National Healthcare Quality and Disparities Report
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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
101 to 125 of 2151 Research Studies DisplayedZullo AR, Hersey M, Lee Y
Outcomes of "diabetes-friendly" vs "diabetes-unfriendly" beta-blockers in older nursing home residents with diabetes after acute myocardial infarction.
This study analyzed outcomes of using beta-blockers that are considered “diabetes-friendly” vs “diabetes-unfriendly” in older nursing home residents with diabetes after acute myocardial infarction (AMI). Primary outcomes included hospitalizations for hypoglycemia and hyperglycemia in the 90 days after AMI and secondary outcomes functional decline, death, all-cause re-hospitalization and fracture hospitalization. Out of 2855 nursing home residents with type-2 diabetes (T2D), 29% were prescribed a diabetes-friendly beta-blocker vs. 24% without. T2D medicine showed a reduction in hospitalization for hyperglycemia but was unassociated with hypoglycemia. For secondary outcomes T2D-friendly beta-blocks were associated with a greater rate of re-hospitalization but not death, functional decline, or fracture.
AHRQ-funded; HS022998.
Citation: Zullo AR, Hersey M, Lee Y .
Outcomes of "diabetes-friendly" vs "diabetes-unfriendly" beta-blockers in older nursing home residents with diabetes after acute myocardial infarction.
Diabetes Obes Metab 2018 Dec;20(12):2724-32. doi: 10.1111/dom.13451..
Keywords: Cardiovascular Conditions, Diabetes, Elderly, Heart Disease and Health, Hospitalization, Medication, Nursing Homes, Outcomes, Patient-Centered Outcomes Research
Greenzang KA, Cronin AM, Kang TI
Parental distress and desire for information regarding long-term implications of pediatric cancer treatment.
In this study, the authors evaluated parental distress associated with information regarding future limitations, and the extent to which distress is associated with information preferences. The investigators concluded that although information regarding future limitations caused by cancer treatment is upsetting to many parents, the majority of them desire this information, and those who are distressed are more likely to value this information.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Cronin AM, Kang TI .
Parental distress and desire for information regarding long-term implications of pediatric cancer treatment.
Cancer 2018 Dec 1;124(23):4529-37. doi: 10.1002/cncr.31772..
Keywords: Cancer, Caregiving, Children/Adolescents, Communication, Children/Adolescents
Ostby PL, Armer JM, Smith K
Patient perceptions of barriers to self-management of breast cancer-related lymphedema.
This article reports on results from a study which used an IRB-approved focus group and mailed surveys to identify barriers to lymphedema self-management, definitions of education and support from breast cancer survivors with lymphedema, types of education and support they had received, what kind of education and support they wanted. Lack of education about lymphedema treatment and risk reduction was identified as a main barrier. Women’s responses also make it unclear whether or not they were exposed to support options other than medical treatment.
AHRQ-funded; HS022140.
Citation: Ostby PL, Armer JM, Smith K .
Patient perceptions of barriers to self-management of breast cancer-related lymphedema.
West J Nurs Res 2018 Dec;40(12):1800-17. doi: 10.1177/0193945917744351..
Keywords: Cancer: Breast Cancer, Education: Patient and Caregiver, Patient Self-Management
Govindan S, Snyder A, Flanders SA
Peripherally inserted central catheters in the ICU: a retrospective study of adult medical patients in 52 hospitals.
This study quantified use of peripherally inserted central catheters in the ICU versus the general ward in 52 Michigan hospitals. Variation in complications and outcomes of use were compared. Use in the ICU produced worse outcomes than those inserted in the general ward.
AHRQ-funded; HS022835.
Citation: Govindan S, Snyder A, Flanders SA .
Peripherally inserted central catheters in the ICU: a retrospective study of adult medical patients in 52 hospitals.
Crit Care Med 2018 Dec;46(12):e1136-e44. doi: 10.1097/ccm.0000000000003423..
Keywords: Adverse Events, Healthcare-Associated Infections (HAIs), Inpatient Care, Intensive Care Unit (ICU), Patient Safety
Yu J, Mink PJ, Huckfeldt PJ
Population-level estimates of telemedicine service provision using an all-payer claims database.
Researchers used information from the Minnesota All Payer Claims Database to conduct a population-level analysis of telemedicine service provision from 2010 to 2015. Variations in provision by coverage type, provider type, and rurality of patient residence were documented. During the 2010-15 period, the number of telemedicine visits increased enormously; rates of use varied by coverage type and location. Telemedicine visits in metropolitan areas were usually direct-to-consumer services covered by commercial insurance and provided by nurse practitioners or physician assistants, while telemedicine use in nonmetropolitan areas was more often real-time provider-initiated, publicly insured services. The researchers conclude that expanded coverage and increased provider reimbursement for telemedicine services could lead to expanded use of telemedicine and new approaches to reach new patient populations.
