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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 128 Research Studies DisplayedChang X, Mazur T, Li HH, Yang D. X, Mazur T, Li HH
A method to recognize anatomical site and image acquisition view in x-ray images.
A method was developed to recognize anatomical site and image acquisition view automatically in 2D X-ray images that are used in image-guided radiation therapy. The purpose was to enable site and view dependent automation and optimization in the image processing tasks including 2D-2D image registration, 2D image contrast enhancement, and independent treatment site confirmation.
AHRQ-funded; HS022888.
Citation: Chang X, Mazur T, Li HH, Yang D. X, Mazur T, Li HH .
A method to recognize anatomical site and image acquisition view in x-ray images.
J Digit Imaging 2017 Dec;30(6):751-60. doi: 10.1007/s10278-017-9981-6..
Keywords: Diagnostic Safety and Quality, Imaging, Patient Safety
Albrecht JS, O'Hara LM, Moser KA
Perception of barriers to the diagnosis and receipt of treatment for neuropsychiatric disturbances after traumatic brain injury.
This study explored perceptions of barriers and facilitators to the diagnosis and receipt of treatment for neuropsychiatric disturbances (NPDs) after traumatic brain injury (TBI). Using semistructured interviews and focus groups, it found that barriers included poor provider education on TBI NPDs and limited access to care due to lack of insurance, transportation, and income. Facilitators included patient education on TBI NPDs and strong caregiver support.
AHRQ-funded; HS024560.
Citation: Albrecht JS, O'Hara LM, Moser KA .
Perception of barriers to the diagnosis and receipt of treatment for neuropsychiatric disturbances after traumatic brain injury.
Arch Phys Med Rehabil 2017 Dec;98(12):2548-52. doi: 10.1016/j.apmr.2017.06.007.
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Keywords: Brain Injury, Caregiving, Diagnostic Safety and Quality, Behavioral Health, Trauma
Maas MB, Francis BA, Sangha RS
Refining prognosis for intracerebral hemorrhage by early reassessment.
The researchers compared the accuracy of a widely used prognostic score against a model derived from clinical data obtained 5 days after admission for patients with intracerebral hemorrhage (ICH), a condition for which prognostication has proven notoriously challenging and prone to bias. They found that a simple reassessment after 5 days of care significantly improves the accuracy of prognosticating outcome in patients with ICH.
AHRQ-funded; HS023437.
Citation: Maas MB, Francis BA, Sangha RS .
Refining prognosis for intracerebral hemorrhage by early reassessment.
Cerebrovasc Dis 2017;43(3-4):110-16. doi: 10.1159/000452679.
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Keywords: Decision Making, Diagnostic Safety and Quality, Patient-Centered Outcomes Research
Juriga LL, Murray DJ, Boulet JR
Simulation and the diagnostic process: a pilot study of trauma and rapid response teams.
Simulation can be used to recreate conditions that engage teams in the diagnostic process. In contrast to most instruction about diagnostic error, teams learn through realistic experiences and receive timely feedback about their decision-making skills. The purpose of this study was to assess how trauma teams (TrT) and pediatric rapid response teams (RRT) managed scenarios that included a diagnostic error.
AHRQ-funded; HS022265; HS018731.
Citation: Juriga LL, Murray DJ, Boulet JR .
Simulation and the diagnostic process: a pilot study of trauma and rapid response teams.
Diagnosis 2017 Nov 27;4(4):241-49. doi: 10.1515/dx-2017-0010..
Keywords: Diagnostic Safety and Quality, Emergency Medical Services (EMS), Injuries and Wounds, Training, Trauma
Pantalone KM, Hobbs TM, Chagin KM
Prevalence and recognition of obesity and its associated comorbidities: cross-sectional analysis of electronic health record data from a large US integrated health system.
The purpose of the study was to determine the prevalence of obesity and its related comorbidities among patients being actively managed at a US academic medical centre, and to examine the frequency of a formal diagnosis of obesity. This cross-sectional summary from a large US integrated health system found that three out of every four patients had overweight or obesity based on BMI. Less than half of patients who were identified as having obesity according to BMI received a formal diagnosis via ICD-9 documentation.
