National Healthcare Quality and Disparities Report
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- Access to Care (1)
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Anxiety (1)
- Asthma (2)
- Back Health and Pain (1)
- Behavioral Health (9)
- Brain Injury (1)
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- COVID-19 (4)
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- Depression (5)
- Diabetes (2)
- Diagnostic Safety and Quality (2)
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- (-) Treatments (57)
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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 57 Research Studies DisplayedCampbell JI, Tabatneck M, Sun M
Increasing use of interferon gamma release assays among children ≥2 years of age in a setting with low tuberculosis prevalence.
This article describes a retrospective cohort study that examined interferon gamma release assays (IGRAs) use to diagnose tuberculosis (TB) infection in children aged 2–17. The objectives of the study were to evaluate whether testing approaches for TB has changed since 2015. Electronic health records were used to identify IGRAs and tuberculin skin tests (TSTs) completed by children in two Boston-area academic health systems. The researchers observed that the proportion of IGRA tests increased between 2015 and 2021 in this low TB-prevalence setting. Testing in public versus private insurance, inpatient/subspecialty settings, lower age, and non-English preferred language were associated with an increased chance of receiving an IGRA. Findings suggest that the TST is being “retired,” and that education and support for primary care clinicians could improve equitable access to IGRA testing for children.
AHRQ-funded; HS000063.
Citation: Campbell JI, Tabatneck M, Sun M .
Increasing use of interferon gamma release assays among children ≥2 years of age in a setting with low tuberculosis prevalence.
Pediatr Infect Dis J 2022 Dec;41(12):e534-e37. doi: 10.1097/inf.0000000000003685..
Keywords: Children/Adolescents, Treatments, Respiratory Conditions, Infectious Diseases
De B, Pasalic D, Barocas DA
Patient-reported outcomes after external beam radiotherapy with low dose rate brachytherapy boost vs radical prostatectomy for localized prostate cancer: five-year results from a prospective comparative effectiveness study.
The purpose of this study was to compare patient reported outcomes through 5 years following radical prostatectomy or external beam radiation therapy with low dose rate brachytherapy boost for localized prostate cancer. The researchers enrolled men 80 years of age or under who had localized prostate adenocarcinoma and followed them longitudinally from 2011 to 2012. The study found that when compared with radical prostatectomy, external beam radiation therapy with low dose rate brachytherapy boost was related with clinically meaningful worse urinary irritative/obstructive and better urinary incontinence function through 5 years. Urinary function bother was similar between groups. Treatment with external beam radiation therapy with low dose rate brachytherapy boost was associated with worse bowel function through 5 years compared to radical prostatectomy. Treatment with external beam radiation therapy with low dose rate brachytherapy boost was associated with better sexual function at 1 year compared to radical prostatectomy, but there was insufficient evidence to reject the supposition that no difference was seen at 3 or 5 years. The researcher concluded that external beam radiation therapy with low dose rate brachytherapy boost was related with clinically meaningful worse urinary irritative/obstructive and bowel functions but better urinary incontinence function through 5 years after treatment compared to radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: De B, Pasalic D, Barocas DA .
Patient-reported outcomes after external beam radiotherapy with low dose rate brachytherapy boost vs radical prostatectomy for localized prostate cancer: five-year results from a prospective comparative effectiveness study.
J Urol 2022 Dec;208(6):1226-39. doi: 10.1097/ju.0000000000002902..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Treatments
Pritchard KT, Baillargeon J, Lee WC
Trends in the use of opioids vs nonpharmacologic treatments in adults with pain, 2011-2019.
This serial cross-sectional analysis on trends in the use of prescription opioids and nonpharmacologic alternatives in treating pain used MEPS to estimate the use of outpatient services by cancer-free adults with chronic or surgical pain from 2011 to 2019. A total of unweighted 46,420 respondents, 9643 (20.4% weighted) received surgery and 36,777 (79.6% weighted) did not. The prevalence of nonpharmacologic treatments increased in 2019 for both chronic and surgical pain cohorts, especially with exclusive use compared with 2011. Chiropractors and physical therapists were the most common licensed healthcare professionals used among the cohort who used nonpharmacologic treatment.
