National Healthcare Quality and Disparities Report
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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 37 Research Studies DisplayedBrei BK, Sawyer T, Umoren R
Associations between family presence and neonatal intubation outcomes: a report from the National Emergency Airway Registry for Neonates: NEAR4NEOS.
This study looked at whether the presence of family members had an impact on neonatal tracheal intubation (TI) outcomes. This retrospective analysis looked at TIs performed in NICUs participating in the National Emergency Airway Registry for Neonates (NEAR4NEOS) at 13 academic NICUS from October 2014 to December 2017. Family members were present in less than 10% of TIs, but this varied by site. Success rates were not significantly different, with the first attempt success rate at 55% with family present versus 49% and success within 2 attempts was 74% versus 66%. Adverse TI-associated events (TIAEs) were 17% versus 20% and severe oxygen desaturation was 49% versus 52%. No independent association between any of these outcomes was found with family presence.
AHRQ-funded; HS027259; HS024511.
Citation: Brei BK, Sawyer T, Umoren R .
Associations between family presence and neonatal intubation outcomes: a report from the National Emergency Airway Registry for Neonates: NEAR4NEOS.
Arch Dis Child Fetal Neonatal Ed 2021 Jul;106(4):392-97. doi: 10.1136/archdischild-2020-319709..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Registries, Patient Safety
Colman N, Newman JW, Nishisaki A
Translational simulation improves compliance with the NEAR4KIDS Airway Safety Bundle in a single-center PICU.
This single-center retrospective review discusses a translational simulation conducted to improve compliance with the National Emergency Airway Registry for Children (NEAR4KIDS) Airway Safety Quality Improvement (QI) bundle to improve the safety of tracheal intubations. The simulation was implemented between March and December 2018. Bundle adherence was assessed 12 months before simulation and 9 months after. Primary outcomes measures were compliance with the bundle and utilization of apneic oxygenation and secondary outcomes was the occurrence of adverse tracheal intubation-associated events. Preintervention bundle compliance was 66%, which increased to 93.7% after the simulation intervention. Adherence to apneic oxygenation was 27.9% before the intervention and increased to 77.9% after. There was no difference in the occurrence of tracheal intubation events.
AHRQ-funded; HS024511.
Citation: Colman N, Newman JW, Nishisaki A .
Translational simulation improves compliance with the NEAR4KIDS Airway Safety Bundle in a single-center PICU.
Pediatr Qual Saf 2021 May-Jun;6(3):e409. doi: 10.1097/pq9.0000000000000409..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Registries, Simulation, Patient Safety, Quality Improvement, Quality of Care
McKinney WT, Schaffhausen CR, Schladt D
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
The Scientific Registry of Transplant Recipients provides transplant program-specific information, but it is unclear what patients and stakeholders need to know. Acceptance criteria for the candidate waitlist and donor organs vary by program and region, but there is no means to search for programs by the clinical profiles of recipients and donors. The authors examined variability in program-specific characteristics that could influence access to transplantation.
AHRQ-funded; HS026379; HS024527.
Citation: McKinney WT, Schaffhausen CR, Schladt D .
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
Clin Transplant 2021 Feb;35(2):e14183. doi: 10.1111/ctr.14183..
Keywords: Transplantation, Surgery, Heart Disease and Health, Cardiovascular Conditions, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice, Decision Making
Axley J, Novak Z, Blakeslee-Carter J
Long-term trends in preoperative cardiac evaluation and myocardial infarction after elective vascular procedures.
This retrospective cohort study was performed using data on elective vascular surgery procedures and evaluated long-term trends in post-operative myocardial infarction (POMI) using Vascular Surgery Vascular Quality Initiative (VQI) registry data for patients undergoing carotid endarterectomy (CEA), thoracic endovascular aortic repair (TEVAR), endovascular aortic repair (EVAR), open abdominal aortic aneurysm repair (oAAA), suprainguinal bypass (SIB), and infrainguinal bypass (IIB). A total of 227,837 elective procedures were identified. The overall rate of POMI was 1.3% across all procedures. POMI rates from 2003-05 to 2015-17 for CEA decreased from 0.9% to 0.7%, EVAR from 2% to 7%, IIB from 3.8% to 2.4%, and oAAA from 6.8% to 5.1%. From 2009 to 2017 SIB decreased from 3.06% to 2.95%. However, TEVAR increased from 2.4% to 3.56% for the period 2006 to 2017. CEA, EVAR, IIB, oAAA all showed a significant increase in postoperative statin use.
AHRQ-funded; HS013852.
