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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 121 Research Studies DisplayedSinger SJ, Sinaiko AD, Tietschert MV
Care integration within and outside health system boundaries.
The purpose of this study was to examine care integration-efforts to unify disparate parts of health care organizations to generate synergy across activities occurring within and between them-to understand whether and at which organizational level health systems impact care quality and staff experience. The investigators concluded that measures of clinical process integration related to higher staff ratings of quality and experience.
AHRQ-funded; HS024067.
Citation: Singer SJ, Sinaiko AD, Tietschert MV .
Care integration within and outside health system boundaries.
Health Serv Res 2020 Dec;55(Suppl 3):1033-48. doi: 10.1111/1475-6773.13578..
Keywords: Health Systems, Healthcare Delivery, Health Services Research (HSR), Research Methodologies
Kang M, Gurbani SS, Kempker JA
The published scientific literature on COVID-19: an analysis of PubMed abstracts.
This article describes a PubMed search done on the published scientific literature on COVID-19 from first reporting of the virus in late December 2019 through Nov. 9, 2020. A total of 57,263 articles were included, with 34% ahead of print, 25.1% e-published, and 40.9% print published at the time of data extraction. There was a peak of 2277 articles the week of May 11. The origin countries of publication were United States (35.7%), followed by England (27%), and the Netherlands (8.7%). Most publications (98%) were in English followed by less than 1% each in Spanish, German, and French.
AHRQ-funded; HS025240.
Citation: Kang M, Gurbani SS, Kempker JA .
The published scientific literature on COVID-19: an analysis of PubMed abstracts.
J Med Syst 2020 Nov 25;45(1):3. doi: 10.1007/s10916-020-01678-4..
Keywords: COVID-19, Public Health, Research Methodologies, Health Services Research (HSR)
Hernandez AV, Roman YM, White CM
Developing criteria and associated instructions for consistent and useful quality improvement study data extraction for health systems.
This paper describes AHRQ’s efforts to collate and assess quality improvement studies to support learning health systems (LHS). The authors identified quality improvement studies and evaluated the consistency of data extraction from two experienced independent reviewers at three time points: baseline, first revision, and final revision. Six investigators looked at the data extracted by the independent reviewers and determined the extent of similarity on a scale of 0 to 10. Two LHS participants were then asked to assess the relative value of their criteria. The consistency of extraction improved from a mean 1.17 score at baseline to 6.07 at first revision, and 6.81 at the final revision. There was not a significant improvement from the first to final revision. However, the LHS participants rated the value of these ratings a 9 and a 6, demonstrating that there is value in developing criteria.
AHRQ-funded; 290201500012I.
Citation: Hernandez AV, Roman YM, White CM .
Developing criteria and associated instructions for consistent and useful quality improvement study data extraction for health systems.
J Gen Intern Med 2020 Nov;35(Suppl 2):802-07. doi: 10.1007/s11606-020-06098-1..
Keywords: Quality Improvement, Quality of Care, Learning Health Systems, Health Systems, Health Services Research (HSR), Research Methodologies
Ward TM, Skubic M, Rantz M
Human-centered approaches that integrate sensor technology across the lifespan: opportunities and challenges.
Children, parents, older adults, and caregivers routinely use sensor technology as a source of health information and health monitoring. The purpose of this paper was to describe three exemplars of research that used a human-centered approach to engage participants in the development, design, and usability of interventions that integrate technology to promote health. The exemplars were based on current research studies that integrated sensor technology into pediatric, adult, and older adult populations living with a chronic health condition.
AHRQ-funded; HS018477.
Citation: Ward TM, Skubic M, Rantz M .
Human-centered approaches that integrate sensor technology across the lifespan: opportunities and challenges.
Nurs Outlook 2020 Nov-Dec;68(6):734-44. doi: 10.1016/j.outlook.2020.05.004..
Keywords: Health Information Technology (HIT), Patient and Family Engagement, Health Services Research (HSR), Research Methodologies
Carroll AR, Johnson DP
Know it when you see it: identifying and using special cause variation for quality improvement.
This article concerning an article that appears in the same issue discusses statistical process control charts. The authors conclude that by understanding the rules of special cause variation and applying them to data in real time, teams will be provided with information that will inform hypotheses testing, bolster knowledge about a system, and ultimately accelerate improvement work.
AHRQ-funded; HS026122.
Citation: Carroll AR, Johnson DP .
Know it when you see it: identifying and using special cause variation for quality improvement.
Hosp Pediatr 2020 Nov;10(11):e8-e10. doi: 10.1542/hpeds.2020-002303..
