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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 35 Research Studies DisplayedAnhang Price R, Quigley DD DD, Hargraves JL
A systematic review of strategies to enhance response rates and representativeness of patient experience surveys.
The purpose of this systematic review study was to explore evidence on survey administration strategies to increase response rates and representativeness of patient surveys. The researchers examined 40 peer-reviewed randomized experiments of administration protocols for patient experience surveys. The study found that when compared to mail-only or telephone-only administration of surveys, mail administration with telephone follow-up provides a median response rate benefit of 13%. Researchers also discovered that while surveys administered only by web usually result in lower response rates than those administered by mail or telephone, the limited evidence for a web-mail-telephone process suggests a potential response rate benefit over a mail-telephone process. Monetary incentives are related with substantial improvements in response rates. The study concluded that mixed-mode survey administration results in increased patient survey response rates than a single mode.
AHRQ-funded; HS025920.
Citation: Anhang Price R, Quigley DD DD, Hargraves JL .
A systematic review of strategies to enhance response rates and representativeness of patient experience surveys.
Med Care 2022 Dec;60(12):910-18. doi: 10.1097/mlr.0000000000001784..
Keywords: Patient Experience, Research Methodologies, Health Services Research (HSR)
Saldanha IJ, Adam GP, Bañez LL
AHRQ Author: Bañez LL
Inclusion of nonrandomized studies of interventions in systematic reviews of interventions: updated guidance from the Agency for Health Care Research and Quality Effective Health Care program.
A guidance workgroup comprised systematic review experts utilized an informal consensus generation method to develop guidelines to inform decisions regarding the inclusion of nonrandomized studies of interventions (NRSIs) in systematic reviews (SRs) of the effects of interventions. The study found that varying topics may require varying decisions regarding NRSI inclusion. The researchers identified key considerations to inform the decisions; from refinement of topics through to development of protocols. During the scoping and refinement of topics, considerations were associated with the clinical decisional dilemma, adequacy of randomized controlled trials (RCTs) to address the crucial questions, risk of bias in NRSIs, and the degree to which NRSIs are likely to complement RCTs. When NRSIs are included, during SR team formation, familiarity with topic-specific data sources and advanced analytic methods for NRSIs should be considered. During protocol development, the decision regarding NRSI inclusion or exclusion should be justified, and potential implications explained. When NRSIs are included, the protocol should describe the processes for synthesizing evidence from RCTs and NRSIs and determining the overall strength of evidence. CONCLUSION: We identified specific considerations for decisions regarding NRSI inclusion in SRs and highlight the importance of flexibility and transparency.
AHRQ-authored; AHRQ-funded; 290-2017-00003 -C; 75Q80120D00001- 75Q8120D00003; 75Q80120D00005 - 75Q8120D00009.
Citation: Saldanha IJ, Adam GP, Bañez LL .
Inclusion of nonrandomized studies of interventions in systematic reviews of interventions: updated guidance from the Agency for Health Care Research and Quality Effective Health Care program.
J Clin Epidemiol 2022 Dec; 152:300-06. doi: 10.1016/j.jclinepi.2022.08.015..
Keywords: Evidence-Based Practice, Research Methodologies, Health Services Research (HSR)
Holtrop JS, Davis MM
Primary care research is hard to do during COVID-19: challenges and solutions.
This study examined challenges in conducting primary care research during the COVID-19 pandemic. The authors used their experience on over 15 individual projects during the pandemic. They identified 3 key challenges to conducting primary care research: (1) practice delivery trickle-down effects, (2) limited/changing resources and procedures for research, and (3) a generally tense milieu in US society during the pandemic. They presented strategies, informed by a set of questions, to help researchers decide how to address these challenges observed during our studies. They encouraged normalization and self-compassion; and encouraged researchers and funders to embrace pragmatic and adaptive research designs as the circumstances with COVID-19 evolve over time.
AHRQ-funded; HS027080.
Citation: Holtrop JS, Davis MM .
Primary care research is hard to do during COVID-19: challenges and solutions.
Ann Fam Med 2022 Nov-Dec; 20(6):568-72. doi: 10.1370/afm.2889..
Keywords: COVID-19, Primary Care, Health Services Research (HSR), Research Methodologies
Coley RY, Duan KI, Hoopes AJ
A call to integrate health equity into learning health system research training.
This paper is a call to integrate health equity into the competency domain for learning health systems (LHS) research training. In 2016, AHRQ recommended seven domains for training and mentoring researchers, but health equity was not included. Scholars in the Consortium for Applied Training to Advance the Learning health system with Scholars/Trainees (CATALyST) K12 program recommend that competency domains be extended to reflect growing demands for evidence on health inequities and interventions to alleviate them. The authors present real-life case studies in an LHS research training program that illustrate facilitators, challenges, and potential solutions at the program, funder, and research community-level to receiving training and mentorship in health equity-focused LHS science. They recommend actions in four areas for LHS research training programs: (a) integrate health equity throughout the current LHS domains; (b) develop training and mentoring in health equity; (c) establish program evaluation standards for consideration of health equity; and (d) bring forth relevant, extant expertise from the areas of health disparities research, community-based participatory research, and community-engaged health services research.
AHRQ-funded; HS026369.
Citation: Coley RY, Duan KI, Hoopes AJ .
A call to integrate health equity into learning health system research training.
Learn Health Syst 2022 Oct;6(4):e10330. doi: 10.1002/lrh2.10330..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR), Training, Disparities
Franklin PD, Drane D, Wakschlag L
Development of a learning health system science competency assessment to guide training and proficiency assessment.
This paper describes the development of the learning health systems (LHS) Competency Assessment by the AHRQ-funded ACCELERAT K12 training program. Domain experts and trainees were recruited to define and operationalize items to include in an LHS Competency Assessment to support emerging and existing LHS scientists in prioritizing and monitoring proficiency development. The method used was to conduct sequential interviews with 18 experts who iteratively defined skills and tasks to illustrate stage in proficiency and its progression for each of 42 competencies in the seven LHS expertise domains: systems science; research questions and standards of scientific evidence; research methods; informatics; ethics of research and implementation in health systems; improvement and implementation science; and engagement, leadership, and research management. The LHS Competency Assessment was reviewed, and pilot tested by current trainees and further refinement was completed using their feedback. The LHS Competency Assessment was found to offer consistent, graded criteria across the seven LHS domains.
AHRQ-funded; HS026369.
Citation: Franklin PD, Drane D, Wakschlag L .
Development of a learning health system science competency assessment to guide training and proficiency assessment.
Learn Health Syst 2022 Oct;6(4):e10343. doi: 10.1002/lrh2.10343..
Keywords: Learning Health Systems, Health Systems, Health Services Research (HSR), Training, Education: Curriculum
O'Malley AJ, Landon BE, Zaborski LA
Weak correlations in health services research: weak relationships or common error?
This study examined whether the correlation between a provider's effect on one population of patients and the same provider's effect on another population is underestimated if the effects for each population are estimated separately as opposed to being jointly modeled as random effects, and characterized how the impact of the estimation procedure varies with sample size. The authors used Medicare claims and enrollment data on emergency department (ED) visits, including patient characteristics, the patient’s hospitalization status, and identification of the doctor responsible for the decision to hospitalize the patient. The simulation analysis demonstrated that the joint modeling approach is generally close to unbiased, whereas the stratified approach can be severely biased in small samples. Correlations included 0.98 for female and male patients and only 0.38 using stratified estimation. Correlations for White and non-White patients are 0.99 and 0.28, and for Medicaid dual-eligible and non-dual-eligible patients 0.99 and 0.31, respectively.
AHRQ-funded; HS025408.
Citation: O'Malley AJ, Landon BE, Zaborski LA .
Weak correlations in health services research: weak relationships or common error?
Health Serv Res 2022 Feb;57(1):182-91. doi: 10.1111/1475-6773.13882..
Keywords: Health Services Research (HSR), Research Methodologies
Russo E, Sittig DF, Murphy DR
Challenges in patient safety improvement research in the era of electronic health records.
The researchers used a case study involving a project on missed or delayed follow-up of test results to discuss real-world challenges in using electronic health records data for patient safety research. They suggested that many current data access and security policies and procedures must be rewritten and standardized across health care organization sin order to advance progress toward safer health care.
AHRQ-funded; HS022901.
Citation: Russo E, Sittig DF, Murphy DR .
Challenges in patient safety improvement research in the era of electronic health records.
Healthc 2016 Dec;4(4):285-90. doi: 10.1016/j.hjdsi.2016.06.005.
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Keywords: Electronic Health Records (EHRs), Health Services Research (HSR), Health Information Technology (HIT), Patient Safety, Quality Improvement
Dodd KW, Berman A, Brown J
Funding research in emergency department shared decision making: a summary of the 2016 Academic Emergency Medicine Consensus Conference Panel Discussion.
