National Healthcare Quality and Disparities Report
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- Access to Care (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 18 of 18 Research Studies DisplayedMogul DB, Perito ER, Wood N
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
In December 2018, UNOS approved an allocation scheme based on recipients' geographic distance from a deceased donor ("acuity circles"). Previous analyses suggested acuity circles (AC) would reduce waitlist mortality overall, but their impact on pediatric subgroups was not considered. In this study, the investigators applied Scientific Registry of Transplant Recipients data from 2011-2016 towards the Liver Simulated Allocation Model (LSAM) to compare outcomes by age and illness severity for the UNOS-approved AC and the existing Donor Service Area (DSA)/Region-based allocation schemes.
AHRQ-funded; HS023876.
Citation: Mogul DB, Perito ER, Wood N .
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
Transplantation 2020 Aug;104(8):1627-32. doi: 10.1097/tp.0000000000003079..
Keywords: Children/Adolescents, Transplantation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Surgery, Access to Care
Gliklich RE, Leavy MB, Cosgrove L
AHRQ Author: Berliner E
Harmonized outcome measures for use in depression patient registries and clinical practice.
This project’s goal was to develop a minimum set of standardized outcome measures relevant to both patients and clinicians that can be collected in depression registries and clinical practice. A multi-stakeholder panel categorized the 27 identified measures using AHRQ's supported Outcome Measures Framework. The panel then identified 10 broadly relevant measures and harmonized definitions for these measures. These harmonized measures represent a minimum set of outcomes that are relevant to clinicians and patients and appropriate for use in depression research and clinical practice.
AHRQ-authored; AHRQ-funded; 290201400004C.
Citation: Gliklich RE, Leavy MB, Cosgrove L .
Harmonized outcome measures for use in depression patient registries and clinical practice.
Ann Intern Med 2020 Jun 16;172(12):803-09. doi: 10.7326/m19-3818..
Keywords: Registries, Depression, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Laughlin-Tommaso SK, Lu D, Thomas L
Short-term quality of life after myomectomy for uterine fibroids from the COMPARE-UF fibroid registry.
Investigators compared women's perception of their short-term health-related quality of life measures and reported time to return to usual activities and return to work for different routes of myomectomy. Using data from the Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF) registry, and including abdominal and laparoscopic myomectomy procedures, they found that women who underwent myomectomy had substantial improvement in health-related quality of life, regardless of route of myomectomy; abdominal myomectomy was associated with a nearly 2-week longer time to return to work than laparoscopic myomectomy.
AHRQ-funded; HS023418.
Citation: Laughlin-Tommaso SK, Lu D, Thomas L .
Short-term quality of life after myomectomy for uterine fibroids from the COMPARE-UF fibroid registry.
Am J Obstet Gynecol 2020 Apr;222(4):345.e1-45.e22. doi: 10.1016/j.ajog.2019.09.052..
Keywords: Quality of Life, Women, Surgery, Patient-Centered Outcomes Research, Registries
Bowring MG, Massie AB, Chu NM
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
Researchers aimed to use national registry data and parametric models to project 20- and 30-year post-transplant outcomes for recently transplanted pediatric liver transplant (LT) recipients. Using Scientific Registry of Transplant Recipients data, they found that projected long-term outcomes for recently transplanted pediatric LT recipients are excellent, reflective of substantial improvements in medical care, and informative for physician-patient education and decision making in the current era.
AHRQ-funded; HS023876.
Citation: Bowring MG, Massie AB, Chu NM .
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
J Pediatr Gastroenterol Nutr 2020 Mar;70(3):356-63. doi: 10.1097/mpg.0000000000002592..
Keywords: Children/Adolescents, Transplantation, Patient-Centered Outcomes Research, Outcomes, Surgery, Registries, Evidence-Based Practice
Dhruva SS, Ross JS, Mortazavi BJ
Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock.