AHRQ-funded; HS026088.
Citation: Yu J, Mink PJ, Huckfeldt PJ .
Population-level estimates of telemedicine service provision using an all-payer claims database.
Health Aff 2018 Dec;37(12):1931-39. doi: 10.1377/hlthaff.2018.05116..
Keywords: Health Information Technology (HIT), Health Insurance, Payment, Telehealth
Borre ED, Goode A, Raitz G
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
This systematic review compared the strength of tools to predict stroke and bleeding risk in patients with atrial fibrillation (AF) taking blood thinners. Sixty-one studies were found to predict thromboembolic risk and 38 to predict bleeding risk.
AHRQ-funded; 290201500004I.
Citation: Borre ED, Goode A, Raitz G .
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
Thromb Haemost 2018 Dec;118(12):2171-87. doi: 10.1055/s-0038-1675400..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Stroke, Blood Clots, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient-Centered Outcomes Research, Evidence-Based Practice
McKernan LC, Clayton EW, Walsh CG
Protecting life while preserving liberty: ethical recommendations for suicide prevention with artificial intelligence.
This paper discusses the ethical considerations for suicide prevention using artificial intelligence. The authors provide recommendations in three areas-communication, consent, and controls-for both providers and researchers.
AHRQ-funded; HS022990.
Citation: McKernan LC, Clayton EW, Walsh CG .
Protecting life while preserving liberty: ethical recommendations for suicide prevention with artificial intelligence.
Front Psychiatry 2018 Dec 3;9:650. doi: 10.3389/fpsyt.2018.00650..
Keywords: Communication, Behavioral Health, Prevention
Reeve BB, Wang M, Weinfurt K
Psychometric evaluation of PROMIS sexual function and satisfaction measures in a longitudinal population-based cohort of men with localized prostate cancer.
The purpose of this study was to evaluate the psychometric properties of the Patient-Reported Outcomes Measurement Information System (PROMIS) Sexual Function and Satisfaction (SexFS) measures. A population-based cohort of men with localized prostate cancer who were living in North Carolina and who could self-report their health-related quality of life in English completed surveys via phone interviews prior to treatment and at 3, 12, and 24 months after cancer treatment initiation. The researchers’ hypothesis was that men undergoing prostatectomy surgery would report the poorest sexual function at the 3-month survey. The study concludes that use of the PROMIS SexFS measures to assess sexual interest, erectile function, and satisfaction is strongly supported, and that these measures may be useful to identify effective interventions to treat sexual dysfunction and monitor sexual functioning in men with localized prostate cancer over time.
AHRQ-funded; 29020050040ITO6.
Citation: Reeve BB, Wang M, Weinfurt K .
Psychometric evaluation of PROMIS sexual function and satisfaction measures in a longitudinal population-based cohort of men with localized prostate cancer.
J Sex Med 2018 Dec;15(12):1792-810. doi: 10.1016/j.jsxm.2018.09.015..
Keywords: Cancer: Prostate Cancer, Men's Health, Sexual Health
Grover S, Desir F, Jing Y
Reduced cancer survival among adults with HIV and AIDS-defining illnesses despite no difference in cancer stage at diagnosis.
A cohort of persons with HIV (PWH) who had AIDS-defining illness (ADI) at the time of cancer diagnosis were compared to those without HIV and ADI with cancer diagnosis at the same stages. Those with ADI had a higher mortality rate (30-70%) with lung cancer statistically significant. This finding is related with HIV-related immune suppression.
AHRQ-funded; 90047713.
Citation: Grover S, Desir F, Jing Y .
Reduced cancer survival among adults with HIV and AIDS-defining illnesses despite no difference in cancer stage at diagnosis.
J Acquir Immune Defic Syndr 2018 Dec 1;79(4):421-29. doi: 10.1097/qai.0000000000001842..
Keywords: Cancer, Diagnostic Safety and Quality, Human Immunodeficiency Virus (HIV), Outcomes
Wang SY, Hsu SH, Huang S
Regional practice patterns and racial/ethnic differences in intensity of end-of-life care.
The purpose of this study was to examine whether regional practice patterns impact racial/ethnic differences in intensity of end-of-life care for cancer decedents. The investigators found that there was greater variation in intensity of end-of-life care among Hispanics, Asians, and whites in high-expenditure hospital referral regions (HRRs) than in low-expenditure HRRs.
