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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
226 to 250 of 3101 Research Studies DisplayedWisk LE, Weitzman ER
Expectancy and achievement gaps in educational attainment and subsequent adverse health effects among adolescents with and without chronic medical conditions.
This study sought to investigate educational aspirations, expectations, and attainment among youth with and without chronic conditions and to determine if these relationships mediated subsequent disparities in health and well-being. Findings suggest an important risk mechanism through which youth with chronic medical conditions may acquire socioeconomic disadvantage as they develop and progress through educational settings.
AHRQ-funded; HS022986; HS000063.
Citation: Wisk LE, Weitzman ER .
Expectancy and achievement gaps in educational attainment and subsequent adverse health effects among adolescents with and without chronic medical conditions.
J Adolesc Health 2017 Oct;61(4):461-70. doi: 10.1016/j.jadohealth.2017.04.006..
Keywords: Children/Adolescents, Chronic Conditions, Disparities, Education, Health Status
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
Ray KN, Ashcraft LE, Mehrotra A
Family perspectives on telemedicine for pediatric subspecialty care.
The researchers sought to understand how subspecialty telemedicine is perceived and to identify design elements with the potential to improve telemedicine uptake and impact. They found that although informants saw the potential value of using telemedicine to replace in-person subspecialty visits, they were more enthusiastic about using telemedicine to complement rather than replace in-person visits.
AHRQ-funded; HS022989.
Citation: Ray KN, Ashcraft LE, Mehrotra A .
Family perspectives on telemedicine for pediatric subspecialty care.
Telemed J E Health 2017 Oct;23(10):852-62. doi: 10.1089/tmj.2016.0236.
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Keywords: Children/Adolescents, Healthcare Delivery, Patient-Centered Healthcare, Children/Adolescents, Telehealth
Ancker JS, Send A, Hafeez B
Health IT usability focus section: adapting EHR-based medication instructions to comply with plain language guidance-a randomized experiment.
Using examples of clinician-written medication instructions from an electronic health record, the investigators conducted an experiment to determine whether parental misinterpretations would be reduced by instructions that followed best practices for plain language. The researchers found that a relatively simple intervention of revising text was associated with a modest reduction in frequency of misinterpretations of medication instructions.
AHRQ-funded; HS021531.
Citation: Ancker JS, Send A, Hafeez B .
Health IT usability focus section: adapting EHR-based medication instructions to comply with plain language guidance-a randomized experiment.
Appl Clin Inform 2017 Oct;8(4):1127-43. doi: 10.4338/aci-2017-06-ra-0111..
Keywords: Communication, Education: Patient and Caregiver, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication
Liang L, Brach C
AHRQ Author: Liang L, Brach C
Health literacy universal precautions are still a distant dream: analysis of U.S. data on health literate practices.
This study sought to examine whether there has been an increase in the delivery of health literate care and whether recommendations for health literacy universal precautions are being followed. It found that the proportion of adults in the U.S. who reported receiving health literate care increased from 2011 to 2014, but fell far short of health literacy universal precautions recommendations of delivering health literate care to everyone.
AHRQ-authored.
Citation: Liang L, Brach C .
Health literacy universal precautions are still a distant dream: analysis of U.S. data on health literate practices.
Health Lit Res Pract 2017 Oct;1(4):e216-e30. doi: 10.3928/24748307-20170929-01.
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Keywords: Healthcare Delivery, Health Literacy, Medical Expenditure Panel Survey (MEPS), Clinician-Patient Communication
Gianfrancesco MA, Schmajuk G, Haserodt S
Hydroxychloroquine dosing in immune-mediated diseases: implications for patient safety.
Evidence suggests that hydroxychloroquine (HCQ) retinal toxicity is more common than previously thought. Adhering to careful weight-based dosing can significantly reduce the risk of this adverse event and is recommended in recent guidelines. The study authors used electronic health record data from a large health system to examine HCQ dosing over a 5-year period and identify risk factors associated with higher dosage of HCQ.
AHRQ-funded; HS024412.
Citation: Gianfrancesco MA, Schmajuk G, Haserodt S .
Hydroxychloroquine dosing in immune-mediated diseases: implications for patient safety.
Rheumatol Int 2017 Oct;37(10):1611-18. doi: 10.1007/s00296-017-3782-6..
Keywords: Adverse Drug Events (ADE), Patient Safety, Risk, Skin Conditions
Charles EJ, Johnston LE, Herbert MA
Impact of Medicaid expansion on cardiac surgery volume and outcomes.
The objective of this study was to evaluate the effect of Medicaid expansion on cardiac surgery volume and outcomes comparing one state that expanded to one that did not. It concluded that Medicaid expansion was associated with fewer uninsured cardiac surgery patients and improved predicted risk scores and morbidity rates. In addition to improving health care financing, Medicaid expansion may positively affect patient care and outcomes.
