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- Adverse Drug Events (ADE) (1)
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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 17 of 17 Research Studies DisplayedCykert S, Keyserling TC, Pignone M
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Researchers assessed the effect of dissemination and implementation of an intervention consisting of practice facilitation and a risk-stratified, population management dashboard on cardiovascular risk reduction for patients at high risk in small, primary care practices. They found that a risk-stratified, population management dashboard combined with practice facilitation led to substantial reductions of 10-year atherosclerotic cardiovascular disease risk for patients at high risk. They recommended utilizing similar approaches to lead to effective dissemination and implementation of other new evidence, especially in rural and other under-resourced practices.
AHRQ-funded; HS023912.
Citation: Cykert S, Keyserling TC, Pignone M .
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Health Serv Res 2020 Dec;55(6):944-53. doi: 10.1111/1475-6773.13571..
Keywords: Cardiovascular Conditions, Risk, Prevention, Primary Care, Implementation, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Mangrum R, Stewart MD, Gifford DR
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
The goal of this study was to create a uniform definition of omission of care in US nursing homes. Lack of a uniform definition has made efforts to prevent them challenging. Subject matter experts and a broad range of nursing home stakeholders were brought together in iterative rounds of engagement to identify key concepts and aspects of omissions of care and develop a consensus-based definition. The concise definition decided on was: “Omissions of care in nursing homes encompass situations when care–either clinical or nonclinical–is not provided for a resident and results in additional monitoring or intervention or increases the risk of an undesirable or adverse physical, emotional, or psychosocial outcome for the resident."
AHRQ-funded; 233201500014I.
Citation: Mangrum R, Stewart MD, Gifford DR .
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
J Am Med Dir Assoc 2020 Nov;21(11):1587-91.e2. doi: 10.1016/j.jamda.2020.08.016..
Keywords: Elderly, Nursing Homes, Long-Term Care, Quality Improvement, Quality of Care, Medical Errors, Adverse Events, Patient Safety, Risk, Patient-Centered Outcomes Research
Luther M, Poppert Cordts KM, Williams CN
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
This is a systematic review to quantify sleep wake disturbances (SWD) after pediatric traumatic brain injury (TBI). These SWD can place children at risk for worse outcomes since sleep is needed for brain development and healing after injury. They also evaluated interventions for SWD and the association between SWD and other post-traumatic outcomes. Literature was searched from 1999-2019 evaluating sleep or fatigue in children hospitalized for TBI. Two independent reviewers assessed quality of the studies using the Newcastle-Ottowa Score for observational studies. Out of 966 identified articles, 126 full text articles were reviewed and 24 studies were included. Studies showed at least 20% of children with TBI had some degree of SWD including trouble falling or staying asleep, fatigue, daytime fatigue, and nightmares. SWD was negatively correlated with cognitive, behavioral, and quality of life outcomes. There was moderate-high risk of bias for all studies due to small sample size and lack of validated or objective SWD measures.
AHRQ-funded; HS022981.
Citation: Luther M, Poppert Cordts KM, Williams CN .
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
Sleep 2020 Oct;43(10):zsaa083. doi: 10.1093/sleep/zsaa083..
Keywords: Children/Adolescents, Sleep Problems, Brain Injury, Neurological Disorders, Trauma, Risk, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Evidence-Based Practice
Villa Zapata L, Hansten PD, Panic J
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Warfarin use can trigger the occurrence of bleeding independently or as a result of a drug-drug interaction when used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs). This article examines the risk of bleeding in individuals exposed to concomitant warfarin and NSAID compared with those taking warfarin alone. The investigators concluded that risk of bleeding was significantly increased among persons taking warfarin and a NSAID or COX-2 inhibitor together as compared with taking warfarin alone.
AHRQ-funded; HS025984.
Citation: Villa Zapata L, Hansten PD, Panic J .
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Thromb Haemost 2020 Jul;120(7):1066-74. doi: 10.1055/s-0040-1710592..
