National Healthcare Quality and Disparities Report
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- Stress (8)
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- Surgery (142)
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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
176 to 200 of 1489 Research Studies DisplayedShaker M, Greenhawt M
The health and economic outcomes of peanut allergy management practices.
Peanut allergy is managed with strict avoidance, epinephrine carriage, and promptly treating reactions. The objective of this study was to assess the health and economic benefits of pre-emptively injecting epinephrine for peanut ingestion in the absence of any symptoms, and to avoid products with peanut precautionary allergen labeling (PAL). The investigators concluded that pre-emptive epinephrine injection in the absence of symptoms, or universal avoidance of PAL, were not cost-effective when compared with administering epinephrine on symptom development or allowing PAL consumption.
AHRQ-funded; HS024599.
Citation: Shaker M, Greenhawt M .
The health and economic outcomes of peanut allergy management practices.
J Allergy Clin Immunol Pract 2018 Nov - Dec;6(6):2073-80. doi: 10.1016/j.jaip.2018.04.036..
Keywords: Healthcare Costs, Prevention
Desai AD, Simon TD, Leyenaar JK
Utilizing family-centered process and outcome measures to assess hospital-to-home transition quality.
This commentary describes the success of using 8 new caregiver-reported measures to assess the quality of hospital- and emergency department (ED)-to-home transitions in pediatric patients. This measures were originally created by the national Pediatric Quality Measures Program mandated by the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). An original article describing these measures was published 2016 and there have been several follow-up studies. These measures are undergoing further testing.
AHRQ-funded; HS024133; HS024299; HS020506.
Citation: Desai AD, Simon TD, Leyenaar JK .
Utilizing family-centered process and outcome measures to assess hospital-to-home transition quality.
Acad Pediatr 2018 Nov - Dec;18(8):843-46. doi: 10.1016/j.acap.2018.07.013..
Keywords: Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Transitions of Care, Quality of Care, Quality Measures, Quality Improvement, Children's Health Insurance Program (CHIP), Evidence-Based Practice
Fu Y, Mazur TR, Wu X
A novel MRI segmentation method using CNN-based correction network for MRI-guided adaptive radiotherapy.
The purpose of this study was to expedite the contouring process for MRI-guided adaptive radiotherapy (MR-IGART), a convolutional neural network (CNN) deep-learning (DL) model is proposed to accurately segment the liver, kidneys, stomach, bowel and duodenum in 3D MR images. The investigators suggest that the proposed method can automatically segment the liver, kidneys, stomach, bowel, and duodenum in 3D MR images with good accuracy.
AHRQ-funded; HS022888.
Citation: Fu Y, Mazur TR, Wu X .
A novel MRI segmentation method using CNN-based correction network for MRI-guided adaptive radiotherapy.
Med Phys 2018 Nov;45(11):5129-37. doi: 10.1002/mp.13221..
Keywords: Imaging
Schiff G, Mirica MM, Dhavle AA
A prescription for enhancing electronic prescribing safety.
The authors review six areas in which electronic prescribing areas can be improved to transform medication ordering quality and safety. They recommend incorporating medication indications into electronic prescribing, establishing a single shared online medication list, implementing an electronic cancellation mechanism for pharmacies, implementing standardized structured and codified prescription instruction, reengineering clinical decision support, and redesigning electronic prescribing to facilitate ordering of nondrug alternatives.
AHRQ-funded; HS023694.
Citation: Schiff G, Mirica MM, Dhavle AA .
A prescription for enhancing electronic prescribing safety.
Health Aff 2018 Nov;37(11):1877-83. doi: 10.1377/hlthaff.2018.0725..
Keywords: Adverse Drug Events (ADE), Adverse Events, Health Information Technology (HIT), Healthcare Delivery, Medical Errors, Medication, Medication: Safety, Patient Safety
Burnett-Zeigler IE, Waldron EM, Hong S
Accessibility and feasibility of using technology to support mindfulness practice, reduce stress and promote long term mental health.
In this study the investigators evaluated the feasibility of using an activity monitor to support mindfulness practice, reduce self-reported stress and physiological indicators of stress. They found that there were no significant changes in self-reported stress, depression, post-traumatic stress and mindfulness from baseline to eight-weeks; pulse pressure and standard deviation of pulse pressure increased over time; and those who were high on the non-judge mindfulness subscale had a lower standard deviation pulse pressure and spent less time stressed.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler IE, Waldron EM, Hong S .
