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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 22 of 22 Research Studies DisplayedIngraham NE, King S, Proper J
Morbidity and mortality trends of pancreatitis: an observational study.
The authors assessed temporal trends of incidence, complications, management, and outcomes for acute pancreatitis in hospitalized patients at the national level. Using HCUP data, they found that the incidence of pancreatitis, from 2008 to 2015, has increased whereas inpatient mortality has decreased.
AHRQ-funded; HS026732.
Citation: Ingraham NE, King S, Proper J .
Morbidity and mortality trends of pancreatitis: an observational study.
Surg Infect 2021 Dec;22(10):1021-30. doi: 10.1089/sur.2020.473..
Keywords: Healthcare Cost and Utilization Project (HCUP), Digestive Disease and Health, Mortality
Bajaj JS, Shamsaddini A, Acharya C
Multiple bacterial virulence factors focused on adherence and biofilm formation associate with outcomes in cirrhosis.
This study’s goal was to define the association of bacterial virulence factors (VFs) with cirrhosis severity and infections, their linkage with outcomes, and impact of fecal microbiota transplant (FMT). This case-control study followed 233 subjects (40 controls, 43 compensated, 30 HE-only (hepatic encephalopathy), 20 ascites-only, 70 both, and 30 infected. Stool samples were collected before and after a 90-day FMT trial. Bacterial species and VFs for all species and selected pathogens (Escherichia, Klebsiella, Pseudomonas, Staphylococcus, Streptococcus, and Enterococcus species) were compared between groups. Decompensated patients, especially those with infections, had higher VFs coding versus the rest. Biofilm and adhesion VFs from Enterobacteriaceae and Enterococcus species were associated with death and hospitalizations independent of clinical factors regardless of when all VFs or selected pathogens were analyzed. FMT was associated with reduced VF post-FMT versus pre-FMT and post-placebo.
AHRQ-funded; HS025412.
Citation: Bajaj JS, Shamsaddini A, Acharya C .
Multiple bacterial virulence factors focused on adherence and biofilm formation associate with outcomes in cirrhosis.
Gut Microbes 2021 Jan-Dec;13(1):1993584. doi: 10.1080/19490976.2021.1993584..
Keywords: Digestive Disease and Health
Bajaj JS, Shamsaddini A, Fagan A
Distinct gut microbial compositional and functional changes associated with impaired inhibitory control in patients with cirrhosis.
The authors sought to assess the impact of inhibitory control versus traditional cirrhosis-related cognitive performance on gut microbial composition and function. They found that the gut microbial signature of impaired inhibitory control, which is associated with addictive disorders that can lead to cirrhosis, is distinct from cirrhosis-related cognitive impairment.
AHRQ-funded; HS025412.
Citation: Bajaj JS, Shamsaddini A, Fagan A .
Distinct gut microbial compositional and functional changes associated with impaired inhibitory control in patients with cirrhosis.
Gut Microbes 2021 Jan-Dec;13(1):1953247. doi: 10.1080/19490976.2021.1953247..
Keywords: Digestive Disease and Health
Lumpkin ST, Harvey E, Mihas P
Understanding patients' decisions to obtain unplanned, high-resource health care after colorectal surgery.
Researchers investigated effective strategies to reduce unplanned post-discharge health care visits following colorectal surgery (CRS). They found that interview participants voiced clear mental algorithms about when to visit an emergency department, identified facilitators and barriers to optimal health care use, and identified tangible targets for health care utilization reduction efforts. The researchers concluded that efforts should be directed at improving post-discharge communication and care coordination in order to reduce CRS patients' high-resource health care utilization.
AHRQ-funded; HS026363.
Citation: Lumpkin ST, Harvey E, Mihas P .
Understanding patients' decisions to obtain unplanned, high-resource health care after colorectal surgery.
Qual Health Res 2021 Jul;31(9):1582-95. doi: 10.1177/10497323211002479..
Keywords: Shared Decision Making, Digestive Disease and Health, Surgery
Dos Santos Marques IC, Theiss LM, Wood LN
Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease.
The authors hypothesized that racial disparities exist for Hispanic and Asian patients undergoing surgery for inflammatory bowel disease (IBD). Data from the American College of Surgeons National Surgical Quality Improvement Program (ACS- NSQIP) was used. They found that racial disparities do exist among IBD patients undergoing surgery. Black, Hispanic, and Asian IBD patients experience major disparities in post-operative complications, readmissions, and length of stay, respectively, when compared to White patients with IBD. They recommended future research to better understand the mechanisms of these disparities including evaluation of social determinants of health.
