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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 17 of 17 Research Studies DisplayedKim HS, Hernaez R, Sansgiry S
Comparative effectiveness of surveillance colonoscopy intervals on colorectal cancer outcomes in a national cohort of patients with inflammatory bowel disease.
The purpose of this study was to determine the comparative effectiveness of varying colonoscopy intervals on colorectal cancer (CRC) outcomes among patients with inflammatory bowel disease (IBD). Data was from the National Veterans Health Administration. Findings showed that, in a national cohort of patients with CRC-IBD, colonoscopy within 3 years prior to CRC diagnosis was associated with early tumor stage at diagnosis, and colonoscopy within 1 year was associated with a reduced all-cause mortality compared with no colonoscopy, supporting colonoscopy intervals of 1 to 3 years in patients with IBD in order to reduce late-stage CRC and all-cause mortality.
AHRQ-funded; HS024122.
Citation: Kim HS, Hernaez R, Sansgiry S .
Comparative effectiveness of surveillance colonoscopy intervals on colorectal cancer outcomes in a national cohort of patients with inflammatory bowel disease.
Clin Gastroenterol Hepatol 2022 Dec;20(12):2848-57.e2. doi: 10.1016/j.cgh.2022.02.048..
Keywords: Cancer: Colorectal Cancer, Cancer, Digestive Disease and Health, Imaging, Screening, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research
Wu A, Wu JY, Lim M
Updates in intraoperative strategies for enhancing intra-axial brain tumor control.
This review looked at recent advances in intraoperative strategies for enhancing intra-axial brain tumor control. The authors looked at published research centered on different innovative tools and techniques, including fluorescence-guided surgery, new methods of drug delivery, and minimally invasive procedural options.
AHRQ-funded; HS028747.
Citation: Wu A, Wu JY, Lim M .
Updates in intraoperative strategies for enhancing intra-axial brain tumor control.
Neuro Oncol 2022 Nov 2;24(suppl 6):S33-S41. doi: 10.1093/neuonc/noac170..
Keywords: Cancer, Surgery, Imaging
Ross RL, Rubio K, Rodriguez HP
Mammography and decision aid use for breast cancer screening in older women.
This study examines the association between practice-level decision-aid use and mammography use among older women. Physician practice responses to the 2017/2018 National Survey of Healthcare Organizations and Systems were linked to 2016-17 Medicare fee-for-service beneficiary data from eligible beneficiaries aged 65-74 years. Findings showed that health information technology-enabled automation of mammography reminders and other advanced health information technology functions may support mammography, whereas breast cancer decision aids may reduce patients' propensities to be screened through the alignment of their preferences and screening decision.
AHRQ-funded; HS022241; HS024075.
Citation: Ross RL, Rubio K, Rodriguez HP .
Mammography and decision aid use for breast cancer screening in older women.
Am J Prev Med 2022 Oct;63(4):630-35. doi: 10.1016/j.amepre.2022.04.014..
Keywords: Imaging, Screening, Decision Making, Cancer: Breast Cancer, Women, Prevention, Cancer, Elderly
Golmakani MK, Hubbard RA, Miglioretti DL
Nonhomogeneous Markov chain for estimating the cumulative risk of multiple false positive screening tests.
This study addressed the general challenge of estimating the cumulative risk of multiple false positive test results. The authors proposed a nonhomogeneous multistate model to describe the screening process including competing events and developed alternative approaches for estimating the cumulative risk of multiple false positive results using this multistate model based on existing estimators for the cumulative risk of a single false positive. The multistate model was based on existing estimators for the cumulative risk of a single false positive. They compared the performance of the newly proposed models through simulation studies and illustrated model performance using data on screening mammography from the Breast Cancer Surveillance Consortium. They found that in the context of screening mammography that the cumulative risk of multiple false positive results is high. For a high-risk individual, the cumulative probability of at least two false positive mammography results after 10 rounds of annual screening is 40.4.
AHRQ-funded; HS018366.
Citation: Golmakani MK, Hubbard RA, Miglioretti DL .
Nonhomogeneous Markov chain for estimating the cumulative risk of multiple false positive screening tests.
Biometrics 2022 Sep;78(3):1244-56. doi: 10.1111/biom.13484..
Keywords: Research Methodologies, Screening, Imaging, Cancer: Breast Cancer, Cancer
Kerlikowske K, Su YR, Sprague BL
Association of screening with digital breast tomosynthesis vs digital mammography with risk of interval invasive and advanced breast cancer.
