National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (8)
- (-) Blood Clots (21)
- Blood Thinners (4)
- Cancer: Breast Cancer (1)
- Cancer: Ovarian Cancer (1)
- Cardiovascular Conditions (3)
- Care Management (2)
- Case Study (1)
- Children/Adolescents (1)
- Comparative Effectiveness (2)
- Critical Care (1)
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- Diagnostic Safety and Quality (1)
- Elderly (1)
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- Evidence-Based Practice (2)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Delivery (1)
- Heart Disease and Health (2)
- Hospitalization (3)
- Hospitals (2)
- Imaging (1)
- Intensive Care Unit (ICU) (1)
- Medication (4)
- Outcomes (2)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (1)
- Patient Safety (6)
- Payment (1)
- Prevention (8)
- Provider Performance (1)
- Public Reporting (1)
- Quality Improvement (3)
- Quality Indicators (QIs) (2)
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- Stroke (2)
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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 21 of 21 Research Studies DisplayedRepplinger MD, Bracken RL, Patterson BW
Downstream imaging utilization after mr angiography versus CT angiography for the initial evaluation of pulmonary embolism.
This single-center, retrospective, observational study examined the use of chest CT or MR for ED patients with MR angiography (MRA) negative for PE during April 2008 to March 2013. The investigators concluded that when comparing patients initially undergoing MRA versus CTA for the evaluation of PE, there was no difference in downstream chest CT or MR use at 1 year.
AHRQ-funded; HS024558; HS024342.
Citation: Repplinger MD, Bracken RL, Patterson BW .
Downstream imaging utilization after mr angiography versus CT angiography for the initial evaluation of pulmonary embolism.
J Am Coll Radiol 2018 Dec;15(12):1692-97. doi: 10.1016/j.jacr.2018.04.017..
Keywords: Blood Clots, Emergency Department, Imaging
Borre ED, Goode A, Raitz G
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
This systematic review compared the strength of tools to predict stroke and bleeding risk in patients with atrial fibrillation (AF) taking blood thinners. Sixty-one studies were found to predict thromboembolic risk and 38 to predict bleeding risk.
AHRQ-funded; 290201500004I.
Citation: Borre ED, Goode A, Raitz G .
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
Thromb Haemost 2018 Dec;118(12):2171-87. doi: 10.1055/s-0038-1675400..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Stroke, Blood Clots, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient-Centered Outcomes Research, Evidence-Based Practice
Murphy PB, Vogt KN, Lau BD
Venous thromboembolism prevention in emergency general surgery: a review.
Operatively and nonoperatively treated emergency general surgery patients are at a comparatively high risk of venous thromboembolism (VTE). This review found that, despite gaps in existing literature with respect to this increasing patient population, successful best practices can be applied. Best practices include assessment of VTE risk, optimal prophylaxis, and physician, nurse, and patient education regarding the use of mechanical and pharmacologic VTE prophylaxis and institutional policies.
AHRQ-funded; HS024547.
Citation: Murphy PB, Vogt KN, Lau BD .
Venous thromboembolism prevention in emergency general surgery: a review.
JAMA Surg 2018 May;153(5):479-86. doi: 10.1001/jamasurg.2018.0015..
Keywords: Blood Clots, Surgery, Emergency Department, Adverse Events, Prevention, Patient Safety
Wang SV, Huybrechts KF, Fischer MA
Generalized boosted modeling to identify subgroups where effect of dabigatran versus warfarin may differ: an observational cohort study of patients with atrial fibrillation.
The purpose of this study was to explore generalized boosted modeling (GBM) as a method for identifying subgroups with greater benefit or harm with dabigatran versus warfarin for treatment of atrial fibrillation. The investigators concluded that dabigatran's superiority to warfarin at prevention of thromboembolism may be greater in secondary than primary prevention. They indicated that in practice, secondary prevention patients are more often treated with warfarin.
AHRQ-funded; HS022193.
Citation: Wang SV, Huybrechts KF, Fischer MA .
Generalized boosted modeling to identify subgroups where effect of dabigatran versus warfarin may differ: an observational cohort study of patients with atrial fibrillation.
Pharmacoepidemiol Drug Saf 2018 Apr;27(4):383-90. doi: 10.1002/pds.4395..
Keywords: Blood Clots, Blood Thinners, Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Heart Disease and Health, Medication, Outcomes, Patient-Centered Outcomes Research, Prevention
Lau BD, Streiff MB, Pronovost PJ
Venous thromboembolism quality measures fail to accurately measure quality.
This study reviewed a large number of international quality measures for venous thromboembolism (VTE) prevention. Researchers discovered that none of them accurately characterize VTE prevention methods or outcomes in hospitalized patients. They describe an ideal, defect-free VTE prevention process.
