National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (5)
- Ambulatory Care and Surgery (1)
- Arthritis (2)
- Blood Thinners (2)
- Brain Injury (1)
- Cancer (2)
- Cancer: Lung Cancer (1)
- Cardiovascular Conditions (7)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Comparative Effectiveness (3)
- Data (6)
- Diabetes (1)
- Education: Patient and Caregiver (1)
- Elderly (1)
- Electronic Health Records (EHRs) (4)
- Evidence-Based Practice (3)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Costs (1)
- Healthcare Delivery (1)
- Health Information Technology (HIT) (9)
- Health Services Research (HSR) (4)
- Health Status (1)
- Heart Disease and Health (8)
- Hospital Discharge (3)
- Hospitalization (1)
- Hospital Readmissions (2)
- Hospitals (2)
- Influenza (1)
- Injuries and Wounds (3)
- Kidney Disease and Health (1)
- Medical Devices (1)
- Medication (4)
- Mortality (4)
- Outcomes (5)
- Palliative Care (1)
- Patient-Centered Outcomes Research (10)
- Patient Safety (3)
- Policy (1)
- Quality Improvement (4)
- Quality Measures (1)
- Quality of Care (3)
- Racial and Ethnic Minorities (3)
- (-) Registries (38)
- Risk (5)
- Shared Decision Making (2)
- Surgery (9)
- Transplantation (4)
- Trauma (1)
- Treatments (1)
- Vaccination (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 25 of 38 Research Studies DisplayedCooper LB, Lippmann SJ, Greiner MA
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. In their study, the investigators found that among patients with heart failure and diabetes mellitus or chronic kidney disease, MRA use was associated with lower risk of all-cause readmission despite greater risk of hyperkalemia and acute renal insufficiency.
AHRQ-funded; HS021092.
Citation: Cooper LB, Lippmann SJ, Greiner MA .
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
J Am Heart Assoc 2017 Dec 23;6(12):pii: e006540. doi: 10.1161/jaha.117.006540..
Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Evidence-Based Practice, Heart Disease and Health, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research, Registries
Henderson ML, Thomas AG, Shaffer A
The national landscape of living kidney donor follow-up in the United States.
The purpose of this study was to understand the impact of the 2013 policy the Organ Procurement and Transplantation Network/United Network for Organ Sharing issued. The policy required that transplant centers collect data on living kidney donors (LKDs) at 6 months, 1 year, and 2 years postdonation, with policy-defined thresholds for the proportion of complete living donor follow-up data submitted in a timely manner (60 days before or after the expected visit date).
AHRQ-funded; HS024600.
Citation: Henderson ML, Thomas AG, Shaffer A .
The national landscape of living kidney donor follow-up in the United States.
Am J Transplant 2017 Dec;17(12):3131-40. doi: 10.1111/ajt.14356..
Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Policy, Registries, Transplantation
Schaffhausen CR, Bruin MJ, Chesley D
What patients and members of their support networks ask about transplant program data.
This study used qualitative document research methods to review 678 detailed Scientific Registry of Transplant Recipients (SRTR) entries and summary counts of 55 362 United Network for Organ Sharing (UNOS) entries to provide a better understanding of what was asked and what requests were most common. Patients sought a wide range of information about outcomes, waiting times, program volumes, and willingness to perform transplants in candidates with specific diseases or demographics.
AHRQ-funded; HS024527.
Citation: Schaffhausen CR, Bruin MJ, Chesley D .
What patients and members of their support networks ask about transplant program data.
Clin Transplant 2017 Dec;31(12). doi: 10.1111/ctr.13125.
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Keywords: Education: Patient and Caregiver, Shared Decision Making, Health Services Research (HSR), Registries, Transplantation
Wey A, Salkowski N, Kasiske BL
Influence of kidney offer acceptance behavior on metrics of allocation efficiency.
