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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 28 Research Studies DisplayedAdelgais KM, Hansen M, Lerner EB
Establishing the key outcomes for pediatric emergency medical services research.
The evidence supporting best practices when treating children in the prehospital setting or even the effect emergency medical services (EMS) has on patient outcomes is limited. This article describes a consensus process among stakeholders in the pediatric emergency medicine and EMS community that identified the critical outcomes for EMS care in five clinical areas (traumatic brain injury, general injury, respiratory disease/failure, sepsis, and seizures).
AHRQ-funded; HS026101.
Citation: Adelgais KM, Hansen M, Lerner EB .
Establishing the key outcomes for pediatric emergency medical services research.
Acad Emerg Med 2018 Dec;25(12):1345-54. doi: 10.1111/acem.13637..
Keywords: Children/Adolescents, Emergency Medical Services (EMS), Evidence-Based Practice, Health Services Research (HSR), Outcomes, Patient-Centered Outcomes Research
Ishimine P, Adelgais K, Barata I
Executive summary: the 2018 Academic Emergency Medicine Consensus Conference: Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps.
Emergency care providers share a compelling interest in developing an effective patient-centered, outcomes-based research agenda that can decrease variability in pediatric outcomes. The 2018 Academic Emergency Medicine Consensus Conference "Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps (AEMCC)" aimed to fulfill this role. This paper discusses the conference which convened major thought leaders and stakeholders to introduce a research, scholarship, and innovation agenda for pediatric emergency care specifically to reduce health outcome gaps.
AHRQ-funded; HS026101.
Citation: Ishimine P, Adelgais K, Barata I .
Executive summary: the 2018 Academic Emergency Medicine Consensus Conference: Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps.
Acad Emerg Med 2018 Dec;25(12):1317-26. doi: 10.1111/acem.13667..
Keywords: Implementation, Evidence-Based Practice, Patient-Centered Outcomes Research, Children/Adolescents, Emergency Department, Outcomes, Research Methodologies
Burgermaster M, Murray M, Saiman L
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
This study investigated the outcomes of children and a subsample of infants in pediatric long-term care facilities are need enteral nutrition (EN). Those patients who need EN had a higher risk of acute pediatric infection (ARI) and a lower odds of discharge than those who did not. Infants had a particular higher risk of comorbidities and infections when they were fed using percutaneous feeding tubes.
AHRQ-funded; HS021470.
Citation: Burgermaster M, Murray M, Saiman L .
Associations between enteral nutrition and acute respiratory infection among patients in New York metropolitan region pediatric long-term care facilities.
Nutr Clin Pract 2018 Dec;33(6):865-71. doi: 10.1002/ncp.10017..
Keywords: Children/Adolescents, Healthcare-Associated Infections (HAIs), Nutrition, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Respiratory Conditions, Long-Term Care
Morrow AS, Whiteside SP, Sim LA
Developing tools to enhance the use of systematic reviews for clinical care in health systems.
The researchers’ goal was to develop tools to facilitate the uptake of evidence as summarized in systematic reviews by clinical decisionmakers in health systems. After they conducted a systematic review on the management of anxiety in children, the researchers interviewed health system representatives, clinicians and patients to gain additional information about decisionmaking. Two decision-aid tools - one for the health system and the other for the clinical encounter - were then developed using stakeholders' feedback and literature searches. The health system decision aid provided information on patients who were candidates for treatment, values and preferences, costs and resources, acceptability, impact on health equity, feasibility, drug dosing, alternative therapies, remission rates, and prognosis. The encounter decision aid was produced as a set of cards that contained information on the issues that drive treatment decisions. Health system stakeholders found the first decision aid useful, and patients, parents, and clinicians found the second to be helpful.
AHRQ-funded; 290201500013I; 29032001T.
Citation: Morrow AS, Whiteside SP, Sim LA .
Developing tools to enhance the use of systematic reviews for clinical care in health systems.
BMJ Evid Based Med 2018 Dec;23(6):206-09. doi: 10.1136/bmjebm-2018-110995..
Keywords: Children/Adolescents, Decision Making, Evidence-Based Practice, Patient-Centered Outcomes Research, Implementation
Lifland B, Wright DR, Mangione-Smith R
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
The purpose of this study was to examine the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway with psychiatric patients’ length of stay (LOS), cost, and readmissions. Patients in the high-adherence category were found to have significantly longer LOS and higher costs when compared to those in the low-adherence category. The authors conclude that understanding which of the care processes within the pathway are most cost-effective for improving patient-centered outcomes requires further investigation.
