National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (3)
- Alcohol Use (1)
- Cancer (1)
- Cancer: Breast Cancer (1)
- Cancer: Lung Cancer (1)
- Cardiovascular Conditions (3)
- Children/Adolescents (2)
- Chronic Conditions (2)
- Comparative Effectiveness (5)
- COVID-19 (1)
- (-) Data (30)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Electronic Health Records (EHRs) (5)
- Evidence-Based Practice (2)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (2)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (8)
- Health Insurance (1)
- Health Services Research (HSR) (2)
- Health Systems (1)
- Heart Disease and Health (1)
- Home Healthcare (1)
- Hospitals (2)
- Imaging (1)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (1)
- Learning Health Systems (1)
- Low-Income (1)
- Medical Devices (2)
- Medical Errors (2)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (3)
- Medication (1)
- Neurological Disorders (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (1)
- Patient Safety (4)
- Policy (1)
- Provider (1)
- Provider: Physician (1)
- Public Health (3)
- Quality Improvement (1)
- Quality Indicators (QIs) (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (3)
- Registries (3)
- Research Methodologies (7)
- Sepsis (1)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- Surgery (4)
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 30 Research Studies DisplayedZuvekas SH, Kashihara D
AHRQ Author: Zuvekas SH
The impacts of the COVID-19 pandemic on the Medical Expenditure Panel Survey.
The COVID-19 pandemic caused substantial disruptions in the field operations of all 3 major components of the Medical Expenditure Panel Survey (MEPS). In this study, the investigators described how the MEPS program successfully responded to these challenges by reengineering field operations, including survey modes, to complete data collection and maintain data release schedules.
AHRQ-authored.
Citation: Zuvekas SH, Kashihara D .
The impacts of the COVID-19 pandemic on the Medical Expenditure Panel Survey.
Am J Public Health 2021 Dec;111(12):2157-66. doi: 10.2105/ajph.2021.306534..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Healthcare Costs, Data
Sangal RB, Fodeh S, Taylor A
Identification of patients with nontraumatic intracranial hemorrhage using administrative claims data.
Nontraumatic intracranial hemorrhage (ICH) is a neurological emergency of research interest; however, unlike ischemic stroke, has not been well studied in large datasets due to the lack of an established administrative claims-based definition. In this study, the investigators aimed to evaluate both explicit diagnosis codes and machine learning methods to create a claims-based definition for this clinical phenotype.
AHRQ-funded; HS023554.
Citation: Sangal RB, Fodeh S, Taylor A .
Identification of patients with nontraumatic intracranial hemorrhage using administrative claims data.
J Stroke Cerebrovasc Dis 2020 Dec;29(12):105306. doi: 10.1016/j.jstrokecerebrovasdis.2020.105306..
Keywords: Cardiovascular Conditions, Neurological Disorders, Diagnostic Safety and Quality, Data
Byrd TF, Ahmad FS, Liebovitz DM
Defragmenting heart failure care: medical records integration.
This article discusses the need to improve interoperability of software systems so that so that providers and patients can access clinical information needed to help coordinate care of heart failure patients. New data standards currently being proposed in legislation would make it possible to guide clinical decision-making.
AHRQ-funded; HS026385.
Citation: Byrd TF, Ahmad FS, Liebovitz DM .
Defragmenting heart failure care: medical records integration.
Heart Fail Clin 2020 Oct;16(4):467-77. doi: 10.1016/j.hfc.2020.06.007..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions, Data
Lin JS, Murad MH, Leas B
A narrative review and proposed framework for using health system data with systematic reviews to support decision-making.
This paper addresses when and how the use of health system data might make systematic reviews more useful to decisionmakers. The authors have developed a framework to guide the use of health system data alongside systematic reviews based on a narrative review of the literature and empirical experience. They recommend future methodological work on how best to handle internal and external validity concerns of health system data in the context of systematically reviewed data and work on developing infrastructure to do this type of work.
AHRQ-funded; 290201500007I; 29032001T05; 290201500005I; 290201500009I.
