National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Blood Pressure (1)
- Cardiovascular Conditions (5)
- Caregiving (1)
- Diabetes (2)
- Disparities (3)
- Electronic Health Records (EHRs) (1)
- Health Promotion (1)
- (-) Heart Disease and Health (9)
- Hospitalization (2)
- Hospital Readmissions (1)
- Imaging (1)
- Medical Devices (1)
- Mortality (2)
- Outcomes (2)
- Quality Improvement (2)
- (-) Racial and Ethnic Minorities (9)
- Risk (1)
- Sex Factors (2)
- Stroke (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 9 of 9 Research Studies DisplayedMarcaccio CL, Patel PB, de Guerre L
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
The purpose of this study was to identify variations in 5-year outcomes and imaging surveillance after elective endovascular aortic aneurysm repair (EVAR) by sex, race, and ethnicity and to examine possible mechanisms contributing to these variations. The primary outcome was 5-year aneurysm rupture. Secondary outcomes were 5-year reintervention and mortality, and having no aortic imaging follow-up from 6 to 24 months after EVAR. The study found that among 16,040 patients, 73% were White males, 18% were White females, 2.6% were Black males, 1.1% were Black females, 0.9% were Asian males, 0.2% were Asian females, 1.7% were Hispanic males, and 0.4% were Hispanic females. At 5 years, Black females had the highest rupture rates at 6.4% and white males had the lowest at 2.3%. Compared with White males, rupture rates were higher in White females, Black females, and Asian females. Among other groups, Black males had higher reintervention and both Black and Hispanic males had higher rates of no imaging follow-up. In adjusted analyses, White, Black, and Asian females remained at significantly higher risk for 5-year rupture. The researchers concluded that Black females had higher 5-year aneurysm rupture, reintervention, and mortality rates after elective EVAR as compared with White male patients, whereas White females had higher rupture, mortality and loss-to-imaging-follow-up compared to White male patients. Black males had higher reintervention and no imaging follow-up, and Asian females had higher rupture rates.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, Patel PB, de Guerre L .
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
J Vasc Surg 2022 Nov;76(5):1205-15.e4. doi: 10.1016/j.jvs.2022.03.886..
Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors, Outcomes, Imaging, Heart Disease and Health, Cardiovascular Conditions
Marcaccio CL, O'Donnell TFX, Dansey KD
Disparities in reporting and representation by sex, race, and ethnicity in endovascular aortic device trials.
The purpose of this study was to examine the demographics of patients enrolled in critical U.S. endovascular aortic device trials to explore the representation of vulnerable populations, including women and racial and ethnic minorities. The primary outcomes included the percentage of trials reporting participant sex, race, and ethnicity and the percentage of participants across sex, racial, and ethnic groups. The study found that the Food and Drug Administration (FDA) provided 29 approvals from 29 trials of 24 devices with a total of 4046 patients: 52% (15) were EVAR devices, 41% (12) were TEVAR devices, and 3.4% (1) was a FEVAR device, with 1 dissection stent (3.4%). Fifty-two percent of the trials reported the three most common racial groups (White, Black, Asian), and 48% reported Hispanic ethnicity. The TEVAR trials were the most likely to report all three racial groups and Hispanic ethnicity (92% and 75%, respectively), while the EVAR trials had the lowest reporting rates (13% and 20%, respectively). The median female enrollment was 21%, with the EVAR trials having the lowest female enrollment compared with 41% in the TEVAR trials, 21% in the FEVAR trial, and 34% in the dissection stent trial. The study concluded that in critical aortic device trials that led to FDA approval, female patients were underrepresented, especially for EVAR, and racial and ethnic minority groups were under-represented and underreported.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, O'Donnell TFX, Dansey KD .
Disparities in reporting and representation by sex, race, and ethnicity in endovascular aortic device trials.
J Vasc Surg 2022 Nov;76(5):1244-52.e2. doi: 10.1016/j.jvs.2022.05.003..
Keywords: Disparities, Racial and Ethnic Minorities, Heart Disease and Health, Cardiovascular Conditions, Medical Devices, Sex Factors
Steinberg RS, Nayak A, Burke MA
Association of race and gender with primary caregiver relationships and eligibility for advanced heart failure therapies.
Caregiver support is considered necessary after heart transplant (HT) and left ventricular assist device (LVAD) for patients with end-stage heart failure (HF). Few studies have demonstrated how caregivers differ by gender and race, and whether that impacts therapy eligibility. In this study, the investigators examined caregiver relationships among 674 patients (32% women, 55% Black) evaluated at Emory University from 2011 to 2017.
AHRQ-funded; HS026081.
Citation: Steinberg RS, Nayak A, Burke MA .
Association of race and gender with primary caregiver relationships and eligibility for advanced heart failure therapies.
Clin Transplant 2022 Jan;36(1):e14502. doi: 10.1111/ctr.14502..
Keywords: Caregiving, Racial and Ethnic Minorities, Heart Disease and Health, Cardiovascular Conditions
Durstenfeld MS, Ogedegbe O, Katz SD
Racial and ethnic differences in heart failure readmissions and mortality in a large municipal healthcare system.
This study sought to determine whether racial and ethnic differences exist among patients with similar access to care. It examined outcomes after heart failure hospitalization within a large municipal health system and determined that racial and ethnic differences in outcomes were present.
