National Healthcare Quality and Disparities Report
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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
26 to 50 of 54 Research Studies DisplayedBaillie CA, Epps M, Hanish A
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
The researchers evaluated the usability and effectiveness of a computerized clinical decision support (CDS) intervention aimed at reducing the duration of urinary tract catheterizations. They found that usability improved to 15% with the revised reminder. The catheter utilization ratio declined over the 3 time periods, as did CAUTIs per 1,000 patient-days. They concluded that the usability of the reminder was highly dependent on its user interface, with a homegrown version of the reminder resulting in higher impact than a stock reminder.
AHRQ-funded; HS016946.
Citation: Baillie CA, Epps M, Hanish A .
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
Infect Control Hosp Epidemiol 2014 Sep;35(9):1147-55. doi: 10.1086/677630.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Clinical Decision Support (CDS), Electronic Health Records (EHRs), Health Information Technology (HIT), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Urinary Tract Infection (UTI)
Sentell T, Chang A, Cheng Y
Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawaii: an observational study from five years of statewide data.
The authors investigated maternal quality and safety outcomes across heterogeneous Asian and Pacific Islanders subgroups in the United States. They found significant variation for Asian and Pacific Islander subgroups across maternal quality and safety outcomes.
AHRQ-funded; HS019990; HS021903.
Citation: Sentell T, Chang A, Cheng Y .
Maternal quality and safety outcomes for Asians and Pacific Islanders in Hawaii: an observational study from five years of statewide data.
BMC Pregnancy Childbirth 2014 Aug 30;14:298. doi: 10.1186/1471-2393-14-298.
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Keywords: Disparities, Labor and Delivery, Patient-Centered Outcomes Research, Quality Indicators (QIs), Racial and Ethnic Minorities
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
Smith SR
AHRQ Author: Smith SR
Preface to the AHRQ supplement.
AHRQ, through its Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) Research Network, sponsored this supplement to present various strategies in the design, analysis, and conduct of health outcomes studies relevant to rare diseases. The purpose of this supplement is to disseminate illustrative examples of research methods that can be applied to understand health outcomes and potentially to stimulate new patient-centered outcomes studies for rare diseases.
AHRQ-authored.
Citation: Smith SR .
Preface to the AHRQ supplement.
J Gen Intern Med 2014 Aug;29 Suppl 3:S712-3. doi: 10.1007/s11606-014-2922-x.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research, Research Methodologies
Holzer JK, Ellis L, Merritt MW
Why we need community engagement in medical research.
The aim of this article was to illustrate how community engagement can help to remedy shortfalls of community trust, participant enrollment, and uptake of research findings. After briefly describing these shortfalls, the authors considered 3 case examples that demonstrate the potential of community engagement to address each. They also discussed the ethical importance and implications of demonstrating respect for the community.
AHRQ-funded; HS017589.
Citation: Holzer JK, Ellis L, Merritt MW .
Why we need community engagement in medical research.
J Investig Med 2014 Aug;62(6):851-5. doi: 10.1097/jim.0000000000000097..
Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies, Implementation
Maggard-Gibbons M
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
This review summarized the history of American College of Surgeons National Surgical Quality Improvement Project and its components, and described the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety.
AHRQ-funded; 2902007100621.
Citation: Maggard-Gibbons M .
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
BMJ Qual Saf 2014 Jul;23(7):589-99. doi: 10.1136/bmjqs-2013-002223..
Keywords: Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Surgery, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Provider Performance
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
McGlynn EA, Lieu TA, Durham ML
Developing a data infrastructure for a learning health system: the PORTAL network.
The authors describe the Patient Outcomes Research To Advance Learning (PORTAL) network established by Kaiser Permanente and three other healthcare delivery systems. They discuss how PORTAL is enhancing its current capabilities by expanding the scope of the common data model and integrating the PCORnet PopMedNet platform across their research centers with the objective of conducting large-scale observational comparative effectiveness research across diverse clinical care settings.
AHRQ-funded; HS022143; HS019912
Citation: McGlynn EA, Lieu TA, Durham ML .