AHRQ-funded; T32HS026133.
Citation: Pritchard KT, Baillargeon J, Lee WC .
Trends in the use of opioids vs nonpharmacologic treatments in adults with pain, 2011-2019.
JAMA Netw Open 2022 Nov;5(11):e2240612. doi: 10.1001/jamanetworkopen.2022.40612..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Medication, Pain, Chronic Conditions, Treatments
McDonagh MS, Morasco BJ, Wagner J
Cannabis-based products for chronic pain : a systematic review.
Researchers sought to evaluate the benefits and harms of cannabinoids for chronic pain. They found that oral, synthetic cannabis products with high THC-to-CBD ratios and sublingual, extracted cannabis products with comparable THC-to-CBD ratios may be associated with short-term improvements in chronic pain and increased risk for dizziness and sedation.
AHRQ-funded; 75Q80120D00006.
Citation: McDonagh MS, Morasco BJ, Wagner J .
Cannabis-based products for chronic pain : a systematic review.
Ann Intern Med 2022 Aug;175(8):1143-53. doi: 10.7326/m21-4520.
AHRQ-funded; 75Q80120D00006..
AHRQ-funded; 75Q80120D00006..
Keywords: Pain, Chronic Conditions, Complementary and Alternative Medicine, Treatments, Evidence-Based Practice
Curatolo M, Rundell SD, Gold LS
Long-term effectiveness of epidural steroid injections after new episodes of low back pain in older adults.
The purpose of this prospective study was to compare older adults undergoing epidural steroid injections (ESI) with patients not receiving ESI to test the hypotheses that those on ESI: 1) have worse outcomes before ESI, 2) have improved outcomes after ESI, and 3) have improved outcomes due to a specific ESI effect. The researchers evaluated patients 65 years of age or older from 3 United States health care systems who presented to primary care with new episodes of back pain. The three outcomes assessed were back and leg pain intensity, disability, and quality of life, all of which were evaluated at baseline, and then with 3-, 6-, 12- and 24- month follow-ups. The study found that in ESI patients, pain intensity, disability, and quality of life at baseline were significantly worse than in non-ESI patients. The study concluded that adults 65 and older who were treated with ESI have long-term improvement, but the improvement is not likely to be related to a specific effect of ESI, making epidural steroid injections unlikely to provide long-term benefits.
AHRQ-funded; HS019222; HS022972.
Citation: Curatolo M, Rundell SD, Gold LS .
Long-term effectiveness of epidural steroid injections after new episodes of low back pain in older adults.
Eur J Pain 2022 Aug;26(7):1469-80. doi: 10.1002/ejp.1975..
Keywords: Elderly, Back Health and Pain, Pain, Treatments
Marks MR, Dux MC, Rao V
Treatment patterns of anxiety and posttraumatic stress disorder following traumatic brain injury.
Investigators examined psychotropic medication use and psychotherapy patterns among individuals diagnosed with anxiety disorders and PTSD post-traumatic brain injury (TBI). They found that receipt of pharmacotherapy pre- and post-TBI was considerably more common than receipt of psychotherapy. Individuals diagnosed with anxiety were 66% less likely to receive psychotherapy compared with individuals diagnosed with PTSD. Overall, psychotropic medication use and rates of antidepressant prescription use in the anxiety group were higher compared to those in the PTSD group.
AHRQ-funded; HS024560.
Citation: Marks MR, Dux MC, Rao V .
Treatment patterns of anxiety and posttraumatic stress disorder following traumatic brain injury.
J Neuropsychiatry Clin Neurosci 2022 Summer;34(3):247-53. doi: 10.1176/appi.neuropsych.21040104..