AHRQ-funded; HS023683.
Citation: Durstenfeld MS, Ogedegbe O, Katz SD .
Racial and ethnic differences in heart failure readmissions and mortality in a large municipal healthcare system.
JACC Heart Fail 2016 Nov;4(11):885-93. doi: 10.1016/j.jchf.2016.05.008.
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Keywords: Heart Disease and Health, Hospital Readmissions, Hospitalization, Mortality, Outcomes, Racial and Ethnic Minorities
Kabra R, Girotra S, Vaughan Sarrazin M
Refining stroke prediction in atrial fibrillation patients by addition of African-American ethnicity to CHA2DS2-VASc score.
The authors hypothesized that the addition of African-American ethnicity to the CHA2DS2-VASc score might improve stroke prediction in patients with atrial fibrillation (AF). They found that, in patients over age 65 with newly diagnosed AF, the addition of ethnicity to CHA2DS2-VASc score significantly improved stroke prediction.
AHRQ-funded; HS023104.
Citation: Kabra R, Girotra S, Vaughan Sarrazin M .
Refining stroke prediction in atrial fibrillation patients by addition of African-American ethnicity to CHA2DS2-VASc score.
J Am Coll Cardiol 2016 Aug 2;68(5):461-70. doi: 10.1016/j.jacc.2016.05.044.
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Keywords: Stroke, Heart Disease and Health, Racial and Ethnic Minorities, Risk, Cardiovascular Conditions
Blecker S, Park H, Katz SD
Association of HbA1c with hospitalization and mortality among patients with heart failure and diabetes.
Comorbid diabetes is common in heart failure and associated with increased hospitalization and mortality. Nonetheless, the association between glycemic control and outcomes among patients with heart failure and diabetes remains poorly characterized, particularly among low income and minority patients. This study found that among a cohort of primarily minority and low income patients with heart failure and diabetes, an increased risk of hospitalization was observed.
AHRQ-funded; HS023683.
Citation: Blecker S, Park H, Katz SD .
Association of HbA1c with hospitalization and mortality among patients with heart failure and diabetes.
BMC Cardiovasc Disord 2016 May 20;16:99. doi: 10.1186/s12872-016-0275-6.
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Keywords: Diabetes, Heart Disease and Health, Mortality, Hospitalization, Racial and Ethnic Minorities
Redmond N, Booth JN, 3rd, Tanner RM
Prevalence of masked hypertension and its association with subclinical cardiovascular disease in African Americans: results from the Jackson Heart Study.
Using data from the Jackson Heart Study, an exclusively African American population-based cohort, the researchers evaluated the association of masked hypertension and prehypertension with left ventricular mass index and common carotid intima media thickness. Masked hypertension was common among African Americans with prehypertension and also normal clinic blood pressure, and was associated with subclinical cardiovascular disease.
AHRQ-funded; HS023009.
Citation: Redmond N, Booth JN, 3rd, Tanner RM .
Prevalence of masked hypertension and its association with subclinical cardiovascular disease in African Americans: results from the Jackson Heart Study.
J Am Heart Assoc 2016 Mar 29;5(3):e002284. doi: 10.1161/jaha.115.002284.
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Keywords: Blood Pressure, Heart Disease and Health, Cardiovascular Conditions, Racial and Ethnic Minorities
Eapen ZJ, Liang L, Shubrook JH
Current quality of cardiovascular prevention for Million Hearts: an analysis of 147,038 outpatients from The Guideline Advantage.
This study examined adherence to clinical quality measures focusing on antiplatelet drugs for ischemic vascular disease, blood pressure control for hypertension, cholesterol control for diabetes, and tobacco use screening among 145,038 patients from 25 U.S. practices. It found that black and people of color races were associated with a lower likelihood of blood pressure and cholesterol control.
AHRQ-funded; HS021092
Citation: Eapen ZJ, Liang L, Shubrook JH .
Current quality of cardiovascular prevention for Million Hearts: an analysis of 147,038 outpatients from The Guideline Advantage.
Am Heart J. 2014 Sep;168(3):398-404. doi: 10.1016/j.ahj.2014.06.007..
Keywords: Electronic Health Records (EHRs), Health Promotion, Heart Disease and Health, Quality Improvement, Racial and Ethnic Minorities
Zhang R, Lee JY, Jean-Jacques M
Factors influencing the increasing disparity in LDL cholesterol control between white and black patients with diabetes in a context of active quality improvement.
The authors conducted a retrospective analysis of black and white patients treated continuously between 2008 and 2010 in order to examine possible causes of an increased disparity in low-density lipoprotein (LDL) cholesterol control following a multifaceted physician-directed quality improvement (QI) initiative. They found that physician-facing, general QI interventions may be insufficient to produce equity in LDL cholesterol control, and that helping patients maintain prior success controlling cholesterol appears as important in addressing this disparity as is helping uncontrolled patients achieve control.
AHRQ-funded; HS021141.
Citation: Zhang R, Lee JY, Jean-Jacques M .
Factors influencing the increasing disparity in LDL cholesterol control between white and black patients with diabetes in a context of active quality improvement.
Am J Med Qual 2014 Jul-Aug;29(4):308-14. doi: 10.1177/1062860613498112.
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Keywords: Heart Disease and Health, Diabetes, Disparities, Quality Improvement, Racial and Ethnic Minorities