Citation: Lin JS, Murad MH, Leas B .
A narrative review and proposed framework for using health system data with systematic reviews to support decision-making.
J Gen Intern Med 2020 Jun;35(6):1830-35. doi: 10.1007/s11606-020-05783-5..
Keywords: Learning Health Systems, Health Systems, Evidence-Based Practice, Data, Shared Decision Making
Dixon BE, Wen C, French T
Extending an open-source tool to measure data quality: case report on Observational Health Data Science and Informatics (OHDSI).
The authors extended the open-source software Observational Health Data Sciences and Informatics (OHDSI) to incorporate new functions useful for population health. They developed and tested methods to measure the completeness, timeliness and entropy of information; timeliness was not adopted as its context did not fit with the existing OHDSI domains. The case report examined the process and reasons for acceptance and rejection of ideas proposed to an open-source community like OHDSI.
AHRQ-funded; HS025502.
Citation: Dixon BE, Wen C, French T .
Extending an open-source tool to measure data quality: case report on Observational Health Data Science and Informatics (OHDSI).
BMJ Health Care Inform 2020 Mar;27(1). doi: 10.1136/bmjhci-2019-100054..
Keywords: Public Health, Data
Jarrin OF, Nyandege AN, Grafova IB
Validity of race and ethnicity codes in Medicare administrative data compared with gold-standard self-reported race collected during routine home health care visits.
The authors compared the validity of two race/ethnicity variables found in Medicare administrative data against a gold-standard source also available in the Medicare data warehouse. They found that the race/ethnicity variables contained in Medicare administrative data for minority health disparities research can be improved through the use of self-reported race/ethnicity data. They conclude that future work to improve the accuracy of Medicare beneficiaries' race/ethnicity data should incorporate and augment the self-reported race/ethnicity data contained in assessment and survey data, available within the Medicare data warehouse.
AHRQ-funded; HS022406.
Citation: Jarrin OF, Nyandege AN, Grafova IB .
Validity of race and ethnicity codes in Medicare administrative data compared with gold-standard self-reported race collected during routine home health care visits.
Med Care 2020 Jan;58(1):e1-e8. doi: 10.1097/mlr.0000000000001216..
Keywords: Racial and Ethnic Minorities, Home Healthcare, Medicare, Data, Disparities, Research Methodologies
Saldanha IJ, Smith BT, Ntzani E
The Systematic Review Data Repository (SRDR): descriptive characteristics of publicly available data and opportunities for research.
Funded by the US Agency for Healthcare Research and Quality (AHRQ), the Systematic Review Data Repository (SRDR) is a free, web-based, open-source, data management and archival platform for reviews. The objectives of this study were to describe (1) the current extent of usage of SRDR and (2) the characteristics of all projects with publicly available data on the SRDR website.
AHRQ-funded; HHSA290201500002I_HHSA29032012T.
Citation: Saldanha IJ, Smith BT, Ntzani E .
The Systematic Review Data Repository (SRDR): descriptive characteristics of publicly available data and opportunities for research.
Syst Rev 2019 Dec 20;8(1):334. doi: 10.1186/s13643-019-1250-y..
Keywords: Evidence-Based Practice, Data, Research Methodologies, Registries
Boudreaux M, Gangopadhyaya A, Long SK
AHRQ Author: Karaca Z
Using data from the Healthcare Cost and Utilization Project for state health policy research.
Investigators describe the opportunities and challenges of using HCUP data to conduct state health policy research and to provide empirical examples of what can go wrong when using the national HCUP data inappropriately. Analyzing cesarean delivery rates, discharges per capita, and discharges by the payer, they found that state-level estimates are volatile and often provide misleading policy conclusions. They conclude that the Nationwide Inpatient Sample should not be used for state-level research and specified that AHRQ provides resources to assist analysts with state-specific studies using State Inpatient Database files.
AHRQ-authored.
Citation: Boudreaux M, Gangopadhyaya A, Long SK .