AHRQ-funded; HS022535.
Citation: Charles EJ, Johnston LE, Herbert MA .
Impact of Medicaid expansion on cardiac surgery volume and outcomes.
Ann Thorac Surg 2017 Oct;104(4):1251-58. doi: 10.1016/j.athoracsur.2017.03.079.
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Keywords: Patient-Centered Outcomes Research, Medicaid, Surgery, Cardiovascular Conditions, Policy
Badawy J, Nguyen OK, Clark C
Is everyone really breathing 20 times a minute? Assessing epidemiology and variation in recorded respiratory rate in hospitalised adults.
The researchers sought to assess the potential accuracy of respiratory rate (RR) by analyzing the distribution and variation as a proxy, since RR should be normally distributed if recorded accurately. The observed patterns suggest that RR is inaccurately recorded, even among those with cardiopulmonary compromise, and represents a 'spot' estimate with values of 18 and 20 breaths per minute representing 'normal.’
AHRQ-funded; HS022418.
Citation: Badawy J, Nguyen OK, Clark C .
Is everyone really breathing 20 times a minute? Assessing epidemiology and variation in recorded respiratory rate in hospitalised adults.
BMJ Qual Saf 2017 Oct;26(10):832-36. doi: 10.1136/bmjqs-2017-006671.
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Keywords: Hospitalization, Inpatient Care, Patient Safety, Quality Improvement, Respiratory Conditions
Davis CM, Guo M, Miyamura J
Key factors in obstetric delivery decision-making among Asian and Pacific Islander women by English proficiency.
Understanding (1) how expectant mothers gather information to decide where to give birth, and (2) who helps make that decision, provides critical health communication and decision-making insights. This survey found that the top three health decision-makers for both those Asian American and Pacific Islanders (AAPIs) with limited English proficiency and English-proficient AAPIs were themselves, their obstetrician, and their spouse, which did not differ significantly by language proficiency.
AHRQ-funded; HS021903.
Citation: Davis CM, Guo M, Miyamura J .
Key factors in obstetric delivery decision-making among Asian and Pacific Islander women by English proficiency.
Hawaii J Med Public Health 2017 Oct;76(10):279-86.
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Keywords: Healthcare Delivery, Cultural Competence, Decision Making, Pregnancy, Racial and Ethnic Minorities
Lyles CR, Fruchterman J, Youdelman M
Legal, practical, and ethical considerations for making online patient portals accessible for all.
The authors argue that there are potential legal mandates for improving portal accessibility (e.g., the Civil Rights and the Rehabilitation Acts), as well as ethical considerations to prevent the exacerbation of existing health and health care disparities. To address these legal, practical, and ethical considerations, they present standards and broad recommendations that could greatly improve the reach and impact of portal Web sites.
AHRQ-funded; HS022408.
Citation: Lyles CR, Fruchterman J, Youdelman M .
Legal, practical, and ethical considerations for making online patient portals accessible for all.
Am J Public Health 2017 Oct;107(10):1608-11. doi: 10.2105/ajph.2017.303933.
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Keywords: Health Information Technology (HIT), Web-Based, Education: Patient and Caregiver, Electronic Health Records (EHRs)
Schmajuk G, Yazdany J
Leveraging the electronic health record to improve quality and safety in rheumatology.
In the coming years, developing and leveraging tools within the electronic health record (EHR) will be the key to making the next big strides in improving the health of patients with rheumatoid arthritis and other rheumatic diseases, including building EHR infrastructure to capture patient outcomes and developing automated methods to retrieve information from free text of clinical notes.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Yazdany J .
Leveraging the electronic health record to improve quality and safety in rheumatology.
Rheumatol Int 2017 Oct;37(10):1603-10. doi: 10.1007/s00296-017-3804-4.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Patient Safety, Quality Improvement, Arthritis
Lieberthal RD, Payton C, Sarfaty M
Measuring the cost of the patient-centered medical home: a cost-accounting approach.
To explore the cost for individual practices to become more patient-centered, this study inventoried and calculated costly activities involved in implementing the Patient-Centered Medical Home (PCMH) as defined by the National Committee for Quality Assurance.
AHRQ-funded; HS022630.
Citation: Lieberthal RD, Payton C, Sarfaty M .
Measuring the cost of the patient-centered medical home: a cost-accounting approach.
J Ambul Care Manage 2017 Oct/Dec;40(4):327-38. doi: 10.1097/jac.0000000000000196..
Keywords: Healthcare Delivery, Healthcare Costs, Patient-Centered Healthcare
Huguet N, Hoopes MJ, Angier H
Medicaid expansion produces long-term impact on insurance coverage rates in community health centers.