Developing a data infrastructure for a learning health system: the PORTAL network.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):596-601. doi: 10.1136/amiajnl-2014-002746..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Health Information Technology (HIT)
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
Ohno-Machado L, Agha Z, Bell DS
pSCANNER: patient-centered Scalable National Network for Effectiveness Research.
The authors describe the patient-centered Scalable National Network for Effectiveness Research (pSCANNER), which is part of the recently formed Patient-Centered Outcomes Research net (PCORnet). It is designed to be a stakeholder-governed federated network that uses a distributed architecture to integrate data from 3 existing networks covering over 21 million patients in all 50 States.
AHRQ-funded; HS019913
Citation: Ohno-Machado L, Agha Z, Bell DS .
pSCANNER: patient-centered Scalable National Network for Effectiveness Research.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):621-6. doi: 10.1136/amiajnl-2014-002751..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Health Information Technology (HIT)
Kaplan RM
AHRQ Author: Kaplan RM
Patient-centered outcome assessment may lead to different conclusions and different treatment decisions.
Over the last few decades, the Agency for Healthcare Research and Quality (AHRQ), clinicians, policy makers, and patient advocates have demonstrated a growing interest in measuring patient-reported outcomes. Most illnesses are now evaluated in terms of their effects on usual life activities. This article discusses Patient-Centered Outcomes Research and the measurement of outcomes from the patient perspective.
AHRQ-authored.
Citation: Kaplan RM .
Patient-centered outcome assessment may lead to different conclusions and different treatment decisions.
American Journal of Accountable Care 2014 Jun 20;2(2):14-15..
Keywords: Decision Making, Patient-Centered Outcomes Research
Bilimoria KY, Cella D, Butt Z
Current challenges in using patient-reported outcomes for surgical care and performance measurement: everybody wants to hear from the patient, but are we ready to listen?
This viewpoint article discussed patient-reported outcomes (PROs). It concludes that PROs undoubtedly capture some of the most important aspects of how successful an operation is, and PRO scores may be the best measure of patient-centered care, but considerable logistical and methodological issues must be addressed before PROs are ready for widespread national implementation.
AHRQ-funded; HS021857.
Citation: Bilimoria KY, Cella D, Butt Z .
Current challenges in using patient-reported outcomes for surgical care and performance measurement: everybody wants to hear from the patient, but are we ready to listen?
JAMA Surg 2014 Jun;149(6):505-6. doi: 10.1001/jamasurg.2013.5285.
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Keywords: Patient-Centered Outcomes Research, Quality Measures, Surgery
Lavallee DC, Wicks P, Alfonso Cristancho R
Stakeholder engagement in patient-centered outcomes research: high-touch or high-tech?
In this article, the authors compared and contrasted high-tech and high-touch approaches to engaging stakeholders and suggested hybrid processes.
AHRQ-funded; HS022135; HS022959.
Citation: Lavallee DC, Wicks P, Alfonso Cristancho R .
Stakeholder engagement in patient-centered outcomes research: high-touch or high-tech?
Expert Rev Pharmacoecon Outcomes Res 2014 Jun;14(3):335-44. doi: 10.1586/14737167.2014.901890.
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Keywords: Patient-Centered Outcomes Research, Evidence-Based Practice, Patient-Centered Healthcare, Patient and Family Engagement
Friedly JL, Bauer Z, Comstock BA
AHRQ Author: Zhan C, Hsia DC, Trontell A
Challenges conducting comparative effectiveness research: the Clinical and Health Outcomes Initiative in Comparative Effectiveness (CHOICE) experience.
This paper explores the collective experience of the Clinical and Health Outcomes Initiative in Comparative (CHOICE) program, which includes 12 ongoing comparative effectiveness research trials funded by AHRQ. It describes the common features of the CHOICE award studies to summarize the strategies undertaken to address the challenges in conducting comparative effectiveness pragmatic trials and observational studies from various perspectives.
AHRQ-authored; AHRQ-funded; HS019222
Citation: Friedly JL, Bauer Z, Comstock BA .
Challenges conducting comparative effectiveness research: the Clinical and Health Outcomes Initiative in Comparative Effectiveness (CHOICE) experience.
Comp Eff Res. 2014 May;4:1-12..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
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.