Citation: Axley J, Novak Z, Blakeslee-Carter J .
Long-term trends in preoperative cardiac evaluation and myocardial infarction after elective vascular procedures.
Ann Vasc Surg 2021 Feb;71:19-28. doi: 10.1016/j.avsg.2020.09.006..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Adverse Events, Registries
Kasiske BL, Salkowski N, Wey A
Potential implications of recent and proposed changes in the regulatory oversight of solid organ transplantation in the United States.
The authors reviewed the details and implications of changes in transplant program oversight.
AHRQ-funded; HS024527.
Citation: Kasiske BL, Salkowski N, Wey A .
Potential implications of recent and proposed changes in the regulatory oversight of solid organ transplantation in the United States.
Am J Transplant 2016 Dec;16(12):3371-77. doi: 10.1111/ajt.13955.
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Keywords: Health Services Research (HSR), Policy, Registries, Policy, Transplantation
Yazdany J, Bansback N, Clowse M
Rheumatology informatics system for effectiveness: a national informatics-enabled registry for quality improvement.
The authors reported on the Rheumatology Informatics System for Effectiveness (RISE) registry's architecture and initial data and demonstrated how RISE is being used to improve care quality. They concluded that RISE provides critical infrastructure for improving care quality in rheumatology and is a unique data source to generate new knowledge.
AHRQ-funded; HS024412.
Citation: Yazdany J, Bansback N, Clowse M .
Rheumatology informatics system for effectiveness: a national informatics-enabled registry for quality improvement.
Arthritis Care Res 2016 Dec;68(12):1866-73. doi: 10.1002/acr.23089.
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Keywords: Quality of Care, Health Information Technology (HIT), Quality Improvement, Registries, Arthritis
Carmody D, Naylor RN, Bell CD
GCK-MODY in the US National Monogenic Diabetes Registry: frequently misdiagnosed and unnecessarily treated.
GCK-MODY (diabetes caused by mutations in the glucokinase (GCK) gene) leads to mildly elevated blood glucose typically not requiring therapy. It has been described in all ethnicities, but mainly in Caucasian Europeans. The researchers describe our US cohort of GCK-MODY. Their data show that a high detection rate of GCK-MODY is possible based on clinical phenotype and that prior to genetic diagnosis, a large percentage are inappropriately treated with glucose-lowering therapies.
AHRQ-funded; HS023007.
Citation: Carmody D, Naylor RN, Bell CD .
GCK-MODY in the US National Monogenic Diabetes Registry: frequently misdiagnosed and unnecessarily treated.
Acta Diabetol 2016 Oct;53(5):703-8. doi: 10.1007/s00592-016-0859-8.
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Keywords: Diabetes, Registries, Diagnostic Safety and Quality, Genetics
Cato KD, Bockting W, Larson E
Did I tell you that? Ethical issues related to using computational methods to discover non-disclosed patient characteristics.
Using the Belmont Report's principles of respect for persons, beneficence, and justice as a framework, the authors examined the ethical issues posed by electronic phenotyping. Ethical issues identified include the ability of the patient to consent for the use of their information, the ability to suppress pediatric information, and ensuring that the potential benefits justify the risks of harm to patients.
AHRQ-funded; HS022961.
Citation: Cato KD, Bockting W, Larson E .
Did I tell you that? Ethical issues related to using computational methods to discover non-disclosed patient characteristics.
J Empir Res Hum Res Ethics 2016 Jul;11(3):214-9. doi: 10.1177/1556264616661611.
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Keywords: Clinician-Patient Communication, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research, Registries, Research Methodologies
Curtis JR, Bharat A, Chen L
Agreement between rheumatologist and patient-reported adherence to methotrexate in a US rheumatoid arthritis registry.
To determine the extent to which methotrexate (MTX) adherence is overestimated by rheumatologists, the researchers deployed an Internet survey to patients with rheumatoid arthritis (RA) participating in a US registry. They found that MTX use was misclassified for 13-20 percent of patients, mainly because of 1 or more missed doses rather than overt discontinuation. Clinicians should be aware of suboptimal adherence when assessing MTX response.
AHRQ-funded; HS018517.
Citation: Curtis JR, Bharat A, Chen L .
Agreement between rheumatologist and patient-reported adherence to methotrexate in a US rheumatoid arthritis registry.
J Rheumatol 2016 Jun;43(6):1027-9. doi: 10.3899/jrheum.151136.