Keywords: Quality Improvement, Quality of Care, Health Services Research (HSR)
Anzuoni K, Field TS, Mazor KM
Recruitment challenges for low-risk health system intervention trials in older adults: a case study.
Researchers assessed factors associated with trial participation in the context of a low-risk intervention intended to reduce adverse drug events in recently hospitalized older adults. They found that recruiting older adults recently discharged from the hospital to participate in trials of low-risk, system-level interventions was challenging and may under-enroll the oldest individuals and those potentially at the highest risk for adverse events, limiting generalizability of study findings.
AHRQ-funded; HS023774.
Citation: Anzuoni K, Field TS, Mazor KM .
Recruitment challenges for low-risk health system intervention trials in older adults: a case study.
J Am Geriatr Soc 2020 Nov;68(11):2558-64. doi: 10.1111/jgs.16696..
Keywords: Elderly, Case Study, Research Methodologies, Health Services Research (HSR), Medication
Gance-Cleveland B, McDonald CC, Walker RK
Use of theory to guide development and application of sensor technologies in nursing.
In this paper, three nurse scientists summarize their presentations at the Council for the Advancement of Nursing Science 2019 Advanced Methods Conference on Expanding Science of Sensor Technology in Research discussing the theoretical underpinnings of sensor technologies development and use in nursing research and practice.
AHRQ-funded; HS024738; HS018646.
Citation: Gance-Cleveland B, McDonald CC, Walker RK .
Use of theory to guide development and application of sensor technologies in nursing.
Nurs Outlook 2020 Nov-Dec;68(6):698-710. doi: 10.1016/j.outlook.2020.04.007..
Keywords: Health Information Technology (HIT), Nursing, Health Services Research (HSR), Research Methodologies
Santry HP, Strassels SA, Ingraham AM
Identifying the fundamental structures and processes of care contributing to emergency general surgery quality using a mixed-methods Donabedian approach.
Acute Care Surgery (ACS) was developed as a structured, team-based approach to providing round-the-clock emergency general surgery (EGS) care for adult patients needing treatment for diseases such as cholecystitis, gastrointestinal perforation, and necrotizing fasciitis. In this study, the investigators sought to use a Donabedian approach to elucidate potential EGS structures and processes that might be associated with improved outcomes as an initial step in designing the optimal model of acute care surgery care for EGS patients.
AHRQ-funded; HS022694.
Citation: Santry HP, Strassels SA, Ingraham AM .
Identifying the fundamental structures and processes of care contributing to emergency general surgery quality using a mixed-methods Donabedian approach.
BMC Med Res Methodol 2020 Oct 2;20(1):247. doi: 10.1186/s12874-020-01096-7..
Keywords: Surgery, Critical Care, Healthcare Delivery, Health Services Research (HSR), Research Methodologies
Callejo-Black A, Wagner DV, Ramanujam K
A systematic review of external validity in pediatric integrated primary care trials.
This study used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to conduct a systematic review of external validity reporting in integrated primary care (IPC) interventions for mental health concerns. A literature search was conducted to identify relevant literature from 1998 to 2018 reporting on open, randomized or quasi-randomized trials of IPC interventions that targeted child (ages 0-18 years) psychological symptoms. The authors included 39 publications describing 25 studies in the review. Publications rarely reported indicators of external validity, including the representatives of participants (12%), rate of adoption clinics or providers (16%), cost of implementation (8%), or evidence of maintenance (16%). Few studies also included key pragmatic factors such as cost or organizational change processes related to implementation and maintenance.
AHRQ-funded; HS022981.
Citation: Callejo-Black A, Wagner DV, Ramanujam K .
A systematic review of external validity in pediatric integrated primary care trials.
J Pediatr Psychol 2020 Oct 1;45(9):1039-52. doi: 10.1093/jpepsy/jsaa068..
Keywords: Children/Adolescents, Primary Care, Behavioral Health, Healthcare Delivery, Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Smith JD, Li DH, Rafferty MR
The Implementation Research Logic Model: a method for planning, executing, reporting, and synthesizing implementation projects.
Numerous models, frameworks, and theories exist for specific aspects of implementation research (IR). However, IR projects often fail to provide a coherent rationale or justification for how these aspects are selected and tested in relation to one another. Despite this need to better specify the conceptual linkages between the core elements involved in projects, few tools or methods have been developed to aid in this task. In this paper, the investigators describe the Implementation Research Logic Model (IRLM) which was created for this purpose.
AHRQ-funded; HS025077.
Citation: Smith JD, Li DH, Rafferty MR .
The Implementation Research Logic Model: a method for planning, executing, reporting, and synthesizing implementation projects.
