National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Blood Pressure (1)
- Breast Feeding (1)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Cancer: Ovarian Cancer (1)
- Cardiovascular Conditions (1)
- Case Study (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- Chronic Conditions (2)
- Clinician-Patient Communication (1)
- Communication (3)
- Comparative Effectiveness (2)
- Data (1)
- Decision Making (1)
- (-) Evidence-Based Practice (20)
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- (-) Guidelines (20)
- Healthcare-Associated Infections (HAIs) (1)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (1)
- Implementation (1)
- Infectious Diseases (1)
- Intensive Care Unit (ICU) (1)
- Labor and Delivery (1)
- Maternal Care (1)
- Medication (4)
- Medication: Safety (1)
- Newborns/Infants (1)
- Nutrition (1)
- Opioids (2)
- Outcomes (1)
- Pain (1)
- Patient-Centered Outcomes Research (2)
- Patient Safety (2)
- Policy (2)
- Practice Patterns (1)
- Pregnancy (1)
- Pressure Ulcers (1)
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- Provider (1)
- Quality Improvement (3)
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- Quality of Care (3)
- Research Methodologies (4)
- Respiratory Conditions (1)
- Risk (1)
- Screening (3)
- Sexual Health (1)
- Sleep Problems (1)
- Social Media (1)
- Surgery (1)
- Teams (1)
- U.S. Preventive Services Task Force (USPSTF) (4)
- Vaccination (1)
- Women (2)
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 20 of 20 Research Studies DisplayedMeisel ZF, Metlay JP, Sinnenberg L
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
The authors compared whether narrative vignettes embedded in the American College of Emergency Physicians (ACEP) daily e-newsletter improved dissemination of the clinical policy to ACEP members, and engagement of members with the clinical policy, compared with traditional summary text. They found that the vignettes outperformed traditional guideline text in promoting engagement with an evidence-based clinical guideline related to opioid prescriptions.
AHRQ-funded; HS021956.
Citation: Meisel ZF, Metlay JP, Sinnenberg L .
A randomized trial testing the effect of narrative vignettes versus guideline summaries on provider response to a professional organization clinical policy for safe opioid prescribing.
Ann Emerg Med 2016 Dec;68(6):719-28. doi: 10.1016/j.annemergmed.2016.03.007.
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Keywords: Communication, Evidence-Based Practice, Guidelines, Opioids, Medication, Medication: Safety, Policy, Provider
Burstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Hand RK, Kenne D, Wolfram TM
Assessing the viability of social media for disseminating evidence-based nutrition practice guideline through content analysis of twitter messages and health professional interviews: an observational study.
This study explored the potential for social media dissemination of the Academy of Nutrition and Dietetics Evidence-Based Nutrition Practice Guideline (EBNPG) for Heart Failure (HF). ). It found that interview participants believed that social media was a useful way to gather professional information. They did not believe that social media was useful for communicating with patients.
AHRQ-funded; HS021953.
Citation: Hand RK, Kenne D, Wolfram TM .
Assessing the viability of social media for disseminating evidence-based nutrition practice guideline through content analysis of twitter messages and health professional interviews: an observational study.
J Med Internet Res 2016 Nov 15;18(11):e295. doi: 10.2196/jmir.5811.
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Keywords: Social Media, Evidence-Based Practice, Guidelines, Heart Disease and Health, Nutrition
Patnode CD, Henninger ML, Senger CA
Primary care interventions to support breastfeeding: updated evidence report and systematic review for the US Preventive Services Task Force.
This updated report found no significant association between interventions and breastfeeding initiation . There was limited mixed evidence of an association between system-level interventions and rates of breastfeeding from well-controlled studies as well as for harms related to breastfeeding interventions, including maternal anxiety scores, decreased confidence, and concerns about confidentiality.
AHRQ-funded.
Citation: Patnode CD, Henninger ML, Senger CA .
Primary care interventions to support breastfeeding: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2016 Oct 25;316(16):1694-705. doi: 10.1001/jama.2016.8882.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Breast Feeding, Primary Care, Evidence-Based Practice, Guidelines
Shay LA, Street RL, Jr., Baldwin AS
Characterizing safety-net providers' HPV vaccine recommendations to undecided parents: a pilot study.
The researchers developed a tool to describe strength and content of provider HPV vaccination recommendations. The tool showed how providers undercut their recommendations through qualifications or support them with a rationale. The authors recommended that providers would benefit from communication skills training on how to make explicit recommendations with an evidence-based rationale.