This study examines outcomes among patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) complicated by cardiogenic shock. Two interventions are compared: intravascular microaxial left ventricular assist devices (LVADs) versus intra-aortic balloon pumps (IABPs). The American College of Cardiology’s National Cardiovascular Data Registry was used to identify patients with AMI complicated by cardiogenic shock from hospitals participating in the CathPCI and Chest Pain-MI registries and identified 28,304 patients. Over the study period (2015 to 2017), LVAD was used in 6.2% of patients and IABP in 29.9%. LVAD was shown to have higher rates of in-hospital death and major bleeding complications compared to IABP.
AHRQ-funded; HS022882; HS025402; HS025517; HS026379.
Citation: Dhruva SS, Ross JS, Mortazavi BJ .
Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock.
JAMA 2020 Feb 25;323(8):734-45. doi: 10.1001/jama.2020.0254..
Keywords: Medical Devices, Heart Disease and Health, Cardiovascular Conditions, Mortality, Adverse Events, Registries, Patient Safety, Patient-Centered Outcomes Research, Evidence-Based Practice
Lomotan EA, Meadows G, Michaels M
AHRQ Author: Lomotan EA
To share is human! Advancing evidence into practice through a national repository of interoperable clinical decision support.
The purpose of this study was to describe how a national repository of clinical decision support (CDS) can serve as a public resource for healthcare systems, academic researchers, and informaticists seeking to share and reuse CDS knowledge resources. AHRQ’s CDS Connect has provided a functional platform where CDS developers are actively sharing their work. CDS sharing may lead to improved implementation efficiency through numerous pathways, and further research is ongoing to quantify efficiencies gained.
AHRQ-authored; AHRQ-funded; 290201600001U; 233201500022I.
Citation: Lomotan EA, Meadows G, Michaels M .
To share is human! Advancing evidence into practice through a national repository of interoperable clinical decision support.
Appl Clin Inform 2020 Jan;11(1):112-21. doi: 10.1055/s-0040-1701253..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Health Information Technology (HIT)
Rymer JA, Chen AY, Thomas L
Advanced practice provider versus physician-only outpatient follow-up after acute myocardial infarction.
This study examines the prevalence of using advanced practice providers (APPs) for care following myocardial infarction as opposed to physicians due to physician shortages and reimbursement changes. Outpatient cardiology or primary care visits within 90 days of MI among 29,477 Medicare-insured patients aged 65 or older from 364 hospitals were examined from data in the Acute Coronary Treatment Intervention Outcomes Network Registry. Medicare adherence, all-cause readmission risk, mortality, and major adverse cardiovascular events were compared for patients seen by APPs versus physicians only. Patients seen by APPs were more likely to have diabetes mellitus, heart failure, be discharged to a nursing facility, and had more outpatient visits. There was no differences in the factors listed between patients seen by APPs or physicians. Patients seen by APPs were in more need of frequent monitoring and were more likely to have other chronic conditions leading to higher risk of post-MI complications.
AHRQ-funded; HS021092.
Citation: Rymer JA, Chen AY, Thomas L .
Advanced practice provider versus physician-only outpatient follow-up after acute myocardial infarction.
J Am Heart Assoc 2018 Sep 4;7(17):e008481. doi: 10.1161/jaha.117.008481..
Keywords: Cardiovascular Conditions, Elderly, Heart Disease and Health, Medicare, Outcomes, Patient-Centered Outcomes Research, Registries
Henderson ML, DiBrito SR, Thomas AG
Landscape of living multiorgan donation in the United States: a registry-based cohort study.
This registry-based cohort study examined the patient characteristics and outcomes associated with living multiorgan donation in the United States. The authors assert that careful documentation of outcomes is needed to ensure ethical practices in selection, informed consent, and postdonation care of this unique donor community.
AHRQ-funded; HS024600.
Citation: Henderson ML, DiBrito SR, Thomas AG .
Landscape of living multiorgan donation in the United States: a registry-based cohort study.
Transplantation 2018 Jul;102(7):1148-55. doi: 10.1097/tp.0000000000002082..
Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Policy, Registries, Transplantation
Devine EB, Van Eaton E, Zadworny ME
Automating electronic clinical data capture for quality improvement and research: The CERTAIN Validation Project of Real World Evidence.
Washington State's Surgical Care Outcomes and Assessment Program (SCOAP) is a network of hospitals participating in quality improvement (QI) registries wherein data are manually abstracted from EHRs. To create the Comparative Effectiveness Research and Translation Network (CERTAIN), researchers semi-automated SCOAP data abstraction using a centralized federated data model, created a central data repository (CDR), and assessed whether these data could be used as real world evidence for QI and research. They concluded that semi-automated data abstraction may be useful, although raw data collected as a byproduct of health care delivery is not immediately available for use as real world evidence. New approaches to gathering and analyzing extant data are required.
AHRQ-funded; HS020025.
Citation: Devine EB, Van Eaton E, Zadworny ME .
Automating electronic clinical data capture for quality improvement and research: The CERTAIN Validation Project of Real World Evidence.
eGEMS 2018 May 22;6(1):8. doi: 10.5334/egems.211..
Keywords: Patient-Centered Outcomes Research, Quality Improvement, Registries, Surgery, Electronic Health Records (EHRs)
Stewart EA, Lytle BL, Thomas L
The comparing options for management: patient-centered results for uterine fibroids (COMPARE-UF) registry: Rationale and design.
The purpose of the study was to design and establish a uterine fibroid (UF) registry based in the United States to provide comparative effectiveness data regarding UF treatment. This registry, called Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF), will generate evidence on the comparative effectiveness of different procedural options for UF, in order to help patients and their caregivers make informed decisions that best meet an individual patient's short- and long-term preferences.
AHRQ-funded; HS023418.
Citation: Stewart EA, Lytle BL, Thomas L .
The comparing options for management: patient-centered results for uterine fibroids (COMPARE-UF) registry: Rationale and design.
Am J Obstet Gynecol 2018 May 8. doi: 10.1016/j.ajog.2018.05.004..
Keywords: Comparative Effectiveness, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Registries, Women
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
Fudim M, Liu PR, Shrader P
Mineralocorticoid receptor antagonism in patients with atrial fibrillation: findings from the ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry.
Mineralocorticoid receptor antagonist (MRA) therapy may be beneficial to patients with atrial fibrillation (AF), but little is known about their use in patients with AF and subsequent outcomes. In order to better understand MRA use and subsequent outcomes, the investigators performed a retrospective cohort study of the contemporary ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry.
AHRQ-funded; HS021092.
Citation: Fudim M, Liu PR, Shrader P .
Mineralocorticoid receptor antagonism in patients with atrial fibrillation: findings from the ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry.
J Am Heart Assoc 2018 Apr 13;7(8). doi: 10.1161/jaha.117.007987..
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Heart Disease and Health, Medication, Outcomes, Patient-Centered Outcomes Research, Prevention, Registries, Stroke
Fanaroff AC, Li S, Webb LE
An observational study of the association of video- versus text-based informed consent with multicenter trial enrollment: lessons from the PALM Study (Patient and Provider Assessment of Lipid Management).
Video informed consent may enhance the appeal of research and help break down barriers to participation. In this observational study of recruitment in a multicenter registry, sites approved for video consent use enrolled the same number of patients as sites with only traditional text-based informed consent but had faster speed to first patient enrolled and more often enrolled older and nonwhite patients.
AHRQ-funded; HS021092.
Citation: Fanaroff AC, Li S, Webb LE .
An observational study of the association of video- versus text-based informed consent with multicenter trial enrollment: lessons from the PALM Study (Patient and Provider Assessment of Lipid Management).
Circ Cardiovasc Qual Outcomes 2018 Apr;11(4):e004675. doi: 10.1161/circoutcomes.118.004675.
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Keywords: Patient-Centered Outcomes Research, Registries, Research Methodologies
Kamal AH, Kirkland KB, Meier DE
A person-centered, registry-based learning health system for palliative care: a path to coproducing better outcomes, experience, value, and science.