AHRQ-funded; HS024128.
Citation: Pantalone KM, Hobbs TM, Chagin KM .
Prevalence and recognition of obesity and its associated comorbidities: cross-sectional analysis of electronic health record data from a large US integrated health system.
BMJ Open 2017 Nov 16;7(11):e017583. doi: 10.1136/bmjopen-2017-017583..
Keywords: Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Systems, Obesity, Patient-Centered Outcomes Research
Yang D, Zhang M, Chang X
A method to detect landmark pairs accurately between intra-patient volumetric medical images.
An image processing procedure was developed in this study to detect large quantity of landmark pairs accurately in pairs of volumetric medical images. The procedure allows a semi-automatic way to generate the ground truth landmark datasets that allow quantitatively evaluation of deformable image registration algorithms for radiation therapy applications.
AHRQ-funded; HS022888.
Citation: Yang D, Zhang M, Chang X .
A method to detect landmark pairs accurately between intra-patient volumetric medical images.
Med Phys 2017 Nov;44(11):5859-72. doi: 10.1002/mp.12526..
Keywords: Imaging, Patient Safety, Diagnostic Safety and Quality
Qiu J, Harold Li H, Zhang T
Automatic x-ray image contrast enhancement based on parameter auto-optimization.
Insufficient image contrast associated with radiation therapy daily setup x-ray images could negatively affect accurate patient treatment setup. The study authors developed a method to perform automatic and user-independent contrast enhancement on 2D kilo voltage (kV) and megavoltage (MV) x-ray images. The study concluded that the proposed method is able to outperform the standard image contrast adjustment procedures that are currently used in the commercial clinical systems.
AHRQ-funded; HS022888.
Citation: Qiu J, Harold Li H, Zhang T .
Automatic x-ray image contrast enhancement based on parameter auto-optimization.
J Appl Clin Med Phys 2017 Nov;18(6):218-23. doi: 10.1002/acm2.12172..
Keywords: Diagnostic Safety and Quality, Quality of Care, Imaging, Patient Safety
Rogith D, Iyengar MS, Singh H
Using fault trees to advance understanding of diagnostic errors.
In this study, the investigators used fault trees to advance understanding of diagnostic errors. A team of three experts reviewed 10 published cases of diagnostic error and constructed fault trees. The fault trees were modeled according to currently available conceptual frameworks characterizing diagnostic error. The 10 trees were then synthesized into a single fault tree to identify common contributing factors and pathways leading to diagnostic error. The investigators indicate that fault trees might provide a useful framework for both quantitative and qualitative analysis of diagnostic errors.
AHRQ-funded; HS022087; HS023602.
Citation: Rogith D, Iyengar MS, Singh H .
Using fault trees to advance understanding of diagnostic errors.
Jt Comm J Qual Patient Saf 2017 Nov;43(11):598-605. doi: 10.1016/j.jcjq.2017.06.007..
Keywords: Diagnostic Safety and Quality, Patient Safety, Quality of Care, Quality Improvement
Clarity C, Sarkar U, Lee J
Clinician perspectives on the management of abnormal subcritical tests in an urban academic safety-net health care system.
Missed or delayed follow-up of abnormal subcritical tests (tests that do not require immediate medical attention) can lead to poor patient outcomes. Safety-net health systems with limited resources and socially complex patients are vulnerable to safety gaps resulting from delayed management. In this study, clinician perspectives to identify system challenges, vulnerable situations, and potential solutions, were sought in focus groups.
AHRQ-funded; HS023558.
Citation: Clarity C, Sarkar U, Lee J .
Clinician perspectives on the management of abnormal subcritical tests in an urban academic safety-net health care system.
Jt Comm J Qual Patient Saf 2017 Oct;43(10):517-23. doi: 10.1016/j.jcjq.2017.05.007..
Keywords: Urban Health, Rural/Inner-City Residents, Diagnostic Safety and Quality, Patient Safety, Vulnerable Populations, Ambulatory Care and Surgery, Communication, Provider: Clinician
Letourneau LR, Carmody D, Wroblewski K
Diabetes presentation in infancy: high risk of diabetic ketoacidosis.
