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
26 to 37 of 37 Research Studies DisplayedLakshminarayan K, Westberg S, Northuis C
A mHealth-based care model for improving hypertension control in stroke survivors: pilot RCT.
Hypertension (HTN) is significantly under-treated in stroke survivors. The study authors examined usability and efficacy of a mHealth -based care model for improving post-stroke HTN control. They concluded that a mHealth-based HTN care model had excellent usability and provided better HTN control than usual care in stroke survivors.
AHRQ-funded; HS021794.
Citation: Lakshminarayan K, Westberg S, Northuis C .
A mHealth-based care model for improving hypertension control in stroke survivors: pilot RCT.
Contemp Clin Trials 2018 Jul;70:24-34. doi: 10.1016/j.cct.2018.05.005..
Keywords: Telehealth, Health Information Technology (HIT), Blood Pressure, Stroke, Cardiovascular Conditions
Regenhardt RW, Mecca AP, Flavin SA
Delays in the air or ground transfer of patients for endovascular thrombectomy.
This study’s objective was to examine associations between transfer time, modes of transfer, endovascular therapy (ET), and outcomes within a hub-and-spoke telestroke network. Results showed an association between longer transfer time and decreased likelihood of undergoing ET. Nocturnal transfers were associated with a substantial delay relative to daytime transfers. In contrast, delivery of tPA was not associated with delays, underscoring the impact of effective protocols at spoke hospitals. More efficient transfer may enable higher ET treatment rates.
AHRQ-funded; HS024561.
Citation: Regenhardt RW, Mecca AP, Flavin SA .
Delays in the air or ground transfer of patients for endovascular thrombectomy.
Stroke 2018 Jun;49(6):1419-25. doi: 10.1161/strokeaha.118.020618.
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Keywords: Health Services Research (HSR), Patient-Centered Outcomes Research, Telehealth, Transitions of Care, Stroke
Krishnan S, Pappadis MR, Weller SC
Patient-centered mobility outcome preferences according to individuals with stroke and caregivers: a qualitative analysis.
This study explored the mobility-related preferences among stroke survivors and caregivers following post-acute rehabilitation at inpatient or skilled nursing facilities. Frequently mentioned outcome preferences by survivors were ability to walk (88 percent), move, and balance. They also wanted to acquire assistive devices to move independently. Caregivers were concerned with the survivor's safety and wanted them to drive (53 percent), prevent falls, have home accommodations, and transfer independently.
AHRQ-funded; HS022134; HS024711.
Citation: Krishnan S, Pappadis MR, Weller SC .
Patient-centered mobility outcome preferences according to individuals with stroke and caregivers: a qualitative analysis.
Disabil Rehabil 2018 Jun;40(12):1401-09. doi: 10.1080/09638288.2017.1297855.
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Keywords: Caregiving, Patient-Centered Outcomes Research, Patient Safety, Rehabilitation, Stroke
Richards CT, Huebinger R, Tataris KL
Cincinnati prehospital stroke scale can identify large vessel occlusion stroke.
This study explores the hypothesize that a cut-off score of the Cincinnati Prehospital Stroke Scale (CPSS), an assessment tool currently used by emergency medical services (EMS) providers, can be used to identify large vessel occlusion (LVO). Patients with acute ischemic stroke arriving via EMS at a high-volume stroke center in a large city were identified in a prospective, single-center registry. LVO was confirmed via head and neck vessel imaging and CPSS scores were abstracted from pre-hospital EMS records. The researchers conclude that a CPSS score of 3 identifies LVO in AIS patients reliably, and that EMS providers may be able to use the CPSS with a cut-off score to screen for patients with suspected LVO.
AHRQ-funded; HS000078.
Citation: Richards CT, Huebinger R, Tataris KL .
Cincinnati prehospital stroke scale can identify large vessel occlusion stroke.
Prehosp Emerg Care 2018 May-Jun;22(3):312-18. doi: 10.1080/10903127.2017.1387629..
Keywords: Diagnostic Safety and Quality, Emergency Department, Emergency Medical Services (EMS), Stroke
Sterling MR, Durant RW, Bryan J
N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study.
Researchers compared the association of N-terminal pro B-type peptide (NT-proBNP) with risk of incident typical myocardial infarction (MI) and microsize MI in the REasons for Geographic and Racial Differences in Stroke Study. Over a median of 5 years of follow-up, there were 315 typical MI, 139 microsize MI, and 195 incident fatal coronary heart disease (CHD). NT-proBNP was independently and strongly associated with all CHD endpoints, with significantly greater risk observed for incident microsize MI.
AHRQ-funded; HS000066.
Citation: Sterling MR, Durant RW, Bryan J .
N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study.
BMC Cardiovasc Disord 2018 Apr 16;18(1):66. doi: 10.1186/s12872-018-0806-4.
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Keywords: Heart Disease and Health, Racial and Ethnic Minorities, Risk, Stroke
Fudim M, Liu PR, Shrader P
Mineralocorticoid receptor antagonism in patients with atrial fibrillation: findings from the ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry.
Mineralocorticoid receptor antagonist (MRA) therapy may be beneficial to patients with atrial fibrillation (AF), but little is known about their use in patients with AF and subsequent outcomes. In order to better understand MRA use and subsequent outcomes, the investigators performed a retrospective cohort study of the contemporary ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry.
AHRQ-funded; HS021092.
Citation: Fudim M, Liu PR, Shrader P .
Mineralocorticoid receptor antagonism in patients with atrial fibrillation: findings from the ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry.
