National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Antibiotics (1)
- Asthma (2)
- Blood Clots (1)
- Blood Pressure (1)
- Cardiovascular Conditions (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- (-) Children/Adolescents (13)
- Chronic Conditions (1)
- Colonoscopy (1)
- Comparative Effectiveness (1)
- Diabetes (1)
- Diagnostic Safety and Quality (2)
- Disparities (1)
- Emergency Department (3)
- Healthcare-Associated Infections (HAIs) (1)
- Heart Disease and Health (1)
- Hospitalization (1)
- Infectious Diseases (1)
- Medical Errors (1)
- Medication (3)
- Medication: Safety (1)
- Outcomes (1)
- Palliative Care (1)
- Patient Safety (1)
- Pneumonia (1)
- Primary Care (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (2)
- (-) Risk (13)
- Screening (1)
- Sepsis (2)
- Social Determinants of Health (1)
- Surgery (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 13 of 13 Research Studies DisplayedCzosek RJ, Anderson JB, Baskar S
Predictors and outcomes of heart block during surgical stage I palliation of patients with a single ventricle: a report from the NPC-QIC.
This study investigated patient and surgical risks of heart block and its effect on 12-month transplant-free survival in children with a single ventricle. In total, 1423 patients were identified from the National Pediatric Cardiology Improvement Collaborative with and without heart block. One-year outcomes were analyzed. A very small percentage (2%) developed heart block during their surgical admission. Associated risk factors for block included heterotaxy syndrome and atrial flutter/fibrillation. Patients with complete heart block had lower 12-month survival, which wasn’t true for patients with second degree block. At 12 months of age, 43% of patients with heart block died and were more likely to experience mortality than patients without heart block.
AHRQ-funded; HS021114.
Citation: Czosek RJ, Anderson JB, Baskar S .
Predictors and outcomes of heart block during surgical stage I palliation of patients with a single ventricle: a report from the NPC-QIC.
Heart Rhythm 2021 Nov;18(11):1876-83. doi: 10.1016/j.hrthm.2021.05.019..
Keywords: Children/Adolescents, Heart Disease and Health, Cardiovascular Conditions, Surgery, Palliative Care, Risk, Outcomes
Reddy P, Mencin A, Lebwohl B
Risk factors for suboptimal bowel preparation for colonoscopy in pediatric patients.
Suboptimal bowel cleansing is common in children and can impact diagnostic and therapeutic outcomes. In this retrospective study, the investigators aimed to identify risk factors for suboptimal bowel preparation for colonoscopy in pediatric patients. The investigators concluded that Medicaid status and English as a second language were risk factors. They highlighted distinct associations from those reported in the adult literature including failure to thrive and younger age.
AHRQ-funded; HS026121.
Citation: Reddy P, Mencin A, Lebwohl B .
Risk factors for suboptimal bowel preparation for colonoscopy in pediatric patients.
J Pediatr Gastroenterol Nutr 2021 Jul;73(1):e1-e6. doi: 10.1097/mpg.0000000000003114..
Keywords: Children/Adolescents, Colonoscopy, Risk, Diagnostic Safety and Quality
Cifra CL, Westlund E, Ten Eyck P
An estimate of missed pediatric sepsis in the emergency department.
AHRQ-funded; HS025753.
Citation: Cifra CL, Westlund E, Ten Eyck P .
An estimate of missed pediatric sepsis in the emergency department.
Diagnosis 2021;8(2):193-98. doi: 10.1515/dx-2020-0023..
Keywords: Children/Adolescents, Sepsis, Emergency Department, Diagnostic Safety and Quality, Medical Errors, Risk
Eigenmann PA, Ebisawa M, Greenhawt M
Addressing risk management difficulties in children with food allergies.
This rostrum article discusses various aspects faced by children with food allergies in the light of risk, and their practical implications. Facets discussed include oral food challenges. Precautionary allergen labeling (PAL) is a widespread strategy to reduce the potential risk of reactions due to traces. However, PAL is currently inefficient due to inconsistent labeling, also not indicating a clear maximum amount possibly present in the manufactured food. Also, cost-effectiveness needs to be considered in risk management, as many risk reduction procedures are clearly not cost-effective.
AHRQ-funded; HS024599.
Citation: Eigenmann PA, Ebisawa M, Greenhawt M .
Addressing risk management difficulties in children with food allergies.
Pediatr Allergy Immunol 2021 May;32(4):658-66. doi: 10.1111/pai.13455..
Keywords: Children/Adolescents, Risk
Lin CY, Xie J, Freedman SB
Predicting adverse outcomes for Shiga toxin-producing Escherichia coli infections in emergency departments.
