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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
126 to 150 of 2151 Research Studies DisplayedWong J, Horwitz MM, Zhou L
Using machine learning to identify health outcomes from electronic health record data.
In this review, the authors discuss four common scenarios that researchers may find helpful for thinking critically about when and for what tasks machine learning may be used to identify health outcomes from electronic health record (EHR) data. The authors suggest that machine learning has great potential to improve the accuracy and efficiency of health outcome identification from EHR systems, especially under certain conditions.
AHRQ-funded; HS022728; HS024264; HS025375.
Citation: Wong J, Horwitz MM, Zhou L .
Using machine learning to identify health outcomes from electronic health record data.
Curr Epidemiol Rep 2018 Dec;5(4):331-42. doi: 10.1007/s40471-018-0165-9..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes
Van Domelen DR, Mitchell EM, Perkins NJ
AHRQ Author: Mitchell EM
Logistic regression with a continuous exposure measured in pools and subject to errors.
A logistic regression model for poolwise data is available, but validity requires that the assay yields the precise mean exposure for members of each pool. To account for errors, the authors assume the assay returns the true mean exposure plus a measurement error (ME) and/or a processing error (PE). They describe their process in this paper.
AHRQ-authored.
Citation: Van Domelen DR, Mitchell EM, Perkins NJ .
Logistic regression with a continuous exposure measured in pools and subject to errors.
Stat Med 2018 Nov 30;37(27):4007-21. doi: 10.1002/sim.7891.
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Keywords: Health Services Research (HSR)
Chudy-Onwugaje K, Abutaleb A, Buchwald A
Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease.
This study researched the association between age and increased depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease (IBD). It was found that patients 40 and older had worse adherence than patients younger than 40 with depressive symptoms.
AHRQ-funded; HS018975.
Citation: Chudy-Onwugaje K, Abutaleb A, Buchwald A .
Age modifies the association between depressive symptoms and adherence to self-testing with telemedicine in patients with inflammatory bowel disease.
Inflamm Bowel Dis 2018 Nov 29;24(12):2648-54. doi: 10.1093/ibd/izy194..
Keywords: Chronic Conditions, Depression, Digestive Disease and Health, Patient Adherence/Compliance, Patient Self-Management, Telehealth
Ross JS, Waldstreicher J, Bamford S
Overview and experience of the YODA Project with clinical trial data sharing after 5 years.
This article provides an overview of the Yale University Open Data Access (YODA) Project, which has facilitated access to clinical trial data since 2013. The Project’s key decisions to establish data sharing policies are described, and the authors suggest how their experience and the experiences of their data-generator partners can be used to enhance other ongoing or future initiatives.
AHRQ-funded; HS022882; HS025164.
Citation: Ross JS, Waldstreicher J, Bamford S .
Overview and experience of the YODA Project with clinical trial data sharing after 5 years.
Sci Data 2018 Nov 27;5:180268. doi: 10.1038/sdata.2018.268..
Keywords: Data, Research Methodologies
Francis BA, Beaumont J, Mass MB
Depressive symptom prevalence after intracerebral hemorrhage: a multi-center study.
In this multi-center study, the investigators examined depressive symptom prevalence after intracerebral hemorrhage. The investigators concluded that depressive symptoms in patients with intracerebral hemorrhage (ICH) are more common than medication treatment or a coded diagnosis in a multi-center cohort, and are a potential opportunity for additional treatment to improve outcomes. There are currently no AHA/ASA treatment guidelines for depression screening of patients with ICH.
AHRQ-funded; HS023437; HS000078.
Citation: Francis BA, Beaumont J, Mass MB .
Depressive symptom prevalence after intracerebral hemorrhage: a multi-center study.
J Patient Rep Outcomes 2018 Nov 23;2(1):55. doi: 10.1186/s41687-018-0083-0..
Keywords: Depression, Patient-Centered Outcomes Research, Quality of Life
Grout RW, Thompson-Fleming R, Carroll AE
Prevalence of pain reports in pediatric primary care and association with demographics, body mass index, and exam findings: a cross-sectional study.