AHRQ-funded; HS022418.
Citation: Shay LA, Street RL, Jr., Baldwin AS .
Characterizing safety-net providers' HPV vaccine recommendations to undecided parents: a pilot study.
Patient Educ Couns 2016 Sep;99(9):1452-60. doi: 10.1016/j.pec.2016.06.027.
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Keywords: Practice Patterns, Vaccination, Infectious Diseases, Sexual Health, Clinician-Patient Communication, Guidelines, Evidence-Based Practice, Communication
Shelley DR, Ogedegbe G, Anane S
Testing the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC.
The long-term goal of the HealthyHearts NYC trial is to create a robust infrastructure for implementing and disseminating evidence-based practice guidelines in primary care practices. The authors hypothesized that practice facilitation will result in superior clinical outcomes compared to usual care and that the effects of practice facilitation will be mediated by greater adoption of system changes in accord with patient-centered medical homes and the chronic care model.
AHRQ-funded; HS023922.
Citation: Shelley DR, Ogedegbe G, Anane S .
Testing the use of practice facilitation in a cluster randomized stepped-wedge design trial to improve adherence to cardiovascular disease prevention guidelines: HealthyHearts NYC.
Implement Sci 2016 Jul 4;11(1):88. doi: 10.1186/s13012-016-0450-2.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, Primary Care
Burda BU, Holmer HK, Norris SL
Limitations of A Measurement Tool to Assess Systematic Reviews (AMSTAR) and suggestions for improvement.
A Measurement Tool to Assess Systematic Reviews (AMSTAR) is a commonly used tool to assess the quality of systematic reviews; however, modifications are needed to improve its usability, reliability, and validity. In this commentary, the authors summarize their experience and the experiences of others who have used AMSTAR and provide suggestions for its improvement.
AHRQ-funded; HS018500.
Citation: Burda BU, Holmer HK, Norris SL .
Limitations of A Measurement Tool to Assess Systematic Reviews (AMSTAR) and suggestions for improvement.
Syst Rev 2016 Apr 12;5:58. doi: 10.1186/s13643-016-0237-1.
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Keywords: Research Methodologies, Data, Evidence-Based Practice, Guidelines, Quality Measures
Wilson KC, Gould MK, Krishnan JA
An official American Thoracic Society workshop report. A framework for addressing multimorbidity in clinical practice guidelines for pulmonary disease, critical illness, and sleep disorders.
The American Thoracic Society convened a workshop to establish a strategy to address multimorbidity within clinical practice guidelines. This report describes a framework that addresses multimorbidity in each of the key steps of guideline development: topic selection, panel composition, identifying clinical questions, searching for and synthesizing evidence, rating the quality of that evidence, summarizing benefits and harms, formulating recommendations, and rating the strength of the recommendations.
AHRQ-funded; HS020672.
Citation: Wilson KC, Gould MK, Krishnan JA .
An official American Thoracic Society workshop report. A framework for addressing multimorbidity in clinical practice guidelines for pulmonary disease, critical illness, and sleep disorders.
Ann Am Thorac Soc 2016 Mar;13(3):S12-21. doi: 10.1513/AnnalsATS.201601-007ST.
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Keywords: Sleep Problems, Guidelines, Evidence-Based Practice, Chronic Conditions, Respiratory Conditions
Ngo-Metzger O, Blitz J
AHRQ Author: Ngo-Metzger Q
Screening for high blood pressure in adults.
This case study involves a 55-year-old black man who presents for a blood pressure evaluation. It poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Ngo-Metzger O, Blitz J .
Screening for high blood pressure in adults.
Am Fam Physician 2016 Mar 15;93(6):511-2.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Screening, Guidelines, Case Study, Evidence-Based Practice
Robinson KA, Chou R, Berkman ND
AHRQ Author: Chang S
Twelve recommendations for integrating existing systematic reviews into new reviews: EPC guidance.
As time and cost constraints in the conduct of systematic reviews increase, the need to consider the use of existing systematic reviews also increases. The authors developed guidance on the integration of systematic reviews into new reviews. Recommendations addressing selecting reviews, assessing risk of bias, qualitative and quantitative synthesis, and summarizing and assessing body of evidence were developed.
AHRQ-authored; AHRQ-funded
Citation: Robinson KA, Chou R, Berkman ND .
Twelve recommendations for integrating existing systematic reviews into new reviews: EPC guidance.
J Clin Epidemiol 2016 Feb. doi: 10.1016/j.jclinepi.2015.05.035..
