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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Arthritis (1)
- (-) Cancer (19)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (4)
- Caregiving (1)
- Children/Adolescents (1)
- Comparative Effectiveness (5)
- Diagnostic Safety and Quality (1)
- Disparities (2)
- Elderly (2)
- Evidence-Based Practice (4)
- Healthcare Costs (2)
- Healthcare Delivery (2)
- Health Information Technology (HIT) (3)
- Imaging (1)
- Medication (2)
- Men's Health (1)
- Opioids (1)
- Outcomes (4)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (5)
- Patient Adherence/Compliance (1)
- Patient Safety (3)
- Quality of Care (1)
- Quality of Life (2)
- Respiratory Conditions (2)
- Risk (1)
- Surgery (4)
- (-) Treatments (19)
- Young Adults (1)
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 19 of 19 Research Studies DisplayedMoazzezi M, Rose B, Kisling K
Prospects for daily online adaptive radiotherapy via ethos for prostate cancer patients without nodal involvement using unedited CBCT auto-segmentation.
This study’s objective was to assess the new online adaptive radiation therapy technology called Ethos for treating prostate cancer. Twenty-five prostate patients previously treated at the author’s clinic were re-planed using an Ethos emulator. Clinical margins of 3 mm posterior, 5 mm left/right/anterior, and 7 mm superior/inferior were used. Dose metrics were compared to unadapted plans to evaluate clinical target volumes (CTV) and online adaptive radiation (OAR) dose changes. Overall, 96% of fractions required auto-segmentation edits, although they were mostly minor. Adaptation improved CTV 98% for the 24 patients with minor auto-segmentation corrections. However, for one in 25 patients, large contour edits were required.
AHRQ-funded; HS025440.
Citation: Moazzezi M, Rose B, Kisling K .
Prospects for daily online adaptive radiotherapy via ethos for prostate cancer patients without nodal involvement using unedited CBCT auto-segmentation.
J Appl Clin Med Phys 2021 Oct;22(10):82-93. doi: 10.1002/acm2.13399..
Keywords: Cancer: Prostate Cancer, Cancer, Treatments, Imaging
Garsa A, Jang JK, Baxi S
Radiation therapy for brain metastases: a systematic review.
This systematic review synthesizes the available evidence on radiation therapy for brain metastases. A literature search was conducted using the major medical databases and included randomized controlled trials and large observational studies which evaluated whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) alone or in combination as initial or postoperative treatment, with or without systemic therapy for adults with brain metastases due to lung cancer, breast cancer, or melanoma. No statistically significant difference in overall survival was found with a combination of SRS plus WBRT compared with SRS alone or WBRT alone. Radiation therapy after surgery did not improve overall survival compared with surgery alone. WBRT plus systemic therapy was associated with increased risks for vomiting compared with WBRT alone. There was not enough data on patient-relevant outcomes such as quality of life, functional status, and cognitive effects.
AHRQ-funded; 290201500010I.
Citation: Garsa A, Jang JK, Baxi S .
Radiation therapy for brain metastases: a systematic review.
Pract Radiat Oncol 2021 Sep-Oct;11(5):354-65. doi: 10.1016/j.prro.2021.04.002..
Keywords: Cancer, Surgery, Treatments, Patient-Centered Outcomes Research, Evidence-Based Practice
Caram MEV, Burns J, Kumbier K
Factors influencing treatment of veterans with advanced prostate cancer.
This study examined factors influencing treatment of veterans with metastatic castration-resistant prostate cancer (CRPC). Clinician and nonclinical factors associated with the first-line treatment for CPRC using data from the Veterans Health Administration was used. Almost 5000 patients who received abiraterone, enzalutamide, docetaxel, or ketoconazole from 2010 through 2017 were identified. Increasing age was associated with receipt of abiraterone or enzalutamide versus docetaxel. Greater preexisting comorbidity was associated with enzalutamide versus abiraterone. Patients with higher PSA values at the start of treatment were more likely to receive docetaxel than the other three treatments. African American men were more likely to receive ketoconazole.
AHRQ-funded; HS025707.
Citation: Caram MEV, Burns J, Kumbier K .
Factors influencing treatment of veterans with advanced prostate cancer.
Cancer 2021 Jul 1;127(13):2311-18. doi: 10.1002/cncr.33485..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Treatments
Pasalic D, Barocas DA, Huang LC
Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer.
This retrospective cohort study’s objective was to determine if there were differences in treatment-related regret or survival between prostate cancer patients who received external-beam radiation therapy (EBRT) with or without a brachytherapy boost (EBRT-LDR), over a 5-year period. The cohort included 695 men who met inclusion criteria and received either EBRT (n=583) or EBRT-LDR (n=112). Men who received either treatment reported clinically worse urinary irritation and bowel function through 3 years but resolved after 5 years. Men who received EBRT-LDR continued to report moderate- to-big problems with urinary function bother and frequent urination at 5 years. There was no difference in treatment-related regret or survival between patients who received either treatment.