In this study, the largest of its kind, diabetic ketoacidosis (DKA) was more frequent than in other early-onset U.S. studies or other cohorts of patients with neonatal diabetes. The authors argue that continuing to educate pediatric providers about the many ways that infants can present with diabetes may help to diagnose cases more efficiently and ultimately decrease the frequency of DKA at diagnosis.
AHRQ-funded; HS023007.
Citation: Letourneau LR, Carmody D, Wroblewski K .
Diabetes presentation in infancy: high risk of diabetic ketoacidosis.
Diabetes Care 2017 Oct;40(10):e147-e48. doi: 10.2337/dc17-1145.
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Keywords: Diabetes, Diagnostic Safety and Quality, Newborns/Infants, Children/Adolescents
Balentine CJ, Xie R, Kirklin JK
Failure to diagnose hyperparathyroidism in 10,432 patients with hypercalcemia: opportunities for system-level intervention to increase surgical referrals and cure.
Researchers sought to determine whether a significant number of patients with hyperparathyroidism remain undiagnosed and untreated. After reviewing administrative data on 682,704 patients from a tertiary referral center between 2011 and 2015 and identifying hypercalcemia (>10.5 mg/dL) in 10,432 patients, they concluded that a significant proportion of patients with hyperparathyroidism do not undergo appropriate evaluation and surgical referral.
AHRQ-funded; HS023009.
Citation: Balentine CJ, Xie R, Kirklin JK .
Failure to diagnose hyperparathyroidism in 10,432 patients with hypercalcemia: opportunities for system-level intervention to increase surgical referrals and cure.
Ann Surg 2017 Oct;266(4):632-40. doi: 10.1097/sla.0000000000002370.
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Keywords: Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Surgery
Kronish IM, Kent S, Moise N
Barriers to conducting ambulatory and home blood pressure monitoring during hypertension screening in the United States.
The goal of the study was to determine the most important barriers to primary care providers' ordering ambulatory and home BP monitoring in the United States. The study found that top-ranked barriers to home BP monitoring were concerns about compliance with the correct test protocol, accuracy of tests results, out-of-pocket costs of home BP devices, and time needed to instruct patients on home BP monitoring protocol.
AHRQ-funded; HS024262.
Citation: Kronish IM, Kent S, Moise N .
Barriers to conducting ambulatory and home blood pressure monitoring during hypertension screening in the United States.
J Am Soc Hypertens 2017 Sep;11(9):573-80. doi: 10.1016/j.jash.2017.06.012..
Keywords: Blood Pressure, Primary Care, Diagnostic Safety and Quality, Screening
Feuille E, Menon NR, Huang F
Knowledge of food protein-induced enterocolitis syndrome among general pediatricians.
In this study, investigators examined knowledge of food protein-induced enterocolitis syndrome among general pediatricians. They created a 32-question survey, collecting information regarding participants’ experience with FPIES and knowledge of FPIES diagnosis and management. Investigators found that many pediatricians had a basic but incomplete understanding of FPIES diagnosis and initial management.
AHRQ-funded; HS024599.
Citation: Feuille E, Menon NR, Huang F .
Knowledge of food protein-induced enterocolitis syndrome among general pediatricians.
Ann Allergy Asthma Immunol 2017 Sep;119(3):291-92.e3. doi: 10.1016/j.anai.2017.07.001..
Keywords: Children/Adolescents, Digestive Disease and Health, Diagnostic Safety and Quality, Nutrition, Provider, Provider: Clinician, Provider: Physician
Fisher KA, Landyn V, Lindenauer PK
Procalcitonin test availability: a survey of acute care hospitals in Massachusetts.
In this study, the investigators conducted a survey of all acute care short-stay hospitals in the state of Massachusetts in August, 2016 to determine procalcitonin (PCT) assay availability, whether testing is performed on site or at an outside laboratory, and turnaround time. They indicate that their findings demonstrated that PCT testing in routine clinical practice was not available to clinicians in a manner that would be expected to yield timely results or favorably impact antibiotic prescribing in the majority of hospitals in Massachusetts.
AHRQ-funded; HS024596.
Citation: Fisher KA, Landyn V, Lindenauer PK .
Procalcitonin test availability: a survey of acute care hospitals in Massachusetts.
