National Healthcare Quality and Disparities Report
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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
126 to 145 of 145 Research Studies DisplayedAllen NB, Zhao L, Liu L
Favorable cardiovascular health, compression of morbidity, and healthcare costs: forty-year follow-up of the CHA Study (Chicago Heart Association Detection Project in Industry).
The researchers examined the association of cardiovascular health at younger ages with the proportion of life lived free of morbidity, the cumulative burden of morbidity, and average healthcare costs at older ages. They found that individuals in favorable cardiovascular health in early middle age live a longer, healthier life free of all types of morbidity.
AHRQ-funded; HS020263.
Citation: Allen NB, Zhao L, Liu L .
Favorable cardiovascular health, compression of morbidity, and healthcare costs: forty-year follow-up of the CHA Study (Chicago Heart Association Detection Project in Industry).
Circulation 2017 May 2;135(18):1693-701. doi: 10.1161/circulationaha.116.026252.
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Keywords: Healthcare Costs, Cardiovascular Conditions, Health Status
Adedinsewo D, Xu J, Agasthi P
Effect of digoxin use among Medicaid enrollees with atrial fibrillation.
The study’s goal was to examine risk factors for hospitalizations and mortality with digoxin use in a diverse real-world atrial fibrillation patient population and evaluate racial differences. It found an overall increased risk of hospitalizations and mortality with digoxin use. No racial/ethnic differences in outcomes were observed.
AHRQ-funded; HS022444.
Citation: Adedinsewo D, Xu J, Agasthi P .
Effect of digoxin use among Medicaid enrollees with atrial fibrillation.
Circ Arrhythm Electrophysiol 2017 May;10(5):e004573. doi: 10.1161/circep.116.004573.
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Keywords: Heart Disease and Health, Medication, Medicaid, Cardiovascular Conditions, Patient-Centered Outcomes Research
Ritchey MD, Loustalot F, Wall HK
AHRQ Author: Steiner CA
Million Hearts: description of the national surveillance and modeling methodology used to monitor the number of cardiovascular events prevented during 2012-2016.
This study describes the national surveillance and modeling methodology developed to monitor achievement of the Million Hearts initiative's aim of preventing 1 million acute myocardial infarctions, strokes, and other related cardiovascular events during 2012-2016. The authors concluded that around 115 000 events were prevented during the initiative's first 2 years compared with what would have occurred had 2011 rates remained stable.
AHRQ-authored.
Citation: Ritchey MD, Loustalot F, Wall HK .
Million Hearts: description of the national surveillance and modeling methodology used to monitor the number of cardiovascular events prevented during 2012-2016.
J Am Heart Assoc 2017 May 2;6(5). doi: 10.1161/jaha.117.006021.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Prevention
Tu JV, Maclagan LC, Ko DT
AHRQ Author: Bierman A
The Cardiovascular Health in Ambulatory Care Research Team performance indicators for the primary prevention of cardiovascular disease: a modified Delphi panel study.
The researchers developed a set of key performance indicators that can be used to measure and improve cardiovascular care in the primary care setting. A set of 28 indicators of primary prevention performance were identified, which were grouped into 5 domains: risk factor prevalence, screening, management, intermediate outcomes and long-term outcomes.
AHRQ-authored.
Citation: Tu JV, Maclagan LC, Ko DT .
The Cardiovascular Health in Ambulatory Care Research Team performance indicators for the primary prevention of cardiovascular disease: a modified Delphi panel study.
CMAJ Open 2017 Apr 25;5(2):E315-e21. doi: 10.9778/cmajo.20160139.
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Keywords: Cardiovascular Conditions, Quality of Care, Ambulatory Care and Surgery, Prevention, Quality Indicators (QIs)
Palta P, Huang ES, Kalyani RR
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
In this paper, the investigators sought to estimate the risk of mortality by HbA1c levels among older adults with and without diabetes. They concluded that an HbA1c >8.0% was associated with increased risk of all-cause and cause-specific mortality in older adults with diabetes. The investigators suggest that their results support the idea that better glycemic control is important for reducing mortality; however, they also indicate that there is a need for individualized glycemic targets for older adults with diabetes depending on their demographics, duration of diabetes, and existing comorbidities.
AHRQ-funded; HS018542.
Citation: Palta P, Huang ES, Kalyani RR .
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
Diabetes Care 2017 Apr;40(4):453-60. doi: 10.2337/dci16-0042.
