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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 202 Research Studies DisplayedCooper LB, Lippmann SJ, Greiner MA
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. In their study, the investigators found that among patients with heart failure and diabetes mellitus or chronic kidney disease, MRA use was associated with lower risk of all-cause readmission despite greater risk of hyperkalemia and acute renal insufficiency.
AHRQ-funded; HS021092.
Citation: Cooper LB, Lippmann SJ, Greiner MA .
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
J Am Heart Assoc 2017 Dec 23;6(12):pii: e006540. doi: 10.1161/jaha.117.006540..
Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Evidence-Based Practice, Heart Disease and Health, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research, Registries
Chou R, Korthuis PT, McCarty D
Management of suspected opioid overdose with naloxone in out-of-hospital settings: a systematic review.
This review synthesized evidence on 1) the effects of naloxone route of administration and dosing for suspected opioid overdose in out-of-hospital settings on mortality, reversal of overdose, and harms, and 2) the need for transport to a health care facility. It concluded that higher-concentration intranasal naloxone (2 mg/mL) seems to have efficacy similar to that of intramuscular naloxone for reversal of opioid overdose, with no difference in adverse events.
AHRQ-funded; 290201500009I.
Citation: Chou R, Korthuis PT, McCarty D .
Management of suspected opioid overdose with naloxone in out-of-hospital settings: a systematic review.
Ann Intern Med 2017 Dec 19;167(12):867-75. doi: 10.7326/m17-2224.
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Keywords: Emergency Medical Services (EMS), Evidence-Based Practice, Medication, Opioids, Patient-Centered Outcomes Research
Reimer T, Lee SJC, Garcia S
Cancer center clinic and research team perceptions of identity and interactions.
The purpose of this study was to determine perceptions of roles of cancer center clinic and research teams. The researchers developed and administered survey to research and clinic staff at a National Cancer Institute-designated comprehensive cancer center. Although there are many similarities between clinic and research teams, the researchers also identified key differences, including perceptions of goal clarity and sharing, understanding and alignment with cancer center goals, and importance of outcomes.
AHRQ-funded; HS022418.
Citation: Reimer T, Lee SJC, Garcia S .
Cancer center clinic and research team perceptions of identity and interactions.
J Oncol Pract 2017 Dec;13(12):e1021-e29. doi: 10.1200/jop.2017.024349..
Keywords: Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Research Methodologies
Edwards ST, Peterson K, Chan B
Effectiveness of intensive primary care interventions: a systematic review.
This study systematically reviewed the impact of intensive primary care programs on all-cause mortality, hospitalization, and emergency department use. The authors found that intensive primary care interventions demonstrated varying effectiveness in reducing hospitalizations, and noted there was limited evidence that these interventions were associated with changes in mortality.
AHRQ-funded; HS022981.
Citation: Edwards ST, Peterson K, Chan B .
Effectiveness of intensive primary care interventions: a systematic review.
J Gen Intern Med 2017 Dec;32(12):1377-86. doi: 10.1007/s11606-017-4174-z..
Keywords: Hospitalization, Mortality, Patient-Centered Outcomes Research, Primary Care
Lindenauer PK, Shieh MS, Stefan MS
Hospital procalcitonin testing and antibiotic treatment of patients admitted for chronic obstructive pulmonary disease exacerbation
The purpose of this study was to determine the impact of procalcitonin (PCT) testing on antibiotic treatment of patients hospitalized for exacerbations of chronic obstructive pulmonary disease (COPD) in routine practice. The study conclude that as currently implemented, PCT testing appears to have had little impact on decisions to initiate antibiotic therapy or on duration of treatment for COPD exacerbations.
AHRQ-funded; HS024596.
Citation: Lindenauer PK, Shieh MS, Stefan MS .
Hospital procalcitonin testing and antibiotic treatment of patients admitted for chronic obstructive pulmonary disease exacerbation
Ann Am Thorac Soc 2017 Dec;14(12):1779-85. doi: 10.1513/AnnalsATS.201702-133OC..
Keywords: Antibiotics, Respiratory Conditions, Hospitalization, Inpatient Care, Patient-Centered Outcomes Research
Aslakson R, Dy SM, Wilson RF
Patient and caregiver-reported assessment tools for palliative care: summary of the 2017 AHRQ Technical Brief.
