National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedChu DK, Abrams EM, Golden BK
Risk of second allergic reaction to SARS-CoV-2 vaccines: a systematic review and meta-analysis.
The purpose of this systematic review and meta-analysis of case studies and case reports was to assess the risk of severe immediate allergic reactions to a second dose of SARS-CoV-2 mRNA vaccine in people who experienced an immediate allergic reaction to the first dose. The researchers evaluated the World Health Organization Global Coronavirus database, Web of Science, MEDLINE, and Embase from the date of inception through October 4th, 2021. The main outcomes and measures were a risk of severe immediate allergic reaction and repeated severe immediate allergic reactions with a second vaccine dose. The study found that among 22 studies of SARS-CoV-2 mRNA vaccines, 1366 individuals had immediate allergic reactions to their first vaccination. Of these, 87.8% were women with a mean age of 46.1 years. Six patients developed severe immediate allergic reactions after their second vaccination, 232 developed mild symptoms, and 1360 tolerated the dose. Among 78 persons with severe immediate allergic reactions to their first SARS-CoV-2 mRNA vaccination, 4 people had a second severe immediate reaction, and 15 had non-severe symptoms. There were no deaths. The study concluded that in a supervised setting equipped to manage severe allergic reactions, revaccination of individuals with an immediate allergic reaction to a first SARS-CoV-2 mRNA vaccine dose can be safe.
AHRQ-funded; HS026395.
Citation: Chu DK, Abrams EM, Golden BK .
Risk of second allergic reaction to SARS-CoV-2 vaccines: a systematic review and meta-analysis.
JAMA Intern Med 2022 Apr;182(4):376-85. doi: 10.1001/jamainternmed.2021.8515..
Keywords: COVID-19, Vaccination, Risk, Evidence-Based Practice, Patient-Centered Outcomes Research
Goswami E, Ogden RK, Bennett WE
Evidence-based development of a nephrotoxic medication list to screen for acute kidney injury risk in hospitalized children.
This paper describes an initiative to develop an evidence-based list of nephrotoxic medications to screen for acute kidney injury (AKI) risk in hospitalized children. This initiative, called the Nephrotoxic Injury Negated by Just-in-time Action quality improvement collaborative, convened a Nephrotoxic Medication (NTMx) Subcommittee composed of pediatric nephrologists, a pharmacist, and a pediatric intensivist. The committee reviewed NTMx lists, conducted a literature review of the disputed medications, and assigned an evidence grade based on the association between nephrotoxicity and the quality of the data. The subcommittee then came to a majority consensus to which medications should be included on the list. The list was presented to the larger collaborative and voted on. This list will be continually updated and voted on annually.
AHRQ-funded; HS023763.
Citation: Goswami E, Ogden RK, Bennett WE .
Evidence-based development of a nephrotoxic medication list to screen for acute kidney injury risk in hospitalized children.
Am J Health Syst Pharm 2019 Oct 30;76(22):1869-74. doi: 10.1093/ajhp/zxz203..
Keywords: Children/Adolescents, Medication: Safety, Medication, Patient Safety, Risk, Evidence-Based Practice, Adverse Drug Events (ADE), Adverse Events
Goldstone AB, Chiu P, Baiocchi M
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Researchers investigated the hypothesis that regionalizing care at high-volume hospitals for acute type A aortic dissections will lower mortality. Operative mortality and long-term survival were compared for Medicare beneficiaries diagnosed with an acute type A aortic dissection who were transferred versus not transferred, underwent surgery at high-volume versus low-volume hospitals, and were rerouted versus not rerouted to a high-volume hospital for treatment. The researchers found that, despite delaying surgery, a regionalization policy that transfers patients to high-volume hospitals was associated with a 7.2% absolute risk reduction in operative mortality. They recommended that policymakers evaluate the feasibility and benefits of regionalizing the surgical treatment of acute type A aortic dissection in the United States.
AHRQ-funded; HS022192.
Citation: Goldstone AB, Chiu P, Baiocchi M .
Interfacility transfer of Medicare beneficiaries with acute type a aortic dissection and regionalization of care in the United States.
Circulation 2019 Oct 8;140(15):1239-50. doi: 10.1161/circulationaha.118.038867..
Keywords: Transitions of Care, Medicare, Heart Disease and Health, Cardiovascular Conditions, Patient-Centered Outcomes Research, Risk, Evidence-Based Practice, Mortality, Hospitals
Parchman ML, Anderson ML, Dorr DA
A randomized trial of external practice support to improve cardiovascular risk factors in primary care.
Researchers conducted a randomized controlled trial to compare the effectiveness of adding various forms of enhanced external support to practice facilitation on primary care practices' clinical quality measure (CQM) performance. They concluded that, although they found no significant differences in CQM performance across study arms, the ability of a practice to reach a target level of performance may be enhanced by adding both educational outreach visits and shared learning to practice facilitation.
AHRQ-funded; HS023908.
Citation: Parchman ML, Anderson ML, Dorr DA .
A randomized trial of external practice support to improve cardiovascular risk factors in primary care.
Ann Fam Med 2019 Aug 12;17(Suppl 1):S40-s49. doi: 10.1370/afm.2407..
Keywords: Cardiovascular Conditions, Primary Care, Quality Improvement, Provider Performance, Quality Measures, Quality of Care, Risk, Evidence-Based Practice, Patient-Centered Healthcare, Chronic Conditions
Yuo TH, Wallace JR, Fish L
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
This study compared outcomes of different revascularization surgeries among end stage renal disease (ESRD) patients with peripheral arterial disease (PAD). There is a high risk of complications for this surgery. Outcomes of endovascular revascularization (ER) and open surgical revascularisation (OSR) were compared. Outcomes measured included mortality and major amputation. There is a lower mortality risk for ER versus OSR. OSR has better 30-day limb salvage although there are similar long-term outcomes.
AHRQ-funded; HS019486.
Citation: Yuo TH, Wallace JR, Fish L .
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
Eur J Vasc Endovasc Surg 2019 Feb;57(2):248-57. doi: 10.1016/j.ejvs.2018.09.008..
Keywords: Adverse Events, Cardiovascular Conditions, Comparative Effectiveness, Dialysis, Evidence-Based Practice, Kidney Disease and Health, Mortality, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Nelson HD, Pappas M, Zakher B
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: a systematic review to update the U.S. Preventive Services Task Force recommendation.
This systematic review was done in support of the U.S. Preventive Services Task Force (USPSTF) updated recommendation on the benefit and harms of risk assessment, genetic testing, and genetic counseling for BRCA-related cancer in women. A systematic review was done on literature from 2004 to July 30, 2013 from MEDLINE, PsycINFO, the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Health Technology Assessment, Scopus, and reference lists. Data on the participants, study design, analysis, follow-up, and results was extracted and a second investigator confirmed key data. The studies were rated on study quality and applicability. The analysis found women with high-risk for breast cancer had decreased risk of breast cancer by 85% to 100% by having a mastectomy, and risk of mortality by 81% to 100% compared to women without surgery. There was also a lower risk of breast and ovarian cancer after having salpingo-oopherectomy surgery.
AHRQ-funded; 290200710057
Citation: Nelson HD, Pappas M, Zakher B .
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: a systematic review to update the U.S. Preventive Services Task Force recommendation.
Ann Intern Med 2014 Feb 18;160(4):255-66. doi: 10.7326/m13-1684..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer: Ovarian Cancer, Cancer, Genetics, Screening, Prevention, Guidelines, Evidence-Based Practice, Women, Risk, Family Health and History