Keywords: Anxiety, Behavioral Health, Trauma, Brain Injury, Treatments, Practice Patterns, Medication
Korthuis PT, Cook RR, Lum PJ
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Opioid Use Disorder (OUD) treatment medications can improve outcomes for human immunodeficiency virus (HIV) and also reduce opioid use. The purpose of the study was to determine if outpatient naltrexone treatment could also reduce opioid use and improve outcomes for HIV. The researchers reported that enrollment was stopped early because of slower than expected recruitment, resulting in 114 final participants with untreated OUD and HIV, with 62% positive for fentanyl, 60% positive for cocaine, and 47% positive for other opioids at the baseline. The intervention compared treatment as usual (TAU) of methadone or buprenorphine with extended-release naltrexone (XR-NTX) on group differences in viral suppression at 24 weeks and past 30-day use of opioids at 24 weeks. The study reported that at 24 weeks the outcome of viral suppression was similar for TAU and XR-NTX, and that fewer XR-NTX participants initiated medication than TAU participants. The outcome of previous 30-day use of opioids was similar for TAU as compared to XR-NTX. Of those participants who did initiate medication, those administered XR-NTX experienced less days of opioid use when compared with TAU in the prior 30 days. The researchers reported that the study evidence was not conclusive but did support that XR-NTX is not inferior to TAU for HIV viral suppression, and that study participants who started XR-NTX used less opioids at 24 weeks than participants who were administered TAU.
AHRQ-funded; HS026370.
Citation: Korthuis PT, Cook RR, Lum PJ .
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Addiction 2022 Jul;117(7):1961-71. doi: 10.1111/add.15836..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Behavioral Health, Medication, Treatments, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Uhl S, Siddique SM, Bloschichak A
Interventions for malnutrition in hospitalized adults: a systematic review and meta-analysis.
The purpose of this review of existing research was to evaluate the effectiveness of hospital-initiated interventions for patients with malnutrition. The study found 11 randomized controlled trials (RCTs) that evaluated 2 types of interventions: 1) specialized nutrition care, and 2) increased protein provision, with moderate evidence in pooled findings that specialized nutrition care and increased protein provision reduced mortality by 21%. Decrease in length of stay was not significant. The researchers concluded that in patients at risk for or diagnosed with malnutrition, specialized nutrition care and increased protein provision reduced mortality.
AHRQ-funded; 75Q80120D00002.
Citation: Uhl S, Siddique SM, Bloschichak A .
Interventions for malnutrition in hospitalized adults: a systematic review and meta-analysis.
J Hosp Med 2022 Jul;17(7):556-64. doi: 10.1002/jhm.12891..
Keywords: Nutrition, Inpatient Care, Treatments
Drewry AM, Mohr NM, Ablordeppey EA
Therapeutic hyperthermia is associated with improved survival in afebrile critically ill patients with sepsis: a pilot randomized trial.
This study’s objective was to test the hypothesis that forced-air warming of critically ill afebrile sepsis patients improves immune function compared to standard temperature management. Patients were considered eligible patients if they were mechanically ventilated septic adults with: 1) a diagnosis of sepsis within 48 hours of enrollment; 2) anticipated need for mechanical ventilation of greater than 48 hours; and 3) a maximum temperature less than 38.3°C within the 24 hours prior to enrollment. Intervention treatment was external warming using a forced-air warming blanket for 48 hours, with a goal temperature 1.5°C above the lowest temperature documented in the previous 24 hours. The authors enrolled 56 patients in this randomized, controlled trial. Participants allocated to external warming had lower 28-day mortality (18% vs 43%) and more 28-day hospital-free days. No differences were observed between the groups in HLA-DR expression or IFN-γ production.
AHRQ-funded; HS025753.
Citation: Drewry AM, Mohr NM, Ablordeppey EA .
Therapeutic hyperthermia is associated with improved survival in afebrile critically ill patients with sepsis: a pilot randomized trial.
Crit Care Med 2022 Jun;50(6):924-34. doi: 10.1097/ccm.0000000000005470..
Keywords: COVID-19, Sepsis, Treatments, Comparative Effectiveness, Evidence-Based Practice, Outcomes
Petragallo R, Bardach N, Ramirez E
Barriers and facilitators to clinical implementation of radiotherapy treatment planning automation: a survey study of medical dosimetrists.
Researchers examined the barriers and facilitators to adoption of commercially available automated planning tools into the clinical workflow using a survey of medical dosimetrists. Through surveys, three categories of barriers to use of automation were identified. This investigation highlighted several concrete approaches that could potentially increase the translation of automation into the clinic, along with areas of needed research.
AHRQ-funded; HS026486.
Citation: Petragallo R, Bardach N, Ramirez E .