This paper summarizes palliative care assessment tools completed by or with patients or caregivers, and identifies needs for future tool development and evaluation. It concluded that few to no tools address the spiritual, ethical, or cultural domains or patient-reported experience with end of life care. While some data exists on psychometric properties of tools, the responsiveness of different tools to change and/or comparisons between tools have not been evaluated.
AHRQ-funded; 290201500006I.
Citation: Aslakson R, Dy SM, Wilson RF .
Patient and caregiver-reported assessment tools for palliative care: summary of the 2017 AHRQ Technical Brief.
J Pain Symptom Manage 2017 Dec;54(6):961-72.e16. doi: 10.1016/j.jpainsymman.2017.04.022.
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Keywords: Caregiving, Evidence-Based Practice, Palliative Care, Patient Experience, Patient-Centered Outcomes Research
Maas MB, Francis BA, Sangha RS
Refining prognosis for intracerebral hemorrhage by early reassessment.
The researchers compared the accuracy of a widely used prognostic score against a model derived from clinical data obtained 5 days after admission for patients with intracerebral hemorrhage (ICH), a condition for which prognostication has proven notoriously challenging and prone to bias. They found that a simple reassessment after 5 days of care significantly improves the accuracy of prognosticating outcome in patients with ICH.
AHRQ-funded; HS023437.
Citation: Maas MB, Francis BA, Sangha RS .
Refining prognosis for intracerebral hemorrhage by early reassessment.
Cerebrovasc Dis 2017;43(3-4):110-16. doi: 10.1159/000452679.
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Keywords: Decision Making, Diagnostic Safety and Quality, Patient-Centered Outcomes Research
Henderson ML, Thomas AG, Shaffer A
The national landscape of living kidney donor follow-up in the United States.
The purpose of this study was to understand the impact of the 2013 policy the Organ Procurement and Transplantation Network/United Network for Organ Sharing issued. The policy required that transplant centers collect data on living kidney donors (LKDs) at 6 months, 1 year, and 2 years postdonation, with policy-defined thresholds for the proportion of complete living donor follow-up data submitted in a timely manner (60 days before or after the expected visit date).
AHRQ-funded; HS024600.
Citation: Henderson ML, Thomas AG, Shaffer A .
The national landscape of living kidney donor follow-up in the United States.
Am J Transplant 2017 Dec;17(12):3131-40. doi: 10.1111/ajt.14356..
Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Policy, Registries, Transplantation
Dykewicz MS, Wallace DV, Baroody F
Treatment of seasonal allergic rhinitis: an evidence-based focused 2017 guideline update.
This article provides an evidence-based focused 2017 guideline update for the treatment of seasonal allergic rhinitis.
AHRQ-funded; HS024599
Citation: Dykewicz MS, Wallace DV, Baroody F .
Treatment of seasonal allergic rhinitis: an evidence-based focused 2017 guideline update.
Ann Allergy Asthma Immunol 2017 Dec;119(6):489-511.e41. doi: 10.1016/j.anai.2017.08.012..
Keywords: Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research
Prochaska MT, Hohmann SF, Modes M
Trends in troponin-only testing for AMI in academic teaching hospitals and the impact of Choosing Wisely(R).
This study examined the variation in cardiac biomarker testing and the effect of the Choosing Wisely(R) troponin-only recommendation for the diagnosis of acute myocardial infarction (AMI). It concluded that in institutions with low rates of troponin-only testing prior to the Choosing Wisely(R) recommendation, the recommendation was associated with a significant increase in the rate of troponin-only testing.
AHRQ-funded; HS023007.
Citation: Prochaska MT, Hohmann SF, Modes M .
Trends in troponin-only testing for AMI in academic teaching hospitals and the impact of Choosing Wisely(R).
J Hosp Med 2017 Dec;12(12):957-62. doi: 10.12788/jhm.2846.
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Keywords: Cardiovascular Conditions, Medication, Heart Disease and Health, Patient-Centered Outcomes Research
Pantalone KM, Hobbs TM, Chagin KM
Prevalence and recognition of obesity and its associated comorbidities: cross-sectional analysis of electronic health record data from a large US integrated health system.