Using data from the Healthcare Cost and Utilization Project for state health policy research.
Med Care 2019 Nov;57(11):855-60. doi: 10.1097/mlr.0000000000001196..
Keywords: Healthcare Cost and Utilization Project (HCUP), Policy, Health Services Research (HSR), Healthcare Costs, Data, Research Methodologies
Shen NT, Salajegheh A, Brown RS
A call to standardize definitions, data collection, and outcome assessment to improve care in alcohol-related liver disease.
Alcohol-related liver disease (ALD) is highly prevalent and appears to be increasingly reported with worsening mortality; thus, optimizing care in this patient population is imperative. This requires a multidisciplinary, multifaceted approach that includes recognizing alcohol use disorder (AUD) and existing treatments for AUD. In this paper, the authors call for standardizing definitions, data collection, and outcome assessment to improve care in alcohol-related liver disease.
AHRQ-funded; HS000066.
Citation: Shen NT, Salajegheh A, Brown RS .
A call to standardize definitions, data collection, and outcome assessment to improve care in alcohol-related liver disease.
Hepatology 2019 Sep;70(3):1038-44. doi: 10.1002/hep.30587..
Keywords: Data, Alcohol Use, Outcomes
Bacon E, Budney G, Bondy J
Developing a regional distributed data network for surveillance of chronic health conditions: the Colorado Health Observation Regional Data Service.
This article describes attributes of regional distributed data networks using electronic health records (EHR) data and the history and design of Colorado Health Observation Regional Data Service as an emerging public health surveillance tool for chronic health conditions. The authors indicate that while benefits from EHR-based surveillance are described, a number of technology, partnership, and value proposition challenges remain.
AHRQ-funded; HS0122143.
Citation: Bacon E, Budney G, Bondy J .
Developing a regional distributed data network for surveillance of chronic health conditions: the Colorado Health Observation Regional Data Service.
J Public Health Manag Pract 2019 Sep/Oct;25(5):498-507. doi: 10.1097/phh.0000000000000810..
Keywords: Chronic Conditions, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Public Health
Liu L, Ni Y, Zhang N
Mining patient-specific and contextual data with machine learning technologies to predict cancellation of children's surgery.
The objectives of this study were: 1) to develop predictive models of last-minute surgery cancellation, utilizing machine learning technologies, from patient-specific and contextual data from two distinct pediatric surgical sites of a single institution; and 2) to identify specific key predictors that impact children's risk of day-of-surgery cancellation. The study demonstrated the capacity of machine learning models for predicting pediatric patients at risk of last-minute surgery cancellation and providing useful insight into root causes of cancellation. The author’s approach offers the promise of targeted interventions to significantly decrease both healthcare costs and families' negative experiences.
AHRQ-funded; HS024983.
Citation: Liu L, Ni Y, Zhang N .
Mining patient-specific and contextual data with machine learning technologies to predict cancellation of children's surgery.
Int J Med Inform 2019 Sep;129:234-41. doi: 10.1016/j.ijmedinf.2019.06.007..
Keywords: Children/Adolescents, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery
Wang E, Kang H, Gong Y
Generating a health information technology event database from FDA MAUDE reports.
This study examined using a health information technology (HIT) event database to identify patient safety events (PSEs) or medical errors. The study used the FDA Manufacturer and User Facility Device Experience (MAUDE) database to extract HIT events. Classic and CNN models were utilized on a test set. The model was capable of identifying HIT event with about a 90% accuracy.
AHRQ-funded; HS022895.
Citation: Wang E, Kang H, Gong Y .
Generating a health information technology event database from FDA MAUDE reports.
Stud Health Technol Inform 2019 Aug 21;264:883-87. doi: 10.3233/shti190350..
Keywords: Health Information Technology (HIT), Medical Devices, Adverse Events, Data, Medical Errors, Patient Safety
Yao B, Kang H, Gong Y
Data quality assessment of narrative medication error reports.
