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
76 to 93 of 93 Research Studies DisplayedDesir FA, Lesko CR, Moore RD
One sIZE fITS (n)one: the influence of sex, age, and sexual human immunodeficiency virus (HIV) acquisition risk on racial/ethnic disparities in the HIV care continuum in the United States.
In this study the investigators examined the impact of sex, age, and sexual HIV acquisition risk (ie, heterosexual vs same-sex contact) on the magnitude of HIV-related racial/ethnic disparities. They found that racial/ethnic differences in HIV care persist in specific populations defined by sex, age, and sexual HIV acquisition risk. They suggest that clinical and public health interventions that jointly target these demographic factors are needed.
AHRQ-funded; 90047713.
Citation: Desir FA, Lesko CR, Moore RD .
One sIZE fITS (n)one: the influence of sex, age, and sexual human immunodeficiency virus (HIV) acquisition risk on racial/ethnic disparities in the HIV care continuum in the United States.
Clin Infect Dis 2019 Feb 15;68(5):795-802. doi: 10.1093/cid/ciy556..
Keywords: Disparities, Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Risk
Huang SS, Singh R, McKinnell JA
Decolonization to reduce postdischarge infection risk among MRSA carriers.
This study compared postdischarge methicillin-resistant Staphylococcus aureus (MRSA) rates in study participant who received education alone versus decolonization and education. Decolonization was done with chlorhexidine mouthwash and showers, and nasal sprays. Decolonization with education resulted in a 30% reduction in MRSA infection versus education alone.
AHRQ-funded; HS019388.
Citation: Huang SS, Singh R, McKinnell JA .
Decolonization to reduce postdischarge infection risk among MRSA carriers.
N Engl J Med 2019 Feb 14;380(7):638-50. doi: 10.1056/NEJMoa1716771..
Keywords: Education: Patient and Caregiver, Healthcare-Associated Infections (HAIs), Hospital Discharge, Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Risk
Wey A, Salkowski N, Kasiske BL
Comparing Scientific Registry of Transplant Recipients posttransplant program-specific outcome ratings at listing with subsequent recipient outcomes after transplant.
To improve accessibility of program-specific reports to patients, the Scientific Registry of Transplant Recipients released a 5-tier system for categorizing 1-year posttransplant program evaluations. Whether this system predicts subsequent posttransplant outcomes at the time patients are waitlisted has been questioned. IN this study, researchers investigated the association of tier at listing and the corresponding continuous score used for tier assignment, which ranges from 0 (poor outcomes) to 1 (good outcomes), with eventual 1-year posttransplant graft survival.
AHRQ-funded; HS024527.
Citation: Wey A, Salkowski N, Kasiske BL .
Comparing Scientific Registry of Transplant Recipients posttransplant program-specific outcome ratings at listing with subsequent recipient outcomes after transplant.
Am J Transplant 2019 Feb;19(2):391-98. doi: 10.1111/ajt.15038..
Keywords: Transplantation, Surgery, Mortality, Registries, Adverse Events, Risk
Forster M, Amy GL, Areba E
Cumulative psychosocial risks, internal asse, and past 30-day tobacco use among middle and high school students: the promise of internal assets.
The authors investigated whether internal assets (IAs), factors that promote healthy youth development, can mitigate the adverse effects of psychosocial risks on tobacco use. Their results indicated that every additional psychosocial risk factor was associated with an increase in the odds of using tobacco and in the estimated number of products used. IAs were inversely associated with tobacco use and attenuated the association between cumulative psychosocial risks and use. They concluded that bolstering resilience by facilitating students' IAs represents a promising direction for youth-focused prevention efforts.
AHRQ-funded; HS022236.
Citation: Forster M, Amy GL, Areba E .
Cumulative psychosocial risks, internal asse, and past 30-day tobacco use among middle and high school students: the promise of internal assets.
Addict Behav 2019 Feb;89:240-47. doi: 10.1016/j.addbeh.2018.10.014..
Keywords: Tobacco Use, Children/Adolescents, Risk, Education
Kang M, Kempker JA
Definitions, epidemiology, clinical risk factors, and health disparities in acute respiratory distress syndrome.