AHRQ-funded; HS019356; HS022640.
Citation: Pasalic D, Barocas DA, Huang LC .
Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer.
Cancer 2021 Jun 1;127(11):1912-25. doi: 10.1002/cncr.33388..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research, Treatments
Maduekwe UN, Herb JN, Esther RJ
Pathologic nodal staging for clinically node negative soft tissue sarcoma of the extremities.
This study looked at the need for pathological nodal staging in patients with extremity synovial, clear cell, angiosarcoma, rhabdomyosarcoma, and epithelioid (SCARE) soft tissue sarcoma. Patients included were without clinical nodal involvement undergoing surgical resection in the National Cancer Database (2004-2017). The cohort included 4158 patients, with 669 patients (16%) undergoing regional lymph node surgery (RLNS). Patients with epithelioid and clear cell sarcomas were most likely to undergo RLNS. Forty-five (7%) had positive nodes with clear cell sarcoma (14%) and angiosarcoma (13%) having the highest rates of nodal positivity. Five-year survival was reduced in patients with positive nodes.
AHRQ-funded; HS000032.
Citation: Maduekwe UN, Herb JN, Esther RJ .
Pathologic nodal staging for clinically node negative soft tissue sarcoma of the extremities.
J Surg Oncol 2021 May;123(8):1792-800. doi: 10.1002/jso.26465..
Keywords: Cancer, Diagnostic Safety and Quality, Treatments
Heneghan MB, Hussain T, Barrera L
Access to technology and preferences for an mHealth intervention to promote medication adherence in pediatric acute lymphoblastic leukemia: approach leveraging behavior change techniques.
This study’s objectives were to examine access to mobile technology and preferences for an mHealth intervention to improve medication adherence in pediatric acute lymphoblastic leukemia (ALL). Parents of children with ALL as well as adolescents and young adults (AYAs) with ALL who received maintenance chemotherapy were given a cross-sectional survey. Findings showed that parents, adolescents, and AYAs reported ubiquitous access to mobile technology and strong interest in multiple adherence-specific mHealth app features. Parents and AYAs provided valuable insight into preferred features for a multifunctional behavioral intervention to promote medication adherence in pediatric ALL.
AHRQ-funded; HS023011.
Citation: Heneghan MB, Hussain T, Barrera L .
Access to technology and preferences for an mHealth intervention to promote medication adherence in pediatric acute lymphoblastic leukemia: approach leveraging behavior change techniques.
J Med Internet Res 2021 Feb 18;23(2):e24893. doi: 10.2196/24893..
Keywords: Children/Adolescents, Young Adults, Caregiving, Cancer, Medication, Patient Adherence/Compliance, Health Information Technology (HIT), Treatments
Gupta A, Sedhom R, Sharma R
Nonpharmacological interventions for managing breathlessness in patients with advanced cancer: a systematic review.
The purpose of this review was to evaluate the advantages and harms of nonpharmacological interventions for managing breathlessness in adults with advanced cancer. PubMed, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials databases were searched for English-language studies about randomized and nonrandomized clinical trials, controlled trials, and observational studies. Findings included the safety and association with improved breathlessness of several nonpharmacological interventions for adults with advanced cancer. Recommendations included incorporating nonpharmacological interventions as first-line treatment for adults with advanced cancer and breathlessness.
AHRQ-funded; 290201500006I.
Citation: Gupta A, Sedhom R, Sharma R .
Nonpharmacological interventions for managing breathlessness in patients with advanced cancer: a systematic review.
JAMA Oncol 2021 Feb;7(2):290-98. doi: 10.1001/jamaoncol.2020.5184..
Keywords: Cancer, Respiratory Conditions, Treatments, Evidence-Based Practice, Comparative Effectiveness, Quality of Life, Outcomes, Patient-Centered Outcomes Research
Feliciano JL, Waldfogel JM, Sharma R
Pharmacologic interventions for breathlessness in patients with advanced cancer: a systematic review and meta-analysis.
This systematic review and meta-analysis examined the use of pharmacological interventions for breathlessness in patients with advanced cancer. Studies were identified from database inception to May 2020 using predefined eligibility criteria. Pharmacologic intervention benefits and harms were compared, focusing on breathlessness, anxiety, exercise capacity and health-related quality of life. Out of 7729 unique citations, 19 studies with a total of 1424 patients were included. Opioids were not associated with more effectiveness than placebo for improving breathlessness or exercise capacity. Anxiolytics were also not associated with more effectiveness than placebo for breathlessness or anxiety. There was limited evidence for other pharmacologic interventions. There was some harm, but it was minimal in those short-term studies.
