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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 25 of 37 Research Studies DisplayedCallejo-Black A, Wagner DV, Ramanujam K
A systematic review of external validity in pediatric integrated primary care trials.
This study used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to conduct a systematic review of external validity reporting in integrated primary care (IPC) interventions for mental health concerns. A literature search was conducted to identify relevant literature from 1998 to 2018 reporting on open, randomized or quasi-randomized trials of IPC interventions that targeted child (ages 0-18 years) psychological symptoms. The authors included 39 publications describing 25 studies in the review. Publications rarely reported indicators of external validity, including the representatives of participants (12%), rate of adoption clinics or providers (16%), cost of implementation (8%), or evidence of maintenance (16%). Few studies also included key pragmatic factors such as cost or organizational change processes related to implementation and maintenance.
AHRQ-funded; HS022981.
Citation: Callejo-Black A, Wagner DV, Ramanujam K .
A systematic review of external validity in pediatric integrated primary care trials.
J Pediatr Psychol 2020 Oct 1;45(9):1039-52. doi: 10.1093/jpepsy/jsaa068..
Keywords: Children/Adolescents, Primary Care, Behavioral Health, Healthcare Delivery, Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Cuthel A, Rogers E, Daniel F
Barriers and facilitators in the recruitment and retention of more than 250 small independent primary care practices for EvidenceNOW.
This study examined barriers and facilitators in the recruitment and retention of small independent practices (SIPs) to participate in research studies. The authors used qualitative data from the HealthyHearts New York City program, part of the EvidenceNOW initiative. This randomized controlled trial took place from 2015 through 2018 across 5 boroughs in NYC. A total of 257 SIPs (<5 full-time clinicians) were recruited originally. The three main factors that facilitated rapid recruitment were: 1) a prior well-established relationship with the local health department; 2) alignment of project goals with practice priorities, and 3) having appropriate monetary incentives. Specific strategies that enhance recruitment of SIPS and fills gaps in knowledge about factors that influence retention are identified.
AHRQ-funded; HS023922.
Citation: Cuthel A, Rogers E, Daniel F .
Barriers and facilitators in the recruitment and retention of more than 250 small independent primary care practices for EvidenceNOW.
Am J Med Qual 2020 Sep/Oct;35(5):388-96. doi: 10.1177/1062860619893422..
Keywords: Primary Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Landes SJ, Kerns SEU, Pilar MR
Proceedings of the Fifth Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2019: where the rubber meets the road: the intersection of research, policy, and practice - part 1.
This paper offers a compilation of the abstracts of the oral and poster presentations from the 2019 Society for Implementation Research Collaboration (SIRC) Conference entitled “Where the Rubber Meets the Road: The Intersection of Research, Policy, and Practice” held in Seattle from 12-14 September. The society had evolved following a NIMH-funded conference grant and is now an international society. The conference included 432 attendees. Highlights of the conference are described.
AHRQ-funded; HS025632.
Citation: Landes SJ, Kerns SEU, Pilar MR .
Proceedings of the Fifth Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2019: where the rubber meets the road: the intersection of research, policy, and practice - part 1.
Implement Sci 2020 Sep 30;15(Suppl 3):76. doi: 10.1186/s13012-020-01034-7..
Keywords: Implementation, Health Services Research (HSR), Evidence-Based Practice, Policy, Research Methodologies
Riggs K, Richman J, Kertesz S
Trial design for ineffectiveness research: a mixed-methods survey.
High-quality research demonstrating a lack of effectiveness may facilitate the 'de-adoption' of ineffective health services. However, there has been little debate on the optimal design for ineffectiveness research-studies exploring the research hypothesis that an intervention is ineffective. The aim of this study was to explore investigators' preferences for trial design for ineffectiveness research. The investigators conducted a mixed-methods online survey with principle investigators identified from clinicaltrials.gov.
AHRQ-funded; HS023009.