Keywords: Blood Thinners, Medication, Medication: Safety, Risk, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Shah SC, Dai Zhu, X
Associations between calcium and magnesium intake and the risk of incident gastric cancer: a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study.
Gastric cancer remains a leading cause of cancer-related mortality. Identifying dietary and other modifiable disease determinants has important implications for risk attenuation in susceptible individuals. The primary aim of the investigators was to estimate the association between dietary and supplemental intakes of calcium and magnesium and the risk of incident gastric cancer. They conducted a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons Diet and Health Study.
AHRQ-funded; HS026395.
Citation: Shah SC, Dai Zhu, X .
Associations between calcium and magnesium intake and the risk of incident gastric cancer: a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study.
Int J Cancer 2020 Jun 1;146(11):2999-3010. doi: 10.1002/ijc.32659..
Keywords: Cancer, Digestive Disease and Health, Risk, Prevention, Nutrition, Patient-Centered Outcomes Research, Evidence-Based Practice
Mahorter SS, Knerr S, Bowles EJA
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
This study examined knowledge of breast density as an important breast cancer risk factor among a set of women in a health system-embedded trial who had clinically elevated breast cancer risk 1 year before state-mandated density disclosure. The majority of the women (91%) had heard of breast density and were aware of its masking effect (87%). Only 60% had ever discussed their breast density with a provider.
AHRQ-funded; HS022982.
Citation: Mahorter SS, Knerr S, Bowles EJA .
Prior breast density awareness, knowledge, and communication in a health system-embedded behavioral intervention trial.
Cancer 2020 Apr 15;126(8):1614-21. doi: 10.1002/cncr.32711..
Keywords: Cancer: Breast Cancer, Cancer, Women, Communication, Clinician-Patient Communication, Risk, Patient-Centered Outcomes Research
Katz D, Petersen T, Amado S
An evaluation of suicidal risk in bipolar patients with comorbid posttraumatic stress disorder.
The impact of concurrent diagnosis posttraumatic stress disorder (PTSD) on persons with bipolar disorder (BD) was analyzed to determine if there was a higher risk of suicidal ideation. Baseline data from the 482 individuals enrolled in the Clinical and Health Outcomes Initiative in Comparative Effectiveness for bipolar disorder study (Bipolar CHOICE) was used. The association of comorbid PTSD with increased suicidal ideation was assessed by the Concise Health Risk Tracking Scale (CHRT) total and factor scores. As the authors hypothesized, diagnosis of comorbid PTSD was a significant predictor of the CHRT total score. All participants with comorbid PTSD (n=58) endorsed current suicidal ideation and were more likely to have had a previous suicide attempt compared to those without PTSD.
AHRQ-funded; HS019371.
Citation: Katz D, Petersen T, Amado S .
An evaluation of suicidal risk in bipolar patients with comorbid posttraumatic stress disorder.
J Affect Disord 2020 Apr 1;266:49-56. doi: 10.1016/j.jad.2020.01.091..
Keywords: Behavioral Health, Risk, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Depression
Oates GR, Juarez LD, Hansen B
Social risk factors for medication nonadherence: findings from the CARDIA study.
The purpose of this study was to investigate the combined effect of social risk factors on medication nonadherence. Using data from the Coronary Artery Risk Development in Young Adults study, the results showed that low income and chronic stress are associated with medication nonadherence, and that the odds of nonadherence increase with the accumulation of social risk factors. These findings may assist with developing risk prediction tools to identify individuals who can benefit from adherence-promoting interventions.
AHRQ-funded; HS023009.
Citation: Oates GR, Juarez LD, Hansen B .
Social risk factors for medication nonadherence: findings from the CARDIA study.
Am J Health Behav 2020 Mar 1;44(2):232-43. doi: 10.5993/ajhb.44.2.10..
Keywords: Patient Adherence/Compliance, Medication, Risk, Young Adults, Cardiovascular Conditions, Patient-Centered Outcomes Research
McIsaac DI, Taljaard M, Bryson GL
Frailty as a predictor of death or new disability after surgery: a prospective cohort study.
