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
76 to 100 of 178 Research Studies DisplayedKenzik KM, Kent EE, Martin MY
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
The purpose of this study was to identify chronic condition clusters at pre- and post-cancer diagnosis, evaluate predictors of developing clusters post-cancer, and examine the impact on functional impairment among older cancer survivors. It found that distinct condition clusters of two or more chronic conditions are prevalent among older cancer survivors. Cluster prevalence increases from pre- to post-cancer diagnosis.
AHRQ-funded; HS023009; HS013852.
Citation: Kenzik KM, Kent EE, Martin MY .
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
J Cancer Surviv 2016 Dec;10(6):1096-103. doi: 10.1007/s11764-016-0553-4.
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Keywords: Chronic Conditions, Cancer, Elderly, Research Methodologies, Health Status
Laccetti AL, Chen B, Cai J
Increase in cancer center staff effort related to electronic patient portal use.
The authors examined patterns of use of electronic portals by clinic staff at a National Cancer Institute-designated comprehensive cancer center. They found that from 2011 to 2014, staff portal activity increased approximately 10-fold, and sixteen percent of all actions occurred outside clinic hours. They concluded that cancer center employee use of an electronic patient portal has increased markedly over time, particularly among nursing staff.
AHRQ-funded; HS022418.
Citation: Laccetti AL, Chen B, Cai J .
Increase in cancer center staff effort related to electronic patient portal use.
J Oncol Pract 2016 Dec;12(12):e981-e90. doi: 10.1200/jop.2016.011817.
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Keywords: Cancer, Health Information Technology (HIT), Provider: Health Personnel, Web-Based, Workforce
Perone JA, Riall TS, Olino K
Palliative care for pancreatic and periampullary cancer.
This article summarizes surgical, endoscopic, and other palliative techniques for relief of obstructive jaundice, relief of duodenal or gastric outlet obstruction, and relief of pain due to invasion of the celiac plexus. It also introduces the utility of the palliative care triangle in clarifying a patient's and family's goals to guide decision making.
AHRQ-funded; HS022134.
Citation: Perone JA, Riall TS, Olino K .
Palliative care for pancreatic and periampullary cancer.
Surg Clin North Am 2016 Dec;96(6):1415-30. doi: 10.1016/j.suc.2016.07.012.
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Keywords: Cancer, Palliative Care, Pain, Decision Making
Prey JE, Qian M, Restaino S
Reliability and validity of the patient activation measure in hospitalized patients.
The objectives of this article are to describe the internal consistency reliability and construct validity of the PAM-13 for hospitalized cardiology and oncology patients and to examine the predictors of low patient activation in the same population. The authors found that patients with unplanned admissions were more likely to have low activation than patients with planned admissions. They also found that PAM-13 was modestly correlated with each of the PROMIS Global Health components: global, physical and mental health. They concluded that this study demonstrates the PAM-13 is a reliable and valid measure for use in the inpatient hospital setting and that type of admission is an important predictor of patient activation.
AHRQ-funded; HS021816.
Citation: Prey JE, Qian M, Restaino S .
Reliability and validity of the patient activation measure in hospitalized patients.
Patient Educ Couns 2016 Dec;99(12):2026-33. doi: 10.1016/j.pec.2016.06.029.
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Keywords: Cancer, Cardiovascular Conditions, Hospitalization, Inpatient Care, Patient and Family Engagement
Henke L, Kashani R, Yang D
Simulated online adaptive magnetic resonance-guided stereotactic body radiation therapy for the treatment of oligometastatic disease of the abdomen and central thorax: characterization of potential advantages.
This study characterized potential advantages of online-adaptive magnetic resonance (MR)-guided stereotactic body radiation therapy (SBRT) to treat oligometastatic disease of the non-liver abdomen and central thorax. It concluded that online-adaptive MRI-guided SBRT may allow planning target volume dose escalation and/or simultaneous tumor/organ at risk sparing compared with nonadaptive SBRT.
AHRQ-funded; HS022888.
Citation: Henke L, Kashani R, Yang D .
Simulated online adaptive magnetic resonance-guided stereotactic body radiation therapy for the treatment of oligometastatic disease of the abdomen and central thorax: characterization of potential advantages.