This study investigated associations of deceased donor kidney offer acceptance with likelihood of the kidney being discarded, cold ischemia time at transplant (CIT), and likelihood of the kidney being exported outside the donation service area (DSA). The authors suggest that improving lower-than-expected offer acceptance would likely reduce discards, CIT, and exports.
AHRQ-funded; HS024527.
Citation: Wey A, Salkowski N, Kasiske BL .
Influence of kidney offer acceptance behavior on metrics of allocation efficiency.
Clin Transplant 2017 Sep;31(9). doi: 10.1111/ctr.13057..
Keywords: Health Services Research (HSR), Registries, Transplantation
Ross JS, Bates J, Parzynski CS
Can machine learning complement traditional medical device surveillance? A case study of dual-chamber implantable cardioverter-defibrillators.
Using data from the National Cardiovascular Data Registry for implantable cardioverter-defibrillators (ICDs) linked to Medicare administrative claims for longitudinal follow-up, the researchers applied three statistical approaches to safety-signal detection for commonly used dual-chamber ICDs that used two propensity score (PS) models. The three approaches, including one machine learning method, identified important safety signals, but without exact agreement.
AHRQ-funded; HS023000.
Citation: Ross JS, Bates J, Parzynski CS .
Can machine learning complement traditional medical device surveillance? A case study of dual-chamber implantable cardioverter-defibrillators.
Med Devices 2017 Aug 16;10:165-88. doi: 10.2147/mder.s138158.
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Keywords: Medical Devices, Registries, Patient Safety, Adverse Events
Boffa D, Fernandez FG, Kim S
Surgically managed clinical stage iiia-clinical n2 lung cancer in the Society of Thoracic Surgeons Database.
The objective of this study was to characterize the management of clinical stage IIIA-N2 positive (cIIIA-N2) lung cancer in The Society of Thoracic Surgeons General Thoracic Surgery Database. Surgeons achieved excellent short- and long-term results treating predominantly lobectomy-amenable cIIIA-N2 lung cancer. However, prevalent overstaging and abstention from induction therapy suggested "overcoding" of false positives on imaging or variable compliance with current guidelines for cIIIA-N2 lung cancer.
AHRQ-funded; HS022279.
Citation: Boffa D, Fernandez FG, Kim S .
Surgically managed clinical stage iiia-clinical n2 lung cancer in the Society of Thoracic Surgeons Database.
Ann Thorac Surg 2017 Aug;104(2):395-403. doi: 10.1016/j.athoracsur.2017.02.031.
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Keywords: Surgery, Cancer: Lung Cancer, Registries, Elderly, Outcomes
Ashby VB, Leichtman AB, Rees MA
A kidney graft survival calculator that accounts for mismatches in age, sex, HLA, and body size.
Models were adjusted for year of transplant and donor and recipient characteristics, with particular attention to mismatches in age, sex, human leukocyte antigens (HLA), body size, and weight. These models were used to create a calculator of estimated graft survival for living donors. This calculator provides useful information to donors, candidates, and physicians of estimated outcomes and potentially in allowing candidates to choose among several living donors.
AHRQ-funded; HS020610.
Citation: Ashby VB, Leichtman AB, Rees MA .
A kidney graft survival calculator that accounts for mismatches in age, sex, HLA, and body size.
Clin J Am Soc Nephrol 2017 Jul 7;12(7):1148-60. doi: 10.2215/cjn.09330916.
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Keywords: Adverse Events, Shared Decision Making, Registries, Risk, Transplantation
Lee SY, Cherian R, Ly I
Designing and implementing an electronic patient registry to improve warfarin monitoring in the ambulatory setting.
The researchers designed and implemented an electronic registry in conjunction with a complementary work flow that established an active tracking system leading to improved treatment monitoring for patients on anticoagulation therapy. For the cohort of the 357 patients in the registry, the no-show rate decreased from 31 percent (preimplementation) to 21 percent (postimplementation).
AHRQ-funded; HS023558; HS021322.