In this paper, the authors discuss measurement of the impact of palliative care, which is critical for determining what works for which patients in what settings, to learn, improve care, and ensure access to high value care for people with serious illness. The authors described an approach to codesigning and implementing a palliative care registry that functions as a learning health system, by combining patient and family inputs and clinical data to support person-centered care, quality improvement, accountability, transparency, and scientific research.
AHRQ-funded; HS023681.
Citation: Kamal AH, Kirkland KB, Meier DE .
A person-centered, registry-based learning health system for palliative care: a path to coproducing better outcomes, experience, value, and science.
J Palliat Med 2018 Mar;21(S2):S61-s67. doi: 10.1089/jpm.2017.0354..
Keywords: Palliative Care, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes, Learning Health Systems, Registries, Patient and Family Engagement
Franklin PD, Lewallen D, Bozic K
Implementation of patient-reported outcome measures in U.S. total joint replacement registries: rationale, status, and plans.
The authors report on the status of patient-reported outcomes (PRO) implementation as well as perceived barriers and facilitators of PRO use among five U.S. total joint replacement registries. They find that the current stage of implementation of patient-reported outcomes measures varies widely among U.S. registries.
AHRQ-funded; HS018910.
Citation: Franklin PD, Lewallen D, Bozic K .
Implementation of patient-reported outcome measures in U.S. total joint replacement registries: rationale, status, and plans.
J Bone Joint Surg Am 2014 Dec 17;96 Suppl 1:104-9. doi: 10.2106/jbjs.n.00328..
Keywords: Registries, Surgery, Comparative Effectiveness, Patient-Centered Outcomes Research
Ayers DC, Franklin PD
Joint replacement registries in the United States: a new paradigm.
This commentary serves as an introduction to an upcoming series of articles about orthopaedic registries, in general, with an emphasis on lessons learned from the evolving U.S. and international total joint replacement registries. Specifically, this paper provides an overview of total joint replacement registries and the current expansion of data collection beyond implant attributes and survival to include postoperative complications and patient-reported outcomes.
AHRQ-funded; HS018910.
Citation: Ayers DC, Franklin PD .
Joint replacement registries in the United States: a new paradigm.
J Bone Joint Surg Am 2014 Sep 17;96(18):1567-9. doi: 10.2106/jbjs.n.00641..
Keywords: Arthritis, Chronic Conditions, Patient-Centered Outcomes Research, Registries, Surgery
Ayers DC, Franklin PD
Joint replacement registries in the United States: a new paradigm.
This commentary serves as an introduction to an upcoming series of articles about orthopaedic registries, in general, with an emphasis on lessons learned from the evolving U.S. and international total joint replacement registries. Specifically, this paper provides an overview of total joint replacement registries and the current expansion of data collection beyond implant attributes and survival to include postoperative complications and patient-reported outcomes.
AHRQ-funded; HS018910.
Citation: Ayers DC, Franklin PD .
Joint replacement registries in the United States: a new paradigm.
J Bone Joint Surg Am 2014 Sep 17;96(18):1567-9. doi: 10.2106/jbjs.n.00641.
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Keywords: Arthritis, Chronic Conditions, Patient-Centered Outcomes Research, Registries, Surgery
O'Brien EC, Holmes DN, Ansell JE
Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.
This study describes the frequencies of and factors associated with oral anticoagulation (OAC) contraindications in clinical practice for patients with atrial fibrillation (AF). Contraindications to OAC therapy among patients with AF are common but subjective. Many patients with reported contraindications were receiving OAC, suggesting that the perceived benefits outweighed the potential harm posed by the relative contraindication.
AHRQ-funded; HS021092
Citation: O'Brien EC, Holmes DN, Ansell JE .
Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.
Am Heart J. 2014 Apr;167(4):601-609.e1. doi: 10.1016/j.ahj.2013.12.014..
Keywords: Heart Disease and Health, Blood Thinners, Medication, Registries, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Practice Patterns