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- Adverse Events (2)
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- (-) Surgery (16)
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 16 of 16 Research Studies DisplayedWissel BD, Greiner HM, Glauser TA
Automated, machine learning-based alerts increase epilepsy surgery referrals: a randomized controlled trial.
Researchers conducted a prospective, randomized controlled trial of a natural language processing-based clinical decision support system in the electronic health record at 14 pediatric neurology outpatient clinics to determine whether automated, electronic alerts increased referrals for epilepsy surgery. Children with epilepsy and at least two prior neurology visits were screened by the system prior to their scheduled visit to identify potential surgical candidates, and the potential candidates randomized 2:1 for their providers to receive an alert or standard of care (no alert). The results showed that patients whose providers received an alert were more likely to be referred for a presurgical evaluation. The researchers concluded that machine learning-based automated alerts may improve the utilization of referrals for epilepsy surgery evaluations.
AHRQ-funded; HS024977.
Citation: Wissel BD, Greiner HM, Glauser TA .
Automated, machine learning-based alerts increase epilepsy surgery referrals: a randomized controlled trial.
Epilepsia 2023 Jul; 64(7):1791-99. doi: 10.1111/epi.17629..
Keywords: Neurological Disorders, Surgery, Health Information Technology (HIT)
Difazio RL, Shore BJ, Melvin P
Pneumonia after hip surgery in children with neurological complex chronic conditions.
The purpose of this retrospective cohort study was to estimate rates of postoperative pneumonia in children with neurological complex chronic conditions (CCC) undergoing hip surgery, to determine the effect of pneumonia on postoperative hospital resource use, and to identify predictors. Researchers used data from the Pediatric Health Information System for children 4 years and older with a neurological CCC who had undergone hip surgery from 2016 to 2018 in U.S. children's hospitals. Findings indicate that postoperative pneumonia in children with a neurological CCC was associated with longer length-of-stay, readmissions, and higher costs. Children who had undergone pelvic osteotomies and who had multimorbidity needed additional clinical support to prevent postoperative pneumonia and to decrease resource utilization.
AHRQ-funded; HS024453.
Citation: Difazio RL, Shore BJ, Melvin P .
Pneumonia after hip surgery in children with neurological complex chronic conditions.
Dev Med Child Neurol 2023 Feb; 65(2):232-42. doi: 10.1111/dmcn.15339..
Keywords: Children/Adolescents, Surgery, Neurological Disorders, Pneumonia, Respiratory Conditions, Hospital Readmissions, Adverse Events
Wissel BD, Greiner HM, Glauser TA
Early identification of epilepsy surgery candidates: a multicenter, machine learning study.
Epilepsy surgery is underutilized. Automating the identification of potential surgical candidates may facilitate earlier intervention. The study objective was to develop site-specific machine learning (ML) algorithms to identify candidates before they undergo surgery. The investigators concluded that site-specific machine learning algorithms could identify candidates for epilepsy surgery early in the disease course in diverse practice settings.
AHRQ-funded; HS024977.
Citation: Wissel BD, Greiner HM, Glauser TA .
Early identification of epilepsy surgery candidates: a multicenter, machine learning study.
Acta Neurol Scand 2021 Jul;114(1):41-50. doi: 10.1111/ane.13418..
Keywords: Neurological Disorders, Surgery, Health Information Technology (HIT)
Berry JG, Difazio RL, Melvin P
Hospital resource use after hip reconstruction surgery in children with neurological complex chronic conditions.
This study assessed how co-occurring conditions influence recovery after hip reconstruction surgery in children with neurological complex chronic conditions (CCCs). This retrospective analysis of 4058 children age 4 years or older was conducted from 2015 to 2018 in 49 children’s hospitals. The presence of CCCs was assessed using the AHRQ Chronic Condition Indicator system. Outcomes looked for included postoperative hospital length of stay (LOS), 30 -day readmission rates, and median hospital costs. The most common co-occurring conditions were digestive (60.1%) and respiratory (37.9%). Median LOS increased 67% as co-existing conditions increased from one to four or more. Median hospital costs increased 41% and readmission rates increased 250%. Malnutrition was associated with the greatest increase in postoperative hospital use.
AHRQ-funded; HS024453.
Citation: Berry JG, Difazio RL, Melvin P .
Hospital resource use after hip reconstruction surgery in children with neurological complex chronic conditions.
Dev Med Child Neurol 2021 Feb;63(2):204-10. doi: 10.1111/dmcn.14712..
Keywords: Children/Adolescents, Chronic Conditions, Surgery, Hospital Readmissions, Hospitals, Neurological Disorders
Sharma D
Perioperative management of aneurysmal subarachnoid hemorrhage.
