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
1 to 25 of 187 Research Studies DisplayedCox ED, Hansen K, Rajamanickam VP
Are parents who feel the need to watch over their children's care better patient safety partners?
In this study, the investigators assessed whether needing to watch over care predicted parent performance of recommended safety behaviors to reduce medication errors and health care-associated infections. The researchers concluded that parents who reported the need to watch over care were more likely to perform behaviors specific to safe medication use (but not hand hygiene) compared with those not reporting this need.
AHRQ-funded; HS018680.
Citation: Cox ED, Hansen K, Rajamanickam VP .
Are parents who feel the need to watch over their children's care better patient safety partners?
Hosp Pediatr 2017 Dec;7(12):716-22. doi: 10.1542/hpeds.2017-0036..
Keywords: Adverse Drug Events (ADE), Adverse Events, Caregiving, Children/Adolescents, Healthcare-Associated Infections (HAIs), Medical Errors, Medication, Patient Safety
Liang C, Gong Y
Automated classification of multi-labeled patient safety reports: a shift from quantity to quality measure.
The capacity for extracting useful information from patient safety reports remains limited. This study investigated the multi-labeled nature of patient safety reports as a key to disclose the complex relations between many components during the courses and development of medical errors. The authors developed automated multi-label text classifiers to process patient safety reports. The experiments demonstrated feasibility and efficiency of a combination of multi-label algorithms in the benchmark comparison.
AHRQ-funded; HS022895.
Citation: Liang C, Gong Y .
Automated classification of multi-labeled patient safety reports: a shift from quantity to quality measure.
Stud Health Technol Inform 2017;245:1070-74..
Keywords: Adverse Events, Data, Patient Safety, Quality Measures
Skube SJ, Hu Z, Arsoniadis EG
Characterizing surgical site infection signals in clinical notes.
Building off of previous work for automated and semi-automated surgical site infections (SSIs) detection using expert-derived "strong features" from clinical notes, researchers hypothesized that additional SSI phrases may be contained in clinical notes. They systematically characterized phrases and expressions associated with SSIs. While 83 percent of expert-derived original terms overlapped with new terms and modifiers, an additional 362 modifiers associated with both positive and negative SSI signals were identified.
AHRQ-funded; HS024532.
Citation: Skube SJ, Hu Z, Arsoniadis EG .
Characterizing surgical site infection signals in clinical notes.
Stud Health Technol Inform 2017;245:955-59.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Patient Safety, Adverse Events, Quality Improvement, Quality of Care
Zhou S, Kang H, Gong Y
Design a learning-oriented fall event reporting system based on Kirkpatrick model.
Patient fall has been a severe problem in healthcare facilities around the world due to its prevalence and cost. Routine fall prevention training programs are not as effective as expected. Using event reporting systems is the trend for reducing patient safety events such as falls, although some limitations of the systems exist at current stage. The authors of this paper summarized these limitations through literature review, and developed an improved web-based fall event reporting system.
AHRQ-funded; HS022895.
Citation: Zhou S, Kang H, Gong Y .
Design a learning-oriented fall event reporting system based on Kirkpatrick model.
Stud Health Technol Inform 2017;245:828-32..
Keywords: Falls, Health Information Technology (HIT), Patient Safety, Web-Based, Adverse Events
Kang H, Gong Y
Design of a user-centered voluntary reporting system for patient safety events.
A knowledge-based and user-centered patient safety events (PSE) reporting system is needed to organize scattered knowledge and improve user-friendliness. The researchers described the development of a knowledge base for patient falls, the most frequent PSE. Based on the knowledge base, user-centered design features were incorporated into the system to improve the reporting accuracy, completeness, and timeliness.
AHRQ-funded; HS022895.
Citation: Kang H, Gong Y .
Design of a user-centered voluntary reporting system for patient safety events.
Stud Health Technol Inform 2017;245:733-37.
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Keywords: Adverse Events, Medical Errors, Health Information Technology (HIT), Patient Safety
Hernandez-Boussard T, Davies S, McDonald K
Interhospital facility transfers in the United States: a nationwide outcomes study.
This study identified and compared characteristics and outcomes of transfer and nontransfer patients. In-hospital adverse events were significantly higher in transfer patients compared with nontransfer patients. Study results suggest that transfer patients have inferior outcomes compared with nontransfer patients.
AHRQ-funded; HS018558.
Citation: Hernandez-Boussard T, Davies S, McDonald K .
Interhospital facility transfers in the United States: a nationwide outcomes study.
J Patient Saf 2017 Dec;13(4):187-91. doi: 10.1097/pts.0000000000000148.
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Keywords: Adverse Events, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Patient Safety, Transitions of Care
Yao B, Kang H, Miao Q
Leveraging event reporting through knowledge support: a knowledge-based approach to promoting patient fall prevention.