Citation: Lee SY, Cherian R, Ly I .
Designing and implementing an electronic patient registry to improve warfarin monitoring in the ambulatory setting.
Jt Comm J Qual Patient Saf 2017 Jul;43(7):353-60. doi: 10.1016/j.jcjq.2017.03.006.
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Keywords: Health Information Technology (HIT), Registries, Blood Thinners, Medication, Ambulatory Care and Surgery
Ong T, Pradhananga R, Holve E
A framework for classification of electronic health data extraction-transformation-loading challenges in data network participation.
The researchers conducted key-informant interviews with data partner representatives to survey the Extract, Transform, Load (ETL) process challenges faced in clinical data research networks (CDRNs) and registries. The paper concluded that overcoming ETL technical challenges requires significant investments in a broad array of information technologies and human resources. Identifying these technical obstacles can inform optimal resource allocation to minimize the barriers and cost of entry for new data partners into extant networks, which in turn can expand data networks' inclusiveness and diversity.
AHRQ-funded; HS019564.
Citation: Ong T, Pradhananga R, Holve E .
A framework for classification of electronic health data extraction-transformation-loading challenges in data network participation.
eGEMS 2017 Jun 13;5(1):10. doi: 10.5334/egems.222..
Keywords: Comparative Effectiveness, Data, Health Information Technology (HIT), Patient-Centered Outcomes Research, Registries
Parikh KS, Lippmann SJ, Greiner M
Scope of sacubitril/valsartan eligibility after heart failure hospitalization: findings from the GWTG-HF Registry (Get With The Guidelines-Heart Failure).
Researchers used the Get With The Guidelines-Heart Failure (GWTG-HF) registry to characterize patients’ eligibility and potential barriers for sacubitril/valsartan initiation. The GWTG-HF registry was established by the American Heart Association to improve adherence to quality of care guidelines for patients hospitalized with heart failure. The FDA has approved sacubitril/valsartan for patients with heart failure with reduced ejection fraction (HFrEF); however, FDA labeling is broader than the trial entry criteria, and the scope of potential sacubitril/valsartan use in HFrEF is not well understood. Findings suggest that discharge from hospitalization from acute heart failure may be an opportunity for re-evaluating medications, including potentially switching the patient from ACEI/ARB, or starting sacubitril/valsartan.
AHRQ-funded; HS021092.
Citation: Parikh KS, Lippmann SJ, Greiner M .
Scope of sacubitril/valsartan eligibility after heart failure hospitalization: findings from the GWTG-HF Registry (Get With The Guidelines-Heart Failure).
Circulation 2017 May 23;135(21):2077-80. doi: 10.1161/circulationaha.117.027773..
Keywords: Cardiovascular Conditions, Guidelines, Heart Disease and Health, Hospitalization, Medication, Registries
Hu Z, Melton GB, Arsoniadis EG
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
Proper handling of missing data is important for many secondary uses of electronic health record (EHR) data. Data imputation methods can be used to handle missing data, but their use for postoperative complication detection is unclear. Overall, models with missing data imputation almost always outperformed reference models without imputation that included only cases with complete data for detection of SSI overall achieving very good average area under the curve values.
AHRQ-funded; HS024532.
Citation: Hu Z, Melton GB, Arsoniadis EG .
Strategies for handling missing clinical data for automated surgical site infection detection from the electronic health record.
J Biomed Inform 2017 Apr;68:112-20. doi: 10.1016/j.jbi.2017.03.009.
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Keywords: Data, Electronic Health Records (EHRs), Healthcare-Associated Infections (HAIs), Registries, Surgery, Injuries and Wounds, Health Information Technology (HIT), Quality Improvement, Quality of Care, Adverse Events
Tonner C, Schmajuk G, Yazdany J
A new era of quality measurement in rheumatology: electronic clinical quality measures and national registries.
