National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- (-) Cancer (19)
- Cancer: Breast Cancer (2)
- Cancer: Colorectal Cancer (3)
- Cancer: Lung Cancer (2)
- Cancer: Prostate Cancer (2)
- Cardiovascular Conditions (1)
- Care Management (2)
- Case Study (1)
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- Comparative Effectiveness (1)
- Decision Making (2)
- Dementia (1)
- Diabetes (1)
- Diagnostic Safety and Quality (2)
- (-) Elderly (19)
- Falls (1)
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- Imaging (1)
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- Men's Health (1)
- Mortality (3)
- Outcomes (1)
- Palliative Care (3)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (4)
- Patient and Family Engagement (1)
- Prevention (4)
- Primary Care (1)
- Primary Care: Models of Care (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (2)
- Risk (3)
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- Social Determinants of Health (1)
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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 19 of 19 Research Studies DisplayedJayadevappa R, Chhatre S, Malkowicz SB
Association between androgen deprivation therapy use and diagnosis of dementia in men with prostate cancer.
The purpose of this study was to analyze the association between androgen deprivation therapy (ADT) exposure and diagnosis of Alzheimer disease or dementia among elderly men with prostate cancer. Results showed that, among elderly patients with prostate cancer, ADT exposure was associated with subsequent diagnosis of Alzheimer disease or dementia over a follow-up period of at least 10 years.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S, Malkowicz SB .
Association between androgen deprivation therapy use and diagnosis of dementia in men with prostate cancer.
JAMA Netw Open 2019 Jul 3;2(7):e196562. doi: 10.1001/jamanetworkopen.2019.6562..
Keywords: Cancer, Cancer: Prostate Cancer, Dementia, Elderly, Men's Health, Risk
Bateni SB, Gingrich AA, Jeon SY
Clinical outcomes and costs following unplanned excisions of soft tissue sarcomas in the elderly.
This study’s goal was to analyze the costs and outcomes of planned vs. unplanned soft tissue sarcoma (STS) excisions in the Medicare population. The authors analyzed 3913 surgical patients with STS >/=66 y old from 1992 to 2011 using the Surveillance, Epidemiology, and End Results-Medicare (SEER-Medicare) datafiles. Planned excision rates were classified from preoperative MRI or biopsy records. There was no difference in survival rates between planned vs. unplanned excisions. Planned excisions costs were higher than unplanned excision with the first resection contributing to the majority of costs.
AHRQ-funded; HS022236.
Citation: Bateni SB, Gingrich AA, Jeon SY .
Clinical outcomes and costs following unplanned excisions of soft tissue sarcomas in the elderly.
J Surg Res 2019 Jul;239:125-35. doi: 10.1016/j.jss.2019.01.055..
Keywords: Healthcare Costs, Cancer, Elderly, Surgery, Outcomes, Patient-Centered Outcomes Research
Bravo RI, Kietzman KG, Toy P
Linking primary care and community organizations to increase colorectal cancer screening rates: the HAPPI project.
This paper describes the Healthy Aging Partnerships in Prevention Initiative (HAPPI) which aims to increase colorectal cancer screening and other preventive services among underserved Latinos and African-Americans in South Los Angeles who are 50 years and older. It uses an evidence-based model (SPARC) to leverage existing resources and has multi-sectoral partnerships among different agencies, community health centers (CHCs), and a university. The authors engaged five CHCs in quality improvement activities and eight non-governmental organizations in networking and programming to increase awareness of these preventive services.
AHRQ-funded; HS010858.
Citation: Bravo RI, Kietzman KG, Toy P .
Linking primary care and community organizations to increase colorectal cancer screening rates: the HAPPI project.
Salud Publica Mex 2019 Jul-Aug;61(4):427-35. doi: 10.21149/9450..
Keywords: Cancer: Colorectal Cancer, Cancer, Screening, Prevention, Primary Care: Models of Care, Primary Care, Elderly, Racial and Ethnic Minorities, Vulnerable Populations, Patient-Centered Healthcare
Hoover DS, Pappadis MR, Housten AJ
Preferences for communicating about breast cancer screening among racially/ethnically diverse older women.
The purpose of this study was to examine preferences for communicating about screening mammography among racially/ethnically diverse older women. Through in-depth interviews, findings revealed that older women desire information about the benefits and harms of screening mammography and would prefer to learn this information through discussions with healthcare providers and multiple other formats. Results were consistent regardless of participants' age, race/ethnicity, or education.