This article discusses aneurysmal subarachnoid hemorrhage, an acute neurologic emergency. Extracranial manifestations of aneurysmal subarachnoid hemorrhage include cardiac dysfunction, neurogenic pulmonary edema, fluid and electrolyte imbalances, and hyperglycemia. The author indicates that prompt definitive treatment of the aneurysm by craniotomy and clipping or endovascular intervention with coils and/or stents is needed to prevent rebleeding. The author also notes that data on the impact of anesthesia on long-term neurologic outcomes of aneurysmal subarachnoid hemorrhage do not exist.
AHRQ-funded; HS026690.
Citation: Sharma D .
Perioperative management of aneurysmal subarachnoid hemorrhage.
Anesthesiology 2020 Dec;133(6):1283-305. doi: 10.1097/aln.0000000000003558..
Keywords: Cardiovascular Conditions, Neurological Disorders, Surgery, Care Management
Shetty KD, Robbins M, Aragaki D
The quality of electrodiagnostic tests for carpal tunnel syndrome: Implications for surgery, outcomes, and expenditures.
The quality of electrodiagnostic tests may influence treatment decisions, particularly regarding surgery, affecting health outcomes and health-care expenditures. In this study, the investigators evaluated test quality among 338 adults with workers' compensation claims for carpal tunnel syndrome. The investigators found that in simulations, suboptimal quality tests rendered surgery inappropriate for 99 of 309 patients (+32 percentage points). They also found that test quality was not associated with overall health, actual receipt of surgery, or expenditures.
AHRQ-funded; HS018982.
Citation: Shetty KD, Robbins M, Aragaki D .
The quality of electrodiagnostic tests for carpal tunnel syndrome: Implications for surgery, outcomes, and expenditures.
Muscle Nerve 2020 Jul;62(1):60-69. doi: 10.1002/mus.26874..
Keywords: Diagnostic Safety and Quality, Neurological Disorders, Surgery, Quality Indicators (QIs), Quality Measures, Quality of Care
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
Madapana N, Gonzalez G, Taneja R
Preference elicitation: obtaining gestural guidelines for PACS in neurosurgery.
The objectives of this study were to: a) Elicit gestures from neurosurgeons to analyze their preferences, b) Develop heuristics for gestural interfaces, and c) Produce a lexicon that maximizes surgeons' preferences. The elicitation study resulted in nine gesture lexicons, each comprised of 28 gestures. Results showed that neurosurgeons do agree on fundamental characteristics of gestures to perform image manipulation tasks. The proposed heuristics could potentially guide the development of future gesture-based interaction of Picture Archiving and Communication Systems for the operating room.
AHRQ-funded; HS024887.
Citation: Madapana N, Gonzalez G, Taneja R .
Preference elicitation: obtaining gestural guidelines for PACS in neurosurgery.
Int J Med Inform 2019 Oct;130:103934. doi: 10.1016/j.ijmedinf.2019.07.013..
Keywords: Guidelines, Neurological Disorders, Patient Safety, Surgery
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
Curtin CM, Kenney D, Suarez P
A double-blind placebo randomized controlled trial of minocycline to reduce pain after carpal tunnel and trigger finger release.
This trial tested whether perioperative administration of minocycline reduced time to pain resolution (TPR) after standardized hand surgeries with known prolonged pain profiles: carpal tunnel release and trigger finger release. It found that oral administration of minocycline did not reduce TPR after minor hand surgery. There was evidence that minocycline might increase length of pain in those with increased posttraumatic stress disorder symptoms.
AHRQ-funded; HS024096.
Citation: Curtin CM, Kenney D, Suarez P .
A double-blind placebo randomized controlled trial of minocycline to reduce pain after carpal tunnel and trigger finger release.
J Hand Surg Am 2017 Mar;42(3):166-74. doi: 10.1016/j.jhsa.2016.12.011.
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Keywords: Neurological Disorders, Medication, Pain, Stress, Surgery
Dy CJ, Baty J, Saeed MJ
A population-based analysis of time to surgery and travel distances for brachial plexus surgery.
Since the published brachial plexus injuries (BPI) experience is largely from individual centers, the authors used a population-based approach to evaluate the delivery of care for patients with BPI. They found that nearly one third of patients underwent BPI surgery more than 1 year after the injury, with patients initially treated at smaller hospitals at risk for undergoing delayed BPI surgery. These findings can inform efforts to expedite timely referral of patients with BPI to experienced centers.
AHRQ-funded; HS019455.
Citation: Dy CJ, Baty J, Saeed MJ .
A population-based analysis of time to surgery and travel distances for brachial plexus surgery.