The purpose of the study was to determine the prevalence of obesity and its related comorbidities among patients being actively managed at a US academic medical centre, and to examine the frequency of a formal diagnosis of obesity. This cross-sectional summary from a large US integrated health system found that three out of every four patients had overweight or obesity based on BMI. Less than half of patients who were identified as having obesity according to BMI received a formal diagnosis via ICD-9 documentation.
AHRQ-funded; HS024128.
Citation: Pantalone KM, Hobbs TM, Chagin KM .
Prevalence and recognition of obesity and its associated comorbidities: cross-sectional analysis of electronic health record data from a large US integrated health system.
BMJ Open 2017 Nov 16;7(11):e017583. doi: 10.1136/bmjopen-2017-017583..
Keywords: Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Systems, Obesity, Patient-Centered Outcomes Research
Kruser JM, Rakhra SS, Sacotte RM
Intensive care unit outcomes among patients with cancer after palliative radiation therapy.
To inform goals of care discussions at the time of palliative radiation therapy (RT) consultation, researchers sought to characterize intensive care unit (ICU) outcomes for patients treated with palliative RT compared to all other patients with metastatic cancer admitted to the ICU. They found that prior treatment with palliative RT is associated with increased in-hospital mortality after ICU admission.
AHRQ-funded; HS000078.
Citation: Kruser JM, Rakhra SS, Sacotte RM .
Intensive care unit outcomes among patients with cancer after palliative radiation therapy.
Int J Radiat Oncol Biol Phys 2017 Nov 15;99(4):854-58. doi: 10.1016/j.ijrobp.2017.06.2463.
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Keywords: Cancer, Intensive Care Unit (ICU), Palliative Care, Patient-Centered Outcomes Research
Goldstone AB, Chiu P, Baiocchi M
Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement.
This study compared long-term mortality and rates of reoperation, stroke, and bleeding between cohorts of patients who underwent primary aortic-valve replacement or mitral-valve replacement with a mechanical or biologic prosthesis. The long-term mortality benefit associated with a mechanical prosthesis, as compared with a biologic prosthesis, persisted until 70 years of age among patients undergoing mitral-valve replacement and until 55 years of age among those undergoing aortic-valve replacement.
AHRQ-funded; HS022192.
Citation: Goldstone AB, Chiu P, Baiocchi M .
Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement.
N Engl J Med 2017 Nov 9;377(19):1847-57. doi: 10.1056/NEJMoa1613792.
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Keywords: Adverse Events, Cardiovascular Conditions, Medical Devices, Patient-Centered Outcomes Research, Surgery
Fisher KA, Mazor KM, Goff S
Successful use of noninvasive ventilation in chronic obstructive pulmonary disease. how do high-performing hospitals do it?
To identify approaches used by hospitals that have been successful in implementing Noninvasive ventilation (NIV) to treat patients with severe exacerbations of chronic obstructive pulmonary disease (COPD). The authors identified factors, such as respiratory therapist autonomy, that facilitated essential processes (e.g., timely initiation) of NIV use at high-performing hospitals.
AHRQ-funded; HS024596.
Citation: Fisher KA, Mazor KM, Goff S .
Successful use of noninvasive ventilation in chronic obstructive pulmonary disease. how do high-performing hospitals do it?
Ann Am Thorac Soc 2017 Nov;14(11):1674-81. doi: 10.1513/AnnalsATS.201612-1005OC..
Keywords: Respiratory Conditions, Hospitals, Patient-Centered Outcomes Research
Lee T, Thamer M, Zhang Z
Vascular access type and clinical outcomes among elderly patients on hemodialysis.
This observational study design was used to compare clinical outcomes in elderly patients who initiated hemodialysis with a central venous catheter and subsequently had an arteriovenous fistula or graft placed. The study concluded that despite extended central venous catheter dependence, elderly patients initiating hemodialysis with a central venous catheter who underwent arteriovenous fistula placement within 6 months had fewer hospitalizations due to infections and a lower likelihood of death than those receiving an arteriovenous graft.
AHRQ-funded; HS022931; HS021229
Citation: Lee T, Thamer M, Zhang Z .
Vascular access type and clinical outcomes among elderly patients on hemodialysis.
Clin J Am Soc Nephrol 2017 Nov 7;12(11):1823-30. doi: 10.2215/cjn.01410217..