The objective of this study was to determine the rate of positive pain screenings in pediatric primary care and evaluate the relationship between reported pain and obesity, demographics, and exam findings during routine pediatric encounters. The investigators concluded that pain is common in general pediatric encounters, and occurs more frequently in obese children and those who previously reported pain. Pain reporting may be influenced by seasonal variation and clinic factors.
AHRQ-funded; HS020640; HS018453; HS017939.
Citation: Grout RW, Thompson-Fleming R, Carroll AE .
Prevalence of pain reports in pediatric primary care and association with demographics, body mass index, and exam findings: a cross-sectional study.
BMC Pediatr 2018 Nov 21;18(1):363. doi: 10.1186/s12887-018-1335-0..
Keywords: Children/Adolescents, Obesity, Pain, Children/Adolescents, Primary Care
Renfro T, Johnson E, Lambert DN
The MEDIA model: an innovative method for digitizing and training community members to facilitate an HIV prevention intervention.
This article describes an effort to train lay community members within predominantly Black churches in Atlanta, GA, to implement an HIV-prevention intervention using digital media. Lay educators were trained by translating a face-to-face Training of Facilitators (TOF) to a digital platform using the MEDIA (Motivate-Engage-Digitize-Implement-Assess) model. The research team worked with topical experts and a production company to develop storyboards for core curriculum activities, which were scripted and filmed. A user guide, toolkit, and program website were also developed as supplemental materials to accompany the video training. The article concludes that creating digital media can be a time-consuming process, that pilot testing in the new format is necessary even for previously tested interventions, and that the structure provided by facilitators in face-to-face training must be embedded within the format of the digitized trainings.
AHRQ-funded; HS022059.
Citation: Renfro T, Johnson E, Lambert DN .
The MEDIA model: an innovative method for digitizing and training community members to facilitate an HIV prevention intervention.
Transl Behav Med 2018 Nov 21;8(6):815-23. doi: 10.1093/tbm/iby012..
Keywords: Health Promotion, Human Immunodeficiency Virus (HIV), Prevention, Racial and Ethnic Minorities, Women
Liu L, Zheng C, Kang J
Exploring causality mechanism in the joint analysis of longitudinal and survival data.
In this paper, the authors examine and compare different models of longitudinal and survival data to investigate causal mechanisms, specifically, those related to the role of random effects. They illustrate the methods by data from two clinical trials: an AIDS study and a liver cirrhosis study.
AHRQ-funded; HS020263.
Citation: Liu L, Zheng C, Kang J .
Exploring causality mechanism in the joint analysis of longitudinal and survival data.
Stat Med 2018 Nov 20;37(26):3733-44. doi: 10.1002/sim.7838.
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Keywords: Research Methodologies
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
Rodriguez HP, Friedberg MW, Vargas-Bustamante A
The impact of integrating medical assistants and community health workers on diabetes care management in community health centers.
The purpose of this study was to compare the impact of implementing team-based diabetes care management involving community health workers (CHWs) vs. medical assistants (MA) in community health centers (CHCs) on diabetes care processes, intermediate outcomes, and patients' experiences of chronic care. The investigators found that diabetes care improved in CHCs integrating CHWs and MAs onto primary care teams, but the improvements were no different than improvements observed among matched control group patients.
AHRQ-funded; HS02012001.
Citation: Rodriguez HP, Friedberg MW, Vargas-Bustamante A .
The impact of integrating medical assistants and community health workers on diabetes care management in community health centers.
BMC Health Serv Res 2018 Nov 20;18(1):875. doi: 10.1186/s12913-018-3710-9..
Keywords: Community-Based Practice, Diabetes, Healthcare Delivery, Teams
Wickwire EM, Schnyer DM, Germain A
Sleep, sleep disorders, and circadian health following mild traumatic brain injury in adults: review and research agenda.
A rapidly expanding scientific literature supports the frequent co-occurrence of sleep and circadian disturbances following mild traumatic brain injury (mTBI). In this paper, the authors review relevant literature and present a research agenda to 1) advance understanding of the reciprocal relationships between sleep and circadian factors and mTBI sequelae and 2) advance rapidly the development of sleep-related treatments in this population.