Barriers and facilitators to clinical implementation of radiotherapy treatment planning automation: a survey study of medical dosimetrists.
J Appl Clin Med Phys 2022 May;23(5):e13568. doi: 10.1002/acm2.13568..
Keywords: Treatments, Implementation
Douin DJ, Krause M, Williams C
Corticosteroid administration and impaired glycemic control in mechanically ventilated COVID-19 patients.
This study’s objective was to determine the association between corticosteroid administration and impaired glycemic control among COVID-19 patients requiring mechanical ventilation and/or veno-venous extracorporeal membrane oxygenation. This multicenter retrospective cohort study was conducted between March 9 and May 17, 2020 at 12 US hospitals. The primary outcome measured was days spent with at least 1 episode of blood glucose either >180 mg/dL or <80 mg/dL within the first 28 days of admission. The authors included 292 mechanically ventilated patients. Sixty-six patients (22.6%) died within 28 days of ICU admission. Seventy-one patients (24.3%) received a cumulative dose of at least an equivalent of 320 mg methylprednisolone. After adjustment for gender, history of diabetes mellitus, chronic liver disease, sequential organ failure assessment score on intensive care unit day 1, and length of stay, administration of ≥320 mg methylprednisolone equivalent was associated with 4 additional days spent with glucose either <80 mg/dL or >180 mg/dL.
AHRQ-funded; HS027795.
Citation: Douin DJ, Krause M, Williams C .
Corticosteroid administration and impaired glycemic control in mechanically ventilated COVID-19 patients.
Semin Cardiothorac Vasc Anesth 2022 Mar;26(1):32-40. doi: 10.1177/10892532211043313..
Keywords: COVID-19, Treatments, Medication
Sun D, Heimall JR, Greenhawt MJ
Cost utility of lifelong immunoglobulin replacement therapy vs hematopoietic stem cell transplant to treat agammaglobulinemia.
This study evaluated the cost utility of lifelong immunoglobulin replacement therapy (IRT) versus hematopoietic stem cell transplant (HSCT) to treat agammaglobulinemia. This economic evaluation used Markov analysis to model the base-case scenario of a patient aged 12 months to receive lifelong IRT vs matched sibling donor (MSD) or matched unrelated donor (MUD) HSCT. In this evaluation, lifelong IRT cost more than HSCT ($1,512,946 compared with $563,776 [MSD] and $637,036 [MUD]) and generated similar quality-adjusted life-years (QALYs) (20.61 vs 17.25 [MSD] and 17.18 [MUD]). While choosing IRT over HSCT generated higher incremental cost-effectiveness ratios (ICERs), it exceeded US willing-to-pay threshold of $100,000/QALY. However, IRT prevented at least 2488 premature deaths per 10,000 microsimulations compared with HSCT treatment. But when the annual IRT price was reduced from $60,145 to below $29,469, IRT became the cost-effective strategy.
AHRQ-funded; HS024599.
Citation: Sun D, Heimall JR, Greenhawt MJ .
Cost utility of lifelong immunoglobulin replacement therapy vs hematopoietic stem cell transplant to treat agammaglobulinemia.
JAMA Pediatr 2022 Feb; 176(2):176-84. doi: 10.1001/jamapediatrics.2021.4583..
Keywords: Medication, Healthcare Costs, Treatments, Evidence-Based Practice
Wright JH, Owen J, Eells TD
Effect of computer-assisted cognitive behavior therapy vs usual care on depression among adults in primary care: a randomized clinical trial.
Computer-assisted cognitive behavior therapy (CCBT) has been proposed as a method for improving access to effective psychotherapy, reducing cost, and increasing the convenience and efficiency of treatment for depression. The purpose of this study was to evaluate whether clinician-supported CCBT is more effective than treatment as usual (TAU) in primary care patients with depression and to examine the feasibility and implementation of CCBT in a primary care population with substantial numbers of patients with low income, limited internet access, and low levels of educational attainment.
AHRQ-funded; HS024047.
Citation: Wright JH, Owen J, Eells TD .
Effect of computer-assisted cognitive behavior therapy vs usual care on depression among adults in primary care: a randomized clinical trial.