Keywords: Research Methodologies, Evidence-Based Practice, Guidelines
Fan T, Blitz J
AHRQ Author: Fan T
Screening for iron deficiency anemia and iron supplementation in pregnant women to improve maternal health and birth outcomes.
This case study involves a 28-year-old woman presents for a routine antepartum visit. She is 33 weeks pregnant and also has a four-year-old son. She has no particular problems, and the findings from your examination are unremarkable. She asks if her blood iron level should be tested. Based on the recommendations of the U.S. Preventive Services Task Force, the quiz asks 3 questions involving screening and treatment.
AHRQ-authored.
Citation: Fan T, Blitz J .
Screening for iron deficiency anemia and iron supplementation in pregnant women to improve maternal health and birth outcomes.
Am Fam Physician 2016 Jan 15;93(2):137-8..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Maternal Care, Women, Guidelines, Evidence-Based Practice
Simianu VV, Bastawrous AL, Farrokhi ET
Addressing the appropriateness of elective colon resection for diverticulitis: a report from the SCOAP CERTAIN collaborative.
The aim of this study was to assess the clinician-reported indications for elective colectomy and describe trends in the number of prior episodes of diverticulitis. It found an increase in the proportion of cases that met expert-established guidelines for appropriate surgery, but nearly 1 in 3 still do not meet established criteria.
AHRQ-funded; HS020025
Citation: Simianu VV, Bastawrous AL, Farrokhi ET .
Addressing the appropriateness of elective colon resection for diverticulitis: a report from the SCOAP CERTAIN collaborative.
Ann Surg. 2014 Sep;260(3):533-8; discussion 38-9. doi: 10.1097/sla.0000000000000894..
Keywords: Decision Making, Surgery, Evidence-Based Practice, Guidelines
Kealey E, Scholle SH, Byron SC
Quality concerns in antipsychotic prescribing for youth: a review of treatment guidelines.
The authors reviewed treatment guidelines relevant to 7 quality concepts for appropriate use and management of youth on antipsychotics.They found that all 7 quality concepts were strongly endorsed by 1 or more guidelines, and 2 or more guidelines assigned their highest strength of recommendation ratings to 6 of the 7 concepts. Two guidelines rated evidence, providing high strength of evidence for 2 quality concepts.
AHRQ-funded; HS020503.
Citation: Kealey E, Scholle SH, Byron SC .
Quality concerns in antipsychotic prescribing for youth: a review of treatment guidelines.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S68-75. doi: 10.1016/j.acap.2014.05.009.
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Keywords: Evidence-Based Practice, Children/Adolescents, Guidelines, Quality of Care, Medication
Padula WV, Mishra MK, Makic MB
A framework of quality improvement interventions to implement evidence-based practices for pressure ulcer prevention.
The purpose of this paper is to enhance the learner’s competence with knowledge about a framework of quality improvement (QI) interventions to implement evidence-based practices for pressure ulcer (PrU) prevention. The best-practice framework offers a reference point to initiating a bundle of QI interventions in support of evidence-based practices. Hospitals and clinicians tasked with quality improvement efforts can use this framework to problem-solve PrU prevention and other critical issues.
AHRQ-funded; HS023710.
Citation: Padula WV, Mishra MK, Makic MB .
A framework of quality improvement interventions to implement evidence-based practices for pressure ulcer prevention.
Adv Skin Wound Care 2014 Jun;27(6):280-4; quiz 85-6. doi: 10.1097/01.ASW.0000450703.87099.5b..
Keywords: Quality Improvement, Patient Safety, Evidence-Based Practice, Pressure Ulcers, Guidelines
Camp KM, Parisi MA, Acosta PB
AHRQ Author: Chang CS
Phenylketonuria Scientific Review Conference: state of the science and future research needs.
An NIH State-of-the-Science Conference was convened in 2012 to address new findings, particularly the use of the medication sapropterin to treat some individuals with phenylketonuria (PKU), and to develop a research agenda. An AHRQ Evidence-based Practice Center conducted a systematic review of adjuvant treatments for PKU and presented its conclusions at the conference. New drugs that are safe, efficacious, and impact a larger proportion of individuals with PKU are needed. The identification of a research agenda has facilitated the development of clinical practice guidelines by professional organizations and serves as a model for other inborn errors of metabolism.
AHRQ-authored.
Citation: Camp KM, Parisi MA, Acosta PB .
Phenylketonuria Scientific Review Conference: state of the science and future research needs.
