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Topics
- Adverse Drug Events (ADE) (2)
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- Behavioral Health (2)
- Brain Injury (3)
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- Care Management (1)
- Case Study (1)
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- Implementation (1)
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- Medication: Safety (1)
- (-) Neurological Disorders (24)
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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 24 of 24 Research Studies DisplayedWilliams CN, Piantino J, McEvoy C
The burden of pediatric neurocritical care in the United States.
This article attempts to quantify the burden of pediatric neurocritical care (PNCC) by developing national estimates of disease incidence, evaluating use of critical care interventions (CCI), and examining hospital outcomes. The Kids Inpatient Database (KID) was analyzed to evaluate cohorts with the following conditions: traumatic brain injury, neuro-infection, or inflammatory diseases; status epilepticus; stroke; hypoxic ischemic injury after cardiac arrest; or spinal cord injury.
AHRQ-funded; HS022981.
Citation: Williams CN, Piantino J, McEvoy C .
The burden of pediatric neurocritical care in the United States.
Pediatr Neurol 2018 Dec;89:31-38. doi: 10.1016/j.pediatrneurol.2018.07.013..
Keywords: Children/Adolescents, Critical Care, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Neurological Disorders, Stroke, Trauma
Heslin KC, Owens PL, Simpson LA
AHRQ Author: Heslin KC Owens PL
Annual report on health care for children and youth in the united states: focus on 30-day unplanned inpatient readmissions, 2009 to 2014.
The authors describe trends in unplanned 30-day all-condition hospital readmissions for children aged 1 to 17 years between 2009 and 2014. Using HCUP data, they found that the rate of readmission was essentially stable between 2009 and 2014. In 2009, the most common reason for readmission was sickle cell anemia, whereas in 2014 the most common reason was epilepsy. Pneumonia fell from the second to the sixth most common reason for readmission over this period. The authors suggest that their study provides a baseline assessment for examining trends in 30-day unplanned pediatric readmissions, an important quality metric as the provisions of the Children's Health Insurance Program Reauthorization Act and the Affordable Care Act are changed and implemented in the future.
AHRQ-authored.
Citation: Heslin KC, Owens PL, Simpson LA .
Annual report on health care for children and youth in the united states: focus on 30-day unplanned inpatient readmissions, 2009 to 2014.
Acad Pediatr 2018 Nov - Dec;18(8):857-72. doi: 10.1016/j.acap.2018.06.006..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospital Readmissions, Hospitalization, Hospitals, Sickle Cell Disease, Pneumonia, Neurological Disorders
Barbash IJ
Cognitive impairment, anesthesia, and critical illness: learning from the past to gain perspective on the future.
This study examined the link between cognitive impairment, ICU admission and anesthesia. The author’s hypothesis was that patients with cognitive impairment would be more likely to undergo surgical procedures. However, analysis using data from the Mayo Clinical Study on Aging on 1,977 cognitive normal patients, 387 patients with mild cognitive impairment (MCI), and 72 patients with established dementia found that patients with MCI were more likely to undergo anesthesia and those with dementia were less likely to undergo procedural anesthesia. The author hypothesizes this may be linked to impaired decision-making of the patient and the risk-benefit analysis of performing surgery on patients with established dementia. However, ICU admissions were increased in patients with MCI and dementia.
AHRQ-funded; HS025455.
Citation: Barbash IJ .
Cognitive impairment, anesthesia, and critical illness: learning from the past to gain perspective on the future.
Mayo Clin Proc 2018 Nov;93(11):1537-39. doi: 10.1016/j.mayocp.2018.09.007..
Keywords: Adverse Events, Critical Care, Medication, Intensive Care Unit (ICU), Neurological Disorders
Albrecht JS, Hanna M, Kim D
Predicting diagnosis of Alzheimer's disease and related dementias using administrative claims.
The objective of this study is to see if a better predictive model could be created for earlier diagnosis of Alzheimer disease and related dementia (ADRD) using the amount of health care utilization (HCU) in individuals prior to diagnosis. A case-control study was conducted including individuals with and without mild cognitive impairment who were diagnosed between 2011 and 2014. They were matched to controls without ADRD and were able to obtain moderate accuracy.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Hanna M, Kim D .
Predicting diagnosis of Alzheimer's disease and related dementias using administrative claims.
J Manag Care Spec Pharm 2018 Nov;24(11):1138-45. doi: 10.18553/jmcp.2018.24.11.1138..