Accessibility and feasibility of using technology to support mindfulness practice, reduce stress and promote long term mental health.
Complement Ther Clin Pract 2018 Nov;33:93-99. doi: 10.1016/j.ctcp.2018.09.001..
Keywords: Depression, Health Information Technology (HIT), Behavioral Health, Patient-Centered Outcomes Research, Stress
Khoong EC, Cherian R, Rivadeneira NA
Accurate measurement In California's safety-net health systems has gaps and barriers.
The purpose of this study was to measure California’s pay-for-performance program in safety-net hospitals. Results showed both suboptimal performance in aspects of ambulatory safety and questionable reliability in data reporting. Health care systems that lack seamlessly integrated electronic health records and patient registries encountered barriers to reporting reliable ambulatory safety data, precluding accurate performance measurement in many areas. The authors recommended that policymakers and safety advocates support the development of information systems and measures that facilitate the accurate ascertainment of the health systems, patients, and clinical tasks at greatest risk for ambulatory safety failures.
AHRQ-funded; HS024412; HS024426.
Citation: Khoong EC, Cherian R, Rivadeneira NA .
Accurate measurement In California's safety-net health systems has gaps and barriers.
Health Aff 2018 Nov;37(11):1760-69. doi: 10.1377/hlthaff.2018.0709..
Keywords: Ambulatory Care and Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider Performance, Quality Indicators (QIs), Payment
Cochon L, Lacson R, Wang A
Assessing information sources to elucidate diagnostic process errors in radiologic imaging - a human factors framework.
The purpose of this study was to assess information sources that may elucidate errors related to radiologic diagnostic imaging, quantify the incidence of potential safety events from each source, and quantify the number of steps involved from diagnostic imaging chain and socio-technical factors. Information sources can elucidate errors in various steps within the diagnostic imaging workflow and can provide insight into socio-technical factors that impact patient safety in the diagnostic process.
AHRQ-funded; HS024722.
Citation: Cochon L, Lacson R, Wang A .
Assessing information sources to elucidate diagnostic process errors in radiologic imaging - a human factors framework.
J Am Med Inform Assoc 2018 Nov;25(11):1507-15. doi: 10.1093/jamia/ocy103..
Keywords: Diagnostic Safety and Quality, Imaging, Medical Errors, Patient Safety
Annapureddy A, Valero-Elizondo J, Khera R
Association between financial burden, quality of life, and mental health among those with atherosclerotic cardiovascular disease in the United States.
Currently, there is little information about the relationship between the financial burden of healthcare for patients with atherosclerotic cardiovascular disease (ASCVD) and their health-related quality of life (HRQoL), well-being, and psychological health. Accordingly, the authors of this study, determined the relationship between healthcare financial burden and patient-reported HRQoL, self-perception of health, psychological distress, and risk of depression in a nationally representative US adult population with established ASCVD.
AHRQ-funded; HS023000.
Citation: Annapureddy A, Valero-Elizondo J, Khera R .
Association between financial burden, quality of life, and mental health among those with atherosclerotic cardiovascular disease in the United States.
Circ Cardiovasc Qual Outcomes 2018 Nov;11(11):e005180. doi: 10.1161/circoutcomes.118.005180..
Keywords: Cardiovascular Conditions, Healthcare Costs, Behavioral Health, Quality of Life
Luthe SK, Hirayama A, Goto T
Association between obesity and acute severity among patients hospitalized for asthma exacerbation.
This study examined the association between obesity and exacerbation of asthma symptoms in hospitalized adults (age 18-54 years). This retrospective cohort study used data from 8 diverse US states from 2010-2013. Among 72,086 patients hospitalized for asthma exacerbation, 24% were considered obese. Obesity was associated with a higher use of mechanical ventilation as well as a longer hospital stay. These findings were consistent among all ages, sex, and race/ethnicity.
AHRQ-funded; HS023305.
Citation: Luthe SK, Hirayama A, Goto T .
Association between obesity and acute severity among patients hospitalized for asthma exacerbation.
J Allergy Clin Immunol Pract 2018 Nov - Dec;6(6):1936-41.e4. doi: 10.1016/j.jaip.2018.02.001..
Keywords: Asthma, Hospitalization, Obesity, Respiratory Conditions
Amin AP, Pinto D, House JA
Association of same-day discharge after elective percutaneous coronary intervention in the United States with costs and outcomes.
