National Healthcare Quality and Disparities Report
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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
26 to 50 of 178 Research Studies DisplayedBallard TNS, Zhong L, Momoh AO
Improved rates of immediate breast reconstruction at safety net hospitals.
Although disparities in receipt of breast reconstruction persist at the patient level, the extent to which hospital factors contribute to these differences remains unclear. This study concluded that, after accounting for sociodemographic factors, women undergoing mastectomies at safety net hospitals remain less likely to undergo immediate breast reconstruction. However, the differences in rates of reconstruction between safety net and non-safety net hospitals have narrowed over time.
AHRQ-funded; HS023313.
Citation: Ballard TNS, Zhong L, Momoh AO .
Improved rates of immediate breast reconstruction at safety net hospitals.
Plast Reconstr Surg 2017 Jul;140(1):1-10. doi: 10.1097/prs.0000000000003412.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Cancer: Breast Cancer, Cancer, Surgery
Schuler MS, Joyce NR, Huskamp HA
Medicare beneficiaries with advanced lung cancer experience diverse patterns of care from diagnosis to death.
Using Medicare claims data for patients diagnosed with extensive-stage small-cell lung cancer, the authors used latent class analysis to identify classes of people with different care patterns. The findings showed substantial heterogeneity in patterns of care for patients with advanced cancer, which should be accounted for in efforts to improve end-of-life care.
AHRQ-funded; HS022998.
Citation: Schuler MS, Joyce NR, Huskamp HA .
Medicare beneficiaries with advanced lung cancer experience diverse patterns of care from diagnosis to death.
Health Aff 2017 Jul;36(7):1193-200. doi: 10.1377/hlthaff.2017.0448..
Keywords: Cancer, Cancer: Lung Cancer, Care Management, Elderly, Medicare, Palliative Care
Gillespie EF, Panjwani N, Golden DW
Multi-institutional randomized trial testing the utility of an interactive three-dimensional contouring atlas among radiation oncology residents.
The present study reports on the efficacy and usability of a web-based contouring atlas compared with those of existing contouring resources in a randomized trial. Compared with the residents using currently available resources, the residents using eContour had improved contour agreement with both the consensus and the expert contours for the high-risk clinical target volume and greater agreement with the expert contour for the contralateral parotid gland.
AHRQ-funded; HS024321.
Citation: Gillespie EF, Panjwani N, Golden DW .
Multi-institutional randomized trial testing the utility of an interactive three-dimensional contouring atlas among radiation oncology residents.
Int J Radiat Oncol Biol Phys 2017 Jul 1;98(3):547-54. doi: 10.1016/j.ijrobp.2016.11.050.
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Keywords: Cancer, Diagnostic Safety and Quality, Education: Continuing Medical Education, Imaging, Web-Based
Lou I, Chennell TB, Schaefer SC
Optimizing outpatient pain management after thyroid and parathyroid surgery: a two-institution experience.
This study aimed to describe the outpatient narcotic medication needs for patients undergoing thyroid and parathyroid surgery, and to identify predictors of higher requirement. It concluded that overall, 93 percent of patients undergoing thyroidectomy and parathyroidectomy require 20 or fewer oral morphine equivalents by their postoperative visit.
AHRQ-funded; HS023009.
Citation: Lou I, Chennell TB, Schaefer SC .
Optimizing outpatient pain management after thyroid and parathyroid surgery: a two-institution experience.
Ann Surg Oncol 2017 Jul;24(7):1951-57. doi: 10.1245/s10434-017-5781-y.
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Keywords: Cancer, Medication, Pain, Patient-Centered Outcomes Research, Surgery
Papaleontiou M, Hughes DT, Guo C
Population-based assessment of complications following surgery for thyroid cancer.
The researchers sought to determine thyroid cancer surgery complication rates and identify at-risk populations by using the Surveillance, Epidemiology, and End Results-Medicare database. They concluded that the rates of thyroid cancer surgery complications are higher than predicted, and patients with older age, more comorbidities, and advanced disease are at greatest risk.
AHRQ-funded; HS024512.
Citation: Papaleontiou M, Hughes DT, Guo C .