AHRQ-funded; HS023900.
Citation: Wang SY, Hsu SH, Huang S .
Regional practice patterns and racial/ethnic differences in intensity of end-of-life care.
Health Serv Res 2018 Dec;53(6):4291-309. doi: 10.1111/1475-6773.12998..
Keywords: Cancer, Palliative Care, Practice Patterns, Racial and Ethnic Minorities
Zhou M, Oakes AH, Bridges JFP
Regional supply of medical resources and systemic overuse of health care among Medicare beneficiaries.
The goal of this study was to explore health care system factors associated with regional variation in overuse of resources, as measured by the Johns Hopkins Overuse Index (JHOI). Medicare fee-for-service claims data from beneficiaries age 65 was used to calculate the JHOI for 306 hospital referral regions in the U.S. Regions with a higher density of primary care physicians had a lower JHOI, which indicates less systemic overuse. Regional characteristics associated with higher JHOI included the number of acute care hospital beds per 1000 residents and number of hospital-based anesthesiologists, pathologists, and radiologists. The authors conclude that regional variations in health care resources are associated with the level of systemic overuse of health care, and that the role of primary care doctors in reducing overuse deserves further attention.
AHRQ-funded; T32 HS000029.
Citation: Zhou M, Oakes AH, Bridges JFP .
Regional supply of medical resources and systemic overuse of health care among Medicare beneficiaries.
J Gen Intern Med 2018 Dec;33(12):2127-31. doi: 10.1007/s11606-018-4638-9..
Keywords: Access to Care, Elderly, Healthcare Delivery, Healthcare Utilization, Medicare, Practice Patterns
Samples H, Williams AR, Olfson M
Risk factors for discontinuation of buprenorphine treatment for opioid use disorders in a multi-state sample of Medicaid enrollees.
The purpose of this study was to examine duration of buprenorphine treatment for opioid use disorder (OUD) following the initiation of treatment in order to identify risk factors for early discontinuation. Researchers analyzed insurance claims from the MarketScan multi-state Medicaid database for 2013 through 2015; their sample included adults aged 18-64 years who had an OUD diagnosis 6 months before initiating buprenorphine treatment. More than 1/4 of the sample discontinued buprenorphine in the first month of treatment, and most of the sample discontinued before 180 days. Risk factors for discontinuation were associated with significantly lower odds of treatment retention for at least 180 days. The study concludes that there is need to implement treatment models that address barriers to treatment retention more effectively.
AHRQ-funded; HS021112.
Citation: Samples H, Williams AR, Olfson M .
Risk factors for discontinuation of buprenorphine treatment for opioid use disorders in a multi-state sample of Medicaid enrollees.
J Subst Abuse Treat 2018 Dec;95:9-17. doi: 10.1016/j.jsat.2018.09.001..
Keywords: Medicaid, Medication, Opioids, Risk, Substance Abuse
Vogel TR, Smith JB, Kruse RL
Risk factors for thirty-day readmissions after lower extremity amputation in patients with vascular disease.
This retrospective cohort study evaluated factors associated with all-cause 30-day readmission after lower extremity amputation procedures. The investigators asserted that the finding- that acute arterial embolism or thrombosis and a below the knee amputation during the index admission was highly associated with readmission, combined with the high rates of 30-day conversion to an above the knee amputation when readmitted- suggests these patients more often develop stump complications or may be undertreated during the initial hospitalization.
AHRQ-funded; HS022140.
Citation: Vogel TR, Smith JB, Kruse RL .
Risk factors for thirty-day readmissions after lower extremity amputation in patients with vascular disease.
PM R 2018 Dec;10(12):1321-29. doi: 10.1016/j.pmrj.2018.05.017..
Keywords: Cardiovascular Conditions, Hospital Readmissions, Risk, Surgery
Felix HC, Bradway C, Bird TM
Safety of obese persons in nursing homes.
This paper discusses the emergence of obese persons as a vulnerable group in the nursing home community. The authors discuss the special needs of this population including that obese residents require special protocols, trained staff, and appropriately sized equipment to prevent and treat skin breakdown.
AHRQ-funded; HS025703.
Citation: Felix HC, Bradway C, Bird TM .
Safety of obese persons in nursing homes.
Med Care 2018 Dec;56(12):1032-34. doi: 10.1097/mlr.0000000000000997..
Keywords: Long-Term Care, Obesity, Nursing Homes, Patient Safety, Skin Conditions
Wilkinson ST, Kiselycznyk C, Banasr M
Serum and plasma brain-derived neurotrophic factor and response in a randomized controlled trial of riluzole for treatment resistant depression.