The purpose of this study was to compare digital breast tomosynthesis (DBT) with digital mammography to determine whether DBT was correlated with lower rates of internal invasive cancer and advanced breast cancer, taking into consideration breast density and breast cancer risk. From 2011 through 2018, the researchers studied a cohort of 504,427 women between the ages of 40 and 79 who underwent 375,189 screening DBT exams and 1,003,900 screening digital mammography exams, and who were then followed up for cancer diagnoses between 2011 and 2019 after being identified via linkage to state or regional cancer registries. The median age at the time of screening was 58 years (IQR 50-65 years) and the diagnostic screenings took place at 44 Breast Cancer Surveillance Consortium (BCSC) facilities in the United States. The study found that among women at low to average risk, or at high risk with almost entirely fatty, scattered fibroglandular densities, or heterogeneously dense breasts, advanced cancer rates were not significantly different for DBT vs digital mammography. There was no significant difference between DBT and digital mammography for interval cancer rates per 1000 exams. Interval invasive cancer rates were also not significantly different among the 413,061 examinations with BCSC 5-year risk of 1.67% or higher (high risk) across breast density categories, or among all the 836,250 examinations with BCSC 5-year risk less than 1.67% (low to average-risk). For the 3.6% of women with extremely dense breasts and at high risk of breast cancer (13,291 examinations in the DBT group and 31,300 in the digital mammography group) advanced cancer rates per 1000 examinations were significantly lower for DBT vs digital mammography, but not for women at low to average risk (10,611 examinations in the DBT group and 37,796 in the digital mammography group). The researchers reported that there was no significant difference in the 96.4% of women with extremely dense breasts not at high risk, heterogeneously dense breasts, or nondense breasts, and concluded that screening with DBT vs digital mammography was associated with a significantly lower risk of advanced breast cancer among the 3.6% of women with extremely dense breasts and at high risk of breast cancer, and was not associated with a significant difference in risk of interval invasive cancer.
AHRQ-funded; HS018366.
Citation: Kerlikowske K, Su YR, Sprague BL .
Association of screening with digital breast tomosynthesis vs digital mammography with risk of interval invasive and advanced breast cancer.
JAMA 2022 Jun 14;327(22):2220-30. doi: 10.1001/jama.2022.7672..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Women, Imaging, Risk
Tice JA, Gard CC, Miglioretti DL
Comparing mammographic density assessed by digital breast tomosynthesis or digital mammography: the Breast Cancer Surveillance Consortium.
This study’s purpose was to assess the consistency of Breast Imaging Reporting and Data System (BI-RADS) breast density reporting comparing digital breast tomosynthesis (DBT) with digital mammography (DM) and to evaluate density as a breast cancer risk factor when assessed using DM versus DBT. A secondary analysis of data from the Breast Cancer Surveillance Consortium was used from 342,149 women aged 40-79 years who underwent at least two screening mammography examinations less than 36 months apart. There were no significant differences in breast density assessment in pairs consisting of one DM and one DBT examination (57,516 of 74,729 [77%]), two DM examinations (238,678 of 301,743 [79%]), and two DBT examinations (20,763 of 26,854). Results were similar when pair analysis was restricted to readings by the same radiologist. The breast cancer hazard ratios (HRs) for breast density were similar for DM and DBT. The HRs for density acquired using DM and DBT, respectively, were 0.55 and 0.37 for almost entirely fat, 1.47 and 1.36 for heterogeneously dense, and 1.72 and 2.05 for extremely dense breasts.
AHRQ-funded; HS018366.
Citation: Tice JA, Gard CC, Miglioretti DL .
Comparing mammographic density assessed by digital breast tomosynthesis or digital mammography: the Breast Cancer Surveillance Consortium.
Radiology 2022 Feb; 302(2):286-92. doi: 10.1148/radiol.2021204579..
Keywords: Cancer: Breast Cancer, Cancer, Women, Imaging, Screening, Diagnostic Safety and Quality
Haymart MR, Reyes-Gastelum D, Caoili E
The relationship between imaging and thyroid cancer diagnosis and survival.
Controversy exists over whether there has been a true increase in the occurrence of thyroid cancer or overdiagnosis secondary to imaging practices. Because cancer overdiagnosis is associated with detection of indolent disease, overdiagnosis can be associated with perceived improvement in survival. The investigators concluded that there was improved disease-specific survival in patients diagnosed with thyroid cancer after thyroid ultrasound as compared with after other imaging.
AHRQ-funded; HS024512.
Citation: Haymart MR, Reyes-Gastelum D, Caoili E .
The relationship between imaging and thyroid cancer diagnosis and survival.
Oncologist 2020 Sep;25(9):765-71. doi: 10.1634/theoncologist.2020-0159..
Keywords: Cancer, Imaging, Diagnostic Safety and Quality
Arana-Chicas E, Kioumarsi A, Carroll-Scott A
Barriers and facilitators to mammography among women with intellectual disabilities: a qualitative approach.
