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Topics
- Adverse Drug Events (ADE) (1)
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- (-) Comparative Effectiveness (23)
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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 23 of 23 Research Studies DisplayedHerrin J, Abraham NS, Yao X
Comparative effectiveness of machine learning approaches for predicting gastrointestinal bleeds in patients receiving antithrombotic treatment.
The purpose of this retrospective cross-sectional study was to compare the performance of 3 machine learning approaches with the commonly-used HAS-BLED (hypertension, abnormal kidney and liver function, stroke, bleeding, labile international normalized ratio, older age, and drug or alcohol use) risk score in predicting antithrombotic-related gastrointestinal bleeding (GIB). The machine-learning models were regularized Cox proportional hazards regression (RegCox), random survival forests, and extreme gradient boosting (XGBoost). Findings showed that the machine learning models revealed similar performance in identifying patients at high risk for GIB after being prescribed antithrombotic agents. Two models (RegCox and XGBoost) performed modestly better than the HAS-BLED score.
AHRQ-funded; HS025402.
Citation: Herrin J, Abraham NS, Yao X .
Comparative effectiveness of machine learning approaches for predicting gastrointestinal bleeds in patients receiving antithrombotic treatment.
JAMA Netw Open 2021 May;4(5):e2110703. doi: 10.1001/jamanetworkopen.2021.10703..
Keywords: Blood Thinners, Medication, Risk, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Patient Safety, Comparative Effectiveness
Katz D, Petersen T, Amado S
An evaluation of suicidal risk in bipolar patients with comorbid posttraumatic stress disorder.
The impact of concurrent diagnosis posttraumatic stress disorder (PTSD) on persons with bipolar disorder (BD) was analyzed to determine if there was a higher risk of suicidal ideation. Baseline data from the 482 individuals enrolled in the Clinical and Health Outcomes Initiative in Comparative Effectiveness for bipolar disorder study (Bipolar CHOICE) was used. The association of comorbid PTSD with increased suicidal ideation was assessed by the Concise Health Risk Tracking Scale (CHRT) total and factor scores. As the authors hypothesized, diagnosis of comorbid PTSD was a significant predictor of the CHRT total score. All participants with comorbid PTSD (n=58) endorsed current suicidal ideation and were more likely to have had a previous suicide attempt compared to those without PTSD.
AHRQ-funded; HS019371.
Citation: Katz D, Petersen T, Amado S .
An evaluation of suicidal risk in bipolar patients with comorbid posttraumatic stress disorder.
J Affect Disord 2020 Apr 1;266:49-56. doi: 10.1016/j.jad.2020.01.091..
Keywords: Behavioral Health, Risk, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Depression
Bath J, Smith JB, Kruse RL
Cohort study of risk factors for 30-day readmission after abdominal aortic aneurysm repair.
This retrospective cohort study examined 30-day readmission rates for patients who had abdominal aortic aneurysm (AAA) repair comparing two different procedures,. The cohort was selected from inpatients (2009-2016) who had undergone elective AAA repair using the multicenter Cerner Health Facts(R) database and were identified ICD-9 procedure codes. The two procedures compared were 3,101 endovascular aneurysm repairs (EVAR) and 1,622 open procedures. Patients who had EVAR were less likely to be readmitted. Risk factors for readmission included surgical site infection, age, receipt of bronchodilators or steroids, serum potassium > 5.2 mEq/L, and higher Charlson co-morbidity scores. The most common infections causing readmission were pneumonia and urinary tract infection after EVAR.
AHRQ-funded; HS022140.
Citation: Bath J, Smith JB, Kruse RL .
Cohort study of risk factors for 30-day readmission after abdominal aortic aneurysm repair.
Vasa 2019 May;48(3):251-61. doi: 10.1024/0301-1526/a000767..
Keywords: Risk, Hospital Readmissions, Surgery, Outcomes, Comparative Effectiveness, Patient-Centered Outcomes Research
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
Wu P, Escobar GJ, Gebretsadik T
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
This retrospective cohort study examined the effectiveness of respiratory syncytial virus (RSV) prophylaxis for infants born between 1996 and 2008. The infants were enrolled in the Kaiser Permanente Northern California integrated health system. Infants who ever received RSV immunoprophylaxis had a 32% decreased risk of bronchiolitis hospitalization and finants with chronic lung disease (CLD) had a 52% decreased risk. The 2014 American Academy of Pediatrics (AAP) guidelines changed recommendations for RSV immunoprophylaxis which made 48% of infants no longer eligible but nearly all infants with CLD would remain eligible.