J Hand Surg Am 2016 Sep;41(9):903-09.e3. doi: 10.1016/j.jhsa.2016.07.054.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Delivery, Surgery, Neurological Disorders
Ladner TR, Greenberg JK, Guerrero N
Chiari malformation type I surgery in pediatric patients. part 1: validation of an ICD-9-CM code search algorithm.
The researchers sought to validate two ICD-9-CM code algorithms using hospital billing data to identify pediatric patients undergoing Chiari malformation Type I (CM-I) decompression surgery. They found that an ICD-9-CM algorithm requiring a primary diagnosis of CM-I has excellent positive predictive value and very good sensitivity for identifying CM-I decompression surgery in pediatric patients. They concluded that these results establish a basis for utilizing administrative billing data to assess pediatric CM-I treatment outcomes.
AHRQ-funded; HS019455.
Citation: Ladner TR, Greenberg JK, Guerrero N .
Chiari malformation type I surgery in pediatric patients. part 1: validation of an ICD-9-CM code search algorithm.
J Neurosurg Pediatr 2016 May;17(5):519-24. doi: 10.3171/2015.10.peds15370.
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Keywords: Children/Adolescents, Neurological Disorders, Surgery
Schlitz NK, Kaiboriboon K, Koroukian SM
Long-term reduction of health care costs and utilization after epilepsy surgery.
This study assessed long-term direct medical costs, health care utilization, and mortality following resective surgery in persons with uncontrolled epilepsy. It found that the mean direct medical cost difference between the surgical group and control group was $6,806 after risk-set matching. The incidence rate ratio of inpatient, emergency room, and outpatient utilization was lower among the surgical group in both unadjusted and adjusted analyses.
AHRQ-funded; HS000059.
Citation: Schlitz NK, Kaiboriboon K, Koroukian SM .
Long-term reduction of health care costs and utilization after epilepsy surgery.
Epilepsia 2016 Feb;57(2):316-24. doi: 10.1111/epi.13280.
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Keywords: Healthcare Costs, Healthcare Utilization, Mortality, Neurological Disorders, Outcomes, Surgery
Fink HA, Hemmy LS, MacDonald R
Intermediate- and long-term cognitive outcomes after cardiovascular procedures in older adults: a systematic review.
This study summarized evidence about cognitive outcomes in adults aged 65 years or older at least 3 months after coronary or carotid revascularization, cardiac valve procedures, or ablation for atrial fibrillation. It concluded that intermediate- and long-term cognitive impairment in older adults attributable to the studied cardiovascular procedures may be uncommon.
AHRQ-funded; 2902007100641.
Citation: Fink HA, Hemmy LS, MacDonald R .
Intermediate- and long-term cognitive outcomes after cardiovascular procedures in older adults: a systematic review.
Ann Intern Med 2015 Jul 21;163(2):107-17. doi: 10.7326/m14-2793..
Keywords: Cardiovascular Conditions, Elderly, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Albrecht JS, Marcantonio ER, Roffey DM
Stability of postoperative delirium psychomotor subtypes in individuals with hip fracture.
This paper's objectives were to determine the stability of psychomotor subtypes of delirium over time and to identify characteristics associated with delirium psychomotor subtypes in individuals undergoing surgical repair of hip fracture. The Transfusion Trigger Trial for Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair Cognitive Ancillary Study was conducted. Results showed that psychomotor subtypes of delirium often fluctuated from assessment to assessment, rather than representing fixed categories of delirium. Hypoactive delirium was the most common presentation of delirium but the least likely to be documented by healthcare providers.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Marcantonio ER, Roffey DM .
Stability of postoperative delirium psychomotor subtypes in individuals with hip fracture.
J Am Geriatr Soc 2015 May;63(5):970-6. doi: 10.1111/jgs.13334.
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Keywords: Adverse Events, Cardiovascular Conditions, Injuries and Wounds, Neurological Disorders, Surgery
Daniels AH, Daiello LA, Lareau CR
Preoperative cognitive impairment and psychological distress in hospitalized elderly hip fracture patients.
The authors conducted a study to evaluate the prevalence of cognitive impairment (CI) compared with normal cognition (NC) in elderly hip fracture patients 65 years and older. Results showed many patients had unrecognized CI before surgery and had significantly more pain and fear than the NC group.
AHRQ-funded; HS017735
Citation: Daniels AH, Daiello LA, Lareau CR .
Preoperative cognitive impairment and psychological distress in hospitalized elderly hip fracture patients.
Ame J Orthop. 2014 Jul; 43(7):E146-52..
Keywords: Elderly, Injuries and Wounds, Neurological Disorders, Surgery