National Healthcare Quality and Disparities Report
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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 88 Research Studies DisplayedFeltner C, Wallace IF, Nowell SW
Screening for speech and language delay and disorders in children 5 years or younger: evidence report and systematic review for the US Preventive Services Task Force.
This evidence report and systematic review reviewed the evidence on screening for speech and language delay or disorders in children 5 years or younger to inform the US Preventive Services Task Force. This literature review looked at English-language studies of screening test accuracy, trials or cohort studies comparing screening vs no screening; randomized clinical trials (RCTs) of interventions. Main outcomes and measures were screening test accuracy, speech and language outcomes, school performance, function, quality of life, and harms. A total of 38 studies in 41 articles were included (N = 9006). There were 21 studies (n = 7489) that assessed the accuracy of 23 different screening tools that varied with regard to whether they were designed to be completed by parents vs trained examiners, and to screen for global (any) language problems vs specific skills (e.g., expressive language). Three studies assessing parent-reported tools for expressive language skills had consistently high sensitivity (range, 88%-93%) and specificity (range, 88%-85%). Other screening tools had widely varying accuracy. Seventeen RCTs (n = 1517) evaluated interventions for speech and language delay or disorders. There were no RCTs included on the harms of interventions.
AHRQ-funded; 75Q80120D00006.
Citation: Feltner C, Wallace IF, Nowell SW .
Screening for speech and language delay and disorders in children 5 years or younger: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2024 Jan 23; 331(4):335-51. doi: 10.1001/jama.2023.24647..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Screening, Prevention, Evidence-Based Practice
Chou R, Bougatsos C, Griffin J
Screening, referral, behavioral counseling, and preventive interventions for oral health in children and adolescents aged 5 to 17 years: a systematic review for the US Preventive Services Task Force.
The purpose of this study was to conduct a systematic evidence review on the effectiveness of primary care screening and prevention of dental caries in children and adolescents aged 5 to 17 years to inform the US Preventive Services Task Force. The main outcomes were dental caries, morbidity, functional status, quality of life, harms; and diagnostic test accuracy. Three systematic reviews with a total of 20,684 participants were included along with 19 randomized clinical trials, 3 nonrandomized trials, and 1 observational study with a total of 15,026 participants. When administered by dental professionals or in school settings, fluoride supplements compared with placebo or no intervention were associated with decreased change from baseline in the number of decayed, missing, or filled permanent teeth (DMFT index) or decayed or filled permanent teeth (DFT index) at 1.5 to 3 years (6 trials; n = 1395). Fluoride gels were associated with a DMFT- or DFT-prevented fraction of 0.18 at outcomes closest to 3 years (4 trials; n = 1525); fluoride varnish was associated with a DMFT- or DFT-prevented fraction of 0.44 at 1 to 4.5 years (5 trials; n = 3902); and resin-based sealants were associated with decreased risk of carious first molars at 48 to 54 months (4 trials; n = 440). There were no trials that evaluated primary care counseling or dental referral. There was very limited evidence on screening accuracy, silver diamine fluoride, xylitol; and harms were very limited, although serious harms were not reported.
AHRQ-funded; 75Q80120D00006.
Citation: Chou R, Bougatsos C, Griffin J .
Screening, referral, behavioral counseling, and preventive interventions for oral health in children and adolescents aged 5 to 17 years: a systematic review for the US Preventive Services Task Force.
JAMA 2023 Nov 7; 330(17):1674-86. doi: 10.1001/jama.2023.20435..