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Keywords: Arthritis, Patient Adherence/Compliance, Medication, Registries
Khazanie P, Greiner MA, Al-Khatib SM
Comparative effectiveness of cardiac resynchronization therapy among patients with heart failure and atrial fibrillation: Findings from the National Cardiovascular Data Registry's Implantable Cardioverter-Defibrillator Registry.
The researchers investigated the outcomes of patients with both atrial fibrillation and heart failure who receive cardiac resynchronization therapy with defibrillator (CRT-D) compared with an implantable cardioverter-defibrillator (ICD) alone. They found that CRT-D was associated with lower risks of mortality, all-cause readmission, and heart failure readmission, as well as with a similar risk of complications compared with ICD alone.
AHRQ-funded; HS021092.
Citation: Khazanie P, Greiner MA, Al-Khatib SM .
Comparative effectiveness of cardiac resynchronization therapy among patients with heart failure and atrial fibrillation: Findings from the National Cardiovascular Data Registry's Implantable Cardioverter-Defibrillator Registry.
Circ Heart Fail 2016 Jun;9(6). doi: 10.1161/circheartfailure.115.002324.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Comparative Effectiveness, Patient-Centered Outcomes Research, Registries, Evidence-Based Practice, Outcomes
Piccini JP, Simon DN, Steinberg BA
Differences in clinical and functional outcomes of atrial fibrillation in women and men: two-year results from the ORBIT-AF Registry.
The purpose of this paper was to determine whether symptoms, quality of life, treatment, and outcomes differ between women and men with atrial fibrillation (AF). The authors found that women with AF have more symptoms and worse quality of life, lower risk-adjusted all-cause and cardiovascular death compared with men, but higher stroke rates.
AHRQ-funded; HS021092.
Citation: Piccini JP, Simon DN, Steinberg BA .
Differences in clinical and functional outcomes of atrial fibrillation in women and men: two-year results from the ORBIT-AF Registry.
JAMA Cardiol 2016 Jun 1;1(3):282-91. doi: 10.1001/jamacardio.2016.0529.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Sex Factors, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Registries, Evidence-Based Practice
Pappas DA, John A, Curtis JR
Dosing of intravenous tocilizumab in a real-world setting of rheumatoid arthritis: analyses from the corrona registry.
The objective of this analysis was to describe patterns of early intravenous tocilizumab (TCZ) dose escalation in a real-world setting using data from the Corrona registry. It determined that of the 213 patients who were eligible for analysis, 86 (40.4 percent) remained on their initial dose of TCZ 4 mg/kg and 110 (51.6 percent) were escalated to TCZ 8 mg/kg by or at 3 months.
AHRQ-funded; HS018517.
Citation: Pappas DA, John A, Curtis JR .
Dosing of intravenous tocilizumab in a real-world setting of rheumatoid arthritis: analyses from the corrona registry.
Rheumatol Ther 2016 Jun;3(1):103-15. doi: 10.1007/s40744-016-0028-0.
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Keywords: Arthritis, Medication, Registries
Bergethon KE, Ju C, DeVore AD
Trends in 30-day readmission rates for patients hospitalized with heart failure: findings from the Get With The Guidelines-Heart Failure Registry.
The researchers analyzed data from the Heart Failure registry linked to Medicare claims between 2009 and 2012 to describe trends and relative reduction of rates of 30-day all-cause readmission among patients with heart failure. They concluded that although there has been slight improvement in 30-day all-cause readmission rates during the past 4 years in patients with heart failure, few hospitals have seen large success.
AHRQ-funded; HS021092.
Citation: Bergethon KE, Ju C, DeVore AD .
Trends in 30-day readmission rates for patients hospitalized with heart failure: findings from the Get With The Guidelines-Heart Failure Registry.
Circ Heart Fail 2016 Jun;9(6). doi: 10.1161/circheartfailure.115.002594.
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Keywords: Guidelines, Heart Disease and Health, Hospital Readmissions, Hospitalization, Registries
Lee SJ, Grobe JE, Tiro JA
Assessing race and ethnicity data quality across cancer registries and EMRs in two hospitals.
The objective of this study was to characterize the quality of race/ethnicity data collection efforts. The authors assessed race and ethnicity data quality across cancer registries and electronic medical records in two hospitals. Their findings suggested that high-quality race/ethnicity data are attainable. Many of the "errors" in race/ethnicity data were caused by missing or "Unknown" data values.
AHRQ-funded; HS022418.
Citation: Lee SJ, Grobe JE, Tiro JA .
Assessing race and ethnicity data quality across cancer registries and EMRs in two hospitals.