JAMA Netw Open 2022 Feb;5(2):e2146716. doi: 10.1001/jamanetworkopen.2021.46716..
Keywords: Depression, Behavioral Health, Primary Care, Treatments, Comparative Effectiveness
Kang MM, Hasan Y, Waller J
Has hypofractionated whole-breast radiation therapy become the standard of care in the United States? An updated report from National Cancer Database.
This study examined trends in the use of hypofractionated whole-breast irradiation (HF-WBI) over time in the United States and factors related to its adoption for patients undergoing a lumpectomy from 2004 to 2016. Lumpectomy patients in the National Cancer Database were identified, with 688,079 early-stage invasive breast cancer patients, and 248,218 patients diagnosed with ductal carcinoma in situ. Among invasive cancer patients, HB-WBI use increased from 0.7% in 2004 to 38.1% in 2016. Among ductal carcinoma in situ patients, HB-WBI use increased significantly from 0.42% in 2004 to 34.3% in 2016. Factors associated with HB-WBI use included age, geographic location, race/ethnicity, tumor stage, grade, treating facility type, and volume.
AHRQ-funded; HS025806.
Citation: Kang MM, Hasan Y, Waller J .
Has hypofractionated whole-breast radiation therapy become the standard of care in the United States? An updated report from National Cancer Database.
Clin Breast Cancer 2022 Jan;22(1):e8-e20. doi: 10.1016/j.clbc.2021.05.016..
Keywords: Cancer: Breast Cancer, Cancer, Treatments, Practice Patterns
Rhee TG, Sint K, Olfson M
Association of ECT with risks of all-cause mortality and suicide in older Medicare patients.
This observational study examined the effects of electroconvulsive therapy (ECT) on suicide and all-cause mortality risk in Medicare psychiatric patients age 65 or older. Patients receiving ECT were exact matched to control subjects in a 1-to-3 ratio on age, gender, principal hospital diagnosis, past-year psychiatric hospitalizations, past-year suicide attempts, and Elixhauser comorbidity index. A total of 10,46 patients were in the ECT group and 31,160 in the control group. Compared with the control group, patients receiving ECT had lower all-cause mortality for up to 1 year following hospital discharge. For death by suicide, ECT was associated with short-lived effects which waned over time.
AHRQ-funded; HS023000.
Citation: Rhee TG, Sint K, Olfson M .
Association of ECT with risks of all-cause mortality and suicide in older Medicare patients.
Am J Psychiatry 2021 Dec;178(12):1089-97. doi: 10.1176/appi.ajp.2021.21040351..
Keywords: Elderly, Behavioral Health, Mortality, Treatments
Andreae SJ, Andreae LJ, Richman JS
Peer-delivered cognitive behavioral therapy-based intervention reduced depression and stress in community dwelling adults with diabetes and chronic pain: a cluster randomized trial.
Researchers examined whether a cognitive behavioral therapy (CBT)-based program intended to increase physical activity despite chronic pain in patients with diabetes delivered by community members trained as peer coaches also improved depressive symptoms and perceived stress. They found that this peer-delivered CBT-based program improved depressive symptoms and stress in individuals with diabetes and chronic pain. They recommended training community members as a feasible strategy for offering CBT-based interventions in rural and under-resourced communities.
AHRQ-funded; HS019239.
Citation: Andreae SJ, Andreae LJ, Richman JS .
Peer-delivered cognitive behavioral therapy-based intervention reduced depression and stress in community dwelling adults with diabetes and chronic pain: a cluster randomized trial.
Ann Behav Med 2021 Oct 4;55(10):970-80. doi: 10.1093/abm/kaab034..
Keywords: Depression, Behavioral Health, Diabetes, Chronic Conditions, Treatments, Pain, Lifestyle Changes
Moazzezi M, Rose B, Kisling K
Prospects for daily online adaptive radiotherapy via ethos for prostate cancer patients without nodal involvement using unedited CBCT auto-segmentation.