AHRQ-funded; HS024299.
Citation: Lifland B, Wright DR, Mangione-Smith R .
The impact of an adolescent depressive disorders clinical pathway on healthcare utilization.
Adm Policy Ment Health 2018 Nov;45(6):979-87. doi: 10.1007/s10488-018-0878-6..
Keywords: Care Management, Children/Adolescents, Depression, Healthcare Costs, Healthcare Utilization, Hospital Readmissions, Hospitalization, Inpatient Care, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Bauer NS, Azer N, Sullivan PD
Acceptability of group visits for attention-deficit hyperactivity disorder in pediatric clinics.
The objective of the study was to describe the acceptability of ADHD group visits in busy pediatric clinics based on caregivers, child participants and facilitators. The authors found that the majority of comments from families and facilitators highlighted a variety of benefits of the use of a group visit model for ADHD chronic care. Despite systems-level barriers to implementation, families and facilitators felt the benefits outweighed the challenges.
AHRQ-funded; HS022434.
Citation: Bauer NS, Azer N, Sullivan PD .
Acceptability of group visits for attention-deficit hyperactivity disorder in pediatric clinics.
J Dev Behav Pediatr 2017 Oct;38(8):565-72. doi: 10.1097/dbp.0000000000000492..
Keywords: Children/Adolescents, Behavioral Health, Patient-Centered Outcomes Research, Chronic Conditions
Leyenaar JK, Bogetz JF
Child mortality in the United States: bridging palliative care and public health perspectives.
This commentary discusses the findings of the article by Trowbridge et al in this same issue of Pediatrics, which examines modes of death rather than causes of death at a freestanding children’s hospital. Five distinct categories were created: withdrawal of life-sustaining technology; non-escalation of care; failed resuscitation; code then withdrawal; death by neurological criteria. More than 60% of the deaths were infants. The authors of this commentary note that conceptualizing the findings of this study from a public health perspective raises important questions about how causes of death are associated with end-of-life care in hospitals.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Bogetz JF .
Child mortality in the United States: bridging palliative care and public health perspectives.
Pediatrics 2018 Oct;142(4). doi: 10.1542/peds.2018-1927..
Keywords: Children/Adolescents, Hospitals, Mortality, Palliative Care, Patient-Centered Outcomes Research, Public Health
Leyenaar JK, Rizzo PA, O'Brien ER
Paediatric hospital admission processes and outcomes: a qualitative study of parents' experiences and priorities.
The investigators aimed to characterize, among children hospitalised with ambulatory care sensitive conditions, families' experiences as they transitioned from outpatient to inpatient care, identify hospital admission processes and outcomes most important to families and determine how parental perspectives differed between children admitted directly and through emergency departments (ED). They conducted semistructured interviews with parents of hospitalised children at four structurally diverse hospitals.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Rizzo PA, O'Brien ER .
Paediatric hospital admission processes and outcomes: a qualitative study of parents' experiences and priorities.
BMJ Qual Saf 2018 Oct;27(10):790-98. doi: 10.1136/bmjqs-2017-007442..
Keywords: Children/Adolescents, Hospitalization, Patient Experience, Patient-Centered Outcomes Research, Children/Adolescents
Desai AD, Jacob-Files EA, Lowry SJ
Development of a caregiver-reported experience measure for pediatric hospital-to-home transitions.
The objective for this study was to develop and test a caregiver-reported experience measure for pediatric hospital-to-home transitions. An eight-item caregiver-reported experience measure to evaluate hospital-to-home transition outcomes in pediatric populations demonstrated acceptable content validity and psychometric properties.
AHRQ-funded; HS024299.
Citation: Desai AD, Jacob-Files EA, Lowry SJ .
Development of a caregiver-reported experience measure for pediatric hospital-to-home transitions.
Health Serv Res 2018 Aug;53 Suppl 1:3084-106. doi: 10.1111/1475-6773.12864..
Keywords: Caregiving, Children/Adolescents, Patient-Centered Outcomes Research, Quality Measures, Transitions of Care
Badawy SM, Barrera L, Cai S
Association between participants' characteristics, patient-reported outcomes, and clinical outcomes in youth with sickle cell disease.
Researchers studied the effects of sickle disease (SCD) on the quality of life (QOL) on youths with the disease. Participant characteristics, chronic pain, and medication adherence were measured against clinical outcomes. Older and female participants had worse QOL than males overall.
AHRQ-funded; HS023011.
Citation: Badawy SM, Barrera L, Cai S .