J Am Med Inform Assoc 2016 May;23(3):627-34. doi: 10.1093/jamia/ocv156..
Keywords: Cancer, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals, Racial and Ethnic Minorities, Registries
Zhu Y, Chen CY, Matsuyama Y
Comparative validity of methods to select appropriate cutoff weight for probabilistic linkage without unique personal identifiers.
The researchers aimed to assess the validity of probabilistic linkage in the absence of unique personal identifiers (UPI) and the methods of cutoff weight selection. They found that probabilistic linkage without UPI generated valid linkages when an optimal cutoff was chosen and concluded that histogram inspection, the duplicate method, and the odds formula method can be used in conjunction when a gold standard is not available.
AHRQ-funded; 29020050016I.
Citation: Zhu Y, Chen CY, Matsuyama Y .
Comparative validity of methods to select appropriate cutoff weight for probabilistic linkage without unique personal identifiers.
Pharmacoepidemiol Drug Saf 2016 Apr;25(4):444-52. doi: 10.1002/pds.3832.
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Keywords: Data, Medical Devices, Registries
Newhall KA, Saunders EC, Larson RJ
Use of protamine for anticoagulation during carotid endarterectomy: a meta-analysis.
The researchers reviewed the evidence for and against protamine use at the conclusion of carotid endarterectomy (CEA), both in its association with increased thrombotic complications and with decreased bleeding. They concluded that based on available evidence, the use of protamine following CEA is associated with a reduction in bleeding complications, without increasing major thrombotic outcomes, including stroke, myocardial infarction, or death.
AHRQ-funded; HS021581.
Citation: Newhall KA, Saunders EC, Larson RJ .
Use of protamine for anticoagulation during carotid endarterectomy: a meta-analysis.
JAMA Surg 2016 Mar;151(3):247-55. doi: 10.1001/jamasurg.2015.3592.
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Keywords: Medication, Adverse Drug Events (ADE), Registries, Cardiovascular Conditions
Alvarez E, Uslan DZ, Malloy T
It is time to revise our approach to registering antimicrobial agents for health care settings.
This paper discusses antimicrobial surfaces, such as copper alloy, for the prevention of healthcare-associated infections. The authors address the current process for registering antimicrobial products, flaws in the registration requirements, and the need for evidence-based approaches to reduce healthcare-associated infections.
AHRQ-funded; HS021188.
Citation: Alvarez E, Uslan DZ, Malloy T .
It is time to revise our approach to registering antimicrobial agents for health care settings.
Am J Infect Control 2016 Feb;44(2):228-32. doi: 10.1016/j.ajic.2015.09.015.
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Keywords: Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Prevention, Evidence-Based Practice, Registries
Shaw JJ, Psoinos CM, Santry HP
It's all about location, location, location: A new perspective on trauma transport.
The objective of this study was to determine the effect of aeromedical transport on trauma mortality when accounting for geographic factors. It concluded that helicopter transport does not impart a survival benefit for trauma patients when geographic considerations are taken into account.
AHRQ-funded; HS022694.
Citation: Shaw JJ, Psoinos CM, Santry HP .
It's all about location, location, location: A new perspective on trauma transport.
Ann Surg 2016 Feb;263(2):413-8. doi: 10.1097/sla.0000000000001265..
Keywords: Trauma, Emergency Medical Services (EMS), Registries, Mortality, Access to Care
Mandl LA, Zhu R, Huang WT
Short-term total hip arthroplasty outcomes in patients with psoriatic arthritis or psoriatic skin disease compared to patients with osteoarthritis.
This study was undertaken to assess whether patients with psoriatic arthritis (PsA) or those with cutaneous psoriasis (PsC) without evidence of inflammatory joint disease are at an increased risk for worse outcomes after total hip arthroplasty (THA) as compared to patients with osteoarthritis (OA). It concluded that neither PsA nor PsC are risk factors for poor outcomes after THA.
AHRQ-funded; HS016075.
Citation: Mandl LA, Zhu R, Huang WT .
Short-term total hip arthroplasty outcomes in patients with psoriatic arthritis or psoriatic skin disease compared to patients with osteoarthritis.
Arthritis Rheumatol 2016 Feb;68(2):410-7. doi: 10.1002/art.39431.
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Keywords: Arthritis, Surgery, Registries, Patient-Centered Outcomes Research
Chimenti PC, Drinkwater CJ, Li W
Factors associated with early improvement in low back pain after total hip arthroplasty: A multi-center prospective cohort analyses.
