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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 25 of 61 Research Studies DisplayedKahwati LC, Kelly BJ, Johnson M
End-user understanding of qualitative comparative analysis used within evidence synthesis: a mixed-methods study.
This study’s purpose was to identify effective approaches to communicating results from a qualitative comparative analysis (QCA) within a systematic review. Interviews with 11 end-users followed by a randomized experiment with 254 participants provided QCA results for a hypothetical review presented through three formats (text, table, and figure). The authors observed a significant different in subjective comprehension across three presentation formats, with figure and text formats scoring higher compared to the table. Overall, there were no significant different for objective comprehension. However, interpretation (a unique component of QCA results) scores among participants that received the figure format were significantly higher than scores for participants who received the text or table. No significant differences were observed in objective comprehension for configuration interpretation.
AHRQ-funded; HS026258.
Citation: Kahwati LC, Kelly BJ, Johnson M .
End-user understanding of qualitative comparative analysis used within evidence synthesis: a mixed-methods study.
Res Synth Methods 2023 Mar;14(2):180-92. doi: 10.1002/jrsm.1602.
Keywords: Comparative Effectiveness, Evidence-Based Practice, Research Methodologies
Kumamaru H, Jalbert JJ, Nguyen LL
Utility of automated data-adaptive propensity score method for confounding by indication in comparative effectiveness study in real world Medicare and registry data.
The authors assessed the utility of an automated data-adaptive analytic approach for confounding adjustment when both claims and clinical registry data are available. Using a comparative study example of carotid artery stenting vs. carotid endarterectomy with strong confounding by indication, they found that the automated data-adaptive propensity score performed better than the investigator-specified propensity score in general, but both claims and registry data were needed to adequately control for bias.
AHRQ-funded; 29020050016I.
Citation: Kumamaru H, Jalbert JJ, Nguyen LL .
Utility of automated data-adaptive propensity score method for confounding by indication in comparative effectiveness study in real world Medicare and registry data.
PLoS One 2022 Aug;17(8):e0272975. doi: 10.1371/journal.pone.0272975..
Keywords: Registries, Comparative Effectiveness, Research Methodologies, Patient-Centered Outcomes Research, Evidence-Based Practice
Reid E, JM JM, Fiordalisi C
AHRQ Author: Chang S
NxGen evidence: redesigning the Agency for Healthcare Research and Quality Effective Health Care website to promote engagement, interactivity and usability of systematic reviews.
This Brief Methods Note critiques the current paper-based format for systematic reviews and describes the development of a next generation (NxGen) AHRQ EPC Effective Health Care website. The authors suggest that this redesigned platform will allow end-users of all types to find and share the evidence they need through data visualizations and other interactive displays. Several design principles guided the development of NxGen to make systematic review findings more accessible, customizable, adaptable, interactive, and shareable.
AHRQ-authored; AHRQ-funded; 290201700003C.
Citation: Reid E, JM JM, Fiordalisi C .
NxGen evidence: redesigning the Agency for Healthcare Research and Quality Effective Health Care website to promote engagement, interactivity and usability of systematic reviews.
Res Synth Methods 2021 Jan;12(1):118-23. doi: 10.1002/jrsm.1438..
Keywords: Research Methodologies, Evidence-Based Practice, Patient-Centered Outcomes Research, Comparative Effectiveness
Riggs K, Richman J, Kertesz S
Trial design for ineffectiveness research: a mixed-methods survey.
High-quality research demonstrating a lack of effectiveness may facilitate the 'de-adoption' of ineffective health services. However, there has been little debate on the optimal design for ineffectiveness research-studies exploring the research hypothesis that an intervention is ineffective. The aim of this study was to explore investigators' preferences for trial design for ineffectiveness research. The investigators conducted a mixed-methods online survey with principle investigators identified from clinicaltrials.gov.
AHRQ-funded; HS023009.
Citation: Riggs K, Richman J, Kertesz S .
Trial design for ineffectiveness research: a mixed-methods survey.
BMJ Evid Based Med 2020 Aug;25(4):143-44. doi: 10.1136/bmjebm-2019-111276..
Keywords: Research Methodologies, Comparative Effectiveness, Evidence-Based Practice
Thomas LE, Yang S, Wojdyla D
Matching with time-dependent treatments: a review and look forward.
