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- (-) Arthritis (34)
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- Obesity: Weight Management (1)
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- Osteoporosis (2)
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- Pain (5)
- Patient-Centered Outcomes Research (11)
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- Patient and Family Engagement (3)
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- Practice Patterns (1)
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- Provider: Physician (1)
- Quality Improvement (2)
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- Quality of Life (1)
- Racial and Ethnic Minorities (4)
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- Surgery (11)
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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 34 Research Studies DisplayedSun K, Szymonifka J, Tian H
Association of traditional Chinese medicine use with adherence to prescribed Western rheumatic medications among Chinese American patients: a cross-sectional survey.
Chinese Americans are a fast-growing immigrant group with worse rheumatic disease outcomes compared to white populations and frequently use traditional Chinese medicine (TCM). Whether TCM use is associated with lower adherence to Western rheumatic medications is unknown. The purpose of this study was to examine adherence to Western medications for systemic rheumatic diseases in the Chinese American immigrant population and its association with TCM use.
Citation: Sun K, Szymonifka J, Tian H .
Association of traditional Chinese medicine use with adherence to prescribed Western rheumatic medications among Chinese American patients: a cross-sectional survey.
Arthritis Care Res 2020 Oct;72(10):1474-80. doi: 10.1002/acr.24031..
Keywords: Medication, Complementary and Alternative Medicine, Patient Adherence/Compliance, Racial and Ethnic Minorities, Arthritis, Chronic Conditions
Ferucci ED, Holck P, Day GM
Factors associated with use of telemedicine for follow-up of rheumatoid arthritis.
The objective of this analysis was to determine factors associated with the use of video telemedicine when offered as part of usual care for follow-up of rheumatoid arthritis (RA). Participants were individuals with a diagnosis of RA recruited from the Alaska Tribal Health System when seeing a rheumatologist either in-person or via video telemedicine. Findings showed that, when offered as an option for rheumatology care, video telemedicine was more likely to be used by RA patients with higher disease activity and more positive perceptions of telemedicine, as well as by patients whose physicians used telemedicine more often.
AHRQ-funded; HS024540.
Citation: Ferucci ED, Holck P, Day GM .
Factors associated with use of telemedicine for follow-up of rheumatoid arthritis.
Arthritis Care Res 2020 Oct;72(10):1404-09. doi: 10.1002/acr.24049.
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Keywords: Telehealth, Health Information Technology (HIT), Arthritis, Healthcare Delivery
Daniel CM, Davila L, Makris UE
Ethnic disparities in atherosclerotic cardiovascular disease incidence and prevalence among rheumatoid arthritis patients in the United States: a systematic review.
In this systematic review, the authors sought to describe the incidence and prevalence of atherosclerotic cardiovascular disease (ASCVD) stratified by race/ethnicity within the US population of those with rheumatoid arthritis (RA). They found insufficient data on racially/ethnically diverse RA patients and ASCVD outcomes. They recommended that future studies report the prevalence of ASCVD in various races/ethnicities with RA in the United States, as these data would help inform clinicians on how best to manage cardiovascular disease risk in RA.
AHRQ-funded; HS022418.
Citation: Daniel CM, Davila L, Makris UE .
Ethnic disparities in atherosclerotic cardiovascular disease incidence and prevalence among rheumatoid arthritis patients in the United States: a systematic review.
ACR Open Rheumatol 2020 Sep;2(9):525-32. doi: 10.1002/acr2.11170..
Keywords: Disparities, Racial and Ethnic Minorities, Arthritis, Cardiovascular Conditions
Giardina JC, Cha T, Atlas SJ
Validation of an electronic coding algorithm to identify the primary indication of orthopedic surgeries from administrative data.
The purpose of this study was to develop and validate an algorithm to identify patients receiving four elective orthopedic surgeries to promote shared decision-making. The surgeries included were: 1) knee arthroplasty to treat knee osteoarthritis (KOA); 2) hip arthroplasty to treat hip osteoarthritis (HOA); 3) spinal surgery to treat lumbar spinal stenosis (SpS); and 4) spinal surgery to treat lumber herniated disc (HD). Electronic medical records were reviewed to ascertain a “gold standard” determination of the procedure and primary indication status. Each case had electronic algorithms consisting of ICD-10 and CPT codes for each combination and indication applied to their record. A total of 790 procedures were included in the study. The sensitivity of the algorithms ranged from 0.70 (HD) to 0.92 (KOA). Specificity ranged from 0.94 (SpS) to 0.99 (HOA, KOA).
AHRQ-funded; HS000055.
Citation: Giardina JC, Cha T, Atlas SJ .