Association between participants' characteristics, patient-reported outcomes, and clinical outcomes in youth with sickle cell disease.
Biomed Res Int 2018 Jul 18;2018:8296139. doi: 10.1155/2018/8296139..
Keywords: Children/Adolescents, Outcomes, Patient-Centered Outcomes Research, Quality of Life, Sickle Cell Disease
Beukelman T, Xie F, Chen L
Risk of malignancy associated with paediatric use of tumour necrosis factor inhibitors.
The objective of the study was to determine whether tumour necrosis factor inhibitor (TNFi) use is associated with an increased rate of incident malignancy compared with no TNFi use in the treatment of juvenile idiopathic arthritis (JIA), paediatric inflammatory bowel disease (pIBD) and paediatric plaque psoriasis (pPsO). The authors concluded that children diagnosed with JIA, pIBD and pPsO had an increased rate of malignancy compared with the general population, but treatment with TNFi did not appear to significantly further increase the risk compared with no TNFi use.
AHRQ-funded; HS021110.
Citation: Beukelman T, Xie F, Chen L .
Risk of malignancy associated with paediatric use of tumour necrosis factor inhibitors.
Ann Rheum Dis 2018 Jul;77(7):1012-16. doi: 10.1136/annrheumdis-2017-212613..
Keywords: Children/Adolescents, Cancer, Patient-Centered Outcomes Research, Risk, Arthritis
Greenhawt M, Chan ES, Fleischer DM
Caregiver and expecting caregiver support for early peanut introduction guidelines.
This study investigates caregiver preferences for early peanut introduction (EPI) recommendations. The study concluded that among new and expecting caregivers, there is poor current willingness and questionable support for early allergenic solid food recommendations, including in-office allergy risk assessment before introduction. Willingness was better among expecting vs current caregivers.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Chan ES, Fleischer DM .
Caregiver and expecting caregiver support for early peanut introduction guidelines.
Ann Allergy Asthma Immunol 2018 Jun;120(6):620-25. doi: 10.1016/j.anai.2018.03.001..
Keywords: Caregiving, Children/Adolescents, Guidelines, Newborns/Infants, Patient-Centered Outcomes Research
Kaiser SV, Rodean J, Bekmezian A
Effectiveness of pediatric asthma pathways for hospitalized children: a multicenter, national analysis.
The purpose of this retrospective, multicenter cohort study was to determine if clinical pathways affect care and outcomes for children hospitalized with asthma, using an administrative database, the Pediatric Health Information System. The investigators found that clinical pathways can decrease length of stay, costs, and unnecessary antibiotic use without increasing rates of readmissions, leading to higher value care.
AHRQ-funded; HS024554.
Citation: Kaiser SV, Rodean J, Bekmezian A .
Effectiveness of pediatric asthma pathways for hospitalized children: a multicenter, national analysis.
J Pediatr 2018 Jun;197:165-71.e2. doi: 10.1016/j.jpeds.2018.01.084..
Keywords: Asthma, Children/Adolescents, Evidence-Based Practice, Hospitalization, Patient-Centered Outcomes Research, Children/Adolescents
Mogul DB, Luo X, Bowring MG
Fifteen-year trends in pediatric liver transplants: split, whole deceased, and living donor grafts.
This study evaluated changes in patient and graft survival for pediatric liver transplant recipients since 2002, and to determine if these outcomes vary by graft type (whole liver transplant, split liver transplant [SLT], and living donor liver transplant [LDLT]). It concluded that in recent years, outcomes after the use of technical variant grafts are comparable with whole grafts, and may be superior for LDLT.
AHRQ-funded; HS023876.
Citation: Mogul DB, Luo X, Bowring MG .
Fifteen-year trends in pediatric liver transplants: split, whole deceased, and living donor grafts.
J Pediatr 2018 May;196:148-53.e2. doi: 10.1016/j.jpeds.2017.11.015.
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Keywords: Children/Adolescents, Patient-Centered Outcomes Research, Children/Adolescents, Transplantation
Brunwasser SM, Gebretsadik T, Gold DR
A new model of wheezing severity in young children using the validated ISAAC wheezing module: a latent variable approach with validation in independent cohorts.
The authors of this paper developed an easily applicable continuous latent variable model of pediatric wheezing severity based on items from the well-validated International Study of Asthma and Allergies in Children (ISAAC) Wheezing Module. Their model prospectively associates with asthma morbidity, as demonstrated in two ECHO birth cohort studies, and provides a more statistically powerful method of testing etiologic hypotheses of childhood wheezing illness and asthma.