AHRQ-funded; HS018454.
Citation: Wu P, Escobar GJ, Gebretsadik T .
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
Am J Epidemiol 2018 Jul;187(7):1490-500. doi: 10.1093/aje/kwy008..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Hospitalization, Newborns/Infants, Outcomes, Patient-Centered Outcomes Research, Prevention, Respiratory Conditions, Risk
Zeitler EP, Al-Khatib SM, Friedman DJ
Predicting appropriate shocks in patients with heart failure: patient level meta-analysis from SCD-HeFT and MADIT II.
The study authors sought to identify characteristics predictive of appropriate shocks in patients with a primary prevention implantable cardioverter defibrillator (ICD). In this meta-analysis of patient level data from Multicenter Automatic Defibrillator Implantation Trial II and Sudden Cardiac Death in Heart Failure Trial, higher NYHA class, lower LVEF, no beta-blocker therapy, and single chamber ICD (vs. dual chamber) were significant predictors of appropriate shocks.
AHRQ-funded; HS018505.
Citation: Zeitler EP, Al-Khatib SM, Friedman DJ .
Predicting appropriate shocks in patients with heart failure: patient level meta-analysis from SCD-HeFT and MADIT II.
J Cardiovasc Electrophysiol 2017 Nov;28(11):1345-51. doi: 10.1111/jce.13307.
Keywords: Comparative Effectiveness, Heart Disease and Health, Medical Devices, Medical Devices, Risk
Nelson HD, Denneson LM, Low AR
Suicide risk assessment and prevention: a systematic review focusing on veterans.
This article reviews studies of the accuracy of methods to identify individuals at increased risk of suicide and the effectiveness and adverse effects of health care interventions relevant to U.S. veteran and military populations in reducing suicide and suicide attempts. It concludes that risk assessment methods have been shown to be sensitive predictors of suicide and suicide attempts, but the frequency of false positives limits their clinical utility.
AHRQ-funded; HS019456.
Citation: Nelson HD, Denneson LM, Low AR .
Suicide risk assessment and prevention: a systematic review focusing on veterans.
Psychiatr Serv 2017 Oct;68(10):1003-15. doi: 10.1176/appi.ps.201600384.
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Keywords: Comparative Effectiveness, Behavioral Health, Prevention, Risk
Simianu VV, Flum DR
Rethinking elective colectomy for diverticulitis: a strategic approach to population health.
The authors argue that a rethinking of elective colectomy should come from a patient-centered approach that considers the risks of recurrence, quality of life, patient wishes and experiences about surgical and medical treatment options as well as operative morbidity and risks.
AHRQ-funded; HS020025.
Citation: Simianu VV, Flum DR .
Rethinking elective colectomy for diverticulitis: a strategic approach to population health.
World J Gastroenterol 2014 Nov 28;20(44):16609-14. doi: 10.3748/wjg.v20.i44.16609..
Keywords: Patient-Centered Outcomes Research, Comparative Effectiveness, Surgery, Adverse Events, Risk
Eng J, Wilson RF, Subramaniam RM
Comparative effect of contrast media type on the incidence of contrast-induced nephropathy: a systematic review and meta-analysis.
This review compared contrast-induced nephropathy (CIN) risk for contrast media within and between osmolality classes in patients receiving diagnostic or therapeutic imaging procedures. No differences were found in CIN risk among types of low-osmolar contrast media (LOCM). Iodixanol had a slightly lower risk for CIN than LOCM, but the lower risk did not exceed a criterion for clinical importance.
AHRQ-funded; 290201200007I.
Citation: Eng J, Wilson RF, Subramaniam RM .
Comparative effect of contrast media type on the incidence of contrast-induced nephropathy: a systematic review and meta-analysis.
Ann Intern Med 2016 Mar 15;164(6):417-24. doi: 10.7326/m15-1402.
