National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (3)
- Blood Clots (2)
- (-) Cancer (19)
- Cancer: Breast Cancer (4)
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- Cardiovascular Conditions (1)
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- Elderly (1)
- Evidence-Based Practice (2)
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- Outcomes (1)
- Patient-Centered Outcomes Research (2)
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- Quality Improvement (2)
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- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- (-) Risk (19)
- Screening (3)
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- Young Adults (1)
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 19 of 19 Research Studies DisplayedBrajcich BC, Bentrem DJ, Yang AD
Short-term risk of performing concurrent procedures with hepatic artery infusion pump placement.
This study’s objective was to characterize the short-term outcomes of concurrent surgery with hepatic artery infusion pump (HAIP) placement using data from the 2005-2017 ACS NSQIP dataset. Findings showed that HAIP placement is not associated with additional morbidity when performed with hepatic and/or colorectal surgery. Decisions regarding HAIP placement should consider the risks of concurrent operations as well as patient- and disease-specific factors.
AHRQ-funded; HS026385.
Citation: Brajcich BC, Bentrem DJ, Yang AD .
Short-term risk of performing concurrent procedures with hepatic artery infusion pump placement.
Ann Surg Oncol 2020 Dec;27(13):5098-106. doi: 10.1245/s10434-020-08938-0..
Keywords: Quality Improvement, Quality of Care, Surgery, Risk, Cancer, Outcomes
Shah SC, Itzkowitz SH
Reappraising risk factors for inflammatory bowel disease-associated neoplasia: implications for colonoscopic surveillance in IBD.
One of the most feared complications of inflammatory bowel disease [IBD]-associated colitis is colorectal cancer. An opportunity for early detection is being missed in a group that is overlooked as high-risk, as a substantial proportion of colorectal cancers are being diagnosed in individuals with colonic IBD who have disease duration shorter than when guidelines recommend surveillance initiation. In this study, the investigators discuss a viewpoint that supports a paradigm shift that will ideally result in a more effective and higher-value colorectal cancer prevention approach in IBD.
AHRQ-funded; HS026395.
Citation: Shah SC, Itzkowitz SH .
Reappraising risk factors for inflammatory bowel disease-associated neoplasia: implications for colonoscopic surveillance in IBD.
J Crohns Colitis 2020 Sep 7;14(8):1172-77. doi: 10.1093/ecco-jcc/jjaa040..
Keywords: Digestive Disease and Health, Risk, Cancer: Colorectal Cancer, Cancer, Colonoscopy, Prevention, Diagnostic Safety and Quality, Screening
Schlick CJR, Merkow RP, Yang AD
Post-discharge venous thromboembolism after pancreatectomy for malignancy: predicting risk based on preoperative, intraoperative, and postoperative factors.
Extended chemoprophylaxis is recommended for high-risk patients following pancreatectomy for malignancy. However, quantifying risk remains difficult. In this study, the investigators sought to (a) identify factors associated with post-discharge venous thromboembolism (VTE) following pancreatectomy for malignancy and (b) develop a post-discharge VTE risk calculator to identify high-risk patients. The investigators concluded that preoperative, intraoperative, and postoperative factors were associated with post-discharge VTE following pancreatectomy for malignancy.
AHRQ-funded; HS026385.
Citation: Schlick CJR, Merkow RP, Yang AD .
Post-discharge venous thromboembolism after pancreatectomy for malignancy: predicting risk based on preoperative, intraoperative, and postoperative factors.
J Surg Oncol 2020 Sep 15;122(4):675-83. doi: 10.1002/jso.26046..
Keywords: Cancer, Surgery, Treatments, Blood Clots, Risk
Mohapatra A, Strope SA, Liu N
Importance of long-term follow-up after endoscopic management for upper tract urothelial carcinoma and factors leading to surgical management.
Patients undergoing endoscopic management for upper tract urothelial carcinoma often progress to definitive therapy with radical nephroureterectomy. This study examined the rate of progression as well as risk factors for transitions in treatment over time. The investigators found that patients who progressed to radical nephroureterectomy after endoscopic management had fewer comorbid conditions and changes in disease status including visible lesions on ureteroscopy and positive biopsies.
AHRQ-funded; HS19455.
Citation: Mohapatra A, Strope SA, Liu N .
Importance of long-term follow-up after endoscopic management for upper tract urothelial carcinoma and factors leading to surgical management.
Int Urol Nephrol 2020 Aug;52(8):1465-69. doi: 10.1007/s11255-020-02439-5..
