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
1 to 25 of 54 Research Studies DisplayedCooper LB, Lippmann SJ, Greiner MA
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
Perceived risks of hyperkalemia and acute renal insufficiency may limit use of mineralocorticoid receptor antagonist (MRA) therapy in patients with heart failure, especially those with diabetes mellitus or chronic kidney disease. In their study, the investigators found that among patients with heart failure and diabetes mellitus or chronic kidney disease, MRA use was associated with lower risk of all-cause readmission despite greater risk of hyperkalemia and acute renal insufficiency.
AHRQ-funded; HS021092.
Citation: Cooper LB, Lippmann SJ, Greiner MA .
Use of mineralocorticoid receptor antagonists in patients with heart failure and comorbid diabetes mellitus or chronic kidney disease.
J Am Heart Assoc 2017 Dec 23;6(12):pii: e006540. doi: 10.1161/jaha.117.006540..
Keywords: Cardiovascular Conditions, Chronic Conditions, Diabetes, Evidence-Based Practice, Heart Disease and Health, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research, Registries
Stevens JP, Nyweide DJ, Maresh S
Comparison of hospital resource use and outcomes among hospitalists, primary care physicians, and other generalists.
The purpose of this study was to examine differences in the use of health care resources and outcomes among hospitalized patients cared for by hospitalists, their own primary care physicians (PCPs), or other generalists. The investigators found that a PCP's prior experience with a patient may be associated with inpatient use of resources and patient outcomes.
AHRQ-funded; HS024288.
Citation: Stevens JP, Nyweide DJ, Maresh S .
Comparison of hospital resource use and outcomes among hospitalists, primary care physicians, and other generalists.
JAMA Intern Med 2017 Dec;177(12):1781-87. doi: 10.1001/jamainternmed.2017.5824..
Keywords: Healthcare Utilization, Hospitalization, Outcomes, Primary Care
Lou Y, Cao J, Zhang S
Sample size calculations for time-averaged difference of longitudinal binary outcomes.
In this study, the researchers investigated sample size calculation for the comparison of time-averaged responses between treatment groups in clinical trials with longitudinally observed binary outcomes. Their simulation showed that the nominal power and type I error are well preserved over a wide range of design parameters. The researchers believe that theirs is the first study to consider the mixture of missing patterns in sample size calculation.
AHRQ-funded; HS022418.
Citation: Lou Y, Cao J, Zhang S .
Sample size calculations for time-averaged difference of longitudinal binary outcomes.
Commun Stat Theory Methods 2017;46(1):344-53. doi: 10.1080/03610926.2014.991040.
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Keywords: Research Methodologies, Comparative Effectiveness, Outcomes
Cole MB, Wilson IB, Trivedi AN
State variation in quality outcomes and disparities in outcomes in community health centers.
The researchers estimated between-state variation in hypertension, diabetes, and pregnancy outcomes and racial/ethnic disparities in these outcomes for health center patients. They found wide variation in both outcomes and racial/ethnic disparities in outcomes between states for patients seen at health centers..
AHRQ-funded; HS024652.
Citation: Cole MB, Wilson IB, Trivedi AN .
State variation in quality outcomes and disparities in outcomes in community health centers.
Med Care 2017 Dec;55(12):1001-07. doi: 10.1097/mlr.0000000000000818.
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Keywords: Community-Based Practice, Disparities, Quality of Care, Outcomes, Racial and Ethnic Minorities
Siegler JE, Albright KC, George AJ
Time to neurological deterioration in ischemic stroke.
This study examined the time to neurological deterioration (ND) in ischemic stroke. The study concluded that despite having similar stroke severity and age, patients with nonreversible causes of ND had significantly shorter median time to ND when compared to patients with reversible causes of ND.
AHRQ-funded; HS013852.
Citation: Siegler JE, Albright KC, George AJ .
Time to neurological deterioration in ischemic stroke.
Med Student Res J 2017 Winter;4:18-24. doi: 10.15404/msrj/03.2016.0005..
Keywords: Neurological Disorders, Outcomes, Stroke
Lee T, Thamer M, Zhang Z
Vascular access type and clinical outcomes among elderly patients on hemodialysis.