Citation: Riggs K, Richman J, Kertesz S .
Trial design for ineffectiveness research: a mixed-methods survey.
BMJ Evid Based Med 2020 Aug;25(4):143-44. doi: 10.1136/bmjebm-2019-111276..
Keywords: Research Methodologies, Comparative Effectiveness, Evidence-Based Practice
Lin D, Lapen K, Sherer MV
A systematic review of contouring guidelines in radiation oncology: analysis of frequency, methodology, and delivery of consensus recommendations.
Clinical trials have described variation in radiation therapy plan quality, of which contour delineation is a key component, and linked this to inferior patient outcomes. In response, consensus guidelines have been developed to standardize contour delineation. This investigation assessed trends in contouring guidelines and examined the methodologies used to generate and deliver recommendations. The investigators concluded that this review highlighted an increase in consensus contouring recommendations over time.
AHRQ-funded; HS026881.
Citation: Lin D, Lapen K, Sherer MV .
A systematic review of contouring guidelines in radiation oncology: analysis of frequency, methodology, and delivery of consensus recommendations.
Int J Radiat Oncol Biol Phys 2020 Jul 15;107(4):827-35. doi: 10.1016/j.ijrobp.2020.04.011..
Keywords: Guidelines, Evidence-Based Practice, Research Methodologies
Thomas LE, Yang S, Wojdyla D
Matching with time-dependent treatments: a review and look forward.
Observational studies of treatment effects attempt to mimic a randomized experiment by balancing the covariate distribution in treated and control groups, thus removing biases related to measured confounders. In this paper, the authors define a class of longitudinal matching methods and provide a review of existing variations, with guidance regarding study design, execution, and analysis. They identify avenues for future research and highlight the relevance of this methodology to high-quality comparative effectiveness studies in the era of big data.
AHRQ-funded; HS24310.
Citation: Thomas LE, Yang S, Wojdyla D .
Matching with time-dependent treatments: a review and look forward.
Stat Med 2020 Jul;39(17):2350-70. doi: 10.1002/sim.8533..
Keywords: Research Methodologies, Evidence-Based Practice, Comparative Effectiveness
Tsou AY, Treadwell JR, Erinoff E
Machine learning for screening prioritization in systematic reviews: comparative performance of Abstrackr and EPPI-Reviewer.
Improving the speed of systematic review (SR) development is key to supporting evidence-based medicine. Machine learning tools which semi-automate citation screening might improve efficiency. Few studies have assessed use of screening prioritization functionality or compared two tools head to head. In this project, the investigators compared performance of two machine-learning tools for potential use in citation screening.
AHRQ-funded; HS025859.
Citation: Tsou AY, Treadwell JR, Erinoff E .
Machine learning for screening prioritization in systematic reviews: comparative performance of Abstrackr and EPPI-Reviewer.
Syst Rev 2020 Apr 2;9(1):73. doi: 10.1186/s13643-020-01324-7..
Keywords: Health Services Research (HSR), Research Methodologies, Evidence-Based Practice, Patient-Centered Outcomes Research
Krist AH, Barry MJ, Wolff TA
AHRQ Author: Wolff TA, Fan TM
Evolution of the U.S. Preventive Services Task Force's methods.
In this commentary on an article appearing in the same issue, the authors stated that the methods used by the USPSTF deliberately set a high bar for making evidence-based recommendations. They indicated that consumers of preventive service guidelines need to know concretely what is known and unknown and further need confidence that what is being recommended is not influenced by economic or political pressures or by professional opinion with a limited evidence basis.
AHRQ-authored.
Citation: Krist AH, Barry MJ, Wolff TA .
Evolution of the U.S. Preventive Services Task Force's methods.
Am J Prev Med 2020 Mar;58(3):332-35. doi: 10.1016/j.amepre.2019.11.003..