Keywords: Cancer, Surgery, Risk, Care Management
Greenzang KA, Fasciano KM, Block SD
Early information needs of adolescents and young adults about late effects of cancer treatment.
This study evaluated the importance, quality, and implications of information about late effects in adolescents and young adults (AYA) recently diagnosed with cancer. Surveying AYAs with cancer who were 15 to 29 years old and were treated at the Dana-Farber Cancer Institute, researchers found that most AYAs with cancer value early information about the risks of late effects and infertility, yet many patients felt that they had not received high-quality information about these topics. They recommended the development of age-appropriate late-effect communication strategies that recognize high AYA distress to address the gap between desired information and perceived information quality.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Fasciano KM, Block SD .
Early information needs of adolescents and young adults about late effects of cancer treatment.
Cancer 2020 Jul 15;126(14):3281-88. doi: 10.1002/cncr.32932..
Keywords: Children/Adolescents, Young Adults, Cancer, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Risk
De la Garza Ramos R, Gelfand Y, Benton JA
Rates, risk factors, and complications of red blood cell transfusion in metastatic spinal tumor surgery: an analysis of a prospective multicenter surgical database.
The goal of this study was to identify rates, risks, and complications of red blood cell (RBC) transfusion in metastatic spinal tumor surgery. The multicenter prospective American College of Surgeons National Quality Improvement Program database was used to identify adult patients with disseminated cancer who underwent metastatic spinal tumor surgery from 2012-2016. A patient was included if at least 1 intraoperative/postoperative RBC transfusion was received within the first 72 hours of surgery start time. Out of 1601 patients included, 623 (38.9%) received a RBC transfusion. There was an overall higher complication rate in patients who received a transfusion compared to those who didn’t. These complications included sepsis (3.5% vs. 1.9%), deep vein thrombosis (6.1% vs. 3.3%), and prolonged ventilation (3.9% vs. 1.3%). Future research into complication prevention was recommended.
https://www.pubmed.ncbi.nlm.nih.gov/32298819
Citation: De la Garza Ramos R, Gelfand Y, Benton JA .
Rates, risk factors, and complications of red blood cell transfusion in metastatic spinal tumor surgery: an analysis of a prospective multicenter surgical database.
World Neurosurg 2020 Jul;139:e308-e15. doi: 10.1016/j.wneu.2020.03.202..
Keywords: Quality Improvement, Quality of Care, Surgery, Risk, Cancer
Shah SC, Dai Zhu, X
Associations between calcium and magnesium intake and the risk of incident gastric cancer: a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study.
Gastric cancer remains a leading cause of cancer-related mortality. Identifying dietary and other modifiable disease determinants has important implications for risk attenuation in susceptible individuals. The primary aim of the investigators was to estimate the association between dietary and supplemental intakes of calcium and magnesium and the risk of incident gastric cancer. They conducted a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons Diet and Health Study.
AHRQ-funded; HS026395.
Citation: Shah SC, Dai Zhu, X .
Associations between calcium and magnesium intake and the risk of incident gastric cancer: a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study.
Int J Cancer 2020 Jun 1;146(11):2999-3010. doi: 10.1002/ijc.32659..
Keywords: Cancer, Digestive Disease and Health, Risk, Prevention, Nutrition, Patient-Centered Outcomes Research, Evidence-Based Practice
Shah SC, Dai Q, Zhu X
Associations between calcium and magnesium intake and the risk of incident oesophageal cancer: an analysis of the NIH-AARP Diet and Health Study prospective cohort.
Risk reduction through dietary modifications is an adjunct strategy for prevention of oesophageal cancer, a leading cause of cancer-related mortality and morbidity worldwide. In this study, the investigators aimed to estimate the association between calcium and magnesium intakes and incident oesophageal cancer (OC) by conducting a retrospective analysis of the NIH-AARP Diet and Health Study prospective cohort.
AHRQ-funded; HS026395.
Citation: Shah SC, Dai Q, Zhu X .
Associations between calcium and magnesium intake and the risk of incident oesophageal cancer: an analysis of the NIH-AARP Diet and Health Study prospective cohort.
Br J Cancer 2020 Jun;122(12):1857-64. doi: 10.1038/s41416-020-0818-6..
Keywords: Cancer, Risk
Eden KB, Ivlev I, Bensching KL
Use of an online breast cancer risk assessment and patient decision aid in primary care practices.