Int J Radiat Oncol Biol Phys 2016 Dec 1;96(5):1078-86. doi: 10.1016/j.ijrobp.2016.08.036.
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Keywords: Cancer, Imaging
Rosenberg AS, Ruthazer R, Paulus JK
Survival analyses and prognosis of plasma-cell myeloma and plasmacytoma-like posttransplantation lymphoproliferative disorders.
Multiple myeloma/plasmacytoma-like posttransplantation lymphoproliferative disorder (PTLD-MM) is a rare complication of solid organ transplantation. Case series have shown variable outcomes, and survival data in the modern era are lacking. This study found that age at diagnosis, elevated creatinine, and white race were associated with inferior survival in patients with PTLD-MM.
AHRQ-funded; HS000060.
Citation: Rosenberg AS, Ruthazer R, Paulus JK .
Survival analyses and prognosis of plasma-cell myeloma and plasmacytoma-like posttransplantation lymphoproliferative disorders.
Clin Lymphoma Myeloma Leuk 2016 Dec;16(12):684-92.e3. doi: 10.1016/j.clml.2016.09.002.
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Keywords: Adverse Events, Cancer, Mortality, Transplantation, Outcomes
Giordano SH, Niu J, Chavez-MacGregor M
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
The objective of the current study was to generate cost estimates for guideline-concordant adjuvant chemotherapy regimens from payers' and patients' perspectives in a large, insured US population. It concluded that the costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden.
AHRQ-funded; HS020263.
Citation: Giordano SH, Niu J, Chavez-MacGregor M .
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
Cancer 2016 Nov 15; 122(2):3447-3455. doi: 10.1002/cncr.30274.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Healthcare Costs
Lee SJ, Clark MA, Cox JV
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
The authors outlined challenges of care coordination in the context of a multiteam system (MTS), through the care experience of a patient in the Dallas County integrated safety-net system. A cancer diagnosis triggered an additional need for augmented coordination between his different provider teams. The authors recommend that further research and practice investigate the relationships of MTS coordination for shared care management, transfer to and from specialty care, treatment compliance, barriers to care, and health outcomes of chronic comorbid conditions, as well as cancer control and surveillance.
AHRQ-funded; HS022418.
Citation: Lee SJ, Clark MA, Cox JV .
Achieving coordinated care for patients with complex cases of cancer: a multiteam system approach.
J Oncol Pract 2016 Nov;12(11):1029-38. doi: 10.1200/jop.2016.013664.
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Keywords: Cancer, Care Coordination, Chronic Conditions, Patient-Centered Healthcare, Teams
Hochman MJ, Kamal AH, Wolf SP
Anticholinergic drug burden in noncancer versus cancer patients near the end of life.
This article's objective is to determine anticholinergic load (ACL) and its impact in noncancer versus cancer palliative care patients. The authors concluded that ACL is associated with worse fatigue and quality of life and may not differ significantly between cancer and noncancer patients nearing end of life. Symptom management drugs are more responsible for ACL in cancer and noncancer patients, although disease management drugs contribute significantly to ACL in the latter group. They recommend more attention to reducing anticholinergic use in all patients with life-limiting illness.
AHRQ-funded; HS023681.
Citation: Hochman MJ, Kamal AH, Wolf SP .
Anticholinergic drug burden in noncancer versus cancer patients near the end of life.
J Pain Symptom Manage 2016 Nov;52(5):737-43.e3. doi: 10.1016/j.jpainsymman.2016.03.020.
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Keywords: Adverse Drug Events (ADE), Cancer, Medication, Palliative Care, Quality of Life
Goodwin JS, Sheffield K, Li S
Receipt of cancer screening is a predictor of life expectancy.
The researchers sought to determine the association between receipt of screening mammography or PSA and overall survival. They found that the subjects with prior cancer screening had actual median survivals higher than those who were not screened, with differences ranging from 1.7 to 2.1 years for women and 0.9 to 1.1 years for men.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Sheffield K, Li S .
Receipt of cancer screening is a predictor of life expectancy.
J Gen Intern Med 2016 Nov;31(11):1308-14. doi: 10.1007/s11606-016-3787-y.
