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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 19 of 19 Research Studies DisplayedYang Y, Bass EJ, Sockolow PS
Knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization.
Researchers elicit knowledge related to expert decision-making processes to inform information technology design and related interventions. In this study, the investigators examine knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization. The investigators concluded that the data collection and validation methodology showed promise for knowledge elicitation in time-constrained situations.
AHRQ-funded; HS024537.
Citation: Yang Y, Bass EJ, Sockolow PS .
Knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization.
AMIA Annu Symp Proc 2018 Dec 5;2018:1127-36..
Keywords: Home Healthcare, Decision Making, Health Information Technology (HIT), Data
Quintana Y, Crotty B, Fahy D
Information sharing across generations and environments (InfoSAGE): study design and methodology protocol.
This open prospective cohort study aimed to assess a novel, Internet based, family-centric communication and collaboration platform created to address the information needs of elders and their informal caregivers in a community setting. It used a mixed methods approach, utilizing qualitative survey data along with website usage analytic data.
AHRQ-funded; HS021495.
Citation: Quintana Y, Crotty B, Fahy D .
Information sharing across generations and environments (InfoSAGE): study design and methodology protocol.
BMC Med Inform Decis Mak 2018 Nov 20;18(1):105. doi: 10.1186/s12911-018-0697-4.
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BMC Med Inform Decis Mak 2018 Nov 20;18(1):105. doi: 10.1186/s12911-018-0697-4.
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Keywords: Caregiving, Communication, Decision Making, Elderly, Health Information Technology (HIT), Patient-Centered Healthcare, Clinician-Patient Communication, Web-Based
Gianfrancesco MA, Tamang S, Yazdany J
Potential biases in machine learning algorithms using electronic health record data.
This Special Communication outlines the potential biases that may be introduced into machine learning-based clinical decision support tools that use electronic health record data and proposes potential solutions to the problems of overreliance on automation, algorithms based on biased data, and algorithms that do not provide information that is clinically meaningful.
AHRQ-funded; HS024412.
Citation: Gianfrancesco MA, Tamang S, Yazdany J .
Potential biases in machine learning algorithms using electronic health record data.
JAMA Intern Med 2018 Nov;178(11):1544-47. doi: 10.1001/jamainternmed.2018.3763..
Keywords: Electronic Health Records (EHRs), Clinical Decision Support (CDS), Health Information Technology (HIT), Decision Making
Panattoni L, Chan A, Yang Y
Nudging physicians and patients with autopend clinical decision support to improve diabetes management.
This study’s objective was to determine the impact on routine glycalated hemoglobin (A1C) laboratory test completion of incorporating an autopend laboratory order functionality into clinical decision support. The clinical decision support includes 1) routing provider alerts to a separate electronic folder, 2) automatically populating preauthorization forms, and 3) linking the timing and content of electronic patient health maintenance topic (HMT) reminders to the provider authorization. The likelihood of A1C laboratory test completion increased after autopend by between 21% to 33.9%.
AHRQ-funded; HS019167.
Citation: Panattoni L, Chan A, Yang Y .
Nudging physicians and patients with autopend clinical decision support to improve diabetes management.
Am J Manag Care 2018 Oct;24(10):479-83..
Keywords: Clinical Decision Support (CDS), Decision Making, Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT)
Meyer AND, Thompson PJ, Khanna A
Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.
This study evaluated if a mobile application improved generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. The study concluded that a mobile app, PTT (partial thromboplastin times) Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes.
AHRQ-funded; HS022087; HS023602.
Citation: Meyer AND, Thompson PJ, Khanna A .
Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.
J Am Med Inform Assoc 2018 Jul;25(7):841-47. doi: 10.1093/jamia/ocy026..
Keywords: Decision Making, Diagnostic Safety and Quality, Health Information Technology (HIT)
Mistry B, Stewart De Ramirez S, Kelen G
Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment.
This study assessed the accuracy and variability of triage score assignment by emergency department (ED) nurses using the Emergency Severity Index (ESI) in 3 countries. It found that the concordance of nurse-assigned ESI score with reference standard was universally poor and variability was high. Although the ESI is the most popular ED triage tool in the United States and is increasingly used worldwide, its findings point to a need for more reliable ED triage tools.
AHRQ-funded; HS023641.
Citation: Mistry B, Stewart De Ramirez S, Kelen G .
Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment.
Ann Emerg Med 2018 May;71(5):581-87.e3. doi: 10.1016/j.annemergmed.2017.09.036.