Population-based assessment of complications following surgery for thyroid cancer.
J Clin Endocrinol Metab 2017 Jul;102(7):2543-51. doi: 10.1210/jc.2017-00255.
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Keywords: Adverse Events, Cancer, Risk, Risk, Surgery
Loucas CA, Brand SR, Bedoya SZ
Preparing youth with cancer for amputation: a systematic review.
This review aimed to examine and identify the type and degree of psychosocial preparation provided to the child with cancer and family prior to amputation. Its findings demonstrate that there is a lack of studies to date that have adequately addressed psychosocial preparation prior to amputation for pediatric oncology patients.
AHRQ-funded; HS000063.
Citation: Loucas CA, Brand SR, Bedoya SZ .
Preparing youth with cancer for amputation: a systematic review.
J Psychosoc Oncol 2017 Jul-Aug;35(4):483-93. doi: 10.1080/07347332.2017.1307894.
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Keywords: Cancer, Children/Adolescents, Behavioral Health, Surgery
Wang Y, Mazur TR, Park JC
Development of a fast Monte Carlo dose calculation system for online adaptive radiation therapy quality assurance.
This article describes the development of a fast Monte Carlo dose calculating system for validating online magnetic resonance imaging radiation therapy adaptive plans with both speed and accuracy. The Monte Carlo system is based on a simplified dose planning method code that incorporates a vendor-provided head model. A validated Monte Carlo code (gPENELOPE) was used to benchmark the new system.
AHRQ-funded; HS022888.
Citation: Wang Y, Mazur TR, Park JC .
Development of a fast Monte Carlo dose calculation system for online adaptive radiation therapy quality assurance.
Phys Med Biol 2017 Jun 21;62(12):4970-90. doi: 10.1088/1361-6560/aa6e38..
Keywords: Cancer, Quality of Care, Imaging
Rickard CM, Marsh NM, Webster J
Peripherally InSerted CEntral catheter dressing and securement in patients with cancer: the PISCES trial. protocol for a 2x2 factorial, superiority randomised controlled trial.
The researchers designed this trial to assess the clinical and cost-effectiveness of dressing and securements to prevent peripherally inserted central catheters (PICCs) failure. For the dressing hypothesis, they hypothesize (chlorhexidine gluconate (CHG) discs will reduce catheter-associated bloodstream infection (CABSI) compared with no CHG disc. For the securement hypothesis, they hypothesize that integrated securement dressing will reduce composite PICC failure (infection (CABSI/local infection), occlusion, dislodgement or thrombosis), compared with securement device.
AHRQ-funded; HS022835.
Citation: Rickard CM, Marsh NM, Webster J .
Peripherally InSerted CEntral catheter dressing and securement in patients with cancer: the PISCES trial. protocol for a 2x2 factorial, superiority randomised controlled trial.
BMJ Open 2017 Jun 15;7(6):e015291. doi: 10.1136/bmjopen-2016-015291.
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Keywords: Cancer, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety
Pisu M, Demark-Wahnefried W, Kenzik KM
A dance intervention for cancer survivors and their partners (RHYTHM).
The purpose of this study was to assess the feasibility, acceptability, and impact of a ballroom dance intervention on improving quality of life (QOL) and relationship outcomes in cancer survivors and their partners. It found that survivors saw this light-intensity physical activity as easing them into becoming more physically active. Light intensity ballroom dancing has the potential to improve cancer survivors' QOL.
AHRQ-funded; HS023009.
Citation: Pisu M, Demark-Wahnefried W, Kenzik KM .
A dance intervention for cancer survivors and their partners (RHYTHM).
J Cancer Surviv 2017 Jun;11(3):350-59. doi: 10.1007/s11764-016-0593-9.
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Keywords: Cancer, Health Promotion, Quality of Life
Bostwick D, Wolf S, Samsa G
Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness.
Researchers compared functionality, advanced care planning, hospital admissions, prognosis, quality of life, pain, dyspnea, fatigue, and depression between patients with cancer and three non-cancer diagnoses-end-stage renal disease (ESRD), heart failure (HF), and chronic obstructive pulmonary disease (COPD). Patients with COPD, ESRD, and HF were less functional and more likely to be hospitalized at time of referral to palliative care than cancer patients.