AHRQ-funded; HS023009.
Citation: Dos Santos Marques IC, Theiss LM, Wood LN .
Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease.
Am J Surg 2021 Apr;221(4):668-74. doi: 10.1016/j.amjsurg.2020.12.010..
Keywords: Disparities, Racial and Ethnic Minorities, Surgery, Digestive Disease and Health, Outcomes
Shah SC, Zhu X, Dai Q
Magnesium intake is associated with a reduced risk of incident liver cancer, based on an analysis of the NIH-American Association of Retired Persons (NIH-AARP) Diet and Health Study prospective cohort.
Liver cancer incidence and mortality are escalating globally. Magnesium intake has been studied extensively in nonmalignant liver pathology, but the association between dietary intake of magnesium and primary liver malignancy has not been previously evaluated. In this study, investigators aimed to determine the association between total magnesium intake and primary liver cancer risk. The investigators concluded that based on their prospective cohort analysis, magnesium intake was associated with a lower risk of primary liver cancer, which was more pronounced among moderate and heavy alcohol users.
AHRQ-funded; HS026395.
Citation: Shah SC, Zhu X, Dai Q .
Magnesium intake is associated with a reduced risk of incident liver cancer, based on an analysis of the NIH-American Association of Retired Persons (NIH-AARP) Diet and Health Study prospective cohort.
Am J Clin Nutr 2021 Mar 11;113(3):630-38. doi: 10.1093/ajcn/nqaa326..
Keywords: Cancer, Risk, Digestive Disease and Health, Prevention
Fischer CP, Knapp L, Cohen ME
Feasibility of enhanced recovery in emergency colorectal operation.
This study examines the feasibility of using enhanced recovery pathways (ERPs) in emergency colorectal operations. It has been successfully used with elective surgical care but has not been examined for emergency procedures. A total of 31,511 patients who underwent colorectal operations at 235 hospitals were identified from a national ERP collaborative. Most were elective surgeries (28,425), with 3,086 emergencies. For emergency cases, rates of early Foley removal and venous thromboembolism prophylaxis were highest. Rates of multimodal pain control, early mobilization, and early liquid intake were modest. Patients younger than age 65 years, those with independent functional status, American Society of Anesthesiologists Physical Status Classification 1 to 3, and without physiologic derangement had the most nonadherence. Lack of mobilization or liquid intake was independently associated with increased odds of ileus and prolonged length of stay.
AHRQ-funded; 233201500020I.
Citation: Fischer CP, Knapp L, Cohen ME .
Feasibility of enhanced recovery in emergency colorectal operation.
J Am Coll Surg 2021 Feb;232(2):178-85. doi: 10.1016/j.jamcollsurg.2020.10.004..
Keywords: Surgery, Digestive Disease and Health, Emergency Department, Patient-Centered Outcomes Research, Outcomes
Diaz A, Ricci KB, Rushing AP
Re-examining "never letting the sun rise or set on a bowel obstruction" in the era of acute care surgery.
This study looked at factors linked to emergency surgery practices for small bowel obstruction (SBO) as opposed to non-operative treatment. Data from adult SBO patients from 17 Statewide Inpatient Databases (SIDS) was linked to the authors’ 2015 survey on emergency general surgery (EGS) practices including queries on operating room (OR) availability and surgical staffing. Of the 32,422 SBO patients identified, 83% were treated non-operatively. Operative patients tended to be older, had more comorbidities (53% vs. 46% with 3 or greater), and experienced more systemic complications (36% vs. 23%), higher mortality (2.8% vs. 1.4%), and longer length of stay (median 10 vs. 4 days). Patients had higher odds of operation if they were treated at hospitals with surgeons sometimes or rarely/never covering EGS at more than one location compared to always.
AHRQ-funded; HS022694.
Citation: Diaz A, Ricci KB, Rushing AP .
Re-examining "never letting the sun rise or set on a bowel obstruction" in the era of acute care surgery.
J Gastrointest Surg 2021 Feb;25(2):512-22. doi: 10.1007/s11605-019-04496-3..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Digestive Disease and Health
Lumpkin ST, Mihas P, Baldwin X
Surgical patient values frame and modify the impact of risk factors for non-routine postdischarge care: a mixed-methods study.
This mixed methods study looked at patient perspectives on risk factors of non-routine postdischarge care (emergency department visit or rehospitalization) for adult colorectal surgery patients. Surgery patients were identified from hospital records from 2017 to 2018. The authors enrolled 258 participants, surveyed 167, and interviewed 18. Depressive symptoms were found to be one of the many risk factors confirmed to increase non-routine health utilization.