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Keywords: Decision Making, Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT), Nursing
Levin S, Toerper M, Hamrock E
Machine-learning-based electronic triage more accurately differentiates patients with respect to clinical outcomes compared with the emergency severity index.
This study seeks to evaluate an electronic triage system (e-triage) based on machine learning that predicts likelihood of acute outcomes enabling improved patient differentiation. It concluded that E-triage more accurately classifies emergency severity index (ESI) level 3 patients and highlights opportunities to use predictive analytics to support triage decisionmaking.
AHRQ-funded; HS023641.
Citation: Levin S, Toerper M, Hamrock E .
Machine-learning-based electronic triage more accurately differentiates patients with respect to clinical outcomes compared with the emergency severity index.
Ann Emerg Med 2018 May;71(5):565-74.e2. doi: 10.1016/j.annemergmed.2017.08.005.
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Keywords: Decision Making, Health Information Technology (HIT), Health Information Technology (HIT), Outcomes
Nanji KC, Seger DL, Slight SP
Medication-related clinical decision support alert overrides in inpatients.
This study examined the use of medical-related clinical decision support alert overrides by clinicians in hospital inpatient settings. Overall, almost three-quarters of alerts were overridden, with 40% of them not being appropriate. The majority of overrides dealing with duplicate drug, patient allergy or formulary substitution alerts were appropriate but very few for renal- or age-based were. The authors concluded that research should be done to optimize alert types and frequencies to reduce alarm fatigue.
AHRQ-funded; HS024764.
Citation: Nanji KC, Seger DL, Slight SP .
Medication-related clinical decision support alert overrides in inpatients.
J Am Med Inform Assoc 2018 May;25(5):476-81. doi: 10.1093/jamia/ocx115..
Keywords: Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT), Inpatient Care, Medication
Wilbanks J
Design issues in e-consent.
Informed consent has not been implemented as a relationship, but instead as a single-point transaction that must be completed in order to enroll participants. This paper discusses e-consent and notes that it is an opportunity to: truly inform research participants about clinical protocols; provide a meaningful choice architecture to support a potential participant’s decision making about whether or not to enroll; and serve as the beginning of an ongoing ethical relationship with study participants.
AHRQ-funded; HS022789.
Citation: Wilbanks J .
Design issues in e-consent.
J Law Med Ethics 2018 Mar;46(1):110-18. doi: 10.1177/1073110518766025..
Keywords: Decision Making, Health Information Technology (HIT), Patient-Centered Outcomes Research, Research Methodologies
Aalsma MC, Zerr AM, Etter DJ
Physician intervention to positive depression screens among adolescents in primary care.
The objective of this study was to determine the effectiveness of computer-based screening and physician feedback to guide adolescent depression management within primary care. The investigators found that when a computer-based decision support system algorithm focused on adolescent depression and was implemented in two primary care clinics, a majority of physicians utilized screening results to guide clinical care.
AHRQ-funded; HS022681.
Citation: Aalsma MC, Zerr AM, Etter DJ .
Physician intervention to positive depression screens among adolescents in primary care.
J Adolesc Health 2018 Feb;62(2):212-18. doi: 10.1016/j.jadohealth.2017.08.023..
Keywords: Care Management, Children/Adolescents, Decision Making, Depression, Health Information Technology (HIT), Behavioral Health, Primary Care, Primary Care: Models of Care, Screening
Dowding D, Merrill JA, Onorato N
The impact of home care nurses' numeracy and graph literacy on comprehension of visual display information: implications for dashboard design.
This study explored home care nurses' numeracy and graph literacy and their relationship to comprehension of visualized data. Results suggest that nurses' comprehension of visualized information is influenced by their numeracy, graph literacy, and the display format of the data. Individual differences in numeracy and graph literacy skills need to be taken into account when designing dashboard technology.
AHRQ-funded; HS023855.
Citation: Dowding D, Merrill JA, Onorato N .
The impact of home care nurses' numeracy and graph literacy on comprehension of visual display information: implications for dashboard design.
J Am Med Inform Assoc 2018 Feb;25(2):175-82. doi: 10.1093/jamia/ocx042.
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Keywords: Decision Making, Health Information Technology (HIT), Health Literacy, Health Information Technology (HIT), Nursing
Ye S, Leppin AL, Chan AY
An informatics approach to implement support for shared decision making for primary prevention statin therapy.
