in surgical oncology.
AHRQ-funded; HS024134.
Citation: Smith AB, Basch E .
Role of patient-reported outcomes in postsurgical monitoring in oncology.
J Oncol Pract 2017 Aug;13(8):535-38. doi: 10.1200/jop.2017.023838..
Keywords: Cancer, Care Management, Health Information Technology (HIT), Electronic Health Records (EHRs), Surgery, Outcomes
Roydhouse JK, Wilson IB
Systematic review of caregiver responses for patient health-related quality of life in adult cancer care.
The aim of this review is to help cancer researchers select a validated health-related quality of life tool if they anticipate using proxy-reported data. It concluded that the evidence base is strongest for the EORTC (disease-specific tools), COOP/WONCA (generic tools), and MQOL (end-of-life-specific tools).
AHRQ-funded; HS000011.
Citation: Roydhouse JK, Wilson IB .
Systematic review of caregiver responses for patient health-related quality of life in adult cancer care.
Qual Life Res 2017 Aug;26(8):1925-54. doi: 10.1007/s11136-017-1540-6.
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Keywords: Cancer, Caregiving, Patient-Centered Outcomes Research, Quality of Life
Maitree R, Perez-Carrillo GJG, Shimony JS
Adaptive anatomical preservation optimal denoising for radiation therapy daily MRI.
An innovative method, adaptive anatomical preservation optimal denoising (AAPOD), was developed for optimal image denoising, i.e., to maximally reduce noise while preserving the tissue boundaries. The experimental results demonstrated that AAPOD was capable of reducing noise adaptively and optimally while avoiding tissue boundary losses.
AHRQ-funded; HS022888.
Citation: Maitree R, Perez-Carrillo GJG, Shimony JS .
Adaptive anatomical preservation optimal denoising for radiation therapy daily MRI.
J Med Imaging 2017 Jul;4(3):034004. doi: 10.1117/1.jmi.4.3.034004.
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Keywords: Imaging, Treatments, Cancer, Patient Safety