Observational studies of treatment effects attempt to mimic a randomized experiment by balancing the covariate distribution in treated and control groups, thus removing biases related to measured confounders. In this paper, the authors define a class of longitudinal matching methods and provide a review of existing variations, with guidance regarding study design, execution, and analysis. They identify avenues for future research and highlight the relevance of this methodology to high-quality comparative effectiveness studies in the era of big data.
AHRQ-funded; HS24310.
Citation: Thomas LE, Yang S, Wojdyla D .
Matching with time-dependent treatments: a review and look forward.
Stat Med 2020 Jul;39(17):2350-70. doi: 10.1002/sim.8533..
Keywords: Research Methodologies, Evidence-Based Practice, Comparative Effectiveness
Toh S
Analytic and data sharing options in real-world multi-database studies of comparative effectiveness and safety of medical products.
A wide range of analytic and data sharing options are available in non-experimental multi-database studies designed to assess the real-world benefits and risks of medical products. This article reviewed available analytic and data sharing options and discussed key scientific and practical considerations when choosing among these options in multi-database studies of comparative effectiveness and safety of medical products.
AHRQ-funded; HS026214.
Citation: Toh S .
Analytic and data sharing options in real-world multi-database studies of comparative effectiveness and safety of medical products.
Clin Pharmacol Ther 2020 Apr;107(4):834-42. doi: 10.1002/cpt.1754..
Keywords: Patient-Centered Outcomes Research, Research Methodologies, Comparative Effectiveness
Gates A, Guitard S, Pillay J
Performance and usability of machine learning for screening in systematic reviews: a comparative evaluation of three tools.
Researchers explored the performance of three machine learning tools designed to facilitate title and abstract screening in systematic reviews (SRs) when used to eliminate irrelevant records and complement the work of a single reviewer. Using Abstrackr, DistillerSR, and RobotAnalyst, they found that the workload savings afforded in the automated simulation came with increased risk of missing relevant records. Supplementing a single reviewer's decisions with relevance predictions sometimes reduced the proportion missed, but performance varied by tool and SR. They recommend designing tools based on reviewers' self-identified preferences to improve compatibility with present workflows.
AHRQ-funded; 290201500001I.
Citation: Gates A, Guitard S, Pillay J .
Performance and usability of machine learning for screening in systematic reviews: a comparative evaluation of three tools.
Syst Rev 2019 Nov 15;8(1):278. doi: 10.1186/s13643-019-1222-2..
Keywords: Patient-Centered Outcomes Research, Health Services Research (HSR), Research Methodologies, Evidence-Based Practice, Comparative Effectiveness
Wheatley LM, Wood R, Nadeau K
Mind the gaps: clinical trial concepts to address unanswered questions in aeroallergen immunotherapy-an NIAID/AHRQ workshop.
A joint AHRQ and National Institute of Allergy and Infectious Diseases (NIAAD) workshop was held to develop trial concepts that could improve the use and effectiveness of aeroallergen immunotherapy (AAIT). Four different expert groups were formed to propose different study designs. These study designs would create clinical trials of long duration and would need highly characterized patient populations.
AHRQ-funded; 290200710061I.
Citation: Wheatley LM, Wood R, Nadeau K .
Mind the gaps: clinical trial concepts to address unanswered questions in aeroallergen immunotherapy-an NIAID/AHRQ workshop.
J Allergy Clin Immunol 2019 May;143(5):1711-26. doi: 10.1016/j.jaci.2019.01.032..
Keywords: Asthma, Comparative Effectiveness, Evidence-Based Practice, Prevention, Research Methodologies, Respiratory Conditions
Natafgi N, Tafari AT, Chauhan C
Patients' early engagement in research proposal development (PEER-PD): patients guiding the proposal writing.
Patient engagement often starts after research funding is secured with little or no involvement of patients in the proposal development phase. This paper compared three levels of patient engagement and described patients' early engagement in the research proposal development process and its contemporary relevance to clinical and translational research. The paper also addressed key patient considerations and questions that had an impact on the proposal development.
AHRQ-funded; HS022135.
Citation: Natafgi N, Tafari AT, Chauhan C .
Patients' early engagement in research proposal development (PEER-PD): patients guiding the proposal writing.
J Comp Eff Res 2019 Apr;8(6):441-53. doi: 10.2217/cer-2018-0129..
Keywords: Research Methodologies, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Hsu YJ, Kosinski AS, Wallace AS
Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study.