The study authors designed an informatics decision-support tool to facilitate use of the Mayo Clinic Statin Choice decision aid at the point-of-care and evaluated its impact. The investigators found that implementation of a point-of-care decision-support tool increased the usage of decision aids for primary prevention statin therapy. This effect does not appear to be mediated by any concomitant changes in physician attitude toward shared decision making.
AHRQ-funded; HS025198.
Citation: Ye S, Leppin AL, Chan AY .
An informatics approach to implement support for shared decision making for primary prevention statin therapy.
MDM Policy Pract 2018 Jan-Jun;3(1):2381468318777752. doi: 10.1177/2381468318777752..
Keywords: Decision Making, Health Information Technology (HIT), Medication, Prevention, Tools & Toolkits
Heisler M, Choi H, Palmisano G
Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
This study compared outcomes between community health worker (CHW) use of a tailored, interactive, Web-based, tablet computer-delivered tool specifically developed for the study and use of printed educational materials. In a population of low-income Latino and African American adults with diabetes and relatively low levels of formal education, participants in both CHW-led interventions reported mostly similar improvements in outcomes over 3 months.
AHRQ-funded; HS019256
Citation: Heisler M, Choi H, Palmisano G .
Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
Ann Intern Med. 2014 Nov 18;161(10 Suppl):S13-22. doi: 10.7326/m13-3012..
Keywords: Health Information Technology (HIT), Diabetes, Decision Making, Outcomes, Social Determinants of Health
Lacson R, Prevedello LM, Andriole KP
Four-year impact of an alert notification system on closed-loop communication of critical test results.
The authors evaluated the impact of an alert notification system on policy adherence for communicating critical imaging test results to referring providers and assessed system adoption over the first 4 years after implementation. They concluded that an automated alert notification system for communicating critical imaging results was successfully adopted and was associated with increased adherence to institutional policy for communicating critical test results and with reduced workflow interruptions.
AHRQ-funded; HS019635.
Citation: Lacson R, Prevedello LM, Andriole KP .
Four-year impact of an alert notification system on closed-loop communication of critical test results.
AJR Am J Roentgenol 2014 Nov;203(5):933-8. doi: 10.2214/ajr.14.13064.
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Keywords: Communication, Decision Making, Guidelines, Health Information Technology (HIT), Imaging
Welch BM, Eilbeck K, Del Fiol G
Technical desiderata for the integration of genomic data with clinical decision support.
The objective of this study is to develop and validate a guiding set of technical desiderata for supporting the clinical use of the whole genome sequence (WGS) through clinical decision support (CDS). A panel of domain experts in genomics and CDS developed a proposed set of seven additional requirements. These additional desiderata provide important guiding principles for the technical development of CDS capabilities for the clinical use of WGS information.
AHRQ-funded; HS018352.
Citation: Welch BM, Eilbeck K, Del Fiol G .
Technical desiderata for the integration of genomic data with clinical decision support.
J Biomed Inform 2014 Oct;51:3-7. doi: 10.1016/j.jbi.2014.05.014..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Genetics, Electronic Health Records (EHRs), Decision Making
Longo DR, Woolf HS
Rethinking the information priorities of patients.
Efforts have intensified to provide consumers with online data tools and consumer reports that offer profiles and statistics for evaluating specialists, hospitals, and other clinical facilities. In this article, the authors examine two key questions: what should these resources look like and do patients really want them?
AHRQ-funded; HS021902
Citation: Longo DR, Woolf HS .
Rethinking the information priorities of patients.
JAMA. 2014 May 14;311(18):1857-8. doi: 10.1001/jama.2014.3038..
Keywords: Education: Patient and Caregiver, Decision Making, Quality of Care, Health Information Technology (HIT), Web-Based
Del Fiol G, Workman TE, Gorman PN
Clinical questions raised by clinicians at the point of care: a systematic review.
The researchers conducted a systematic review of studies examining the questions that clinicians raise in the context of patient care decisionmaking. They concluded that clinicians frequently raise questions about patient care in their practice. Although they are effective at finding answers to questions they pursue, roughly half of the questions are never pursued.
AHRQ-funded; HS018352.
Citation: Del Fiol G, Workman TE, Gorman PN .
Clinical questions raised by clinicians at the point of care: a systematic review.
JAMA Intern Med. 2014 May;174(5):710-8. doi: 10.1001/jamainternmed.2014.368..
Keywords: Education: Patient and Caregiver, Decision Making, Health Information Exchange (HIE), Health Information Technology (HIT), Practice Patterns
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care