AHRQ-funded; HS022134.
Citation: Hoover DS, Pappadis MR, Housten AJ .
Preferences for communicating about breast cancer screening among racially/ethnically diverse older women.
Health Commun 2019 Jun;34(7):702-06. doi: 10.1080/10410236.2018.1431026..
Keywords: Cancer, Cancer: Breast Cancer, Clinician-Patient Communication, Communication, Elderly, Women, Prevention, Racial and Ethnic Minorities, Screening
Ellis CT, Cole AL, Sanoff HK
Evaluating surveillance patterns after chemoradiation-only compared with conventional management for older patients with rectal cancer.
This study examined surveillance patterns for elderly patients who were treated only with chemoradiation (CR) as opposed to traditional treatment (chemoradiation and protectomy). In the cohort study, a total of 2,482 individuals met the inclusion criteria, with 21% receiving CR-only treatment, and 79% had conventional treatment. In comparison to patients who had traditional treatment, patients with CR-only treatment had far less follow-up during the first 2 years post-treatment. Adherence to guideline-recommended surveillance was poor for all Medicare patients, but especially for CR-only treated patients.
AHRQ-funded; HS000032.
Citation: Ellis CT, Cole AL, Sanoff HK .
Evaluating surveillance patterns after chemoradiation-only compared with conventional management for older patients with rectal cancer.
J Am Coll Surg 2019 May;228(5):782-91.e2. doi: 10.1016/j.jamcollsurg.2019.01.010..
Keywords: Cancer, Cancer: Colorectal Cancer, Care Management, Treatments, Elderly, Patient-Centered Outcomes Research
Haymart MR, Banerjee M, Reyes-Gastelum D
Adverse Events, Health Status, Provider: Clinician, Provider: Nurse, Provider: Physician, Surgery
This study used Surveillance, Epidemiology, and End Results (SEER) data to analyze thyroid cancer incidence in adults aged 65 years or older. Data was analyzed in the SEER-Medicare database from 2002 and 2013. Thyroid ultrasound use as initial imaging increased in all types of thyroid cancer, which increased the diagnosis of low-risk thyroid cancer. It was associated with female and comorbidities. Researchers believe that there is greater thyroid ultrasound use which results in increased diagnosis.
AHRQ-funded; HS024512.
Citation: Haymart MR, Banerjee M, Reyes-Gastelum D .
Adverse Events, Health Status, Provider: Clinician, Provider: Nurse, Provider: Physician, Surgery
J Clin Endocrinol Metab 2019 Mar;104(3):785-92. doi: 10.1210/jc.2018-01933..
Keywords: Cancer, Diagnostic Safety and Quality, Elderly, Imaging
Kistler CE, Golin C, Morris C
Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults.
This paper reports on the design of a randomized clinical trial to understand the effects of a patient decision aid on appropriate colorectal cancer screening. The study aims to determine the ability of a patient decision aid to increase individualized and appropriate colorectal cancer screening.
AHRQ-funded; HS021133.
Citation: Kistler CE, Golin C, Morris C .
Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults.
Clin Trials 2017 Dec;14(6):648-58. doi: 10.1177/1740774517725289..
Keywords: Cancer, Cancer: Colorectal Cancer, Decision Making, Elderly, Prevention, Screening
Park JS, Bateni SB, Bold RJ
The modified frailty index to predict morbidity and mortality for retroperitoneal sarcoma resections.
The researchers performed a retrospective analysis of patients with a diagnosis of primary malignant retroperitoneal neoplasm who underwent surgical resection. The modified frailty index (mFI) was calculated according to standard published methods. Their data demonstrate that the majority of patients undergoing retroperitoneal sarcoma resections have few, if any, comorbidities. The mFI was a limited predictor of overall and serious complications and was not a significant predictor of mortality.
AHRQ-funded; HS022236.
Citation: Park JS, Bateni SB, Bold RJ .
The modified frailty index to predict morbidity and mortality for retroperitoneal sarcoma resections.
J Surg Res 2017 Sep;217:191-97. doi: 10.1016/j.jss.2017.05.025.
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Keywords: Cancer, Elderly, Health Status, Mortality, Risk
Shih YT, Xu Y, Liu L
Rising prices of targeted oral anticancer medications and associated financial burden on Medicare beneficiaries.