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Keywords: Cancer, Cancer: Breast Cancer, Cancer: Prostate Cancer, Screening, Women, Men's Health, Health Status
Gerber DE, Reimer T, Williams EL
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
This article describes the care processes for a 64-year-old man with newly diagnosed advanced non-small-cell lung cancer who was enrolled in a first-line clinical trial of a new immunotherapy regimen. Research team and clinical team members have limited knowledge of the roles and work of individuals outside their team. Recommendations to increase trust and collaboration are provided.
AHRQ-funded; HS022418.
Citation: Gerber DE, Reimer T, Williams EL .
Resolving rivalries and realigning goals: challenges of clinical and research multiteam systems.
J Oncol Pract 2016 Nov;12(11):1020-28. doi: 10.1200/jop.2016.013060.
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Keywords: Cancer, Cancer: Lung Cancer, Case Study, Healthcare Delivery, Patient-Centered Healthcare, Teams
Scarinci IC, Garces-Palacio IC, Morales-Aleman MM
Sowing the seeds of health: training of community health advisors to promote breast and cervical cancer screening among Latina immigrants in Alabama.
The researchers sought to develop and evaluate a culturally relevant training for Community Health Advisors (CHA) to promote breast and cervical cancer screening among Latina immigrants in Alabama. They found that a knowledge and skills training increased the CHAs' (1) knowledge of cancer screening and other health topics and (2) their perceived confidence to communicate with women in their communities about cancer screening and to motivate them to attain screenings.
AHRQ-funded; HS013852.
Citation: Scarinci IC, Garces-Palacio IC, Morales-Aleman MM .
Sowing the seeds of health: training of community health advisors to promote breast and cervical cancer screening among Latina immigrants in Alabama.
J Health Care Poor Underserved 2016;27(4):1779-93. doi: 10.1353/hpu.2016.0162.
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Keywords: Cancer, Cancer: Breast Cancer, Racial and Ethnic Minorities, Screening, Women
Pierorazio PM, Johnson MH, Patel HD
Management of renal masses and localized renal cancer: Systematic review and meta-analysis.
This review aimed to summarize evidence on effectiveness and comparative effectiveness of active surveillance (AS), thermal ablation (TA), and radical (RN) or partial nephrectomy (PN) for patients with a renal mass suspicious for localized renal cancer. It concluded that comparative studies demonstrated similar cancer-secific survival across management strategies, with some differences in renal functional outcomes, perioperative outcomes, and postoperative harms that should be considered when choosing a management strategy.
AHRQ-funded; 290201200007I.
Citation: Pierorazio PM, Johnson MH, Patel HD .
Management of renal masses and localized renal cancer: Systematic review and meta-analysis.
J Urol 2016 Oct;296(4):989-99. doi: 10.1016/j.juro.2016.04.081.
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Keywords: Cancer, Evidence-Based Practice, Comparative Effectiveness, Outcomes, Kidney Disease and Health
Murphy DR, Meyer AN, Bhise V
Computerized triggers of big data to detect delays in follow-up of chest imaging results.
A "trigger" algorithm was used to identify delays in follow-up of abnormal chest imaging results in a large national clinical data warehouse of electronic health record (EHR) data. In this study, the authors applied a trigger in a repository hosting EHR data from all Department of Veterans Affairs health-care facilities and analyzed data from seven facilities. The investigators concluded that application of triggers on "big" EHR data may aid in identifying patients experiencing delays in diagnostic evaluation of chest imaging results suspicious for malignancy.
Citation: Murphy DR, Meyer AN, Bhise V .
Computerized triggers of big data to detect delays in follow-up of chest imaging results.
Chest 2016 Sep;150(3):613-20. doi: 10.1016/j.chest.2016.05.001..
Keywords: Imaging, Electronic Health Records (EHRs), Health Information Technology (HIT), Data, Diagnostic Safety and Quality, Cancer
Darlow S, Wen KY
Development testing of mobile health interventions for cancer patient self-management: a review.
The purpose of the current study was to conduct a review of published articles that describe the development process of mobile health interventions for patients’ cancer care self-management. The following trends emerged: importance of stakeholder engagement during the development process, addressing the unique needs and experiences of cancer patients and care providers, ensuring user satisfaction with the system, and identifying perceived benefits and limitations of the system.