Investigators assessed the performance of a hemolytic uremic syndrome (HUS) severity score among children with Shiga toxin-producing Escherichia coli (STEC) infections and HUS by stratifying them according to their risk of adverse events. They found that the HUS severity score was able to discriminate between high- and low-risk children less than 5 years old with STEC-associated HUS at a statistically acceptable level; however, it did not appear to provide clinical benefit at a meaningful risk threshold.
AHRQ-funded; HS026503.
Citation: Lin CY, Xie J, Freedman SB .
Predicting adverse outcomes for Shiga toxin-producing Escherichia coli infections in emergency departments.
J Pediatr 2021 May;232:200-06.e4. doi: 10.1016/j.jpeds.2020.12.077..
Keywords: Children/Adolescents, Infectious Diseases, Emergency Department, Risk
Javalkar K, Robson VK, Gaffney L
Socioeconomic and racial and/or ethnic disparities in multisystem inflammatory syndrome.
Researchers characterized the socioeconomic and racial and/or ethnic disparities impacting the diagnosis and outcomes of multisystem inflammatory syndrome in children (MIS-C). They found that lower socioeconomic status or higher social vulnerability index, Hispanic ethnicity, and Black race independently increased risk for MIS-C. They recommended additional studies to target interventions to improve health equity for children.
AHRQ-funded; HS000063.
Citation: Javalkar K, Robson VK, Gaffney L .
Socioeconomic and racial and/or ethnic disparities in multisystem inflammatory syndrome.
Pediatrics 2021 May;147(5). doi: 10.1542/peds.2020-039933..
Keywords: Children/Adolescents, Social Determinants of Health, Disparities, Racial and Ethnic Minorities, Risk
Daymont C, Balamuth F, Scott HF
Elevated heart rate and risk of revisit with admission in pediatric emergency patients.
This study examines whether emergency department (ED) heart rate (HR) values can identify children at elevated risk of ED revisit with admission. The authors performed a retrospective cohort study of children ages 0-18 years discharged from a tertiary-care pediatric ED from 2013 to 2014. They created percentile curves for the last recorded HR for age using data from calendar year 2013 and used receiver operating characteristic (ROC) curves to characterize the performance of the percentiles for predicting ED revisit with admission within 72 hours. They evaluated 183,433 eligible ED visits and found that the last recorded HR for age had poor discrimination for predicting revisit with admission.
AHRQ-funded; HS023827.
Citation: Daymont C, Balamuth F, Scott HF .
Elevated heart rate and risk of revisit with admission in pediatric emergency patients.
Pediatr Emerg Care 2021 Apr;37(4):e185-e91. doi: 10.1097/pec.0000000000001552..
Keywords: Children/Adolescents, Emergency Department, Risk, Hospitalization
Richardson L, Parker EO, Zhou C
Electronic health risk behavior screening with integrated feedback among adolescents in primary care: randomized controlled trial.
Health risk behaviors are the most common sources of morbidity among adolescents. Adolescent health guidelines (Guidelines for Preventive Services by the AMA and Bright Futures by the Maternal Child Health Bureau) recommend screening and counseling, but the implementation is inconsistent. This study aimed to test the efficacy of electronic risk behavior screening with integrated patient-facing feedback on the delivery of adolescent-reported clinician counseling and risk behaviors over time.
AHRQ-funded; HS023383.
Citation: Richardson L, Parker EO, Zhou C .
Electronic health risk behavior screening with integrated feedback among adolescents in primary care: randomized controlled trial.
J Med Internet Res 2021 Mar 12;23(3):e24135. doi: 10.2196/24135..
Keywords: Children/Adolescents, Primary Care, Risk, Screening
Turi KN, Gebretsadik T, Ding T
Dose, timing, and spectrum of prenatal antibiotic exposure and risk of childhood asthma.
The potential for prenatal antibiotic exposure to influence asthma risk is not clear. The investigators aimed to determine the effect of timing, dose, and spectrum of prenatal antibiotic exposure on the risk of childhood asthma. The investigators concluded that increased cumulative dose, early pregnancy first course, and broad-spectrum antibiotic exposure were associated with childhood asthma risk.
AHRQ-funded; HS026395; HS018454.
Citation: Turi KN, Gebretsadik T, Ding T .
Dose, timing, and spectrum of prenatal antibiotic exposure and risk of childhood asthma.
Clin Infect Dis 2021 Feb 1;72(3):455-62. doi: 10.1093/cid/ciaa085.