This observational study design was used to compare clinical outcomes in elderly patients who initiated hemodialysis with a central venous catheter and subsequently had an arteriovenous fistula or graft placed. The study concluded that despite extended central venous catheter dependence, elderly patients initiating hemodialysis with a central venous catheter who underwent arteriovenous fistula placement within 6 months had fewer hospitalizations due to infections and a lower likelihood of death than those receiving an arteriovenous graft.
AHRQ-funded; HS022931; HS021229
Citation: Lee T, Thamer M, Zhang Z .
Vascular access type and clinical outcomes among elderly patients on hemodialysis.
Clin J Am Soc Nephrol 2017 Nov 7;12(11):1823-30. doi: 10.2215/cjn.01410217..
Keywords: Elderly, Kidney Disease and Health, Outcomes, Patient-Centered Outcomes Research
Borah BJ, Yao X, Laughlin-Tommaso SK
Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database.
The objective of this retrospective analysis of administrative claims from a large U.S. commercial insurance database, was to compare risk of reintervention, long-term clinical outcomes, and health care utilization among women who have bulk symptoms from leiomyoma and who underwent the following procedures: hysterectomy, myomectomy, uterine artery embolization, and magnetic resonance-guided, focused ultrasound surgery.
AHRQ-funded; HS023418.
Citation: Borah BJ, Yao X, Laughlin-Tommaso SK .
Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database.
Obstet Gynecol 2017 Nov;130(5):1047-56. doi: 10.1097/AOG.0000000000002331..
Keywords: Cancer, Comparative Effectiveness, Health Insurance, Outcomes, Patient-Centered Outcomes Research, Surgery, Women
Varban OA, Cassidy RB, Bonham A
Factors associated with achieving a body mass index of less than 30 after bariatric surgery.
This study identified predictors for achieving a BMI of less than 30 after bariatric surgery. Patients who had a sleeve gastrectomy, gastric bypass, or duodenal switch were more likely to achieve a BMI of less than 30 compared with those who underwent adjustable gastric banding. Only 8.5 percent of patients with a BMI greater than 50 achieved a BMI of less than 30 after bariatric surgery.
AHRQ-funded; HS023621.
Citation: Varban OA, Cassidy RB, Bonham A .
Factors associated with achieving a body mass index of less than 30 after bariatric surgery.
JAMA Surg 2017 Nov;152(11):1058-64. doi: 10.1001/jamasurg.2017.2348.
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Keywords: Health Status, Obesity, Outcomes, Obesity: Weight Management
Gray, 2nd DM, Hefner JL, Nguyen MC
The link between clinically validated patient safety indicators and clinical outcomes.
The authors performed a retrospective analysis of patient discharges from an academic medical center comprising 6 hospitals from July 2012 to June 2014. The study demonstrated a strong association between clinically validated PSIs and patient outcomes. The findings have important implications in policy and practice as health care reform dictates improvement in the experience of care, health of populations, and per capita costs.
AHRQ-funded; HS024379.
Citation: Gray, 2nd DM, Hefner JL, Nguyen MC .
The link between clinically validated patient safety indicators and clinical outcomes.
Am J Med Qual 2017 Nov/Dec;32(6):583-90. doi: 10.1177/1062860616683014..
Keywords: Outcomes, Patient Safety, Quality Indicators (QIs)
Ehrlich SF, Hedderson MM, Brown SD
Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes.
The aim of the study was to assess the association of regular, unsupervised sports and exercise during pregnancy, by intensity level, with glycaemic control in women with gestational diabetes (GDM). The study concluded that higher volumes of moderate intensity sports and exercise, reported shortly after GDM diagnosis, were significantly associated with increased odds of achieving glycaemic control.
AHRQ-funded; HS019367.
Citation: Ehrlich SF, Hedderson MM, Brown SD .
Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes.
Diabetes Metab 2017 Oct;43(5):416-23. doi: 10.1016/j.diabet.2017.01.006..
Keywords: Diabetes, Lifestyle Changes, Outcomes, Patient-Centered Outcomes Research, Pregnancy, Women
Leeds IL, Alimi Y, Hobson DR
Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway.