The authors assessed the utility of using external databases for quality improvement (QI) evaluations in the context of an innovative QI collaborative aimed to reduce three infections and improve patient safety across the cardiac surgery service line. They compared changes in each outcome between 15 intervention hospitals and 52 propensity score-matched hospitals, and found that improvement trends in several outcomes among the studied intervention hospitals were not statistically different from those in comparison hospitals. They conclude that using external databases may permit comparative effectiveness assessment by providing concurrent comparison groups, additional outcome measures, and longer follow-up.
AHRQ-funded; HS019934.
Citation: Hsu YJ, Kosinski AS, Wallace AS .
Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study.
J Comp Eff Res 2019 Jan;8(1):21-32. doi: 10.2217/cer-2018-0051..
Keywords: Patient Safety, Quality Improvement, Quality Indicators (QIs), Quality of Care, Surgery, Cardiovascular Conditions, Comparative Effectiveness, Data, Hospitals, Research Methodologies, Patient-Centered Outcomes Research
Ma X, Lin L, Qu Z
Performance of between-study heterogeneity measures in the Cochrane Library.
The growth in comparative effectiveness research and evidence-based medicine has increased attention to systematic reviews and meta-analyses. Assessing heterogeneity is critical for performing a meta-analysis and interpreting results. This article evaluates two heterogeneity measures. To evaluate these measures' performance empirically, the investigators applied them to 20,599 meta-analyses in the Cochrane Library.
AHRQ-funded; HS024743.
Citation: Ma X, Lin L, Qu Z .
Performance of between-study heterogeneity measures in the Cochrane Library.
Epidemiology 2018 Nov;29(6):821-24. doi: 10.1097/ede.0000000000000857..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Simon KC, Tideman S, Hillman L
Design and implementation of pragmatic clinical trials using the electronic medical record and an adaptive design.
The purpose of this study was to demonstrate the feasibility of pragmatic clinical trials comparing the effectiveness of treatments using the electronic medical record (EMR) and an adaptive assignment design. The authors suggest that the demonstration of successful pragmatic clinical trials based on a customized EMR and adaptive design is an important next step in achieving personalized medicine and provides a framework for future studies of comparative effectiveness.
AHRQ-funded; HS024057.
Citation: Simon KC, Tideman S, Hillman L .
Design and implementation of pragmatic clinical trials using the electronic medical record and an adaptive design.
JAMIA Open 2018 Jul;1(1):99-106. doi: 10.1093/jamiaopen/ooy017..
Keywords: Comparative Effectiveness, Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, System Design
Tian L, Fu H, Ruberg SJ
Efficiency of two sample tests via the restricted mean survival time for analyzing event time observations.
This article assesses the relative efficiency of the hazard ratio (HR) and restricted means survival time or t-year mean survival time (t-MST) tests with respect to the statistical power under various proportional hazards (PH) and non-PH models, both theoretically and empirically. The results indicate that when the PH assumption is valid, the t-MST test performs almost as well as the HR test, but for non-PH models, the t-MST test can substantially outperform its HR counterpart. The authors discuss issues and implications regarding their sample tests.
AHRQ-funded; HS022193.
Citation: Tian L, Fu H, Ruberg SJ .
Efficiency of two sample tests via the restricted mean survival time for analyzing event time observations.
Biometrics 2018 Jun;74(2):694-702. doi: 10.1111/biom.12770..
Keywords: Comparative Effectiveness, Research Methodologies
Hoffman SR, Vines AI, Halladay JR
Optimizing research in symptomatic uterine fibroids with development of a computable phenotype for use with electronic health records.
The objective of the study was to develop an electronic health record-based algorithm to identify women with symptomatic uterine fibroids for a comparative effectiveness study of medical or surgical treatments on quality-of-life measures. The study concluded that an electronic health record-based algorithm is capable of identifying cases of symptomatic uterine fibroids with moderate positive predictive value and may be an efficient approach for large-scale study recruitment.
AHRQ-funded; HS023418.
Citation: Hoffman SR, Vines AI, Halladay JR .
Optimizing research in symptomatic uterine fibroids with development of a computable phenotype for use with electronic health records.
Am J Obstet Gynecol 2018 Jun;218(6):610.e1-10.e7. doi: 10.1016/j.ajog.2018.02.002..