In this paper, the authors report serum brain-derived neurotrophic factor (BDNF) and plasma BDNF levels from a randomized controlled, adjunctive, sequential parallel comparison design trial of riluzole in major depressive disorder. The investigators noted that preliminary evidence suggested that lower baseline BDNF may be associated with better clinical response to riluzole.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Kiselycznyk C, Banasr M .
Serum and plasma brain-derived neurotrophic factor and response in a randomized controlled trial of riluzole for treatment resistant depression.
J Affect Disord 2018 Dec 1;241:514-18. doi: 10.1016/j.jad.2018.08.075..
Keywords: Comparative Effectiveness, Depression, Medication, Patient-Centered Outcomes Research
Marcum ZA, Walker R, Bobb JF
Serum cholesterol and incident Alzheimer's disease: findings from the adult changes in thought study.
The purpose of this prospective population-based cohort study was to evaluate associations between high-density lipoprotein cholesterol (HDL) and non-HDL-C levels at specific ages and subsequent Alzheimer's disease (AD) risk. The investigators concluded that people with low (120 mg/dL) and high (210 mg/dL) non-HDL-C levels during their 60s and 70s had modestly higher risk of AD than those with intermediate (160 mg/dL) levels.
AHRQ-funded; HS022982.
Citation: Marcum ZA, Walker R, Bobb JF .
Serum cholesterol and incident Alzheimer's disease: findings from the adult changes in thought study.
J Am Geriatr Soc 2018 Dec;66(12):2344-52. doi: 10.1111/jgs.15581..
Keywords: Heart Disease and Health, Dementia, Elderly, Risk
Kempker JA, Martin GS
Severity and timing of onset drive economic costs and clinical outcomes with sepsis.
Sepsis disproportionately affects older adults (mean age, 65 yr); is predominantly community acquired (87%); is expensive (mean hospital costs $21,500); and is associated with high hospital mortality (one in eight patients) and high rates of 30-day readmission for survivors (one in eight patients). In this editorial, the authors discuss an article- by Paoli et al, published in 2018 in Volume 46 of Critical Care Medicine- on sepsis epidemiology.
AHRQ-funded; HS025240.
Citation: Kempker JA, Martin GS .
Severity and timing of onset drive economic costs and clinical outcomes with sepsis.
Crit Care Med 2018 Dec;46(12):2043-44. doi: 10.1097/ccm.0000000000003376..
Keywords: Healthcare Costs, Mortality, Outcomes, Sepsis
Tamblyn R, Meyers D, Kratzmann M
AHRQ Author: Meyers D, Bierman AS
Shared vision for primary care delivery and research in Canada and the United States: highlights from the cross-border symposium.
This paper discusses highlights from a cross-border symposium between Canada and the United States on primary care. This symposium brought together more than 150 leaders in primary care delivery to exchange cross-border stories in primary care transformation, develop a binational research agenda to support primary care transformation, and support cross-border learning and collaboration.
AHRQ-authored.
Citation: Tamblyn R, Meyers D, Kratzmann M .
Shared vision for primary care delivery and research in Canada and the United States: highlights from the cross-border symposium.
Can Fam Physician 2018 Dec;64(12):930-34..
Keywords: Healthcare Delivery, Primary Care
Coupet E, Karp D, Wiebe DJ
Shift in U.S. payer responsibility for the acute care of violent injuries after the Affordable Care Act: Implications for prevention.
In this study, the investigators determined the total annual charges for the acute care of injuries from interpersonal violence and the shift in financial responsibility for these charges after the Medicaid expansion from the Affordable Care Act in 2014. After Medicaid expansion, taxpayers are now accountable for nearly half of the $10.7 billion in annual charges for the acute care of violent injury in the U.S. The investigators suggest that these findings highlight the benefit to state Medicaid programs of preventing interpersonal violence.
AHRQ-funded; HS000028.
Citation: Coupet E, Karp D, Wiebe DJ .
Shift in U.S. payer responsibility for the acute care of violent injuries after the Affordable Care Act: Implications for prevention.
Am J Emerg Med 2018 Dec;36(12):2192-96. doi: 10.1016/j.ajem.2018.03.070..
Keywords: Domestic Violence, Emergency Department, Healthcare Costs, Policy, Healthcare Cost and Utilization Project (HCUP), Medicaid
Kalogera E, Nelson G
Surgical technical evidence review for gynecologic surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
The objective of this study was to review the enhanced recovery pathways (ERPs) literature in gynecologic surgery (GS) and provide the framework for Improving Surgical Care and Recovery (ISCR) pathway for GS. The investigators concluded that evidence and existing guidelines supported 29 protocol elements for the AHRQ Safety Program for ISCR in GS.