AHRQ-funded; HS026363.
Citation: Lumpkin ST, Mihas P, Baldwin X .
Surgical patient values frame and modify the impact of risk factors for non-routine postdischarge care: a mixed-methods study.
Am J Surg 2021 Jan;221(1):195-203. doi: 10.1016/j.amjsurg.2020.05.016..
Keywords: Digestive Disease and Health, Surgery, Risk, Hospital Readmissions, Emergency Department
Strassle PD, Kinlaw AC, Chaumont N
Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change.
Gastroenterology 2019 Dec;157(6):1679-81.e11. doi: 10.1053/j.gastro.2019.08.045.
The purpose of this retrospective cohort study was to assess whether trends in elective and urgent/emergent colectomy changed after July 2006. The authors suggest that given the risks associated with elective colectomy, their findings demonstrate the need for a more evidence-based decision-making process, incorporating both patient preferences and patient-reported outcomes, for those considering elective colectomy for uncomplicated and some cases of complicated diverticulitis.
The purpose of this retrospective cohort study was to assess whether trends in elective and urgent/emergent colectomy changed after July 2006. The authors suggest that given the risks associated with elective colectomy, their findings demonstrate the need for a more evidence-based decision-making process, incorporating both patient preferences and patient-reported outcomes, for those considering elective colectomy for uncomplicated and some cases of complicated diverticulitis.
AHRQ-funded; HS026363.
Citation: Strassle PD, Kinlaw AC, Chaumont N .
Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change.
Gastroenterology 2019 Dec;157(6):1679-81.e11. doi: 10.1053/j.gastro.2019.08.045..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Healthcare Utilization, Guidelines, Shared Decision Making, Digestive Disease and Health
Leeds IL, DiBrito SR, Canner JK
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
This goal of this study was to assess the cost-effectiveness of extended prophylaxis in patients with Crohn's disease after abdominal surgery. A decision tree model was used to assess cost-effectiveness and cost-per-case averted with extended-duration venous thromboembolism prophylaxis following abdominal surgery. Results showed that extended prophylaxis in patients with Crohn's disease postoperatively is not cost-effective when the cumulative incidence of posthospital thrombosis remains less than 4.9%. These findings are driven by the low absolute risk of thrombosis in this population and the considerable cost of universal treatment.
AHRQ-funded; HS024547.
Citation: Leeds IL, DiBrito SR, Canner JK .
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
Dis Colon Rectum 2019 Nov;62(11):1371-80. doi: 10.1097/dcr.0000000000001461..
Keywords: Prevention, Digestive Disease and Health, Surgery, Healthcare Costs, Adverse Events, Patient Safety, Blood Clots, Shared Decision Making, Medication
Nguyen N, Lavery WJ, Capocelli KE, N, Lavery WJ, Capocelli
Transnasal endoscopy in unsedated children with eosinophilic esophagitis using virtual reality video goggles.
Evaluation and treatment of children with eosinophilic esophagitis (EoE) requires serial endoscopic, visual, and histologic assessment by sedated esophagogastroduodenoscopy (EGD). Unsedated transnasal endoscopy (TNE) was reported to be successful in a pilot study of children. In this study, the investigators evaluated video goggle and virtual reality-based unsedated TNE in children with EoE, collecting data on rates of completion, adverse events, and adequacy of visual and histologic findings.
AHRQ-funded; HS024599.
Citation: Nguyen N, Lavery WJ, Capocelli KE, N, Lavery WJ, Capocelli .
Transnasal endoscopy in unsedated children with eosinophilic esophagitis using virtual reality video goggles.
Clin Gastroenterol Hepatol 2019 Nov;17(12):2455-62. doi: 10.1016/j.cgh.2019.01.023..
Keywords: Children/Adolescents, Digestive Disease and Health, Care Management
Shah SC, Tepler A, Peek RM
Association between Helicobacter pylori exposure and decreased odds of eosinophilic esophagitis-a systematic review and meta-analysis.
Previous or current infection with Helicobacter pylori (exposure) has been reported to protect against eosinophilic esophagitis (EoE), perhaps owing to H pylori-induced immunomodulation. However, findings vary. In this study the investigators performed a systematic review and meta-analysis of comparative studies to define the association between H pylori exposure and EoE more clearly. The investigators found evidence for a significant association between H pylori exposure and reduced odds of EoE.