The purpose of this study was to compare the accuracy of the modified Fried Index (mFI) and the Clinical Frailty Scale (CFS) to predict death or patient-reported new disability 90 days after major elective surgery. Results showed that older people with frailty are significantly more likely to die or experience a new patient-reported disability after surgery and that although accuracy was similar, the CFS, compared to the mFI, was easier to use and feasibility was higher.
AHRQ-funded; HS023313.
Citation: McIsaac DI, Taljaard M, Bryson GL .
Frailty as a predictor of death or new disability after surgery: a prospective cohort study.
Ann Surg 2020 Feb;271(2):283-89. doi: 10.1097/sla.0000000000002967..
Keywords: Elderly, Patient-Centered Outcomes Research, Surgery, Mortality, Adverse Events, Risk, Outcomes
McCoy RG, Lipska KJ, Van Houten HK
Paradox of glycemic management: multimorbidity, glycemic control, and high-risk medication use among adults with diabetes.
Researchers examined contemporary patterns of glycemic control and use of medications known to cause hypoglycemia among adults with diabetes across age and multimorbidity. They found that the proportion of patients achieving low HbA1c levels was highest among older and multimorbid patients. Older patients and patients with higher comorbidity burden were more likely to be treated with insulin to achieve these HbA1c levels despite the potential for hypoglycemia and uncertain long-term benefit.
AHRQ-funded; HS024075.
Citation: McCoy RG, Lipska KJ, Van Houten HK .
Paradox of glycemic management: multimorbidity, glycemic control, and high-risk medication use among adults with diabetes.
BMJ Open Diabetes Res Care 2020 Feb;8(1). doi: 10.1136/bmjdrc-2019-001007..
Keywords: Diabetes, Medication, Patient-Centered Outcomes Research, Patient-Centered Healthcare, Evidence-Based Practice, Risk, Chronic Conditions
Bucholz EM, Strait KM, Dreyer RP
Sex differences in young patients with acute myocardial infarction: a VIRGO study analysis.
This study sought to compare young women and men at the time of acute myocardial infarction (AMI) on six domains of demographic and clinical factors in order to determine whether they have distinct profiles. The authors concluded that young women with AMI represent a distinct, higher-risk population that is different from young men.
AHRQ-funded; HS023000.
Citation: Bucholz EM, Strait KM, Dreyer RP .
Sex differences in young patients with acute myocardial infarction: a VIRGO study analysis.
Eur Heart J Acute Cardiovasc Care 2017 Oct;6(7):610-22. doi: 10.1177/2048872616661847..
Keywords: Heart Disease and Health, Patient-Centered Outcomes Research, Risk, Sex Factors
Makris UE, Alvarez CA, Wei W
Association of statin use with risk of back disorder diagnoses.
Statins may increase vulnerability to myalgias and contribute to the myopathic component often experienced with back pain. This study’s goal was to examine the association of statin use with the risk of back disorder diagnoses. Researchers retrieved health care data for patients enrolled in TRICARE in the San Antonio military area. The overall cohort included 60,455 patients. Two treatment groups were identified: Statin users who recently received a first-time prescription for a statin and had been taking it for 120 days or more; statin non-users who never used statins and current users before they were prescribed statins. The study concludes that statin use is associated with increased likelihood of back disorder diagnoses.
AHRQ-funded; HS022418.
Citation: Makris UE, Alvarez CA, Wei W .
Association of statin use with risk of back disorder diagnoses.
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Keywords: Back Health and Pain, Medication, Pain, Patient-Centered Outcomes Research, Risk
Makam AN, Nguyen OK, Clark C
Incidence, predictors, and outcomes of hospital-acquired anemia.
This study examined the incidence, predictors, and postdischarge outcomes associated with hospital-acquired anemia (HAA). Most patients with severe HAA (85 percent) underwent a major procedure, had a discharge diagnosis of hemorrhage, and/or a discharge diagnosis of hemorrhagic disorder. Severe HAA is associated with increased odds for 30-day mortality and readmission after discharge; however, it is uncertain whether severe HAA is preventable.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Clark C .
Incidence, predictors, and outcomes of hospital-acquired anemia.
J Hosp Med 2017 May;12(5):317-22. doi: 10.12788/jhm.2723
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Keywords: Electronic Health Records (EHRs), Hospital Readmissions, Hospitalization, Patient-Centered Outcomes Research, Risk
Frei CR, Rehani S, Lee GC
Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy.
The researchers assessed the impact of empiric Pseudomonas pharmacotherapy on 30-day mortality in hospitalized patients with community-onset pneumonia stratified according to their risk (low, medium, or high) of drug-resistant pathogens. By using a risk score, they found that empiric Pseudomonas therapy was associated with lower 30-day mortality in the high-risk group but not the low- or medium-risk groups.
AHRQ-funded; HS022418.
Citation: Frei CR, Rehani S, Lee GC .
Application of a risk score to identify older adults with community-onset pneumonia most likely to benefit from empiric pseudomonas therapy.
Pharmacotherapy 2017 Feb;37(2):195-203. doi: 10.1002/phar.1891.
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Keywords: Elderly, Community-Acquired Infections, Pneumonia, Patient-Centered Outcomes Research, Risk
Hart R, Veenstra DL, Boudreau DM
Impact of body mass index and genetics on warfarin major bleeding outcomes in a community setting.
The researchers conducted a case-control study to evaluate the association between body mass index and major bleeding risk among patients receiving warfarin. They found that obese patients had significantly lower major bleeding risk relative to non-obese patients . An exploratory analysis indicated a statistically significant interaction between CYP4F2*3 genetic status and obesity.
AHRQ-funded; HS022982.
Citation: Hart R, Veenstra DL, Boudreau DM .
Impact of body mass index and genetics on warfarin major bleeding outcomes in a community setting.
Am J Med 2017 Feb;130(2):222-28. doi: 10.1016/j.amjmed.2016.08.017.
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Keywords: Blood Thinners, Obesity, Patient-Centered Outcomes Research, Risk, Adverse Events
Goodwin JS, Zhou J, Kuo YF
Risk of jaw osteonecrosis after intravenous bisphosphonates in cancer patients and patients without cancer.
The researchers compared the risk of jaw osteonecrosis after intravenous (IV) bisphosphonate administered to patients with cancer vs patients without cancer. During follow-up, 40 (0.42 percent) out of 9,482 patients with cancer developed probable jaw osteonecrosis compared with 8 (0.05 percent) out of 16,046 patients without cancer.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Zhou J, Kuo YF .
Risk of jaw osteonecrosis after intravenous bisphosphonates in cancer patients and patients without cancer.
Mayo Clin Proc 2017 Jan;92(1):106-13. doi: 10.1016/j.mayocp.2016.09.015.
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Keywords: Cancer, Osteoporosis, Risk, Medication, Patient-Centered Outcomes Research
Nguyen OK, Makam AN, Clark C
Vital signs are still vital: instability on discharge and the risk of post-discharge adverse outcomes.
This study assessed the association between vital sign instability at hospital discharge and post-discharge adverse outcomes. Having two or more vital sign instabilities at discharge had a positive predictive value of 22 percent and positive likelihood ratio of 1.8 for 30-day death or readmission. Vital sign instability on discharge is thus associated with increased risk-adjusted rates of 30-day mortality and readmission.
AHRQ-funded; HS022418.
Citation: Nguyen OK, Makam AN, Clark C .
Vital signs are still vital: instability on discharge and the risk of post-discharge adverse outcomes.
J Gen Intern Med 2017 Jan;32(1):42-48. doi: 10.1007/s11606-016-3826-8.
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Keywords: Hospital Discharge, Hospital Readmissions, Patient-Centered Outcomes Research, Risk