Keywords: Dementia, Diagnostic Safety and Quality, Neurological Disorders
Meyers S, Claire Simon K, Bergman-Bock S
Structured clinical documentation to improve quality and support practice-based research in headache.
The authors developed a proprietary toolkit to aid clinicians when creating clinical documentation in electronic medical records (EMRs). This toolkit will help clinicians provide discrete data and not unstructured free text which many clinicians enter into the EMR. The toolkit collects hundreds of fields of data and interprets score tests for a number of difference assessment tools for anxiety disorder, depression, migraine disability, and insomnia. The toolkit was used at 4346 initial patient visits as of April 1, 2018. The toolkit is being shared with other clinics as part of the Neurology Practice-Based Research Network.
AHRQ-funded; HS024057.
Citation: Meyers S, Claire Simon K, Bergman-Bock S .
Structured clinical documentation to improve quality and support practice-based research in headache.
Headache 2018 Sep;58(8):1211-18. doi: 10.1111/head.13348..
Keywords: Quality Improvement, Quality of Life, Tools & Toolkits, Neurological Disorders, Electronic Health Records (EHRs), Health Information Technology (HIT), Practice-Based Research Network (PBRN)
Naidech AM, Beaumont J, Muldoon K
Prophylactic seizure medication and health-related quality of life after intracerebral hemorrhage.
Using a prospective cohort study design, the investigators tested the hypothesis that prophylactic levetiracetam is independently associated with differences in cognitive function health-related quality of life. They found that prophylactic levetiracetam was independently associated with lower cognitive function health-related quality of life at follow-up after intracerebral hemorrhage.
AHRQ-funded; HS023437.
Citation: Naidech AM, Beaumont J, Muldoon K .
Prophylactic seizure medication and health-related quality of life after intracerebral hemorrhage.
Crit Care Med 2018 Sep;46(9):1480-85. doi: 10.1097/ccm.0000000000003272..
Keywords: Medication, Neurological Disorders, Quality of Life
Lee AK, Rawlings AM, Lee CJ
Severe hypoglycaemia, mild cognitive impairment, dementia and brain volumes in older adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) cohort study.
In this study, the investigators aimed to evaluate the link between severe hypoglycaemia and domain-specific cognitive decline, smaller brain volumes and dementia in adults with type 2 diabetes. The investigators concluded that their results demonstrated a strong link between severe hypoglycaemia and poor cognitive outcomes, suggesting a need for discussion of appropriate diabetes treatments for high-risk older adults.
AHRQ-funded; HS018542.
Citation: Lee AK, Rawlings AM, Lee CJ .
Severe hypoglycaemia, mild cognitive impairment, dementia and brain volumes in older adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) cohort study.
Diabetologia 2018 Sep;61(9):1956-65. doi: 10.1007/s00125-018-4668-1..
Keywords: Dementia, Diabetes, Elderly, Neurological Disorders, Risk
Parker WF, Georges RJ, Gao YN
Association between groundwater lithium and the diagnosis of bipolar disorder and dementia in the United States.
This study examined the association between groundwater lithium and the diagnoses of bipolar disorder and dementia in the United States, with adjustment for local health care resources and demographics. Data on groundwater lithium concentrations was collected by the US Geological Survey, and diagnoses were identified from inpatient hospital, long-term care, and other therapy claims files from several sources. The results of the study indicate that, in spite of the substantial variations in groundwater lithium exposure, no significant association between exposure and the risk of bipolar disorder or dementia after adjustment for county-level demographics and health care resource was found. The authors note that therapeutic lithium doses are orders of magnitude larger than groundwater lithium concentrations, which makes a true causal relationship between groundwater lithium and mental health dubious.
AHRQ-funded; HS000084.
Citation: Parker WF, Georges RJ, Gao YN .
Association between groundwater lithium and the diagnosis of bipolar disorder and dementia in the United States.
JAMA Psychiatry 2018 Jul;75(7):751-54. doi: 10.1001/jamapsychiatry.2018.1020..
Keywords: Dementia, Behavioral Health, Neurological Disorders, Risk
Trivedi LU, Alvarez CA, Mansi IA
Association of statin therapy with risk of epilepsy in 2 propensity score-matched cohorts.
The objective of this study was to examine the association between statin use and epilepsy risk in a general population and in a healthy population (individuals with no severe comorbidities). The study did not demonstrate a significant beneficial or deleterious effect of statin use on risk of being diagnosed with epilepsy. The authors assert that clinicians should not withhold statins, whenever indicated, in patients with epilepsy.
AHRQ-funded; HS022418.