Keywords: U.S. Preventive Services Task Force (USPSTF), Guidelines, Evidence-Based Practice, Prevention, Research Methodologies
Byham-Gray LD, Peters EN, Rothpletz-Puglia P
Patient-centered model for protein-energy wasting: stakeholder deliberative panels.
Integrating the patient's voice into research prioritization is essential for solving problems that patients care the most about in terms of health, symptom management, and survival. In this study, the investigators used deliberative processes for adapting the existing model of protein-energy wasting (PEW) to one that included stakeholder priorities, addressing gaps from the initial concept.
AHRQ-funded; HS023434.
Citation: Byham-Gray LD, Peters EN, Rothpletz-Puglia P .
Patient-centered model for protein-energy wasting: stakeholder deliberative panels.
J Ren Nutr 2020 Mar;30(2):137-44. doi: 10.1053/j.jrn.2019.06.001..
Keywords: Patient-Centered Healthcare, Patient-Centered Outcomes Research, Evidence-Based Practice, Patient and Family Engagement, Research Methodologies
Gaynes BN, Lux L, Gartlehner G
Defining treatment-resistant depression.
The authors conducted a review for the Centers for Medicare & Medicaid Services and AHRQ to clarify how experts and investigators have defined treatment-resistant depression (TRD) and to review systematically how well this definition comports with TRD definitions in clinical trials through July 5, 2019. They found that no consensus definition existed for TRD. While depressive outcomes and clinical global impressions were commonly measured, functional impairment and quality-of-life tools were rarely used. They recommend stronger approaches to designing and conducting TRD research in order to foster better evidence to translate into clearer guidelines for treating patients with TRD.
AHRQ-funded; 290201500011I.
Citation: Gaynes BN, Lux L, Gartlehner G .
Defining treatment-resistant depression.
Depress Anxiety 2020 Feb;37(2):134-45. doi: 10.1002/da.22968..
Keywords: Depression, Behavioral Health, Evidence-Based Practice, Implementation, Research Methodologies
Lin L, Shi L, Chu H
The magnitude of small-study effects in the Cochrane Database of Systematic Reviews: an empirical study of nearly 30 000 meta-analyses.
The authors’ goal was to provide rules of thumb for interpreting measures to quantify small-study effects' magnitude. They used six measures to evaluate small-study effects in 29,932 meta-analyses from the Cochrane Database of Systematic Reviews. They presented the empirical distributions of the six measures and proposed a rough guide to interpret the measures' magnitude. They suggested that their proposed rules of thumb may help evidence users grade the certainty in evidence as impacted by small-study effects.
AHRQ-funded; HS024743.
Citation: Lin L, Shi L, Chu H .
The magnitude of small-study effects in the Cochrane Database of Systematic Reviews: an empirical study of nearly 30 000 meta-analyses.
BMJ Evid Based Med 2020 Feb;25(1):27-32. doi: 10.1136/bmjebm-2019-111191..
Keywords: Research Methodologies, Evidence-Based Practice
Krist AH, Davidson KW, Ngo-Metzger Q
AHRQ Author: Ngo-Metzger Q, Mills J
Social determinants as a preventive service: U.S. Preventive Services Task Force methods considerations for research.
The authors offer a brief review of the social determinants of health that may be germane to the USPSTF, the methods the USPSTF uses to evaluate relevant evidence, and current evidence gaps for social risks. Their road map for research is intended to spark ingenuity and purpose in the next generation of research studies, thereby ensuring that future recommendations to address and prevent social risks in primary care are informed by high-quality evidence.
AHRQ-authored; AHRQ-funded; HS026664.
Citation: Krist AH, Davidson KW, Ngo-Metzger Q .
Social determinants as a preventive service: U.S. Preventive Services Task Force methods considerations for research.
Am J Prev Med 2019 Dec;57(6s1):S6-s12. doi: 10.1016/j.amepre.2019.07.013..