This study’s objective was to assess the new online adaptive radiation therapy technology called Ethos for treating prostate cancer. Twenty-five prostate patients previously treated at the author’s clinic were re-planed using an Ethos emulator. Clinical margins of 3 mm posterior, 5 mm left/right/anterior, and 7 mm superior/inferior were used. Dose metrics were compared to unadapted plans to evaluate clinical target volumes (CTV) and online adaptive radiation (OAR) dose changes. Overall, 96% of fractions required auto-segmentation edits, although they were mostly minor. Adaptation improved CTV 98% for the 24 patients with minor auto-segmentation corrections. However, for one in 25 patients, large contour edits were required.
AHRQ-funded; HS025440.
Citation: Moazzezi M, Rose B, Kisling K .
Prospects for daily online adaptive radiotherapy via ethos for prostate cancer patients without nodal involvement using unedited CBCT auto-segmentation.
J Appl Clin Med Phys 2021 Oct;22(10):82-93. doi: 10.1002/acm2.13399..
Keywords: Cancer: Prostate Cancer, Cancer, Treatments, Imaging
Garsa A, Jang JK, Baxi S
Radiation therapy for brain metastases: a systematic review.
This systematic review synthesizes the available evidence on radiation therapy for brain metastases. A literature search was conducted using the major medical databases and included randomized controlled trials and large observational studies which evaluated whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) alone or in combination as initial or postoperative treatment, with or without systemic therapy for adults with brain metastases due to lung cancer, breast cancer, or melanoma. No statistically significant difference in overall survival was found with a combination of SRS plus WBRT compared with SRS alone or WBRT alone. Radiation therapy after surgery did not improve overall survival compared with surgery alone. WBRT plus systemic therapy was associated with increased risks for vomiting compared with WBRT alone. There was not enough data on patient-relevant outcomes such as quality of life, functional status, and cognitive effects.
AHRQ-funded; 290201500010I.
Citation: Garsa A, Jang JK, Baxi S .
Radiation therapy for brain metastases: a systematic review.
Pract Radiat Oncol 2021 Sep-Oct;11(5):354-65. doi: 10.1016/j.prro.2021.04.002..
Keywords: Cancer, Surgery, Treatments, Patient-Centered Outcomes Research, Evidence-Based Practice
Crits-Christoph P, King C, Goldstein E
Use of cognitive techniques is associated with change in positive compensatory skills in the treatment of major depressive disorder in a community mental health setting.
Investigators sought to examine the association between adherence and competence in cognitive therapy (CT) techniques and change in positive compensatory skills and depressive symptoms within a community mental health setting. They found that adherence and competence were both significantly associated with linear change in positive compensatory skills from baseline to month 5. They concluded that their results support the hypothesis that use of CT techniques is associated with change in compensatory skills in a community mental health setting.
AHRQ-funded; HS018440.
Citation: Crits-Christoph P, King C, Goldstein E .
Use of cognitive techniques is associated with change in positive compensatory skills in the treatment of major depressive disorder in a community mental health setting.
Psychother Res 2021 Sep;31(7):909-20. doi: 10.1080/10503307.2020.1866785..
Keywords: Depression, Behavioral Health, Treatments
Xu L, Xie D, Griffin KS
Objective adherence to dental device versus positive airway pressure treatment in adults with obstructive sleep apnea.
Although mandibular advancement device (MAD) treatment of adults with obstructive sleep apnea (OSA) is generally less efficacious than positive airway pressure (PAP), the two treatments are associated, with similar clinical outcomes. As a sub-analysis of a randomized trial comparing the effect of MAD versus PAP on blood pressure, this study compared objectively measured adherence to MAD versus PAP treatment in adults with OSA.
AHRQ-funded; HS019738.
Citation: Xu L, Xie D, Griffin KS .
Objective adherence to dental device versus positive airway pressure treatment in adults with obstructive sleep apnea.
J Sleep Res 2021 Aug;30(4):e13240. doi: 10.1111/jsr.13240..
Keywords: Sleep Problems, Patient Adherence/Compliance, Treatments, Dental and Oral Health, Respiratory Conditions
Vemulakonda VM, Sevick C, Juarez-Colunga E
Treatment of infants with ureteropelvic junction obstruction: findings from the PURSUIT network.