This study examined the data quality of patient safety event (PSE) reports that are used to analyze the root causes of PSE. If the data quality is poor then the reporting and root cause analysis (RCA) will also be poor. Incomplete or missing data is the most prevalent problem in these reports. The researchers used an adapted taxonomy to assess the data quality of PSE reports, and extracted sample reports based on eight error types. The extracts were scored by experts. They found that most structured fields were ignored by reporters, but the narrative parts of the reports contained rich and valuable information. The results show that the adapted taxonomy could be a promising tool for report quality assessment and improvement.
AHRQ-funded; HS022895.
Citation: Yao B, Kang H, Gong Y .
Data quality assessment of narrative medication error reports.
Stud Health Technol Inform 2019 Aug 9;265:101-06. doi: 10.3233/shti190146..
Keywords: Adverse Drug Events (ADE), Medication, Medical Errors, Adverse Events, Data, Patient Safety
Polubriaginof FCG, Ryan P, Salmasian H
Challenges with quality of race and ethnicity data in observational databases.
This study assessed the quality of race and ethnicity information in observational health databases as well as electronic health records (EHRs) and to propose patient self-recording as a way to improve accuracy. Data from the Healthcare Cost and Utilization Project (HCUP) and Optum Labs, and from a single New York City healthcare system’s EHR was compared. Among 160 million patients in the HCUP database, no race or ethnicity data was recorded for 25% of the records. Among the 2.4 million patients in the New York City HER, race or ethnicity was unknown for 57%. However, when patients were allowed to directly record their race and ethnicity, percentages rose to 86%.
AHRQ-funded; HS021816; HS023704; HS024713.
Citation: Polubriaginof FCG, Ryan P, Salmasian H .
Challenges with quality of race and ethnicity data in observational databases.
J Am Med Inform Assoc 2019 Aug;26(8-9):730-36. doi: 10.1093/jamia/ocz113..
Keywords: Healthcare Cost and Utilization Project (HCUP), Data, Racial and Ethnic Minorities, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR)
Lewis VA, Joynet Maddox K, Austin AM
Developing and validating a measure to estimate poverty in Medicare administrative data.
The purpose of this study was to develop and validate a measure that estimates individual level poverty in Medicare administrative data that can be used in studies of Medicare claims. The investigators indicate that a poverty score can be calculated using Medicare administrative data for use as a continuous or binary measure and that this measure can improve researchers' ability to identify poverty in Medicare administrative data.
AHRQ-funded; HS024075.
Citation: Lewis VA, Joynet Maddox K, Austin AM .
Developing and validating a measure to estimate poverty in Medicare administrative data.
Med Care 2019 Aug;57(8):601-07. doi: 10.1097/mlr.0000000000001154..
Keywords: Medicare, Data, Low-Income, Research Methodologies
Li X, Fireman BH, Curtis JR
Validity of privacy-protecting analytical methods that use only aggregate-level information to conduct multivariable-adjusted analysis in distributed data networks.
Researchers analyzed the impact of using distributed data networks to conduct large-scale epidemiologic studies on protecting privacy of the subjects. Three aggregate-level data-sharing approaches were tested (risk-set, summary-table, and effect-estimate). Four confounding adjustment methods (matching, stratification, inverse probability matching, and matching weighting) and 2 summary scores (propensity and disease risk) for binary and time-to-event-outcomes were assessed. Risk-set data sharing generally performed better than summary-table and effect-estimate data-sharing which often produced discrepancies in settings with rare outcomes and small sample sizes.
AHRQ-funded; HS026214.
Citation: Li X, Fireman BH, Curtis JR .
Validity of privacy-protecting analytical methods that use only aggregate-level information to conduct multivariable-adjusted analysis in distributed data networks.
Am J Epidemiol 2019 Apr;188(4):709-23. doi: 10.1093/aje/kwy265..
Keywords: Data, Research Methodologies
Tong BC, Kim S, Kosinski A
Penetration, completeness, and representativeness of the Society of Thoracic Surgeons General Thoracic Surgery Database for lobectomy.
