National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Brain Injury (2)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (2)
- Diagnostic Safety and Quality (2)
- Emergency Department (3)
- Emergency Medical Services (EMS) (2)
- Evidence-Based Practice (1)
- Guidelines (2)
- Health Information Technology (HIT) (1)
- Health Services Research (HSR) (2)
- (-) Imaging (9)
- Kidney Disease and Health (1)
- Medical Errors (1)
- Neurological Disorders (1)
- Orthopedics (1)
- Quality Improvement (1)
- (-) Shared Decision Making (9)
- Stroke (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 9 of 9 Research Studies DisplayedMarin JR, Rodean J, Mannix RC
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
The objective of this study was to examine whether the presence of clinical guidelines and clinical decision support (CDS) for mild traumatic brain injury (mTBI) were associated with lower head computed tomography (CT) use. The investigators concluded that clinical guidelines for mTBI, and particularly CDS, were associated with lower rates of head CT use without adverse clinical outcomes.
AHRQ-funded; HS026006.
Citation: Marin JR, Rodean J, Mannix RC .
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
J Pediatr 2021 Aug;235:178-83.e1. doi: 10.1016/j.jpeds.2021.04.026..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Brain Injury, Guidelines, Evidence-Based Practice, Imaging
Long S, Thomas GW, Karam MD
Surgical skill can be objectively measured from fluoroscopic images using a novel image-based Decision Error Analysis (IDEA) score.
This study introduces and evaluates a novel Image-based Decision Error Analysis (IDEA) score that captures performance during fluoroscopically assisted wire navigation. Findings showed that the fluoroscopic images obtained in the course of placing a guide wire contained a rich amount of information related to surgical skill. The IDEA scoring provided a basis for evaluating the competence of a resident. The score can be used to assess skill at key timepoints throughout residency, such as when rotating onto/off of a new surgical service and before performing certain procedures in the operating room, or as a tool for debriefing/providing feedback after a procedure is completed.
AHRQ-funded; HS022077; HS025353.
Citation: Long S, Thomas GW, Karam MD .
Surgical skill can be objectively measured from fluoroscopic images using a novel image-based Decision Error Analysis (IDEA) score.
Clin Orthop Relat Res 2021 Jun;479(6):1386-94. doi: 10.1097/corr.0000000000001623..
Keywords: Orthopedics, Surgery, Shared Decision Making, Medical Errors, Adverse Events, Imaging
Schoenfeld EM, Poronsky KE, Westafer LM
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Both ultrasound and CT scan can be used for diagnosis of ureterolithiasis (or renal colic, the pain from an obstructing kidney stone), but the majority of patients receive a CT scan. Diagnostic pathways utilizing ultrasound have been shown to decrease radiation exposure to patients but are potentially less accurate. The investigators developed a decision aid to facilitate SDM in this scenario. The objective of this study was to determine the effects of this decision aid, as compared to usual care, on patient knowledge, radiation exposure, engagement, safety, and healthcare utilization.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Poronsky KE, Westafer LM .
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Trials 2021 Mar 10;22(1):201. doi: 10.1186/s13063-021-05140-9..
Keywords: Emergency Department, Shared Decision Making, Kidney Disease and Health, Imaging, Diagnostic Safety and Quality
Finnerty NM, Rodriguez RM, Carpenter CR
Clinical decision rules for diagnostic imaging in the emergency department: a research agenda.
The objective of this working group and article was to generate a consensus-based research agenda for the development and implementation of clinical decision rules (CDRs) for diagnostic imaging in the emergency department. A research agenda was developed, prioritizing a number of questions, including: what are the optimal methods to justify the derivation and validation of diagnostic imaging CDRs?
AHRQ-funded; HS023498.
Citation: Finnerty NM, Rodriguez RM, Carpenter CR .
Clinical decision rules for diagnostic imaging in the emergency department: a research agenda.
Acad Emerg Med 2015 Dec;22(12):1406-16. doi: 10.1111/acem.12828.
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Keywords: Shared Decision Making, Emergency Department, Health Services Research (HSR), Imaging
Blackmore CC, Castro A
Improving the quality of imaging in the emergency department.
The six-tier efficacy hierarchy of Fryback and Thornbury enables understanding of the value of imaging on multiple levels, ranging from technical efficacy to medical decision-making and higher-level patient and societal outcomes. In this article, the authors elucidate the Fryback and Thornbury framework to define the value of imaging in the ED and to relate emergency imaging to the IOM quality domains.
AHRQ-funded; HS023498.
Citation: Blackmore CC, Castro A .
Improving the quality of imaging in the emergency department.
Acad Emerg Med 2015 Dec;22(12):1385-92. doi: 10.1111/acem.12816.
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Keywords: Shared Decision Making, Emergency Department, Imaging, Quality Improvement
Melnick ER, Shafer K, Rodulfo N
Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
The objective was to identify nonclinical, human factors that promote or inhibit the appropriate use of computed tomography (CT) in patients presenting to the emergency department (ED) with minor head injury. Five core domains emerged from the analysis: establishing trust, anxiety (patient and provider), constraints related to ED practice, the influence of others, and patient expectations.
AHRQ-funded; HS021271.
Citation: Melnick ER, Shafer K, Rodulfo N .
Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
Acad Emerg Med 2015 Dec;22(12):1474-83. doi: 10.1111/acem.12824.
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Keywords: Emergency Medical Services (EMS), Imaging, Brain Injury, Shared Decision Making, Health Services Research (HSR)
Callaghan BC, Kerber KA, Pace RJ
Headache neuroimaging: routine testing when guidelines recommend against them.
The aim of this article was to determine the patient-level factors associated with headache neuroimaging in outpatient practice. It concluded that neuroimaging is routinely ordered in outpatient headache patients including populations where guidelines specifically recommend against their use (migraines, chronic headaches, no red flags).
AHRQ-funded; HS017690.
Citation: Callaghan BC, Kerber KA, Pace RJ .
Headache neuroimaging: routine testing when guidelines recommend against them.
Cephalalgia 2015 Nov;35(13):1144-52. doi: 10.1177/0333102415572918.
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Keywords: Neurological Disorders, Imaging, Shared Decision Making, Guidelines, Diagnostic Safety and Quality
Melnick ER, Keegan J, Taylor RA
Redefining overuse to include costs: a decision analysis for computed tomography in minor head injury.
This study was conducted to (1) determine the testing threshold for head computed tomography (CT) in minor head injury in the emergency department using decision analysis with and without costs included in the analysis. If only effectiveness is considered, current clinical decision rules might not provide a sufficient degree of certainty to ensure identification of all patients for whom the benefits of CT outweigh its risks.
AHRQ-funded; HS021271.
Citation: Melnick ER, Keegan J, Taylor RA .
Redefining overuse to include costs: a decision analysis for computed tomography in minor head injury.
Jt Comm J Qual Patient Saf 2015 Jul;41(7):313-22..
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Imaging, Emergency Medical Services (EMS)
George AJ, Boehme AK, Dunn CR
Trimming the fat in acute ischemic stroke: an assessment of 24-h CT scans in tPA patients.
The authors questioned the utility of routine 24-h computed tomography imaging and looked at the National Institutes of Health Stroke Scale as a possible clinical screen for selecting candidates for 24-h imaging. They found that routine 24-h computed tomography scan in patients without 24-h National Institutes of Health Stroke Scale worsening was less likely to yield information that results in a deviation from standard acute stroke care, and that no patient without worsening had parenchymal hematoma on 24-h computed tomography. They concluded that application of this Stroke Scale to distinguish patients who should have 24-h follow-up imaging from those who will not benefit is a potential avenue for improving utilization of resources and warrants further study.
AHRQ-funded; HS013852.
Citation: George AJ, Boehme AK, Dunn CR .
Trimming the fat in acute ischemic stroke: an assessment of 24-h CT scans in tPA patients.
Int J Stroke 2015 Jan;10(1):37-41. doi: 10.1111/ijs.12293.
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Keywords: Shared Decision Making, Imaging, Stroke