This article reviews the evolution of quality measurement in rheumatology, highlighting new health-information technology infrastructure and standards that are enabling unprecedented innovation in this field. Its authors assert that quality measurement and improvement is increasingly an essential component of rheumatology practice. Advances in health information technology are likely to continue to make implementation of electronic clinical quality measures (eCQMs) easier and measurement more clinically meaningful and accurate in coming years.
AHRQ-funded; HS024412.
Citation: Tonner C, Schmajuk G, Yazdany J .
A new era of quality measurement in rheumatology: electronic clinical quality measures and national registries.
Curr Opin Rheumatol 2017 Mar;29(2):131-37. doi: 10.1097/bor.0000000000000364.
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Keywords: Quality Measures, Registries, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement
Curtis JR, Chen L, Greenberg JD
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights.
Treat to target guidelines recommend achieving remission or low disease activity in rheumatoid arthritis (RA). However, the reduction in adverse events and costs associated with lower disease activity is unclear. This study found that leveraging the benefits of linking registry and administrative data together, lower disease activity in RA was associated with incrementally reduced risks of all-cause hospitalization, ED visits, mortality, and medical costs in a dose-dependent fashion.
AHRQ-funded; HS021694.
Citation: Curtis JR, Chen L, Greenberg JD .
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights.
Pharmacoepidemiol Drug Saf 2017 Mar;26(3):310-19. doi: 10.1002/pds.4126.
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Keywords: Patient-Centered Outcomes Research, Registries, Arthritis, Healthcare Costs, Guidelines
Desai NR, Parzynski CS, Krumholz HM
Patterns of institutional review of percutaneous coronary intervention appropriateness and the effect on quality of care and clinical outcomes.
The researchers sought to determine whether internal review of percutaneous coronary intervention (PCI) appropriateness using appropriate use criteria is associated with differences in procedural appropriateness, quality of care, and patient outcomes. They concluded that there was a modest association between procedural appropriateness and clinical outcomes and a similarly modest correlation between nonacute PCI volume and procedural appropriateness.
AHRQ-funded; HS023000
Citation: Desai NR, Parzynski CS, Krumholz HM .
Patterns of institutional review of percutaneous coronary intervention appropriateness and the effect on quality of care and clinical outcomes.
JAMA Intern Med. 2015 Dec;175(12):1988-90.
Keywords: Cardiovascular Conditions, Patient-Centered Outcomes Research, Heart Disease and Health, Registries
O'Brien EC, Simon DN, Thomas LE
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
The researchers sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based in atrial fibrillation (AF) population. They concluded that their five-element ORBIT bleeding risk score had better ability to predict major bleeding in AF patients when compared with HAS-BLED and ATRIA risk scores.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Simon DN, Thomas LE .
The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation.
Eur Heart J 2015 Dec 7;36(46):3258-64. doi: 10.1093/eurheartj/ehv476.
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Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Adverse Drug Events (ADE), Adverse Events, Risk, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice
Goldberg J, Paugh TA, Dickinson TA
Greater volume of acute normovolemic hemodilution may aid in reducing blood transfusions after cardiac surgery.
The researchers describe the relationship between acute normovolemic hemodilution (ANH) and red blood cell (RBC) transfusions after cardiac surgery using a multicenter registry. They found a significant association between ANH and reduced perioperative RBC transfusion in cardiac surgery. Transfusion reduction is most profound with larger volumes of ANH.
AHRQ-funded; HS022535; HS022909.
Citation: Goldberg J, Paugh TA, Dickinson TA .
Greater volume of acute normovolemic hemodilution may aid in reducing blood transfusions after cardiac surgery.
Ann Thorac Surg 2015 Nov;100(5):1581-7; discussion 87. doi: 10.1016/j.athoracsur.2015.04.135.
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Keywords: Cardiovascular Conditions, Surgery, Registries
Hu Y, McMurry TL, Stukenborg GJ
Readmission predicts 90-day mortality after esophagectomy: analysis of surveillance, epidemiology, and end results registry linked to Medicare outcomes.