Keywords: Comparative Effectiveness, Electronic Health Records (EHRs), Research Methodologies, Women
Horiguchi M, Tian L, Uno H
Quantification of long-term survival benefit in a comparative oncology clinical study.
The authors discuss the quantification of long-term survival benefit in a comparative oncology clinical study. They assert that from the perspective of cost-risk-benefit, using a long-term survival benefit criterion for selecting anticancer therapies may be more appropriate.
AHRQ-funded; HS022193.
Citation: Horiguchi M, Tian L, Uno H .
Quantification of long-term survival benefit in a comparative oncology clinical study.
JAMA Oncol 2018 Jun;4(6):881-82. doi: 10.1001/jamaoncol.2018.0518..
Keywords: Cancer, Comparative Effectiveness, Outcomes, Research Methodologies
Lou Y, Cao J, Zhang S
Sample size calculations for time-averaged difference of longitudinal binary outcomes.
In this study, the researchers investigated sample size calculation for the comparison of time-averaged responses between treatment groups in clinical trials with longitudinally observed binary outcomes. Their simulation showed that the nominal power and type I error are well preserved over a wide range of design parameters. The researchers believe that theirs is the first study to consider the mixture of missing patterns in sample size calculation.
AHRQ-funded; HS022418.
Citation: Lou Y, Cao J, Zhang S .
Sample size calculations for time-averaged difference of longitudinal binary outcomes.
Commun Stat Theory Methods 2017;46(1):344-53. doi: 10.1080/03610926.2014.991040.
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Keywords: Research Methodologies, Comparative Effectiveness, Outcomes
Butler M, Epstein RA, Totten A
AHRQ series on complex intervention systematic reviews-paper 3: adapting frameworks to develop protocols.
This article identifies and describes elements of frameworks and how they can be adapted to inform the protocol and conduct of systematic reviews of complex interventions. Possible approaches to analytic frameworks for complex interventions that illustrate causal and associative linkages are outlined, including time elements, which systematic reviews of complex interventions may need to address.
AHRQ-funded; 290201200004C; 290201500008I; 290201500005I; 290201500006I; 290201500010I.
Citation: Butler M, Epstein RA, Totten A .
AHRQ series on complex intervention systematic reviews-paper 3: adapting frameworks to develop protocols.
J Clin Epidemiol 2017 Oct;90:19-27. doi: 10.1016/j.jclinepi.2017.06.013.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Braun D, Gorfine M, Parmigiani G
Propensity scores with misclassified treatment assignment: a likelihood-based adjustment.
The researchers show that misclassification of treatment assignment can impact three distinct stages of a propensity score analysis. They examine how error in the treatment assignment impacts each stage in the context of three common propensity score implementations: subclassification, matching, and inverse probability of treatment weighting (IPTW). They propose a two-step likelihood-based approach which fully adjusts for treatment misclassification bias under subclassification
AHRQ-funded; HS021991.
Citation: Braun D, Gorfine M, Parmigiani G .
Propensity scores with misclassified treatment assignment: a likelihood-based adjustment.
Biostatistics 2017 Oct 1;18(4):695-710. doi: 10.1093/biostatistics/kxx014.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Landsittel DP, Kessler L, Schmid CH
Training in patient-centered outcomes research for specific researcher communities.
A number of publications have discussed approaches to training the scientific workforce in comparative effectiveness research (CER) and patient-centered outcomes research (PCOR). To extend these efforts into specific researcher communities, the AHRQ developed a Funding Opportunity Announcement that called for training for a specific researcher community in collaboration with associated program partners. This paper describes the strategies developed by the 5 subsequently funded programs, and the challenges associated with developing in-person and online programs.
AHRQ-funded; HS023214; HS023199; HS023299; HS023207; HS023185.
Citation: Landsittel DP, Kessler L, Schmid CH .
Training in patient-centered outcomes research for specific researcher communities.
J Clin Transl Sci 2017 Oct;1(5):278-84. doi: 10.1017/cts.2017.307.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies, Training
Garcia-Albeniz X, Hsu J, Hernan MA
The value of explicitly emulating a target trial when using real world evidence: an application to colorectal cancer screening.
Researchers reviewed a recent observational analysis that explicitly emulated a target trial of screening colonoscopy using insurance claims from U.S. Medicare. They then compared this explicit emulation with alternative, simpler observational analyses. This empirical comparison suggests that lack of an explicit emulation of the target trial leads to biased estimates, and shows that allowing for repeated eligibility increases the statistical efficiency of the estimates.