AHRQ-funded; HS019001.
Citation: Darlow S, Wen KY .
Development testing of mobile health interventions for cancer patient self-management: a review.
Health Informatics J 2016 Sep;22(3):633-50. doi: 10.1177/1460458215577994..
Keywords: Patient Self-Management, Cancer, Chronic Conditions, Telehealth, Health Information Technology (HIT)
Vemana G, Kim EH, Bhayani SB
Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-Medicare data.
The researchers sought to determine survival differences among patients receiving endoscopic vs surgical management for upper tract urothelial carcinoma (UTUC). They found that although initial survival outcomes are similar for endoscopic and surgical management of nonmuscle-invasive, low-grade UTUC, both cancer-specific survival and overall survival are significantly inferior for the endoscopic management group in the longer term. They also found that transition from initial endoscopic management to surgical intervention appears to have limited impact on survival.
AHRQ-funded; HS019455.
Citation: Vemana G, Kim EH, Bhayani SB .
Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-Medicare data.
Urology 2016 Sep;95:115-20. doi: 10.1016/j.urology.2016.05.033.
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Keywords: Cancer, Comparative Effectiveness, Elderly, Mortality, Surgery
Nadpara PA, Madhavan SS, Tworek C
Tobacco-use cessation counseling service usage.
The authors evaluated patterns of receipt of Tobacco-use Cessation Counseling (TCC) services among elderly lung cancer patients. They found a critical need to address disparities in receipt of TCC services among elderly. They concluded that, although lung cancer preventive services are covered under the Medicare program, these services are underutilized.
AHRQ-funded; HS018622.
Citation: Nadpara PA, Madhavan SS, Tworek C .
Tobacco-use cessation counseling service usage.
W V Med J 2016 Sep-Oct;112(5):66-71.
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Keywords: Cancer, Cancer: Lung Cancer, Elderly, Healthcare Utilization, Lifestyle Changes, Tobacco Use
Brand SR, Pickard L, Mack JW
What adult cancer care can learn from pediatrics.
However, pediatric cancer centers follow three core principles that enhance their patients’ overall care experience. This article discusses those principles, with the aim of helping adult cancer centers learn from what pediatric centers do well.
AHRQ-funded; HS000063.
Citation: Brand SR, Pickard L, Mack JW .
What adult cancer care can learn from pediatrics.
J Oncol Pract 2016 Sep;12(9):765-7. doi: 10.1200/jop.2016.015057..
Keywords: Cancer, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient Experience, Children/Adolescents
Wong SL, Revels SL, Yin H
Variation in hospital mortality rates with inpatient cancer surgery.
The purpose of this national study was to elucidate clinical mechanisms underlying variation in hospital mortality with major cancer surgery. It found that case-fatality rates among patients with complications at high-mortality hospitals were approximately twice as high as at low-mortality hospitals. This study implicates failure to rescue as the major reason for differences in hospital mortality rates with major cancer surgery.
AHRQ-funded; HS020937.
Citation: Wong SL, Revels SL, Yin H .
Variation in hospital mortality rates with inpatient cancer surgery.
Ann Surg 2015 Apr;261(4):632-6. doi: 10.1097/sla.0000000000000690..
Keywords: Mortality, Surgery, Cancer, Patient Safety, Quality of Care
Wang SY, Hall J, Pollack CE
Associations between end-of-life cancer care patterns and Medicare expenditures.
The authors examined the extent to which patterns of intensive end-of-life care explain geographic variation in end-of-life care expenditures among cancer decedents. The mean expenditure per cancer decedent in the last month of life was $10,800, with considerable variation in the percentage of decedents receiving intensive end-of-life care intervention. Regional patterns of late chemotherapy or late hospice use explained only approximately 1% of the expenditure difference, while the proportion of decedents who had ICU admissions within 30 days of death was a major driver of variation, explaining 37.6% of the expenditure difference. They concluded that promoting appropriate end-of-life care has the potential to reduce geographic variation in end-of-life care expenditures.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Associations between end-of-life cancer care patterns and Medicare expenditures.
J Natl Compr Canc Netw 2016 Aug;14(8):1001-8.
