National Healthcare Quality and Disparities Report
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- Antibiotics (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 11 of 11 Research Studies DisplayedShaker M, Verma K, Greenhawt M
The health and economic outcomes of early egg introduction strategies.
This study compared the costs and benefits of early egg introduction (EEI) using simulation and Markov modeling over a 20-year horizon with data from the United States, Europe, and Canada. Per child it was more expensive to provide early screening for all children with early-onset eczema than to have a “wait and see” approach. While there would be more egg allergy diagnosis with early screening, the increased costs were too great compared to the no-screening approach.
Citation: Shaker M, Verma K, Greenhawt M .
The health and economic outcomes of early egg introduction strategies.
Allergy 2018 Nov;73(11):2214-23. doi: 10.1111/all.13565..
Keywords: Children/Adolescents, Screening, Healthcare Costs, Diagnostic Safety and Quality, Medication
Rao G, Naureckas S, Datta A
Pediatric hypertension: diagnostic patterns derived from electronic health records.
This study examined the rates of diagnostic for pediatric hypertension using electronic health records (EHRs). The rates of diagnosis were very low (6.1%) among 1478 children identified as hypertensive. Rates of diagnosis improved in children aged 12 and above but was very low for children aged 6 and under. Underdiagnosis can lead to organ failure and increased risk for adult hypertension.
AHRQ-funded; HS024100.
Citation: Rao G, Naureckas S, Datta A .
Pediatric hypertension: diagnostic patterns derived from electronic health records.
Diagnosis 2018 Sep;5(3):157-60. doi: 10.1515/dx-2018-0010..
Keywords: Children/Adolescents, Blood Pressure, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Shaker M, Stukus D, Chan ES
"To screen or not to screen": comparing the health and economic benefits of early peanut introduction strategies in five countries.
This study compared the costs and benefits of early peanut introduction (EPI) using data from five countries: US, Canada, Australia, New Zealand and United Kingdom. Per child it was more expensive to provide early screening for all children with early-onset eczema and/or egg allergy than to have a “wait and see” approach. While there would be more peanut allergy diagnosis with early screening, the increased costs were too great compared to the no-screening approach.
AHRQ-funded; HS024599.
Citation: Shaker M, Stukus D, Chan ES .
"To screen or not to screen": comparing the health and economic benefits of early peanut introduction strategies in five countries.
Allergy 2018 Aug;73(8):1707-14. doi: 10.1111/all.13446..
Keywords: Children/Adolescents, Screening, Diagnostic Safety and Quality, Healthcare Costs, Medication, Medication
Egorova NN, Pincus HA, Shemesh E
Behavioral health diagnoses among children and adolescents hospitalized in the United States: observations and implications.
The study described rates and characteristics of U.S. children hospitalized with a behavioral (mental or substance use) disorder. The study concluded that nearly 500,000 pediatric admissions in 2012 included behavioral disorders. Comorbidities were associated with longer stays and an estimated $1.36 billion additional annual costs, which were disproportionately borne by public insurance.
AHRQ-funded; HS20518; HS024433.
Citation: Egorova NN, Pincus HA, Shemesh E .
Behavioral health diagnoses among children and adolescents hospitalized in the United States: observations and implications.
Psychiatr Serv 2018 Aug;69(8):910-18. doi: 10.1176/appi.ps.201700389..
Keywords: Behavioral Health, Children/Adolescents, Diagnostic Safety and Quality, Healthcare Cost and Utilization Project (HCUP)
Martinez M, Thomas KC, Williams CS
Family experiences with the diagnosis of autism spectrum Disorder: system barriers and facilitators of efficient diagnosis.
This paper examines family experiences with the efficiency of Autism Spectrum Disorder diagnosis. Screening, travel distance, and delay in diagnosis were associated with shifting diagnoses and being told child did not have ASD. Physician and parent training in communication and addressing mental health professional shortages and maldistribution may improve the diagnosis experiences of families of children with ASD.
AHRQ-funded; HS000032.
Citation: Martinez M, Thomas KC, Williams CS .
Family experiences with the diagnosis of autism spectrum Disorder: system barriers and facilitators of efficient diagnosis.
