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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 25 of 43 Research Studies DisplayedMentias A, Shantha G, Chaudhury P
Assessment of outcomes of treatment with oral anticoagulants in patients with atrial fibrillation and multiple chronic conditions: a comparative effectiveness analysis.
The purpose of this retrospective comparative effectiveness analysis was to determine whether there are differences in efficacy and safety of dabigatran, rivaroxaban, and warfarin regarding stroke prevention and bleeding rates, respectively, in elderly patients with atrial fibrillation (AF) with multiple chronic conditions (MCC). The investigators concluded that oral anticoagulants were similarly effective in stroke prevention among patients with AF with MCC. However, the indicate that dabigatran and rivaroxaban use may be associated with lower rates of mortality in patients with MCC.
AHRQ-funded; HS023104.
Citation: Mentias A, Shantha G, Chaudhury P .
Assessment of outcomes of treatment with oral anticoagulants in patients with atrial fibrillation and multiple chronic conditions: a comparative effectiveness analysis.
JAMA Netw Open 2018 Sep 7;1(5):e182870. doi: 10.1001/jamanetworkopen.2018.2870..
Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Outcomes, Patient-Centered Outcomes Research, Medication, Evidence-Based Practice, Comparative Effectiveness, Chronic Conditions
Bailey SR, Stevens VJ, Fortmann SP
Long-term outcomes from repeated smoking cessation assistance in routine primary care.
This study assessed the importance of primary care support for smokers trying to quit. This retrospective, observational cohort study followed over 33,000 patients at six diverse health systems over 4 years. Long-term quit (LTQ) status (longer than 365 days) was measured, and it was determined that frequent visits (more than 75% of visits) had almost 3 times the success than patients who visited less than 25%.
AHRQ-funded; HS019828.
Citation: Bailey SR, Stevens VJ, Fortmann SP .
Long-term outcomes from repeated smoking cessation assistance in routine primary care.
Am J Health Promot 2018 Sep;32(7):1582-90. doi: 10.1177/0890117118761886..
Keywords: Comparative Effectiveness, Lifestyle Changes, Outcomes, Patient-Centered Outcomes Research, Primary Care, Tobacco Use
Ciolino JD, Jackson KL, Liss DT
Design of Healthy Hearts in the Heartland (H3): a practice-randomized, comparative effectiveness study.
The Healthy Hearts in the Heartland (H3) study is part of a nationwide effort, EvidenceNOW, seeking to better understand the ability of small primary care practices to improve "ABCS" clinical quality measures: appropriate Aspirin therapy, Blood pressure control, Cholesterol management, and Smoking cessation. In this paper, the authors describe the design and randomization of the H3 study.
AHRQ-funded; HS023921.
Citation: Ciolino JD, Jackson KL, Liss DT .
Design of Healthy Hearts in the Heartland (H3): a practice-randomized, comparative effectiveness study.
Contemp Clin Trials 2018 Aug;71:47-54. doi: 10.1016/j.cct.2018.06.004..
Keywords: Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Heart Disease and Health, Prevention, Primary Care, Quality of Care, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Tyson MD, Koyama T, Lee D
Effect of prostate cancer severity on functional outcomes after localized treatment: comparative effectiveness analysis of surgery and radiation study results.
The purpose of this study was to determine whether differences in predicted function over time between radical prostatectomy (RP) or external beam radiotherapy (EBRT) for localized cancer varied by risk group. Patient-reported, disease-specific function was measured using the Expanded Prostate Index Composite and predicted function was estimated using regression models, compared by disease risk. The study found that sexual function was similar between surgery and radiation for patients with high-risk disease, and the authors conclude that high-risk patients undergoing radiation therapy should be counseled that their sexual function may not be as good as low-risk patients also undergoing radiation.
AHRQ-funded; HS019356; HS022640.
Citation: Tyson MD, Koyama T, Lee D .
Effect of prostate cancer severity on functional outcomes after localized treatment: comparative effectiveness analysis of surgery and radiation study results.
Eur Urol 2018 Jul;74(1):26-33. doi: 10.1016/j.eururo.2018.02.012..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Treatments, Surgery, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Wu P, Escobar GJ, Gebretsadik T
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
This retrospective cohort study examined the effectiveness of respiratory syncytial virus (RSV) prophylaxis for infants born between 1996 and 2008. The infants were enrolled in the Kaiser Permanente Northern California integrated health system. Infants who ever received RSV immunoprophylaxis had a 32% decreased risk of bronchiolitis hospitalization and finants with chronic lung disease (CLD) had a 52% decreased risk. The 2014 American Academy of Pediatrics (AAP) guidelines changed recommendations for RSV immunoprophylaxis which made 48% of infants no longer eligible but nearly all infants with CLD would remain eligible.
AHRQ-funded; HS018454.
Citation: Wu P, Escobar GJ, Gebretsadik T .
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
Am J Epidemiol 2018 Jul;187(7):1490-500. doi: 10.1093/aje/kwy008..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Hospitalization, Newborns/Infants, Outcomes, Patient-Centered Outcomes Research, Prevention, Respiratory Conditions, Risk
Horiguchi M, Tian L, Uno H
Quantification of long-term survival benefit in a comparative oncology clinical study.
The authors discuss the quantification of long-term survival benefit in a comparative oncology clinical study. They assert that from the perspective of cost-risk-benefit, using a long-term survival benefit criterion for selecting anticancer therapies may be more appropriate.
AHRQ-funded; HS022193.
Citation: Horiguchi M, Tian L, Uno H .
Quantification of long-term survival benefit in a comparative oncology clinical study.
JAMA Oncol 2018 Jun;4(6):881-82. doi: 10.1001/jamaoncol.2018.0518..
Keywords: Cancer, Comparative Effectiveness, Outcomes, Research Methodologies
Skrivankova V, Heagerty PJ
Single index methods for evaluation of marker-guided treatment rules based on multivariate marker panels.
Answering the scientific challenge to identify and validate the factors that can reliably be used to target treatment and to quantify the expected treatment benefit as a function of candidate markers, the authors of this article propose to focus on a smooth, non-parametric evaluation of a canonical single-index score that estimates the expected treatment benefit associated with patient characteristics. Their methods decouple the model used to generate the treatment benefit score from the methods adopted in order to evaluate the performance of the resulting single-index score. They also demonstrate that the canonical single-index treatment benefit score can be used for selecting subsets of patients with enriched expected treatment response.
AHRQ-funded; HS019222.
Citation: Skrivankova V, Heagerty PJ .
Single index methods for evaluation of marker-guided treatment rules based on multivariate marker panels.
Biometrics 2018 Jun;74(2):663-72. doi: 10.1111/biom.12752..
Keywords: Comparative Effectiveness, Shared Decision Making, Outcomes, Treatments
Semenkovich TR, Panni RZ, Hudson JL
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
This study examined comparative effectiveness and survival rates for upfront esophagectomy versus induction chemoradiation in patients with clinical stage T2N20 esophageal cancer. A decision analysis model was created for the two treatment strategies. Results showed comparable median survival rates for both strategies. The optimal treatment strategy depended on the accuracy of endoscopic ultrasound staging.
AHRQ-funded; HS022330.
Citation: Semenkovich TR, Panni RZ, Hudson JL .
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
J Thorac Cardiovasc Surg 2018 May;155(5):2221-30.e1. doi: 10.1016/j.jtcvs.2018.01.006..
Keywords: Treatments, Cancer, Surgery, Comparative Effectiveness, Shared Decision Making, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes, Medication
Wang SV, Huybrechts KF, Fischer MA
Generalized boosted modeling to identify subgroups where effect of dabigatran versus warfarin may differ: an observational cohort study of patients with atrial fibrillation.
The purpose of this study was to explore generalized boosted modeling (GBM) as a method for identifying subgroups with greater benefit or harm with dabigatran versus warfarin for treatment of atrial fibrillation. The investigators concluded that dabigatran's superiority to warfarin at prevention of thromboembolism may be greater in secondary than primary prevention. They indicated that in practice, secondary prevention patients are more often treated with warfarin.
AHRQ-funded; HS022193.
Citation: Wang SV, Huybrechts KF, Fischer MA .
Generalized boosted modeling to identify subgroups where effect of dabigatran versus warfarin may differ: an observational cohort study of patients with atrial fibrillation.
Pharmacoepidemiol Drug Saf 2018 Apr;27(4):383-90. doi: 10.1002/pds.4395..
Keywords: Blood Clots, Blood Thinners, Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Heart Disease and Health, Medication, Outcomes, Patient-Centered Outcomes Research, Prevention
Bove AM, Smith KJ, Bise CG
Exercise, manual therapy, and booster sessions in knee osteoarthritis: cost-effectiveness analysis from a multicenter randomized controlled trial.
The study objective was to compare the cost-effectiveness of 4 different combinations of exercise, manual therapy, and booster sessions for individuals with knee osteoarthritis (OA). The authors found that spacing exercise-based physical therapy sessions over 12 months using periodic booster sessions was less costly and more effective over 2 years than strategies not containing booster sessions for individuals with knee OA.
AHRQ-funded; HS019642.
Citation: Bove AM, Smith KJ, Bise CG .
Exercise, manual therapy, and booster sessions in knee osteoarthritis: cost-effectiveness analysis from a multicenter randomized controlled trial.
Phys Ther 2018 Jan;98(1):16-27. doi: 10.1093/ptj/pzx104..
Keywords: Arthritis, Comparative Effectiveness, Healthcare Costs, Outcomes
DeLia D, Wang HE, Kutzin J
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
This study provides a real world evaluation of the effectiveness of post-arrest care in therapeutic hypothermia (TH) centers during a time of growing TH dissemination in the state of New Jersey. It concluded that post-arrest outcomes are more favorable at TH centers but these improved outcomes are not apparent until after hospital discharge.
AHRQ-funded; HS020097.
Citation: DeLia D, Wang HE, Kutzin J .
Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.
BMC Health Serv Res 2015 Dec 2;15:533. doi: 10.1186/s12913-015-1199-z.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Emergency Medical Services (EMS), Outcomes
Bangalore S, Ogedegbe G, Gyamfi J
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
The study’s objective was to evaluate the effectiveness of angiotensin-converting enzyme inhibitors when compared with other antihypertensive agents in hypertensive blacks. It found that in a large cohort of hypertensive blacks, angiotensin-converting enzyme inhibitors were associated with less benefit when compared with calcium channel blockers or thiazide diuretics.
AHRQ-funded; HS018589.
Citation: Bangalore S, Ogedegbe G, Gyamfi J .
Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks.
Am J Med 2015 Nov;128(11):1195-203. doi: 10.1016/j.amjmed.2015.04.034..
Keywords: Blood Pressure, Racial and Ethnic Minorities, Medication, Outcomes, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Comparative Effectiveness
Fritz JM, Magel JS, McFadden M
Early physical therapy vs usual care in patients with recent-onset low back pain: a randomized clinical trial.
This study evaluated whether early physical therapy (manipulation and exercise) is more effective than usual care in improving disability for patients with LBP fitting a decision rule. It concluded that among adults with recent-onset LBP, early physical therapy resulted in statistically significant improvement in disability, but the improvement was modest and did not achieve the minimum clinically important difference compared with usual care.
AHRQ-funded; HS018672.
Citation: Fritz JM, Magel JS, McFadden M .
Early physical therapy vs usual care in patients with recent-onset low back pain: a randomized clinical trial.
JAMA 2015 Oct 13;314(14):1459-67. doi: 10.1001/jama.2015.11648..
Keywords: Back Health and Pain, Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research
Cochran GL, Horn SD
Potential effect of coding differences on comparisons of rural and urban outcomes.
To investigate the concern that systematic differences in coding exist, the researchers conducted a small pilot study. Their study compared rural and urban disease severity for four common diagnoses in a Midwestern urban academic medical center and eight critical access hospitals (CAHs). They found significantly fewer comorbidities (identified according to ICD-9 codes) in rural subjects, despite their being approximately 15 years older than subjects in the urban comparator group.
AHRQ-funded; HS018059.
Citation: Cochran GL, Horn SD .
Potential effect of coding differences on comparisons of rural and urban outcomes.
J Am Geriatr Soc 2015 Oct;63(10):2210-2. doi: 10.1111/jgs.13692..
Keywords: Rural Health, Urban Health, Comparative Effectiveness, Outcomes
Bannuru RR, McAlindon TE, Sullivan MC
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
The researchers evaluated the effects of alternative placebo types on pain outcomes in knee osteoarthritis. Their review concluded that all placebos are not equal, and some can trigger clinically relevant responses. Differential placebo effects can substantially alter estimates of the relative efficacies of active treatments.
AHRQ-funded; HS021396.
Citation: Bannuru RR, McAlindon TE, Sullivan MC .
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
Ann Intern Med 2015 Sep 1;163(5):365-72. doi: 10.7326/m15-0623..
Keywords: Comparative Effectiveness, Arthritis, Medication, Pain, Outcomes
Bannuru RR, McAlindon TE, Sullivan MC
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
The researchers evaluated the effects of alternative placebo types on pain outcomes in knee osteoarthritis. Their review concluded that all placebos are not equal, and some can trigger clinically relevant responses. Differential placebo effects can substantially alter estimates of the relative efficacies of active treatments.
AHRQ-funded; HS021396.
Citation: Bannuru RR, McAlindon TE, Sullivan MC .
Effectiveness and implications of alternative placebo treatments: a systematic review and network meta-analysis of osteoarthritis trials.
Ann Intern Med 2015 Sep 1;163(5):365-72. doi: 10.7326/m15-0623..
Keywords: Comparative Effectiveness, Arthritis, Medication, Pain, Outcomes
Bewtra M, Newcomb CW, Wu Q
Mortality associated with medical therapy versus elective colectomy in ulcerative colitis: a cohort study.
This study sought to determine whether patients with advanced ulcerative colitis (UC) treated with elective colectomy have improved survival compared with those treated with medical therapy. It found that elective colectomy was associated with improved survival compared with long-term medical therapy, although this result did not remain statistically significant in all sensitivity analyses.
AHRQ-funded; HS018517.
Citation: Bewtra M, Newcomb CW, Wu Q .
Mortality associated with medical therapy versus elective colectomy in ulcerative colitis: a cohort study.
Ann Intern Med 2015 Aug 18;163(4):262-70. doi: 10.7326/m14-0960..
Keywords: Comparative Effectiveness, Mortality, Outcomes, Surgery, Digestive Disease and Health
Chung H, Kim J, Askew RL
Assessing measurement invariance of three depression scales between neurologic samples and community samples.
The purpose of this study was to test measurement invariance of three patient-reported measures of depressive symptoms between neurologic and community samples. Its results suggest that depressive symptoms as measured by three different outcome measures have the same meaning across clinical and community samples. Thus, the use of these measures for group comparisons is supported.
AHRQ-funded; HS020700.
Citation: Chung H, Kim J, Askew RL .
Assessing measurement invariance of three depression scales between neurologic samples and community samples.
Qual Life Res 2015 Aug;24(8):1829-34. doi: 10.1007/s11136-015-0927-5..
Keywords: Depression, Outcomes, Comparative Effectiveness
FitzHenry F, Resnic FS, Robbins SL
Creating a common data model for comparative effectiveness with the observational medical outcomes partnership.
This case study describes the challenges and opportunities of a study specific use of the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM) by two health systems and describe three comparative effectiveness use cases developed from the CDM. It concluded that the data transformation to the CDM was time consuming and resources required were substantial, beyond requirements for collecting native source data.
AHRQ-funded; HS019913.
Citation: FitzHenry F, Resnic FS, Robbins SL .
Creating a common data model for comparative effectiveness with the observational medical outcomes partnership.
Appl Clin Inform 2015 Aug 26;6(3):536-47. doi: 10.4338/aci-2014-12-cr-0121..
Keywords: Comparative Effectiveness, Outcomes, Data
Chen CY, Stevenson LW, Stewart GC
Real world effectiveness of primary implantable cardioverter defibrillators implanted during hospital admissions for exacerbation of heart failure or other acute co-morbidities: cohort study of older patients with heart failure.
The researchers examined the effectiveness of primary implantable cardioverter defibrillators (ICDs) in elderly patients receiving the device during a hospital admission for exacerbation of heart failure or other acute co-morbidities. They concluded that the benefits of primary ICD therapy seen in pivotal trials were not apparent in patients aged 66 or over who received ICDs during a hospital admission for exacerbation of heart failure or other acute co-morbidities.
AHRQ-funded; 290-2005-0016-I -TO3; HS017731.
Citation: Chen CY, Stevenson LW, Stewart GC .
Real world effectiveness of primary implantable cardioverter defibrillators implanted during hospital admissions for exacerbation of heart failure or other acute co-morbidities: cohort study of older patients with heart failure.
BMJ 2015 Jul 14;351:h3529. doi: 10.1136/bmj.h3529..