This article summarizes a panel discussion of funding priorities and examples of successfully funded projects related to shared decision making in emergency medicine. The discussion was part of the 2016 Academic Emergency Medicine Consensus Conference, "Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda."
AHRQ-funded; HS024172.
Citation: Dodd KW, Berman A, Brown J .
Funding research in emergency department shared decision making: a summary of the 2016 Academic Emergency Medicine Consensus Conference Panel Discussion.
Acad Emerg Med 2016 Dec;23(12):1340-45. doi: 10.1111/acem.13063.
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Keywords: Emergency Department, Decision Making, Emergency Medical Services (EMS), Health Services Research (HSR)
Mueller LR, Donnelly JP, Jacobson KE
National characteristics of emergency medical services in frontier and remote areas.
This study sought to describe the national characteristics and outcomes of EMS care provided in frontier and remote (FAR) areas in the continental United States (US). It found that FAR responses were more likely to be of American Indian or Alaska Native race. Age, ethnicity, location type, and clinical impressions were similar between FAR and non-FAR responses. On-scene death was more likely in FAR than non-FAR responses.
AHRQ-funded; HS013852.
Citation: Mueller LR, Donnelly JP, Jacobson KE .
National characteristics of emergency medical services in frontier and remote areas.
Prehosp Emerg Care 2016;20(2):191-9. doi: 10.3109/10903127.2015.1086846.
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Keywords: Emergency Medical Services (EMS), Rural Health, Provider: Health Personnel, Health Services Research (HSR), Outcomes
Kasiske BL, Salkowski N, Wey A
Potential implications of recent and proposed changes in the regulatory oversight of solid organ transplantation in the United States.
The authors reviewed the details and implications of changes in transplant program oversight.
AHRQ-funded; HS024527.
Citation: Kasiske BL, Salkowski N, Wey A .
Potential implications of recent and proposed changes in the regulatory oversight of solid organ transplantation in the United States.
Am J Transplant 2016 Dec;16(12):3371-77. doi: 10.1111/ajt.13955.
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Keywords: Health Services Research (HSR), Policy, Registries, Policy, Transplantation
Sockolow P, Dowding D, Randell R
Using mixed methods in health information technology evaluation.
The authors illustrated some of the benefits and challenges of using mixed methods in evaluation. The diversity of the informatics scholars' research experience provides a broad overview of approaches in combining robust analysis of outcome data with qualitative methods that provide an understanding of the processes through which, and the contexts in which, those outcomes are achieved.
AHRQ-funded; HS021008.
Citation: Sockolow P, Dowding D, Randell R .
Using mixed methods in health information technology evaluation.
Stud Health Technol Inform 2016;225:83-7.
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Keywords: Health Information Technology (HIT), Health Services Research (HSR), Research Methodologies
Harrison KL, Taylor HA
Healthcare resource allocation decisions affecting uninsured services.
The authors described resource allocation and policy decisions related to providing health services for the uninsured. They recommend that how healthcare decisions are actually made can be matched with literature that describes how healthcare resource decisions ought to be made, in order to provide a normative grounding for future decisions.
AHRQ-funded; HS000029.
Citation: Harrison KL, Taylor HA .
Healthcare resource allocation decisions affecting uninsured services.
J Health Organ Manag 2016 Nov 21;30(8):1162-82. doi: 10.1108/jhom-01-2016-0003.
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Keywords: Decision Making, Health Services Research (HSR), Policy, Uninsured
Groeneveld PW, Rumsfeld JS
Can big data fulfill its promise?
This article discusses the pros and cons of using big data analytics in healthcare. The authors note that the rise of big data analytics in health care settings has promise. However, they assert that it is critical to recognize that the fundamental pitfalls of observational data analysis cannot be ignored, and in fact the risks of such pitfalls demand rigorous scientific testing and novel methods for peer review of big data analytic models.
AHRQ-funded; HS023615.
Citation: Groeneveld PW, Rumsfeld JS .
Can big data fulfill its promise?
Circ Cardiovasc Qual Outcomes 2016 Nov;9(6):679-82. doi: 10.1161/circoutcomes.116.003097..
Keywords: Data, Health Services Research (HSR)
Ferrante JM, Friedman A, Shaw EK
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
In this paper, the authors comprehensively describe their experiences, from start to finish, of designing and using an asynchronous online discussion forum for collecting and analyzing information elicited from care coordinators in Patient-Centered Medical Homes across the United States. They conclude that an asynchronous online discussion forum is a feasible, efficient, and effective method to conduct a qualitative study, particularly when subjects are health professionals.
AHRQ-funded; HS020682.
Citation: Ferrante JM, Friedman A, Shaw EK .
Lessons learned designing and using an online discussion forum for care coordinators in primary care.
Qual Health Res 2016 Nov;26(13):1851-61. doi: 10.1177/1049732315609567..
Keywords: Care Coordination, Health Services Research (HSR), Patient-Centered Healthcare, Primary Care, Research Methodologies
Ray KN, Mehrotra A
Trends in access to primary care for children in the United States, 2002-2013.
Using MEPS data, the authors described how access to primary care has changed over the last decade for children. They found no change in the proportion of children with a usual source of care (USC). Other measures improved, but out-of-pocket costs increased among privately insured children. Results suggested that after-hours accommodation within the USC is worsening, despite the promotion of patient-centered medical home initiatives. All measures of acceptability improved, consistent with a growing focus on family-centeredness of care.
AHRQ-funded; HS022989.
Citation: Ray KN, Mehrotra A .
Trends in access to primary care for children in the United States, 2002-2013.
JAMA Pediatr 2016 Oct;170(10):1023-25. doi: 10.1001/jamapediatrics.2016.0985.
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Keywords: Access to Care, Children/Adolescents, Health Services Research (HSR), Medical Expenditure Panel Survey (MEPS), Primary Care
Gaglioti AH, Werner JJ, Rust G
Practice-based research networks (PBRNs) bridging the gaps between communities, funders, and policymakers.
In this commentary, the authors propose that practice-based research networks (PBRNs) engage with funders and policymakers by applying the same engagement strategies they have successfully used to build relationships with community stakeholders. A community engagement approach to achieve new funding streams for PBRNs should include a strategy to engage key stakeholders from the communities of funders, thought leaders, and policymakers using collaborative principles and methods.
AHRQ-funded; HS021639; HS021641; HS021648.
Citation: Gaglioti AH, Werner JJ, Rust G .
Practice-based research networks (PBRNs) bridging the gaps between communities, funders, and policymakers.
J Am Board Fam Med 2016 Sep-Oct;29(5):630-5. doi: 10.3122/jabfm.2016.05.160080.
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Keywords: Health Services Research (HSR), Practice-Based Research Network (PBRN), Primary Care, Policy
Brand SR, Pickard L, Mack JW
What adult cancer care can learn from pediatrics.
However, pediatric cancer centers follow three core principles that enhance their patients’ overall care experience. This article discusses those principles, with the aim of helping adult cancer centers learn from what pediatric centers do well.
AHRQ-funded; HS000063.
Citation: Brand SR, Pickard L, Mack JW .
What adult cancer care can learn from pediatrics.
J Oncol Pract 2016 Sep;12(9):765-7. doi: 10.1200/jop.2016.015057..
Keywords: Cancer, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient Experience, Children/Adolescents
Haidari LA, Brown ST, Constenla D
The economic value of increasing geospatial access to tetanus toxoid immunization in Mozambique.
The researchers assessed how well tetanus toxoid (TT) immunization locations meet population demand in Mozambique. They found that TT immunization locations are not geographically accessible by a significant proportion of pregnant women, resulting in substantial healthcare and productivity costs that could potentially be averted by adding or reconfiguring TT immunization locations.
AHRQ-funded; HS023317.
Citation: Haidari LA, Brown ST, Constenla D .
The economic value of increasing geospatial access to tetanus toxoid immunization in Mozambique.
Vaccine 2016 Jul 29;34(35):4161-65. doi: 10.1016/j.vaccine.2016.06.065.
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Keywords: Access to Care, Healthcare Costs, Health Services Research (HSR), Pregnancy, Vaccination
Mueller LE, Haidari LA, Wateska AR
The impact of implementing a demand forecasting system into a low-income country's supply chain.
The authors evaluated the potential impact and value of applications of data from demand forecasting systems implemented in a lower-income country's vaccine supply chain with different levels of population change to urban areas. They used their HERMES software to study Niger's entire vaccine supply chain and found that demand forecasting systems have the potential to greatly improve vaccine demand fulfilment, and decrease logistics cost/dose, when implemented with storage and transportation increases.
AHRQ-funded; HS023317.
Citation: Mueller LE, Haidari LA, Wateska AR .
The impact of implementing a demand forecasting system into a low-income country's supply chain.
Vaccine 2016 Jul 12;34(32):3663-9. doi: 10.1016/j.vaccine.2016.05.027.
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Keywords: Access to Care, Health Services Research (HSR), Low-Income, Medication, Vaccination
Wang SY, Aldridge MD, Gross CP
End-of-life care intensity and hospice use: a regional-level analysis.
The authors sought to examine regional variation in intensive end-of-life care and determine its associations with hospice use patterns. They concluded that at the regional level, increased end-of-life care intensity was consistently associated with very short hospice use.
AHRQ-funded; HS023900.
Citation: Wang SY, Aldridge MD, Gross CP .
End-of-life care intensity and hospice use: a regional-level analysis.
Med Care 2016 Jul;54(7):672-8. doi: 10.1097/mlr.0000000000000547.
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Keywords: Elderly, Healthcare Utilization, Health Services Research (HSR)
Luff D, Allair B, Litterer K
Parent and teen engagement in pediatric health services research training.
The Harvard-wide Pediatric Health Services Research (HSR) Fellowship Program is a multidisciplinary program that has trained child health researchers for over 20 years. In 2013, it set out to engage patients and families in the redesign of its research training activities. The authors concluded that the benefits from including parents and teens in our program exceeded their expectations. Patients and parents of children with chronic illness came to understand how research informs the care they receive.
AHRQ-funded; HS000063.
Citation: Luff D, Allair B, Litterer K .
Parent and teen engagement in pediatric health services research training.
Acad Pediatr 2016 Jul;16(5):496-98. doi: 10.1016/j.acap.2016.02.004.
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Keywords: Children/Adolescents, Health Services Research (HSR), Health Services Research (HSR), Patient and Family Engagement, Children/Adolescents
Bishai D, Xu J, Sherry M
Strengthening the efferent arm in public health.
The purpose of the efferent arm in public health is to convene, coordinate, and shepherd the energy and resources of a community into collectively addressing shared health problems. The authors argue that the secret of an effective efferent arm is to focus on convening and communicating clearly the public health burdens and threats as widely as possible and to speak with authority about the evidence base of proven approaches.
AHRQ-funded; HS000029.
Citation: Bishai D, Xu J, Sherry M .
Strengthening the efferent arm in public health.
Am J Public Health 2016 Jul;106(7):1196-7. doi: 10.2105/ajph.2016.303216.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Public Health
McConnochie KM, Wood NE, Alarie C
Care offered by an information-rich pediatric acute illness connected care model.
The authors described care provided over a 12-year period by Health-e-Access, an evidence-based, information-rich, connected care model designed to serve children with acute illness. They demonstrated the broad clinical capacity of this care model and key components imparting this capacity. They concluded that Health-e-Access included technology essential for establishing diagnoses, ruling out more serious conditions, and identifying problems beyond its scope.
AHRQ-funded; HS018912; HS016871; HS015165.
Citation: McConnochie KM, Wood NE, Alarie C .
Care offered by an information-rich pediatric acute illness connected care model.
Telemed J E Health 2016 Jun;22(6):465-72. doi: 10.1089/tmj.2015.0161.
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Keywords: Critical Care, Children/Adolescents, Health Services Research (HSR), Children/Adolescents, Telehealth
Terza JV
Inference using sample means of parametric nonlinear data transformations.
AHRQ-funded; HS017434.
Citation: Terza JV .
Inference using sample means of parametric nonlinear data transformations.
Health Serv Res 2016 Jun;51(3):1109-13. doi: 10.1111/1475-6773.12494.
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Keywords: Research Methodologies, Health Services Research (HSR), Data
Gidengil CA, Linder JA, Beach S
Using clinical vignettes to assess quality of care for acute respiratory infections.
Overprescribing of antibiotics for acute respiratory infections (ARIs) is common. The objective of this study was to develop and validate a vignette-based method to estimate clinician ARI antibiotic prescribing. The researchers concluded that responses to 3 clinical vignettes can identify clinicians with relatively poor quality ARI antibiotic prescribing. Vignettes may be a mechanism to target clinicians for quality improvement efforts.
AHRQ-funded; HS018419.
Citation: Gidengil CA, Linder JA, Beach S .
Using clinical vignettes to assess quality of care for acute respiratory infections.
Inquiry 2016 Apr 20;53:pii: 0046958016636531. doi: 10.1177/0046958016636531..
Keywords: Antibiotics, Antimicrobial Stewardship, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Medication, Practice Patterns, Primary Care, Quality of Care, Respiratory Conditions