Keywords: Children/Adolescents, Dental and Oral Health, Screening, Prevention, Evidence-Based Practice, U.S. Preventive Services Task Force (USPSTF), Guidelines
Guirguis-Blake JM, Evans CV, Coppola EL
Screening for lipid disorders in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to examine benefits and harms of screening and treatment of pediatric dyslipidemia due to familial hypercholesterolemia (FH) and multifactorial dyslipidemia. Forty-three studies were included (n = 491,516). The study found that No RCTs directly addressed screening effectiveness and harms. Three US studies (n = 395,465) reported prevalence of phenotypically defined FH of 0.2% to 0.4% (1:250 to 1:500). Five studies (n = 142,257) reported multifactorial dyslipidemia prevalence; the prevalence of elevated total cholesterol level was 7.1% to 9.4% and of any lipid abnormality was 19.2%. Ten RCTs in children and adolescents with FH (n = 1,230) demonstrated that statins were related with an 81- to 82-mg/dL higher mean reduction in levels of total cholesterol and LDL-C compared with placebo at up to 2 years. Nonstatin-drug trials showed statistically significant lowering of lipid levels in FH populations, but few studies were available for any single drug. Observational studies indicate that starting statin treatment for FH in childhood or adolescence decreases long-term cardiovascular disease risk. Two multifactorial dyslipidemia behavioral counseling trials (n = 934) showed 3- to 6-mg/dL greater reductions in total cholesterol levels compared with the control group, but findings did not continue at longest follow-up. Harms reported in the short-term drug trials were similar in the intervention and control groups.
AHRQ-funded; 75Q80120D00004.
Citation: Guirguis-Blake JM, Evans CV, Coppola EL .
Screening for lipid disorders in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Jul 18; 330(3):261-74. doi: 10.1001/jama.2023.8867..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Prevention, Evidence-Based Practice, Guidelines, Children/Adolescents
Ahmad FA, Chan P, McGovern C
Adapting an electronic STI risk assessment program for use in pediatric primary care.
This study’s goal was to evaluate the usability of an electronic risk assessment tool to support sexually transmitted disease (STI) testing in the authors’ pediatric emergency department that they had previously designed and implemented. They conducted qualitative interviews of pediatricians, clinic staff, and adolescents from 4 pediatric practices as part of a study whose goal is to ultimately implement STI screening in pediatric primary care. The goal of the interviews was (1) to understand contextual factors related to STI screening in primary care, which they reported previously, and (2) to obtain feedback on their electronic platform, the questionnaire content, and their perspective on implementing it in primary care settings. They received quantitative feedback using the System Usability Scale (SUS). The SUS is a validated, reliable tool to measure the usability of hardware, software, websites, and applications, with a score of 68 (range 0-100) being average usability. They recruited 14 physicians, 9 clinic staff, and 12 adolescents. Participants rated the tool with a median score of 92.5, which shows a high level of usability.
AHRQ-funded; HS026704.
Citation: Ahmad FA, Chan P, McGovern C .
Adapting an electronic STI risk assessment program for use in pediatric primary care.
J Prim Care Community Health 2023 Jan-Dec; 14:21501319231172900. doi: 10.1177/21501319231172900..
Keywords: Children/Adolescents, Sexual Health, Infectious Diseases, Primary Care, Health Information Technology (HIT), Screening, Prevention
McNeil JC, Sommer LM, Vallejo JG
Going back in time: Increasing penicillin susceptibility among methicillin-susceptible staphylococcus aureus osteoarticular infections in children.
Researchers investigated the prevalence of penicillin susceptibility (PSSA) among pediatric methicillin susceptible S. aureus (MSSA) acute hematogenous osteoarticular infection (OAI) isolates; the isolates were obtained through surveillance studies at Texas Children's and St. Louis Children's Hospitals. Overall, PSSA isolates were found to be associated with a similar clinical presentation as penicillin-resistant isolates. The researchers concluded that potential for use of penicillin treatment in PSSA OAI merits further study.
AHRQ-funded; HS026896'HS021736' HS024269.
Citation: McNeil JC, Sommer LM, Vallejo JG .
Going back in time: Increasing penicillin susceptibility among methicillin-susceptible staphylococcus aureus osteoarticular infections in children.
Antimicrob Agents Chemother 2023 Jan 24; 67(1):e0119622. doi: 10.1128/aac.01196-22..
Keywords: Children/Adolescents, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Medication, Prevention
Mills J, Barnhart H
AHRQ Author: Mills J
Screening for prediabetes and type 2 diabetes in children and adolescents.
This Putting Prevention into Practice case study is used to increase understanding of the USPSTF final recommendation on screening for prediabetes and type 2 diabetes in children and adolescents. A case study was presented using a 12-year-old-patient with no specific concerns but had gained 18 pounds since their last wellness visit and lives a sedentary lifestyle. The patient’s family history of type 2 diabetes mellitus in maternal and paternal grandparents is described. Three multiple-choice questions are presented regarding harms and benefits of screening for prediabetes and type 2 diabetes for that patient.
AHRQ-authored.
Citation: Mills J, Barnhart H .
Screening for prediabetes and type 2 diabetes in children and adolescents.
Am Fam Physician 2023 Jan; 107(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Evidence-Based Practice, Guidelines, Prevention, Chronic Conditions, Case Study
Angier H, Kaufmann J, Heintzman J
Association of parent preventive care with their child's recommended well-child visits.
The purpose of this retrospective, cohort study was to explore whether there is a relationship between parent preventive care and their children's well-child visits. The researchers utilized electronic health record data to identify children and link them to parents both seen in an OCHIN network of 363 clinics from 17 states, then randomly selected a child between the ages of 3 and 17 with more than 1 ambulatory medical visit between the years 2015 and 2018. The study included a sample of 75,398 linked mother only pairs, 12,438 father only pairs, and 4,156 2-parent pairs. Children in the mother only sample had a 6% greater rate of yearly well-child visits when their mother received preventive care compared to no preventive care, children in the father only sample had a 7% greater rate of yearly well-child visits when their father received preventive care versus no preventive care, and children in the two parent sample had an 11% greater rate of yearly well-child visits when both parents received preventive care compared to neither receiving preventive care. The researchers concluded that well-child visit rates may improve when care is provided for the entire family.
AHRQ-funded; HS025962.
Citation: Angier H, Kaufmann J, Heintzman J .
Association of parent preventive care with their child's recommended well-child visits.
Acad Pediatr 2022 Nov-Dec;22(8):1422-28. doi: 10.1016/j.acap.2022.03.019..
Keywords: Children/Adolescents, Prevention, Family Health and History, Healthcare Utilization
Viswanathan M, Wallace IF, Cook Middleton J
Screening for depression and suicide risk in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors sought to review the evidence on screening for depression or suicide risk in children and adolescents to inform the US Preventive Services Task Force. They found indirect evidence that suggested some screening instruments were reasonably accurate for detecting depression. Further, psychotherapy and pharmacotherapy were associated with some benefits and no statistically significant harms for depression, but the evidence was limited for suicide risk screening instruments and interventions.
AHRQ-funded; 290201500011I.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for depression and suicide risk in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 18;328(15):1543-56. doi: 10.1001/jama.2022.16310..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Depression, Behavioral Health, Screening, Primary Care, Guidelines, Evidence-Based Practice, Prevention
Viswanathan M, Wallace IF, Cook Middleton J
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this paper was to review the evidence on screening for anxiety in children and adolescents to inform the US Preventive Services Task Force. Indirect evidence of findings suggested that some screening instruments were reasonably accurate. Cognitive behavioral therapy and pharmacotherapy were associated with benefits; no statistically significant association with harms was reported.
AHRQ-funded; 290201500011I, 75Q80120D00007.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 11;328(14):1445-55. doi: 10.1001/jama.2022.16303..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Anxiety, Behavioral Health, Primary Care, Screening, Guidelines, Evidence-Based Practice, Prevention
Jonas DE, Vander Schaaf EB, Riley S
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to explore the evidence on the benefits and harms of screening children and adolescents for prediabetes and type 2 diabetes to inform the US Preventive Services Task Force (USPSTF). The researchers utilized references; experts; literature surveillance, and PubMed/MEDLINE, Cochrane Library, and trial registries. The final review included 8 publications with 856 participants with a mean age of 14 years. The researchers found that none of the eligible studies directly assessed the benefits or harms of preventive screening. The limited eligible clinical trials reported few health outcomes and found no difference between groups.
AHRQ-funded; 290201500007I.
Citation: Jonas DE, Vander Schaaf EB, Riley S .
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Sep 13;328(10):968-79. doi: 10.1001/jama.2022.7957..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Prevention, Evidence-Based Practice, Guidelines
Isserman RS, Cheung J , Varallo D
Increasing cefazolin use for perioperative antibiotic prophylaxis in penicillin-allergic children.
The purpose of this quality improvement initiative was to increase the percentage of pediatric patients with non-severe penicillin-class allergies who receive cefazolin for antibiotic prophylaxis. The researchers included approximately 400 children in their multidisciplinary education-focused interventions, and through the initiative were able to increase the percent of eligible patients receiving cefazolin for antibiotic prophylaxis to 80%. The increase lasted through the project, and in the final month the study exceeded the study goal of 85%m with 90% of eligible patients receiving cefazolin. The researchers concluded that the initiative resulted in a considerable increase in the use of cefazolin for perioperative antibiotic prophylaxis in pediatric patients with penicillin allergies.
AHRQ-funded; HS026393.
Citation: Isserman RS, Cheung J , Varallo D .
Increasing cefazolin use for perioperative antibiotic prophylaxis in penicillin-allergic children.
Pediatrics 2022 Mar;149(3). doi: 10.1542/peds.2021-050694..
Keywords: Children/Adolescents, Antibiotics, Medication, Prevention
Kalu IC, Kao CM, Fritz SA
Management and prevention of Staphylococcus aureus infections in children.
This review article discusses management and prevention of Staphylococcus aureus infections in children. Up to 30% of children are colonized with S aureus, though infection typically does not occur without skin barrier disruption. The article discusses ways to manage infection including promptly addressing the source of infection, including sites of metastatic infection, and initiation of effective antibiotics, which should be selected based on local antibiotic susceptibility patterns. Preventive measures including optimizing hygiene and decolonization regimens for outpatients and critically ill children with prolonged hospitalizations is also discussed.
AHRQ-funded; HS024269.
Citation: Kalu IC, Kao CM, Fritz SA .
Management and prevention of Staphylococcus aureus infections in children.
Infect Dis Clin North Am 2022 Mar;36(1):73-100. doi: 10.1016/j.idc.2021.11.006..
Keywords: Children/Adolescents, Infectious Diseases, Prevention
Holland JE, Varni SE, Pulcini CD
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
This study investigated the association between adolescent and young adult (AYA) well-care visits and emergency department (ED) utilization. Vermont’s all-payer claims data for 2018 was used to evaluate visits for 49,089 AYAs (aged 12-21 years) with a health-care claim. Nearly half (49%) of AYAs who engaged with the health-care system did not have a well-care visit in 2018. Those AYAs had 24% greater odds of going to the ED at least once in 2018, controlling for age, sex, insurance type, and medical complexity. Late adolescents and young adults (aged 18-21) who did not attend a well-care visit had 47% greater odds of ED visits, middle adolescents (15-17 years) had 9% greater odds, and early adolescents (12-14 years) had 16% greater odds.
AHRQ-funded; HS024575.
Citation: Holland JE, Varni SE, Pulcini CD .
Assessing the relationship between well-care visit and emergency department utilization among adolescents and young adults.
J Adolesc Health 2022 Jan;70(1):64-69. doi: 10.1016/j.jadohealth.2021.08.011..
Keywords: Children/Adolescents, Young Adults, Emergency Department, Healthcare Utilization, Medicaid, Prevention
Bastani R, Glenn BA, Singhal R
Increasing HPV vaccination among low-income, ethnic minority adolescents: effects of a multicomponent system intervention through a county health department hotline.
The human papillomavirus (HPV) vaccine has cancer prevention benefits, yet low uptake. The purpose of the study was to evaluate an intervention intended to improve vaccine uptake in low-income, ethnic minority adolescents using a telephone hotline to seek county health department services. The researchers recruited participants through randomization of health department hotline callers who were caregivers of never-vaccinated adolescents aged 11-17. The intervention included multi-lingual print and telephone education and personalized referral to a low cost or free provider of vaccines. Participants completed baseline, 3-month, and 9-month telephone surveys. The study found that by the end of the 9-month follow up period, the HPV vaccination rates had increased, however there were no differences between the intervention (45%) and control (42%) groups. The researchers also observed significant improvements in perceived HPV knowledge, perceived HPV risk, and barriers to vaccination. The study concluded that the county hotline intervention did not produce a greater increase in HPV vaccine rates in the intervention group than the group without the intervention. The study authors recommend that future studies should evaluate interventions which are more intensive and address accessing and using services in complex, safety net settings. The authors also noted that because 44% of unvaccinated adolescents in both the intervention and control groups received at least one dose of the vaccine during the study period, investigators of future studies should be aware of the potential priming effects of participation in the study, which may impact the results of interventions.
AHRQ-funded; HS000046.
Citation: Bastani R, Glenn BA, Singhal R .
Increasing HPV vaccination among low-income, ethnic minority adolescents: effects of a multicomponent system intervention through a county health department hotline.
Cancer Epidemiol Biomarkers Prev 2022 Jan;31(1):175-82. doi: 10.1158/1055-9965.Epi-20-1578..
Keywords: Children/Adolescents, Vaccination, Low-Income, Racial and Ethnic Minorities, Sexual Health, Prevention
Chou R, Pappas M, Dana T
Screening and interventions to prevent dental caries in children younger than 5 years: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this evidence review was to update the 2014 review on dental caries screening and preventive interventions to inform the USPSTF. Findings showed no direct evidence on benefits and harms of primary care oral health screening or referral to dentist, while dietary fluoride supplementation and fluoride varnish were associated with improved caries outcomes in higher-risk children and settings.
AHRQ-funded; 290201500009I.
Citation: Chou R, Pappas M, Dana T .
Screening and interventions to prevent dental caries in children younger than 5 years: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Dec 7;326(21):2179-92. doi: 10.1001/jama.2021.15658..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Dental and Oral Health, Screening, Evidence-Based Practice, Guidelines, Prevention
Hogan PG, Parrish KL, Mork RL
HOME2 study: household versus personalized decolonization in households of children with methicillin-resistant staphylococcus aureus skin and soft tissue infection-a randomized clinical trial.
This study’s goal was to compare the effectiveness of colonization measures to prevent skin and soft tissue infection (SSTI) from Methicillin-resistant Staphylococcus aureus (MRSA) with targeted household members with prior years SSTI to decolonizing all household members to prevent infections in children. The hypothesis was that the former method would be noninferior. Upon completion of the 12-month observational Household Observation of Methicillin-resistant Staphylococcus aureus in the Environment (HOME) study, 102 households were enrolled with the follow-up HOME2 study, a 12-month randomized noninferiority trial. Households were randomized 1:1 to the personalized (targeted members) or household (all members) approaches. Participants followed a 5-day regimen of hygiene education, twice-daily intranasal mupirocin, and daily bleach-water baths. At 5 follow-up visits at participants’ homes, swabs were taken to detect S. aureus. Noninferiority of the personalized approach was established, with little difference in SSTI rates in the two household approaches.
AHRQ-funded; HS021736; HS024269.
Citation: Hogan PG, Parrish KL, Mork RL .
HOME2 study: household versus personalized decolonization in households of children with methicillin-resistant staphylococcus aureus skin and soft tissue infection-a randomized clinical trial.
Clin Infect Dis 2021 Dec 6;73(11):e4568-e77. doi: 10.1093/cid/ciaa752..
Keywords: Children/Adolescents, Methicillin-Resistant Staphylococcus aureus (MRSA), Skin Conditions, Prevention
Michelson KA, Reeves SD, Grubenhoff JA
Clinical features and preventability of delayed diagnosis of pediatric appendicitis.
In this case-control study, researchers sought to determine clinical features associated with delayed diagnosis of pediatric appendicitis, to assess the frequency of preventable delay, and to compare delay outcomes. They found that delayed appendicitis was associated with initially milder symptoms but worse outcomes. Their findings suggest that a majority of delayed diagnoses were at least possibly preventable and that many of the studied patients did not undergo indicated imaging, suggesting an opportunity to prevent delayed diagnosis of appendicitis in some children.
AHRQ-funded; HS026503.
Citation: Michelson KA, Reeves SD, Grubenhoff JA .
Clinical features and preventability of delayed diagnosis of pediatric appendicitis.
JAMA Netw Open 2021 Aug;4(8):e2122248. doi: 10.1001/jamanetworkopen.2021.22248..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Prevention
Wang ML, Minyé HM, Egan KA
Community-based sugar-sweetened beverage intervention associated with short-term improvements in self-rated oral health.
The purpose of this study was to assess the efficacy of a community-based childhood obesity prevention intervention targeting sugar-sweetened beverage (SSB) consumption on self-rated oral health among children and their parents/caregivers. The investigators found that short-term improvements in oral health among children and their parents/caregivers were observed among those participating in a SSB behavioural intervention.
AHRQ-funded; HS022242.
Citation: Wang ML, Minyé HM, Egan KA .
Community-based sugar-sweetened beverage intervention associated with short-term improvements in self-rated oral health.
Community Dent Oral Epidemiol 2021 Aug;49(4):362-68. doi: 10.1111/cdoe.12610..
Keywords: Children/Adolescents, Obesity, Dental and Oral Health, Prevention
Silverstein M, Kemper AR, Henderson JT
AHRQ Author: Mabry-Hernandez I
Importance of assessing wellbeing for United States Preventive Services Task Force recommendations.
The investigators discuss the importance of assessing wellbeing for United States Preventive Services Task Force recommendations despite the current data limitations. They discuss the pathway out of the current limitations of the data on meaningful health outcomes for child and adolescent preventive services. They assert that developing measures of subjective wellbeing for children and families and deploying them at appropriate time intervals in prevention trials offers a promising, although admittedly challenging, pathway out of the child health evidence void.
AHRQ-authored.
Citation: Silverstein M, Kemper AR, Henderson JT .
Importance of assessing wellbeing for United States Preventive Services Task Force recommendations.
Pediatrics 2021 Jul;148(Suppl 1):s37-s39. doi: 10.1542/peds.2021-050693H..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Evidence-Based Practice, Guidelines, Screening, Prevention
Mabry-Hernandez I, O'Dowd N
AHRQ Author: Mabry-Hernandez I
Screening for hepatitis B virus infection in adolescents and adults.
This AHRQ-authored Putting Prevention Into Practice (PPIP) quiz is on the Hepatitis B virus (HBV) screening U.S. Preventive Services Task Force (USPSTF) recommendation. Only three questions are included with the answers at the end of the quiz. The questions are about 1) When to screen for HBV; 2) Who are the high-risk groups for HBV; and 3) Which country has the highest prevalence of HBV infection.
AHRQ-authored.
Citation: Mabry-Hernandez I, O'Dowd N .
Screening for hepatitis B virus infection in adolescents and adults.
Am Fam Physician 2021 Apr 15;103(8):493-94..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Hepatitis, Screening, Prevention, Case Study
Milstone AM, Rosenberg C, Yenokyan G
Alcohol-impregnated caps and ambulatory central-line-associated bloodstream infections (CLABSIs): a randomized clinical trial.