Studies based on administrative databases show that infant pyeloplasty is associated with minority race/ethnicity but lack clinical data that may influence treatment. The objective of this study was to identify clinical and demographic factors associated with pyeloplasty in infants from three large tertiary centers. The investigators found that infant pyeloplasty rates varied between sites. In addition, they found that prolonged T½ was associated with surgery despite prior studies suggesting this was a poor predictor of worsening dilation or function.
AHRQ-funded; HS024597.
Citation: Vemulakonda VM, Sevick C, Juarez-Colunga E .
Treatment of infants with ureteropelvic junction obstruction: findings from the PURSUIT network.
Int Urol Nephrol 2021 Aug;53(8):1485-95. doi: 10.1007/s11255-021-02866-y..
Keywords: Newborns/Infants, Treatments, Practice Patterns
Ibrahim S, Lowe JR, Bramante CT
Metformin and Covid-19: focused review of mechanisms and current literature suggesting benefit.
In the current Covid-19 pandemic, four observational studies have been published showing reduced mortality among individuals with home metformin use. This article discusses these studies.
AHRQ-funded; HS026379.
Citation: Ibrahim S, Lowe JR, Bramante CT .
Metformin and Covid-19: focused review of mechanisms and current literature suggesting benefit.
Front Endocrinol 2021 Jul 22;12:587801. doi: 10.3389/fendo.2021.587801..
Keywords: COVID-19, Medication, Treatments
Wilkinson ST, Kitay BM, Harper A
Barriers to the implementation of electroconvulsive therapy (ECT): results from a nationwide survey of ECT practitioners.
Electroconvulsive therapy (ECT) is an effective treatment for major depressive disorder; yet, its use is confined to <1% of individuals with this disorder. In this study, the authors aimed to examine barriers to ECT from the perspective of the provider. The investigators concluded that coordinated efforts to overcome identified barriers may allow ECT to be more broadly implemented. Investments in education may increase the number of competent practitioners.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Kitay BM, Harper A .
Barriers to the implementation of electroconvulsive therapy (ECT): results from a nationwide survey of ECT practitioners.
Psychiatr Serv 2021 Jul;72(7):752-57. doi: 10.1176/appi.ps.202000387..
Keywords: Depression, Behavioral Health, Treatments
Caram MEV, Burns J, Kumbier K
Factors influencing treatment of veterans with advanced prostate cancer.
This study examined factors influencing treatment of veterans with metastatic castration-resistant prostate cancer (CRPC). Clinician and nonclinical factors associated with the first-line treatment for CPRC using data from the Veterans Health Administration was used. Almost 5000 patients who received abiraterone, enzalutamide, docetaxel, or ketoconazole from 2010 through 2017 were identified. Increasing age was associated with receipt of abiraterone or enzalutamide versus docetaxel. Greater preexisting comorbidity was associated with enzalutamide versus abiraterone. Patients with higher PSA values at the start of treatment were more likely to receive docetaxel than the other three treatments. African American men were more likely to receive ketoconazole.
AHRQ-funded; HS025707.
Citation: Caram MEV, Burns J, Kumbier K .
Factors influencing treatment of veterans with advanced prostate cancer.
Cancer 2021 Jul 1;127(13):2311-18. doi: 10.1002/cncr.33485..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Treatments
Bramante CT, Buse J, Tamaritz L
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
This study investigated whether outpatient metformin use is associated with reduced severity of COVID-19 in adults with overweight or obesity. Metformin can decrease interleukin-6 and tumor-necrosis factor- α, which appears to contribute to COVID-19 mortality. The authors conducted a retrospective cohort analysis of electronic health record (EHR) data that was pooled across multiple EHR systems from 12 hospitals and 60 primary care clinics in the Midwest between March and December 2020. Inclusion criteria included data for BMI > 25 kg/m(2); age range 30-85 years; and a positive SARS-CoV-2 polymerase chain reaction test. Metformin was associated with a decrease in mortality from COVID-19 and a nonsignificant decrease in hospital admission in the overall cohort.
AHRQ-funded; HS026379.
Citation: Bramante CT, Buse J, Tamaritz L .
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
J Med Virol 2021 Jul;93(7):4273-79. doi: 10.1002/jmv.26873..
Keywords: COVID-19, Infectious Diseases, Obesity, Medication, Treatments, Outcomes