This study assesses changes in insurance status of patients visiting community health centers (CHCs) comparing states that expanded Medicaid to those that did not. Rates of uninsured visits decreased pre- to post- Affordable Care Act with greater drops in expansion (-57 percent) versus nonexpansion (-20 percent) states. Medicaid-insured visits increased 60 percent in expansion states while remaining unchanged in nonexpansion states.
AHRQ-funded; HS024270.
Citation: Huguet N, Hoopes MJ, Angier H .
Medicaid expansion produces long-term impact on insurance coverage rates in community health centers.
J Prim Care Community Health 2017 Oct;8(4):206-12. doi: 10.1177/2150131917709403.
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Keywords: Community Partnerships, Health Insurance, Policy, Medicaid, Uninsured
Adams LB, Richmond J, Corbie-Smith G
Medical mistrust and colorectal cancer screening among African Americans.
The goal of this systematic review was to summarize evidence investigating associations between medical mistrust and CRC screening among African Americans, and variations in these associations by gender, CRC screening type, and level of mistrust. The study found that quantitative differences in mistrust and CRC screening by gender were mixed, but qualitative studies highlighted fear of experimentation and intrusiveness of screening methods as unique themes among African American men.
AHRQ-funded; HS000032.
Citation: Adams LB, Richmond J, Corbie-Smith G .
Medical mistrust and colorectal cancer screening among African Americans.
J Community Health 2017 Oct;42(5):1044-61. doi: 10.1007/s10900-017-0339-2..
Keywords: Cancer: Colorectal Cancer, Prevention, Racial and Ethnic Minorities, Screening
Zullo AR, Dore DD, Gutman R
Metformin safety warnings and diabetes drug prescribing patterns for older nursing home residents.
Diabetes mellitus is common in US nursing homes (NHs), and the mainstay treatment, metformin, has US Food and Drug Administration (FDA) boxed warnings indicating safety concerns in those with advanced age, heart failure, or renal disease. The researchers quantified the determinants of initiating sulfonylureas over metformin with the aim of understanding the impact of FDA-labeled boxed warnings in older NH residents.
AHRQ-funded; HS022998.
Citation: Zullo AR, Dore DD, Gutman R .
Metformin safety warnings and diabetes drug prescribing patterns for older nursing home residents.
J Am Med Dir Assoc 2017 Oct;18(10):879-84.e7. doi: 10.1016/j.jamda.2017.05.020..
Keywords: Elderly, Medication, Nursing Homes, Patient Safety, Practice Patterns
Ehrlich SF, Hedderson MM, Brown SD
Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes.
The aim of the study was to assess the association of regular, unsupervised sports and exercise during pregnancy, by intensity level, with glycaemic control in women with gestational diabetes (GDM). The study concluded that higher volumes of moderate intensity sports and exercise, reported shortly after GDM diagnosis, were significantly associated with increased odds of achieving glycaemic control.
AHRQ-funded; HS019367.
Citation: Ehrlich SF, Hedderson MM, Brown SD .
Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes.
Diabetes Metab 2017 Oct;43(5):416-23. doi: 10.1016/j.diabet.2017.01.006..
Keywords: Diabetes, Lifestyle Changes, Outcomes, Patient-Centered Outcomes Research, Pregnancy, Women
Kazi DS, Lu CY, Lin GA
Nationwide coverage and cost-sharing for PCSK9 inhibitors among Medicare Part D plans.
In this research letter the investigators analyzed the June 2016 Centers for Medicare and Medicaid Services Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files for all Part D plans (except special-needs plans that may have had specialized formularies) and out-of-pocket cost requirements for PCSK9is (alirocumab and evolocumab) averaged across all plans by counties and states. The authors asserted that their findings suggest a need to lower out-of pocket costs to ensure affordability of PCSK9is for Medicare beneficiaries covered by Part D.
AHRQ-funded; HS016772.
Citation: Kazi DS, Lu CY, Lin GA .
Nationwide coverage and cost-sharing for PCSK9 inhibitors among Medicare Part D plans.
JAMA Cardiol 2017 Oct;2(10):1164-66. doi: 10.1001/jamacardio.2017.3051..
Keywords: Healthcare Costs, Medicare, Medication, Policy
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
Barker AK, Zellmer C, Tischendorf J
On the hands of patients with Clostridium difficile: a study of spore prevalence and the effect of hand hygiene on C difficile removal.
This study assessed the prevalence of Clostridium difficile spores in 48 observations of infected inpatients after randomly assigning them to hand hygiene with either alcohol-based handrub or soap and water.
AHRQ-funded; HS023791.
Citation: Barker AK, Zellmer C, Tischendorf J .