AHRQ-funded; HS023128.
Citation: Garcia-Albeniz X, Hsu J, Hernan MA .
The value of explicitly emulating a target trial when using real world evidence: an application to colorectal cancer screening.
Eur J Epidemiol 2017 Jun;32(6):495-500. doi: 10.1007/s10654-017-0287-2.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Comparative Effectiveness, Evidence-Based Practice, Research Methodologies
Zhang S, Cao J, Ahn C
Inference and sample size calculation for clinical trials with incomplete observations of paired binary outcomes.
The researchers investigated the estimation of intervention effect and sample size determination for experiments where subjects are supposed to contribute paired binary outcomes with some incomplete observations. They theoretically prove that if incomplete data are evenly distributed between the pre-intervention and post-intervention periods, the proposed estimator will always be more efficient than the traditional estimator.
AHRQ-funded; HS022418.
Citation: Zhang S, Cao J, Ahn C .
Inference and sample size calculation for clinical trials with incomplete observations of paired binary outcomes.
Stat Med 2017 Feb 20;36(4):581-91. doi: 10.1002/sim.7168.
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Keywords: Research Methodologies, Treatments, Comparative Effectiveness
Wang WJ, Robertson JC, Basu A
Burden of illness and research investments in translational sciences for pharmaceuticals in metastatic cancers.
This study explored whether investments in translational sciences for six metastatic cancers follow idiosyncratic returns to those investments rather than levels of burden of illness (BI). It concluded that investments in trials were positively associated only with contemporary changes in BI (2008-2014). The relationship was stronger for government-sponsored comparative-effectiveness trials than for industry.
AHRQ-funded; HS022982.
Citation: Wang WJ, Robertson JC, Basu A .
Burden of illness and research investments in translational sciences for pharmaceuticals in metastatic cancers.
J Comp Eff Res 2017 Jan;6(1):15-24. doi: 10.2217/cer-2016-0021.
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Keywords: Cancer, Comparative Effectiveness, Medication, Research Methodologies
Dagne GA, Brown CH, Howe G
Testing moderation in network meta-analysis with individual participant data.
The authors extended existing network methods for main effects to examining moderator effects. They further studied how the use of individual participant data may increase the sensitivity of network meta-analysis (NMA) for detecting moderator effects. They proposed a new NMA diagram and applied it to data from a classroom-based randomized study that involved two sub-trials, each comparing interventions that were contrasted with separate control groups.
AHRQ-funded; HS020263.
Citation: Dagne GA, Brown CH, Howe G .
Testing moderation in network meta-analysis with individual participant data.
Stat Med 2016 Jul 10;35(15):2485-502. doi: 10.1002/sim.6883.
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Keywords: Comparative Effectiveness, Data, Research Methodologies
Kahwati L, Viswanathan M, Golin CE
Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.
The researchers aimed to extend the results from an existing systematic review of interventions to improve medication adherence by using qualitative comparative analysis (QCA) to identify necessary or sufficient configurations of behavior change techniques among effective interventions. They were able to identify seven configurations of behavior change techniques sufficient for improving adherence, which together accounted for 26 (76 percent) of the effective studies.
AHRQ-funded; HS022563.
Citation: Kahwati L, Viswanathan M, Golin CE .
Identifying configurations of behavior change techniques in effective medication adherence interventions: a qualitative comparative analysis.
Syst Rev 2016 May 4;5:83. doi: 10.1186/s13643-016-0255-z.
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Keywords: Medication, Patient Adherence/Compliance, Research Methodologies, Comparative Effectiveness, Behavioral Health
Kahwati L, Jacobs S, Kane H
Using qualitative comparative analysis in a systematic review of a complex intervention.
The objective of this study was to describe in detail and examine the suitability of using qualitative comparative analysis (QCA) within the context of a systematic review. It concluded that QCA was suitable for use within a systematic review of medication adherence interventions and offered insights beyond the single dimension stratifications used in the original completed review.
AHRQ-funded; HS022563.
Citation: Kahwati L, Jacobs S, Kane H .
Using qualitative comparative analysis in a systematic review of a complex intervention.
Syst Rev 2016 May 4;5:82. doi: 10.1186/s13643-016-0256-y.
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Keywords: Medication, Patient Adherence/Compliance, Research Methodologies, Comparative Effectiveness, Behavioral Health