Keywords: U.S. Preventive Services Task Force (USPSTF), Social Determinants of Health, Research Methodologies, Evidence-Based Practice, Prevention
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
Broder-Fingert S, Kuhn J, Sheldrick RC
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol.
Researchers describe a study protocol for a large randomized controlled trial using the Multiphase Optimization Strategy (MOST), a novel framework developed to optimize interventions. They apply this framework to delivery of Family Navigation (FN), an evidence-based care management strategy designed to reduce disparities and improve access to behavioral health services, and test four components related to its implementation. In this paper, they describe how the MOST framework can be used to improve intervention delivery. These methods will be useful for future studies testing intervention delivery strategies and their impact on implementation.
AHRQ-funded; HS022242.
Citation: Broder-Fingert S, Kuhn J, Sheldrick RC .
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol.
Trials 2019 Dec 16;20(1):728. doi: 10.1186/s13063-019-3853-y..
Keywords: Research Methodologies, Health Services Research (HSR), Healthcare Delivery, Behavioral Health, Evidence-Based Practice, Access to Care
Gates A, Guitard S, Pillay J
Performance and usability of machine learning for screening in systematic reviews: a comparative evaluation of three tools.
Researchers explored the performance of three machine learning tools designed to facilitate title and abstract screening in systematic reviews (SRs) when used to eliminate irrelevant records and complement the work of a single reviewer. Using Abstrackr, DistillerSR, and RobotAnalyst, they found that the workload savings afforded in the automated simulation came with increased risk of missing relevant records. Supplementing a single reviewer's decisions with relevance predictions sometimes reduced the proportion missed, but performance varied by tool and SR. They recommend designing tools based on reviewers' self-identified preferences to improve compatibility with present workflows.
AHRQ-funded; 290201500001I.
Citation: Gates A, Guitard S, Pillay J .
Performance and usability of machine learning for screening in systematic reviews: a comparative evaluation of three tools.
Syst Rev 2019 Nov 15;8(1):278. doi: 10.1186/s13643-019-1222-2..
Keywords: Patient-Centered Outcomes Research, Health Services Research (HSR), Research Methodologies, Evidence-Based Practice, Comparative Effectiveness
Gartlehner G, Wagner G, Lux L
Assessing the accuracy of machine-assisted abstract screening with DistillerAI: a user study.
The goal of this project was to conduct a case study to explore a screening approach that temporarily replaces a human screener with a semi-automated screening tool. The authors used DistillerAI as a semi-automated screening tool, and a published comparative effectiveness review served as their reference standard. They found that the accuracy of DistillerAI was not yet adequate to replace a human screener temporarily during abstract screening for systematic reviews.
AHRQ-funded; 290201500011I.
Citation: Gartlehner G, Wagner G, Lux L .
Assessing the accuracy of machine-assisted abstract screening with DistillerAI: a user study.
Syst Rev 2019 Nov 15;8(1):277. doi: 10.1186/s13643-019-1221-3..
Keywords: Patient-Centered Outcomes Research, Health Services Research (HSR), Research Methodologies, Evidence-Based Practice
Wang L, Rouse B, Marks-Anglin A
Rapid network meta-analysis using data from Food and Drug Administration approval packages is feasible but with limitations.
The purpose of this study was to test rapid approaches that use Drugs@FDA (a public database of approved drugs) and ClinicalTrials.gov to identify trials and to compare these two sources with bibliographic databases as an evidence base for a systematic review and network meta-analysis (NMA). The investigators concluded that a rapid NMA approach using data from Drugs@FDA was feasible but had its own limitations. They asserted that reporting of trial design and results can be improved in both the drug approval packages and on ClinicalTrials.gov.
AHRQ-funded; HS024788.
Citation: Wang L, Rouse B, Marks-Anglin A .
Rapid network meta-analysis using data from Food and Drug Administration approval packages is feasible but with limitations.