AHRQ-funded; HS022990.
Citation: Brunwasser SM, Gebretsadik T, Gold DR .
A new model of wheezing severity in young children using the validated ISAAC wheezing module: a latent variable approach with validation in independent cohorts.
PLoS One 2018 Apr 17;13(4):e0194739. doi: 10.1371/journal.pone.0194739..
Keywords: Asthma, Children/Adolescents, Diagnostic Safety and Quality, Patient-Centered Outcomes Research
Foster BA, Fu E, Bendiks N
Capacity-oriented approaches to developing childhood obesity interventions: a systematic review.
Capacity-oriented approaches to health interventions seek to empower the target population or community to manage the health issue themselves using resources they can control. Positive deviance, resilience and asset-based approaches are three such methods of developing and implementing health interventions. This study aimed to review the efficacy of interventions explicitly applying these methods in addressing childhood obesity using adiposity as the primary outcome, measured by standardized body mass index.
AHRQ-funded; HS024332.
Citation: Foster BA, Fu E, Bendiks N .
Capacity-oriented approaches to developing childhood obesity interventions: a systematic review.
Clin Obes 2018 Apr;8(2):95-104. doi: 10.1111/cob.12234..
Keywords: Children/Adolescents, Obesity, Patient-Centered Outcomes Research
Silverberg JI, Kwa L, Kwa MC
Cardiovascular and cerebrovascular comorbidities of juvenile dermatomyositis in US children: an analysis of the National Inpatient Sample.
Juvenile dermatomyositis (JDM) is associated with multiple potential risk factors for cardiovascular disease, however, little is known about cardiovascular risk in JDM. This study sought to examine the association between JDM and cardiovascular risk factors and disease in US children. It concluded that there are significantly higher odds of cardiovascular and cerebrovascular comorbidities among inpatients with JDM, with adolescents, girls and racial/ethnic minorities being at highest risk.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Kwa L, Kwa MC .
Cardiovascular and cerebrovascular comorbidities of juvenile dermatomyositis in US children: an analysis of the National Inpatient Sample.
Rheumatology 2018 Apr;57(4):694-702. doi: 10.1093/rheumatology/kex465..
Keywords: Cardiovascular Conditions, Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Patient-Centered Outcomes Research, Risk
Parikh K, Hall M, Kenyon CC
Impact of discharge components on readmission rates for children hospitalized with asthma.
This study described hospital-based asthma-specific discharge components at children's hospitals and determine the association of these discharge components with pediatric asthma readmission rates. No individual or combination discharge components were associated with lower 30-day adjusted readmission rates. The only single-component significantly associated with a lower rate of readmission at 3 months was having comprehensive content of education.
AHRQ-funded; HS024554.
Citation: Parikh K, Hall M, Kenyon CC .
Impact of discharge components on readmission rates for children hospitalized with asthma.
J Pediatr. 2018 Apr;195:175-181.e2. doi: 10.1016/j.jpeds.2017.11.062..
Keywords: Asthma, Children/Adolescents, Hospital Discharge, Hospital Readmissions, Patient-Centered Outcomes Research
Bavishi A, Boss E, Shah RK
Outcomes after endoscopic dilation of laryngotracheal stenosis: an analysis of ACS-NSQIP.
Endoscopic management of pediatric subglottic stenosis (SGS) is common, however no multi-institutional studies have assessed its perioperative outcomes. This study examined outcomes after endoscopic dilation of laryngotracheal stenosis. The study found that open airway reconstruction is associated with longer length of stay and increased reintubations and reoperations, suggesting a possible opportunity to improve value in healthcare in the appropriately selected patient. Reoperations and readmissions following endoscopic dilation are more prevalent in children less than one year.
AHRQ-funded; HS022932.
Citation: Bavishi A, Boss E, Shah RK .
Outcomes after endoscopic dilation of laryngotracheal stenosis: an analysis of ACS-NSQIP.
J Clin Outcomes Manag 2018 Mar;25(3):111-16..
Keywords: Children/Adolescents, Patient-Centered Outcomes Research, Quality Improvement, Respiratory Conditions, Surgery
Kao LM, Greenhawt MJ, Warren CM
Parental and parent-perceived child interest in clinical trials for food allergen immunotherapy.
This investigation of the motivations and desires of caregivers related to enrolling their child in a clinical trial for food allergen immunotherapy found that the majority of respondents would consider enrolling their child in a trial, irrespective of most patient demographic and disease characteristics. Families earning ≥$100,000/ year reported significantly greater willingness to enroll in a trial.