Validation of an electronic coding algorithm to identify the primary indication of orthopedic surgeries from administrative data.
BMC Med Inform Decis Mak 2020 Aug 12;20(1):187. doi: 10.1186/s12911-020-01175-1.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Orthopedics, Surgery, Arthritis, Decision Making
Liu LH, Garrett SB, Li J
Patient and clinician perspectives on a patient-facing dashboard that visualizes patient reported outcomes in rheumatoid arthritis.
The authors’ goal was to develop a rheumatoid arthritis (RA) 'dashboard' that could facilitate conversations about patient-reported outcomes (PROs) and that would be acceptable to a wide range of patients, including English and Spanish speakers and patients with adequate or limited health literacy. Using focus groups and principles of human-centered design, they created an RA dashboard that was well-accepted among patients and clinicians. They indicated that the ability to customize the data display was important for tailoring the dashboard to patients with diverse needs and preferences, with special attention to be given to feasibility concerns voiced by clinicians.
AHRQ-funded; HS025405.
Citation: Liu LH, Garrett SB, Li J .
Patient and clinician perspectives on a patient-facing dashboard that visualizes patient reported outcomes in rheumatoid arthritis.
Health Expect 2020 Aug;23(4):846-59. doi: 10.1111/hex.13057..
Keywords: Arthritis, Health Information Technology (HIT), Patient and Family Engagement, Clinician-Patient Communication, Communication, Health Literacy
Kulhawy-Wibe SC, Zell J, Michaud K
Systematic review and appraisal of the cross-cultural validity of functional status assessment measures in rheumatoid arthritis.
Researchers conducted a systematic review and appraisal of the cross-cultural adaptation and cross-cultural validity of the Health Assessment Questionnaire and its derivatives, and of the more recent Patient-Reported Outcomes Measurement Information System (PROMIS) functional status assessment measures (FSAMs) in rheumatoid arthritis. They concluded that their review highlighted a paucity of data on the cross-cultural validity of FSAMs and the mostly poor- or fair-quality methods by which they were translated and adapted.
AHRQ-funded; HS025638.
Citation: Kulhawy-Wibe SC, Zell J, Michaud K .
Systematic review and appraisal of the cross-cultural validity of functional status assessment measures in rheumatoid arthritis.
Arthritis Care Res 2020 Jun;72(6):798-805. doi: 10.1002/acr.23904..
Keywords: Arthritis, Cultural Competence, Health Status
Gaskin DJ, Karmarkar TD, Maurer A
Potential role of cost and quality of life in treatment decisions for arthritis-related knee pain in African American and Latina women.
This study examined whether using a decision-making tool would aid Latina and African-American women over age 45 years with arthritic knee pain in making more informed treatment decisions. The researchers conducted 4 focus groups of Latina and African-American women and 2 focus groups with primary care providers who treated them for knee pain. They found that minority women and primary care providers all endorsed the use of a decision-making tool that provided information on the impact of treatment on quality of life, medical care costs, and work productivity.
AHRQ-funded; HS000029.
Citation: Gaskin DJ, Karmarkar TD, Maurer A .
Potential role of cost and quality of life in treatment decisions for arthritis-related knee pain in African American and Latina women.
Arthritis Care Res 2020 May;72(5):692-98. doi: 10.1002/acr.23903..
Keywords: Arthritis, Orthopedics, Pain, Quality of Life, Healthcare Costs, Decision Making, Racial and Ethnic Minorities, Women
Birru Talabi M, Clowse MEB, Blalock SJ
Perspectives of adult rheumatologists regarding family planning counseling and care: a qualitative study.
This qualitative study sought to assess rheumatologists' perspectives, attitudes, and practices regarding family planning counseling and reproductive health care (FPCC). A geographically diverse sample of U.S. rheumatologists were interviewed and the transcripts of the interviews developed into a code book based on their content. Findings showed that rheumatologists feel a sense of responsibility to provide some aspects of FPCC to reproductive-age female patients. However, their own apprehensions about managing complicated pregnancies may negatively influence how they advise patients about pregnancy planning or avoidance. Future work should focus on eliminating barriers and identifying solutions that support rheumatologists' efforts to provide high-quality FPCC to patients.
AHRQ-funded; HS022989.
Citation: Birru Talabi M, Clowse MEB, Blalock SJ .
Perspectives of adult rheumatologists regarding family planning counseling and care: a qualitative study.
Arthritis Care Res 2020 Mar;72(3):452-58. doi: 10.1002/acr.23872..