AHRQ-funded; HS018517
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
Band RA, Salhi RA, Holena DN
Severity-adjusted mortality in trauma patients transported by police.
Two decades ago, Philadelphia began allowing police transport of patients with penetrating trauma. In this retrospective cohort study, the investigators conduct a large, multiyear, citywide analysis of this policy. They examine the association between mode of out-of-hospital transport (police department versus emergency medical services [EMS]) and mortality among patients with penetrating trauma in Philadelphia.
AHRQ-funded; HS017960.
Citation: Band RA, Salhi RA, Holena DN .
Severity-adjusted mortality in trauma patients transported by police.
Ann Emerg Med 2014 May;63(5):608-14.e3. doi: 10.1016/j.annemergmed.2013.11.008..
Keywords: Injuries and Wounds, Mortality, Patient-Centered Outcomes Research, Trauma
Huo J, Lairson DR, Du XL
Survival and cost-effectiveness of hospice care for metastatic melanoma patients.
The authors analyzed the association of hospice use with survival and health care costs among patients diagnosed with metastatic melanoma. They found that the median survival time was 6.1 months for patients with no hospice care, 6.5 months for patients enrolled in hospice for 1 to 3 days, and 10.2 months for patients enrolled for 4 or more days. Patients with 4 or more days of hospice care incurred lower end-of-life costs than the comparison groups.
AHRQ-funded; HS018956.
Citation: Huo J, Lairson DR, Du XL .
Survival and cost-effectiveness of hospice care for metastatic melanoma patients.
Am J Manag Care 2014 May;20(5):366-73.
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Keywords: Cancer, Cancer: Skin Cancer, Healthcare Costs, Palliative Care, Patient-Centered Outcomes Research
Tugwell P, Boers M, D'Agostino MA
Updating the OMERACT filter: implications of filter 2.0 to select outcome instruments through assessment of "truth": content, face, and construct validity.
Two discussion groups critically reviewed the variety of ways in which five case studies of current OMERACT Working Groups complied with the ‘Truth’ component of the Filter and what issues remained to be resolved. The case studies showed that there is broad agreement on criteria for meeting the ‘Truth’ criteria through demonstration of content, face and construct validity; however several issues were identified that the Filter Working Group will need to address.
AHRQ-funded; HS013852
Citation: Tugwell P, Boers M, D'Agostino MA .
Updating the OMERACT filter: implications of filter 2.0 to select outcome instruments through assessment of "truth": content, face, and construct validity.
J Rheumatol. 2014 May;41(5):1000-4. doi: 10.3899/jrheum.131310..
Keywords: Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Bannuru RR, Flavin NE, Vaysbrot E
High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: a systematic review.
Calcific and noncalcific tendinitis of the shoulder can be unresponsive to conventional therapies. Extracorporeal shock-wave therapy (ESWT) has been suggested as an alternative treatment. The purpose of this study was to assess the efficacy of ESWT in patients with calcific and noncalcific tendinitis. The investigators found that high-energy ESWT was effective for improving pain and shoulder function in chronic calcific shoulder tendinitis and can result in complete resolution of calcifications.
AHRQ-funded; HS017960.
Citation: Bannuru RR, Flavin NE, Vaysbrot E .
High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: a systematic review.
Ann Intern Med 2014 Apr 15;160(8):542-9. doi: 10.7326/m13-1982..
Keywords: Chronic Conditions, Comparative Effectiveness, Complementary and Alternative Medicine, Patient-Centered Outcomes Research
Bannuru RR, Flavin NE, Vaysbrot E
High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: a systematic review.
Calcific and noncalcific tendinitis of the shoulder can be unresponsive to conventional therapies. Extracorporeal shock-wave therapy (ESWT) has been suggested as an alternative treatment. The purpose of this study was to assess the efficacy of ESWT in patients with calcific and noncalcific tendinitis. The investigators found that high-energy ESWT was effective for improving pain and shoulder function in chronic calcific shoulder tendinitis and can result in complete resolution of calcifications.
AHRQ-funded; HS017960.
Citation: Bannuru RR, Flavin NE, Vaysbrot E .