A cross-sectional study evaluating a web-based breast cancer risk assessment and decision aid (MammoScreen) was conducted in an academic general internal medicine clinic. Breast cancer risk assessment and mammography screening decision support were efficiently implemented through a web-based tool for patients sent through an electronic patient portal. Findings indicated that integration of patient decision aids with risk algorithms in clinical practice may help support the implementation of USPSTF recommendations that include risk assessment and shared decision-making.
AHRQ-funded; HS026370.
Citation: Eden KB, Ivlev I, Bensching KL .
Use of an online breast cancer risk assessment and patient decision aid in primary care practices.
J Womens Health 2020 Jun;29(6):763-69. doi: 10.1089/jwh.2019.8143..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Screening, Decision Making, Risk, Health Information Technology (HIT), Prevention, Women
Schlick CJR, Khorfan R, Odell DD
Margin positivity in resectable esophageal cancer: are there modifiable risk factors?
Patients with esophageal cancer have poor overall survival, with positive resection margins worsening survival. Margin positivity rates are used as quality measures in other malignancies, but modifiable risk factors are necessary to develop actionable targets for improvement. The objectives of this study were to (1) evaluate trends in esophageal cancer margin positivity, and (2) identify modifiable patient/hospital factors associated with margin positivity.
AHRQ-funded; HS026385.
Citation: Schlick CJR, Khorfan R, Odell DD .
Margin positivity in resectable esophageal cancer: are there modifiable risk factors?
Ann Surg Oncol 2020 May;27(5):1496-507. doi: 10.1245/s10434-019-08176-z..
Keywords: Cancer, Risk, Surgery
Greenzang KA, Al-Sayegh H, Ma C
Parental considerations regarding cure and late effects for children with cancer.
The purpose of this study was to learn how parents and physicians consider late-effects risks against a potential survival benefit when making treatment decisions. Parents of children with cancer and physicians at Dana-Farber/Boston Children's Cancer and Blood Disorders Center were surveyed. Investigators found that avoidance of severe neurocognitive impairment was the predominant driver of parent and physician treatment preferences, even over an increased chance of cure. They concluded that their study highlights the importance of exploring parental late-effects priorities when discussing treatment options.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Al-Sayegh H, Ma C .
Parental considerations regarding cure and late effects for children with cancer.
Pediatrics 2020 May;145(5):e20193552. doi: 10.1542/peds.2019-3552..
Keywords: Children/Adolescents, Cancer, Decision Making, Caregiving, Risk
Mahorter SS, Knerr S, Bowles EJA
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
This study examined knowledge of breast density as an important breast cancer risk factor among a set of women in a health system-embedded trial who had clinically elevated breast cancer risk 1 year before state-mandated density disclosure. The majority of the women (91%) had heard of breast density and were aware of its masking effect (87%). Only 60% had ever discussed their breast density with a provider.
AHRQ-funded; HS022982.
Citation: Mahorter SS, Knerr S, Bowles EJA .
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
Cancer 2020 Apr 15;126(8):1614-21. doi: 10.1002/cncr.32711..
Keywords: Cancer: Breast Cancer, Cancer, Women, Communication, Clinician-Patient Communication, Risk, Patient-Centered Outcomes Research
Chen DW, Reyes-Gastelum D, Wallner LP
Disparities in risk perception of thyroid cancer recurrence and death.
The authors studied risk perception among survivors of thyroid cancer. Patients diagnosed with differentiated thyroid cancer from the Surveillance, Epidemiology, and End Results registries were surveyed and an analytic cohort defined by a 5% or greater risk of disease recurrence and mortality. The authors found that less educated patients and Hispanic patients were more likely to report inaccurate risk perceptions, which were associated with worry and a decreased quality of life.
AHRQ-funded; HS024512.
Citation: Chen DW, Reyes-Gastelum D, Wallner LP .
Disparities in risk perception of thyroid cancer recurrence and death.
Cancer 2020 Apr 1;126(7):1512-21. doi: 10.1002/cncr.32670..
Keywords: Disparities, Cancer, Risk, Quality of Life, Social Determinants of Health, Racial and Ethnic Minorities
Shah SC, Boffetta P, Johnson KC SC, Boffetta P, Johnson KC
Occupational exposures and odds of gastric cancer: a StoP project consortium pooled analysis.
Gastric cancer pathogenesis represents a complex interaction of host genetic determinants, microbial virulence factors and environmental exposures. The primary aim of this study was to determine the association between occupations/occupational exposures and odds of gastric cancer. Based on a large pooled analysis, the investigators identified several occupations and related exposures that were associated with elevated odds of gastric cancer.
AHRQ-funded; HS026395.
Citation: Shah SC, Boffetta P, Johnson KC SC, Boffetta P, Johnson KC .
Occupational exposures and odds of gastric cancer: a StoP project consortium pooled analysis.
Int J Epidemiol 2020 Apr 1;49(2):422-34. doi: 10.1093/ije/dyz263..
Keywords: Cancer, Risk, Digestive Disease and Health
Fan T, Fakolade A
AHRQ Author: Fan T
Medication use to reduce risk of breast cancer.
In this case study, a 40-year-old woman comes to her doctor’s office for a routine gynecologic visit. She is not taking any medications and is generally healthy. She is sexually active, and her last menstrual period started 10 days ago. She states that her mother was diagnosed with bilateral breast cancer at 49 years of age and that she would like to discuss her options for reducing the risk of breast cancer. Three questions are posed about risk-reducing medications.
AHRQ-authored
Citation: Fan T, Fakolade A .
Medication use to reduce risk of breast cancer.
Am Fam Physician 2020 Mar 15;101(6):373-74..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Medication, Risk, Prevention, Case Study, Women
Fakhri B, Fiala MA, Shah N
Measuring cardiopulmonary complications of carfilzomib treatment and associated risk factors using the SEER-Medicare database.
This study’s goal was to measure rates of cardiopulmonary complications from carfilzomib treatment in patients with recurrent myeloma. Myeloma case data was extracted from the SEER-Medicare linked database from 2000 to 2013, and corresponding claims through 2014. There were 635 patients identified as being treated with carfilzomib. Of these, median age was 72 years, 55% were male, and 79% were white. Median duration of treatment was 58 days. Overall, 66% of patients had codes identifying cardiac or pulmonary adverse events. Cardiac adverse events included hypertension, peripheral edema and heart failure. Pulmonary adverse events included dyspnea, cough, and pneumonia.
AHRQ-funded; HS019455.
Citation: Fakhri B, Fiala MA, Shah N .
Measuring cardiopulmonary complications of carfilzomib treatment and associated risk factors using the SEER-Medicare database.
Cancer 2020 Feb 15;128(4):808-13. doi: 10.1002/cncr.32601..
Keywords: Adverse Events, Medication, Cardiovascular Conditions, Risk, Cancer, Patient Safety
De Roo AC, Li Y, Abrahamse PH
Long-term functional decline after high-risk elective colorectal surgery in older adults.
This study examined the long-term risks of functional decline after elective colorectal surgery in older adults. This retrospective matched cohort study used data from the Health and Retirement Study, a nationally representative, longitudinal survey of adults >50 years of age. This survey collected data on functional status, cognition, and demographics, among other topics. The survey was linked with Medicare claims and National Death Index data from 1992 to 2012 and used patients 65 years and older. Surgery patients did experience a greater likelihood of functional decline with or without complications compared to control subjects. The older the patient, the more likelihood of a functional decline occurring after surgery.
AHRQ-funded; HS000053.
Citation: De Roo AC, Li Y, Abrahamse PH .
Long-term functional decline after high-risk elective colorectal surgery in older adults.
Dis Colon Rectum 2020 Jan;63(1):75-83. doi: 10.1097/dcr.0000000000001541..
Keywords: Elderly, Cancer: Colorectal Cancer, Cancer, Surgery, Adverse Events, Risk
Schlick CJR, Liu JY, Yang AD
Pre-operative, intra-operative, and post-operative factors associated with post-discharge venous thromboembolism following colorectal cancer resection.
Venous thromboembolism (VTE) is the most common preventable cause of 30-day post-operative mortality, with many events occurring after hospital discharge. High-level evidence supports post-discharge VTE chemoprophylaxis following abdominal/pelvic cancer resection; however, some studies support a more tailored approach. The objectives of this study were to (1) identify risk factors associated with post-discharge VTE in a large cohort of patients undergoing colorectal cancer resection and (2) develop a post-discharge VTE risk calculator.
AHRQ-funded; HS024516; HS026385.
Citation: Schlick CJR, Liu JY, Yang AD .
Pre-operative, intra-operative, and post-operative factors associated with post-discharge venous thromboembolism following colorectal cancer resection.
J Gastrointest Surg 2020 Jan;24(1):144-54. doi: 10.1007/s11605-019-04354-2..
Keywords: Cancer: Colorectal Cancer, Cancer, Surgery, Blood Clots, Adverse Events, Risk, Hospital Discharge
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