Keywords: Arthritis, Pregnancy, Sexual Health, Provider: Physician, Women
Gandrup J, Li J, Izadi Z
Three quality improvement initiatives and performance of rheumatoid arthritis disease activity measures in electronic health records: results from an interrupted time series study.
This study evaluated the effect of 3 HIT initiatives on the performance of rheumatoid arthritis (RA) disease activity measures and outcomes in an academic rheumatology clinic. The three initiatives implemented to facilitate performance of the Clinical Disease Activity Index (CDAI) were: 1) an EHR flowsheet to input scores, 2) peer performance reports, and 3) an EHR Smartform including a CDAI calculator. Data from 995 patients with 8,040 encounters between 2012 and 2017 was included. Electronic capture of CDAI scores increased from 0% to 64%. Peer performance reporting and the SmartForm kept performance stable. Physician satisfaction increased after SmartForm implementation.
AHRQ-funded; HS025638.
Citation: Gandrup J, Li J, Izadi Z .
Three quality improvement initiatives and performance of rheumatoid arthritis disease activity measures in electronic health records: results from an interrupted time series study.
Arthritis Care Res 2020 Feb;72(2):283-91. doi: 10.1002/acr.23848..
Keywords: Arthritis, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Lange JK, DiSegna ST, Yang W
Using cluster analysis to identify patient factors linked to differential functional gains after total knee arthroplasty.
This study used cluster analysis to identify patient factors linked to different outcomes following total knee arthroplasty (TKA). The study analyzed Short Form 36 Physical Component Score (PCS) trajectories of 656 patients at 3 time points over a 1-year period. The MultiExperiment View (MeV) built-in bootstrapping method was used to assess statistical significance of the clusters. They found two distinct clusters: Cluster 1 included 550 patients (84%) who demonstrated persistent improvement at 6 and 12 months. The remainder of patients consisted of Cluster 2 who demonstrated decline in PCS at 6 months but improved by 12 months. Cluster 1 was found to have higher baseline mental health scores, lower baseline PCS, and a significantly higher proportion of non-Hispanic Whites compared to Cluster 2.
AHRQ-funded; HS018910.
Citation: Lange JK, DiSegna ST, Yang W .
Using cluster analysis to identify patient factors linked to differential functional gains after total knee arthroplasty.
J Arthroplasty 2020 Jan;35(1):121-26.e6. doi: 10.1016/j.arth.2019.08.039..
Keywords: Orthopedics, Surgery, Arthritis, Outcomes, Chronic Conditions
Schmajuk G, Yazdany J
Leveraging the electronic health record to improve quality and safety in rheumatology.
In the coming years, developing and leveraging tools within the electronic health record (EHR) will be the key to making the next big strides in improving the health of patients with rheumatoid arthritis and other rheumatic diseases, including building EHR infrastructure to capture patient outcomes and developing automated methods to retrieve information from free text of clinical notes.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Yazdany J .
Leveraging the electronic health record to improve quality and safety in rheumatology.
Rheumatol Int 2017 Oct;37(10):1603-10. doi: 10.1007/s00296-017-3804-4.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Patient Safety, Quality Improvement, Arthritis
Pellegrini CA, Song J, Semanik PA
Patients less likely to lose weight following a knee replacement: results from the osteoarthritis initiative.
The purpose of this study was to examine weight change patterns preoperatively and postoperatively among overweight/obese knee replacement patients. Overweight and obese patients initially lost weight during the interval including knee replacement; however, they were less likely to lose more than 2.5% of their weight in the 1 to 2 years immediately after the surgery.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Song J, Semanik PA .
Patients less likely to lose weight following a knee replacement: results from the osteoarthritis initiative.
J Clin Rheumatol 2017 Oct;23(7):355-60. doi: 10.1097/rhu.0000000000000579..
Keywords: Obesity: Weight Management, Arthritis, Patient-Centered Outcomes Research, Surgery
Herbert MS, Goodin BR, Bulls HW
Ethnicity, cortisol, and experimental pain responses among persons with symptomatic knee osteoarthritis.
This study aimed to examine the relationship between cortisol and pain responses during a cold-pressor task (CPT) among African American (AA) and non-Hispanic White (NHW) adults with knee osteoarthritis (OA). Consistent with previous findings in young healthy adults, cold-pressor pain responses are related to pre-CPT cortisol concentrations in NHW persons with knee OA but not in their AA counterparts.
AHRQ-funded; HS013852.
Citation: Herbert MS, Goodin BR, Bulls HW .
Ethnicity, cortisol, and experimental pain responses among persons with symptomatic knee osteoarthritis.
Clin J Pain 2017 Sep;33(9):820-26. doi: 10.1097/ajp.0000000000000462.