The authors constructed a knowledge base of fall events by combining expert-reviewed fall prevention solutions and then integrating them into a reporting system. The knowledge base enables timely and tailored knowledge support and thus will serve as a prevailing fall prevention tool. This effort holds promise in making knowledge acquisition and management a routine process for enhancing the reporting and understanding of patient safety events.
AHRQ-funded; HS022895.
Citation: Yao B, Kang H, Miao Q .
Leveraging event reporting through knowledge support: a knowledge-based approach to promoting patient fall prevention.
Stud Health Technol Inform 2017;245:973-77.
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Keywords: Adverse Events, Falls, Patient Safety, Prevention
Gephart SM, Hanson C, Wetzel CM
NEC-zero recommendations from scoping review of evidence to prevent and foster timely recognition of necrotizing enterocolitis.
The purpose of this paper is to present a scoping review with two new meta-analyses, clinical recommendations, and implementation strategies to prevent and foster timely recognition of necrotizing enterocolitis. The researchers conducted a stakeholder-engaged scoping review to classify strength of evidence and form implementation recommendations across subgroup areas: 1) promoting human milk, 2) feeding protocols and transfusion, 3) timely recognition strategies, and 4) medication stewardship.
AHRQ-funded; HS022908.
Citation: Gephart SM, Hanson C, Wetzel CM .
NEC-zero recommendations from scoping review of evidence to prevent and foster timely recognition of necrotizing enterocolitis.
Matern Health Neonatol Perinatol 2017 Dec;3:23. doi: 10.1186/s40748-017-0062-0.
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Keywords: Adverse Events, Digestive Disease and Health, Guidelines, Newborns/Infants, Prevention
George MD, Baker JF, Hsu JY
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
The purpose of this retrospective cohort study was to evaluate the association between infliximab timing and serious infection after elective hip or knee arthroplasty. The investigators concluded that administering infliximab within 4 weeks of elective knee or hip arthroplasty was not associated with a higher risk of short- or long-term serious infection compared to withholding infliximab for longer time periods. They also concluded that glucocorticoid use, especially >10 mg/day, was associated with an increased infection risk.
AHRQ-funded; HS018517.
Citation: George MD, Baker JF, Hsu JY .
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Orthopedics, Patient Safety, Surgery
Liang C, Gong Y
Predicting harm scores from patient safety event reports.
The Harm Scale developed by the AHRQ is widely used in the US hospitals. However, recent studies have indicated a moderate to poor inter-rater reliability of the scale across a number of US hospitals. This study proposed that key information to identify and refine the severity of harm is contained in the narrative data in patient safety reports. The researchers found that using automated text classification to categorize harm score provided reduced subjective judgments and improved efficiency.
AHRQ-funded; HS022895.
Citation: Liang C, Gong Y .
Predicting harm scores from patient safety event reports.
Stud Health Technol Inform 2017;245:1075-79..
Keywords: Adverse Events, Data, Hospitals, Patient Safety
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
Goldstone AB, Chiu P, Baiocchi M
Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement.
This study compared long-term mortality and rates of reoperation, stroke, and bleeding between cohorts of patients who underwent primary aortic-valve replacement or mitral-valve replacement with a mechanical or biologic prosthesis. The long-term mortality benefit associated with a mechanical prosthesis, as compared with a biologic prosthesis, persisted until 70 years of age among patients undergoing mitral-valve replacement and until 55 years of age among those undergoing aortic-valve replacement.
AHRQ-funded; HS022192.
Citation: Goldstone AB, Chiu P, Baiocchi M .
Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement.
N Engl J Med 2017 Nov 9;377(19):1847-57. doi: 10.1056/NEJMoa1613792.
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Keywords: Adverse Events, Cardiovascular Conditions, Medical Devices, Patient-Centered Outcomes Research, Surgery
Richards JR, Smith NE, Moulin AK
Unintentional cannabis ingestion in children: a systematic review.
The purpose of this study was to analyze published reports of unintentional cannabis ingestions in children to determine presenting signs and symptoms, route of exposure, treatment, and outcome. The investigators assert that unintentional cannabis ingestion by children is a serious public health concern and is well-documented in numerous studies and case reports; and that clinicians should consider cannabis toxicity in any child with sudden onset of lethargy or ataxia.
AHRQ-funded; HS022236.
Citation: Richards JR, Smith NE, Moulin AK .
Unintentional cannabis ingestion in children: a systematic review.
J Pediatr 2017 Nov;190:142-52. doi: 10.1016/j.jpeds.2017.07.005..
Keywords: Adverse Events, Children/Adolescents, Adverse Drug Events (ADE)
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
Zenga J, Suko J, Kallogjeri D
Postoperative hemorrhage and hospital revisit after transoral robotic surgery.