On the hands of patients with Clostridium difficile: a study of spore prevalence and the effect of hand hygiene on C difficile removal.
Am J Infect Control 2017 Oct;45(10):1154-56. doi: 10.1016/j.ajic.2017.03.005..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Kamal AH, Taylor DH, Neely B
One size does not fit all: disease profiles of serious illness patients receiving specialty palliative care.
This study was one of the first to describe symptom burden and functional scores by diagnostic categories and care settings across a community-based interdisciplinary specialty palliative care program. Results demonstrated statistically significant and clinically relevant differences among settings of care, functional status, and symptom profiles between patients with various serious illnesses.
AHRQ-funded; HS023681.
Citation: Kamal AH, Taylor DH, Neely B .
One size does not fit all: disease profiles of serious illness patients receiving specialty palliative care.
J Pain Symptom Manage 2017 Oct;54(4):476-83. doi: 10.1016/j.jpainsymman.2017.07.035..
Keywords: Quality of Care, Palliative Care, Quality Improvement
Hubley S, Uebelacker LA, Nash J
Open trial of integrated primary care consultation for medically unexplained symptoms.
In this study, a behavioral consultation intervention for primary care patients with medically unexplained symptoms (n = 10) was developed and assessed. Notwithstanding the limitations of open trial designs, the findings demonstrated high feasibility for a behavioral health consultation treatment model for patients with medically unexplained symptoms and highlight the need for further research.
AHRQ-funded; HS022401.
Citation: Hubley S, Uebelacker LA, Nash J .
Open trial of integrated primary care consultation for medically unexplained symptoms.
J Behav Health Serv Res 2017 Oct;44(4):590-601. doi: 10.1007/s11414-016-9528-5..
Keywords: Behavioral Health, Primary Care, Primary Care: Models of Care
Tedesco D, Asch SM, Curtin C
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
This study analyzed national trends in inpatient and emergency department (ED) discharges for opioid abuse, dependence, and poisoning using Healthcare Cost and Utilization Project data.
AHRQ-funded; HS024096.
Citation: Tedesco D, Asch SM, Curtin C .
Opioid abuse and poisoning: trends in inpatient and emergency department discharges.
Health Aff 2017 Oct;36(10):1748-53. doi: 10.1377/hlthaff.2017.0260..
Keywords: Emergency Department, Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Opioids, Substance Abuse
Offorjebe OA, Wynn A, Moshashane N
Partner notification and treatment for sexually transmitted infections among pregnant women in Gaborone, Botswana.
This paper describes a prospective cohort study which was conducted among 300 pregnant women presenting to the antenatal clinic at Princess Marina Hospital in Gaborone, Botswana who enrolled in an STI screening study. The authors specifically examine partner notification and treatment. They conclude that their findings suggest that pregnant women are willing to utilize patient-based partner notification, but actual partner treatment might be lower than intended.
AHRQ-funded; HS000046.
Citation: Offorjebe OA, Wynn A, Moshashane N .
Partner notification and treatment for sexually transmitted infections among pregnant women in Gaborone, Botswana.
Int J STD AIDS 2017 Oct;28(12):1184-89. doi: 10.1177/0956462417692455..
Keywords: Infectious Diseases, Pregnancy, Screening, Women
Fisher KA, Mazor KM
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
This paper comments on the Mack et al. article “Evaluation of Patient and Family Outpatient Complaints as a Strategy to Prioritize Efforts to Improve Cancer Care Delivery”, published in 2017 in The Joint Commission Journal on Quality and Patient Safety, in which Mack et al. categorized all complaints filed at a large outpatient cancer center during a two-year period, put forth a preliminary rating system for assessing complaint severity, and catalogued the actions taken in response to the complaints.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Mazor KM .
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
Jt Comm J Qual Patient Saf 2017 Oct;43(10):495-97. doi: 10.1016/j.jcjq.2017.07.003..
Keywords: Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient Experience, Patient Safety, Quality of Care, Quality Improvement
Pellegrini CA, Song J, Semanik PA
Patients less likely to lose weight following a knee replacement: results from the osteoarthritis initiative.
The purpose of this study was to examine weight change patterns preoperatively and postoperatively among overweight/obese knee replacement patients. Overweight and obese patients initially lost weight during the interval including knee replacement; however, they were less likely to lose more than 2.5% of their weight in the 1 to 2 years immediately after the surgery.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Song J, Semanik PA .
Patients less likely to lose weight following a knee replacement: results from the osteoarthritis initiative.
J Clin Rheumatol 2017 Oct;23(7):355-60. doi: 10.1097/rhu.0000000000000579..
Keywords: Obesity: Weight Management, Arthritis, Patient-Centered Outcomes Research, Surgery