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Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Antibiotics, Medication, Risk
Horton DB, Xie F, Chen L
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
The purpose of this study was to quantify rates of incident treatment for diabetes mellitus, hypertension, and venous thromboembolism (VTE) associated with oral glucocorticoid exposure in children aged 1-18 years. Participants were identified using US Medicaid claims data and included more than 930,000 children diagnosed with autoimmune diseases or a nonimmune comparator condition. Findings showed strong dose-dependent relationships between current glucocorticoid exposure and all outcomes, suggesting strong relative risks, but low absolute risks, of newly-treated VTE, diabetes, and especially hypertension in children taking high-dose oral glucocorticoids.
AHRQ-funded; HS021110.
Citation: Horton DB, Xie F, Chen L .
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
Am J Epidemiol 2021 Feb 1;190(3):403-12. doi: 10.1093/aje/kwaa197..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Blood Clots, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient Safety, Blood Pressure
Sabbagh SE, Neely J, Chow A
Risk factors associated with Pneumocystis jirovecii pneumonia in juvenile myositis in North America.
Pneumocystis jirovecii pneumonia (PJP) is associated with significant morbidity and mortality in adult myositis patients; however, there are few studies examining PJP in juvenile myositis [juvenile idiopathic inflammatory myopathy (JIIM)]. The purpose of this study was to determine the risk factors and clinical phenotypes associated with PJP in JIIM. The investigators concluded that having PJP was associated with more immunosuppressive therapy, anti-MDA5 autoantibodies, Asian race and certain clinical features, including digital infarcts, cutaneous ulcerations and interstitial lung disease.
AHRQ-funded; HS000063.
Citation: Sabbagh SE, Neely J, Chow A .
Risk factors associated with Pneumocystis jirovecii pneumonia in juvenile myositis in North America.
Rheumatology 2021 Feb;60(2):829-36. doi: 10.1093/rheumatology/keaa436..
Keywords: Children/Adolescents, Pneumonia, Respiratory Conditions, Risk
Rinke ML, Heo M, Saiman L
Pediatric ambulatory central line-associated bloodstream infections.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-0524.
This study looked at ambulatory pediatric central line-associated bloodstream infection (CLABSI) incidence density, risk factors, and outcomes. This retrospective cohort with nested case-control study used data from 5 sites from 2010 through 2015. Chart review was used to confirm central line (CL) use and adjudicated CLABSIs. Out of 4600 potential at-risk children, 247 (15%) experienced 466 ambulatory CLABSIs. Incidence density was highest among patients with tunneled externalized catheters versus peripherally inserted central catheters and totally implanted devices. Clinic visits and low albumin levels were potentially associated with CLABSI. Prophylactic antimicrobial agents for underlying conditions within the preceding 30 days and operating room CL placement were inversely associated with CLABSI. A total of 396 patients were hospitalized because of ambulatory CLABSI with an 8-day median length of stay.
This study looked at ambulatory pediatric central line-associated bloodstream infection (CLABSI) incidence density, risk factors, and outcomes. This retrospective cohort with nested case-control study used data from 5 sites from 2010 through 2015. Chart review was used to confirm central line (CL) use and adjudicated CLABSIs. Out of 4600 potential at-risk children, 247 (15%) experienced 466 ambulatory CLABSIs. Incidence density was highest among patients with tunneled externalized catheters versus peripherally inserted central catheters and totally implanted devices. Clinic visits and low albumin levels were potentially associated with CLABSI. Prophylactic antimicrobial agents for underlying conditions within the preceding 30 days and operating room CL placement were inversely associated with CLABSI. A total of 396 patients were hospitalized because of ambulatory CLABSI with an 8-day median length of stay.
AHRQ-funded; HS024432.
Citation: Rinke ML, Heo M, Saiman L .
Pediatric ambulatory central line-associated bloodstream infections.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-0524..
Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Ambulatory Care and Surgery, Risk, Sepsis
Wu AC, Li L, Fung V
Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids.
The researchers compared the effectiveness of different controller medication regimens under real-life conditions. They found that the risk of emergency department visits, hospitalizations, and oral corticosteroids did not differ between children who initiated leukotriene antagonist and those who initiated inhaled corticosteroid. These findings may be explainable by leukotriene antagonist having similar effectiveness as inhaled corticosteroid in real-life usage.
AHRQ-funded; HS019669.
Citation: Wu AC, Li L, Fung V .
Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids.
J Allergy Clin Immunol Pract 2014 Sep-Oct;2(5):607-13. doi: 10.1016/j.jaip.2014.05.009..
Keywords: Comparative Effectiveness, Medication, Children/Adolescents, Asthma, Risk