Not all surgeons performing lobectomy in the United States report outcomes to The Society of Thoracic Surgeons General Thoracic Surgery Database (STS GTSD). In this study, the investigators examined penetration, completeness, and representativeness of the STS GTSD for lobectomy in the Centers for Medicare and Medicaid Services (CMS) patient population. The investigators concluded that participation in the STS GTSD increased over time, but penetration lagged behind that of the other STS National Databases.
AHRQ-funded; HS022279.
Citation: Tong BC, Kim S, Kosinski A .
Penetration, completeness, and representativeness of the Society of Thoracic Surgeons General Thoracic Surgery Database for lobectomy.
Ann Thorac Surg 2019 Mar;107(3):897-902. doi: 10.1016/j.athoracsur.2018.07.059..
Keywords: Surgery, Cancer: Lung Cancer, Cancer, Data, Provider: Physician, Provider
Lindell RB, Nishisaki A, Weiss SL
Comparison of methods for identification of pediatric severe sepsis and septic shock in the Virtual Pediatric Systems Database.
This study compared the use of Virtual Pediatric Systems with traditional use of International Classification of Diseases, 9th edition (ICD) to identify children with severe sepsis or septic shock in PICU settings. Two different systems were compared “Martin” and “Angus”. Both showed good agreement, but ICD9 identified a smaller more accurate cohort of children. Additional analysis of discrepancies between the reference standard the two virtual systems showed that prospective screening missed 66 patients who were diagnosed with severe sepsis or severe shock. Once they were included in the standard cohort, agreement improved with a positive predictive value of 70%.
AHRQ-funded; HS024511; HS022464.
Citation: Lindell RB, Nishisaki A, Weiss SL .
Comparison of methods for identification of pediatric severe sepsis and septic shock in the Virtual Pediatric Systems Database.
Crit Care Med 2019 Feb;47(2):e129-e35. doi: 10.1097/ccm.0000000000003541..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Data, Sepsis
Hsu YJ, Kosinski AS, Wallace AS
Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study.
The authors assessed the utility of using external databases for quality improvement (QI) evaluations in the context of an innovative QI collaborative aimed to reduce three infections and improve patient safety across the cardiac surgery service line. They compared changes in each outcome between 15 intervention hospitals and 52 propensity score-matched hospitals, and found that improvement trends in several outcomes among the studied intervention hospitals were not statistically different from those in comparison hospitals. They conclude that using external databases may permit comparative effectiveness assessment by providing concurrent comparison groups, additional outcome measures, and longer follow-up.
AHRQ-funded; HS019934.
Citation: Hsu YJ, Kosinski AS, Wallace AS .
Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study.
J Comp Eff Res 2019 Jan;8(1):21-32. doi: 10.2217/cer-2018-0051..
Keywords: Patient Safety, Quality Improvement, Quality Indicators (QIs), Quality of Care, Surgery, Cardiovascular Conditions, Comparative Effectiveness, Data, Hospitals, Research Methodologies, Patient-Centered Outcomes Research
Sumner W, Stwalley DL, Asaro PV
Adding flexible temporal constraints to identify chronic comorbid conditions in ambulatory claims data.
The researchers particularly wanted to increase the temporal flexibility of comorbidity definitions in response to common documentation patterns. They report the development and testing of a chronic disease list with temporal criteria for analyzing outpatient claims data. They concluded that temporal constraints applied to ambulatory claims may improve comorbid condition categorization.
AHRQ-funded; HS019455.
Citation: Sumner W, Stwalley DL, Asaro PV .
Adding flexible temporal constraints to identify chronic comorbid conditions in ambulatory claims data.
AMIA Annu Symp Proc 2014 Nov 14;2014:1088-97..
Keywords: Chronic Conditions, Data, Health Insurance
Angier H, Gold R, Crawford C
Linkage methods for connecting children with parents in electronic health record and state public health insurance data.