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Keywords: Arthritis, Pain, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Treatments
Li W, Ayers DC, Lewis CG
Functional gain and pain relief after total joint replacement according to obesity status.
The researchers examined the changes between preoperative and postoperative function and pain in a large representative U.S. cohort to determine if there was a relationship to obesity status. They found that six months after total joint replacement, severely or morbidly obese patients reported excellent pain relief and substantial functional gain that was similar to the findings in other patients.
AHRQ-funded; HS018910.
Citation: Li W, Ayers DC, Lewis CG .
Functional gain and pain relief after total joint replacement according to obesity status.
J Bone Joint Surg Am 2017 Jul 19;99(14):1183-89. doi: 10.2106/jbjs.16.00960.
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Keywords: Obesity, Surgery, Pain, Arthritis, Patient-Centered Outcomes Research
Gandek B, Ware JE, Jr.
Validity and responsiveness of the knee injury and osteoarthritis outcome score: a comparative study among total knee replacement patients.
The researchers evaluated validity and responsiveness of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in relation to other patient-reported outcome measures before and after total knee replacement (TKR). They concluded that KOOS scales were valid and responsive in a cohort of 1,143 US TKR patients. KOOS QOL performed particularly well in capturing aggregate knee-specific outcomes.
AHRQ-funded; HS018910; HS024632.
Citation: Gandek B, Ware JE, Jr. .
Validity and responsiveness of the knee injury and osteoarthritis outcome score: a comparative study among total knee replacement patients.
Arthritis Care Res 2017 Jun;69(6):817-25. doi: 10.1002/acr.23193.
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Keywords: Arthritis, Surgery, Patient-Centered Outcomes Research, Outcomes, Injuries and Wounds
Singh JA, Hossain A, Mudano AS
Biologics or tofacitinib for people with rheumatoid arthritis naive to methotrexate: a systematic review and network meta-analysis.
The researchers performed a systematic review to compare the benefits and harms of biologics and small molecule tofacitinib versus comparator (methotrexate (MTX) and other disease-modifying antirheumatic drugs) in patients with rheumatoid arthritis (RA) who are naive to methotrexate. They concluded that in MTX-naive RA participants, there was moderate-quality evidence that, compared with MTX alone, biologics with MTX were associated with absolute and relative clinically meaningful benefits in three of the efficacy outcomes.
AHRQ-funded; HS021110.
Citation: Singh JA, Hossain A, Mudano AS .
Biologics or tofacitinib for people with rheumatoid arthritis naive to methotrexate: a systematic review and network meta-analysis.
Cochrane Database Syst Rev 2017 May 8;5:CD012657. doi: 10.1002/14651858.cd012657.
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Keywords: Comparative Effectiveness, Medication, Arthritis, Patient-Centered Outcomes Research, Evidence-Based Practice
Zheng H, Tulu B, Choi W
Using mHealth app to support treatment decision-making for knee arthritis: patient perspective.
The authors explored patient preferences on content and design of a mobile health app to facilitate daily symptom capture and summary feedback reporting, in order to inform treatment decisions, including use of total knee replacement surgery (TKR). The authors suggest that user input can inform the design and implementation of mHealth technology to meet patient needs for their treatment decisions. Patient priorities must be considered through patient-centered app design.
AHRQ-funded; HS018910.
Citation: Zheng H, Tulu B, Choi W .
Using mHealth app to support treatment decision-making for knee arthritis: patient perspective.
eGEMS 2017 Apr 20;5(2):7. doi: 10.13063/2327-9214.1284..
Keywords: Arthritis, Decision Making, Health Information Technology (HIT), Surgery
Kathuria P, Gordon KB, Silverberg JI
Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures.
This study investigated whether psoriasis (Pso) and psoriatic arthritis (PsA) are associated with osteoporosis and fractures in US adults. Using records of 183,725 persons with Pso and 28,765 with PsA from the 2006-2012 National Emergency Department Sample, including 20 percent of the emergency care visits throughout the United States, it found that Pso and PsA were associated with osteopenia, osteoporosis, ankylosing spondylitis, and pathologic fractures.
AHRQ-funded; HS023011.
Citation: Kathuria P, Gordon KB, Silverberg JI .
Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures.
J Am Acad Dermatol 2017 Mar 14;76(6):1045-53.e3. doi: 10.1016/j.jaad.2016.11.046.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Osteoporosis, Injuries and Wounds, Arthritis
Singh JA, Hossain A, Tanjong Ghogomu E
Biologics or tofacitinib for people with rheumatoid arthritis unsuccessfully treated with biologics: a systematic review and network meta-analysis.