The purpose of this study was to examine (1) the incidence and trends in same day discharge (SDD); (2) hospital variation in SDD; (3) the association between SDD and readmissions for bleeding, acute kidney injury (AKI), acute myocardial infarction (AMI), or mortality at 30, 90, and 365 days after PCI; and (4) hospital costs of SDD and its drivers.
AHRQ-funded; HS022418.
Citation: Amin AP, Pinto D, House JA .
Association of same-day discharge after elective percutaneous coronary intervention in the United States with costs and outcomes.
JAMA Cardiol 2018 Nov;3(11):1041-49. doi: 10.1001/jamacardio.2018.3029..
Keywords: Healthcare Costs, Hospital Discharge, Patient-Centered Outcomes Research, Heart Disease and Health
Gallagher TH, Mello MM, Sage WM
Can communication-and-resolution programs achieve their potential? Five key questions.
Communication-and-resolution programs (CRPs) are intended to promote accountability, transparency, and learning after adverse events. In this article the authors address five key challenges to the programs' future success: implementation fidelity, the evidence base for CRPs and their link to patient safety, fair compensation of harmed patients, alignment of CRP design with participants' needs, and public policy on CRPs.
AHRQ-funded; HS024504.
Citation: Gallagher TH, Mello MM, Sage WM .
Can communication-and-resolution programs achieve their potential? Five key questions.
Health Aff 2018 Nov;37(11):1845-52. doi: 10.1377/hlthaff.2018.0727..
Keywords: Adverse Events, Communication, Medical Liability
Carayon P, Wooldridge A, Hose BZ
Challenges and opportunities for improving patient safety through human factors and systems engineering.
In this paper, the authors provide an overview of human factors and systems engineering (HF/SE), its demonstrated value to a wide range of patient safety problems and challenges to its broader implementation across health care. In addition, they make a variety of recommendations to maximize the spread of HF/SE.
AHRQ-funded; HS024453.
Citation: Carayon P, Wooldridge A, Hose BZ .
Challenges and opportunities for improving patient safety through human factors and systems engineering.
Health Aff 2018 Nov;37(11):1862-69. doi: 10.1377/hlthaff.2018.0723..
Keywords: Quality of Care, Patient Safety, Quality Improvement, System Design
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
Likosky DS, Harrington SD, Cabrera L
Collaborative quality improvement reduces postoperative pneumonia after isolated coronary artery bypass grafting surgery.
This study examined post cardiac surgery pneumonia rates associated with participation in a statewide, quality improvement collaborative relative to a national physician reporting program. The investigators concluded that participation in a physician-led collaborative was associated with significant reductions in pneumonia relative to a national quality reporting program. They suggest that interventions including collaborative learning may yield superior outcomes relative to solely using physician feedback reporting.
AHRQ-funded; HS022535.
Citation: Likosky DS, Harrington SD, Cabrera L .
Collaborative quality improvement reduces postoperative pneumonia after isolated coronary artery bypass grafting surgery.
Circ Cardiovasc Qual Outcomes 2018 Nov;11(11):e004756. doi: 10.1161/circoutcomes.118.004756..
Keywords: Outcomes, Patient Safety, Pneumonia, Quality of Care, Quality Improvement, Surgery
Mork RL, Hogan PG, Muenks CE
Comprehensive modeling reveals proximity, seasonality, and hygiene practices as key determinants of MRSA colonization in exposed households.
To develop interventions to prevent recurrent infections, household attributes and individual practices influencing S. aureus colonization must be discerned. In this paper, the investigators discuss key determinants of methicillin-resistant S. aureus (MRSA) colonization in exposed households. They suggest that the practices they identified in their study, that correlate with MRSA colonization, will inform physician counseling and multifaceted interventions among MRSA-affected households to mitigate MRSA in the community.
AHRQ-funded; HS021736; HS024269.
Citation: Mork RL, Hogan PG, Muenks CE .
Comprehensive modeling reveals proximity, seasonality, and hygiene practices as key determinants of MRSA colonization in exposed households.
Pediatr Res 2018 Nov;84(5):668-76. doi: 10.1038/s41390-018-0113-x..
Keywords: Community-Acquired Infections, Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Patient Safety
Fox AB, Earnshaw VA, Taverna EC
Conceptualizing and measuring mental illness stigma: the Mental Illness Stigma Framework and critical review of measures.