Implement Sci 2020 Sep 25;15(1):84. doi: 10.1186/s13012-020-01041-8.
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Keywords: Implementation, Health Services Research (HSR)
Li X, Lewis KH, Callaway K
Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?
The authors assessed the availability and validity of claims-based weight-related diagnosis codes among bariatric surgery patients who underwent adjusted gastric banding, Roux-en-Y gastric bypass, or sleeve gastrectomy. They found that claims-based weight-related diagnosis codes had excellent validity before and after bariatric surgical operation but suboptimal availability after operation. Claims databases can be used for bariatric surgery studies of non-weight-related effectiveness and safety outcomes that are well-captured.
AHRQ-funded; HS026214.
Citation: Li X, Lewis KH, Callaway K .
Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?
BMC Med Res Methodol 2020 Sep 7;20(1):225. doi: 10.1186/s12874-020-01106-8..
Keywords: Obesity: Weight Management, Obesity, Surgery, Health Services Research (HSR), Research Methodologies
O'Malley AJ, Park S
A novel cluster sampling design that couples multiple surveys to support multiple inferential objectives.
The authors of this paper designed a new sampling methodology for complex health systems that own practices or hospitals to assess the relationship between health organization factors and health outcomes. These complex organizations complicate the construction of optimal survey designs. The authors developed an alternative approach based on constraining the sampling design to satisfy desired statistical properties. They illustrated the new sampling methodology by developing the constraints and solving the ensuing systems of equations to obtain the sampling design for the National Survey of United States Health Care Systems, Hospitals and Practices. They used what they called “coupled” sampling by comparing the proportion of eligible systems for whom the corporate owner and both a hospital and a practice can be used for.
AHRQ-funded; HS024075.
Citation: O'Malley AJ, Park S .
A novel cluster sampling design that couples multiple surveys to support multiple inferential objectives.
Health Serv Outcomes Res Methodol 2020 Sep;20(2-3):85-110. doi: 10.1007/s10742-020-00210-y..
Keywords: Research Methodologies, Health Services Research (HSR)
Burke RE, Canamucio A, Medvedeva E
External validation of the skilled nursing facility prognosis score for predicting mortality, hospital readmission, and community discharge in veterans.
The goal of this study was to evaluate the Skilled Nursing Facility (SNF) Prognosis Score’s performance in an external validation cohort. Participants were previously community-dwelling veterans who received post-acute care in a SNF; both VA and non-VA hospitals and SNFs were included. Findings showed that the SNF Prognosis Score had reasonable discrimination and calibration, and it was simple to calculate using an admission SNF assessment and a nomogram. Recommendations included future work embedding the score into practice in order to determine real-world feasibility, acceptability, and effectiveness.
AHRQ-funded; HS026116.
Citation: Burke RE, Canamucio A, Medvedeva E .
External validation of the skilled nursing facility prognosis score for predicting mortality, hospital readmission, and community discharge in veterans.
J Am Geriatr Soc 2020 Sep;68(9):2090-94. doi: 10.1111/jgs.16650..
Keywords: Nursing Homes, Risk, Health Services Research (HSR)
Landes SJ, Kerns SEU, Pilar MR
Proceedings of the Fifth Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2019: where the rubber meets the road: the intersection of research, policy, and practice - part 1.
This paper offers a compilation of the abstracts of the oral and poster presentations from the 2019 Society for Implementation Research Collaboration (SIRC) Conference entitled “Where the Rubber Meets the Road: The Intersection of Research, Policy, and Practice” held in Seattle from 12-14 September. The society had evolved following a NIMH-funded conference grant and is now an international society. The conference included 432 attendees. Highlights of the conference are described.
AHRQ-funded; HS025632.
Citation: Landes SJ, Kerns SEU, Pilar MR .
Proceedings of the Fifth Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2019: where the rubber meets the road: the intersection of research, policy, and practice - part 1.
Implement Sci 2020 Sep 30;15(Suppl 3):76. doi: 10.1186/s13012-020-01034-7..
Keywords: Implementation, Health Services Research (HSR), Evidence-Based Practice, Policy, Research Methodologies
Heintzman J, Marino M, Clark K
Using electronic health record data to study Latino immigrant populations in health services research.
The purpose of this study was to validate an electronic health record (EHR)-based algorithm that could serve as a safe proxy for self-reported immigration status for health services researchers. Researchers developed an EHR algorithm to classify a population of patients as likely undocumented or recent Latino immigrants and validated this algorithm by conducting semi-structured interviews of staff. They concluded that the EHR has potential for studying immigration status in health services research, although more study is needed to determine the accuracy and utility of EHRs for this purpose.