AHRQ-funded; 290201500006I.
Citation: Feliciano JL, Waldfogel JM, Sharma R .
Pharmacologic interventions for breathlessness in patients with advanced cancer: a systematic review and meta-analysis.
JAMA Netw Open 2021 Feb;4(2):e2037632. doi: 10.1001/jamanetworkopen.2020.37632..
Keywords: Cancer: Lung Cancer, Cancer, Respiratory Conditions, Medication, Treatments, Opioids, Evidence-Based Practice, Comparative Effectiveness, Quality of Life, Outcomes, Patient-Centered Outcomes Research
Giordano SH, Niu J, Chavez-MacGregor M
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
The objective of the current study was to generate cost estimates for guideline-concordant adjuvant chemotherapy regimens from payers' and patients' perspectives in a large, insured US population. It concluded that the costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden.
AHRQ-funded; HS020263.
Citation: Giordano SH, Niu J, Chavez-MacGregor M .
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
Cancer 2016 Nov 15; 122(2):3447-3455. doi: 10.1002/cncr.30274.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Healthcare Costs
Liu S, Mazur T, Li H
SU-F-T-275: A correlation study on 3D fluence-based QA and 2D dose measurement-based QA.
The aim of this paper was to demonstrate the feasibility and creditability of computing and verifying 3D fluencies to assure IMRT and VMAT treatment deliveries, by correlating the passing rates of the 3D fluence-based QA (P(alpha)) to the passing rates of 2D dose measurement based QA (P(Dm)). It concluded that the demonstrated correlations improve the creditability of using 3D fluence-based QA for assuring treatment deliveries for IMRT/VMAT plans.
AHRQ-funded; HS022888.
Citation: Liu S, Mazur T, Li H .
SU-F-T-275: A correlation study on 3D fluence-based QA and 2D dose measurement-based QA.
Med Phys 2016 Jun;43(6 Part 17):3525-26. doi: 10.1118/1.4956415.
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Keywords: Cancer, Healthcare Delivery, Treatments, Patient Safety, Health Information Technology (HIT)
Liu S, Wu Y, Chang X
TU-FG-201-03: Automatic pre-delivery verification using statistical analysis of consistencies in treatment plan parameters by the treatment site and modality.
A novel computer software system, namely APDV (Automatic Pre-Delivery Verification), was developed for verifying patient treatment plan parameters right prior to treatment deliveries in order to automatically detect and prevent catastrophic errors. This study implemented APDV as a stand-alone program to ensure required real time performance. It concluded that APDV could be useful in detecting and preventing catastrophic errors immediately before treatment deliveries.
AHRQ-funded; HS022888.
Citation: Liu S, Wu Y, Chang X .
TU-FG-201-03: Automatic pre-delivery verification using statistical analysis of consistencies in treatment plan parameters by the treatment site and modality.
Med Phys 2016 Jun;43(6 Part 35):3753. doi: 10.1118/1.4957526.
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Keywords: Cancer, Healthcare Delivery, Treatments, Patient Safety, Health Information Technology (HIT)
Ellis CT, Samuel CA, Stitzenberg KB
National trends in nonoperative management of rectal adenocarcinoma.
The researchers examined the use of non-operative management (NOM) for rectal cancer over time and the patient- and facility-level factors associated with its use. They found evidence of increasing NOM use, with this increase occurring more frequently in black and uninsured/Medicaid patients, raising concern that increased NOM use may actually represent increasing disparities in rectal cancer care rather than innovation. They recommended further studies to assess survival differences by treatment strategy.
AHRQ-funded; HS000032.
Citation: Ellis CT, Samuel CA, Stitzenberg KB .
National trends in nonoperative management of rectal adenocarcinoma.
J Clin Oncol 2016 May 10;34(14):1644-51. doi: 10.1200/jco.2015.64.2066.
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Keywords: Cancer, Cancer: Colorectal Cancer, Disparities, Patient-Centered Healthcare, Treatments
Yang D, Wooten HO, Green O
A software tool to automatically assure and report daily treatment deliveries by a Cobalt-60 radiation therapy device.
The researchers developed a method for verification of treatment delivery after each treatment fraction in order to detect and correct errors, and they developed a comprehensive daily report. The end result has been integrated into a commercial version of the treatment delivery system, and it has been in clinical use for over one year.
AHRQ-funded; HS022888.
Citation: Yang D, Wooten HO, Green O .
A software tool to automatically assure and report daily treatment deliveries by a Cobalt-60 radiation therapy device.
J Appl Clin Med Phys 2016 May 8;17(3):6001.
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Keywords: Treatments, Cancer, Quality of Care, Patient Safety
Healy MA, Yin H, Wong SL
Multimodal cancer care in poor prognosis cancers: resection drives long-term outcomes.