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Keywords: Cancer, Cardiovascular Conditions, Diabetes, Elderly, Mortality, Risk
Palamaner Subash Shantha G, Bhave PD, Girotra S
Sex-specific comparative effectiveness of oral anticoagulants in elderly patients with newly diagnosed atrial fibrillation.
This study assessed the sex-specific, comparative effectiveness of direct oral anticoagulants (rivaroxaban and dabigatran), compared to each other and to warfarin among patients with atrial fibrillation. It concluded that the reduced risk of ischemic stroke in patients taking rivaroxaban, compared with dabigatran and warfarin, seems to be limited to men, whereas the higher risk of bleeding seems to be limited to women.
AHRQ-funded; HS023104.
Citation: Palamaner Subash Shantha G, Bhave PD, Girotra S .
Sex-specific comparative effectiveness of oral anticoagulants in elderly patients with newly diagnosed atrial fibrillation.
Circ Cardiovasc Qual Outcomes 2017 Apr;10(4). doi: 10.1161/circoutcomes.116.003418.
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Keywords: Elderly, Heart Disease and Health, Blood Thinners, Medication, Comparative Effectiveness, Cardiovascular Conditions, Sex Factors, Patient-Centered Outcomes Research, Evidence-Based Practice
Karaca-Mandic P, Town RJ, Wilcock A
The effect of physician and hospital market structure on medical technology diffusion.
The researchers examined the influence of physician and hospital market structures on medical technology diffusion, studying the diffusion of drug-eluting stents (DESs), which became available in April 2003. They found that DESs diffused faster in markets where cardiology practices faced more competition. Conversely, there was no evidence that the structure of the hospital market mattered.
AHRQ-funded; HS023473; HS000036.
Citation: Karaca-Mandic P, Town RJ, Wilcock A .
The effect of physician and hospital market structure on medical technology diffusion.
Health Serv Res 2017 Apr;52(2):579-98. doi: 10.1111/1475-6773.12506.
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Keywords: Hospitals, Cardiovascular Conditions
Masoudi FA, Curtis JP, Desai NR
PCI appropriateness in New York: if it makes it there, can it make it everywhere?
In this article, the authors discuss cardiovascular medicine in the United States, specifically percutaneous coronary intervention (PCI) procedures. They discuss New York’s experience with PCI. They assert that systematic examination of trends in utilization and characteristics of patients undergoing PCI in New York could provide important insights into these actions’ potential impact on clinical care.
AHRQ-funded; K12 HS023000.
Citation: Masoudi FA, Curtis JP, Desai NR .
PCI appropriateness in New York: if it makes it there, can it make it everywhere?
J Am Coll Cardiol 2017 Mar 14;69(10):1243-46. doi: 10.1016/j.jacc.2017.01.009..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Surgery
Yim CK, Barron Y, Moore S
Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization.
Patients with advanced heart failure (HF) enroll in hospice at low rates, and data on their acute medical service utilization after hospice enrollment is limited. This descriptive analysis of Medicare fee-for-service beneficiaries found that home health care Medicare beneficiaries with advanced HF who enrolled in hospice had lower acute medical service utilization after their enrollment.
AHRQ-funded; HS020257.
Citation: Yim CK, Barron Y, Moore S .
Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization.
Circ Heart Fail 2017 Mar;10(3). doi: 10.1161/circheartfailure.116.003335.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Healthcare Utilization, Medicare, Palliative Care
Wang SV, Rogers JR, Jin Y
Use of electronic healthcare records to identify complex patients with atrial fibrillation for targeted intervention.
The researchers tested algorithms for identifying atrial fibrillation (AF) patients who also have known risk factors for stroke and major bleeding using electronic healthcare records (EHRs) data. The performance of candidate algorithms in 1000 bootstrap resamples was compared to a gold standard of manual chart review by experienced resident physicians of 480 patient charts. For 11 conditions, the median positive predictive value of the EHR-derived algorithms was greater than 0.90.
AHRQ-funded; HS022193.
Citation: Wang SV, Rogers JR, Jin Y .
Use of electronic healthcare records to identify complex patients with atrial fibrillation for targeted intervention.
J Am Med Inform Assoc 2017 Mar 1;24(2):339-44. doi: 10.1093/jamia/ocw082.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Risk
Flory J
Will cardiovascular outcomes data on newer diabetes drugs bury the older agents?