AHRQ-funded; HS021522.
Citation: Heintzman J, Marino M, Clark K .
Using electronic health record data to study Latino immigrant populations in health services research.
J Immigr Minor Health 2020 Aug;22(4):754-61. doi: 10.1007/s10903-019-00925-2..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities, Health Services Research (HSR)
Brach C, Borsky A
AHRQ Author: Brach C, Borsky A
How the U.S. Agency for Healthcare Research and Quality promotes health literate health care.
This AHRQ-authored study traces the history of the AHRQ Health Literacy Action Plan to promote health literate health care delivery systems. This Plan has been developed and implemented for almost 15 years and serves as the framework for AHRQ’s efforts to 1) Develop measures; 2) Improve the evidence base and create implementation tools; 3) Create and support change; 4) Disseminate and transfer knowledge and tools; and 5) Practice what we preach.
AHRQ-authored.
Citation: Brach C, Borsky A .
How the U.S. Agency for Healthcare Research and Quality promotes health literate health care.
Stud Health Technol Inform 2020 Jun 25;269:313-23. doi: 10.3233/shti200046..
Keywords: Health Literacy, Healthcare Delivery, Health Services Research (HSR), Implementation
Di Tosto G, McAlearney AS, Fareed N
Metrics for outpatient portal use based on log file analysis: algorithm development.
This study’s goal was to document the functionality of an outpatient portal in the context of outpatient care by mining portal usage data and to provide insights into how patients use this tool. The authors developed a taxonomy of functions and actions and computed analytic metrics, including frequency and comprehensiveness of use. They found that function use was comprehensive at the patient level, while each session was instead limited to the use of one specific function. They hope to promote the replicability of their study at other institutions and to contribute to the establishment of best practices that can facilitate the adoption of behavioral metrics that enable the measurement of patient engagement based on the outpatient portal use.
AHRQ-funded; HS024091; HS024349; HS024379.
Citation: Di Tosto G, McAlearney AS, Fareed N .
Metrics for outpatient portal use based on log file analysis: algorithm development.
J Med Internet Res 2020 Jun 12;22(6):e16849. doi: 10.2196/16849..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Health Services Research (HSR), Research Methodologies
Hodgkin D, Moscarelli M, Rupp A
AHRQ Author: Zuvekas SH
Mental health economics: bridging research, practice and policy.
The authors discuss the past and current work of the World Psychiatric Association Section on Mental Health Economics. They conclude with stating that The Section strives for excellence in mental health economics research and education to promote the mission and fulfill the goals of the World Psychiatric Association.
Citation: Hodgkin D, Moscarelli M, Rupp A .
Mental health economics: bridging research, practice and policy.
World Psychiatry 2020 Jun;19(2):258-59. doi: 10.1002/wps.20753..
Keywords: Behavioral Health, Healthcare Costs, Health Services Research (HSR), Policy
Weng Y, Tian L, Tedesco D
Trajectory analysis for postoperative pain using electronic health records: a nonparametric method with robust linear regression and K-medians cluster analysis.
Postoperative pain scores are widely monitored and collected in the electronic health record, yet current methods fail to fully leverage the data with fast implementation. This article describes a trajectory analysis for postoperative pain using electronic health records. A robust linear regression was fitted to describe the association between the log-scaled pain score and time from discharge after total knee replacement.
AHRQ-funded; HS024096.
Citation: Weng Y, Tian L, Tedesco D .
Trajectory analysis for postoperative pain using electronic health records: a nonparametric method with robust linear regression and K-medians cluster analysis.
Health Informatics J 2020 Jun;26(2):1404-18. doi: 10.1177/1460458219881339..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Pain, Surgery, Orthopedics, Research Methodologies, Health Services Research (HSR)
Gernant SA, Adeoye-Olatunde OA, Murawski MM
Experiences applying technology to overcome common challenges in pharmacy practice-based research in the United States.
Despite the importance of pharmacy practice-based research in generating knowledge that results in better outcomes for patients, health systems and society alike, common challenges to PPBR persist. In this paper, the authors described PPBR challenges their research teams have encountered, and their experiences using technology-driven solutions to overcome such challenges. The authors describe the technology driven solutions they have used to address PPBR challenges.
AHRQ-funded; HS025943.
Citation: Gernant SA, Adeoye-Olatunde OA, Murawski MM .
Experiences applying technology to overcome common challenges in pharmacy practice-based research in the United States.
Pharmacy 2020 May 30;8(2):93. doi: 10.3390/pharmacy8020093..