The purpose of this study was to develop ways to create child-parent links in two healthcare-related data sources: Oregon clinics sharing an electronic health record (EHR) and Oregon Health Plan’s (OHP) administrative data. To create the child-parent links, researchers used the child’s emergency contact information from the EHR and household identification numbers from the OHP.
AHRQ-funded; HS018569
Citation: Angier H, Gold R, Crawford C .
Linkage methods for connecting children with parents in electronic health record and state public health insurance data.
Matern Child Health J. 2014 Nov;18(9):2025-33. doi: 10.1007/s10995-014-1453-8..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Data
Jalbert JJ, Ritchey ME, Mi X
Methodological considerations in observational comparative effectiveness research for implantable medical devices: an epidemiologic perspective.
This article discusses some of the most salient issues encountered in conducting comparative effectiveness research on implantable devices. Included in this discussion are special methodological considerations regarding the use of data sources, exposure and outcome definitions, timing of exposure, and sources of bias.
AHRQ-funded; 29020050016; HS017731
Citation: Jalbert JJ, Ritchey ME, Mi X .
Methodological considerations in observational comparative effectiveness research for implantable medical devices: an epidemiologic perspective.
Am J Epidemiol. 2014 Nov 1;180(9):949-58. doi: 10.1093/aje/kwu206..
Keywords: Comparative Effectiveness, Research Methodologies, Data
Warren DK, Nickel KB, Wallace AE
Can additional information be obtained from claims data to support surgical site infection diagnosis codes?
The authors sought to confirm a claims algorithm to identify surgical site infections (SSIs) by examining the presence of clinically expected SSI treatment. They found that over 94% of patients identified by their claims algorithm as having an SSI received clinically expected treatment for infection, including antibiotics, surgical treatment, and culture, suggesting that this algorithm has very good positive predictive value. They concluded that their method may facilitate retrospective SSI surveillance and comparison of SSI rates across facilities and providers.
AHRQ-funded; HS019713.
Citation: Warren DK, Nickel KB, Wallace AE .
Can additional information be obtained from claims data to support surgical site infection diagnosis codes?
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S124-32. doi: 10.1086/677830.
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Keywords: Data, Healthcare-Associated Infections (HAIs), Patient Safety, Surgery, Injuries and Wounds, Adverse Events
Gomez SL, Lichtensztajn DY, Parikh P
Hospital practices in the collection of patient race, ethnicity, and language data: a statewide survey, California, 2011.
The authors reported on a sruvey of general acute care hospitals in California to elucidate practices regarding collection and auditing of patient race, ethnicity, and primary spoken language (REL). They found that the majority of hospitals used standardized forms for collection, and 75% audited patient information for completeness. They concluded that California hospitals are collecting information on patient REL as mandated, but variation in data collection exists, and hospitals may benefit from standardized data collection and auditing practices.
AHRQ-funded; HS019963.
Citation: Gomez SL, Lichtensztajn DY, Parikh P .
Hospital practices in the collection of patient race, ethnicity, and language data: a statewide survey, California, 2011.
J Health Care Poor Underserved 2014 Aug;25(3):1384-96. doi: 10.1353/hpu.2014.0126.
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Keywords: Data, Hospitals, Racial and Ethnic Minorities, Social Determinants of Health
Holmes JH, Elliott TE, Brown JS
Clinical research data warehouse governance for distributed research networks in the USA: a systematic review of the literature.
The researchers reviewed the published, peer-reviewed literature on clinical research data warehouse governance in distributed research networks (DRNs). They determined that a peer-reviewed literature on data warehouse governance is emerging but is still sparse. Understanding of DRN data governance policies and procedures is limited but expected to change as more DRN projects disseminate their governance approaches.
AHRQ-funded; HS019912
Citation: Holmes JH, Elliott TE, Brown JS .
Clinical research data warehouse governance for distributed research networks in the USA: a systematic review of the literature.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):730-6. doi: 10.1136/amiajnl-2013-002370..
Keywords: Comparative Effectiveness, Data, Health Information Technology (HIT)