J Autism Dev Disord 2018 Jul;48(7):2368-78. doi: 10.1007/s10803-018-3493-1..
Keywords: Autism, Children/Adolescents, Diagnostic Safety and Quality, Patient-Centered Healthcare, Patient Experience
Bardach NS, Burkhart Q, Richardson LP
Hospital-based quality measures for pediatric mental health care.
The objective of this study was to develop and test medical record-based measures used to assess quality of pediatric mental health care in the emergency department (ED) and inpatient settings. The investigators drafted an evidence-based set of pediatric mental health care quality measures for the ED and inpatient settings and used them to identify sex and race disparities and substantial hospital variation.
AHRQ-funded; HS020506.
Citation: Bardach NS, Burkhart Q, Richardson LP .
Hospital-based quality measures for pediatric mental health care.
Pediatrics 2018 Jun;141(6). doi: 10.1542/peds.2017-3554..
Keywords: Cancer, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Decision Making, Diagnostic Safety and Quality, Patient Experience, Patient and Family Engagement
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
Rinke ML, Singh H, Heo M
Diagnostic errors in primary care pediatrics: Project RedDE.
The objective of this study was to investigate the frequency of two high-frequency/subacute diagnostic errors (DEs), and one missed opportunity for diagnosis (MOD) in primary care pediatrics. DE or MOD rates in pediatric primary care were found to be 54 percent for patients with elevated BP, 11 percent for patients with abnormal laboratory values, and 62 percent for adolescents with an opportunity to evaluate for depression.
AHRQ-funded; HS022087; HS023608; HS023602.
Citation: Rinke ML, Singh H, Heo M .
Diagnostic errors in primary care pediatrics: Project RedDE.
Acad Pediatr 2018 Mar;18(2):220-27. doi: 10.1016/j.acap.2017.08.005.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Primary Care, Quality Improvement
Geis GL, Wheeler DS, Bunger A
A validation argument for a simulation-based training course centered on assessment, recognition, and early management of pediatric sepsis.
The aim of this study was to create a validity argument for the use of a simulation-based training course centered on assessment, recognition, and early management of sepsis in a laboratory-based setting. The authors concluded that, although incomplete, evidence from initial testing suggests that the simulations of pediatric sepsis were sufficiently valid to justify their use in training novice pediatric physicians in the assessment, recognition, and management of pediatric sepsis.
AHRQ-funded; HS020455.
Citation: Geis GL, Wheeler DS, Bunger A .
A validation argument for a simulation-based training course centered on assessment, recognition, and early management of pediatric sepsis.
Simul Healthc 2018 Feb;13(1):16-26. doi: 10.1097/sih.0000000000000271..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Sepsis, Training
Fierro JL, Prasad PA, Localio AR
Variability in the diagnosis and treatment of group a streptococcal pharyngitis by primary care pediatricians.
The researchers compared practice patterns regarding the diagnosis and management of streptococcal pharyngitis across 25 pediatric primary care practices sharing an electronic health record. They found that only 18 of 222 clinicians wrote 50 percent of all broad-spectrum antibiotic prescriptions for children with group a streptococcus pharyngitis. They suggested targeted interventions to improve adherence to prescribing guidelines.
AHRQ-funded; 290200710013
Citation: Fierro JL, Prasad PA, Localio AR .
Variability in the diagnosis and treatment of group a streptococcal pharyngitis by primary care pediatricians.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S79-85. doi: 10.1086/677820..
Keywords: Antibiotics, Children/Adolescents, Diagnostic Safety and Quality, Primary Care, Practice Patterns
Lawrence JM, Black MH, Zhang JL
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
The researchers explored the utility of different algorithms for diabetes case identification by using electronic health records. They found that case identification accuracy was highest in 75% of bootstrapped samples for those who had 1 or more outpatient diabetes diagnoses or 1 or more insulin prescriptions and in 25% of samples for those who had 2 or more outpatient diabetes diagnoses and 1 or more antidiabetic medications.
AHRQ-funded; HS019859.
Citation: Lawrence JM, Black MH, Zhang JL .
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
Am J Epidemiol 2014 Jan;179(1):27-38. doi: 10.1093/aje/kwt230..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality