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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 8 of 8 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
Arora S, Fowler ME, Harmon C
Differences in pretreatment frailty across gastrointestinal cancers in older adults: results from the Cancer and Aging Resilience Evaluation registry.
The purpose of this study was to explore differences in pretreatment frailty between colorectal (CRC), hepatobiliary, and pancreatic cancers. The researchers included adults aged 60 years and higher enrolled in the Cancer and Aging Resilience Evaluation registry. A 44-item Cancer and Aging Resilience Evaluation frailty index was utilized to define frailty, which included geriatric assessment impairments of functional status, cognitive complaints, health-related quality of life, comorbidities, polypharmacy, anxiety, depression, malnutrition, falls, ability to walk one block, and interference in social activities. A total of 505 patients were included in the study: 41.8% with CRC, 35.2% with pancreatic cancer, and 116 23.0% with hepatobiliary cancer. The study found the following prevalence of frailty: 40.6% pancreatic, 34.3% hepatobiliary, and 23.3% CRC. Frailty was linked with higher rates of malnutrition and instrumental activities of daily living impairments in patients with pancreatic cancer and higher number of comorbidities in patients with hepatobiliary cancer. The study concluded that adults aged 60 and over with pancreatic and hepatobiliary cancers are at high-risk of pretreatment frailty.
AHRQ-funded; HS013852.
Citation: Arora S, Fowler ME, Harmon C .
Differences in pretreatment frailty across gastrointestinal cancers in older adults: results from the Cancer and Aging Resilience Evaluation registry.
JCO Oncol Pract 2022 Nov;18(11):e1796-e806. doi: 10.1200/op.22.00270..
Keywords: Elderly, Cancer, Digestive Disease and Health
Huang RJ, Epplein M, Hamashima C
An approach to the primary and secondary prevention of gastric cancer in the United States.
In 2020, a summit was convened at Stanford University to address the disparity of gastric cancer as a leading cause of mortality among certain racial, ethnic and immigrant groups in the United States, and the absence of a national strategy for addressing gastric cancer prevention. A working group was formed to conduct a structured literature review to critically evaluate the effectiveness, potential benefits, and potential harms of methods of primary and secondary prevention. The purpose of this article was to provide a consensus statement from that group. The authors found that the distribution of gastric cancer rates is highly inequitable and falls primarily on Asian, African American, Hispanic, and American Indian/Alaskan Native populations. The group concluded that there is an urgent need for cancer prevention trials in high-risk minority populations in the United States.
AHRQ-funded; HS026395.
Citation: Huang RJ, Epplein M, Hamashima C .
An approach to the primary and secondary prevention of gastric cancer in the United States.
Clin Gastroenterol Hepatol 2022 Oct;20(10):2218-28.e2. doi: 10.1016/j.cgh.2021.09.039..
Keywords: Cancer, Digestive Disease and Health, Prevention
Shah SC, Bonnet K, Schulte R
Helicobacter pylori management is associated with predominantly negative patient experiences: results from a focused qualitative analysis.
This paper is a qualitative analysis of the patient experience of H. pylori management using a focus group and one-on-one telephone interviews. A total of 13 participants were included (mean age 50.4 years; 62% female; 38% non-Hispanic white). A total of 987 codes were yielded that five major themes related to the patient H. pylori experience: context of decision-making; health beliefs; barriers experienced; cues to action; and impact of new knowledge. The perceived patient-provider interaction contributed most prominently to the negative patient experience along with treatment-related side effects. Knowledge that lack of treatment can lead to gastric cancer along with symptoms modified participants’ perceptions and motivation to accept treatment.
AHRQ-funded; HS026395.
Citation: Shah SC, Bonnet K, Schulte R .
Helicobacter pylori management is associated with predominantly negative patient experiences: results from a focused qualitative analysis.
Dig Dis Sci 2022 Sep;67(9):4387-94. doi: 10.1007/s10620-021-07320-8..
Keywords: Digestive Disease and Health, Patient Experience
Kanters AE, Evilsizer SK, Regenbogen SE
Correlation of colorectal surgical skill with patient outcomes: a cautionary tale.