This study aims to demonstrate the association between recovery pathway implementation, process measures, and short-term surgical outcomes by population subgroup. It concluded that differences in outcomes by race and socioeconomic status did not arise following implementation of an enhanced recovery pathway. Differences in process measures by population subgroups highlight differences in care that require further investigation.
AHRQ-funded; HS024736; HS024547.
Citation: Leeds IL, Alimi Y, Hobson DR .
Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway.
Dis Colon Rectum 2017 Oct;60(10):1092-101. doi: 10.1097/dcr.0000000000000879.
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Keywords: Racial and Ethnic Minorities, Social Determinants of Health, Surgery, Outcomes, Adverse Events
Fallah-Fini S, Adam A, Cheskin LJ
The additional costs and health effects of a patient having overweight or obesity: a computational model.
This paper estimates specific additional disease outcomes and costs that could be prevented by helping a patient go from an obesity or overweight category to a normal weight category at different ages.
AHRQ-funded; HS023317.
Citation: Fallah-Fini S, Adam A, Cheskin LJ .
The additional costs and health effects of a patient having overweight or obesity: a computational model.
Obesity 2017 Oct;25(10):1809-15. doi: 10.1002/oby.21965.
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Keywords: Healthcare Costs, Obesity, Outcomes
Ehlers AP, Khor S, Cizik AM
Use of patient-reported outcomes and satisfaction for quality assessments.
This study investigated the relationship between PROs and satisfaction among spine surgery patients. The authors hypothesized that there would be significant disparities between patient satisfaction and PROs at the 1-year postoperative time point. The study found that overall, patients undergoing elective lumbar spine surgery reported being satisfied with outcomes, but the reported responses in PROs were much more variable.
AHRQ-funded; HS020025.
Citation: Ehlers AP, Khor S, Cizik AM .
Use of patient-reported outcomes and satisfaction for quality assessments.
Am J Manag Care 2017 Oct;23(10):618-22..
Keywords: Patient-Centered Outcomes Research, Patient Experience, Quality of Care, Surgery, Outcomes, Orthopedics
Waljee JF, Dimick JB
Do patient-reported outcomes correlate with clinical outcomes following surgery?
This study examines whether patient-reported outcomes (PROs) correlate with clinical outcomes following surgery. PROs are distinct from clinical outcomes and represent a potential indicator of performance that can be targeted to improve quality of care. Future studies that examine the influence of measurement techniques, case mix, and disease characteristics on PROs will inform efforts to routinely and efficiently integrate these critical outcomes into existing strategies to capture treatment effectiveness and quality of care for surgical conditions.
AHRQ-funded; HS023313.
Citation: Waljee JF, Dimick JB .
Do patient-reported outcomes correlate with clinical outcomes following surgery?
Adv Surg 2017 Sep;51(1):141-50. doi: 10.1016/j.yasu.2017.03.011..
Keywords: Quality of Care, Outcomes, Patient-Centered Outcomes Research, Surgery, Patient Experience, Quality Measures
Handley MA, Quan J, Chao MT
Use of complementary health approaches among diverse primary care patients with type 2 diabetes and association with cardiometabolic outcomes: from the SF Bay Collaborative Research Network (SF Bay CRN).
The purpose of this study is to describe use of complementary health approaches (CHAs) among patients with type 2 diabetes, and independent associations between CHA use and Hemoglobin A1c (A1C) and lower-density lipoprotein (LDL) cholesterol. The study concluded that CHA use is common among patients with type 2 diabetes and may be associated with poor cardiometabolic control and medication adherence.
AHRQ-funded; HS022561.
Citation: Handley MA, Quan J, Chao MT .
Use of complementary health approaches among diverse primary care patients with type 2 diabetes and association with cardiometabolic outcomes: from the SF Bay Collaborative Research Network (SF Bay CRN).
J Am Board Fam Med 2017 Sep-Oct;30(5):624-31. doi: 10.3122/jabfm.2017.05.170030..
Keywords: Heart Disease and Health, Complementary and Alternative Medicine, Diabetes, Outcomes, Patient Self-Management
Holland DE, Brandt C, Targonski PV
Validating performance of a hospital discharge planning decision tool in community hospitals.
The researchers aimed to determine the predictive performance of the Early Screen for Discharge Planning (ESDP) in a rural regional community hospital practice setting. Patients with high ESDP scores reported more problems after discharge, reported lower quality of life, had longer length of stays, and used post-acute care services more than patients with low ESDP scores.