J Clin Epidemiol 2019 Oct;114:84-94. doi: 10.1016/j.jclinepi.2019.06.010..
Keywords: Medication, Research Methodologies, Evidence-Based Practice
Ivlev I, Vander Ley KJ, Wiedrick J
Training patients to review scientific reports for the Patient-Centered Outcomes Research Institute: an observational study.
This observational study aimed to evaluate the effect of new training for patient peer reviewers of scientific reports for the Patient-Centered Outcomes Research Institute (PCORI). A new online training in peer review was used to help change reviewers’ knowledge and skills and change self-efficacy and attitudes. Reviewers improved their answers to the knowledge questions. Median numbers of answers improved after the training, particularly in questions targeting the specifics of PCORI peer review. It modestly increased reviewers’ confidence in completing a high-quality peer review. Their excitement about providing a review slightly increased. All reviewers were satisfied with the training.
AHRQ-funded; HS026370.
Citation: Ivlev I, Vander Ley KJ, Wiedrick J .
Training patients to review scientific reports for the Patient-Centered Outcomes Research Institute: an observational study.
BMJ Open 2019 Sep;9(9):e028732. doi: 10.1136/bmjopen-2018-028732..
Keywords: Patient-Centered Outcomes Research, Evidence-Based Practice, Research Methodologies, Patient and Family Engagement, Education: Patient and Caregiver, Training
Istl AC, Ruck JM, Morris CD
Call for improved design and reporting in soft tissue sarcoma studies: a systematic review and meta-analysis of chemotherapy and survival outcomes in resectable STS.
Researchers completed a meta-analysis of chemotherapy in localized STS, assessing OS, PFS, and local and distant recurrence. They found no benefit of chemotherapy over locoregional therapy alone for all-comers or site-specific STS. Recommendations to improve outcome reporting and quality indices are suggested.
AHRQ-funded; HS024736.
Citation: Istl AC, Ruck JM, Morris CD .
Call for improved design and reporting in soft tissue sarcoma studies: a systematic review and meta-analysis of chemotherapy and survival outcomes in resectable STS.
J Surg Oncol 2019 Jun;119(7):824-35. doi: 10.1002/jso.25401..
Keywords: Cancer, Treatments, Evidence-Based Practice, Mortality, Outcomes, Research Methodologies
Millar MM, Kinney AY, Camp NJ
Predictors of response outcomes for research recruitment through a central cancer registry: evidence from 17 recruitment efforts for population-based studies.
The authors conducted multivariable mixed-effects logistic regression to identify case and study characteristics associated with making contact with and obtaining cooperation of Utah cancer cases. They found that characteristics associated with lower odds of contact included Hispanic ethnicity, nonwhite race, and younger age at contact. Years since diagnosis was inversely associated with making contact. Increased odds of cooperation were associated with including a questionnaire, postage stamps, and incentives. They concluded that obtaining high response is challenging, but study features identified in this analysis support better results when recruiting through central cancer registries.
AHRQ-funded; HS019356; HS022640.
Citation: Millar MM, Kinney AY, Camp NJ .
Predictors of response outcomes for research recruitment through a central cancer registry: evidence from 17 recruitment efforts for population-based studies.
Am J Epidemiol 2019 May;188(5):928-39. doi: 10.1093/aje/kwz011..
Keywords: Cancer, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Outcomes, Research Methodologies
Wheatley LM, Wood R, Nadeau K
Mind the gaps: clinical trial concepts to address unanswered questions in aeroallergen immunotherapy-an NIAID/AHRQ workshop.
A joint AHRQ and National Institute of Allergy and Infectious Diseases (NIAAD) workshop was held to develop trial concepts that could improve the use and effectiveness of aeroallergen immunotherapy (AAIT). Four different expert groups were formed to propose different study designs. These study designs would create clinical trials of long duration and would need highly characterized patient populations.
AHRQ-funded; 290200710061I.