Keywords: Elderly, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research
Borah BJ, Yao X, Laughlin-Tommaso SK
Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database.
The objective of this retrospective analysis of administrative claims from a large U.S. commercial insurance database, was to compare risk of reintervention, long-term clinical outcomes, and health care utilization among women who have bulk symptoms from leiomyoma and who underwent the following procedures: hysterectomy, myomectomy, uterine artery embolization, and magnetic resonance-guided, focused ultrasound surgery.
AHRQ-funded; HS023418.
Citation: Borah BJ, Yao X, Laughlin-Tommaso SK .
Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database.
Obstet Gynecol 2017 Nov;130(5):1047-56. doi: 10.1097/AOG.0000000000002331..
Keywords: Cancer, Comparative Effectiveness, Health Insurance, Outcomes, Patient-Centered Outcomes Research, Surgery, Women
Chopra R, Vakharia PP, Sacotte R
Efficacy of bleach baths in reducing severity of atopic dermatitis: a systematic review and meta-analysis.
This study sought to determine the efficacy of bleach vs water baths at decreasing atopic dermatitis (AD) severity. In pooled analyses, there were no significant differences observed between bleach vs water baths at 4 weeks vs baseline for the Eczema Area and Severity Index. Although bleach baths are effective in decreasing AD severity, they do not appear to be more effective than water baths alone.
AHRQ-funded; HS023011.
Citation: Chopra R, Vakharia PP, Sacotte R .
Efficacy of bleach baths in reducing severity of atopic dermatitis: a systematic review and meta-analysis.
Ann Allergy Asthma Immunol 2017 Nov;119(5):435-40. doi: 10.1016/j.anai.2017.08.289.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Skin Conditions
Heerman WJ, Jackson N, Roumie CL
Recruitment methods for survey research: findings from the Mid-South Clinical Data Research Network.
The objective of this study was to report survey response rates and demographic characteristics of eight recruitment approaches to determine acceptability and effectiveness of large-scale patient recruitment among various populations. The study concluded that technology-enabled recruitment approaches such as registries and emails are effective for recruiting but may yield less racial/ethnic diversity compared to traditional, more time-intensive approaches.
AHRQ-funded; HS022990.
Citation: Heerman WJ, Jackson N, Roumie CL .
Recruitment methods for survey research: findings from the Mid-South Clinical Data Research Network.
Contemp Clin Trials 2017 Nov;62:50-55. doi: 10.1016/j.cct.2017.08.006..
Keywords: Patient-Centered Outcomes Research, Research Methodologies, Racial and Ethnic Minorities, Social Determinants of Health
Albrecht JS, Slejko JF, Stein DM
Treatment charges for traumatic brain injury among older adults at a trauma center.
The objective of this study was to provide charge estimates of treatment for traumatic brain injury (TBI), including both hospital and physician charges, among adults 65 years and older treated at a trauma center. The study provided the first estimates of hospital and physician charges associated with hospitalization for TBI among older adults at a trauma center that will aid in resource allocation, triage decisions, and healthcare policy.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Slejko JF, Stein DM .
Treatment charges for traumatic brain injury among older adults at a trauma center.
J Head Trauma Rehabil 2017 Nov/Dec;32(6):E45-e53. doi: 10.1097/htr.0000000000000297..
Keywords: Brain Injury, Elderly, Healthcare Costs, Hospitalization, Patient-Centered Outcomes Research
Haessler S, Lagu T, Lindenauer PK
Treatment trends and outcomes in healthcare-associated pneumonia.
This retrospective cohort study assessed changes in hospital rates of concordant antibiotic use over time and their correlation with outcomes related to management of healthcare-associated pneumonia (HCAP). The study concluded that only 1 in 5 patients with risk factors for HCAP received treatment that was fully in accordance with guidelines, and many received community-acquired pneumonia (CAP) therapy instead.
AHRQ-funded; HS018723.
Citation: Haessler S, Lagu T, Lindenauer PK .
Treatment trends and outcomes in healthcare-associated pneumonia.
J Hosp Med 2017 Nov;12(11):886-91. doi: 10.12788/jhm.2877..
Keywords: Antibiotics, Elderly, Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Pneumonia
Hiratsuka VY, Beans JA, Robinson RF
Self-determination in health research: an Alaska native example of tribal ownership and research regulation.