The researchers investigated the incidence and complications related to postoperative hemorrhage (POH) after transoral robotic surgery (TORS). Using HCUP data, they found that the incidence of POH after TORS was low, and few of these patients had a severe complication related to this event. Medical comorbidity and tonsillar subsite may be independent risk factors for POH.
AHRQ-funded; HS019455.
Citation: Zenga J, Suko J, Kallogjeri D .
Postoperative hemorrhage and hospital revisit after transoral robotic surgery.
Laryngoscope 2017 Oct;127(10):2287-92. doi: 10.1002/lary.26626.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Adverse Events, Risk
Leeds IL, Alimi Y, Hobson DR
Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway.
This study aims to demonstrate the association between recovery pathway implementation, process measures, and short-term surgical outcomes by population subgroup. It concluded that differences in outcomes by race and socioeconomic status did not arise following implementation of an enhanced recovery pathway. Differences in process measures by population subgroups highlight differences in care that require further investigation.
AHRQ-funded; HS024736; HS024547.
Citation: Leeds IL, Alimi Y, Hobson DR .
Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway.
Dis Colon Rectum 2017 Oct;60(10):1092-101. doi: 10.1097/dcr.0000000000000879.
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Keywords: Racial and Ethnic Minorities, Social Determinants of Health, Surgery, Outcomes, Adverse Events
Khan A, Furtak SL, Melvin P
Parent-provider miscommunications in hospitalized children.
The objectives of this study were to: (1) examine characteristics of parent-provider miscommunications about hospitalized children; (2) describe associations among parent-provider miscommunications, parent-reported errors, and hospital experience; and (3) compare parent and attending physician reports of parent-provider miscommunications. The investigators found that parent-provider miscommunications were associated with parent-reported errors and suboptimal hospital experience. Parents reported parent-provider miscommunications more often than attending physicians did.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Furtak SL, Melvin P .
Parent-provider miscommunications in hospitalized children.
Hosp Pediatr 2017 Sep;7(9):505-15. doi: 10.1542/hpeds.2016-0190..
Keywords: Adverse Events, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Hospitalization, Hospitals, Medical Errors, Patient Safety
Symer MM, Abelson JS, Milsom J
A mobile health application to track patients after gastrointestinal surgery: results from a pilot study.
Many surgical readmissions are preventable. Mobile health technology can identify nascent complications and potentially prevent readmission. The researchers performed a pilot study of a new mobile health application in adults undergoing major abdominal surgery and determined the app can track patient recovery from major abdominal surgery, is easy to use, and has potential to improve outcomes.
AHRQ-funded; HS000066.
Citation: Symer MM, Abelson JS, Milsom J .
A mobile health application to track patients after gastrointestinal surgery: results from a pilot study.
J Gastrointest Surg 2017 Sep;21(9):1500-05. doi: 10.1007/s11605-017-3482-2..
Keywords: Telehealth, Health Information Technology (HIT), Hospital Readmissions, Surgery, Adverse Events, Patient Safety, Digestive Disease and Health, Prevention
Amin AP, Bach RG, Caruso ML
Association of variation in contrast volume with acute kidney injury in patients undergoing percutaneous coronary intervention.
The purpose of this study was to examine the national variation in acute kidney injury (AKI) incidence and contrast use among US physicians and the variation's association with patients' risk of developing AKI after percutaneous coronary intervention (PCI). This cross-sectional study used the American College of Cardiology National Cardiovascular Data Registry (NCDR) CathPCI Registry to identify in-hospital care for percutaneous coronary intervention (PCI) in the United States.
AHRQ-funded; HS022481.
Citation: Amin AP, Bach RG, Caruso ML .
Association of variation in contrast volume with acute kidney injury in patients undergoing percutaneous coronary intervention.
JAMA Cardiol 2017 Sep;2(9):1007-12. doi: 10.1001/jamacardio.2017.2156..
Keywords: Adverse Events, Kidney Disease and Health, Cardiovascular Conditions, Patient Safety, Heart Disease and Health, Practice Patterns
Jackson SS, Leekha S, Magder LS
Electronically available comorbidities should be used in surgical site infection risk adjustment.
A multicenter retrospective cohort study of patients undergoing surgical procedures at 28 US hospitals was performed. The authors developed a well-performing risk adjustment model for surgical site infections (SSI) using electronically available comorbidities. Healthcare-associated infections, such as SSIs, are used by the Centers for Medicare and Medicaid Services (CMS) as pay-for-performance metrics. The authors recommended that comorbidity-based risk adjustment should be strongly considered by the Centers for Disease Control and Prevention and CMS to adequately compare SSI rates across hospitals.
AHRQ-funded; HS022291.
Citation: Jackson SS, Leekha S, Magder LS .
Electronically available comorbidities should be used in surgical site infection risk adjustment.