High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: a systematic review.
Ann Intern Med 2014 Apr 15;160(8):542-9. doi: 10.7326/m13-1982..
Keywords: Chronic Conditions, Comparative Effectiveness, Complementary and Alternative Medicine, Patient-Centered Outcomes Research
Bressler B, Siegel CA
Beware of the swinging pendulum: anti-tumor necrosis factor monotherapy vs combination therapy for inflammatory bowel disease.
An editorial commenting on a study in the same issue by Osterman, et al. in the context of related studies concludes that it is more reasonable to consider slightly modifying the approach to anti-tumor necrosis factor combination therapy as opposed to a full pendulum swing back to monotherapy.
AHRQ-funded; HS021747
Citation: Bressler B, Siegel CA .
Beware of the swinging pendulum: anti-tumor necrosis factor monotherapy vs combination therapy for inflammatory bowel disease.
Gastroenterolog.y 2014 Apr;146(4):884-7. doi: 10.1053/j.gastro.2014.02.018..
Keywords: Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research, Medication, Chronic Conditions
Rowland M, Peterson-Besse J, Dobbertin K
Health outcome disparities among subgroups of people with disabilities: a scoping review.
The authors described recent research activity that has examined health outcome disparities within populations of people with disabilities. They found that the health outcomes most frequently examined were diabetes and heart disease, and the most frequently examined disparity factors were the type of disabling condition and gender. Identifying that there are significant gaps in available research, they concluded that building a body of research that identifies disparities and potentially vulnerable subgroups may improve understanding of the causes of disparities and contribute to efforts to improve quality of life and health outcomes for individuals with disabilities.
AHRQ-funded.
Citation: Rowland M, Peterson-Besse J, Dobbertin K .
Health outcome disparities among subgroups of people with disabilities: a scoping review.
Disabil Health J 2014 Apr;7(2):136-50. doi: 10.1016/j.dhjo.2013.09.003.
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Keywords: Disabilities, Disparities, Health Status, Patient-Centered Outcomes Research
O'Brien EC, Holmes DN, Ansell JE
Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.
This study describes the frequencies of and factors associated with oral anticoagulation (OAC) contraindications in clinical practice for patients with atrial fibrillation (AF). Contraindications to OAC therapy among patients with AF are common but subjective. Many patients with reported contraindications were receiving OAC, suggesting that the perceived benefits outweighed the potential harm posed by the relative contraindication.
AHRQ-funded; HS021092
Citation: O'Brien EC, Holmes DN, Ansell JE .
Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.
Am Heart J. 2014 Apr;167(4):601-609.e1. doi: 10.1016/j.ahj.2013.12.014..
Keywords: Heart Disease and Health, Blood Thinners, Medication, Registries, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Practice Patterns
Meddings J, Rogers MA, Krein SL
Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.
The authors updated a prior systematic review and a meta-analysis regarding interventions prompting urinary catheter (UC) removal by reminders or stop orders. They found that UC reminders and stop orders appear to reduce catheter-associated urinary tract infection rates and should be used to improve patient safety.
AHRQ-funded; 290200710062I; HS019767; HS018344.
Citation: Meddings J, Rogers MA, Krein SL .
Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.
BMJ Qual Saf 2014 Apr;23(4):277-89. doi: 10.1136/bmjqs-2012-001774.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Patient-Centered Outcomes Research, Prevention, Quality Improvement, Urinary Tract Infection (UTI)
Buckley DI, Ansari MT, Butler M
AHRQ Author: Chang CS
The refinement of topics for systematic reviews: lessons and recommendations from the Effective Health Care Program.
AHRQ convened a work group to assess approaches and develop recommendations for topic refinement for the Effective Health Care Program. They concluded that accurate, rigorous, and useful systematic reviews require well-refined topics, and the work group's guiding principles and methodological recommendations may help investigators refine topics for reviews.
AHRQ-authored.
Citation: Buckley DI, Ansari MT, Butler M .
The refinement of topics for systematic reviews: lessons and recommendations from the Effective Health Care Program.
J Clin Epidemiol 2014 Apr;67(4):425-32. doi: 10.1016/j.jclinepi.2013.10.023.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies