National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
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- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (2)
- Caregiving (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
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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 8 of 8 Research Studies DisplayedShear K, Rice H, Garabedian PM
Usability testing of an interoperable computerized clinical decision support tool for fall risk management in primary care.
The purpose of this study was to conduct usability testing of the ASPIRE fall risk management tool for use in divergent primary care clinics. Participants recruited from two sites with different electronic health records and clinical organizations used ASPIRE across two clinical scenarios; they rated ASPIRE usability as above average, based on usability benchmarks. Time spent on tasks decreased significantly between the first and second scenarios, indicating ease of learnability. The authors conclude that ASPIRE could be integrated into diverse organizations, since it allows a tailored implementation without the need to build a new system for each organization. ASPIRE is therefore well positioned to impact the challenge of falls at scale.
AHRQ-funded; HS027557.
Citation: Shear K, Rice H, Garabedian PM .
Usability testing of an interoperable computerized clinical decision support tool for fall risk management in primary care.
Appl Clin Inform 2023 Mar;14(2):212-26. doi: 10.1055/a-2006-4936.
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Falls, Primary Care, Risk, Prevention
Eden KB, Ivlev I, Bensching KL
Use of an online breast cancer risk assessment and patient decision aid in primary care practices.
A cross-sectional study evaluating a web-based breast cancer risk assessment and decision aid (MammoScreen) was conducted in an academic general internal medicine clinic. Breast cancer risk assessment and mammography screening decision support were efficiently implemented through a web-based tool for patients sent through an electronic patient portal. Findings indicated that integration of patient decision aids with risk algorithms in clinical practice may help support the implementation of USPSTF recommendations that include risk assessment and shared decision-making.
AHRQ-funded; HS026370.
Citation: Eden KB, Ivlev I, Bensching KL .
Use of an online breast cancer risk assessment and patient decision aid in primary care practices.
J Womens Health 2020 Jun;29(6):763-69. doi: 10.1089/jwh.2019.8143..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Screening, Shared Decision Making, Risk, Health Information Technology (HIT), Prevention, Women
Greenzang KA, Al-Sayegh H, Ma C
Parental considerations regarding cure and late effects for children with cancer.
The purpose of this study was to learn how parents and physicians consider late-effects risks against a potential survival benefit when making treatment decisions. Parents of children with cancer and physicians at Dana-Farber/Boston Children's Cancer and Blood Disorders Center were surveyed. Investigators found that avoidance of severe neurocognitive impairment was the predominant driver of parent and physician treatment preferences, even over an increased chance of cure. They concluded that their study highlights the importance of exploring parental late-effects priorities when discussing treatment options.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Al-Sayegh H, Ma C .
Parental considerations regarding cure and late effects for children with cancer.
Pediatrics 2020 May;145(5):e20193552. doi: 10.1542/peds.2019-3552..
Keywords: Children/Adolescents, Cancer, Shared Decision Making, Caregiving, Risk
Almasri J, Tello M, Benkhadra R
A systematic review for variables to be collected in a transplant database for improving risk prediction.
This study is a systematic review that was commissioned to identify new variables associated with transplant outcomes that are not currently collected by the Organ Procurement and Transplantation Network. They identified 81 unique studies including almost 1.2 million patients with median follow-up of 36 months posttransplant. A total of 108 unique risk factors were reported with most (104) recipient related and only 4 donor related. Most risk factors were small to moderate (ranging between 1.0 and 2.0). There were four relative association measures that were the strongest: 1) heart transplant recipients with a previous Fontan operation (8.6); 2) kidney transplant recipients with sickle cell nephropathy as primary cause of end-stage renal disease (2.8); 3) liver transplant recipients with serum ferritin >500 microg/L (14.3); and 4) lung transplant recipients with Burkholderia cepacia complex infection for 1 year or less (63.). These four risk factors were considered candidates for collection in databases and registries.
AHRQ-funded; HS024527.
Citation: Almasri J, Tello M, Benkhadra R .
A systematic review for variables to be collected in a transplant database for improving risk prediction.
Transplantation 2019 Dec;103(12):2591-601. doi: 10.1097/tp.0000000000002652..
Keywords: Transplantation, Risk, Shared Decision Making
Reeder HT, Shen C, Buxton AE
Joint shock/death risk prediction model for patients considering implantable cardioverter-defibrillators.
This study’s goal was to develop a joint shock/death risk prediction tool for patients who received implantable cardioverter-defibrillators (ICDs). Secondary analysis of patients was conducted as part of the SCD-HeFT trial (Sudden Cardiac Death in Heart Failure Trial). An illness-death regression model was applied for both ICD shocks and deaths. Among 803 ICD recipients, 430 (53.5%) did not receive an ICD shock or die, 206 (25.7%) received at least 1 shock but did not die, 113 (14.1%) died before receiving a shock, and 54 (6.7%) received at least 1 shock but still died. This predictive performance can be used as a tool for individualized counseling for patients contemplating an ICD.
AHRQ-funded; HS024520.
Citation: Reeder HT, Shen C, Buxton AE .
Joint shock/death risk prediction model for patients considering implantable cardioverter-defibrillators.
Circ Cardiovasc Qual Outcomes 2019 Aug;12(8):e005675. doi: 10.1161/circoutcomes.119.005675..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Medical Devices, Risk, Shared Decision Making, Mortality
Pang PS, Fermann GJ, Hunter BR
TACIT (High Sensitivity Troponin T Rules Out Acute Cardiac Insufficiency Trial).
This study examined the use of high-sensitivity troponin assays to determine whether a patient presenting in the emergency department with chest pains is safe for discharge. An observational study called High Sensitivity Troponin T Rules Out Acute Cardiac Insufficiency Trial (TACIT) explored whether serial high-sensitivity troponin (hsTnT) might aid in making diagnosis of acute heart failure faster. The presence of hsTnT above the 99th percentile usually indicates acute heart failure. Patients in the cohort with hsTnT at or above the 99th percentile were older, more often male, less often black, and more likely to have chronic kidney disease. The study found no difference in risk for 90-day death or rehospitalization or return ED visits in the group with hsTnT above the 99th percentile than those with levels below the 99th percentile so hsTnT would not be considered useful.
AHRQ-funded; HS025411.
Citation: Pang PS, Fermann GJ, Hunter BR .
TACIT (High Sensitivity Troponin T Rules Out Acute Cardiac Insufficiency Trial).
Circ Heart Fail 2019 Jul;12(7):e005931. doi: 10.1161/circheartfailure.119.005931..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Emergency Department, Risk, Shared Decision Making
Ellis RJ, Brock Hewitt D, Liu JB
Preoperative risk evaluation for pancreatic fistula after pancreaticoduodenectomy.
The purpose of this study was to identify risk factors for clinically relevant postoperative pancreatic fistula that are routinely available in the preoperative setting. Results showed that outcomes were best for patients with three or fewer identified risk factors. The researchers conclude that risk evaluation could be a useful tool in patient counseling and surgical planning.
AHRQ-funded; HS000078.
Citation: Ellis RJ, Brock Hewitt D, Liu JB .
Preoperative risk evaluation for pancreatic fistula after pancreaticoduodenectomy.
J Surg Oncol 2019 Jun;119(8):1128-34. doi: 10.1002/jso.25464..
Keywords: Adverse Events, Shared Decision Making, Patient Safety, Risk, Surgery
Ellis RJ, Gupta AR, Hewitt DB
Risk factors for post-pancreaticoduodenectomy delayed gastric emptying in the absence of pancreatic fistula or intra-abdominal infection.
Researchers sought to define the incidence of delayed gastric emptying (DGE) and identify risk factors for DGE in patients without pancreatic fistula or other intra-abdominal infections. They found that patients were more likely to develop DGE if they were over 74 years of age, male, had undergone pylorus-sparing pancreaticoduodenectomy (PD), or had a prolonged operative time. They conclude that the incidence of DGE after PD is notable even in patients without other abdominal complications and suggested that identification of patients at increased risk for DGE may aid patient counseling as well as decisions regarding surgical technique, enteral feeding access, and enhanced-recovery pathways.
AHRQ-funded; HS000078.
Citation: Ellis RJ, Gupta AR, Hewitt DB .
Risk factors for post-pancreaticoduodenectomy delayed gastric emptying in the absence of pancreatic fistula or intra-abdominal infection.
J Surg Oncol 2019 Jun;119(7):925-31. doi: 10.1002/jso.25398..
Keywords: Adverse Events, Shared Decision Making, Patient Safety, Risk, Surgery