The purpose of this study was to characterize postesophagectomy readmissions and determine their relationship with subsequent 90-day mortality. It found that one in 5 esophagectomy patients are readmitted early after discharge. Readmitted patients have a 5-fold increase in early mortality.
AHRQ-funded; HS018049.
Citation: Hu Y, McMurry TL, Stukenborg GJ .
Readmission predicts 90-day mortality after esophagectomy: analysis of surveillance, epidemiology, and end results registry linked to Medicare outcomes.
J Thorac Cardiovasc Surg 2015 Nov;150(5):1254-60. doi: 10.1016/j.jtcvs.2015.08.071..
Keywords: Hospital Readmissions, Mortality, Outcomes, Registries, Surgery
Likosky DS, Wallace AS, Prager RL
Sources of variation in hospital-level infection rates after coronary artery bypass grafting: an analysis of the Society of Thoracic Surgeons Adult Heart Surgery Database.
This descriptive study characterized the hospital-level variability in healthcare-acquired infection (HAI) rates across hospitals participating in The Society of Thoracic Surgeons Adult Cardiac Surgery Database. It found substantial hospital-level variation exists in postoperative HAIs among patients undergoing coronary artery bypass graft surgery, driven predominantly by pneumonia.
AHRQ-funded; HS022535; HS022909.
Citation: Likosky DS, Wallace AS, Prager RL .
Sources of variation in hospital-level infection rates after coronary artery bypass grafting: an analysis of the Society of Thoracic Surgeons Adult Heart Surgery Database.
Ann Thorac Surg 2015 Nov;100(5):1570-5; discussion 75-6. doi: 10.1016/j.athoracsur.2015.05.015.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Adverse Events, Injuries and Wounds, Registries
Hoopes MJ, Dankovchik J, Weiser T
Uncovering a missing demographic in trauma registries: epidemiology of trauma among American Indians and Alaska Natives in Washington state.
The objectives of this study were to evaluate racial misclassification in a statewide trauma registry and to describe the epidemiology of trauma among the Washington American Indian and Alaska Native (AI/AN) population. Linkage to a state trauma registry improved data quality by correcting racial misclassification, allowing for a comprehensive description of injury patterns for the AI/AN population. Compared to Caucasians, AI/AN sustained more severe injuries with similar postinjury outcomes.
AHRQ-funded; HS019972.
Citation: Hoopes MJ, Dankovchik J, Weiser T .
Uncovering a missing demographic in trauma registries: epidemiology of trauma among American Indians and Alaska Natives in Washington state.
Inj Prev 2015 Oct;21(5):335-43. doi: 10.1136/injuryprev-2014-041419.
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Keywords: Trauma, Registries, Racial and Ethnic Minorities, Health Status, Injuries and Wounds
Marsolo K, Margolis PA, Forrest CB
A digital architecture for a network-based learning health system: integrating chronic care management, quality improvement, and research.
The authors collaborated with the ImproveCareNow Network to create a proof-of-concept architecture for a network-based Learning Health System. This collaboration involved transitioning an existing registry to one that is linked to the electronic health record (EHR), enabling a “data in once” strategy. This required automating a series of reports that support care improvement while also demonstrating the use of observational registry data for comparative effectiveness research.
AHRQ-funded; HS020024; HS022974.
Citation: Marsolo K, Margolis PA, Forrest CB .
A digital architecture for a network-based learning health system: integrating chronic care management, quality improvement, and research.
eGEMS 2015 Aug 17;3(1):1168. doi: 10.13063/2327-9214.1168..
Keywords: Electronic Health Records (EHRs), Registries, Patient-Centered Outcomes Research, Comparative Effectiveness, Health Information Technology (HIT)
Kaplan RM, Irvin VL
AHRQ Author: Kaplan RM
Likelihood of null effects of large NHLBI clinical trials has increased over time.