Citation: Trivedi LU, Alvarez CA, Mansi IA .
Association of statin therapy with risk of epilepsy in 2 propensity score-matched cohorts.
Ann Pharmacother 2018 Jun;52(6):546-53. doi: 10.1177/1060028018756650..
Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Neurological Disorders, Risk
Nuckols TK, Conlon C, Robbins M
Quality of care and patient-reported outcomes in carpal tunnel syndrome: a prospective observational study.
This prospective observational study examined the association of higher quality care for carpal tunnel syndrome (CTS) with better outcomes. Adults diagnosed with CTS from 30 occupational health centers were recruited and their physicians' adherence to recommended care processes evaluated. Among 343 individuals, receiving better was associated with greater improvements. CTS symptoms showed greater improvement when physicians assessed and managed patient activity, when patients underwent necessary surgery, and when employers adjusted job tasks. The researchers conclude that efforts should be made to ensure patients with CTS receive essential care processes, including activity assessment and management as well as necessary surgery.
AHRQ-funded; HS018982.
Citation: Nuckols TK, Conlon C, Robbins M .
Quality of care and patient-reported outcomes in carpal tunnel syndrome: a prospective observational study.
Muscle Nerve 2018 Jun;57(6):896-904. doi: 10.1002/mus.26041..
Keywords: Neurological Disorders, Outcomes, Patient Experience, Patient-Centered Outcomes Research, Quality of Care
McCreedy E, Loomer L, Palmer JA
Representation in the care planning process for nursing home residents with dementia.
This study examined the participation of residents, family members, or representatives in nursing home (NH) long-term care planning for residents with cognitive impairment. A large for-profit NH system was used to recruit study participants. A sample of 18,552 long-stay NH residents in 2016 were surveyed. Of residents with no cognitive impairment, 8% had family or representative participation in care planning, compared with 26% of residents with severe impairments. Family participation was greater in NHs with more social workers.
AHRQ-funded; HS000011.
Citation: McCreedy E, Loomer L, Palmer JA .
Representation in the care planning process for nursing home residents with dementia.
J Am Med Dir Assoc 2018 May;19(5):415-21. doi: 10.1016/j.jamda.2018.01.004..
Keywords: Dementia, Nursing Homes, Long-Term Care, Patient and Family Engagement, Neurological Disorders
Mahmoud L, Zullo AR, Thompson BB
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Researchers conducted a retrospective cohort study of 1197 mechanically ventilated patients admitted to a 12-bed neurocritical care unit (NCCU) over four years in order to evaluate the effect of an analgesia-based sedation protocol on medication use and costs in the NCCU. The protocol resulted in increased in fentanyl use and decreased in propofol use, but their findings indicate no effect on healthcare utilization, healthcare costs, or in-hospital mortality. Based on these results, the researchers suggest that similar NCCUs should consider using population-specific protocols to manage analgesia and sedation.
AHRQ-funded; HS022998.
Citation: Mahmoud L, Zullo AR, Thompson BB .
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Brain Inj 2018;32(7):941-47. doi: 10.1080/02699052.2018.1469167..
Keywords: Care Management, Brain Injury, Critical Care, Healthcare Costs, Intensive Care Unit (ICU), Medication, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research
Callahan CM, Bateman DR, Wang S
State of science: bridging the science-practice gap in aging, dementia and mental health.
This article describes why new models of care in aging, dementia, and mental health diffuse inadequately into the healthcare systems and communities where they might benefit older adults. The investigators review a general framework for the diffusion of innovations and highlight the importance of other features of innovations that deter or facilitate diffusion.
AHRQ-funded; HS024384.
Citation: Callahan CM, Bateman DR, Wang S .
State of science: bridging the science-practice gap in aging, dementia and mental health.
J Am Geriatr Soc 2018 Apr;66(Suppl 1):S28-s35. doi: 10.1111/jgs.15320..
Keywords: Elderly, Dementia, Behavioral Health, Healthcare Delivery, Neurological Disorders, Implementation, Evidence-Based Practice
Vouri SM, Schootman M, Strope SA
Differential prescribing of antimuscarinic agents in older adults with cognitive impairment.
The objective of this study was to describe the use of oral oxybutynin versus other antimuscarinics in older adults with documented cognitive impairment. Patients with cognitive impairment were 5 percent more likely to initiate another antimuscarinic versus oral oxybutynin. The proportion of patients with cognitive impairment initiated on oral oxybutynin increased from 24.1 percent in 2008 to 41.1 percent in 2011.
AHRQ-funded; HS019455.
Citation: Vouri SM, Schootman M, Strope SA .
Differential prescribing of antimuscarinic agents in older adults with cognitive impairment.
Drugs Aging 2018 Apr;35(4):321-31. doi: 10.1007/s40266-018-0531-9.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication, Neurological Disorders
Bush RA, Beaumont JL, Liotta EM
Fever burden and health-related quality of life after intracerebral hemorrhage.
In this prospective observational cohort study, the investigators tested the hypothesis that increased burden of fever is independently associated with decreased health-related quality of life (HRQoL) at follow-up. The authors found that each additional day with a fever was predictive of worse HRQoL domains of Cognitive Function and Mobility after intracerebral hemorrhage up to 1 year. They suggest that HRQoL outcomes may be a sensitive and powerful way to measure the efficacy of fever control in future research.
AHRQ-funded; HS023437.
Citation: Bush RA, Beaumont JL, Liotta EM .
Fever burden and health-related quality of life after intracerebral hemorrhage.
Neurocrit Care 2018 Mar 29;29(2):189-94. doi: 10.1007/s12028-018-0523-y..
Keywords: Brain Injury, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research, Quality of Life
Wang S, Hammes J, Khan S
Improving Recovery and Outcomes Every Day after the ICU (IMPROVE): study protocol for a randomized controlled trial.
The Improving Recovery and Outcomes Every Day after the ICU (IMPROVE) trial is an ongoing clinical trial which evaluates the efficacy of a combined physical exercise and cognitive training on cognitive function among ICU survivors 50 years and older who experienced delirium during an ICU stay. This article describes the study protocol for IMPROVE.
AHRQ-funded; HS024384.
Citation: Wang S, Hammes J, Khan S .
Improving Recovery and Outcomes Every Day after the ICU (IMPROVE): study protocol for a randomized controlled trial.
Trials 2018 Mar 27;19(1):196. doi: 10.1186/s13063-018-2569-8.
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Keywords: Critical Care, Elderly, Intensive Care Unit (ICU), Neurological Disorders, Patient-Centered Outcomes Research
Sterling MR, Safford MM, Goggins K
Numeracy, health literacy, cognition, and 30-day readmissions among patients with heart failure.
Numeracy, health literacy, and cognition are important for chronic disease management. Prior studies have found them to be associated with poorer selfcare and worse clinical outcomes, but limited data exists in the context of heart failure (HF), a condition that requires patients to monitor their weight, fluid intake, and dietary salt, especially in the post hospitalization period. The purpose of this study was to examine the relationship between numeracy, health literacy, and cognition with 30-day readmissions among patients hospitalized for acute decompensated HF (ADHF).
AHRQ-funded; HS000066.
Citation: Sterling MR, Safford MM, Goggins K .
Numeracy, health literacy, cognition, and 30-day readmissions among patients with heart failure.
J Hosp Med 2018 Mar;13(3):145-51. doi: 10.12788/jhm.2932..
Keywords: Health Literacy, Hospital Readmissions, Hospitalization, Heart Disease and Health, Cardiovascular Conditions, Neurological Disorders, Risk
Lewis AH, Chugh A, Sobotka SA
Behavioral outbursts in a child with a deletion syndrome, generalized epilepsy, global developmental delay, and failure to thrive.
This paper presents the case of a 7-year-old girl with 20q13.33 deletion and a history of generalized convulsive epilepsy who presented to the Developmental and Behavioral Pediatrics Clinic due to concerns about her behavioral outbursts in the context of overall delayed development.
AHRQ-funded; HS023007.
Citation: Lewis AH, Chugh A, Sobotka SA .
Behavioral outbursts in a child with a deletion syndrome, generalized epilepsy, global developmental delay, and failure to thrive.
Pediatr Ann 2018 Mar;47(3):e130-e34. doi: 10.3928/19382359-20180223-01..
Keywords: Case Study, Children/Adolescents, Disabilities, Genetics, Neurological Disorders
Callahan ML, Binder LM, O'Neil ME
Sensory sensitivity in operation enduring freedom/operation Iraqi freedom veterans with and without blast exposure and mild traumatic brain injury.
To examine factors associated with noise and light sensitivity among returning Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans with a self-reported history of mild traumatic brain injury (mTBI) due to blast exposure, the researchers compared the self-report of noise and light sensitivity of 42 OEF/OIF Veterans diagnosed with mTBI resulting from combat blast-exposure to that of 36 blast-exposed OEF/OIF Veterans without a history of mTBI.
AHRQ-funded; HS022981.
Citation: Callahan ML, Binder LM, O'Neil ME .
Sensory sensitivity in operation enduring freedom/operation Iraqi freedom veterans with and without blast exposure and mild traumatic brain injury.
Appl Neuropsychol Adult 2018 Mar-Apr;25(2):126-36. doi: 10.1080/23279095.2016.1261867..
Keywords: Brain Injury, Neurological Disorders
Hui KY, Fernandez-Hernandez H, Hu J
Functional variants in the LRRK2 gene confer shared effects on risk for Crohn's disease and Parkinson's disease.
Researchers studied the risk for Crohn’s disease (CD) and Parkinson’s disease (PD) in a population of Ashkenazi Jews who have the LRRK2 gene. This gene provides a risk for both conditions, However, some alleles (like N2081D variant) conferred more risk for CD or protection from CD (N551K variant). These shared alleles may provide insight into disease mechanisms and treatments.
AHRQ-funded; HS021747.
Citation: Hui KY, Fernandez-Hernandez H, Hu J .
Functional variants in the LRRK2 gene confer shared effects on risk for Crohn's disease and Parkinson's disease.
Sci Transl Med 2018 Jan 10;10(423). doi: 10.1126/scitranslmed.aai7795..
Keywords: Genetics, Neurological Disorders, Risk
Butler M, McCreedy E, Nelson VA
Does cognitive training prevent cognitive decline?: A systematic review.
This review summarized evidence on the effects of cognitive training on cognitive performance and incident dementia outcomes for adults with normal cognition or mild cognitive impairment (MCI). It concluded that results for populations with MCI suggested no effect of training on performance (low-strength and insufficient evidence). Evidence for prevention of cognitive decline or dementia was insufficient.
AHRQ-funded; 290201500008I.
Citation: Butler M, McCreedy E, Nelson VA .
Does cognitive training prevent cognitive decline?: A systematic review.
Ann Intern Med 2018 Jan 2;168(1):63-68. doi: 10.7326/m17-1531.
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Keywords: Dementia, Evidence-Based Practice, Neurological Disorders, Prevention
Butler M, Nelson VA, Davila H
Over-the-counter supplement interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
This review summarizes the evidence on efficacy and harms of over-the-counter (OTC) supplements to prevent or delay cognitive decline, mild cognitive impairment (MCI), or clinical Alzheimer-type dementia in adults with normal cognition or MCI but no dementia diagnosis. It concluded that evidence is insufficient to recommend any OTC supplement for cognitive protection in adults with normal cognition or MCI.
AHRQ-funded; 290201500008I.
Citation: Butler M, Nelson VA, Davila H .
Over-the-counter supplement interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
Ann Intern Med 2018 Jan 2;168(1):52-62. doi: 10.7326/m17-1530.
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Keywords: Dementia, Evidence-Based Practice, Prevention, Neurological Disorders
Senders A, Borgatti A, Hanes D
Association between pain and mindfulness in multiple sclerosis: a cross-sectional survey.
The objective of this study was to evaluate the association between pain interference and trait mindfulness in people with multiple sclerosis (MS). The results suggest a clinically significant association between mindfulness and pain interference in MS and support further exploration of mindfulness-based interventions in the management of MS-related pain.
AHRQ-funded; HS017582.
Citation: Senders A, Borgatti A, Hanes D .
Association between pain and mindfulness in multiple sclerosis: a cross-sectional survey.
Int J MS Care 2018 Jan-Feb;20(1):28-34. doi: 10.7224/1537-2073.2016-076.
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Keywords: Chronic Conditions, Chronic Conditions, Complementary and Alternative Medicine, Neurological Disorders, Patient-Centered Outcomes Research
Blackburn J, Zheng Q, Grabowski DC
Nursing home chain affiliation and its impact on specialty service designation for Alzheimer disease.
Specialty care units (SCUs) in nursing homes (NHs) grew in popularity during the 1990s to attract residents while national policies and treatment paradigms changed. Alzheimer disease has consistently been the dominant form of SCU. This study explored the extent to which chain affiliation, which is common among NHs, affected SCU bed designation.
AHRQ-funded; HS023009.
Citation: Blackburn J, Zheng Q, Grabowski DC .
Nursing home chain affiliation and its impact on specialty service designation for Alzheimer disease.
Inquiry 2018 Jan-Dec;55:46958018787992. doi: 10.1177/0046958018787992..
Keywords: Elderly, Nursing Homes, Long-Term Care, Dementia, Neurological Disorders