AHRQ-funded; HS022763.
Citation: Bostwick D, Wolf S, Samsa G .
Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness.
J Pain Symptom Manage 2017 Jun;53(6):1079-84.e1. doi: 10.1016/j.jpainsymman.2017.02.014.
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Keywords: Cancer, Respiratory Conditions, Kidney Disease and Health, Heart Disease and Health, Palliative Care
Iyer AS, Bakitas M
Early palliative care in advanced illness: do right by mama.
This letter describes a case study where the doctor and the family decided not to do aggressive treatment on their mother in her 80’s with metastatic lung cancer and pneumonia. After describing the intubation procedure and the use of mechanical ventilation, the family decided that palliative care was the best option. The doctor emphasizes the use of palliative care as the best outcome for many terminally ill patients.
AHRQ-funded; HS023009; HS013852.
Citation: Iyer AS, Bakitas M .
Early palliative care in advanced illness: do right by mama.
JAMA Intern Med 2017 Jun;177(6):761-62. doi: 10.1001/jamainternmed.2017.0764.
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Keywords: Cancer, Cancer: Lung Cancer, Case Study, Decision Making, Elderly, Palliative Care, Patient-Centered Outcomes Research
Winters-Stone KM, Moe E, Graff JN
Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy.
This study compared the prevalence of and association between falls and frailty of prostate cancer survivors (PCSs) who were current, past or never users of androgen deprivation therapy (ADT). It concluded that current and past exposure to ADT is linked to higher risk of falls and frailty than no treatment.
AHRQ-funded; HS022981.
Citation: Winters-Stone KM, Moe E, Graff JN .
Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy.
J Am Geriatr Soc 2017 Jul;65(7):1414-19. doi: 10.1111/jgs.14795.
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Keywords: Cancer: Prostate Cancer, Cancer, Falls, Medication, Elderly
Rocque GB, Halilova KI, Varley AL
Feasibility of a telehealth educational program on self-management of pain and fatigue in adult cancer patients.
The primary objective was to assess the feasibility of a telehealth pain and fatigue self-management program among adult cancer patients. The program did not meet feasibility requirements because of only 34% of eligible patients choosing to participate. However, 50 percent of patients starting the program graduated. Differences in baseline characteristics and retention rates were noted by recruitment strategy.
AHRQ-funded; HS013852.
Citation: Rocque GB, Halilova KI, Varley AL .
Feasibility of a telehealth educational program on self-management of pain and fatigue in adult cancer patients.
J Pain Symptom Manage 2017 Jun;53(6):1071-78. doi: 10.1016/j.jpainsymman.2016.12.345.
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Keywords: Cancer, Pain, Education: Patient and Caregiver, Patient Self-Management, Telehealth
Rocque GB, Pisu M, Jackson BE
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
This study examined the influence of lay navigation on health care spending and resource use among geriatric patients with cancer within The University of Alabama at Birmingham Health System Cancer Community Network. It found that, compared with a matched comparison group, the mean total costs declined by $781.29 more per quarter per navigated patient, for an estimated $19 million decline per year across the network.
AHRQ-funded; HS023009.
Citation: Rocque GB, Pisu M, Jackson BE .
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
JAMA Oncol 2017 Jun;3(6):817-25. doi: 10.1001/jamaoncol.2016.6307.
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Keywords: Elderly, Cancer, Healthcare Costs, Medicare, Patient and Family Engagement, Patient-Centered Healthcare, Healthcare Delivery
Cannon CM, Musuuza JS, Barker AK
Risk of Clostridium difficile infection in hematology-oncology patients colonized with toxigenic C. difficile.
This study determined that the prevalence of colonization with toxigenic Clostridium difficile among patients with hematological malignancies and/or bone marrow transplant at admission to a 566-bed academic medical care center was 9.3 percent. Thirteen percent of colonized patients developed symptomatic disease during hospitalization. This population may benefit from targeted C. difficile infection control interventions.
AHRQ-funded; HS024039; HS023791.
Citation: Cannon CM, Musuuza JS, Barker AK .