Ann Am Thorac Soc 2017 Sep;14(9):1489-91. doi: 10.1513/AnnalsATS.201704-306RL..
Keywords: Diagnostic Safety and Quality, Hospitals
Greenhawt M, Bird JA, Nowak-Wegrzyn AH
Trends in provider management of patients with food protein-induced enterocolitis syndrome.
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy. This study sought to better understand provider-level variation in FPIES knowledge and management. It found that nearly one-third of respondents reported poor familiarity with FPIES. Considerable variation exists in the use of diagnostic tests, management, and choice of "safe" nutrition, indicating a strong need for FPIES practice guidelines.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Bird JA, Nowak-Wegrzyn AH .
Trends in provider management of patients with food protein-induced enterocolitis syndrome.
J Allergy Clin Immunol Pract 2017 Sep - Oct;5(5):1319-24.e12. doi: 10.1016/j.jaip.2016.11.036.
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Keywords: Diagnostic Safety and Quality, Evidence-Based Practice, Guidelines, Nutrition, Provider
Jorgensen SM, Carnahan RM, Weckmann MT
Validity of the delirium observation screening scale in identifying delirium in home hospice patients.
The Delirium Observation Screening Scale (DOS) was developed to improve delirium recognition but has yet to be validated in the home hospice setting. This pilot study aimed to explore the accuracy of the DOS for identifying delirium in home hospice patients. It concluded that the DOS appears to be an accurate way to screen for delirium in home hospice patients.
AHRQ-funded; HS022666.
Citation: Jorgensen SM, Carnahan RM, Weckmann MT .
Validity of the delirium observation screening scale in identifying delirium in home hospice patients.
Am J Hosp Palliat Care 2017 Sep;34(8):744-47. doi: 10.1177/1049909116658468.
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Keywords: Diagnostic Safety and Quality, Elderly, Home Healthcare, Neurological Disorders, Palliative Care
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
Bowen ME, Merchant Z, Abdullah K
Patient, provider, and system factors associated with failure to follow-up elevated glucose results in patients without diagnosed diabetes.
Patient, provider, and system factors associated with failure to follow-up elevated glucose values in electronic medical records (EMRs) are not well described. The researchers conducted a chart review in a comprehensive EMR with a patient portal and results management features but found no associations between patient characteristics, diabetes risk factors, or provider characteristics and follow-up failures.
AHRQ-funded; HS022418.
Citation: Bowen ME, Merchant Z, Abdullah K .
Patient, provider, and system factors associated with failure to follow-up elevated glucose results in patients without diagnosed diabetes.
Health Serv Res Manag Epidemiol 2017 Aug 29;4:2333392817721647. doi: 10.1177/2333392817721647.
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Keywords: Diabetes, Electronic Health Records (EHRs), Web-Based, Patient-Centered Healthcare, Diagnostic Safety and Quality
Goldberg EM, Morphis B, Youssef R
An analysis of diagnoses that drive readmission: what can we learn from the hospitals in Southern New England with the highest and lowest readmission performance?
This study examined the most common diagnoses driving readmissions among fee-for-service Medicare beneficiaries in the hospitals with the highest and lowest readmission performance in Southern New England from 2014 to 2016. It found that the lowest-performing hospitals readmitted higher percentages of patients for sepsis and complications of device, implant, or graft, compared to highest-performing hospitals.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Morphis B, Youssef R .
An analysis of diagnoses that drive readmission: what can we learn from the hospitals in Southern New England with the highest and lowest readmission performance?
R I Med J 2017 Aug;100(8):23-28.
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Keywords: Adverse Events, Diagnostic Safety and Quality, Hospital Readmissions, Hospitals, Quality Indicators (QIs)
Caldieraro MA, Sylvia LG, Dufour S
Clinical correlates of acute bipolar depressive episode with psychosis.
The aim of this study was to identify the characteristics of depressed bipolar patients with current psychosis compared to those without psychosis. Results showed that psychosis was present in 10.6% of the studied depressed patients. Psychotic patients had less education, lower income, and were more frequently single and unemployed. Psychosis was also associated with a more severe depressive episode, higher suicidality, more comorbid conditions and worse functioning. Most group differences disappeared when controlling for depression severity.