Citation: Wheatley LM, Wood R, Nadeau K .
Mind the gaps: clinical trial concepts to address unanswered questions in aeroallergen immunotherapy-an NIAID/AHRQ workshop.
J Allergy Clin Immunol 2019 May;143(5):1711-26. doi: 10.1016/j.jaci.2019.01.032..
Keywords: Asthma, Comparative Effectiveness, Evidence-Based Practice, Prevention, Research Methodologies, Respiratory Conditions
Marshall IJ, Marshall R, Wallace BC
Rapid reviews may produce different results to systematic reviews: a meta-epidemiological study.
Researchers analyzed the difference in results between systematic reviews and rapid reviews. They stimulated searching only PubMed, excluding older articles, smaller trials, and using the largest trial only. They examined percentage changes in pooled odds ratios (ORs), statistical significance, and biases between systematic reviews and rapid reviews. A total of 2,512 systematic reviews were included. Using only PubMed had the smallest risk of changed ORs. There were also changes in statistical significance but no evidence of bias. They concluded that rapid reviews can be considered where approximately 10% risk of the primary outcome or by changing greater than 20% could be tolerated.
AHRQ-funded; HS025024.
Citation: Marshall IJ, Marshall R, Wallace BC .
Rapid reviews may produce different results to systematic reviews: a meta-epidemiological study.
J Clin Epidemiol 2019 May;109:30-41. doi: 10.1016/j.jclinepi.2018.12.015..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Natafgi N, Tafari AT, Chauhan C
Patients' early engagement in research proposal development (PEER-PD): patients guiding the proposal writing.
Patient engagement often starts after research funding is secured with little or no involvement of patients in the proposal development phase. This paper compared three levels of patient engagement and described patients' early engagement in the research proposal development process and its contemporary relevance to clinical and translational research. The paper also addressed key patient considerations and questions that had an impact on the proposal development.
AHRQ-funded; HS022135.
Citation: Natafgi N, Tafari AT, Chauhan C .
Patients' early engagement in research proposal development (PEER-PD): patients guiding the proposal writing.
J Comp Eff Res 2019 Apr;8(6):441-53. doi: 10.2217/cer-2018-0129..
Keywords: Research Methodologies, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Cherla DV, Viso CP, Holihan JL
The effect of financial conflict of interest, disclosure status, and relevance on medical research from the United States.
The aim of this study was to determine if authors who fail to disclose reportable conflicts of interest (COI) are more likely to publish findings that are favorable to industry than authors with no COI. The investigators found that all financial COIs (disclosed or undisclosed, relevant or not relevant, research or non-research) influence whether studies report findings favorable to industry sponsors.
AHRQ-funded; HS023009.
Citation: Cherla DV, Viso CP, Holihan JL .
The effect of financial conflict of interest, disclosure status, and relevance on medical research from the United States.
J Gen Intern Med 2019 Mar;34(3):429-34. doi: 10.1007/s11606-018-4784-0..
Keywords: Evidence-Based Practice, Research Methodologies
Gartlehner G, Nussbaumer-Streit B, Wagner G
Increased risks for random errors are common in outcomes graded as high certainty of evidence.
The goal of this article was to assess the risk for random errors in outcomes graded as high certainty of evidence (CoE). Results showed that, overall, 38% of high CoE outcomes had increased risks for random errors. Outcomes assessing harms were more frequently affected than outcomes assessing benefits. Regrading of outcomes with increased random errors showed that 74% should have been downgraded based on current guidance. Recommendations included being aware that outcomes rated as high CoE often have increased risks for false-positive or false-negative findings.
AHRQ-funded; HS024749.
Citation: Gartlehner G, Nussbaumer-Streit B, Wagner G .
Increased risks for random errors are common in outcomes graded as high certainty of evidence.
J Clin Epidemiol 2019 Feb;106:50-59. doi: 10.1016/j.jclinepi.2018.10.009..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies