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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 13 of 13 Research Studies DisplayedIvlev I, Beil TL, Haynes JS
Rapid evidence review of digital cognitive-behavioral therapy for adolescents with depression.
This rapid evidence review was conducted to explore the benefits and harms of digital cognitive-behavioral therapy (dCBT) and the barriers to and facilitators of implementing dCBT for adolescents. An extensive literature review was done through December 6, 2021 for controlled trials conducted in settings highly applicable to the US. Additionally, the authors searched relevant systematic reviews for eligible studies. They identified 12 trials that examined the effects of nine dCBT programs. Overall, dCBT was slightly superior to other therapies in improving depression symptoms immediately, but not at a longer follow-up. There did not appear to be an increased risk for suicidal attempts or ideation with dCBT, however the number of events was very small. Potential barriers to implementing and maintaining dCBT included challenges engaging/retaining patients, developing infrastructure, and training therapists to facilitate dCBT. No data on harms or unintended negative consequences were reported in the included studies.
AHRQ-funded; HS026370.
Citation: Ivlev I, Beil TL, Haynes JS .
Rapid evidence review of digital cognitive-behavioral therapy for adolescents with depression.
J Adolesc Health 2022 Jul;71(1):14-19. doi: 10.1016/j.jadohealth.2022.01.220..
Keywords: Children/Adolescents, Depression, Behavioral Health, Evidence-Based Practice, Patient-Centered Outcomes Research
Capone CA, Emerson B, Sweberg T
Intubation practice and outcomes among pediatric emergency departments: a report from National Emergency Airway Registry for Children (NEAR4KIDS).
The purpose of this study was to describe Tracheal Intubation (TI) practice and outcomes in pediatric Emergency Departments as compared to those in intensive care units (ICUs) and use the resulting data to identify targets for quality improvement. The researchers analyzed consecutive TI encounters from pediatric EDs and ICUs in the National Emergency Airway Registry for Children (NEAR4KIDS) database from 2015 to 2018. The study found a total of 12,512 TIs in 51 pediatric/cardiac ICUs, and 756 TIs in 13 pediatric EDs and were reported. Proportion of TIs for shock (26% ED vs. 14% ICU), respiratory decompensation (52% vs. 64%), and neurologic deterioration (30% vs. 11%) also differed by location. Limited neck mobility was reported more often in the ED (16% vs. 6%). TIs in the ED were performed more often via video laryngoscopy (64% vs. 29%). Oxygen desaturation was less commonly reported in ED TIs (13.6%) than ICU TIs (17%). Among ED TIs, shock as an indication and limited mouth opening were independently associated with adverse TI-associated events (TIAEs). The study concluded that TI characteristics vary between pediatric EDs and ICUs, yet outcomes are similar.
AHRQ-funded; HS022464.
Citation: Capone CA, Emerson B, Sweberg T .
Intubation practice and outcomes among pediatric emergency departments: a report from National Emergency Airway Registry for Children (NEAR4KIDS).
Acad Emerg Med 2022 Apr;29(4):406-14. doi: 10.1111/acem.14431..
Keywords: Children/Adolescents, Emergency Department, Registries, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Critical Care, Intensive Care Unit (ICU)
Bhalala US, Gist KM, Tripathi S
Characterization and outcomes of hospitalized children with coronavirus disease 2019: a report from a multicenter, viral infection and respiratory illness universal study (Coronavirus Disease 2019) registry.
The purpose of this retrospective study was to examine data from the Society of Critical Care Medicine Viral Infection and Respiratory Illness Universal Study (Coronavirus Disease 2019) registry and describe the characteristics, ICU admissions, and outcomes in children hospitalized with COVID-19. The study included 874 children under the age of 18 hospitalized with coronavirus disease 2019 at 51 participating hospital centers from February 2020 to January 2021. The primary outcome was ICU admission. Secondary outcomes included hospital and ICU duration of stay and ICU, hospital, and 28-day mortality. The researchers found that the median age was 8 years, with 62.9% non-Hispanic and a boy to girl ratio of 1:2. A total of 28.2% of the children met the Centers for Disease Control and Prevention criteria for multisystem inflammatory syndrome in children, and 46.2% were admitted to the ICU. A child’s age, the presence of a fever, multisystem inflammatory syndrome, and pre-existing seizure disorder were independently associated with a greater odds of ICU admission. The rate of hospital mortality for this group was 1.8%. The median duration of ICU stay was 3.9 days and the median duration of hospital stay was 4 days. For those patients with 28-day data, the survival rate was 86.3%. The researchers concluded that in this study, older age, fever, multisystem inflammatory syndrome in children, and seizure disorder were independently related with ICU admission.
AHRQ-funded; HS026393; HS026485.
Citation: Bhalala US, Gist KM, Tripathi S .
Characterization and outcomes of hospitalized children with coronavirus disease 2019: a report from a multicenter, viral infection and respiratory illness universal study (Coronavirus Disease 2019) registry.
Crit Care Med 2022 Jan;50(1):e40-e51. doi: 10.1097/ccm.0000000000005232..
Keywords: COVID-19, Children/Adolescents, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice, Inpatient Care
Choi KR, Bhakta B, Knight EA
Patient outcomes after applied behavior analysis for autism spectrum disorder.
The purpose of this study was to examine patterns of service receipt and patient outcomes for children receiving applied behavior analysis (ABA) for autism spectrum disorder (ASD) in an integrated health care system in which commercially insured children were covered by a state autism mandate. Findings showed that, in a health system implementation of ABA for children with ASD, there were high rates of ABA discontinuation and low ABA dosing. These challenges may diminish the potential benefits of ABA, even with mandated commercial insurance coverage.
AHRQ-funded; HS026407.
Citation: Choi KR, Bhakta B, Knight EA .
Patient outcomes after applied behavior analysis for autism spectrum disorder.
J Dev Behav Pediatr 2022 Jan;43(1):9-16. doi: 10.1097/dbp.0000000000000995..
Keywords: Children/Adolescents, Autism, Behavioral Health, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Paul R, Niedner M, Brilli R
Metric development for the multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative.
A 56 US hospital collaborative, Improving Pediatric Sepsis Outcomes (IPSO), has developed variables, metrics and a data analysis plan to track quality improvement (QI)-based patient outcomes over time. Improving Pediatric Sepsis Outcomes expands on previous pediatric sepsis QI efforts by improving electronic data capture and uniformity across sites. This paper describes the metric development for the multicenter IPSO Collaborative.
AHRQ-funded; HS025696.
Citation: Paul R, Niedner M, Brilli R .
Metric development for the multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative.
Pediatrics 2021 May;147(5):e2020017889. doi: 10.1542/peds.2020-017889..
Keywords: Children/Adolescents, Sepsis, Quality Improvement, Quality of Care, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Kemme S, Stahl M, Brigham D
Outcomes of severe seronegative hepatitis-associated aplastic anemia: a pediatric case series.
Hepatitis-associated aplastic anemia (HAAA) is a potentially life-threatening diagnosis without clear treatment guidelines. The goal of the study was to characterize the presentation, evaluation, histopathology, and outcomes of therapy in children with HAAA to guide future research and to develop standardized care guidelines for this rare disease. The investigators found that ATG-based IST induced remission of hepatitis in patients with steroid-refractory HAAA.
AHRQ-funded; HS026510.
Citation: Kemme S, Stahl M, Brigham D .
Outcomes of severe seronegative hepatitis-associated aplastic anemia: a pediatric case series.
J Pediatr Gastroenterol Nutr 2021 Feb;72(2):194-201. doi: 10.1097/mpg.0000000000002940..
Keywords: Children/Adolescents, Hepatitis, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Guidelines
Silverberg JI, Lei D, Yousaf M
Measurement properties of the product of investigator's global assessment and body surface area in children and adults with atopic dermatitis.
This study’s goal was to determine the measurement properties of the product of validated Investigator’s Global Assessment for AD and body surface area (vIGA*BSA) for atopic dermatitis (AD) severity. The authors performed a prospective practice-based study using questionnaires and evaluation by a dermatologist (n = 653). The vIGA*BSA can also be divided into six categories (vIGA*cBSA: 0%/0.1, <10%/10, <30%/30, <50%/50, <70%/70 and <90%/90-100%)). The assessment was compared with other rating scales such as SCORAD, Patient-Oriented Eczema Measure, Dermatology Life Quality Index, ItchyOOL, PROMISE Sleep Disturbance, and sleep-related impairment. Scores showed good convergent and discriminant validity, reliability, responsiveness and interpretability in adults and children with AD.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Lei D, Yousaf M .
Measurement properties of the product of investigator's global assessment and body surface area in children and adults with atopic dermatitis.
J Eur Acad Dermatol Venereol 2021 Jan;35(1):180-87. doi: 10.1111/jdv.16846..
Keywords: Children/Adolescents, Skin Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice
Silverberg JI, Lei D, Yousaf M
Measurement properties of the Rajka-Langeland severity score in children and adults with atopic dermatitis.
This study looked at the measurement properties of the Rajka-Langeland severity score for atopic dermatitis (AD) in children and adults and compared it with other clinician-reported outcomes. The study used questionnaires and evaluation by a dermatologist (n = 427). Rajka-Langeland had good concurrent validity with the Eczema Area and Severity Index and body surface area; good convergent validity with the numeric rating scale average-itch and worst-itch, Patient-Oriented Eczema Measure, Dermatology Life Quality Index, Patient Reported Outcomes Measurement Information System Itch Questionnaire in adults and/or children; fair discriminant validity for patient- and physician reported global AD severity; good responsive to change of severity of AD and itch; and good reliability, internal consistency; with no floor or ceiling effects.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Lei D, Yousaf M .
Measurement properties of the Rajka-Langeland severity score in children and adults with atopic dermatitis.
Br J Dermatol 2021 Jan;184(1):87-95. doi: 10.1111/bjd.19159..
Keywords: Children/Adolescents, Skin Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice
Shah RK, Stey AM, Jantana KR
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
This study evaluated perioperative outcomes in pediatric otolaryngology through analysis of records residing in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS-NSQIP) database. It found that although the overall rate of major postoperative morbidity in pediatric otolaryngology is low, the following areas may be targeted for targeted quality-improvement interventions: tracheostomy, airway reconstruction, mastoidectomy, and abscess drainage.
AHRQ-funded; HS022932
Citation: Shah RK, Stey AM, Jantana KR .
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
JAMA Otolaryngol Head Neck Surg. 2014 Nov;140(11):1019-26. doi: 10.1001/jamaoto.2014.2067..
Keywords: Surgery, Children/Adolescents, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Mannion ML, Xie F, Curtis JR
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
The researchers investigated temporal trends in medication use among children diagnosed with juvenile idiopathic arthritis (JIA). They found that the use of tumor necrosis factor inhibitors (TNFi) in the treatment of JIA increased 2- to 3-fold from 2005 to 2012. New TNFi use was associated with decreased NSAID and oral glucocorticoids use. TNFi may be replacing, rather than complementing, methotrexate in the treatment of many patients.
AHRQ-funded; HS018517.
Citation: Mannion ML, Xie F, Curtis JR .
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
J Rheumatol 2014 Oct;41(10):2078-84. doi: 10.3899/jrheum.140012.
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Keywords: Children/Adolescents, Medication, Patient-Centered Outcomes Research, Practice Patterns, Arthritis
Feudtner C, Freedman J, Kang T
Comparative effectiveness of senna to prevent problematic constipation in pediatric oncology patients receiving opioids: a multicenter study of clinically detailed administrative data.
The researcher investigated senna’s effectiveness, compared with other prophylactic oral bowel medications, in reducing opioid-induced constipation in pediatric cancer patients. They found that initiating senna therapy within two days of starting opioids, compared with initiating another oral bowel medication, was significantly associated with a lower risk of problematic constipation.
AHRQ-funded; HS018425.
Citation: Feudtner C, Freedman J, Kang T .
Comparative effectiveness of senna to prevent problematic constipation in pediatric oncology patients receiving opioids: a multicenter study of clinically detailed administrative data.
J Pain Symptom Manage 2014 Aug;48(2):272-80. doi: 10.1016/j.jpainsymman.2013.09.009..
Keywords: Cancer, Children/Adolescents, Comparative Effectiveness, Patient-Centered Outcomes Research, Medication
Johnson MA, Grahan BJ, Haukoos JS
Demographics, bystander CPR, and AED use in out-of-hospital pediatric arrests.
The researchers sought to determine if the 2005 American Heart Association guidelines for routine use of automated external defibrillators during pediatric out-of-hospital arrest are used during resuscitations. They found that young children suffering from presumed out-of-hospital cardiac arrests are less likely to have a shockable rhythm when compared to adults, and are less likely to have an AED used during resuscitation.
AHRQ-funded; HS017526.
Citation: Johnson MA, Grahan BJ, Haukoos JS .
Demographics, bystander CPR, and AED use in out-of-hospital pediatric arrests.
Resuscitation 2014 Jul;85(7):920-6. doi: 10.1016/j.resuscitation.2014.03.044.
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Keywords: Cardiovascular Conditions, Children/Adolescents, Emergency Medical Services (EMS), Guidelines, Patient-Centered Outcomes Research
Kranz AM, Rozier RG, Preisser JS
Preventive services by medical and dental providers and treatment outcomes.
The researchers compared the association between the provider of preventive services (PCP, dentist, or both) with Medicaid-enrolled children before their third birthday and subsequent dental caries-related treatment (CRT) and CRT payment. They concluded that, due to children's increased opportunity to receive multiple visits in medical offices during well-child visits, preventive oral health services provided by PCPs may lead to a greater reduction in CRT than dentist visits alone.
AHRQ-funded; HS000032.
Citation: Kranz AM, Rozier RG, Preisser JS .
Preventive services by medical and dental providers and treatment outcomes.
J Dent Res 2014 Jul;93(7):633-8. doi: 10.1177/0022034514536731.
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Keywords: Children/Adolescents, Dental and Oral Health, Patient-Centered Outcomes Research, Prevention, Primary Care