Keywords: Comparative Effectiveness, Elderly, Medical Devices, Heart Disease and Health, Outcomes
Osterman MT, Haynes K, Delzell E
Effectiveness and safety of immunomodulators with anti-tumor necrosis factor therapy in Crohn's disease.
This study assessed the effectiveness and safety of immunomodulators with anti-tumor necrosis factor (anti-TNF) therapy in Crohn’s disease (CD). It found that continuation of immunomodulators after “stepping up” to anti-TNF therapy did not improve outcomes but was associated with an increased risk of opportunistic infection.
AHRQ-funded; HS018517.
Citation: Osterman MT, Haynes K, Delzell E .
Effectiveness and safety of immunomodulators with anti-tumor necrosis factor therapy in Crohn's disease.
Clin Gastroenterol Hepatol 2015 Jul;13(7):1293-301.e5; quiz e70, e72. doi: 10.1016/j.cgh.2015.02.017..
Keywords: Patient Safety, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Dahabreh IJ, Steele DW, Shah N
Oral mechanical bowel preparation for colorectal surgery: systematic review and meta-analysis.
The purpose of this review was to synthesize the evidence on the comparative effectiveness and safety of oral mechanical bowel preparation versus no preparation or enema. It found weak evidence suggesting that oral mechanical bowel preparation has similar effectiveness compared with no preparation with respect to all-cause mortality, anastomotic leakage, wound infection, and peritonitis for patients undergoing elective surgery for colorectal cancer.
AHRQ-funded; 290201200012I.
Citation: Dahabreh IJ, Steele DW, Shah N .
Oral mechanical bowel preparation for colorectal surgery: systematic review and meta-analysis.
Dis Colon Rectum 2015 Jul;58(7):698-707. doi: 10.1097/dcr.0000000000000375..
Keywords: Comparative Effectiveness, Surgery, Outcomes, Adverse Events
Frasier LL, Leverson G, Gosain A
Laparoscopic versus open Ladd's procedure for intestinal malrotation in adults.
This study was designed to investigate outcomes for adults undergoing laparoscopic surgery vs. open Ladd’s repair for malrotation. It found no significant differences in complication rates, need for re-operation, or symptom resolution. There was a statistically significant decrease in length of stay following laparoscopy compared to open surgery.
AHRQ-funded; HS022403.
Citation: Frasier LL, Leverson G, Gosain A .
Laparoscopic versus open Ladd's procedure for intestinal malrotation in adults.
Surg Endosc 2015 Jun;29(6):1598-604. doi: 10.1007/s00464-014-3849-3..
Keywords: Surgery, Outcomes, Patient-Centered Outcomes Research, Adverse Events, Comparative Effectiveness
Gibbons MB, Thompson SM, Mack RA
The relation of baseline skills to psychotherapy outcome across diverse psychotherapies.
The researchers explored the role of baseline skills deficits in compensatory skills and self-understanding across both cognitive and dynamic treatment modalities. Their results support a capitalization model for cognitive therapy but failed to support either a compensation model or a capitalization model for the short-term dynamic model.
AHRQ-funded; HS022124.
Citation: Gibbons MB, Thompson SM, Mack RA .
The relation of baseline skills to psychotherapy outcome across diverse psychotherapies.
J Clin Psychol 2015 Jun;71(6):491-9. doi: 10.1002/jclp.22165..
Keywords: Comparative Effectiveness, Depression, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Francis DO, Krishnaswami S, Mcpheeters M
Treatment of ankyloglossia and breastfeeding outcomes: a systematic review.
This systematic review of literature on surgical and nonsurgical treatments for infants with ankyloglossia, a condition restricting tongue mobility in infants, found that frenotomy may be associated with mother-reported improvements in breastfeeding, and potentially in nipple pain. Since the existing studies are small and short-term with inconsistent methodology, the strength of the evidence is low to insufficient.
AHRQ-funded; 290201200009I.
Citation: Francis DO, Krishnaswami S, Mcpheeters M .
Treatment of ankyloglossia and breastfeeding outcomes: a systematic review.
Pediatrics 2015 Jun;135(6):e1458-66. doi: 10.1542/peds.2015-0658..
Keywords: Breast Feeding, Outcomes, Comparative Effectiveness, Evidence-Based Practice, Newborns/Infants