Risk of Clostridium difficile infection in hematology-oncology patients colonized with toxigenic C. difficile.
Infect Control Hosp Epidemiol 2017 Jun;38(6):718-20. doi: 10.1017/ice.2017.48.
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Keywords: Cancer, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Risk
Shih YT, Chien CR
A review of cost communication in oncology: patient attitude, provider acceptance, and outcome assessment.
This review identified 15 articles that covered 3 topics related to patient-physician cost communication: patient attitude, physician acceptance, and the associated outcomes. The data suggested that cost communication was associated with improved patient satisfaction, lower out-of-pocket expenses, and a higher likelihood of medication nonadherence; none of the studies established causality.
AHRQ-funded; HS020263.
Citation: Shih YT, Chien CR .
A review of cost communication in oncology: patient attitude, provider acceptance, and outcome assessment.
Cancer 2017 May 15;123(6):928-39. doi: 10.1002/cncr.30423.
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Keywords: Cancer, Communication, Healthcare Costs, Outcomes, Clinician-Patient Communication
Lin JS, Bowles EJA, Williams SB
Screening for thyroid cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
The researchers systematically reviewed the benefits and harms associated with thyroid cancer screening and treatment of early thyroid cancer in asymptomatic adults to inform the US Preventive Services Task Force. They concluded that although ultrasonography of the neck using high-risk sonographic characteristics plus follow-up cytology from fine-needle aspiration can identify thyroid cancers, it is unclear if population-based or targeted screening can decrease mortality rates or improve important patient health outcomes.
AHRQ-funded; 290201200015I.
Citation: Lin JS, Bowles EJA, Williams SB .
Screening for thyroid cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 May 9;317(18):1888-903. doi: 10.1001/jama.2017.0562.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Cancer, Evidence-Based Practice, Guidelines
Jayadevappa R, Chhatre S, Wong YN
Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant).
This review analyzed the comparative effectiveness of prostate cancer (PCa) treatments through systematic review and meta-analysis with a focus on outcomes that matter most to newly diagnosed localized PCa patients. The studies provided moderate data for the patient-centered outcome of mortality. Radical prostatectomy demonstrated mortality benefit compared to watchful waiting and radiation therapy.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S, Wong YN .
Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant).
Medicine 2017 May;96(18):e6790. doi: 10.1097/md.0000000000006790.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer, Cancer: Prostate Cancer
Haidari LA, Brown ST, Constenla D
Geospatial planning and the resulting economic impact of human papillomavirus vaccine introduction in Mozambique.
Researchers developed the Strategic Integrated Geo-temporal Mapping Application) to determine the potential economic impact of HPV immunization in Mozambique. If each health center covers a catchment area with a 5-km radius, then 40 percent of the target population could be reached to prevent 50 cases, 178 disability-adjusted life years, and US $202,854 in health care costs and lost productivity.
AHRQ-funded; HS023317.
Citation: Haidari LA, Brown ST, Constenla D .
Geospatial planning and the resulting economic impact of human papillomavirus vaccine introduction in Mozambique.
Sex Transm Dis 2017 Apr;44(4):222-26. doi: 10.1097/olq.0000000000000574.
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Keywords: Cancer, Healthcare Costs, Infectious Diseases, Sexual Health, Vaccination
Palta P, Huang ES, Kalyani RR
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
In this paper, the investigators sought to estimate the risk of mortality by HbA1c levels among older adults with and without diabetes. They concluded that an HbA1c >8.0% was associated with increased risk of all-cause and cause-specific mortality in older adults with diabetes. The investigators suggest that their results support the idea that better glycemic control is important for reducing mortality; however, they also indicate that there is a need for individualized glycemic targets for older adults with diabetes depending on their demographics, duration of diabetes, and existing comorbidities.
AHRQ-funded; HS018542.
Citation: Palta P, Huang ES, Kalyani RR .
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
Diabetes Care 2017 Apr;40(4):453-60. doi: 10.2337/dci16-0042.
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Keywords: Cancer, Cardiovascular Conditions, Diabetes, Elderly, Mortality, Risk
Graboyes EM, Kallogjeri D, Saeed MJ
Postoperative care fragmentation and thirty-day unplanned readmissions after head and neck cancer surgery.
