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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 7 of 7 Research Studies Displayed
Friese CR, Fauer AJ, Kuisell C
Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates.
The purpose of this study was to examine the feasibility of soliciting outcomes from adults who received chemotherapy treatment for cancer and to describe the patterns and correlates of patient-reported toxicities. Results determined that querying patients on chemotherapy treatment experiences and toxicities was feasible. Toxicity rates varied across practices, informing quality improvement. Toxicity severity and service use incidence exceed previously published trial data, particularly for pain, fatigue, and gastrointestinal issues. Open-text questions enabled exploration with newer treatment regimens.
Citation: Friese CR, Fauer AJ, Kuisell C . Patient-reported outcomes collected in ambulatory oncology practices: feasibility, patterns, and correlates. Health Serv Res 2020 Dec;55(6):966-72. doi: 10.1111/1475-6773.13574..
Keywords: Ambulatory Care and Surgery, Cancer, Treatments, Quality of Care, Patient-Centered Outcomes Research, Outcomes
Fink HA, Linskens EJ, MacDonald R
Benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia
This is a systematic review and meta-analysis of the benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia (CATD). Studies with low or medium risk of bias (ROB) were analyzed and rated. The analysis concluded there was a slight reduction in short-term cognitive decline with cholinesterase inhibitors and memantime, and cholinesterase inhibitors slightly reduced reported functional decline. There was mostly insufficient evidence on drug treatment of behavioral and psychological symptoms of dementia and on supplements for all outcomes.
Citation: Fink HA, Linskens EJ, MacDonald R . Benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia Ann Intern Med 2020 May 19;172(10):656-68. doi: 10.7326/m19-3887..
Keywords: Elderly, Dementia, Neurological Disorders, Medication, Vitamins and Supplements, Patient-Centered Outcomes Research, Evidence-Based Practice, Adverse Drug Events (ADE), Adverse Events, Outcomes, Treatments
Khorfan R, Schlick CJR, Yang AD
Utilization of minimally invasive surgery and its association with chemotherapy for locally advanced gastric cancer.
This study compared outcomes of patients with T3 or greater and/or N+ gastric carcinoma who had minimally invasive surgery (MIS) or traditional open surgery. Patients who received MIS had a greater likelihood of receiving postoperative chemotherapy. Patients from the National Cancer Database (21,872) from 2010 to 2015 were identified. The majority (72.2%) received open surgery although MIS rates went up during that time period. Predictors of MIS were Asian race, any insurance coverage and treatment at high-volume centers. Survival rates were higher for MIS patients although that could be explained by their increased likelihood of receiving adjuvant chemotherapy.
Citation: Khorfan R, Schlick CJR, Yang AD . Utilization of minimally invasive surgery and its association with chemotherapy for locally advanced gastric cancer. J Gastrointest Surg 2020 Feb;24(2):243-52. doi: 10.1007/s11605-019-04410-x.
Keywords: Surgery, Treatments, Cancer, Digestive Disease and Health, Healthcare Utilization, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Hoffman KE, Penson DF, Zhao Z
Patient-reported outcomes through 5 years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer.
This study compared different treatment of men with favorable-risk prostate cancer and those with unfavorable-risk disease and their functional outcomes 5 years post-treatment. Treatment options for favorable-risk disease include active surveillance, nerve-sparing prostatectomy, external beam radiation therapy (EBRT), or low-dose-rate brachytherapy with prostatectomy being the most common. Treatment options for men with unfavorable-risk disease is prostatectomy or EBRT with androgen deprivation therapy (ADT). The cohort analyzed included men diagnosed with prostate cancer in 2011 through 2012, accrued from 5 Surveillance, Epidemiology and End Results Program sites and a US prostate cancer registry, using surveys through September 2017. A total of 2005 men met inclusion criteria. For men with favorable-risk disease low-dose-rate brachytherapy was associated with worse urinary irritative, and sexual and bowel function at 1 year compared with active surveillance. Nerve-sparing prostatectomy was associated with worse urinary incontinence at 5 years and sexual function at 3 years compared with active surveillance. EBRT was not associated with clinically different function changes from active surveillance at any point during the 5 years. For men with unfavorable-risk disease, EBRT with ADT was associated with lower hormonal function at 6 months, bowel function at 1 year, but better sexual function and incontinence than prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Hoffman KE, Penson DF, Zhao Z . Patient-reported outcomes through 5 years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer. JAMA 2020 Jan 14;323(2):149-63. doi: 10.1001/jama.2019.20675..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Treatments, Men's Health, Adverse Events, Surgery
Dulai PS, Siegel CA, Colombel JF
Systematic review: monotherapy with antitumour necrosis factor alpha agents versus combination therapy with an immunosuppressive for IBD.
The authors discussed the efficacy and the risks of anti-TNF monotherapy versus combination therapy with an immunosuppressive in patients with IBD. They concluded that the addition of an immunosuppressive to anti-TNF therapy improves treatment efficacy for infliximab in ulcerative colitis and Crohn’s disease. Further, the use of combination therapy appears to add no significant incremental risk for serious infections above that seen with anti-TNF or immunosuppressive monotherapy in most patients.
Citation: Dulai PS, Siegel CA, Colombel JF . Systematic review: monotherapy with antitumour necrosis factor alpha agents versus combination therapy with an immunosuppressive for IBD. Gut 2014 Dec;63(12):1843-53. doi: 10.1136/gutjnl-2014-307126.
Keywords: Comparative Effectiveness, Evidence-Based Practice, Medication, Outcomes, Patient-Centered Outcomes Research, Treatments
Goode AP, Richardson WJ, Schectman RM
Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions.
The authors sought to determine the 1-year risk of complications, cervical revision fusions, hospital readmissions, and health care services utilization after bone morphogenetic protein (BMP) use with cervical spine fusions. They found that patients receiving BMP were 29% more likely to have a complication and a nervous system complication; cervical revision fusions were more likely among patients receiving BMP; the risk of 30-day readmission was greater with BMP use; and readmission occurred 27.4% sooner on an average. Additionally, patients receiving BMP were more likely to receive computed tomography scans and epidurals with anterior surgical approaches.
Citation: Goode AP, Richardson WJ, Schectman RM . Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions. Spine J 2014 Sep;14(9):2051-9. doi: 10.1016/j.spinee.2013.11.042.
Keywords: Adverse Events, Hospital Readmissions, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Surgery, Treatments
Osterman MT, Haynes K, Delzell E
Comparative effectiveness of infliximab and adalimumab for Crohn's disease.
This study compared the effectiveness of infliximab and adalimumab, the two most commonly used anti-tumor necrosis factor agents in patients with Crohn’s disease (CD). It found that both drugs were of similar effectiveness with respect to surgical rates, hospitalization rates, and the percentage of patients remaining on the drugs after 26 weeks.
Citation: Osterman MT, Haynes K, Delzell E . Comparative effectiveness of infliximab and adalimumab for Crohn's disease. Clin Gastroenterol Hepatol. 2014 May;12(5):811-817.e3. doi: 10.1016/j.cgh.2013.06.010..
Keywords: Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research, Treatments