This paper comments on the variety of drug treatment options for patients with type 2 diabetes. The authors assert that the FDA has an opportunity to champion public health because the agency exerts great influence on how type 2 diabetes drugs are studied. The authors also suggest that the FDA’s influence and regulatory powers should be used to improve the health of patients with diabetes who now face many uninformed choices between newer and older drugs.
AHRQ-funded; HS023898.
Citation: Flory J .
Will cardiovascular outcomes data on newer diabetes drugs bury the older agents?
JAMA Intern Med 2017 Mar;177(3):301-02. doi: 10.1001/jamainternmed.2016.8284..
Keywords: Cardiovascular Conditions, Diabetes, Medication
Tam MC, Lee R, Cascino TM
Current perspectives on systemic hypertension in heart failure with preserved ejection fraction.
Heart failure with preserved ejection fraction (HFpEF) is a prevalent but incompletely understood syndrome. Traditional models of HFpEF pathophysiology revolve around systemic hypertension (HTN) and other causes of increased left ventricular afterload leading to left ventricular hypertrophy (LVH) and diastolic dysfunction. However, emerging models attribute the development of HFpEF to systemic proinflammatory changes secondary to common comorbidities which include HTN.
AHRQ-funded; HS024567.
Citation: Tam MC, Lee R, Cascino TM .
Current perspectives on systemic hypertension in heart failure with preserved ejection fraction.
Curr Hypertens Rep 2017 Feb;19(2):12. doi: 10.1007/s11906-017-0709-2.
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Keywords: Blood Pressure, Heart Disease and Health, Cardiovascular Conditions, Stroke, Outcomes
Musey PI, Jr., Kline JA
Do gender and race make a difference in acute coronary syndrome pretest probabilities in the emergency department?
The objective was to test for significant differences in subjective and objective pretest probabilities for acute coronary syndrome (ACS) in chest pain patients. Despite consistently estimating the risk for ACS to be lower for both females and minorities concordantly with calculated objective pretest assessments, there does not appear to have been any significant decrease in subsequent evaluation of these perceived lower-risk groups when radiation exposure and costs are taken into account.
AHRQ-funded; HS018519.
Citation: Musey PI, Jr., Kline JA .
Do gender and race make a difference in acute coronary syndrome pretest probabilities in the emergency department?
Acad Emerg Med 2017 Feb;24(2):142-51. doi: 10.1111/acem.13131.
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Keywords: Sex Factors, Racial and Ethnic Minorities, Cardiovascular Conditions, Emergency Medical Services (EMS)
Lu Y, Zhou S, Dreyer RP
Sex differences in inflammatory markers and health status among young adults with acute myocardial infarction: results from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients) Study.
This study assessed sex differences in post-acute myocardial infarction (AMI) inflammatory markers and whether such differences account for sex differences in 12-month health status, using data from 2219 adults with AMI, 18 to 55 years of age, in the United States. Overall, women had higher levels of inflammatory markers after AMI compared with men, and this remained statistically significant after multivariable adjustment.
AHRQ-funded; HS023000.
Citation: Lu Y, Zhou S, Dreyer RP .
Sex differences in inflammatory markers and health status among young adults with acute myocardial infarction: results from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients) Study.
Circ Cardiovasc Qual Outcomes 2017 Feb;10(2):e003470. doi: 10.1161/circoutcomes.116.003470.
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Keywords: Cardiovascular Conditions, Health Status, Heart Disease and Health, Patient-Centered Outcomes Research, Sex Factors
Dreyer RP, Sciria C, Spatz ES
Young women with acute myocardial infarction: current perspectives.
The purpose of this cardiovascular perspective piece is to review recent studies of acute myocardial infarction (AMI) in young women. More specifically, it emphasizes differences in the epidemiology, diagnosis, and management of AMI in young women (when compared with men) across the continuum of care, including their pre-AMI, in-hospital, and post-AMI periods, and highlights gaps in knowledge and outcomes that can inform the next generation of research.
AHRQ-funded; HS023000.
Citation: Dreyer RP, Sciria C, Spatz ES .
Young women with acute myocardial infarction: current perspectives.
Circ Cardiovasc Qual Outcomes 2017 Feb;10(2). doi: 10.1161/circoutcomes.116.003480.