AHRQ-funded; HS022923.
Citation: Holland DE, Brandt C, Targonski PV .
Validating performance of a hospital discharge planning decision tool in community hospitals.
Prof Case Manag 2017 Sep/Oct;22(5):204-13. doi: 10.1097/ncm.0000000000000233.
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Keywords: Decision Making, Hospital Discharge, Outcomes, Rural Health, Tools & Toolkits
Liotta EM, Prabhakaran S, Sangha RS
Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.
The researchers tested the hypothesis that admission serum magnesium levels are associated with hematoma volume, hematoma growth, and functional outcomes in patients with intracerebral hemorrhage (ICH). Their findings support the hypothesis that magnesium exerts a clinically meaningful influence on hemostasis in patients with ICH.
AHRQ-funded; HS023437.
Citation: Liotta EM, Prabhakaran S, Sangha RS .
Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.
Neurology 2017 Aug 22;89(8):813-19. doi: 10.1212/wnl.0000000000004249..
Keywords: Patient-Centered Outcomes Research, Treatments, Outcomes, Brain Injury
Sinha SS, Sjoding MW, Sukul D
Changes in primary noncardiac diagnoses over time among elderly cardiac intensive care unit patients in the United States.
This study examined changes in primary noncardiac diagnoses among elderly patients admitted to a cardiac intensive care unit (CICU) during the past decade. More than half of all elderly patients with a CICU stay across the United States now have primary noncardiac diagnoses at discharge. These patients receive different types of care and have worse outcomes than patients with primary cardiac diagnoses.
AHRQ-funded; HS020672.
Citation: Sinha SS, Sjoding MW, Sukul D .
Changes in primary noncardiac diagnoses over time among elderly cardiac intensive care unit patients in the United States.
Circ Cardiovasc Qual Outcomes 2017 Aug;10(8):e003616. doi: 10.1161/circoutcomes.117.003616.
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Keywords: Elderly, Heart Disease and Health, Intensive Care Unit (ICU), Outcomes, Respiratory Conditions
Nahhas GJ, Wilson D, Talbot V
Feasibility of implementing a hospital-based "opt-out" tobacco-cessation service.
This study assessed the feasibility and outcomes of implementing a hospital-based "opt-out" tobacco-cessation service. The service consisted of a bedside consult and phone follow-up 3, 14, and 30 days after hospital discharge using interactive-voice-response. Findings from this study suggest that an inpatient smoking-cessation service with an "opt-out" approach can positively impact short-term cessation outcomes.
AHRQ-funded; HS023863.
Citation: Nahhas GJ, Wilson D, Talbot V .
Feasibility of implementing a hospital-based "opt-out" tobacco-cessation service.
Nicotine Tob Res 2017 Aug;19(8):937-43. doi: 10.1093/ntr/ntw312.
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Keywords: Health Information Technology (HIT), Hospitalization, Tobacco Use, Outcomes
Costa DK, White MR, Ginier E
Identifying barriers to delivering the awakening and breathing coordination, delirium, and early exercise/mobility bundle to minimize adverse outcomes for mechanically ventilated patients: a systematic review.
The purpose of this review was to identify and catalog the barriers to the Awakening and Breathing Coordination, Delirium, and Early exercise/mobility bundle (ABCDE) delivery based on a widely used implementation framework, and to provide a resource to guide clinicians in overcoming barriers to implementation. It provides the first, to the authors’ knowledge, systematic differential diagnosis of barriers to ABCDE delivery, moving beyond the conventional focus on patient-level factors.
AHRQ-funded; HS024552.
Citation: Costa DK, White MR, Ginier E .
Identifying barriers to delivering the awakening and breathing coordination, delirium, and early exercise/mobility bundle to minimize adverse outcomes for mechanically ventilated patients: a systematic review.
Chest 2017 Aug;152(2):304-11. doi: 10.1016/j.chest.2017.03.054.
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Keywords: Respiratory Conditions, Adverse Events, Prevention, Outcomes
Smith AB, Basch E
Role of patient-reported outcomes in postsurgical monitoring in oncology.