AHRQ-funded; HS024560.
Citation: Wickwire EM, Schnyer DM, Germain A .
Sleep, sleep disorders, and circadian health following mild traumatic brain injury in adults: review and research agenda.
J Neurotrauma 2018 Nov 15;35(22):2615-31. doi: 10.1089/neu.2017.5243..
Keywords: Sleep Problems, Brain Injury, Evidence-Based Practice
Fan T, Duffy M
Screening for osteoporosis to prevent fractures.
This case study provides case questions and answers related to the U.S. Preventive Services Task Force recommendations on screening for osteoporosis to prevent fractures. It is part of the “Putting Prevention into Practice” series.
AHRQ-authored.
Citation: Fan T, Duffy M .
Screening for osteoporosis to prevent fractures.
Am Fam Physician 2018 Nov 15;98(10):593-94..
Keywords: Case Study, Injuries and Wounds, Osteoporosis, Prevention, Screening
Silbverberg JI, Kantor RW, Dalal P
A comprehensive conceptual model of the experience of chronic itch in adults.
This study sought to develop a comprehensive conceptual model of itch to improve the understanding of itch for clinicians and to serve as a framework for development of efficient and valid patient-reported outcome measures (PROMs) of itch. The study’s conceptual model demonstrated the profound patient-burden of itch and identified unmet needs in the evaluation and management of itch.
AHRQ-funded; HS023011.
Citation: Silbverberg JI, Kantor RW, Dalal P .
A comprehensive conceptual model of the experience of chronic itch in adults.
Am J Clin Dermatol 2018 Oct;19(5):759-69. doi: 10.1007/s40257-018-0381-6..
Keywords: Chronic Conditions, Patient Experience
Spatz ES
Fostering a culture to support surgical outcome measures.
This editorial comments on the relationship of surgical skills (referring to the gentleness, tissue exposure, instrument handling, time and motion, and flow of operation) and patient outcomes
AHRQ-funded; HS023000.
Citation: Spatz ES .
Fostering a culture to support surgical outcome measures.
Circ Cardiovasc Qual Outcomes 2016 Jul;9(4):345-7. doi: 10.1161/circoutcomes.116.003038.
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Keywords: Outcomes, Provider Performance, Quality Measures, Surgery
Huckfeldt P, Escarce J, Wilcock A
HF mortality trends under Medicare readmissions reduction program at penalized and nonpenalized hospitals.
After announcement and implementation of the Medicare Hospital Readmissions Reduction Program (HRRP), 30-day readmissions declined rapidly among seniors with heart failure (HF) while 30-day mortality rose. This raised questions about whether the policy was responsible, because lower HF readmission rates have historically been associated with higher mortality. In this study, the investigators compared trends in heart failure (HF) mortality at penalized and nonpenalized hospitals nationally.
AHRQ-funded; HS024284.
Citation: Huckfeldt P, Escarce J, Wilcock A .
HF mortality trends under Medicare readmissions reduction program at penalized and nonpenalized hospitals.
J Am Coll Cardiol 2018 Nov 13;72(20):2539-40. doi: 10.1016/j.jacc.2018.08.2174..
Keywords: Mortality, Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Medicare, Hospitals, Provider Performance, Payment
Kwa MC, Silverberg JI, Ardalan K
Inpatient burden of juvenile dermatomyositis among children in the United States.
The purpose of this study was to determine the prevalence and risk factors for hospitalization with juvenile dermatomyositis and assess inpatient burden of juvenile dermatomyositis (JDM). The study authors found that JDM contributes to both increased length of hospitalization and inpatient cost of care. Non-Medicaid government insurance was associated with higher rates of hospitalization for JDM while Hispanic and other non-white racial/ethnic groups demonstrated increased length of stay and cost of care.
AHRQ-funded; HS023011.
Citation: Kwa MC, Silverberg JI, Ardalan K .