AHRQ-funded; HS024547.
Citation: Lau BD, Streiff MB, Pronovost PJ .
Venous thromboembolism quality measures fail to accurately measure quality.
Circulation 2018 Mar 20;137(12):1278-84. doi: 10.1161/circulationaha.116.026897..
Keywords: Blood Clots, Hospitalization, Prevention, Quality Indicators (QIs), Quality Measures
Lau BD, Streiff MB, Kraus PS
Missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals: cause for alarm.
This study examined the rate of missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals in the Washington, DC and greater Baltimore metropolitan areas. This retrospective study included four hospitals within the Johns Hopkins Health System. Non-administration of VTE prophylaxis was found 10.9% to 15.0% of the time among the three community hospitals. About 43.6% of patients missed at least one dose in all four hospitals. The investigators weren’t able to categorize patients by specialty, however it has been reported that more doses are missed with medically ill patients than other hospitalized patients.
AHRQ-funded; HS024547.
Citation: Lau BD, Streiff MB, Kraus PS .
Missed doses of venous thromboembolism (VTE) prophylaxis at community hospitals: cause for alarm.
J Gen Intern Med 2018 Jan;33(1):19-20. doi: 10.1007/s11606-017-4203-y..
Keywords: Blood Clots, Prevention, Blood Thinners, Patient Adherence/Compliance, Medication, Hospitals
Cramer JD, Dilger AE, Schneider A
Risk of venous thromboembolism among otolaryngology patients vs general surgery and plastic surgery patients.
Researchers examined the rate of venous thromboembolism (VTE) for various otolaryngology procedures compared with an established average-risk field and low-risk field. They identified a high-risk group for VTE in otolaryngology; however, they found that most patients undergoing otolaryngology procedures are at low risk of VTE, indicating that guidelines for a low-risk population could be adapted to otolaryngology. The authors concluded that patients undergoing high-risk otolaryngology procedures should be considered as candidates for more aggressive VTE prophylaxis.
AHRQ-funded; HS023011.
Citation: Cramer JD, Dilger AE, Schneider A .
Risk of venous thromboembolism among otolaryngology patients vs general surgery and plastic surgery patients.
JAMA Otolaryngol Head Neck Surg 2018 Jan;144(1):9-17. doi: 10.1001/jamaoto.2017.1768..
Keywords: Surgery, Blood Clots, Risk, Adverse Events, Patient Safety
Beckman MG, Abe K, Barnes K
AHRQ Author: Brady PJ
Strategies and partnerships toward prevention of healthcare-associated venous thromboembolism.
This issue of the Journal of Hospital Medicine showcases the initiatives of several of the CDC’s healthcare-associated venous thromboembolism (HA-VTE) prevention champions. The CDC and AHRQ are partnering to disseminate and promote these best practices. In addition to this challenge, the CDC, AHRQ and the Joint Commission Center for Transforming Healthcare are working on activities and programs dedicated to improving prevention of HA-VTE. They are summarized in the article.
AHRQ-authored.
Citation: Beckman MG, Abe K, Barnes K .
Strategies and partnerships toward prevention of healthcare-associated venous thromboembolism.
J Hosp Med 2016 Dec;11 Suppl 2:S5-s7. doi: 10.1002/jhm.2659.
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Keywords: Prevention, Blood Clots, Quality Improvement, Guidelines, Adverse Events
Lau BD, Haut ER, Hobson DB
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Suboptimal prevention practices have prompted payers to consider hospital-associated Venous thromboembolism (VTE) as a potentially preventable condition for which financial incentives or penalties exist to drive practice improvement. The authors reviewed a subset of hospital-associated VTE that were identified by ICD-9 codes used by a state-run pay-for-performance quality improvement program and discuss their findings.
AHRQ-funded; HS017952.
Citation: Lau BD, Haut ER, Hobson DB .
ICD-9 code-based venous thromboembolism performance targets fail to measure up.
Am J Med Qual 2016 Sep;31(5):448-53. doi: 10.1177/1062860615583547.
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Keywords: Healthcare-Associated Infections (HAIs), Quality Indicators (QIs), Prevention, Hospitals, Quality Improvement, Blood Clots, Payment, Provider Performance
Farrow NE, Lau BD, JohnBull EA
Is the meaningful use venous thromboembolism VTE-6 measure meaningful? A retrospective analysis of one hospital's VTE-6 cases.
The researchers assessed the validity of the Meaningful Use VTE-6 measure by reviewing the quality of venous thromboembolism (VTE) prophylaxis provided to patients. Sixty percent of the patients identified as having sustained potentially preventable VTE were false positives. For the remaining forty percent, VTE was considered to be truly potentially preventable and those patients therefore provided targets for quality improvement measures.