This study explores whether the number of null results in large National Heart Lung, and Blood Institute (NHLBI) funded trials has increased over time. It found that the number NHLBI trials reporting positive results declined after the year 2000. Prospective declaration of outcomes in RCTs, and the adoption of transparent reporting standards, as required by clinicaltrials.gov, may have contributed to the trend toward null findings.
AHRQ-authored
Citation: Kaplan RM, Irvin VL .
Likelihood of null effects of large NHLBI clinical trials has increased over time.
PLoS One 2015 Aug 5;10(8):e0132382. doi: 10.1371/journal.pone.0132382..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Registries
Zingmond DS, Parikh P, Louie R
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
This study investigated new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals. It examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort in California. It concluded that comparison between reported R/E and R/E estimates using zip code level data may be a reasonable first approach to evaluate and track hospital R/E reporting.
AHRQ-funded; HS019963.
Citation: Zingmond DS, Parikh P, Louie R .
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
Health Serv Res 2015 Aug;50 Suppl 1:1372-89. doi: 10.1111/1475-6773.12324..
Keywords: Racial and Ethnic Minorities, Hospitals, Hospital Discharge, Health Services Research (HSR), Registries, Quality Improvement, Quality of Care, Data
Naessens JM, Visscher SL, Peterson SM
Incorporating the last four digits of social security numbers substantially improves linking patient data from de-identified hospital claims databases.
The study objective was to assess algorithms for linking patients across de-identified databases without compromising confidentiality. It found that addition of SSNL4 to administrative data, accompanied by appropriate data use and data release policies, can enable trusted repositories to link data with nearly perfect accuracy.
AHRQ-funded; HS020043.
Citation: Naessens JM, Visscher SL, Peterson SM .
Incorporating the last four digits of social security numbers substantially improves linking patient data from de-identified hospital claims databases.
Health Serv Res 2015 Aug;50 Suppl 1:1339-50. doi: 10.1111/1475-6773.12323..
Keywords: Data, Registries, Hospital Discharge, Health Information Technology (HIT)
Bigback KM, Hoopes M, Dankovchik J
Using record linkage to improve race data quality for American Indians and Alaska Natives in two Pacific Northwest State Hospital Discharge Databases.
This study aimed to evaluate and adjust for American Indian and Alaska Native (AI/AN) racial misclassification in two hospital discharge datasets in the Pacific Northwest. It found that in Oregon, 55.4 percent of matching records were misclassified (66.5 percent miscoded white, and 22.1 percent were missing race information). Linkage increased ascertainment of AI/AN hospitalizations by 31.8 percent in Oregon and 33.9 percent in Washington.
AHRQ-funded; HS019972.
Citation: Bigback KM, Hoopes M, Dankovchik J .
Using record linkage to improve race data quality for American Indians and Alaska Natives in two Pacific Northwest State Hospital Discharge Databases.
Health Serv Res 2015 Aug;50 Suppl 1:1390-402. doi: 10.1111/1475-6773.12331..
Keywords: Racial and Ethnic Minorities, Quality Improvement, Registries, Hospital Discharge, Data
Qian F, Hannan EL, Pine M
Can adding laboratory values improve risk-adjustment mortality models using clinical percutaneous cardiac intervention registry data?
The authors predicted in-hospital/30-day mortality with and without appended laboratory data using New York's percutaneous coronary intervention registry data from 2008-2010. They found that adding laboratory data did not significantly improve the risk-adjustment mortality models' performance and did not dramatically change the quality assessment of hospitals.
AHRQ-funded; HS019965.
Citation: Qian F, Hannan EL, Pine M .
Can adding laboratory values improve risk-adjustment mortality models using clinical percutaneous cardiac intervention registry data?
J Invasive Cardiol 2015 Jul;27(7):E117-24.
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Keywords: Heart Disease and Health, Mortality, Registries, Risk