AHRQ-funded; HS024599.
Citation: Kao LM, Greenhawt MJ, Warren CM .
Parental and parent-perceived child interest in clinical trials for food allergen immunotherapy.
Ann Allergy Asthma Immunol 2018 Mar;120(3):331-33.e1. doi: 10.1016/j.anai.2017.12.012.
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Keywords: Children/Adolescents, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Michelson KA, Hudgins JD, Monuteaux MC
Cardiac arrest survival in pediatric and general emergency departments.
Understanding whether pediatric emergency departments (EDs) have higher survival than general EDs may help identify ways to improve care for all patients with out-of-hospital cardiac arrest (OHCA). Researchers sought to determine if OHCA survival differs between pediatric and general EDs. In their nationally representative sample, survival from nontraumatic OHCA was higher in pediatric EDs than general EDs. Survival did not differ in traumatic OHCA.
AHRQ-funded; HS000063.
Citation: Michelson KA, Hudgins JD, Monuteaux MC .
Cardiac arrest survival in pediatric and general emergency departments.
Pediatrics 2018 Feb;141(2). doi: 10.1542/peds.2017-2741.
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Keywords: Cardiovascular Conditions, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Patient-Centered Outcomes Research, Children/Adolescents
Brunwasser SM, Gillham JE
Identifying moderators of response to the Penn Resiliency Program: a synthesis study.
Researchers sought to identify moderators of a cognitive-behavioral depression prevention program's effect on depressive symptoms among youth in early adolescence. Data from three randomized controlled trials of the Penn Resiliency Program (PRP) were aggregated to maximize statistical power and sample diversity. The primary analyses suggested that PRP's effects are limited to youth whose parents are unmarried.
AHRQ-funded; HS022990.
Citation: Brunwasser SM, Gillham JE .
Identifying moderators of response to the Penn Resiliency Program: a synthesis study.
Prev Sci 2018 Feb;19(Suppl 1):38-48. doi: 10.1007/s11121-015-0627-y.
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Keywords: Behavioral Health, Children/Adolescents, Depression, Patient-Centered Outcomes Research, Prevention
Kemper AR, Krist AH, Tseng CW
AHRQ Author: Mabry-Hernandez IR, Wolff TA
Challenges in developing U.S. Preventive Services Task Force child health recommendations.
In March 2016, the USPSTF convened an expert panel to discuss its portfolio of child and adolescent recommendations and identify unique methodologic issues when evaluating evidence regarding children and adolescents. The panel identified key domains of challenges, including measuring patient-centered health outcomes; identifying intermediate outcomes predictive of important health outcomes and evaluating the long time horizon needed to assess the balance of benefits and harms.
AHRQ-authored.
Citation: Kemper AR, Krist AH, Tseng CW .
Challenges in developing U.S. Preventive Services Task Force child health recommendations.
Am J Prev Med 2018 Jan;54(1s1):S63-s69. doi: 10.1016/j.amepre.2017.08.023.
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Keywords: Children/Adolescents, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, U.S. Preventive Services Task Force (USPSTF)
Shah RK, Stey AM, Jantana KR
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
This study evaluated perioperative outcomes in pediatric otolaryngology through analysis of records residing in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS-NSQIP) database. It found that although the overall rate of major postoperative morbidity in pediatric otolaryngology is low, the following areas may be targeted for targeted quality-improvement interventions: tracheostomy, airway reconstruction, mastoidectomy, and abscess drainage.
AHRQ-funded; HS022932
Citation: Shah RK, Stey AM, Jantana KR .
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
JAMA Otolaryngol Head Neck Surg. 2014 Nov;140(11):1019-26. doi: 10.1001/jamaoto.2014.2067..
Keywords: Surgery, Children/Adolescents, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Mannion ML, Xie F, Curtis JR
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
The researchers investigated temporal trends in medication use among children diagnosed with juvenile idiopathic arthritis (JIA). They found that the use of tumor necrosis factor inhibitors (TNFi) in the treatment of JIA increased 2- to 3-fold from 2005 to 2012. New TNFi use was associated with decreased NSAID and oral glucocorticoids use. TNFi may be replacing, rather than complementing, methotrexate in the treatment of many patients.
AHRQ-funded; HS018517.
Citation: Mannion ML, Xie F, Curtis JR .
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
J Rheumatol 2014 Oct;41(10):2078-84. doi: 10.3899/jrheum.140012.
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Keywords: Children/Adolescents, Medication, Patient-Centered Outcomes Research, Practice Patterns, Arthritis