Keywords: Provider: Pharmacist, Provider, Health Information Technology (HIT), Patient-Centered Outcomes Research, Evidence-Based Practice, Health Services Research (HSR)
Tsou AY, Treadwell JR, Erinoff E
Machine learning for screening prioritization in systematic reviews: comparative performance of Abstrackr and EPPI-Reviewer.
Improving the speed of systematic review (SR) development is key to supporting evidence-based medicine. Machine learning tools which semi-automate citation screening might improve efficiency. Few studies have assessed use of screening prioritization functionality or compared two tools head to head. In this project, the investigators compared performance of two machine-learning tools for potential use in citation screening.
AHRQ-funded; HS025859.
Citation: Tsou AY, Treadwell JR, Erinoff E .
Machine learning for screening prioritization in systematic reviews: comparative performance of Abstrackr and EPPI-Reviewer.
Syst Rev 2020 Apr 2;9(1):73. doi: 10.1186/s13643-020-01324-7..
Keywords: Health Services Research (HSR), Research Methodologies, Evidence-Based Practice, Patient-Centered Outcomes Research
Manojlovich M, Bedard L, Griggs JJ
Facilitators and barriers to recruiting ambulatory oncology practices into a large multisite study: mixed methods study.
The authors of this article aimed to describe the facilitators and barriers to recruiting ambulatory oncology practices into a large multisite study. They used a mixed methods design and 4 domains of the Consolidated Framework for Implementation Research to describe facilitators and barriers to recruitment. They identified numerous recruitment barriers and facilitators and devised strategies to enhance recruitment efforts. They concluded that researchers and clinicians can partner effectively to design and implement research protocols that ultimately benefit patients who are increasingly seeking care in ambulatory practices.
AHRQ-funded; HS024914.
Citation: Manojlovich M, Bedard L, Griggs JJ .
Facilitators and barriers to recruiting ambulatory oncology practices into a large multisite study: mixed methods study.
JMIR Cancer 2020 Apr 20;6(1):e14476. doi: 10.2196/14476..
Keywords: Ambulatory Care and Surgery, Health Services Research (HSR), Research Methodologies
Bucholz EM, Toomey SL, Butala NM
Suitability of elderly adult hospital readmission rates for profiling readmissions in younger adult and pediatric populations.
Investigators sought to determine the correlation between hospital 30-day risk-standardized readmission rates in elderly adults and those in nonelderly adults and children. Data from U.S. hospitals in the 2013-2014 Nationwide Readmissions Database were used. The researchers found that hospital readmission rates in elderly adults may reflect broader hospital readmission performance in middle-aged and young adult populations, but they are not reflective of hospital performance in pediatric populations.
AHRQ-funded; HS020513; HS025299.
Citation: Bucholz EM, Toomey SL, Butala NM .
Suitability of elderly adult hospital readmission rates for profiling readmissions in younger adult and pediatric populations.
Health Serv Res 2020 Apr;55(2):277-87. doi: 10.1111/1475-6773.13269..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Health Services Research (HSR), Research Methodologies, Children/Adolescents
Smith JD, Rafferty MR, Heinemann AW
Pragmatic adaptation of implementation research measures for a novel context and multiple professional roles: a factor analysis study.
In this study, the investigators examined the internal consistency, factor structure, and structural invariance of four well-validated measures of inner setting factors across four groups of respondents. The items in these measures were adapted as part of an evaluation of a large-scale organizational change in a rehabilitation hospital, which involved transitioning to a new building and a new model of patient care, facilitated by a significant redesign of patient care and research spaces.
AHRQ-funded; HS025077.
Citation: Smith JD, Rafferty MR, Heinemann AW .
Pragmatic adaptation of implementation research measures for a novel context and multiple professional roles: a factor analysis study.
BMC Health Serv Res 2020 Mar 30;20(1):257. doi: 10.1186/s12913-020-05118-4..
Keywords: Implementation, Health Services Research (HSR), Organizational Change
Beam DM, Brown J, Kaji AH
Evolution of the Strategies to Innovate Emergency Care Clinical Trials Network (SIREN).
This article describes SIREN, the Strategies to Innovate Emergency Care Clinical Trials Network. The authors conclude that, through a strong collaborative research network, SIREN offers the opportunity to significantly enhance emergency care research with the aim of improvement in patient outcomes.
AHRQ-funded; HS023901.
Citation: Beam DM, Brown J, Kaji AH .
Evolution of the Strategies to Innovate Emergency Care Clinical Trials Network (SIREN).
Ann Emerg Med 2020 Mar;75(3):400-07. doi: 10.1016/j.annemergmed.2019.07.029..
Keywords: Emergency Department, Health Services Research (HSR), Research Methodologies