This review is focused on biologic or tofacitinib therapy in people with rheumatoid arthritis (RA) who had previously been treated unsuccessfully with biologics. Biologic (with or without methotrexate (MTX)) or tofacitinib (with MTX) use was associated with clinically meaningful and statistically significant benefits compared to placebo or an active comparator (MTX/other traditional disease-modifying anti-rheumatic drugs) among people with RA previously unsuccessfully treated with biologics.
AHRQ-funded; HS021110.
Citation: Singh JA, Hossain A, Tanjong Ghogomu E .
Biologics or tofacitinib for people with rheumatoid arthritis unsuccessfully treated with biologics: a systematic review and network meta-analysis.
Cochrane Database Syst Rev 2017 Mar 10;3:CD012591. doi: 10.1002/14651858.cd012591.
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Keywords: Comparative Effectiveness, Medication, Arthritis, Patient-Centered Outcomes Research, Evidence-Based Practice
Curtis JR, Chen L, Greenberg JD
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights.
Treat to target guidelines recommend achieving remission or low disease activity in rheumatoid arthritis (RA). However, the reduction in adverse events and costs associated with lower disease activity is unclear. This study found that leveraging the benefits of linking registry and administrative data together, lower disease activity in RA was associated with incrementally reduced risks of all-cause hospitalization, ED visits, mortality, and medical costs in a dose-dependent fashion.
AHRQ-funded; HS021694.
Citation: Curtis JR, Chen L, Greenberg JD .
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights.
Pharmacoepidemiol Drug Saf 2017 Mar;26(3):310-19. doi: 10.1002/pds.4126.
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Keywords: Patient-Centered Outcomes Research, Registries, Arthritis, Healthcare Costs, Guidelines
Franklin PD, Miozzari H, Christofilopoulos P
Important patient characteristics differ prior to total knee arthroplasty and total hip arthroplasty between Switzerland and the United States.
The researchers compared preoperative patient and clinical characteristics from two large cohorts who underwent either total knee (TKA) or hip (THA) arthroplasty, one in Switzerland, the other in the US. They found substantial differences between US and Swiss cohorts in pre-operative patient characteristics and pain levels, which has potentially important implications for cross-cultural comparison of TKA/THA outcomes.
AHRQ-funded; HS018910.
Citation: Franklin PD, Miozzari H, Christofilopoulos P .
Important patient characteristics differ prior to total knee arthroplasty and total hip arthroplasty between Switzerland and the United States.
BMC Musculoskelet Disord 2017 Jan 11;18(1):14. doi: 10.1186/s12891-016-1372-5.
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Keywords: Surgery, Pain, Patient-Centered Outcomes Research, Osteoporosis, Arthritis
Charles-Schoeman C, Yin Lee Y, Shahbazian A
Improvement of high-density lipoprotein function in patients with early rheumatoid arthritis treated with methotrexate monotherapy or combination therapies in a randomized controlled trial.
This study was undertaken to evaluate changes in HDL function and HDL-associated proteins over 2 years of follow-up in patients with early rheumatoid arthritis receiving either methotrexate (MTX) monotherapy, MTX + etanercept (ETN) combination therapy, or MTX + sulfasalazine (SSZ) + hydroxychloroquine (HCQ) triple therapy. It found that reduced disease activity in patients with any of the 3 therapies in the trial was associated with improvements in the HDL function profile.
AHRQ-funded; HS018517.
Citation: Charles-Schoeman C, Yin Lee Y, Shahbazian A .
Improvement of high-density lipoprotein function in patients with early rheumatoid arthritis treated with methotrexate monotherapy or combination therapies in a randomized controlled trial.
Arthritis Rheumatol 2017 Jan;69(1):46-57. doi: 10.1002/art.39833.
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Keywords: Arthritis, Medication, Comparative Effectiveness
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
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
Ghomrawi HM, Alexiades M, Pavlov H
Evaluation of two appropriateness criteria for total knee replacement.
The researchers evaluated the performance of 2 sets of non-U.S. appropriateness criteria (one from Spain and the other from Canada) for total knee replacement (TKR) in a group of 508 TKR patients. Although only 4.7 percent were classified as inappropriate by both sets of criteria, there was little agreement between the two.
AHRQ-funded; HS016075
Citation: Ghomrawi HM, Alexiades M, Pavlov H .
Evaluation of two appropriateness criteria for total knee replacement.
Arthritis Care Res. 2014 Nov;66(11):1749-53. doi: 10.1002/acr.22390..
Keywords: Surgery, Arthritis, Decision Making