This case definition introduces challenges to the reliable and accurate epidemiologic study of acute respiratory distress syndrome (ARDS). Within these limitations, ARDS appears to be a condition that is relatively rare within the general population but common within the context of the intensive care unit. Furthermore, the frequency and outcomes of ARDS seem to vary between populations, with no clearly discernible temporal trends in incidence or case fatality that are uniform across studies.
AHRQ-funded; HS025240.
Citation: Kang M, Kempker JA .
Definitions, epidemiology, clinical risk factors, and health disparities in acute respiratory distress syndrome.
Semin Respir Crit Care Med 2019 Feb;40(1):3-11. doi: 10.1055/s-0039-1683884..
Keywords: Disparities, Respiratory Conditions, Chronic Conditions, Risk
Gadgil MD, Ehrlich SF, Zhu Y
Dietary quality and glycemic control among women with gestational diabetes mellitus.
Poor dietary quality, measured by the Healthy Eating Index 2010 (HEI-2010), is associated with risk of gestational diabetes mellitus (GDM) and type 2 diabetes. The aim was to investigate the association between dietary quality and glycemic control in women with GDM. The authors concluded that clinicians should be aware that even a small improvement in diet quality may be beneficial for the achievement of improved glycemic control in women with GDM.
AHRQ-funded; HS019367.
Citation: Gadgil MD, Ehrlich SF, Zhu Y .
Dietary quality and glycemic control among women with gestational diabetes mellitus.
J Womens Health 2019 Feb;28(2):178-84. doi: 10.1089/jwh.2017.6788..
Keywords: Pregnancy, Diabetes, Nutrition, Women, Risk, Prevention
Dunn T, Saeed MJ, Shpigel A
The association of preoperative cardiac stress testing with 30-day death and myocardial infarction among patients undergoing kidney transplantation.
This study examined whether the use of preoperative cardiac stress testing of patients undergoing kidney transplantation reduced 30-day- death and myocardial infarction post-transplantation. ESRD patients 40 years or older with primary Medicare insurance between 2006 and 2013 were identified using the United States Renal Data System. In a matched cohort of 17,304 patients, there was little difference in 30-day post-transplantation mortality and myocardial infarction between those receiving a stress test and those who did not.
AHRQ-funded; HS019455.
Citation: Dunn T, Saeed MJ, Shpigel A .
The association of preoperative cardiac stress testing with 30-day death and myocardial infarction among patients undergoing kidney transplantation.
PLoS One 2019 Feb;14(2):e0211161. doi: 10.1371/journal.pone.0211161..
Keywords: Transplantation, Kidney Disease and Health, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Risk, Surgery
Althoff KN, Gebo KA, Moore RD
Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies.
Adults with HIV have an increased burden of non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease. The objective of this study was to estimate the population attributable fractions (PAFs) of preventable or modifiable HIV-related and traditional risk factors for non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease outcomes.
AHRQ-funded; 90047713.
Citation: Althoff KN, Gebo KA, Moore RD .
Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies.
Lancet HIV 2019 Feb;6(2):e93-e104. doi: 10.1016/s2352-3018(18)30295-9.
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Keywords: Cancer, Cardiovascular Conditions, Chronic Conditions, Kidney Disease and Health, Human Immunodeficiency Virus (HIV), Heart Disease and Health, Risk
Yuo TH, Wallace JR, Fish L
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
This study compared outcomes of different revascularization surgeries among end stage renal disease (ESRD) patients with peripheral arterial disease (PAD). There is a high risk of complications for this surgery. Outcomes of endovascular revascularization (ER) and open surgical revascularisation (OSR) were compared. Outcomes measured included mortality and major amputation. There is a lower mortality risk for ER versus OSR. OSR has better 30-day limb salvage although there are similar long-term outcomes.
AHRQ-funded; HS019486.
Citation: Yuo TH, Wallace JR, Fish L .
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
Eur J Vasc Endovasc Surg 2019 Feb;57(2):248-57. doi: 10.1016/j.ejvs.2018.09.008..
Keywords: Adverse Events, Cardiovascular Conditions, Comparative Effectiveness, Dialysis, Evidence-Based Practice, Kidney Disease and Health, Mortality, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Gerber JS, Ross RK, Szymczak JE
Infections after pediatric ambulatory surgery: incidence and risk factors.
Investigators studied the prevalence of surgical-site infections (SSIs) in a single pediatric healthcare network between ambulatory surgery facilities and a hospital-based facility. No statistical difference in the number of SSIs was found.
AHRQ-funded; HS020921.
Citation: Gerber JS, Ross RK, Szymczak JE .
Infections after pediatric ambulatory surgery: incidence and risk factors.
Infect Control Hosp Epidemiol 2019 Feb;40(2):150-57. doi: 10.1017/ice.2018.211..
Keywords: Ambulatory Care and Surgery, Children/Adolescents, Healthcare-Associated Infections (HAIs), Patient Safety, Risk, Surgery, Injuries and Wounds
Albrecht JS, Barbour L, Abariga SA
Risk of depression after traumatic brain injury in a large national sample.
The goal of this study was to estimate the risk of depression post-traumatic brain injury (TBI) among adults 18 years of age and older and to identify risk factors associated with developing depression post-TBI. Claims data for privately insured and Medicare Advantage enrollees was used. Results showed that history of neuropsychiatric disturbances pre-TBI was the strongest predictor of depression post-TBI. The risk of depression increases substantially post-TBI. Groups at increased risk include those with a history of neuropsychiatric disturbances, older adults, and men. This study highlights the importance of long-term monitoring for depression post-TBI.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Barbour L, Abariga SA .
Risk of depression after traumatic brain injury in a large national sample.
J Neurotrauma 2019 Jan 15;36(2):300-07. doi: 10.1089/neu.2017.5608..
Keywords: Depression, Behavioral Health, Brain Injury, Trauma, Risk
Mills J, Thomas A
AHRQ Author: Mills J
Risk assessment for cardiovascular disease with nontraditional risk factors.
This case study considers a 46-year-old Asian American woman who is concerned about risk of cardiovascular disease because of her new, less active working conditions. She has no personal history of hypertension or hypercholesterolemia, but does have a family history. The case study questions are based on USPSTF recommendations for nontraditional cardiovascular risk factors for CVD in asymptomatic adults.
AHRQ-authored.
Citation: Mills J, Thomas A .
Risk assessment for cardiovascular disease with nontraditional risk factors.
Am Fam Physician 2019 Jan 15;99(2):123-24.
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Keywords: Cardiovascular Conditions, Case Study, Diagnostic Safety and Quality, Risk, U.S. Preventive Services Task Force (USPSTF)
Bozaan D, Skicki D, Brancaccio A
Less lumens-less risk: a pilot intervention to increase the use of single-lumen peripherally inserted central catheters.
To reduce risk of complications, existing guidelines recommend use of peripherally inserted central catheters (PICCs) with the minimal number of lumens. This recommendation, however, is difficult to implement in practice. The investigators conducted a pilot study to increase the use of single-lumen PICCs in hospitalized patients. The authors indicated that implementing a single-lumen PICC default and providing education and indications for multilumen devices improved PICC appropriateness.
AHRQ-funded; HS025891.
Citation: Bozaan D, Skicki D, Brancaccio A .
Less lumens-less risk: a pilot intervention to increase the use of single-lumen peripherally inserted central catheters.
J Hosp Med 2019 Jan 8;14(1):42-46. doi: 10.12788/jhm.3097..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Adverse Events, Patient Safety, Risk
Aspinall SL, Springer SP, Zhao X
Central nervous system medication burden and risk of recurrent serious falls and hip fractures in Veterans Affairs nursing home residents.
This study investigated the association between taking central nervous system (CNS) medications with the risk of serious falls and hip fractures. Study participants were residents at a Veterans Health Administration (VHA) Community Living Center (CLC) between July 1, 2005 and June 30, 2009. This was a nested case-control study. The investigators concluded that there was a higher risk in those residents receiving 3.0 or more daily CNS medications.
AHRQ-funded; HS023779.
Citation: Aspinall SL, Springer SP, Zhao X .
Central nervous system medication burden and risk of recurrent serious falls and hip fractures in Veterans Affairs nursing home residents.