The purpose of this qualitative study was to examine barriers and facilitators to mammography among women with intellectual disabilities. During 2015-2016 the researchers administered in-depth interviews with 30 women with intellectual disabilities and their caregivers in Philadelphia. The study found additional evidence supporting prior research on barriers to mammography among women with intellectual disabilities as well as novel barriers (e.g., lack of awareness of breast ultrasound, sedation failing to work, and lack of mammogram education) and novel facilitators (e.g., extended family support and positive attitudes.) The researchers concluded that the study results support the need to address barriers and focus on facilitators to improve the mammography experience in women with intellectual disabilities.
AHRQ-funded; HS023966.
Citation: Arana-Chicas E, Kioumarsi A, Carroll-Scott A .
Barriers and facilitators to mammography among women with intellectual disabilities: a qualitative approach.
Disabil Soc 2020;35(8):1290-314. doi: 10.1080/09687599.2019.1680348..
Keywords: Women, Disabilities, Vulnerable Populations, Screening, Prevention, Cancer: Breast Cancer, Cancer, Imaging
Sprague BL, Miglioretti DL, Lee CI
New mammography screening performance metrics based on the entire screening episode.
Established mammography screening performance metrics use the initial screening mammography assessment because they were developed for radiologist performance auditing, yet these metrics are frequently used to inform health policy and screening decision making. The authors developed new performance metrics based on the final assessment that consider the entire screening episode, including diagnostic workup. They concluded that established screening performance metrics underestimated the interval cancer rate of a mammography screening episode, particularly for women with dense breasts or an elevated breast cancer risk.
AHRQ-funded; HS018366.
Citation: Sprague BL, Miglioretti DL, Lee CI .
New mammography screening performance metrics based on the entire screening episode.
Cancer 2020 Jul 15;126(14):3289-96. doi: 10.1002/cncr.32939..
Keywords: Screening, Diagnostic Safety and Quality, Cancer: Breast Cancer, Cancer, Prevention, Women, Provider Performance, Imaging
Lowry KP, Coley RY, Miglioretti DL
Screening performance of digital breast tomosynthesis vs digital mammography in community practice by patient age, screening round, and breast density.
The purpose of this study was to compare digital mammography (DM) vs digital breast tomosynthesis (DBT) performance by age, baseline vs subsequent screening round, and breast density category. Information was taken from screening examinations at participating Breast Cancer Surveillance Consortium facilities of 1.5 million women aged 40 to 79 with no prior history of breast cancer. Findings showed that improvements in recall and cancer detection rates with DBT were greatest on baseline mammograms. On subsequent screening mammograms, the benefits of DBT varied by age and breast density, and women with extremely dense breasts did not benefit from improved recall or cancer detection with DBT on subsequent screening rounds.
AHRQ-funded; HS018366.
Citation: Lowry KP, Coley RY, Miglioretti DL .
Screening performance of digital breast tomosynthesis vs digital mammography in community practice by patient age, screening round, and breast density.
JAMA Netw Open 2020 Jul;3(7):e2011792. doi: 10.1001/jamanetworkopen.2020.11792..
Keywords: Imaging, Screening, Cancer: Breast Cancer, Cancer, Women, Evidence-Based Practice, Comparative Effectiveness, Diagnostic Safety and Quality
DiPiro PJ, Alper DP, Giess CS
Comparing breast and abdominal subspecialists' follow-up recommendations for incidental liver lesions on breast MRI.
This study compared breast and abdominal subspecialists’ follow-up recommendations following discovery of incidental liver lesions (ILLs) after breast MRI. When breast subspecialists recommended no follow-up abdominal subspecialists agreed with them in 29 out of 30 cases examined, but disagreed with 28 or 30 breast subspecialists’ follow-up recommendations. When breast imagers reported no ILLs, there was 93% agreement with abdominal subspecialists.
AHRQ-funded; HS024722.
Citation: DiPiro PJ, Alper DP, Giess CS .
Comparing breast and abdominal subspecialists' follow-up recommendations for incidental liver lesions on breast MRI.
J Am Coll Radiol 2020 Jun;17(6):773-78. doi: 10.1016/j.jacr.2019.12.024..
Keywords: Imaging, Diagnostic Safety and Quality, Screening, Cancer: Breast Cancer, Cancer, Women
Franc BL, Thombley R, Luo BL, Franc BL, Thombley R, Luo R, Luo Y
Identifying tests related to breast cancer care in claims data.
The goal of this study was to develop a method for calculating rates of testing for breast cancer recurrence in patients who have already undergone initial treatment for breast cancer. Rates were calculated from a cohort of Medicare breast cancer patients and an age-matched noncancer cohort. They calculated testing rates in the breast cancer cohort above the background rate in the noncancer population. There were similar estimates of testing prevalence and frequency in the two groups, with exception of prevalence of computed tomography (CT).
AHRQ-funded; HS024936.
Citation: Franc BL, Thombley R, Luo BL, Franc BL, Thombley R, Luo R, Luo Y .