In this article, the authors bring together the different foci of mental illness stigma research with the Mental Illness Stigma Framework (MISF). The MISF provides a common framework and set of terminology for understanding mechanisms of mental illness stigma that are relevant to the study of both the stigmatized and the stigmatizer. The investigators apply this framework to systematically review and classify stigma measures used in the past decade according to their corresponding stigma mechanisms.
AHRQ-funded; HS022986.
Citation: Fox AB, Earnshaw VA, Taverna EC .
Conceptualizing and measuring mental illness stigma: the Mental Illness Stigma Framework and critical review of measures.
Stigma Health 2018 Nov;3(4):348-76. doi: 10.1037/sah0000104.
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Keywords: Behavioral Health, Social Stigma
Kenzik KM, Mehta A, Richman JS
Congestive heart failure in older adults diagnosed with follicular lymphoma: a population-based study.
This population-based study examined congestive heart failure in older adults diagnosed with follicular lymphoma. The investigators concluded that patients with follicular lymphoma who were exposed to anthracyclines between the ages of 66 years and 75 years were found to be at an increased risk of new-onset CHF; preexisting hypertension and diabetes appeared to increase this risk.
AHRQ-funded; HS023009.
Citation: Kenzik KM, Mehta A, Richman JS .
Congestive heart failure in older adults diagnosed with follicular lymphoma: a population-based study.
Cancer 2018 Nov 1;124(21):4221-30. doi: 10.1002/cncr.31695..
Keywords: Cancer, Elderly, Heart Disease and Health
Wang SV, Maro JC, Baro E
Data mining for adverse drug events with a propensity score-matched tree-based scan statistic.
In this study, the investigators propose a method that combines tree-based scan statistics with propensity score-matched analysis of new initiator cohorts, a robust design for investigations of drug safety. They subsequently conducted plasmode simulations to evaluate performance. The authors suggest that TreeScan with propensity score matching shows promise as a method for screening and prioritization of potential adverse events.
AHRQ-funded; HS022193.
Citation: Wang SV, Maro JC, Baro E .
Data mining for adverse drug events with a propensity score-matched tree-based scan statistic.
Epidemiology 2018 Nov;29(6):895-903. doi: 10.1097/ede.0000000000000907..
Keywords: Adverse Drug Events (ADE), Adverse Events, Patient Safety, Medication, Medication: Safety, Data, Research Methodologies
Patel MB, Bednarik J, Lee P
Delirium monitoring in neurocritically ill patients: a systematic review.
In this study, the investigators systematically reviewed Cumulative Index to Nursing and Allied Health Literature, Web of Science, and PubMed to determine whether there are valid and reliable tools to monitor delirium in neurocritically ill patients and whether delirium is associated with relevant clinical outcomes (e.g., survival, length of stay, functional independence, cognition) in this population.
AHRQ-funded; HS023437.
Citation: Patel MB, Bednarik J, Lee P .
Delirium monitoring in neurocritically ill patients: a systematic review.
Crit Care Med 2018 Nov;46(11):1832-41. doi: 10.1097/ccm.0000000000003349..
Keywords: Critical Care, Patient-Centered Outcomes Research
Anstey DE, Muntner P, Bello NA
Diagnosing masked hypertension using ambulatory blood pressure monitoring, home blood pressure monitoring, or both?
The aim of this study was to determine the overlap between ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM) for the detection of masked hypertension (MHT). The investigators asserted that their data suggested that conducting ABPM will detect many individuals with MHT who have an increased cardiovascular disease risk.
AHRQ-funded; HS024262.
Citation: Anstey DE, Muntner P, Bello NA .
Diagnosing masked hypertension using ambulatory blood pressure monitoring, home blood pressure monitoring, or both?
Hypertension 2018 Nov;72(5):1200-07. doi: 10.1161/hypertensionaha.118.11319..
Keywords: Blood Pressure, Diagnostic Safety and Quality
Kadri SS, Adjemian J, Lai YL
Difficult-to-treat resistance in gram-negative bacteremia at 173 US hospitals: retrospective cohort analysis of prevalence, predictors, and outcome of resistance to all first-line agents.
