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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.
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1 to 6 of 6 Research Studies DisplayedRolfzen ML, Wick A, Mascha EJ
Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): a cluster randomized multiple crossover trial.
This study tested the hypothesis that a decision-support tool embedded in electronic health records (EHRs) leads clinicians to prescribe fewer opioids at discharge after inpatient surgery. Over 21,000 surgical inpatient discharges in a cluster randomized multiple crossover trial in four Colorado hospitals were included. The results indicated that within the context of vigorous opioid education and awareness efforts a decision-support tool incorporated into EHRs did not reduce discharge opioid prescribing for postoperative patients. The authors concluded that opioid prescribing alerts might be valuable in other contexts.
AHRQ-funded; HS027795.
Citation: Rolfzen ML, Wick A, Mascha EJ .
Best Practice Alerts Informed by Inpatient Opioid Intake to Reduce Opioid Prescribing after Surgery (PRIOR): a cluster randomized multiple crossover trial.
Anesthesiology 2023 Aug 1; 139(2):186-96. doi: 10.1097/aln.0000000000004607..
Keywords: Opioids, Medication, Surgery, Inpatient Care, Clinical Decision Support (CDS), Health Information Technology (HIT)
Ingraham NE, Jones EK, King S
Re-aiming equity evaluation in clinical decision support: a scoping review of equity assessments in surgical decision support systems.
This scoping review explored surgical literature to determine frequency and rigor of clinical decision support (CDS) equity assessments and offer recommendations to improve CDS equity by appending existing frameworks. The authors performed a scoping review of PubMed and Google Scholar and identified 1,415 citations with 229 abstracts meeting criteria for review. A total of 84 papers underwent full review after 145 were excluded if they did not assess outcomes of an electronic CDS tool or have a surgical use case. Only 6% of surgical CDS systems reported equity analyses, suggesting that current methods for optimizing equity in surgical CDS are inadequate. The authors proposed revising the RE-AIM framework to include an Equity element (RE2-AIM) specifying that CDS foundational analyses and algorithms are performed or trained on balanced datasets with sociodemographic characteristics that accurately represent the CDS target population and are assessed by sensitivity analyses focused on vulnerable subpopulations.
AHRQ-funded; HS026379; HS024532.
Citation: Ingraham NE, Jones EK, King S .
Re-aiming equity evaluation in clinical decision support: a scoping review of equity assessments in surgical decision support systems.
Ann Surg 2023 Mar; 277(3):359-64. doi: 10.1097/sla.0000000000005661..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Disparities, Surgery
Nanji KC, Garabedian PM, Langlieb ME
Usability of a perioperative medication-related clinical decision support software application: a randomized controlled trial.
The purpose of this study was assess the usability of a newly developed, comprehensive, medication-related operating room clinical decision support (CDS) software and compare it with the standard electronic health record (EHR) medication workflow. Forty participants were randomized to a CDS group (n=20) or a control group (n=20) and asked to complete 7 simulation tasks. The study found that in a simulation setting the new CDS software improved efficiency and quality of care and reduced task time, excelling over the current EHR workflow.
AHRQ-funded; HS024764.
Citation: Nanji KC, Garabedian PM, Langlieb ME .
Usability of a perioperative medication-related clinical decision support software application: a randomized controlled trial.
J Am Med Inform Assoc 2022 Jul 12;29(8):1416-24. doi: 10.1093/jamia/ocac035..
Keywords: Medication, Clinical Decision Support (CDS), Health Information Technology (HIT), Surgery, Decision Making
Wissel BD, Greiner TA, Holland-Bouley KD
Prospective validation of a machine learning model that uses provider notes to identify candidates for resective epilepsy surgery.
Delay to resective epilepsy surgery results in avoidable disease burden and increased risk of mortality. The objective of this study was to prospectively validate a natural language processing (NLP) application that uses provider notes to assign epilepsy surgery candidacy scores. The authors suggest that an electronic health record-integrated NLP application can accurately assign surgical candidacy scores to patients in a clinical setting.
AHRQ-funded; HS024977.
Citation: Wissel BD, Greiner TA, Holland-Bouley KD .
Prospective validation of a machine learning model that uses provider notes to identify candidates for resective epilepsy surgery.
Epilepsia 2020 Jan;61(1):39-48. doi: 10.1111/epi.16398..
Keywords: Neurological Disorders, Surgery, Health Information Technology (HIT), Clinical Decision Support (CDS), Decision Making
Wissel BD, Greiner HM, Glauser TA
Investigation of bias in an epilepsy machine learning algorithm trained on physician notes.
Racial disparities in the utilization of epilepsy surgery are well documented, but it is unknown whether a natural language processing (NLP) algorithm trained on physician notes would produce biased recommendations for epilepsy presurgical evaluations. To assess this, an NLP algorithm was trained to identify potential surgical candidates using 1097 notes from 175 epilepsy patients with a history of resective epilepsy surgery and 268 patients who achieved seizure freedom without surgery (total N = 443 patients).
AHRQ-funded; HS024977.
Citation: Wissel BD, Greiner HM, Glauser TA .
Investigation of bias in an epilepsy machine learning algorithm trained on physician notes.
Epilepsia 2019 Sep;60(9):e93-e98. doi: 10.1111/epi.16320..
Keywords: Neurological Disorders, Surgery, Clinical Decision Support (CDS), Healthcare Utilization, Health Information Technology (HIT), Decision Making
Leeds IL, Rosenblum AJ, Wise PE
Eye of the beholder: risk calculators and barriers to adoption in surgical trainees.
This study examined barriers to surgical trainees in using risk calculator tools before surgery. A total of 124 surgical residents responded to a survey and most still favored more traditional methods for risk calculation including direct verbal communication, sketch diagrams, and brochures. Only about half or less were familiar with more contemporary tools such as best-worst case scenario framing, case-specific risk calculators, and all-procedure calculators.
AHRQ-funded; HS024736.
Citation: Leeds IL, Rosenblum AJ, Wise PE .
Eye of the beholder: risk calculators and barriers to adoption in surgical trainees.
Surgery 2018 Nov;164(5):1117-23. doi: 10.1016/j.surg.2018.07.002..
Keywords: Clinical Decision Support (CDS), Decision Making, Education: Continuing Medical Education, Risk, Surgery