AHRQ-funded; HS019371.
Citation: Caldieraro MA, Sylvia LG, Dufour S .
Clinical correlates of acute bipolar depressive episode with psychosis.
J Affect Disord 2017 Aug 1;217:29-33. doi: 10.1016/j.jad.2017.03.059.
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Keywords: Comparative Effectiveness, Diagnostic Safety and Quality, Behavioral Health, Patient-Centered Healthcare
Bhise V, Meyer AND, Singh H
Errors in diagnosis of spinal epidural abscesses in the era of electronic health records.
With this study, the investigators set out to identify missed opportunities in diagnosis of spinal epidural abscesses to outline areas for process improvement. The investigators found that despite wide availability of clinical data, errors in diagnosis of spinal epidural abscesses were common and involved inadequate history, physical examination, and test ordering. They suggested that solutions should include renewed attention to basic clinical skills.
AHRQ-funded; HS022087.
Citation: Bhise V, Meyer AND, Singh H .
Errors in diagnosis of spinal epidural abscesses in the era of electronic health records.
Am J Med 2017 Aug;130(8):975-81. doi: 10.1016/j.amjmed.2017.03.009..
Keywords: Adverse Events, Back Health and Pain, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Patient Safety
Brown SM, Duggal A, Hou PC
Nonlinear imputation of PaO2/FIO2 from SpO2/FIO2 among mechanically ventilated patients in the ICU: a prospective, observational study.
The objective of the study was to validate the superiority of nonlinear imputation of PaO2/FIO2 (a clinical indicator of hypoxaemia) among mechanically ventilated patients and understand what factors influence the accuracy of imputation. It concluded that in mechanically ventilated patients, nonlinear imputation of PaO2/FIO2 from SpO2/FIO2 seems accurate, especially for moderate-severe hypoxemia. Linear and log-linear imputations cannot be recommended.
AHRQ-funded; HS021456.
Citation: Brown SM, Duggal A, Hou PC .
Nonlinear imputation of PaO2/FIO2 from SpO2/FIO2 among mechanically ventilated patients in the ICU: a prospective, observational study.
Crit Care Med 2017 Aug;45(8):1317-24. doi: 10.1097/ccm.0000000000002514.
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Keywords: Diagnostic Safety and Quality, Respiratory Conditions, Intensive Care Unit (ICU), Emergency Medical Services (EMS)
Meyer AND, Murphy DR, Al-Mutairi A
Electronic detection of delayed test result follow-up in patients with hypothyroidism.
Researchers developed and tested an electronic health record (EHR)-based trigger algorithm to identify instances of delayed follow-up of abnormal thyroid-stimulating hormone (TSH) results in patients being treated for hypothyroidism. Their automated trigger algorithm applied to records in a large EHR data warehouse was able to identify patients with hypothyroidism with potential delays in thyroid function test results follow-up.
AHRQ-funded; HS022901.
Citation: Meyer AND, Murphy DR, Al-Mutairi A .
Electronic detection of delayed test result follow-up in patients with hypothyroidism.
J Gen Intern Med 2017 Jul;32(7):753-59. doi: 10.1007/s11606-017-3988-z.
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Keywords: Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Chandakkar PS, Venkatesan R, Li B
MIRank-KNN: multiple-instance retrieval of clinically relevant diabetic retinopathy images.
Computer-aided diagnosis has the potential of improving diabetic retinopathy (DR) screening or diagnosis. The researchers developed a feature space of a modified color correlogram appended with statistics of steerable Gaussian filter responses selected by fast radial symmetric transform points. Experiments with real DR images collected from five different datasets demonstrate that the proposed approach is able to outperform existing methods.
AHRQ-funded; HS019792.
Citation: Chandakkar PS, Venkatesan R, Li B .
MIRank-KNN: multiple-instance retrieval of clinically relevant diabetic retinopathy images.
J Med Imaging 2017 Jul;4(3):034003. doi: 10.1117/1.jmi.4.3.034003.
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Keywords: Diabetes, Imaging, Eye Disease and Health, Health Information Technology (HIT), Diagnostic Safety and Quality
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