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Keywords: Cardiovascular Conditions, Health Status, Heart Disease and Health, Risk
Vaughan Sarrazin MS, Jones M, Mazur A
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
The purpose of this study was to examine the impact of anticoagulant choice on inpatient costs in patients with nonvalvular atrial fibrillation (AF). Analysis used 3-way propensity matching to create groups from AF patients taking dabigatran, rivaroxaban, or warfarin, and were plausible candidates for all 3 anticoagulants. Predicted values from two models were multiplied together to estimate expected costs per patient-year. The study concludes from its data that patients with newly diagnosed AF taking 150 mg dabigatran or 20 mg rivaroxaban experience lower annual inpatient costs than patients taking warfarin, due to fewer hospital admissions for stroke, non-gastrointestinal-related hemorrhages, and heart failure events.
AHRQ-funded; HS023104.
Citation: Vaughan Sarrazin MS, Jones M, Mazur A .
Cost of hospital admissions in Medicare patients with atrial fibrillation taking warfarin, dabigatran, or rivaroxaban.
J Am Coll Cardiol 2017 Jan 24;69(3):360-62. doi: 10.1016/j.jacc.2016.11.023..
Keywords: Blood Thinners, Heart Disease and Health, Medication, Healthcare Costs, Medicare, Hospitalization, Cardiovascular Conditions
Dhruva SS, Desai NR, Karaca-Mandic P
Medicare formulary changes after the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline.
This letter describes a study which examined the use of statins and non-statin medications at Medicare formularies before and after the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guideline was released. The study found that while many formularies did restrict nonstatin medications as per the new guidelines, many others did not.
AHRQ-funded; HS023000.
Citation: Dhruva SS, Desai NR, Karaca-Mandic P .
Medicare formulary changes after the 2013 American College of Cardiology/American Heart Association Cholesterol Guideline.
J Am Coll Cardiol 2017 Jan 17;69(2):244-46. doi: 10.1016/j.jacc.2016.10.053..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Guidelines, Medicare, Medication
Webb M, Fahimi S, Singh GM
Cost effectiveness of a government supported policy strategy to decrease sodium intake: global analysis across 183 nations.
This study quantified the cost effectiveness of a government policy combining targeted industry agreements and public education to reduce sodium intake in 183 countries worldwide. It concluded that a government "soft regulation" strategy combining targeted industry agreements and public education to reduce dietary sodium is projected to be highly cost effective worldwide, even without accounting for potential healthcare savings.
AHRQ-funded; HS000062.
Citation: Webb M, Fahimi S, Singh GM .
Cost effectiveness of a government supported policy strategy to decrease sodium intake: global analysis across 183 nations.
BMJ 2017 Jan 10;356:i6699. doi: 10.1136/bmj.i6699.
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Keywords: Healthcare Costs, Nutrition, Cardiovascular Conditions, Blood Pressure, Policy
Davis JD, Olsen MA, Bommarito K
All-payer analysis of heart failure hospitalization 30-day readmission: comorbidities matter.
In this study, the researchers investigated readmission characteristics and the magnitude of 30-day hospital readmissions after hospital discharge for heart failure using the Healthcare Cost and Utilization Project State Inpatient Databases (SID). They found in this large all-payer cohort, ∼70% of 30-day readmissions were for non-heart failure causes, and the median time to readmission was 12 days.
AHRQ-funded; HS019455.
Citation: Davis JD, Olsen MA, Bommarito K .
All-payer analysis of heart failure hospitalization 30-day readmission: comorbidities matter.
Am J Med 2017 Jan;130(1):93.e9-93.e28. doi: 10.1016/j.amjmed.2016.07.030..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Hospitalization, Hospitals, Provider Performance
Shafi T, Powe NR, Meyer TW
Trimethylamine N-oxide and cardiovascular events in hemodialysis patients.
This study determined the association of the proatherogenic metabolite trimethylamine N-oxide (TMAO) with cardiovascular outcomes in hemodialysis patients and assessed whether this association differs by race. It found that, compared with blacks in the same quintile, whites in the highest quintile for TMAO (>/=135 muM) had a 4-fold higher risk of cardiac or sudden cardiac death and a 2-fold higher risk of any-cause death.
AHRQ-funded; HS008365.
Citation: Shafi T, Powe NR, Meyer TW .
Trimethylamine N-oxide and cardiovascular events in hemodialysis patients.
J Am Soc Nephrol 2017 Jan;28(1):321-31. doi: 10.1681/asn.2016030374.
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Keywords: Kidney Disease and Health, Racial and Ethnic Minorities, Cardiovascular Conditions