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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 14 of 14 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
Kenzik KM, Mehta A, Richman JS
Congestive heart failure in older adults diagnosed with follicular lymphoma: a population-based study.
This population-based study examined congestive heart failure in older adults diagnosed with follicular lymphoma. The investigators concluded that patients with follicular lymphoma who were exposed to anthracyclines between the ages of 66 years and 75 years were found to be at an increased risk of new-onset CHF; preexisting hypertension and diabetes appeared to increase this risk.
AHRQ-funded; HS023009.
Citation: Kenzik KM, Mehta A, Richman JS .
Congestive heart failure in older adults diagnosed with follicular lymphoma: a population-based study.
Cancer 2018 Nov 1;124(21):4221-30. doi: 10.1002/cncr.31695..
Keywords: Cancer, Elderly, Heart Disease and Health
Mian HS, Wildes TM, Fiala MA
Development of a Medicare health outcomes survey deficit-accumulation frailty index and its application to older patients with newly diagnosed multiple myeloma.
JCO Clinical Cancer Informatics 2018; 2):1-13. doi: 10.1200/cci.18.00043.
This study’s objective was to develop a frailty index for older patients and apply it to a subset of patients newly diagnosed with multiple myeloma. The study used the Rockwood Accumulation of Deficits approach for the Medicare Health Outcomes Study (MHOS). Data from over 2 million patients without cancer older than 66 years of age from SEER-MHOS linked databases were compared to the cohort with multiple myeloma. It was found that among patients without cancer, each 10% increase in the frailty index was associated with a 40% increased risk of death. For the multiple myeloma cohort, each 10% increase in the frailty index was associated with a 16% increased risk for death. Median time for overall survival was only 26.8 months for patients considered frail, compared with 43.7 months for those who were not. This frailty index could be used a predictor of overall survival in older multiple myeloma patients.
This study’s objective was to develop a frailty index for older patients and apply it to a subset of patients newly diagnosed with multiple myeloma. The study used the Rockwood Accumulation of Deficits approach for the Medicare Health Outcomes Study (MHOS). Data from over 2 million patients without cancer older than 66 years of age from SEER-MHOS linked databases were compared to the cohort with multiple myeloma. It was found that among patients without cancer, each 10% increase in the frailty index was associated with a 40% increased risk of death. For the multiple myeloma cohort, each 10% increase in the frailty index was associated with a 16% increased risk for death. Median time for overall survival was only 26.8 months for patients considered frail, compared with 43.7 months for those who were not. This frailty index could be used a predictor of overall survival in older multiple myeloma patients.
AHRQ-funded; HS019455.
Citation: Mian HS, Wildes TM, Fiala MA .
Development of a Medicare health outcomes survey deficit-accumulation frailty index and its application to older patients with newly diagnosed multiple myeloma.
JCO Clin Cancer Inform 2018;2. doi: 10.1200/cci.18.00043..
Keywords: Cancer, Diagnostic Safety and Quality, Elderly, Health Status, Medicare
Lewis CL, Kistler CE, Dalton AF
A decision aid to promote appropriate colorectal cancer screening among older adults: a randomized controlled trial.
The purpose of this study was to test a patient decision aid (PtDA) to promote CRC screening in older adults. The PtDA was designed to facilitate individual decision-making to help patients understand the potential risks and benefit of CRC screening. 424 patients aged 70 – 84 who were not up to date with CRC screening participated in a double-blinded randomized controlled trial, using the PtDA or an attention control. Two outcomes - appropriate CRC screening behavior at 6 months following the initial visit or appropriate screening intent immediately after the visit - were defined as completed screening or intent for patients in good health, discussion about screening with their provider for patients in intermediate health, or no screening or intent for patients in poor health. Appropriate screening behavior at 6 months was higher in the intervention group; appropriate screening intent following the provider visit was also higher. The authors conclude that the PtDA for older adults promoted appropriate CRC screening behavior.
AHRQ-funded; HS021133.
Citation: Lewis CL, Kistler CE, Dalton AF .
A decision aid to promote appropriate colorectal cancer screening among older adults: a randomized controlled trial.
Med Decis Making 2018 Jul;38(5):614-24. doi: 10.1177/0272989x18773713..
Keywords: Cancer, Cancer: Colorectal Cancer, Decision Making, Education: Patient and Caregiver, Elderly, Prevention, Screening
Pappadis MR, Volk RJ, Krishnan S
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
The authors explored older women's perceptions about the concept of overdetection of breast cancer and its influence on future screening intentions. Semistructured interviews were conducted with 59 English-speaking women aged 70 years or older with no prior history of breast cancer. The authors found that many older women did not understand the concept of overdetection, in addition to being suspicious of or resistant to the concept. Providing older women with descriptions of overdetection may not be sufficient to influence screening intentions.
AHRQ-funded; HS022134.
Citation: Pappadis MR, Volk RJ, Krishnan S .
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
BMJ Open 2018 Jun 14;8(6):e022138. doi: 10.1136/bmjopen-2018-022138..
Keywords: Cancer: Breast Cancer, Cancer, Elderly, Screening, Decision Making, Women, Prevention, Imaging
Mehta HB, Sura SD, Adhikari D
Adapting the Elixhauser comorbidity index for cancer patients.
This study was designed to adapt the Elixhauser comorbidity index for 4 cancer-specific populations and compare 3 versions of the Elixhauser comorbidity score with 3 versions of the Charlson comorbidity score for predicting 2-year survival with 4 types of cancer. Using data from the Texas Cancer Registry-linked Medicare data from 2005 to 2011, the researchers found that cancer-specific Elixhauser comorbidity scores performed slightly better than cancer-specific Charlson comorbidity scores. Individual Elixhauser comorbidities performed best.
AHRQ-funded; HS022134.
Citation: Mehta HB, Sura SD, Adhikari D .
Adapting the Elixhauser comorbidity index for cancer patients.
Cancer 2018 May 1;124(9):2018-25. doi: 10.1002/cncr.31269.
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Keywords: Cancer, Elderly, Medicare, Patient-Centered Outcomes Research, Registries
Olszewski AJ, Zullo AR, Nering CR
Use of charity financial assistance for novel oral anticancer agents.
Novel oral targeted drugs are increasingly used for cancer therapy, but their extreme cost, often exceeding $10,000 per month, poses a significant barrier for patients and insurers alike. The findings findings of this study indicate that high out-of-pocket burden for expensive novel oral anticancer drugs leads to widespread use of charity support in the United States and that a significant financial barrier disparately affects older Medicare beneficiaries.
AHRQ-funded; HS022998.
Citation: Olszewski AJ, Zullo AR, Nering CR .
Use of charity financial assistance for novel oral anticancer agents.
J Oncol Pract 2018 Apr;14(4):e221-e28. doi: 10.1200/jop.2017.027896.
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Keywords: Cancer, Elderly, Healthcare Costs, Medicare, Medication
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