J Am Geriatr Soc 2019 Jan;67(1):74-80. doi: 10.1111/jgs.15603..
Keywords: Elderly, Falls, Injuries and Wounds, Long-Term Care, Medication, Nursing Homes, Patient Safety, Risk
Mokhateb-Rafii T, Bakar A, Gangadharan S
Hemodynamic impact of oxygen desaturation during tracheal intubation among critically ill children with cyanotic and noncyanotic heart disease.
The objective of this study was to determine a level of oxygen desaturation associated with increased risk of tracheal intubation events in children in a pediatric or cardiac ICU with cyanotic and noncyanotic heart disease. Oxygen desaturation was measured by a fall in pulse oximetry from baseline after pre-oxygenation. The primary outcome was occurrence of hemodynamic tracheal intubation associated events defined as cardiac arrest, hypotension, or dysrhythmia. Results indicate that oxygen desaturation by 30% or more is associated with increased odds for adverse hemodynamic events, after adjusting for confounders. Oxygen desaturation was observed more often in children with cyanotic than those with noncyanotic heart disease, but hemodynamic tracheal intubation associated event rates were similar.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Mokhateb-Rafii T, Bakar A, Gangadharan S .
Hemodynamic impact of oxygen desaturation during tracheal intubation among critically ill children with cyanotic and noncyanotic heart disease.
Pediatr Crit Care Med 2019 Jan;20(1):19-26. doi: 10.1097/pcc.0000000000001766..
Keywords: Adverse Events, Cardiovascular Conditions, Children/Adolescents, Heart Disease and Health, Respiratory Conditions, Intensive Care Unit (ICU), Patient Safety, Risk
O'Brien EC, Holmes DN, Thomas L
Incremental prognostic value of renal function for stroke prediction in atrial fibrillation.
This study investigated whether renal function predicted stroke in patients diagnosed with atrial fibrillation (AF). Data from the Outcomes Registry for Better Informed Treatment (ORBIT-AF) was used. Investigators concluded that renal dysfunction was not independently associated with embolic risk in either treated or untreated patients.
AHRQ-funded; HS021092.
Citation: O'Brien EC, Holmes DN, Thomas L .
Incremental prognostic value of renal function for stroke prediction in atrial fibrillation.
Int J Cardiol 2019 Jan 1;274:152-57. doi: 10.1016/j.ijcard.2018.07.113..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Risk, Stroke
Gordon SH, Sommers BD, Wilson IB
Risk factors for early disenrollment from Colorado's Affordable Care Act marketplace.
This study looked at risk factors for early disenrollment from Colorado’s Affordable Care Act marketplace. Researchers used all-payer claims data from individual market enrollees from 2014-2016. They discovered that nearly 25% Marketplace beneficiaries disenrolled midyear. The hazard rate of disenrollement was 30% lower in individuals with cost-sharing plans and 21% lower for those enrolled in gold plans compared to those enrolled in silver plans without cost-sharing subsidies. There was greater disenrollment in beneficiaries with greater hospital and emergency utilization before disenrollment. Also, young adults were 70% more likely to disenroll than older adults.
AHRQ-funded; HS025560.
Citation: Gordon SH, Sommers BD, Wilson IB .
Risk factors for early disenrollment from Colorado's Affordable Care Act marketplace.
Med Care 2019 Jan;57(1):49-53. doi: 10.1097/mlr.0000000000001020..
Keywords: Healthcare Costs, Health Insurance, Policy, Risk, Uninsured
Albrecht JS, Al Kibria G, Gruber-Baldini A
Risk of mortality in individuals with hip fracture and traumatic brain injury.
Researchers estimated the prevalence of TBI (traumatic brain injury) with individuals hospitalized with hip fracture and their all-cause mortality. The population studied were Medicare beneficiaries aged 65 and older from 2006 to 2010. They concluded that there was a higher risk of death with individuals who had TBI than those who had only a hip fracture.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Al Kibria G, Gruber-Baldini A .
Risk of mortality in individuals with hip fracture and traumatic brain injury.
J Am Geriatr Soc 2019 Jan;67(1):124-27. doi: 10.1111/jgs.15661..
Keywords: Brain Injury, Injuries and Wounds, Mortality, Risk, Trauma