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Keywords: Comparative Effectiveness, Imaging, Risk, Kidney Disease and Health, Adverse Events
Scott FI, Mamtani R, Brensinger CM
Risk of nonmelanoma skin cancer associated with the use of immunosuppressant and biologic agents in patients with a history of autoimmune disease and nonmelanoma skin cancer.
The study objective was to determine the relative hazard of a second nonmelanoma skin cancer (NMSC) in patients with rheumatoid arthritis and inflammatory bowel disease who use methotrexate, anti-tumor necrosis factor (anti-TNF) therapy, or thiopurines after an initial NMSC. It concluded that methotrexate use is associated with an increased risk of a second NMSC.
AHRQ-funded; HS018517.
Citation: Scott FI, Mamtani R, Brensinger CM .
Risk of nonmelanoma skin cancer associated with the use of immunosuppressant and biologic agents in patients with a history of autoimmune disease and nonmelanoma skin cancer.
JAMA Dermatol 2016 Feb;152(2):164-72. doi: 10.1001/jamadermatol.2015.3029.
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Keywords: Cancer, Arthritis, Risk, Comparative Effectiveness, Treatments
Yun H, Xie F, Delzell E
Comparative risk of hospitalized infection associated with biologic agents in rheumatoid arthritis patients enrolled in Medicare.
The aim of this study was to determine whether the associated risk of hospitalized infections differed between specific biologic agents used to treat rheumatoid arthritis (RA). It concluded that RA patients with prior exposure to a biologic agent, exposure to etanercept, infliximab, or rituximab was associated with a greater 1-year risk of hospitalized infection compared with the risk associated with exposure to abatacept.
AHRQ-funded; HS021694; HS018517.
Citation: Yun H, Xie F, Delzell E .
Comparative risk of hospitalized infection associated with biologic agents in rheumatoid arthritis patients enrolled in Medicare.
Arthritis Rheumatol 2016 Jan;68(1):56-66. doi: 10.1002/art.39399..
Keywords: Comparative Effectiveness, Healthcare-Associated Infections (HAIs), Arthritis, Hospitalization, Risk
Curtis JR, Sarsour K, Napalkov P
Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor alpha agents, a retrospective cohort study.
Interstitial lung disease (ILD) is a common extra-articular condition in rheumatoid arthritis (RA), but few studies have systematically investigated its incidence and risk factors in patients receiving anti-tumor necrosis factor-alpha (anti-TNFα) agents or alternate mechanisms of action (MOAs). After examining 13,795 episodes of biologic exposure in 11,219 patients, researchers found no significant differences in the risk of ILD and its related complications between RA patients receiving anti-TNFα agents and those receiving alternate MOA agents.
AHRQ-funded; HS018517.
Citation: Curtis JR, Sarsour K, Napalkov P .
Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor alpha agents, a retrospective cohort study.
Arthritis Res Ther 2015 Nov 11;17:319. doi: 10.1186/s13075-015-0835-7..
Keywords: Arthritis, Comparative Effectiveness, Medication, Respiratory Conditions, Risk
Vogel JA, Seleno N, Hopkins E
Denver ED Trauma Organ Failure Score outperforms traditional methods of risk stratification in trauma.
The objective of this study was to compare prognostic accuracies of the Denver Emergency Department (ED) Trauma Organ Failure (TOF) Score, ED Sequential Organ Failure Assessment (SOFA) score, and ED base deficit and ED lactate for inhospital mortality in adult trauma patients. It concluded that The Denver ED TOF Score more accurately predicts inhospital mortality in adult trauma patients compared to the other three.
AHRQ-funded; HS017526.
Citation: Vogel JA, Seleno N, Hopkins E .
Denver ED Trauma Organ Failure Score outperforms traditional methods of risk stratification in trauma.
Am J Emerg Med 2015 Oct;33(10):1440-4. doi: 10.1016/j.ajem.2015.07.006..
Keywords: Emergency Medical Services (EMS), Risk, Mortality, Comparative Effectiveness, Emergency Department
Polgreen LA, Cook EA, Brooks JM
Increased statin prescribing does not lower pneumonia risk.