Resistance to all first-line antibiotics necessitates the use of less effective or more toxic "reserve" agents. In this study, the Premier Database was analyzed for inpatients with select Gram-negative bloodstream infections (GNBSIs). Prevalence and aminoglycoside resistance of difficult-to-treat resistance (DTR) episodes were compared with carbapenem-resistant, extended-spectrum cephalosporin-resistant, and fluoroquinolone-resistant episodes using CDC definitions. The investigators concluded that nonsusceptibility to first-line antibiotics was associated with decreased survival in GNBSIs. They suggest that DSR is a simple bedside prognostic measure of treatment-limiting coresistance.
AHRQ-funded; HS025008.
Citation: Kadri SS, Adjemian J, Lai YL .
Difficult-to-treat resistance in gram-negative bacteremia at 173 US hospitals: retrospective cohort analysis of prevalence, predictors, and outcome of resistance to all first-line agents.
Clin Infect Dis 2018 Nov 28;67(12):1803-14. doi: 10.1093/cid/ciy378..
Keywords: Antibiotics, Antimicrobial Stewardship, Infectious Diseases
Brauner D, Werner RM, Shippee TP
Does Nursing Home Compare reflect patient safety in nursing homes?
In this study the investigators compared nursing homes' performance on several composite quality measures from Nursing Home Compare, the most prominent recent example of a national policy aimed at improving the quality of nursing home care, to their performance on measures of patient safety in nursing homes such as pressure sores, infections, falls, and medication errors.
AHRQ-funded; HS024967.
Citation: Brauner D, Werner RM, Shippee TP .
Does Nursing Home Compare reflect patient safety in nursing homes?
Health Aff 2018 Nov;37(11):1770-78. doi: 10.1377/hlthaff.2018.0721.
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Keywords: Quality of Care, Nursing Homes, Patient Safety, Provider Performance, Quality Measures
Fry CE, Sommers BD
Effect of Medicaid expansion on health insurance coverage and access to care among adults with depression.
This quasi-experimental study sought to determine the relationship between Medicaid expansion and various health and financial outcomes among low-income adults with depression. The investigators found that Medicaid expansion was associated with a significant reduction in the proportion of adults with depression who lacked health insurance. Medicaid expansion was also associated with significant reductions in delaying care and medications because of cost.
AHRQ-funded; HS021291.
Citation: Fry CE, Sommers BD .
Effect of Medicaid expansion on health insurance coverage and access to care among adults with depression.
Psychiatr Serv 2018 Nov;69(11):1146-52. doi: 10.1176/appi.ps.201800181..
Keywords: Access to Care, Depression, Health Insurance, Medicaid, Behavioral Health
Prey JE, Polubriaginof F, Grossman LV
Engaging hospital patients in the medication reconciliation process using tablet computers.
Researchers conducted a pilot study to determine whether patients’ use of an electronic home medication review tool on a table computer could improve medication safety before or after hospitalization. Patients were randomized to the tool and out of 76 patients approached, 65 participated. About three-quarters (74%) made changes to their home medication list. Out of that total, 74% of the changes identified had a significant or greater potential severity, and 49% had a greater than 50-50 chance of harm. This medication reconciliation tool showed great potential to improve medication safety during and after hospitalization.
AHRQ-funded; HS021816.
Citation: Prey JE, Polubriaginof F, Grossman LV .
Engaging hospital patients in the medication reconciliation process using tablet computers.
J Am Med Inform Assoc 2018 Nov;25(11):1460-69. doi: 10.1093/jamia/ocy115..
Keywords: Adverse Drug Events (ADE), Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitalization, Hospitals, Medication, Medication: Safety, Patient and Family Engagement, Patient Safety, Prevention
Akinboyo IC, Voskertchian A, Gorfu G
Epidemiology and risk factors for recurrent Staphylococcus aureus colonization following active surveillance and decolonization in the NICU.
In this single center retrospective cohort study, the investigators sought to examine neonatal risk factors associated with recurrent Staphylococcus aureus colonization and to determine the genetic relatedness of S. aureus strains cultured from neonates before and after decolonization.
AHRQ-funded; HS022872.
Citation: Akinboyo IC, Voskertchian A, Gorfu G .
Epidemiology and risk factors for recurrent Staphylococcus aureus colonization following active surveillance and decolonization in the NICU.
Infect Control Hosp Epidemiol 2018 Nov;39(11):1334-39. doi: 10.1017/ice.2018.223..
Keywords: Healthcare-Associated Infections (HAIs), Neonatal Intensive Care Unit (NICU), Newborns/Infants, Risk