Inpatient burden of juvenile dermatomyositis among children in the United States.
Pediatr Rheumatol Online J 2018 Nov 13;16(1):70. doi: 10.1186/s12969-018-0286-1..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Skin Conditions
Bartsch SM, Taitel MS, DePasse JV
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
During an influenza epidemic, where early vaccination is crucial, pharmacies may be a resource to increase vaccine distribution reach and capacity. In this paper, the investigators utilized an agent-based model of the US and a clinical and economics outcomes model to simulate the impact of different influenza epidemics and the impact of utilizing pharmacies in addition to traditional (hospitals, clinic/physician offices, and urgent care centers) locations for vaccination for the year 2017.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Taitel MS, DePasse JV .
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
Vaccine 2018 Nov 12;36(46):7054-63. doi: 10.1016/j.vaccine.2018.09.040..
Keywords: Healthcare Costs, Influenza, Provider: Pharmacist, Public Health, Vaccination
McConeghy KW, Lee Y, Zullo AR
Influenza illness and hip fracture hospitalizations in nursing home residents: are they related?
In this retrospective cohort study, the investigators evaluated the association between influenza and hip fracture hospitalizations in long-stay (LS) nursing home (NH) residents. The study authors found that influenza like illness (ILI) hospitalizations were associated with a 13% average increase in hip fracture hospitalization risk. In a given NH week, an increase in the number ILI hospitalizations from none to two was associated with an approximate one percentage point increase in hip fracture hospitalization risk.
AHRQ-funded; HS022998.
Citation: McConeghy KW, Lee Y, Zullo AR .
Influenza illness and hip fracture hospitalizations in nursing home residents: are they related?
J Gerontol A Biol Sci Med Sci 2018 Nov 10;73(12):1638-42. doi: 10.1093/gerona/glx200..
Keywords: Elderly, Injuries and Wounds, Hospitalization, Influenza, Long-Term Care, Nursing Homes
Oates GR, Hamby BW, Bae S
Bikeshare use in urban communities: individual and neighborhood factors.
This study examined factors associated with bikeshare use in a metropolitan area in the southern United States. The study found that higher neighborhood socioeconomic disadvantage was associated with higher bikeshare use. Bikeshare was a viable transportation option in low-resource neighborhoods and may be an effective tool to improve the connectivity, livability, and health of urban communities.
AHRQ-funded; HS023009.
Citation: Oates GR, Hamby BW, Bae S .
Bikeshare use in urban communities: individual and neighborhood factors.
Ethn Dis 2017 Nov 9;27(Suppl 1):303-12. doi: 10.18865/ed.27.S1.303..
Keywords: Health Status, Social Determinants of Health, Urban Health
Leroy G, Gu Y, Pettygrove S
Automated extraction of diagnostic criteria from electronic health records for autism spectrum disorders: development, evaluation, and application.
The objective of this study was to automatically extract from EHRs the description of behaviors noted by the clinicians in evidence of the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The investigators concluded that their results demonstrated that natural language processing can support large-scale analysis useful for autism spectrum disorder surveillance and research.
AHRQ-funded; HS024988.
Citation: Leroy G, Gu Y, Pettygrove S .
Automated extraction of diagnostic criteria from electronic health records for autism spectrum disorders: development, evaluation, and application.
J Med Internet Res 2018 Nov 7;20(11):e10497. doi: 10.2196/10497..
Keywords: Autism, Electronic Health Records (EHRs)
Amin AP, Miller S, Rahn B
Reversing the "risk-treatment paradox" of bleeding in patients undergoing percutaneous coronary intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs.
Bleeding avoidance strategies (BAS) are effective, but are paradoxically used less often with patients at high risk of bleeding. This article describes the implementation of an intervention in a St. Louis, MO, hospital intended to reverse the bleeding risk-treatment paradox. Temporal trends in BAS use and the association of risk-concordant BAS use with bleeding as well as hospital costs of percutaneous coronary intervention were examined. Patient-centered care that aimed directly toward making treatment-related decisions based on predicted risk of bleeding led to a more risk-concordant use of BAS and a reversal of the risk-treatment paradox. The authors conclude that larger multicentered studies will be needed to corroborate these results.