AHRQ-funded; HS017952.
Citation: Farrow NE, Lau BD, JohnBull EA .
Is the meaningful use venous thromboembolism VTE-6 measure meaningful? A retrospective analysis of one hospital's VTE-6 cases.
Jt Comm J Qual Patient Saf 2016 Sep;42(9):410-6.
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Keywords: Blood Clots, Quality Improvement, Quality Measures, Quality Measures, Electronic Health Records (EHRs)
Poonawalla IB, Piller LB, Lairson DR
Use of hematopoietic growth factors and risk of thromboembolic and pulmonary toxicities in elderly patients with advanced ovarian cancer.
This study evaluated the risk of thromboembolic and pulmonary toxicities associated with hematopoietic growth factor (HGF) use (i.e., erythropoietin-stimulating agent [ESA] and/or colony-stimulating factor [CSF]) in a community-dwelling cohort of elderly patients with advanced ovarian cancer. An increased risk of thromboembolic events was observed in elderly patients with ovarian cancer who received ESA + CSF.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Piller LB, Lairson DR .
Use of hematopoietic growth factors and risk of thromboembolic and pulmonary toxicities in elderly patients with advanced ovarian cancer.
Womens Health Issues 2016 Sep-Oct;26(5):574-83. doi: 10.1016/j.whi.2016.05.007.
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Keywords: Adverse Events, Blood Clots, Elderly, Cancer: Ovarian Cancer, Risk
Wang SV, Franklin JM, Glynn RJ
Prediction of rates of thromboembolic and major bleeding outcomes with dabigatran or warfarin among patients with atrial fibrillation: new initiator cohort study.
The authors compared stratified event rates from randomized controlled trials with predicted event rates from models developed in observational data and assessed their ability to accurately capture observed rates of thromboembolism and major bleeding for patients treated with dabigatran or warfarin as part of routine care. They found that estimated rates of thromboembolism under dabigatran or warfarin treatment in randomized controlled trials were close to observed rates in routine care patients, but that rates of major bleeding were underestimated. They concluded that models developed in routine care patients can provide accurate, tailored estimates of risk and benefit under alternative treatment to enhance patient centered care.
AHRQ-funded; HS022193.
Citation: Wang SV, Franklin JM, Glynn RJ .
Prediction of rates of thromboembolic and major bleeding outcomes with dabigatran or warfarin among patients with atrial fibrillation: new initiator cohort study.
BMJ 2016 May 24;353:i2607. doi: 10.1136/bmj.i2607.
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Keywords: Blood Thinners, Adverse Drug Events (ADE), Blood Clots, Patient Safety, Medication
Jindai K, Sterkel AK, Reed KD
Limb embolism in a 52-year-old woman.
In response to a photo quiz, the authors make the following diagnosis: arterial thrombus caused by Histoplasma capsulatum deriving from native valve endocarditis caused by the same organism. Various aspects of the case are discussed.
AHRQ-funded; HS022465; HS023779.
Citation: Jindai K, Sterkel AK, Reed KD .
Limb embolism in a 52-year-old woman.
Clin Infect Dis 2016 May 15;62(10):1320-1. doi: 10.1093/cid/ciw081.
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Keywords: Blood Clots, Care Management, Case Study, Diagnostic Safety and Quality, Patient Safety
Grant PJ, Greene MT, Chopra V
Assessing the Caprini score for risk assessment of venous thromboembolism in hospitalized medical patients.
The authors examined how well the Caprini risk assessment model predicts venous thromboembolism in hospitalized medical patients. They concluded that the Caprini risk assessment model was unable to identify a subset of medical patients who benefit from pharmacologic prophylaxis.
AHRQ-funded; HS022835.
Citation: Grant PJ, Greene MT, Chopra V .
Assessing the Caprini score for risk assessment of venous thromboembolism in hospitalized medical patients.
Am J Med 2016 May;129(5):528-35. doi: 10.1016/j.amjmed.2015.10.027.
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Keywords: Adverse Events, Blood Clots, Hospitalization, Risk, Patient Safety
Du XL, Zhang Y, Hardy D
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
The researchers sought to determine the risk of venous thromboembolism (VTE), stroke, ischemic heart disease, and myelodysplastic syndrome (MDS) in association with the receipt of colony-stimulating factors (CSFs) and/or erythropoiesis-stimulating agents (ESAs) in women with breast cancer. They found that receipts of CSFs and ESAs were significantly associated with an increased risk of VTE in women with breast cancer.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Hardy D .
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
Cancer Causes Control 2016 May;27(5):695-707. doi: 10.1007/s10552-016-0742-5.