Researchers sought to determine the frequency, risk factors, and outcomes for head and neck cancer patients experiencing postdischarge care fragmentation. They found that postdischarge care fragmentation following head and neck cancer surgery is common, as 37 percent of readmitted patients and 31 percent of patients readmitted with a treatment complication are readmitted to a hospital other than the surgical hospital.
AHRQ-funded; HS019455.
Citation: Graboyes EM, Kallogjeri D, Saeed MJ .
Postoperative care fragmentation and thirty-day unplanned readmissions after head and neck cancer surgery.
Laryngoscope 2017 Apr;127(4):868-74. doi: 10.1002/lary.26301.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Cancer, Surgery, Hospital Readmissions, Mortality
Chetta MD, Aliu O, Zhong L
Reconstruction of the irradiated breast: a national claims-based assessment of postoperative morbidity.
This study aims to assess the morbidity associated with various breast reconstruction techniques in irradiated patients. It found that overall complication rates were 45.3 percent and 30.8 percent for patients with implant and autologous reconstruction, respectively. Failure of reconstruction occurred in 29.4 percent of patients with implant reconstruction compared with 4.3 percent of patients with autologous reconstruction.
AHRQ-funded; HS023313.
Citation: Chetta MD, Aliu O, Zhong L .
Reconstruction of the irradiated breast: a national claims-based assessment of postoperative morbidity.
Plast Reconstr Surg 2017 Apr;139(4):783-92. doi: 10.1097/prs.0000000000003168.
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Keywords: Cancer, Cancer: Breast Cancer, Surgery, Adverse Events, Patient-Centered Outcomes Research
Wilfond BS, Morales C, Taylor HA
Should patients be required to undergo standard chemotherapy before being eligible for novel phase I immunotherapy clinical trials?
Many Phase I oncology trials include an eligibility criterion requiring potential participants to fail standard chemotherapy. The rationale for this approach is to ensure that patients do not forgo established clinical approaches. The case described in this report has the additional feature of the consultation being requested by a research participant who wanted to challenge the ethical rationale for such an eligibility criterion.
AHRQ-funded; HS000029.
Citation: Wilfond BS, Morales C, Taylor HA .
Should patients be required to undergo standard chemotherapy before being eligible for novel phase I immunotherapy clinical trials?
Am J Bioeth 2017 Apr;17(4):66-67. doi: 10.1080/15265161.2017.1284934..
Keywords: Cancer, Treatments, Medication
Wilfond BS, Morales C, Taylor HA
Should patients be required to undergo standard chemotherapy before being eligible for novel phase I immunotherapy clinical trials?
Many Phase I oncology trials include an eligibility criterion requiring potential participants to fail standard chemotherapy. The rationale for this approach is to ensure that patients do not forgo established clinical approaches. The case described in this report has the additional feature of the consultation being requested by a research participant who wanted to challenge the ethical rationale for such an eligibility criterion.
AHRQ-funded; HS000029.
Citation: Wilfond BS, Morales C, Taylor HA .
Should patients be required to undergo standard chemotherapy before being eligible for novel phase I immunotherapy clinical trials?
Am J Bioeth 2017 Apr;17(4):66-67. doi: 10.1080/15265161.2017.1284934..
Keywords: Cancer, Treatments, Medication
Abdelsattar ZM, Hendren S, Wong SL
The impact of health insurance on cancer care in disadvantaged communities.
The extent to which health insurance can mitigate the effects of the social determinants of health on cancer care is unknown. This study of cancer patients diagnosed with the 4 leading causes of cancer deaths between 2007 and 2011 found that patients from disadvantaged communities benefit most from health insurance, and there is a reduction in disparities in outcome.
AHRQ-funded; HS020937; HS000053.
Citation: Abdelsattar ZM, Hendren S, Wong SL .
The impact of health insurance on cancer care in disadvantaged communities.
Cancer 2017 Apr 1;123(7):1219-27. doi: 10.1002/cncr.30431.
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Keywords: Cancer, Health Insurance, Patient-Centered Outcomes Research, Vulnerable Populations