Identifying tests related to breast cancer care in claims data.
Breast J 2020 Jun;26(6):1227-30. doi: 10.1111/tbj.13691..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Diagnostic Safety and Quality, Healthcare Utilization
Zhou Y, Abel GA, Hamilton W
Imaging activity possibly signalling missed diagnostic opportunities in bladder and kidney cancer: a longitudinal data-linkage study using primary care electronic health records.
Sub-optimal use or interpretation of imaging investigations prior to diagnosis of certain cancers may be associated with less timely diagnosis, but pre-diagnostic imaging activity for urological cancer is unknown. In this study, the investigators analysed linked data derived from primary and secondary care records and cancer registration to evaluate the use of clinically relevant imaging tests pre-diagnosis, in patients with bladder and kidney cancer diagnosed in 2012-15 in England.
AHRQ-funded; HS022087.
Citation: Zhou Y, Abel GA, Hamilton W .
Imaging activity possibly signalling missed diagnostic opportunities in bladder and kidney cancer: a longitudinal data-linkage study using primary care electronic health records.
Cancer Epidemiol 2020 Jun;66:101703. doi: 10.1016/j.canep.2020.101703..
Keywords: Cancer, Diagnostic Safety and Quality, Imaging, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT)
Lacson R, Wang A, Cochon L
Factors associated with optimal follow-up in women with BI-RADS 3 breast findings.
Investigators assessed the rate of and the factors associated with optimal follow-up in patients with BI-RADS 3 breast findings. They found that follow-up of BI-RADS 3 breast imaging findings is optimal in only 74% of women. They recommended further interventions to promote follow-up targeting younger, unmarried women, those with Hispanic ethnicity, and women without history of breast cancer and without insurance coverage.
AHRQ-funded; HS024722.
Citation: Lacson R, Wang A, Cochon L .
Factors associated with optimal follow-up in women with BI-RADS 3 breast findings.
J Am Coll Radiol 2020 Apr;17(4):469-74. doi: 10.1016/j.jacr.2019.10.003..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Women, Diagnostic Safety and Quality
Sprague BL, Coley RY, Kerlikowske K
Assessment of radiologist performance in breast cancer screening using digital breast tomosynthesis vs digital mammography.
Many US radiologists have screening mammography recall rates above the expert-recommended threshold of 12%. The influence of digital breast tomosynthesis (DBT) on the distribution of radiologist recall rates is uncertain. The objective of this study was to evaluate radiologists' recall and cancer detection rates before and after beginning interpretation of DBT examinations.
AHRQ-funded; HS018366.
Citation: Sprague BL, Coley RY, Kerlikowske K .
Assessment of radiologist performance in breast cancer screening using digital breast tomosynthesis vs digital mammography.
JAMA Netw Open 2020 Mar 2;3(3):e201759. doi: 10.1001/jamanetworkopen.2020.1759..
Keywords: Cancer: Breast Cancer, Cancer, Diagnostic Safety and Quality, Imaging, Screening, Women, Prevention, Provider Performance
Smieliauskas F, MacMahon H, Salgia R
Geographic variation in radiologist capacity and widespread implementation of lung cancer CT screening.
The researchers estimated the prevalence of capacity constraints in the radiologist workforce and resulting potential disparities in access to lung cancer screening. They found that scaling up lung cancer screening would increase imaging procedures by an average of 4% across Health Service Areas (HSAs). HSAs that were rural, with many eligible smokers, and disproportionately Hispanic or low-income smokers had significantly higher odds of facing capacity constraints.
AHRQ-funded; HS018535.
Citation: Smieliauskas F, MacMahon H, Salgia R .
Geographic variation in radiologist capacity and widespread implementation of lung cancer CT screening.
J Med Screen 2014 Dec;21(4):207-15. doi: 10.1177/0969141314548055..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer, Cancer: Lung Cancer, Screening, Imaging
Deppen SA, Blume JD, Kensinger CD
Accuracy of FDG-PET to diagnose lung cancer in areas with infectious lung disease: a meta-analysis.
The purpose of this study was to estimate the diagnostic accuracy of positron emission tomography (PET) combined with fludeoxyglucose F18 (FDG) for pulmonary modules suspicious for lung cancer in regions where infectious lung disease is endemic and compare the accuracy in regions where such disease is rare. It found that the accuracy of FDG-PET was extremely heterogeneous.
AHRQ-funded; HS021554.
Citation: Deppen SA, Blume JD, Kensinger CD .
Accuracy of FDG-PET to diagnose lung cancer in areas with infectious lung disease: a meta-analysis.
JAMA 2014 Sep 24;312(12):1227-36. doi: 10.1001/jama.2014.11488..
Keywords: Cancer, Cancer: Lung Cancer, Diagnostic Safety and Quality, Respiratory Conditions, Imaging