Southcentral Foundation (SCF), an Alaska Native-owned and operated health care organization, is transforming the relationship between researchers and the tribal community by making trust and accountability required features of health research in Alaska Native (AN) and American Indian (AI) communities. This review evaluates research through the lens of tribal principles, practices, and priorities. The SCF example provides a framework for other tribes and organizations seeking to reshape the future of health research in AN/AI communities.
AHRQ-funded; HS000079.
Citation: Hiratsuka VY, Beans JA, Robinson RF .
Self-determination in health research: an Alaska native example of tribal ownership and research regulation.
Int J Environ Res Public Health 2017 Oct 31;14(11). doi: 10.3390/ijerph14111324.
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Keywords: Health Services Research (HSR), Racial and Ethnic Minorities, Patient-Centered Outcomes Research, Policy, Racial and Ethnic Minorities
Kelly G, Wang SY, Lucas G
Facilitating meaningful engagement on community advisory committees in patient-centered outcome research.
In this study, the investigators conducted a process evaluation of ongoing activities of a Patient Advisory Committee (PAC) formed around the development of an individualized decision aid for older women with early stage breast cancer. They indicated that their results suggested that engaging committee members in a process of evaluation and collective reflection during a research collaboration can break down barriers to collaboration, build relationships, create opportunities for co-learning and strengthen researchers' capacity to engage meaningfully with stakeholders.
AHRQ-funded; HS023900.
Citation: Kelly G, Wang SY, Lucas G .
Facilitating meaningful engagement on community advisory committees in patient-centered outcome research.
Prog Community Health Partnersh 2017;11(3):243-51. doi: 10.1353/cpr.2017.0029..
Keywords: Cancer, Cancer: Breast Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Research Methodologies
Bachmann JM, Huang S, Gupta DK
Association of neighborhood socioeconomic context with participation in cardiac rehabilitation.
This study investigated the association of neighborhood socioeconomic context with Cardiac Rehabilitation (CR) participation in the Southern Community Cohort Study- a prospective cohort study of 84 569 adults in the southeastern United States from 2002 to 2009, 52 117 of whom have Medicare or Medicaid claims. The study found that lower neighborhood socioeconomic context was associated with decreased CR participation independent of individual socioeconomic status. These data invite research on interventions to increase CR access in deprived communities.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Huang S, Gupta DK .
Association of neighborhood socioeconomic context with participation in cardiac rehabilitation.
J Am Heart Assoc 2017 Oct 11;6(10). doi: 10.1161/jaha.117.006260..
Keywords: Cardiovascular Conditions, Healthcare Utilization, Patient-Centered Outcomes Research, Rehabilitation, Social Determinants of Health
Angraal S, Ross JS, Dhruva SS
Merits of data sharing: The Digitalis Investigation Group Trial.
This letter discusses the merits of data sharing, such as its importance in maximizing what can be learned from clinical trials. The letter describes The DIG (Digitalis Investigation Group) trial as an ideal o assess the effects of data sharing.
AHRQ-funded; HS023000.
Citation: Angraal S, Ross JS, Dhruva SS .
Merits of data sharing: The Digitalis Investigation Group Trial.
J Am Coll Cardiol 2017 Oct 3;70(14):1825-27. doi: 10.1016/j.jacc.2017.07.786..
Keywords: Data, Patient-Centered Outcomes Research, Research Methodologies
Butler M, Epstein RA, Totten A
AHRQ series on complex intervention systematic reviews-paper 3: adapting frameworks to develop protocols.
This article identifies and describes elements of frameworks and how they can be adapted to inform the protocol and conduct of systematic reviews of complex interventions. Possible approaches to analytic frameworks for complex interventions that illustrate causal and associative linkages are outlined, including time elements, which systematic reviews of complex interventions may need to address.
AHRQ-funded; 290201200004C; 290201500008I; 290201500005I; 290201500006I; 290201500010I.
Citation: Butler M, Epstein RA, Totten A .
AHRQ series on complex intervention systematic reviews-paper 3: adapting frameworks to develop protocols.
J Clin Epidemiol 2017 Oct;90:19-27. doi: 10.1016/j.jclinepi.2017.06.013.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies