National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (3)
- Adverse Events (3)
- Ambulatory Care and Surgery (1)
- Arthritis (3)
- Asthma (1)
- Blood Thinners (5)
- Cardiovascular Conditions (7)
- Children/Adolescents (1)
- Comparative Effectiveness (1)
- Elderly (1)
- Emergency Department (2)
- Evidence-Based Practice (2)
- Guidelines (1)
- Health Information Technology (HIT) (2)
- Heart Disease and Health (7)
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- (-) Medication (16)
- Medication: Safety (1)
- Newborns/Infants (2)
- Outcomes (3)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Patient Safety (3)
- Practice Patterns (2)
- Prevention (1)
- Quality Improvement (1)
- Quality of Care (1)
- (-) Registries (16)
- Risk (1)
- Sepsis (1)
- Stroke (2)
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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 16 of 16 Research Studies DisplayedMohr NM, Pape SG, Runde D
Etomidate use is associated with less hypotension than ketamine for emergency department sepsis intubations: a NEAR cohort study.
The objectives of this study were to describe the current use of etomidate and other induction agents in patients with sepsis and to compare adverse events between etomidate and ketamine in sepsis. Using the National Emergency Airway Registry data set, findings showed that etomidate is used less frequently in sepsis patients than in non-sepsis patients, with ketamine being the most frequently used alternative. Further, ketamine was associated with more postprocedural hypotension than etomidate. Recommendations included future clinical trials to determine the optimal induction agent in patients with sepsis.
AHRQ-funded; HS025753.
Citation: Mohr NM, Pape SG, Runde D .
Etomidate use is associated with less hypotension than ketamine for emergency department sepsis intubations: a NEAR cohort study.
Acad Emerg Med 2020 Nov;27(11):1140-49. doi: 10.1111/acem.14070..
Keywords: Medication, Sepsis, Emergency Department, Registries, Adverse Drug Events (ADE), Adverse Events
Jackson LR, Kim S, Blanco R
Discontinuation rates of warfarin versus direct acting oral anticoagulants in US clinical practice: results from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II).
The objective of this study was to evaluate discontinuation rates among patients on warfarin and direct oral anticoagulants (DOACs) in clinical practice. Over 10,000 AF patients were enrolled from the ORBIT-AF II Registry as subjects. Findings showed that, in a community based atrial fibrillation cohort, adjusted rates of discontinuation at 12 months were higher in DOAC-treated versus vitamin K antagonist-treated patients. Discontinuation of oral anticoagulation was associated with increased absolute risk of all-cause mortality and cardiovascular death.
AHRQ-funded; HS021092.
Citation: Jackson LR, Kim S, Blanco R .
Discontinuation rates of warfarin versus direct acting oral anticoagulants in US clinical practice: results from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II).
Am Heart J 2020 Aug;226:85-93. doi: 10.1016/j.ahj.2020.04.016..
Keywords: Blood Thinners, Medication, Registries, Stroke, Heart Disease and Health, Cardiovascular Conditions, Outcomes
Hansen JE, Brown DW, Hanke SP
Angiotensin-converting enzyme inhibitor prescription for patients with single ventricle physiology enrolled in the NPC-QIC registry.
This study examined trends in the routine use of angiotension-converting enzyme inhibitors (ACEI) during palliation of hypoplastic left heart syndrome, which is considered controversial. The authors used patients enrolled in the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) registry from 2008 to 2016 who had been prescribed ACEI between stage 1 palliation (stage I Norwood procedure) discharge and stage 2 palliation (stage II superior cavopulmonary anastomosis procedure) admission. ACEI prescriptions declined from 45% in the pre-2010 period to 36.8% from 2011 to 2016. No difference was found in interstage mortality, change in atrioventricular valve regurgitation, or change in ventricular dysfunction between groups. Atrioventricular septal defect, and preoperative mechanical ventilation were associated with increased ACEI prescription.
AHRQ-funded; HS021114.
Citation: Hansen JE, Brown DW, Hanke SP .
Angiotensin-converting enzyme inhibitor prescription for patients with single ventricle physiology enrolled in the NPC-QIC registry.
J Am Heart Assoc 2020 May 18;9(10):e014823. doi: 10.1161/jaha.119.014823..
Keywords: Newborns/Infants, Medication, Heart Disease and Health, Cardiovascular Conditions, Practice Patterns, Registries, Quality Improvement, Quality of Care
Johnson MD, Zorc JJ, Nelson DS
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
Researchers examined the use, efficacy, and safety of intravenous magnesium sulfate (IVMg) in children with asthma whose emergency department (ED) management is recorded in the Pediatric Emergency Care Applied Research Network (PECARN) Registry. They found that, in PECARN Registry EDs, administration of IVMg occurred late in ED treatment, for a minority of the children likely to benefit, with variation between sites, which suggested the current clinical role for IVMg in preventing hospitalization was limited. Discharge after IVMg administration would likely be safe. They recommended further research to assess the efficacy and safety of early IVMg administration.
AHRQ-funded; HS020270.
Citation: Johnson MD, Zorc JJ, Nelson DS .
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
J Pediatr 2020 May;220:165-74.e2. doi: 10.1016/j.jpeds.2020.01.062..
Keywords: Children/Adolescents, Asthma, Medication, Emergency Department, Registries, Treatments, Patient Safety, Medication: Safety
Ozawa Y, Ades A, Foglia EE
Premedication with neuromuscular blockade and sedation during neonatal intubation is associated with fewer adverse events.
This study assessed the impact of using sedation with neuromuscular blockade in non-emergency tracheal intubation of neonates. The retrospective cohort was from infants in neonatal intensive care units (NICUs) participating the National Emergency Airway Registry for Neonates from 2014 to 2017. There was less adverse events associated with use of the neuromuscular blockade premedication.
AHRQ-funded; HS024511.
Citation: Ozawa Y, Ades A, Foglia EE .
Premedication with neuromuscular blockade and sedation during neonatal intubation is associated with fewer adverse events.
J Perinatol 2019 Jun;39(6):848-56. doi: 10.1038/s41372-019-0367-0..
Keywords: Adverse Events, Medication, Newborns/Infants, Outcomes, Patient Safety, Registries
Mentias A, Briasoulis A, Shantha G
Impact of heart failure type on thromboembolic and bleeding risk in patients with atrial fibrillation on oral anticoagulation.
Differential impact of heart failure (HF) category on thromboembolic and bleeding risk in atrial fibrillation (AF) patients on oral anticoagulation (OAC) is unknown. In this study, the investigators used Medicare data for beneficiaries with new AF diagnosed between 2011 and 2013 to identify patients with HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and no HF. The investigators concluded that in AF patients, HFrEF and HFpEF are both associated with higher risk of ischemic stroke, HF and AMI admissions, even after adjusting for OAC use, compared with patients without HF.
AHRQ-funded; HS023104.
Citation: Mentias A, Briasoulis A, Shantha G .
Impact of heart failure type on thromboembolic and bleeding risk in patients with atrial fibrillation on oral anticoagulation.
Am J Cardiol 2019 May 15;123(10):1649-53. doi: 10.1016/j.amjcard.2019.02.027..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Elderly, Patient-Centered Healthcare, Registries
Fudim M, Liu PR, Shrader P
Mineralocorticoid receptor antagonism in patients with atrial fibrillation: findings from the ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry.
Mineralocorticoid receptor antagonist (MRA) therapy may be beneficial to patients with atrial fibrillation (AF), but little is known about their use in patients with AF and subsequent outcomes. In order to better understand MRA use and subsequent outcomes, the investigators performed a retrospective cohort study of the contemporary ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry.
AHRQ-funded; HS021092.
Citation: Fudim M, Liu PR, Shrader P .
Mineralocorticoid receptor antagonism in patients with atrial fibrillation: findings from the ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation) registry.
J Am Heart Assoc 2018 Apr 13;7(8). doi: 10.1161/jaha.117.007987..
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Heart Disease and Health, Medication, Outcomes, Patient-Centered Outcomes Research, Prevention, Registries, Stroke
Lee SY, Cherian R, Ly I
Designing and implementing an electronic patient registry to improve warfarin monitoring in the ambulatory setting.
The researchers designed and implemented an electronic registry in conjunction with a complementary work flow that established an active tracking system leading to improved treatment monitoring for patients on anticoagulation therapy. For the cohort of the 357 patients in the registry, the no-show rate decreased from 31 percent (preimplementation) to 21 percent (postimplementation).
AHRQ-funded; HS023558; HS021322.
Citation: Lee SY, Cherian R, Ly I .
Designing and implementing an electronic patient registry to improve warfarin monitoring in the ambulatory setting.
Jt Comm J Qual Patient Saf 2017 Jul;43(7):353-60. doi: 10.1016/j.jcjq.2017.03.006.
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Keywords: Health Information Technology (HIT), Registries, Blood Thinners, Medication, Ambulatory Care and Surgery
Parikh KS, Lippmann SJ, Greiner M
Scope of sacubitril/valsartan eligibility after heart failure hospitalization: findings from the GWTG-HF Registry (Get With The Guidelines-Heart Failure).
Researchers used the Get With The Guidelines-Heart Failure (GWTG-HF) registry to characterize patients’ eligibility and potential barriers for sacubitril/valsartan initiation. The GWTG-HF registry was established by the American Heart Association to improve adherence to quality of care guidelines for patients hospitalized with heart failure. The FDA has approved sacubitril/valsartan for patients with heart failure with reduced ejection fraction (HFrEF); however, FDA labeling is broader than the trial entry criteria, and the scope of potential sacubitril/valsartan use in HFrEF is not well understood. Findings suggest that discharge from hospitalization from acute heart failure may be an opportunity for re-evaluating medications, including potentially switching the patient from ACEI/ARB, or starting sacubitril/valsartan.
AHRQ-funded; HS021092.
Citation: Parikh KS, Lippmann SJ, Greiner M .
Scope of sacubitril/valsartan eligibility after heart failure hospitalization: findings from the GWTG-HF Registry (Get With The Guidelines-Heart Failure).
Circulation 2017 May 23;135(21):2077-80. doi: 10.1161/circulationaha.117.027773..
Keywords: Cardiovascular Conditions, Guidelines, Heart Disease and Health, Hospitalization, Medication, Registries
Curtis JR, Bharat A, Chen L
Agreement between rheumatologist and patient-reported adherence to methotrexate in a US rheumatoid arthritis registry.
To determine the extent to which methotrexate (MTX) adherence is overestimated by rheumatologists, the researchers deployed an Internet survey to patients with rheumatoid arthritis (RA) participating in a US registry. They found that MTX use was misclassified for 13-20 percent of patients, mainly because of 1 or more missed doses rather than overt discontinuation. Clinicians should be aware of suboptimal adherence when assessing MTX response.
AHRQ-funded; HS018517.
Citation: Curtis JR, Bharat A, Chen L .
Agreement between rheumatologist and patient-reported adherence to methotrexate in a US rheumatoid arthritis registry.
J Rheumatol 2016 Jun;43(6):1027-9. doi: 10.3899/jrheum.151136.
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Keywords: Arthritis, Patient Adherence/Compliance, Medication, Registries
Pappas DA, John A, Curtis JR
Dosing of intravenous tocilizumab in a real-world setting of rheumatoid arthritis: analyses from the corrona registry.
The objective of this analysis was to describe patterns of early intravenous tocilizumab (TCZ) dose escalation in a real-world setting using data from the Corrona registry. It determined that of the 213 patients who were eligible for analysis, 86 (40.4 percent) remained on their initial dose of TCZ 4 mg/kg and 110 (51.6 percent) were escalated to TCZ 8 mg/kg by or at 3 months.
AHRQ-funded; HS018517.
Citation: Pappas DA, John A, Curtis JR .
Dosing of intravenous tocilizumab in a real-world setting of rheumatoid arthritis: analyses from the corrona registry.
Rheumatol Ther 2016 Jun;3(1):103-15. doi: 10.1007/s40744-016-0028-0.
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Keywords: Arthritis, Medication, Registries
Newhall KA, Saunders EC, Larson RJ
Use of protamine for anticoagulation during carotid endarterectomy: a meta-analysis.
The researchers reviewed the evidence for and against protamine use at the conclusion of carotid endarterectomy (CEA), both in its association with increased thrombotic complications and with decreased bleeding. They concluded that based on available evidence, the use of protamine following CEA is associated with a reduction in bleeding complications, without increasing major thrombotic outcomes, including stroke, myocardial infarction, or death.
AHRQ-funded; HS021581.
Citation: Newhall KA, Saunders EC, Larson RJ .
Use of protamine for anticoagulation during carotid endarterectomy: a meta-analysis.
JAMA Surg 2016 Mar;151(3):247-55. doi: 10.1001/jamasurg.2015.3592.
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Keywords: Medication, Adverse Drug Events (ADE), Registries, Cardiovascular Conditions
Kavanaugh A, Lee SJ, Curtis JR
Discontinuation of tumour necrosis factor inhibitors in patients with rheumatoid arthritis in low-disease activity: persistent benefits. Data from the Corrona registry.
There is increasing interest in discontinuing biological therapies for patients with rheumatoid arthritis achieving good clinical responses, provided patients maintain clinical benefit. Using data from the Corrona registry, the investigators found that discontinuation of a first course of tumour necrosis factor inhibitor may be associated with persistent clinical benefit. Half of the registry patients included in the study maintained response through 20 months.
AHRQ-funded; HS018517.
Citation: Kavanaugh A, Lee SJ, Curtis JR .
Discontinuation of tumour necrosis factor inhibitors in patients with rheumatoid arthritis in low-disease activity: persistent benefits. Data from the Corrona registry.
Ann Rheum Dis 2015 Jun;74(6):1150-5. doi: 10.1136/annrheumdis-2014-206435.
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Keywords: Medication, Patient-Centered Outcomes Research, Registries, Arthritis
Ayvaz S, Horn J, Hassanzadeh O
Toward a complete dataset of drug-drug interaction information from publicly available sources.
The researchers combined all the publicly available sources of potential drug-drug interaction information using a common data model after conducting a comprehensive and broad search. They examined the overlap between and across the data sources. Their analysis determined that there was little overlap and that there is heterogeneity between the information provided by each source.
AHRQ-funded; HS019461.
Citation: Ayvaz S, Horn J, Hassanzadeh O .
Toward a complete dataset of drug-drug interaction information from publicly available sources.
J Biomed Inform 2015 Jun;55:206-17. doi: 10.1016/j.jbi.2015.04.006..
Keywords: Medication, Patient Safety, Registries, Health Information Technology (HIT)
O'Brien EC, Holmes DN, Ansell JE
Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.
This study describes the frequencies of and factors associated with oral anticoagulation (OAC) contraindications in clinical practice for patients with atrial fibrillation (AF). Contraindications to OAC therapy among patients with AF are common but subjective. Many patients with reported contraindications were receiving OAC, suggesting that the perceived benefits outweighed the potential harm posed by the relative contraindication.
AHRQ-funded; HS021092
Citation: O'Brien EC, Holmes DN, Ansell JE .
Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry.
Am Heart J. 2014 Apr;167(4):601-609.e1. doi: 10.1016/j.ahj.2013.12.014..
Keywords: Heart Disease and Health, Blood Thinners, Medication, Registries, Cardiovascular Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Practice Patterns
Eapen ZJ, Grau-Sepulveda MV, Fonarow GC
Prescribing warfarin at discharge for heart failure patients: findings from the Get With The Guidelines-Heart Failure Registry
The researchers used data from a heart failure (HF) registry to determine the prevalence and variation, as well as patient characteristics, in warfarin prescription among real-world HF population. They found that warfarin was prescribed at discharge for more than 1 out of 10 patients hospitalized for HF without evident indications or contraindications for anticoagulation.
AHRQ-funded; HS021092
Citation: Eapen ZJ, Grau-Sepulveda MV, Fonarow GC .
Prescribing warfarin at discharge for heart failure patients: findings from the Get With The Guidelines-Heart Failure Registry
Int J Cardiol. 2014 Mar 15;172(2):e322-3. doi: 10.1016/j.ijcard.2013.12.161..
Keywords: Heart Disease and Health, Registries, Comparative Effectiveness, Blood Thinners, Medication