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Keywords: Cancer, Elderly, Healthcare Costs, Medicare, Palliative Care
Sohn W, Resnick MJ, Greenfield S
Impact of adherence to quality measures for localized prostate cancer on patient-reported health-related quality of life outcomes, patient satisfaction, and treatment-related complications.
Given the small number of narrowly focused measures in prostate cancer care, the researchers sought to determine whether adherence to any of the available payer-driven quality measures influences patient-centered outcomes, including health-related quality of life (HRQOL), patient satisfaction, and treatment-related complications. They concluded that compliance with available nationally endorsed quality indicators was not associated with clinically important changes in patient-centered outcomes (HRQOL, satisfaction, or complications) within 1-year.
AHRQ-funded; HS019356; HS022640.
Citation: Sohn W, Resnick MJ, Greenfield S .
Impact of adherence to quality measures for localized prostate cancer on patient-reported health-related quality of life outcomes, patient satisfaction, and treatment-related complications.
Med Care 2016 Aug;54(8):738-44. doi: 10.1097/mlr.0000000000000562.
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Keywords: Cancer, Cancer: Prostate Cancer, Quality of Life, Comparative Effectiveness, Patient Experience
Wernli KJ, Henrikson NB, Morrison CC
Screening for skin cancer in adults: Updated evidence report and systematic review for the US Preventive Services Task Force.
The researchers updated a systematic review for the US Preventive Services Task Force regarding clinical skin cancer screening among adults. No randomized clinical trials were identified. There was limited evidence on the association between skin cancer screening and mortality. Future research on skin cancer screening should focus on evaluating the effectiveness of targeted screening in those considered to be at higher risk for skin cancer.
AHRQ-funded.
Citation: Wernli KJ, Henrikson NB, Morrison CC .
Screening for skin cancer in adults: Updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Jul 26;316(4):436-47. doi: 10.1001/jama.2016.5415.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer, Screening, Prevention, Evidence-Based Practice
Croswell J, Owings J
Screening for breast cancer.
This case study involves a 47-year-old woman who presents to your office for a well-woman visit. She is healthy, takes no medications, and has no health concerns. She has never been diagnosed with breast cancer, nor have any of her first-degree relatives. Her digital mammography two years ago was negative, and she asks whether she should be screened again this year. The study poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Croswell J, Owings J .
Screening for breast cancer.
Am Fam Physician 2016 Jul 15;94(2):143-4.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Screening, Prevention, Evidence-Based Practice, Women, Imaging, Case Study
Park JK, Yang JA, Ahn EY
Survival rates of cancer patients with and without rheumatic disease: a retrospective cohort analysis.
The researchers compared the outcomes of gastric, colon, lung, and breast cancer patients with and without rheumatic diseases. They found that rheumatoid arthritis and dermatomyositis/polymyositis seemed to be associated with a higher mortality in patients with lung or breast cancers, whereas systemic sclerosis seemed to be associated with decreased mortality in patients with lung cancer.
AHRQ-funded; HS018517.
Citation: Park JK, Yang JA, Ahn EY .
Survival rates of cancer patients with and without rheumatic disease: a retrospective cohort analysis.
BMC Cancer 2016 Jul 4;16:381. doi: 10.1186/s12885-016-2444-5.
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Keywords: Cancer, Mortality, Arthritis, Skin Conditions
Wang SY, Hsu SH, Gross CP
Association between time since cancer diagnosis and health-related quality of life: a population-level analysis.
The purpose of this paper is to examine the association between time since cancer diagnosis and health-related quality of life (HRQOL) among cancer survivors in remission. The researchers found that most cancer survivors did not experience poorer mental health, but that survivors of prostate or cervical cancer had lower mental component summary scores after 10 years of diagnosis. They concluded that the level of HRQOL among cancer survivors depends on time since cancer diagnosis and cancer type.
AHRQ-funded; HS023900.
Citation: Wang SY, Hsu SH, Gross CP .
Association between time since cancer diagnosis and health-related quality of life: a population-level analysis.
Value Health 2016 Jul-Aug;19(5):631-8. doi: 10.1016/j.jval.2016.02.010.
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Keywords: Cancer, Diagnostic Safety and Quality, Health Status, Patient-Centered Outcomes Research, Quality of Life