AHRQ-funded; HS022481.
Citation: Amin AP, Miller S, Rahn B .
Reversing the "risk-treatment paradox" of bleeding in patients undergoing percutaneous coronary intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs.
J Am Heart Assoc 2018 Nov 6;7(21):e008551. doi: 10.1161/jaha.118.008551..
Keywords: Adverse Events, Patient Safety, Heart Disease and Health, Risk, Surgery, Cardiovascular Conditions, Healthcare Costs
Bartsch SM, Avelis CM, Asti L
The economic value of identifying and treating Chagas disease patients earlier and the impact on Trypanosoma cruzi transmission.
Researchers evaluated the economic value of identifying and treatment Chagas disease patients as early as possible. Chagas disease is a parasitic disease which effects many people around the world. Investigators went to a village in Yucatan, Mexico with a population of 2,000 and evaluated impact and economic outcomes of identifying and treating patients in acute and indeterminate states of the disease. They estimated the number of acute cases averted, the number of chronic cases, disability-adjusted life years (DALYs), and savings from the cost of treating more advanced stages of the disease.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Avelis CM, Asti L .
The economic value of identifying and treating Chagas disease patients earlier and the impact on Trypanosoma cruzi transmission.
PLoS Negl Trop Dis 2018 Nov 5;12(11):e0006809. doi: 10.1371/journal.pntd.0006809..
Keywords: Healthcare Costs, Infectious Diseases, Prevention
Wheeler KK, Shi J, Xiang H
US pediatric trauma patient unplanned 30-day readmissions.
This study sought to determine readmission rates and risk factors for acutely injured pediatric trauma patients. The study found that overall, the readmission rate for pediatric trauma patients was low. Measures of injury severity, specifically length of stay, were most useful in identifying those who would benefit from targeted care coordination resources.
AHRQ-funded; HS024263.
Citation: Wheeler KK, Shi J, Xiang H .
US pediatric trauma patient unplanned 30-day readmissions.
J Pediatr Surg 2018 Apr;53(4):765-70. doi: 10.1016/j.jpedsurg.2017.08.003..
Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Children/Adolescents, Trauma
Rolnick JA, Ryskina KL
The use of individual provider performance reports by US Hospitals.
In this study, the investigators examined overall trends in how hospitals use the electronic health record to track and provide feedback on provider performance. They used data from 2013 to 2015 from the American Hospital Association (AHA) Annual Survey Information Technology Supplement, which asked hospitals if they have used electronic data to create performance profiles. They linked these data to AHA Annual Survey responses for all general adult and pediatric hospitals and used Multivariable logistic regression to model the odds of use as a function of hospital characteristics.
AHRQ-funded; HS022198.
Citation: Rolnick JA, Ryskina KL .
The use of individual provider performance reports by US Hospitals.
J Hosp Med 2018 Aug;13(8):562-65. doi: 10.12788/jhm.2922..
Keywords: Provider Performance, Quality of Care, Provider, Hospitals, Electronic Health Records (EHRs), Health Information Technology (HIT)
Latulipe C, Quandt SA, Melius KA
Insights into older adult patient concerns around the caregiver proxy portal use: qualitative interview study.
The objective of this study was to examine how older adult patients perceive the benefits and risks of proxy patient portal access by their caregivers. The investigators concluded that patients shared their electronic patient portal credentials with caregivers to receive the benefits of those caregivers having access to important medical information but were unaware of all the information those caregivers could access. They suggest that better portal design could alleviate these unwanted information disclosures.
AHRQ-funded; HS021679.
Citation: Latulipe C, Quandt SA, Melius KA .
Insights into older adult patient concerns around the caregiver proxy portal use: qualitative interview study.
J Med Internet Res 2018 Nov 2;20(11):e10524. doi: 10.2196/10524..
Keywords: Electronic Health Records (EHRs), Elderly, Health Information Technology (HIT), Caregiving