J Am Heart Assoc 2018 Apr 13;7(8). doi: 10.1161/jaha.117.007987..
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Heart Disease and Health, Medication, Outcomes, Patient-Centered Outcomes Research, Prevention, Registries, Stroke
Mullen MT, Pajerowski W, Messe SR
Geographic modeling to quantify the impact of primary and comprehensive stroke center destination policies.
The purpose of this study was to evaluate the impact of a primary stroke center (PSC) destination policy in a major metropolitan city and to use geographic modeling in order to evaluate expected changes for a comprehensive stroke center policy. Suspected stroke emergency medical services encounters in Philadelphia, PA, were identified, and transport times before and after the initiation of a PSC destination policy in October 2011 were compared. Geographic modeling was used to estimate the impact of bypassing the closest hospital for the closest PSC or comprehensive stroke centers, which was common before the official policy and increased steadily over time. The researchers conclude that the time taken to route patients to PSCs or comprehensive stroke centers is low.
AHRQ-funded; HS018362.
Citation: Mullen MT, Pajerowski W, Messe SR .
Geographic modeling to quantify the impact of primary and comprehensive stroke center destination policies.
Stroke 2018 Apr;49(4):1021-23. doi: 10.1161/strokeaha.118.020691.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Hospitals, Policy, Stroke
Mefford MT, Rosenson RS, Cushman M
PCSK9 variants, low-density lipoprotein cholesterol, and neurocognitive impairment: Reasons for Geographic and Racial Differences in Stroke Study(REGARDS).
Researchers examined if there was an association between low lifelong exposure to PCSK9 levels and lower levels of low-density lipoprotein cholesterol with neurocognitive function in blacks. Data was analyzed from subjects in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. The mean sample age was 64, with 62% women but a low prevalence of neurocognitive impairments at any level (6.3% by CERAD battery, and 15.4% by SIS definitions). No association with found.
AHRQ-funded; HS013852.
Citation: Mefford MT, Rosenson RS, Cushman M .
PCSK9 variants, low-density lipoprotein cholesterol, and neurocognitive impairment: Reasons for Geographic and Racial Differences in Stroke Study(REGARDS).
Circulation 2018 Mar 20;137(12):1260-69. doi: 10.1161/circulationaha.117.029785..
Keywords: Heart Disease and Health, Racial and Ethnic Minorities, Risk, Stroke
Saber Tehrani AS, Kattah JC, Kerber KA
Diagnosing stroke in acute dizziness and vertigo: pitfalls and pearls.
Diagnosing cerebrovascular causes of acute dizziness and vertigo is both important and difficult. It is not routinely done well in current clinical ED practice. Current best evidence suggests an approach emphasizing dizziness timing and triggers, focused ocular motor examinations, and MRI, as needed. Alternative strategies to disseminate this approach may be required.
AHRQ-funded; HS022258.
Citation: Saber Tehrani AS, Kattah JC, Kerber KA .
Diagnosing stroke in acute dizziness and vertigo: pitfalls and pearls.
Stroke 2018 Mar;49(3):788-95. doi: 10.1161/strokeaha.117.016979.
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Keywords: Diagnostic Safety and Quality, Imaging, Stroke
Mendelson SJ, Courtney DM, Gordon EJ
National practice patterns of obtaining informed consent for stroke thrombolysis.
No standard approach to obtaining informed consent for stroke thrombolysis with tPA (tissue-type plasminogen activator) currently exists. The researchers aimed to assess current nationwide practice patterns of obtaining informed consent for tPA. They concluded that most clinicians always or often require informed consent for stroke thrombolysis.
AHRQ-funded; HS025330.
Citation: Mendelson SJ, Courtney DM, Gordon EJ .
National practice patterns of obtaining informed consent for stroke thrombolysis.
Stroke 2018 Mar;49(3):765-67. doi: 10.1161/strokeaha.117.020474.
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Keywords: Practice Patterns, Stroke
Blackburn J, Albright KC, Haley WE
Men lacking a caregiver have greater risk of long-term nursing home placement after stroke.
The purpose of this study was to understand how the availability of a caregiver can affect nursing home placement after ischemic stroke and how this affects different subgroups differently. The investigators found that in men aged 65 and older who have survived an ischemic stroke, the lack of an available caregiver is associated with triple the risk of NHP within 5 years.
AHRQ-funded; HS023009.
Citation: Blackburn J, Albright KC, Haley WE .
Men lacking a caregiver have greater risk of long-term nursing home placement after stroke.
J Am Geriatr Soc 2018 Jan;66(1):133-39. doi: 10.1111/jgs.15166..
Keywords: Cardiovascular Conditions, Caregiving, Elderly, Long-Term Care, Men's Health, Nursing Homes, Stroke
Sanders BD, Davis MG, Holley SL
Pregnancy-associated stroke.
This article reviews assessment and treatment of pregnant and postpartum women experiencing stroke. There are 2 main types of stroke, ischemic and hemorrhagic that present similar symptoms but have very different pathophysiology and treatment. This article provides guidance for subsequent maternity and primary care for front-line perinatal care providers.
AHRQ-funded; HS024733.
Citation: Sanders BD, Davis MG, Holley SL .
Pregnancy-associated stroke.
J Midwifery Womens Health 2018 Jan;63(1):23-32. doi: 10.1111/jmwh.12720..
Keywords: Cardiovascular Conditions, Maternal Care, Pregnancy, Primary Care, Risk, Stroke, Women