This study identified factors associated with an improvement in low back pain (LBP) at six-month follow-up after total hip arthroplasty (THA). It found that among patients reporting severe or moderate LBP preoperatively, 56 percent improved 6 months after surgery. Patients without improvement were more likely to be on Medicare, have a high school education or less, have household income less than $45,000 and have one or more comorbid conditions.
AHRQ-funded; HS018910.
Citation: Chimenti PC, Drinkwater CJ, Li W .
Factors associated with early improvement in low back pain after total hip arthroplasty: A multi-center prospective cohort analyses.
J Arthroplasty 2016 Jan;31(1):176-9. doi: 10.1016/j.arth.2015.07.028.
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Keywords: Back Health and Pain, Arthritis, Surgery, Patient-Centered Outcomes Research, Registries
Bakken S, Reame N
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
The purposes of this chapter are to (a) briefly summarize the current drivers for the use of big data in research; (b) describe the promise of big data and associated data science methods for advancing symptom management research; and (c) explicate the potential perils of big data and data science from the perspective of the ethical principles of autonomy, beneficence, and justice.
AHRQ-funded; HS022961.
Citation: Bakken S, Reame N .
The promise and potential perils of big data for advancing symptom management research in populations at risk for health disparities.
Annu Rev Nurs Res 2016;34:247-60. doi: 10.1891/0739-6686.34.247..
Keywords: Disparities, Data, Patient-Centered Outcomes Research, Registries
Franklin PD, Lewallen D, Bozic K
Implementation of patient-reported outcome measures in U.S. total joint replacement registries: rationale, status, and plans.
The authors report on the status of patient-reported outcomes (PRO) implementation as well as perceived barriers and facilitators of PRO use among five U.S. total joint replacement registries. They find that the current stage of implementation of patient-reported outcomes measures varies widely among U.S. registries.
AHRQ-funded; HS018910.
Citation: Franklin PD, Lewallen D, Bozic K .
Implementation of patient-reported outcome measures in U.S. total joint replacement registries: rationale, status, and plans.
J Bone Joint Surg Am 2014 Dec 17;96 Suppl 1:104-9. doi: 10.2106/jbjs.n.00328..
Keywords: Registries, Surgery, Comparative Effectiveness, Patient-Centered Outcomes Research
Singh JA, Lewallen DG
Increasing obesity and comorbidity in patients undergoing primary total hip arthroplasty in the U.S.: a 13-year study of time trends.
The researchers examined the time-trends in key demographic and clinical characteristics of patients undergoing primary total hip arthroplasty (THA). They found that obesity, medical and psychological comorbidity increased and the underlying diagnosis of RA/inflammatory arthritis decreased rapidly in primary THA patients over 13-years.
AHRQ-funded; HS021110.
Citation: Singh JA, Lewallen DG .
Increasing obesity and comorbidity in patients undergoing primary total hip arthroplasty in the U.S.: a 13-year study of time trends.
BMC Musculoskelet Disord 2014 Dec 17;15:441. doi: 10.1186/1471-2474-15-441..
Keywords: Surgery, Obesity, Risk, Registries, Arthritis
Banerjee M, Muenz DG, Worden FP
Conditional survival in patients with thyroid cancer.
This study used data from Surveillance, Epidemiology, and End Results (SEER) registry to determine conditional 5-year disease-specific survival based on patient age, gender, and stage. It found that patients with localized thyroid cancer have excellent conditional 5-year survival, irrespective of where they are in their survivorship phase. In addition, patients with regional thyroid cancer have relatively stable conditional 5-year survival.
AHRQ-funded; HS020937.
Citation: Banerjee M, Muenz DG, Worden FP .
Conditional survival in patients with thyroid cancer.
Thyroid 2014 Dec;24(12):1784-9. doi: 10.1089/thy.2014.0264..
Keywords: Cancer, Mortality, Outcomes, Registries
Curtis JR, Chen L, Bharat A
Linkage of a de-identified United States rheumatoid arthritis registry with administrative data to facilitate comparative effectiveness research.
In order to address a gap in linkage methodology, the researchers sought to link a large, de-identified outpatient registry of patients with rheumatoid arthritis with national Medicare administrative claims data. The purpose of their report was to describe the methods and validity of this linkage.
AHRQ-funded; HS018517
Citation: Curtis JR, Chen L, Bharat A .
Linkage of a de-identified United States rheumatoid arthritis registry with administrative data to facilitate comparative effectiveness research.
Arthritis Care Res. 2014 Dec;66(12):1790-8. doi: 10.1002/acr.22377..
Keywords: Arthritis, Registries, Comparative Effectiveness