This study examined trends in targeted oral anticancer medication (TOAM) prices and patient out-of-pocket (OOP) payments in Medicare Part D and estimated the actual effects on patient OOP payments of partial filling of the coverage gap by 2012. It concluded that rising TOAM prices threaten the financial relief patients have begun to experience under closure of the coverage gap in Medicare Part D.
AHRQ-funded; HS020263.
Citation: Shih YT, Xu Y, Liu L .
Rising prices of targeted oral anticancer medications and associated financial burden on Medicare beneficiaries.
J Clin Oncol 2017 Aug 1;35(22):2482-89. doi: 10.1200/jco.2017.72.3742.
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Keywords: Cancer, Medication, Healthcare Costs, Medicare, Elderly
Schuler MS, Joyce NR, Huskamp HA
Medicare beneficiaries with advanced lung cancer experience diverse patterns of care from diagnosis to death.
Using Medicare claims data for patients diagnosed with extensive-stage small-cell lung cancer, the authors used latent class analysis to identify classes of people with different care patterns. The findings showed substantial heterogeneity in patterns of care for patients with advanced cancer, which should be accounted for in efforts to improve end-of-life care.
AHRQ-funded; HS022998.
Citation: Schuler MS, Joyce NR, Huskamp HA .
Medicare beneficiaries with advanced lung cancer experience diverse patterns of care from diagnosis to death.
Health Aff 2017 Jul;36(7):1193-200. doi: 10.1377/hlthaff.2017.0448..
Keywords: Cancer, Cancer: Lung Cancer, Care Management, Elderly, Medicare, Palliative Care
Iyer AS, Bakitas M
Early palliative care in advanced illness: do right by mama.
This letter describes a case study where the doctor and the family decided not to do aggressive treatment on their mother in her 80’s with metastatic lung cancer and pneumonia. After describing the intubation procedure and the use of mechanical ventilation, the family decided that palliative care was the best option. The doctor emphasizes the use of palliative care as the best outcome for many terminally ill patients.
AHRQ-funded; HS023009; HS013852.
Citation: Iyer AS, Bakitas M .
Early palliative care in advanced illness: do right by mama.
JAMA Intern Med 2017 Jun;177(6):761-62. doi: 10.1001/jamainternmed.2017.0764.
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Keywords: Cancer, Cancer: Lung Cancer, Case Study, Decision Making, Elderly, Palliative Care, Patient-Centered Outcomes Research
Winters-Stone KM, Moe E, Graff JN
Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy.
This study compared the prevalence of and association between falls and frailty of prostate cancer survivors (PCSs) who were current, past or never users of androgen deprivation therapy (ADT). It concluded that current and past exposure to ADT is linked to higher risk of falls and frailty than no treatment.
AHRQ-funded; HS022981.
Citation: Winters-Stone KM, Moe E, Graff JN .
Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy.
J Am Geriatr Soc 2017 Jul;65(7):1414-19. doi: 10.1111/jgs.14795.
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Keywords: Cancer: Prostate Cancer, Cancer, Falls, Medication, Elderly
Rocque GB, Pisu M, Jackson BE
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
This study examined the influence of lay navigation on health care spending and resource use among geriatric patients with cancer within The University of Alabama at Birmingham Health System Cancer Community Network. It found that, compared with a matched comparison group, the mean total costs declined by $781.29 more per quarter per navigated patient, for an estimated $19 million decline per year across the network.
AHRQ-funded; HS023009.
Citation: Rocque GB, Pisu M, Jackson BE .
Resource use and Medicare costs during lay navigation for geriatric patients with cancer.
JAMA Oncol 2017 Jun;3(6):817-25. doi: 10.1001/jamaoncol.2016.6307.
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Keywords: Elderly, Cancer, Healthcare Costs, Medicare, Patient and Family Engagement, Patient-Centered Healthcare, Healthcare Delivery
Palta P, Huang ES, Kalyani RR
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
In this paper, the investigators sought to estimate the risk of mortality by HbA1c levels among older adults with and without diabetes. They concluded that an HbA1c >8.0% was associated with increased risk of all-cause and cause-specific mortality in older adults with diabetes. The investigators suggest that their results support the idea that better glycemic control is important for reducing mortality; however, they also indicate that there is a need for individualized glycemic targets for older adults with diabetes depending on their demographics, duration of diabetes, and existing comorbidities.
AHRQ-funded; HS018542.
Citation: Palta P, Huang ES, Kalyani RR .