The purpose of this study was to evaluate the effect of 70% isopropyl alcohol-impregnated central venous catheter caps on ambulatory central-line-associated bloodstream infections (CLABSIs) in pediatric hematology-oncology patients. Findings showed that isopropyl alcohol-impregnated central-line caps did not lead to a statistically significant reduction in CLABSI rates in ambulatory hematology-oncology patients. In the per-protocol analysis, there was a statistically significant decrease in positive blood cultures.
AHRQ-funded; HS022870.
Citation: Milstone AM, Rosenberg C, Yenokyan G .
Alcohol-impregnated caps and ambulatory central-line-associated bloodstream infections (CLABSIs): a randomized clinical trial.
Infect Control Hosp Epidemiol 2021 Apr;42(4):431-39. doi: 10.1017/ice.2020.467..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Sepsis, Children/Adolescents, Prevention
Hill SC, Zuvekas SH
AHRQ Author: Hill SC, Zuvekas SH
Patient-centered medical homes and pediatric preventive counseling.
The authors sought to measure pediatric preventive counseling at patient-centered medical homes (PCMHs) compared with practices that reported undertaking some or no quality-related activities. Using MEPS data, they found that PCMHs were associated with substantially greater receipt of pediatric preventive counseling. They recommended that evaluations of PCMHs account for the quality-related activities of comparison practices.
AHRQ-authored.
Citation: Hill SC, Zuvekas SH .
Patient-centered medical homes and pediatric preventive counseling.
Acad Pediatr 2021 Apr 1;21(3):488-96. doi: 10.1016/j.acap.2020.07.001..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Patient-Centered Healthcare, Prevention
Mabry-Hernandez I, Baker SM
AHRQ Author: Mabry-Hernandez I
Screening for high blood pressure in children and adolescents.
This Putting Prevention into Practice case study concerns a 10-year-old boy with obesity and a family history significant for hypertension and hyperlipidemia presenting for a well-child examination. The parents express concern about their child’s risk for hypertension and ask whether they should be monitoring his blood pressure. Three questions are presented, along with answers.
AHRQ-authored.
Citation: Mabry-Hernandez I, Baker SM .
Screening for high blood pressure in children and adolescents.
Am Fam Physician 2021 Mar 15;103(6):371-72..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Blood Pressure, Screening, Guidelines, Evidence-Based Practice, Prevention, Case Study
Chou R, Blazina I, Bougatsos C
Screening for hepatitis B virus infection in nonpregnant adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors updated the 2014 hepatitis B virus (HBV) screening review in nonpregnant adolescents and adults to inform the USPSTF. They found no direct evidence for the clinical benefits and harms of HBV screening vs no screening. Antiviral therapy for HBV infection was associated with improved intermediate outcomes and may improve clinical outcomes.
AHRQ-funded; 290201500009I.
Citation: Chou R, Blazina I, Bougatsos C .
Screening for hepatitis B virus infection in nonpregnant adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Dec 15;324(23):2423-36. doi: 10.1001/jama.2020.19750..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Hepatitis, Chronic Conditions, Screening, Evidence-Based Practice, Prevention
Gartlehner G, Vander Schaaf EB, Orr C
Gartlehner G, Vander Schaaf EB, Orr C, Kennedy SM, Clark R, Viswanathan M. Screening for hypertension in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
This paper is an evidence update that accompanies the final recommendation from the U.S. Preventive Services Task Force (USPSTF) on screening and treatment of hypertension in childhood and adolescence. The update confirmed the previous update that the evidence is inconclusive whether the diagnostic accuracy of blood pressure measurements is adequate for screening asymptomatic children and adolescents in primary care. Forty-two studies from 43 publications were included in the final review.
AHRQ-funded; 290201500011I.
Citation: Gartlehner G, Vander Schaaf EB, Orr C .
Gartlehner G, Vander Schaaf EB, Orr C, Kennedy SM, Clark R, Viswanathan M. Screening for hypertension in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Nov 10;324(18):1884-95. doi: 10.1001/jama.2020.11119..
Keywords: Children/Adolescents, U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Screening, Evidence-Based Practice, Prevention, Cardiovascular Conditions