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Keywords: Blood Clots, Cancer: Breast Cancer, Cardiovascular Conditions, Risk, Stroke
Yen J, Van Arendonk KJ, Streiff MB
Risk factors for venous thromboembolism in pediatric trauma patients and validation of a novel scoring system: the risk of clots in kids with trauma score.
The researchers identified risk factors for venous thromboembolism and developed venous thromboembolism risk assessment models for pediatric trauma patients. They found that venous thromboembolism is infrequent after trauma in pediatric patients, and they developed weighted scoring systems to stratify pediatric trauma patients at risk.
AHRQ-funded; HS017952.
Citation: Yen J, Van Arendonk KJ, Streiff MB .
Risk factors for venous thromboembolism in pediatric trauma patients and validation of a novel scoring system: the risk of clots in kids with trauma score.
Pediatr Crit Care Med 2016 May;17(5):391-9. doi: 10.1097/pcc.0000000000000699.
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Keywords: Blood Clots, Children/Adolescents, Risk, Risk, Trauma
Admon AJ, Seymour CW, Gershengorn HB
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
The researchers examined the relationship between intensive care unit (ICU) use for patients with pulmonary embolism (PE) and cost, mortality, readmission, and procedure use in 263 hospitals. They found wide variations in ICU admission rates for acute PE without a detectable impact on mortality, cost, or readmission.
AHRQ-funded; HS020672
Citation: Admon AJ, Seymour CW, Gershengorn HB .
Hospital-level variation in ICU admission and critical care procedures for patients hospitalized for pulmonary embolism.
Chest. 2014 Dec;146(6):1452-61. doi: 10.1378/chest.14-0059..
Keywords: Blood Clots, Care Management, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU)
Ju MH, Chung JW, Kinnier CV
Association between hospital imaging use and venous thromboembolism events rates based on clinical data.
This study assessed the presence and extent of venous thromboembolism (VTE) surveillance bias using high-quality clinical data from 208 hospitals. It concluded that hospitals may be unfairly deemed poor performers for the outcome VTE measure if they have increased vigilance for VTE by performing more VTE imaging studies that result in higher VTE event rates.
AHRQ-funded; HS021857
Citation: Ju MH, Chung JW, Kinnier CV .
Association between hospital imaging use and venous thromboembolism events rates based on clinical data.
Ann Surg. 2014 Sep; 260(3):558-64; discussion 64-6. doi: 10.1097/sla.0000000000000897..
Keywords: Blood Clots, Public Reporting, Adverse Events, Outcomes, Quality of Care
Chopra V, Ratz D, Kuhn L
Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors.
This study was designed to determine patient, provider, and device outcome of deep vein thrombosis (DVT) associated with peripherally inserted central catheters (PICCs). Larger PICC gauge, especially in the use of recently diagnosed cancer patients, increases the likelihood of DVT.
AHRQ-funded; HS022835
Citation: Chopra V, Ratz D, Kuhn L .
Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors.
J Thromb Haemost 2014 Jun;12(6):847-54. doi: 10.1111/jth.12549..
Keywords: Adverse Events, Blood Clots, Patient Safety, Risk
Streiff MB, Brady JP, Grant AM
AHRQ Author: Brady JP
CDC Grand Rounds: preventing hospital-associated venous thromboembolism.
Approximately half of new venous thromboembolism (VTE) cases occur during a hospital stay or within 90 days of an inpatient admission or surgical procedure, and many are not diagnosed until after discharge. Prevention of VTE can be complicated as physicians must balance the risk for thrombosis with the risk for bleeding from anticoagulants. A collaborative, team-based approach to care is needed for significant and sustained improvement, and it also offers efficiency and capacity to tackle other patient safety problems.
AHRQ-authored.
Citation: Streiff MB, Brady JP, Grant AM .
CDC Grand Rounds: preventing hospital-associated venous thromboembolism.
MMWR Morb Mortal Wkly Rep 2014 Mar 7;63(9):190-3.
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Keywords: Blood Clots, Healthcare-Associated Infections (HAIs), Hospitalization, Prevention, Teams
Lau BD, Haut ER
Practices to prevent venous thromboembolism: a brief review.
The purpose of this review is to provide an update on the most effective interventions aimed at improving adherence to guidelines on the use of venous thromboembolism (VTE) prevention strategies. After reviewing sixteen studies, the researchers concluded that the greatest and most sustained improvements were those that combined education with computerised tools.
AHRQ-funded; 290200710.
Citation: Lau BD, Haut ER .
Practices to prevent venous thromboembolism: a brief review.
BMJ Qual Saf 2014 Mar;23(3):187-95. doi: 10.1136/bmjqs-2012-001782..
Keywords: Comparative Effectiveness, Blood Clots, Prevention, Decision Making, Guidelines