AHRQ-funded; 23337004T.
Citation: Kalogera E, Nelson G .
Surgical technical evidence review for gynecologic surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
Am J Obstet Gynecol 2018 Dec;219(6):563.e1-63.e19. doi: 10.1016/j.ajog.2018.07.014..
Keywords: Evidence-Based Practice, Quality of Care, Patient Safety, Quality Improvement
Shuman CJ, Xie XJ, Herr KA
Sustainability of evidence-based acute pain management practices for hospitalized older adults.
This article reported on the sustainability of evidence-based acute pain management practices in hospitalized older adults following testing of a multifaceted Translating Research Into Practice (TRIP) implementation intervention. Results revealed most evidence-based acute pain management practices were sustained for 18 months following implementation.
AHRQ-funded; HS010482.
Citation: Shuman CJ, Xie XJ, Herr KA .
Sustainability of evidence-based acute pain management practices for hospitalized older adults.
West J Nurs Res 2018 Dec;40(12):1749-64. doi: 10.1177/0193945917738781..
Keywords: Care Management, Elderly, Evidence-Based Practice, Inpatient Care, Pain, Implementation
Williams CN, Piantino J, McEvoy C
The burden of pediatric neurocritical care in the United States.
This article attempts to quantify the burden of pediatric neurocritical care (PNCC) by developing national estimates of disease incidence, evaluating use of critical care interventions (CCI), and examining hospital outcomes. The Kids Inpatient Database (KID) was analyzed to evaluate cohorts with the following conditions: traumatic brain injury, neuro-infection, or inflammatory diseases; status epilepticus; stroke; hypoxic ischemic injury after cardiac arrest; or spinal cord injury.
AHRQ-funded; HS022981.
Citation: Williams CN, Piantino J, McEvoy C .
The burden of pediatric neurocritical care in the United States.
Pediatr Neurol 2018 Dec;89:31-38. doi: 10.1016/j.pediatrneurol.2018.07.013..
Keywords: Children/Adolescents, Critical Care, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Neurological Disorders, Stroke, Trauma
Musci RJ, Kharrazi H, Wilson RF
The study of effect moderation in youth suicide-prevention studies.
A systematic review was conducted focusing on identifying youth suicide-prevention studies within the United States. This paper reports on the methods utilized for understanding possible moderators of suicide-prevention program outcomes. The investigators found that only a small percentage of the reviewed articles assessed moderation effects. They assert that this is a substantial research gap driven by sample size or other limitations which have impeded the identification of intervention effect heterogeneity.
AHRQ-funded; 29020150000XI.
Citation: Musci RJ, Kharrazi H, Wilson RF .
The study of effect moderation in youth suicide-prevention studies.
Soc Psychiatry Psychiatr Epidemiol 2018 Dec;53(12):1303-10. doi: 10.1007/s00127-018-1574-2..
Keywords: Children/Adolescents, Behavioral Health, Prevention
Kim K, Heinze K, Xu J
Theories of health care decision making at the end of life: a meta-ethnography.
The aim of this meta-ethnography was to appraise the types and uses of theories relative to end-of-life decision making and to develop a conceptual framework to describe end-of-life decisionmaking among patients with advanced cancers, heart failure, and amyotrophic lateral sclerosis (ALS), and their caregivers or providers. A conceptual framework was developed using themes including context of decision making, communication and negotiation of decisionmaking, characteristics of decision makers, goals of decision making, options and alternatives, and outcomes.
AHRQ-funded; HS022140.
Citation: Kim K, Heinze K, Xu J .
Theories of health care decision making at the end of life: a meta-ethnography.
West J Nurs Res 2018 Dec;40(12):1861-84. doi: 10.1177/0193945917723010..
Keywords: Caregiving, Communication, Decision Making, Palliative Care
Gray SL, Marcum ZA, Schmader KE
Update on medication use quality and safety in older adults, 2017.
Improving the quality of medication use and medication safety in older adults is an important public health priority and is of paramount importance for clinicians who care for them. In this paper, the investigators selected four important articles (from 2017), that address these issues, to annotate and critique. In addition, they discuss the broader implications for optimizing medication use.
AHRQ-funded; HS023779; HS022982.
Citation: Gray SL, Marcum ZA, Schmader KE .
Update on medication use quality and safety in older adults, 2017.
J Am Geriatr Soc 2018 Dec;66(12):2254-58. doi: 10.1111/jgs.15665..
Keywords: Elderly, Quality of Care, Medication, Medication: Safety, Patient Safety