The researchers compared effects of resection with other therapies on long-term outcomes across U.S. hospitals. They examined claims in the Surveillance, Epidemiology, and End Results (SEER) Medicare dataset for patients with esophageal and pancreatic cancers and found that a significant association exists between long-term survival and rates of cancer-directed surgery across hospitals, without variation in rates of other therapies.
AHRQ-funded; HS020937.
Citation: Healy MA, Yin H, Wong SL .
Multimodal cancer care in poor prognosis cancers: resection drives long-term outcomes.
J Surg Oncol 2016 May;113(6):599-604. doi: 10.1002/jso.24217.
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Keywords: Cancer, Outcomes, Surgery, Treatments, Disparities
Scott FI, Mamtani R, Brensinger CM
Risk of nonmelanoma skin cancer associated with the use of immunosuppressant and biologic agents in patients with a history of autoimmune disease and nonmelanoma skin cancer.
The study objective was to determine the relative hazard of a second nonmelanoma skin cancer (NMSC) in patients with rheumatoid arthritis and inflammatory bowel disease who use methotrexate, anti-tumor necrosis factor (anti-TNF) therapy, or thiopurines after an initial NMSC. It concluded that methotrexate use is associated with an increased risk of a second NMSC.
AHRQ-funded; HS018517.
Citation: Scott FI, Mamtani R, Brensinger CM .
Risk of nonmelanoma skin cancer associated with the use of immunosuppressant and biologic agents in patients with a history of autoimmune disease and nonmelanoma skin cancer.
JAMA Dermatol 2016 Feb;152(2):164-72. doi: 10.1001/jamadermatol.2015.3029.
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Keywords: Cancer, Arthritis, Risk, Comparative Effectiveness, Treatments
Mohanty S, Rajaram R, Bilimoria KY
Assessment of non-surgical versus surgical therapy for localized hepatocellular carcinoma.
Hypothesizing that non-surgical techniques have expanded to localized disease, the researchers examined treatment patterns, factors associated with surgical therapy, and the impact of modality on survival for patients with hepatocellular carcinoma (HCC). They concluded that non-surgical therapy has become as common as surgery in the treatment of non-cirrhotic, localized HCC.
AHRQ-funded; HS000078.
Citation: Mohanty S, Rajaram R, Bilimoria KY .
Assessment of non-surgical versus surgical therapy for localized hepatocellular carcinoma.
J Surg Oncol 2016 Feb;113(2):175-80. doi: 10.1002/jso.24113.
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Keywords: Cancer, Surgery, Treatments
Shen C, Tina Shih YC
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
The authors studied the impact of the fast diffusion of robotic surgical systems on the overall treatment pattern of localized prostate cancer. They found that the density of robotic systems at state-level had a significantly positive impact on the rate of surgery and a significantly negative impact on the rate of radiation therapy. They concluded that part of the increase in the rate of surgery was driven by substitution across treatment types with a large proportion originating from the younger population.
AHRQ-funded; HS018535; HS020263.
Citation: Shen C, Tina Shih YC .
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
Soc Sci Med 2016 Feb;151:110-20. doi: 10.1016/j.socscimed.2016.01.016.
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Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Healthcare Costs, Treatments
Poonawalla IB, Piller LB, Lairson DR
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
The researchers sought to determine the effectiveness of erythropoietin-stimulating agent (ESA) and granulocyte colony-stimulating factor (CSF) in reducing blood transfusion needs and neutropenia incidence in community-dwelling elderly ovarian cancer patients. They found that erythropoietin-stimulating agents were effective in reducing blood transfusion need. Granulocyte colony-stimulating factors were effective in lowering neutropenia incidence and also were associated with improved survival in elderly ovarian cancer patients.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Piller LB, Lairson DR .
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
Int J Gynecol Cancer 2016 Jan;26(1):95-103. doi: 10.1097/igc.0000000000000564.
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Keywords: Cancer, Treatments, Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research
Gupta A, Long JB, Chen J
Risk of vascular toxicity with platinum based chemotherapy in elderly patients with bladder cancer.
The researchers evaluated the short-term (less than 1 year) and intermediate-term (2 to 5 years) vascular toxicity of platinum agents in older patients with bladder cancer. They found that patients receiving platinum based chemotherapy were at higher risk for thromboembolism but not other vascular events, particularly in the first year after diagnosis. This risk of thromboembolism is similar for cisplatin and carboplatin.
AHRQ-funded; HS018781.
Citation: Gupta A, Long JB, Chen J .
Risk of vascular toxicity with platinum based chemotherapy in elderly patients with bladder cancer.
J Urol 2016 Jan;195(1):33-40. doi: 10.1016/j.juro.2015.08.088..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cancer, Treatments, Elderly