Mol Genet Metab 2014 Jun;112(2):87-122. doi: 10.1016/j.ymgme.2014.02.013.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Guidelines, Medication, Research Methodologies
Nelson HD, Pappas M, Zakher B
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: a systematic review to update the U.S. Preventive Services Task Force recommendation.
This systematic review was done in support of the U.S. Preventive Services Task Force (USPSTF) updated recommendation on the benefit and harms of risk assessment, genetic testing, and genetic counseling for BRCA-related cancer in women. A systematic review was done on literature from 2004 to July 30, 2013 from MEDLINE, PsycINFO, the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Health Technology Assessment, Scopus, and reference lists. Data on the participants, study design, analysis, follow-up, and results was extracted and a second investigator confirmed key data. The studies were rated on study quality and applicability. The analysis found women with high-risk for breast cancer had decreased risk of breast cancer by 85% to 100% by having a mastectomy, and risk of mortality by 81% to 100% compared to women without surgery. There was also a lower risk of breast and ovarian cancer after having salpingo-oopherectomy surgery.
AHRQ-funded; 290200710057
Citation: Nelson HD, Pappas M, Zakher B .
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: a systematic review to update the U.S. Preventive Services Task Force recommendation.
Ann Intern Med 2014 Feb 18;160(4):255-66. doi: 10.7326/m13-1684..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer: Ovarian Cancer, Cancer, Genetics, Screening, Prevention, Guidelines, Evidence-Based Practice, Women, Risk, Family Health and History
Nuckols TK, Anderson L, Popescu I
Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain.
This review evaluated the quality and content of guidelines on the use of opioids for chronic pain. Despite limited evidence and variable development methods, it concluded that recent guidelines on chronic pain agree on several opioid risk mitigation strategies, including upper dosing thresholds; cautions with certain medications; attention to drug–drug and drug–disease interactions; and use of risk assessment tools, treatment agreements, and urine drug testing.
AHRQ-funded; HS017954.
Citation: Nuckols TK, Anderson L, Popescu I .
Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain.
Ann Intern Med 2014 Jan 7;160(1):38-47. doi: 10.7326/0003-4819-160-1-201401070-00732..
Keywords: Opioids, Pain, Guidelines, Medication, Evidence-Based Practice, Chronic Conditions
Lawrence WF
AHRQ Author: Lawrence WF
Comparative effectiveness research in practice and policy for radiation oncology.
In radiation oncology, the line between comparative effectiveness research (CER) and traditional research may be blurred, but an increased emphasis on CER can help to bridge the research enterprise and clinical practice, helping to inform decision making at the patient, clinician, and policy levels.
AHRQ-authored.
Citation: Lawrence WF .
Comparative effectiveness research in practice and policy for radiation oncology.
Semin Radiat Oncol 2014 Jan;24(1):54-60. doi: 10.1016/j.semradonc.2013.09.001.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Guidelines, Policy, Research Methodologies
Rangachari P, Madaio M, Rethemeyer RK
Role of communication content and frequency in enabling evidence-based practices.
The study sought to promote central line bundle (CLB) implementation in a medical ICU and a pediatric ICU through periodic quality improvement (QI) interventions over a 52-week period. It found that proactive communications increased by 68 percent in the MICU and 61 percent in the PICU. During the same timeframe, both units increased CLB adherence to 100 percent. Both units also demonstrated statistically significant declines in catheter days.
AHRQ-funded; HS019785.
Citation: Rangachari P, Madaio M, Rethemeyer RK .
Role of communication content and frequency in enabling evidence-based practices.
Qual Manag Health Care 2014 Jan-Mar;23(1):43-58. doi: 10.1097/qmh.0000000000000017..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Communication, Evidence-Based Practice, Guidelines, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Quality of Care, Quality Improvement
Weng C, Payne PR, Velez M
Towards symbiosis in knowledge representation and natural language processing for structuring clinical practice guidelines.
This vision paper discusses the value and feasibility of supporting symbiosis in text-based knowledge acquisition (KA) and knowledge representation (KR). It concludes that KA for KR should be made explicit, scalable, elastic, iterative, and “just expressive enough” to allow NLP-assisted knowledge engineering and increase the facility by which clinical practice guidelines are translated from research into practice.
AHRQ-funded; HS022961.
Citation: Weng C, Payne PR, Velez M .
Towards symbiosis in knowledge representation and natural language processing for structuring clinical practice guidelines.
Stud Health Technol Inform 2014;201:461-9..
Keywords: Evidence-Based Practice, Guidelines, Implementation, Health Information Technology (HIT)