The objective of this study was to determine if the observed protective effects of statins against pneumonia are a result of nonrandom treatment assignment rather than a direct effect of the medication. It found that in at least 1 major population of statin users the protective effects of statins against pneumonia disappear once nonrandom treatment assignment is accounted for.
AHRQ-funded; HS018381.
Citation: Polgreen LA, Cook EA, Brooks JM .
Increased statin prescribing does not lower pneumonia risk.
Clin Infect Dis 2015 Jun 15;60(12):1760-6. doi: 10.1093/cid/civ190..
Keywords: Medication, Healthcare-Associated Infections (HAIs), Risk, Comparative Effectiveness
Parmar AD, Sheffield KM, Adhikari D
PREOP-Gallstones: a prognostic nomogram for the management of symptomatic cholelithiasis in older patients.
The objective of this study was to develop and validate a risk prediction model that would identify older patients who are at highest risk for recurrent episodes. It concluded that surgeons can use a prognostic nomogram to accurately provide patients with their 2-year risk of developing gallstone-related complications, allowing patients and physicians to make informed decisions in the context of their symptom severity and its impact on their quality of life.
AHRQ-funded; HS022134
Citation: Parmar AD, Sheffield KM, Adhikari D .
PREOP-Gallstones: a prognostic nomogram for the management of symptomatic cholelithiasis in older patients.
Ann Surg. 2015 Jun;261(6):1184-90. doi: 10.1097/sla.0000000000000868..
Keywords: Comparative Effectiveness, Risk, Elderly, Decision Making
Curtis JR, Xie F, Yun H
Risk of hospitalized infection among rheumatoid arthritis patients concurrently treated with a biologic agent and denosumab.
The researchers evaluated rates of hospitalized infection among patients treated with biologic agents for RA who subsequently initiated denosumab in order to assess whether rates of infection were increased with concurrent biologic agent use for RA. They found that the rate of hospitalized infection among RA patients receiving denosumab concurrently with biologic agents for RA was not increased compared to those receiving zoledronate.
AHRQ-funded; HS018517
Citation: Curtis JR, Xie F, Yun H .
Risk of hospitalized infection among rheumatoid arthritis patients concurrently treated with a biologic agent and denosumab.
Arthritis Rheumatol. 2015 Jun;67(6):1456-64. doi: 10.1002/art.39075..
Keywords: Arthritis, Healthcare-Associated Infections (HAIs), Risk, Patient Safety, Comparative Effectiveness
Bowen ME, Xuan L, Lingvay I
Random blood glucose: a robust risk factor for type 2 diabetes.
This study examined the association between random glucose values and undiagnosed diabetes and prediabetes. In a nationally representative sample of the U.S. population without diagnosed diabetes, the researchers found that a single random blood glucose value of at least 100 mg/dL (5.6 mmol/L) is strongly associated with undiagnosed diabetes and demonstrates a robust dose response.
AHRQ-funded; HS022418
Citation: Bowen ME, Xuan L, Lingvay I .
Random blood glucose: a robust risk factor for type 2 diabetes.
J Clin Endocrinol Metab. 2015 Apr;100(4):1503-10. doi: 10.1210/jc.2014-4116..
Keywords: Diabetes, Risk, Comparative Effectiveness
Ko EM, Sturmer T, Hong JL
Metformin and the risk of endometrial cancer: a population-based cohort study.
The researchers sought to estimate the risk of incident endometrial cancer in women who were new users of metformin compared to new users of sulfonylureas. They did not find a difference in cancer incidence in new initiators of metformin compared with sulfonylureas in the population under study.
AHRQ-funded; HS017950.
Citation: Ko EM, Sturmer T, Hong JL .
Metformin and the risk of endometrial cancer: a population-based cohort study.
Gynecol Oncol 2015 Feb;136(2):341-7. doi: 10.1016/j.ygyno.2014.12.001..
Keywords: Comparative Effectiveness, Cancer, Medication, Risk
Spangler EL, Goodney PP, Schanzer A
Outcomes of carotid endarterectomy versus stenting in comparable medical risk patients.
The purpose of this study was to compare risk-stratified outcomes of carotid artery stenting (CAS) and carotid endarterectomy (CEA). Included in the study group were 11,336 patients who underwent isolated primary CEA and 544 who underwent primary CAS. The researchers found that asymptomatic normal- and high-risk patients do equally well after CEA or CAS. However, normal- and high-risk symptomatic patients have substantially worse outcomes with CAS compared with CEA.
AHRQ-funded; HS021581.
Citation: Spangler EL, Goodney PP, Schanzer A .
Outcomes of carotid endarterectomy versus stenting in comparable medical risk patients.
J Vasc Surg 2014 Nov;60(5):1227-31, 31.e1. doi: 10.1016/j.jvs.2014.05.044..
Keywords: Outcomes, Comparative Effectiveness, Risk, Cardiovascular Conditions, Heart Disease and Health
Schelleman H, Han X, Brensinger CM
Pharmacoepidemiologic and in vitro evaluation of potential drug-drug interactions of sulfonylureas with fibrates and statins.
This study examined whether initiation of fibrates or statins in sulfonylurea users is associated with hypoglycemia and in vitro inhibition of cytochrome P450 (CYP) enzymes by statins, fenofibrate and glipizide. It found that use of fenofibrate or gemfibrozil together with glyburide was associated with
elevated overall risks of serious hypoglycemia.
elevated overall risks of serious hypoglycemia.
AHRQ-funded; HS019818.
Citation: Schelleman H, Han X, Brensinger CM .
Pharmacoepidemiologic and in vitro evaluation of potential drug-drug interactions of sulfonylureas with fibrates and statins.
Br J Clin Pharmacol 2014 Sep;78(3):639-48. doi: 10.1111/bcp.12353..
Keywords: Comparative Effectiveness, Medication, Risk
Wu AC, Li L, Fung V
Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids.
The researchers compared the effectiveness of different controller medication regimens under real-life conditions. They found that the risk of emergency department visits, hospitalizations, and oral corticosteroids did not differ between children who initiated leukotriene antagonist and those who initiated inhaled corticosteroid. These findings may be explainable by leukotriene antagonist having similar effectiveness as inhaled corticosteroid in real-life usage.
AHRQ-funded; HS019669.
Citation: Wu AC, Li L, Fung V .
Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids.
J Allergy Clin Immunol Pract 2014 Sep-Oct;2(5):607-13. doi: 10.1016/j.jaip.2014.05.009..
Keywords: Comparative Effectiveness, Medication, Children/Adolescents, Asthma, Risk
Thacker EL, Muntner P, Zhao H
Claims-based algorithms for identifying Medicare beneficiaries at high estimated risk for coronary heart disease events: a cross-sectional study.
The researchers sought to develop claims-based algorithms to identify individuals at high risk for coronary artery disease (CHD) and to identify low-density lipoprotein (LDL) cholesterol among statin users at high risk for CHD events. They found that despite low sensitivity, the high predictive value of their algorithm for high risk for CHD events supports the use of claims to identify Medicare beneficiaries at high risk for CHD events.
AHRQ-funded; HS018517
Citation: Thacker EL, Muntner P, Zhao H .
Claims-based algorithms for identifying Medicare beneficiaries at high estimated risk for coronary heart disease events: a cross-sectional study.
BMC Health Serv Res. 2014 Apr 29;14:195. doi: 10.1186/1472-6963-14-195..
Keywords: Comparative Effectiveness, Medicare, Risk, Cardiovascular Conditions, Chronic Conditions
Jonsson Funk M, Visco AG, Weidner AC
Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse.
This study estimated the rate of repeat surgery after vaginal mesh versus native tissue repair for anterior vaginal wall prolapse. The researchers found that the overall risk of any future surgery was higher in the women receiving mesh; however, native tissue and vaginal mesh surgery had similar 5-year risks for recurrent prolapse.
AHRQ-funded; HS017950
Citation: Jonsson Funk M, Visco AG, Weidner AC .
Long-term outcomes of vaginal mesh versus native tissue repair for anterior vaginal wall prolapse.
Int Urogynecol J. 2013 Aug;24(8):1279-85. doi: 10.1007/s00192-013-2043-9..
Keywords: Comparative Effectiveness, Surgery, Women, Outcomes, Risk