AHRQ-funded; HS026395.
Citation: Shah SC, Tepler A, Peek RM .
Association between Helicobacter pylori exposure and decreased odds of eosinophilic esophagitis-a systematic review and meta-analysis.
Clin Gastroenterol Hepatol 2019 Oct;17(11):2185-98.e3. doi: 10.1016/j.cgh.2019.01.013..
Keywords: Digestive Disease and Health, Evidence-Based Practice
Tepler A, Narula N, Peek RM
Systematic review with meta-analysis: association between Helicobacter pylori CagA seropositivity and odds of inflammatory bowel disease.
Accumulating data support a protective role of Helicobacter pylori against inflammatory bowel diseases (IBD), which might be mediated by strain-specific constituents, specifically cagA expression. The aim of this study was to perform a systematic review and meta-analysis to more clearly define the association between CagA seropositivity and IBD. The investigators found evidence for a significant association between CagA seropositive H pylori exposure and reduced odds of IBD, particularly CD, but not for CagA seronegative H pylori exposure.
AHRQ-funded; HS026395.
Citation: Tepler A, Narula N, Peek RM .
Systematic review with meta-analysis: association between Helicobacter pylori CagA seropositivity and odds of inflammatory bowel disease.
Aliment Pharmacol Ther 2019 Jul;50(2):121-31. doi: 10.1111/apt.15306..
Keywords: Digestive Disease and Health, Evidence-Based Practice
Quinn CC, Chard S, Roth EG
The Telemedicine for Patients With Inflammatory Bowel Disease (TELE-IBD) clinical trial: qualitative assessment of participants' perceptions.
This qualitative clinical trial examined the use of telemedicine for managing patients with inflammatory bowel disease (IBD). The study called TELE-IBD, enrolled 348 patients, with 259 completing the study. Patients completing the study were interviewed after and results were positive in improving quality of life (QOL) by improving patient education and self-management.
AHRQ-funded; HS018975.
Citation: Quinn CC, Chard S, Roth EG .
The Telemedicine for Patients With Inflammatory Bowel Disease (TELE-IBD) clinical trial: qualitative assessment of participants' perceptions.
J Med Internet Res 2019 Jun 3;21(6):e14165. doi: 10.2196/14165..
Keywords: Telehealth, Digestive Disease and Health, Health Information Technology (HIT), Care Management
Law AC, Stevens JP, Walkey AJ
Gastrostomy tube use in the critically ill, 1994-2014.
This study used AHRQ’s Healthcare Cost and Utilization Project’s (HCUP’s) National Inpatient Sample to evaluate trends in gastrostomy tube use among critically ill adults from 1994 to 2014. Patients with dementia were excluded from the study. It was found that tube use more than doubled during that time period. Most patients were discharged to long-term care facilities after tube placement. Population-based rates went from 11.9 to 28.8 gastrostomies per 100,000 adults which is an increase of 142%.
AHRQ-funded; HS024288.
Citation: Law AC, Stevens JP, Walkey AJ .
Gastrostomy tube use in the critically ill, 1994-2014.
Ann Am Thorac Soc 2019 Jun;16(6):724-30. doi: 10.1513/AnnalsATS.201809-638OC..
Keywords: Critical Care, Digestive Disease and Health, Healthcare Cost and Utilization Project (HCUP), Outcomes, Patient-Centered Outcomes Research, Surgery
Shah SC, Nakata C, Polydorides AD
Upper endoscopy up to 3 years prior to a diagnosis of gastric cancer is associated with lower stage of disease in a USA multiethnic urban population, a retrospective study.
This study focused on the feasibility of earlier diagnosis of non-cardia gastic cancer (NCGC) for high-risk populations in the US who include multiracial and ethnic populations. A retrospective study was conducted with patients who were positively identified endoscopically with NCGC at Mount Sinai Hospital in New York City. The primary outcome was an increased frequency of patients diagnosed with stage 0-Ia (38%) as opposed to stage Ib-III (34%) and stage IV (20.3%). For patients with stage 0-Ia if they had a prior negative endoscopy there was a 94% higher likelihood of the NCGC being in a curable stage.
AHRQ-funded; HS026395.
Citation: Shah SC, Nakata C, Polydorides AD .
Upper endoscopy up to 3 years prior to a diagnosis of gastric cancer is associated with lower stage of disease in a USA multiethnic urban population, a retrospective study.
J Prev Med Public Health 2019 May;52(3):179-87. doi: 10.3961/jpmph.18.262..