This article describes the benefits of electronic patient-reported outcomes (ePROs) in postsurgical symptom monitoring for surgical oncology patients; ePROs can identify at-risk patients, provide closer monitoring, and provide a mechanism to identify and treat complications before they worsen. The article also summarizes the literature of ePRO use in surgical oncology.
AHRQ-funded; HS024134.
Citation: Smith AB, Basch E .
Role of patient-reported outcomes in postsurgical monitoring in oncology.
J Oncol Pract 2017 Aug;13(8):535-38. doi: 10.1200/jop.2017.023838..
Keywords: Cancer, Care Management, Health Information Technology (HIT), Electronic Health Records (EHRs), Surgery, Outcomes
Boffa D, Fernandez FG, Kim S
Surgically managed clinical stage iiia-clinical n2 lung cancer in the Society of Thoracic Surgeons Database.
The objective of this study was to characterize the management of clinical stage IIIA-N2 positive (cIIIA-N2) lung cancer in The Society of Thoracic Surgeons General Thoracic Surgery Database. Surgeons achieved excellent short- and long-term results treating predominantly lobectomy-amenable cIIIA-N2 lung cancer. However, prevalent overstaging and abstention from induction therapy suggested "overcoding" of false positives on imaging or variable compliance with current guidelines for cIIIA-N2 lung cancer.
AHRQ-funded; HS022279.
Citation: Boffa D, Fernandez FG, Kim S .
Surgically managed clinical stage iiia-clinical n2 lung cancer in the Society of Thoracic Surgeons Database.
Ann Thorac Surg 2017 Aug;104(2):395-403. doi: 10.1016/j.athoracsur.2017.02.031.
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Keywords: Surgery, Cancer: Lung Cancer, Registries, Elderly, Outcomes
Payne P, Lele O, Johnson B
Enabling open science for health research: Collaborative Informatics Environment for Learning on Health Outcomes (CIELO).
AcademyHealth's Electronic Data Methods (EDM) Forum implemented a proof-of-concept open science platform for health research called the Collaborative Informatics Environment for Learning on Health Outcomes (CIELO). This provided the basis for a vigorous dialogue between stakeholder community members regarding the capabilities that will add the greatest value to an open science platform for the health research community.
AHRQ-funded; HS022789.
Citation: Payne P, Lele O, Johnson B .
Enabling open science for health research: Collaborative Informatics Environment for Learning on Health Outcomes (CIELO).
J Med Internet Res 2017 Jul 31;19(7):e276. doi: 10.2196/jmir.6937.
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Keywords: Health Services Research (HSR), Health Information Technology (HIT), Outcomes, Patient-Centered Outcomes Research
Ibrahim AM, Ghaferi AA, Thumma JR
Variation in outcomes at bariatric surgery centers of excellence.
This review describes the variation in surgical outcomes across bariatric centers of excellence and the geographic availability of high-quality centers. Even among accredited bariatric surgery centers, wide variation exists in rates of postoperative serious complications across geographic location and operative volumes.
AHRQ-funded; HS02362; HS024403.
Citation: Ibrahim AM, Ghaferi AA, Thumma JR .
Variation in outcomes at bariatric surgery centers of excellence.
JAMA Surg 2017 Jul;152(7):629-36. doi: 10.1001/jamasurg.2017.0542.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Obesity, Surgery, Outcomes, Adverse Events
Chang SH, Liu X, Carlsson NP
Reexamining the association of body mass index with overall survival outcomes after liver transplantation.
The purpose of this study is to identify the range of body mass index (BMI) at liver transplantation (LT) associated with the lowest risks of posttransplant mortality by Model of End Stage Liver Disease (MELD) category. It concluded that obesity in LT patients is not necessarily associated with higher posttransplantation mortality and highlighted the importance of the interaction between BMI and MELD category to determine their survival likelihood.
AHRQ-funded; HS022330.
Citation: Chang SH, Liu X, Carlsson NP .
Reexamining the association of body mass index with overall survival outcomes after liver transplantation.
Transplant Direct 2017 Jun 12;3(7):e172. doi: 10.1097/txd.0000000000000681.
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Keywords: Obesity, Transplantation, Mortality, Patient-Centered Outcomes Research, Outcomes