Some have proposed that video-based skill assessments be used as a way to measure technical skills, quality improvement, and credentialing in colorectal surgeons and other practitioners. However, it must first be determined whether video-based assessments can accurately predict patient outcomes. The researchers assembled a panel of 10 peer surgeons to evaluate videos of minimally invasive colectomy procedures submitted by 21 surgeons. Each surgeon submitted one video, and the videos were edited to highlight key steps in the procedure. The panel and the surgeon participants were all associated with the Michigan Surgical Quality Collaborative. The panel used a validated American Society of Colon and Rectal Surgeons assessment instrument to rate the surgeon’s skills. The surgeon’s ratings were then linked to a validated registry of surgical outcomes, and the researchers assessed the relationship between skill level and risk-adjusted complication rates. The researchers found that after risk-adjustment there was no statistically significant difference in complication rates between the bottom (17.5%) and top (16.8%) quartile surgeons (p=0.41). The study concluded that there was no correlation between video-based peer rating of minimally invasive colectomy and postoperative complications among specialty surgeons, and that caution should be used when utilizing video review in credentialing.
AHRQ-funded; HS025365.
Citation: Kanters AE, Evilsizer SK, Regenbogen SE .
Correlation of colorectal surgical skill with patient outcomes: a cautionary tale.
Dis Colon Rectum 2022 Mar;65(3):444-51. doi: 10.1097/dcr.0000000000002124..
Keywords: Surgery, Provider: Physician, Provider Performance, Digestive Disease and Health, Outcomes
Dos Santos Marques IC, Herbey II, Theiss LM
Understanding the surgical experience for Black and White patients with inflammatory bowel disease (IBD): the importance of health literacy.
The purpose of this qualitative study was to describe the surgical experience for Black and White inflammatory bowel disease patients. Same race, semi-structured qualitative interviews with patients with IBD who had undergone surgery were conducted to explore barriers and facilitators to a positive or negative surgical experience. The study reported that 6 focus groups were conducted with 10 Black and 17 White IBD participants with a mean age of 44.8 years, 52% of whom were male and 65% of whom had Crohn’s disease. Four themes were identified that most characterized the surgical experience: the impact of the IBD diagnosis, the quality of the information that was provided, disease management, and the surgery. Within these theme groupings, identified barriers to a positive surgical experience included inadequate personal knowledge of IBD, ineffective written and verbal communication, lack of a support system and complications after surgery. Both groups indicated that information was provided inconsistently which led to unclear expectations of surgical outcomes. The study concluded that surgical experiences vary between Black and White patients, but both groups emphasized the need for understandable, accurate, and trustworthy health information.
AHRQ-funded; HS023009; HS013852.
Citation: Dos Santos Marques IC, Herbey II, Theiss LM .
Understanding the surgical experience for Black and White patients with inflammatory bowel disease (IBD): the importance of health literacy.
Am J Surg 2022 Feb;223(2):303-11. doi: 10.1016/j.amjsurg.2021.06.003..
Keywords: Health Literacy, Surgery, Racial and Ethnic Minorities, Racial and Ethnic Minorities, Digestive Disease and Health, Patient Experience
Lee GJ, Dotson JL, Kappelman MD
Seasonality and pediatric inflammatory bowel disease.
The researchers sought to determine whether disease activity in pediatric-onset inflammatory bowel disease (IBD) is associated with a seasonal pattern. Studying 1325 patients with Crohn disease and 587 patients with ulcerative colitis, their findings do not support any strong associations between season of the year and disease activity in pediatric IBD.
AHRQ-funded; HS020024.
Citation: Lee GJ, Dotson JL, Kappelman MD .
Seasonality and pediatric inflammatory bowel disease.
J Pediatr Gastroenterol Nutr 2014 Jul;59(1):25-8. doi: 10.1097/mpg.0000000000000362.
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Keywords: Children/Adolescents, Digestive Disease and Health, Children/Adolescents
Liu TC, Gao F, McGovern DP
Spatial and temporal stability of paneth cell phenotypes in Crohn's disease: implications for prognostic cellular biomarker development.
The researchers sought to develop Paneth cell phenotype as a prognostic biomarker in Crohn’s disease by additional characterization building on their earlier research. Specifically, they examined the effects of disease activity, phenotype duration, and the minimal crypt number that would allow for accurate Paneth cell phenotyping. They demonstrated that Paneth cell phenotypes are not affected either by disease activity or by exposure to therapeutic agents.
AHRQ-funded; HS021747.
Citation: Liu TC, Gao F, McGovern DP .
Spatial and temporal stability of paneth cell phenotypes in Crohn's disease: implications for prognostic cellular biomarker development.
Inflamm Bowel Dis 2014 Apr;20(4):646-51. doi: 10.1097/01.MIB.0000442838.21040.d7..
Keywords: Chronic Conditions, Digestive Disease and Health