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
Diabetes Care 2017 Apr;40(4):453-60. doi: 10.2337/dci16-0042.
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Keywords: Cancer, Cardiovascular Conditions, Diabetes, Elderly, Mortality, Risk
Koroukian SM, Schiltz NK, Warner DF
Social determinants, multimorbidity, and patterns of end-of-life care in older adults dying from cancer.
In this study, the researchers examined the association between end-of-life care and each of the social determinants of health and multimorbidity (MM), hypothesizing that higher MM is associated with less aggressive care. They found that, while 61.2 percent of the patients enrolled in hospice, 24.6 percent underwent cancer-directed treatment; 55.1 percent were admitted to the hospital and/or ED; and 21.7 percent died in the hospital.
AHRQ-funded; HS023113.
Citation: Koroukian SM, Schiltz NK, Warner DF .
Social determinants, multimorbidity, and patterns of end-of-life care in older adults dying from cancer.
J Geriatr Oncol 2017 Mar;8(2):117-24. doi: 10.1016/j.jgo.2016.10.001.
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Keywords: Cancer, Elderly, Palliative Care, Social Determinants of Health
Shen C, Zhao B, Liu L
Financial burden for patients with chronic myeloid leukemia enrolled in Medicare Part D taking targeted oral anticancer medications.
In this study, the investigators examined financial burden for patients with chronic myeloid leukemia enrolled in Medicare Part D taking targeted oral anticancer medications. The authors concluded that patients experience quick entry and exit from the coverage gap (also called the donut hole) as a result of the high price of targeted oral anticancer medications. They suggested that closing the donut hole would provide financial relief during the initial month(s) of treatment but will not completely eliminate the financial burden.
AHRQ-funded; HS020263.
Citation: Shen C, Zhao B, Liu L .
Financial burden for patients with chronic myeloid leukemia enrolled in Medicare Part D taking targeted oral anticancer medications.
J Oncol Pract 2017 Feb;13(2):e152-e62. doi: 10.1200/JOP.2016.014639..
Keywords: Cancer, Chronic Conditions, Elderly, Healthcare Costs, Medicare, Medication
Arvold ND, Cefalu M, Wang Y
Comparative effectiveness of radiotherapy with vs. without temozolomide in older patients with glioblastoma.
It is unknown whether the addition of temozolomide (TMZ) to radiotherapy (RT) is associated with improved overall survival among older glioblastoma patients. This study found that among a large cohort of older glioblastoma patients treated in a real-world setting, the addition of TMZ to RT was associated with a small survival gain.
AHRQ-funded; HS021991.
Citation: Arvold ND, Cefalu M, Wang Y .
Comparative effectiveness of radiotherapy with vs. without temozolomide in older patients with glioblastoma.
J Neurooncol 2017 Jan;131(2):301-11. doi: 10.1007/s11060-016-2294-7.
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Keywords: Cancer, Comparative Effectiveness, Elderly, Medication, Patient-Centered Outcomes Research
Vyas A, Madhavan S, Sambamoorthi U
Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.
The objective of this study is to determine the association between persistence with mammography screening and stage at breast cancer (BC) diagnosis among elderly women. It found that, as compared to women who were not persistent with mammography screening, women who were persistent with mammography screening were significantly more likely to be diagnosed at earlier stages of BC.
AHRQ-funded; HS018622.
Citation: Vyas A, Madhavan S, Sambamoorthi U .
Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.
Breast Cancer Res Treat 2014 Dec;148(3):645-54. doi: 10.1007/s10549-014-3204-3..
Keywords: Cancer, Cancer: Breast Cancer, Diagnostic Safety and Quality, Elderly, Prevention, Screening, Women
Arvold ND, Wang Y, Zigler C
Hospitalization burden and survival among older glioblastoma patients.
The researchers performed a retrospective cohort study among patients aged 65 years and older with glioblastoma diagnosed between 1999 and 2007. They found that higher comorbidity score and black race were associated with an increased risk of being hospitalized for at least 25% of remaining life, whereas radiation, temozolomide, and extensive surgery were associated with a decreased risk.
AHRQ-funded; HS021991.
Citation: Arvold ND, Wang Y, Zigler C .
Hospitalization burden and survival among older glioblastoma patients.
Neuro Oncol 2014 Nov;16(11):1530-40. doi: 10.1093/neuonc/nou060.
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Keywords: Cancer, Elderly, Hospitalization, Mortality, Quality of Life