Keywords: Cancer, Diagnostic Safety and Quality, Digestive Disease and Health, Imaging, Racial and Ethnic Minorities, Urban Health
Chung CF, Wang Q, Schroeder J
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
This study examined if the use of a photo-based food diary app will help patients with irritable bowel syndrome (IBS) help gather food and symptom data to help their doctors with disease management. The investigators designed and developed Foodprint which includes a mobile and web app and pre-visit note to go to experts which communicate an individual’s expectations and questions. A control group and a group with IBS were used to determine the effectiveness of Foodprint.
AHRQ-funded; HS023654.
Citation: Chung CF, Wang Q, Schroeder J .
Identifying and planning for individualized change: patient-provider collaboration using lightweight food diaries in healthy eating and irritable bowel syndrome.
Proc ACM Interact Mob Wearable Ubiquitous Technol 2019 Mar;3(1). doi: 10.1145/3314394..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Digestive Disease and Health, Health Information Technology (HIT), Lifestyle Changes, Nutrition, Patient Self-Management
Faye AS, Polubriaginof F, Green PHR
Low rates of screening for celiac disease among family members.
This study determined how many family members of patients diagnosed with celiac disease were screened. Even among those patients with a family history, nearly 30% of symptomatic first-degree relatives were not tested. These tests are recommended in guidelines for all relatives with a documented family history.
AHRQ-funded; HS021816.
Citation: Faye AS, Polubriaginof F, Green PHR .
Low rates of screening for celiac disease among family members.
Clin Gastroenterol Hepatol 2019 Feb;17(3):463-68. doi: 10.1016/j.cgh.2018.06.016..
Keywords: Diagnostic Safety and Quality, Digestive Disease and Health, Family Health and History, Screening
Daniel VT, Ayturk D, Ward DV
The influence of payor status on outcomes associated with surgical repair of upper gastrointestinal perforations due to peptic ulcer disease in the United States.
An association between lack of insurance and inferior outcomes has been well described for a number of surgical emergencies, yet little is known about the relationship of payor status and outcomes of patients undergoing emergent surgical repair for upper gastrointestinal (UGI) perforations. In this study, the investigators evaluated the association of payor status and in-hospital mortality for patients undergoing emergency surgery for UGI perforations in the United States.
AHRQ-funded; HS022694.
Citation: Daniel VT, Ayturk D, Ward DV .
The influence of payor status on outcomes associated with surgical repair of upper gastrointestinal perforations due to peptic ulcer disease in the United States.
Am J Surg 2019 Jan;217(1):121-25. doi: 10.1016/j.amjsurg.2018.06.025..
Keywords: Adverse Events, Digestive Disease and Health, Health Insurance, Healthcare Cost and Utilization Project (HCUP), Mortality, Outcomes, Patient Safety, Surgery, Uninsured
Lee GJ, Dotson JL, Kappelman MD
Seasonality and pediatric inflammatory bowel disease.
The researchers sought to determine whether disease activity in pediatric-onset inflammatory bowel disease (IBD) is associated with a seasonal pattern. Studying 1325 patients with Crohn disease and 587 patients with ulcerative colitis, their findings do not support any strong associations between season of the year and disease activity in pediatric IBD.
AHRQ-funded; HS020024.
Citation: Lee GJ, Dotson JL, Kappelman MD .
Seasonality and pediatric inflammatory bowel disease.
J Pediatr Gastroenterol Nutr 2014 Jul;59(1):25-8. doi: 10.1097/mpg.0000000000000362.
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Keywords: Children/Adolescents, Digestive Disease and Health, Children/Adolescents
Liu TC, Gao F, McGovern DP
Spatial and temporal stability of paneth cell phenotypes in Crohn's disease: implications for prognostic cellular biomarker development.
The researchers sought to develop Paneth cell phenotype as a prognostic biomarker in Crohn’s disease by additional characterization building on their earlier research. Specifically, they examined the effects of disease activity, phenotype duration, and the minimal crypt number that would allow for accurate Paneth cell phenotyping. They demonstrated that Paneth cell phenotypes are not affected either by disease activity or by exposure to therapeutic agents.
AHRQ-funded; HS021747.
Citation: Liu TC, Gao F, McGovern DP .
Spatial and temporal stability of paneth cell phenotypes in Crohn's disease: implications for prognostic cellular biomarker development.
Inflamm Bowel Dis 2014 Apr;20(4):646-51. doi: 10.1097/01.MIB.0000442838.21040.d7..
Keywords: Chronic Conditions, Digestive Disease and Health