Clin Infect Dis 2017 Sep 1;65(5):803-10. doi: 10.1093/cid/cix431..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Risk, Injuries and Wounds, Adverse Events
Olsen MA, Nickel KB, Fraser VJ
Prevalence and predictors of postdischarge antibiotic use following mastectomy.
This study determined utilization, predictors, and outcomes of postdischarge prophylactic antibiotics after mastectomy with or without immediate breast reconstruction. The study conclude that prophylactic postdischarge antibiotics are commonly prescribed after mastectomy; immediate reconstruction is the strongest predictor. The authors recommended stewardship efforts in this population to limit continuation of prophylactic antibiotics after discharge are needed to limit antimicrobial resistance.
AHRQ-funded; HS019455.
Citation: Olsen MA, Nickel KB, Fraser VJ .
Prevalence and predictors of postdischarge antibiotic use following mastectomy.
Infect Control Hosp Epidemiol 2017 Sep;38(9):1048-54. doi: 10.1017/ice.2017.128.
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Keywords: Antibiotics, Healthcare-Associated Infections (HAIs), Medication, Patient Safety, Surgery, Injuries and Wounds, Prevention, Adverse Events, Risk
Calderwood MS, Huang SS, Keller V
Variable case detection and many unreported cases of surgical-site infection following colon surgery and abdominal hysterectomy in a statewide validation.
This study assesses hospital surgical-site infection (SSI) identification and reporting following colon surgery and abdominal hysterectomy via a statewide external validation. The authors concluded that claims-based surveillance is a standardized approach that hospitals can use to augment traditional surveillance methods and health departments can use for external validation.
AHRQ-funded; HS021424.
Citation: Calderwood MS, Huang SS, Keller V .
Variable case detection and many unreported cases of surgical-site infection following colon surgery and abdominal hysterectomy in a statewide validation.
Infect Control Hosp Epidemiol 2017 Sep;38(9):1091-97. doi: 10.1017/ice.2017.134..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Injuries and Wounds, Patient Safety, Women, Adverse Events, Diagnostic Safety and Quality, Hospitals
Gong Y, Kang H, Wu X
Enhancing patient safety event reporting. a systematic review of system design features.
Electronic patient safety event reporting (e-reporting) is an effective mechanism to learn from errors and enhance patient safety. This paper aimed at revealing the current status of system features, detecting potential gaps in system design, and accordingly proposing suggestions for future design and implementation of the system. Three literature databases were searched for publications that contain informative descriptions of e-reporting systems. In addition, both online publicly accessible reporting forms and systems were investigated. The authors concluded that the current e-reporting systems are at an immature stage in their development, and discussed their future development direction toward efficient and effective systems to improve patient safety.
AHRQ-funded; HS022895.
Citation: Gong Y, Kang H, Wu X .
Enhancing patient safety event reporting. a systematic review of system design features.
Appl Clin Inform 2017 Aug 30;8(3):893-909. doi: 10.4338/aci-2016-02-r-0023..
Keywords: Adverse Events, Medical Errors, Health Information Technology (HIT), Patient Safety, System Design
Ross JS, Bates J, Parzynski CS
Can machine learning complement traditional medical device surveillance? A case study of dual-chamber implantable cardioverter-defibrillators.
Using data from the National Cardiovascular Data Registry for implantable cardioverter-defibrillators (ICDs) linked to Medicare administrative claims for longitudinal follow-up, the researchers applied three statistical approaches to safety-signal detection for commonly used dual-chamber ICDs that used two propensity score (PS) models. The three approaches, including one machine learning method, identified important safety signals, but without exact agreement.
AHRQ-funded; HS023000.
Citation: Ross JS, Bates J, Parzynski CS .
Can machine learning complement traditional medical device surveillance? A case study of dual-chamber implantable cardioverter-defibrillators.
Med Devices 2017 Aug 16;10:165-88. doi: 10.2147/mder.s138158.
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Keywords: Medical Devices, Registries, Patient Safety, Adverse Events
Sears ED, Momoh AO, Chung KC
A national study of the impact of delayed flap timing for treatment of patients with deep sternal wound infection.
This study aimed to evaluate the impact of delayed flap closure on mortality and resource use for treatment of deep sternal wound infection. The timing of flap closure was delayed more than 7 days after diagnosis in 39 percent of patients. The study concluded that delay in flap closure was associated with greater mortality and resource use.
AHRQ-funded; HS023313.
Citation: Sears ED, Momoh AO, Chung KC .
A national study of the impact of delayed flap timing for treatment of patients with deep sternal wound infection.
Plast Reconstr Surg 2017 Aug;140(2):390-400. doi: 10.1097/prs.0000000000003514.
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Keywords: Injuries and Wounds, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Patient-Centered Outcomes Research