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
26 to 46 of 46 Research Studies DisplayedObremskey WT, Schmidt AH, O'Toole RV
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
The POvIV study is a prospective, multicenter, randomized trial to compare oral (PO) with intravenous (IV) antibiotic therapy in patients with postoperative wound infections after extremity fractures. This study will be the largest prospective randomized trial to evaluate the safety and effectiveness of PO antibiotic use for treatment of postoperative wound infections. Results will inform clinician decisions on antibiotic delivery in patients with postoperative wound infections.
AHRQ-funded; HS000029.
Citation: Obremskey WT, Schmidt AH, O'Toole RV .
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
J Orthop Trauma 2017 Apr;31 Suppl 1:S32-s38. doi: 10.1097/bot.0000000000000802.
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Keywords: Antibiotics, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Medication, Patient Safety, Adverse Events, Prevention, Patient-Centered Outcomes Research, Outcomes
Bosse MJ, Morshed S, Reider L
Transtibial Amputation Outcomes Study (TAOS): comparing transtibial amputation with and without a tibiofibular synostosis (Ertl) Procedure.
The TAOS is a prospective, multicenter randomized trial comparing 18-month outcomes after transtibial amputation using the Ertl versus Burgess approach among adults aged 18 to 60. The primary outcomes include surgical treatment for a complication and patient-reported function. Secondary outcomes include physical impairment, pain, and treatment cost.
AHRQ-funded; HS000029.
Citation: Bosse MJ, Morshed S, Reider L .
Transtibial Amputation Outcomes Study (TAOS): comparing transtibial amputation with and without a tibiofibular synostosis (Ertl) Procedure.
J Orthop Trauma 2017 Apr;31 Suppl 1:S63-s69. doi: 10.1097/bot.0000000000000791.
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Keywords: Adverse Events, Comparative Effectiveness, Patient-Centered Outcomes Research, Patient Safety
Dorris K, Liu C, Li D
A comparison of safety and efficacy of cytotoxic versus molecularly targeted drugs in pediatric phase I solid tumor oncology trials.
A systematic review of pediatric phase I solid tumor trials published in 1990-2013 was performed. The published reports were evaluated for patient characteristics, toxicity information, and response numbers. The review concluded that in phase I pediatric solid tumor trials, objective response rates were significantly higher for cytotoxic versus targeted agents. Stable disease rates were similar in targeted and cytotoxic drug trials.
AHRQ-funded; HS022437.
Citation: Dorris K, Liu C, Li D .
A comparison of safety and efficacy of cytotoxic versus molecularly targeted drugs in pediatric phase I solid tumor oncology trials.
Pediatr Blood Cancer 2017 Mar;64(3). doi: 10.1002/pbc.26258.
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Keywords: Patient Safety, Patient-Centered Outcomes Research, Children/Adolescents, Cancer, Medication
Roxbury CR, Jatana KR, Shah RK
Safety and postoperative adverse events in pediatric airway reconstruction: analysis of ACS-NSQIP-P 30-day outcomes.
The researchers describe postoperative sequelae of pediatric airway reconstructive procedures and identify predictive factors for adverse events. They conclude that the 30-day adverse event rate in pediatric airway surgery is high, with no identifiable predictors noted in the analysis of these data. Findings imply that systematic collection of variables and outcomes will be essential to truly effect quality improvement in these high-risk procedures..
AHRQ-funded; HS022932.
Citation: Roxbury CR, Jatana KR, Shah RK .
Safety and postoperative adverse events in pediatric airway reconstruction: analysis of ACS-NSQIP-P 30-day outcomes.
Laryngoscope 2017 Feb;127(2):504-08. doi: 10.1002/lary.26165.
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Keywords: Children/Adolescents, Patient Safety, Adverse Events, Patient-Centered Outcomes Research, Surgery
Burstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Waljee JF, Ghaferi A, Cassidy R
Are patient-reported outcomes correlated with clinical outcomes after surgery? A population-based study.
The researchers evaluated the extent to which patient-reported outcomes (eg, health-related quality of life) are distinct from clinical outcomes following bariatric surgery. They concluded that patient-reported outcomes are not correlated with early perioperative events, but are correlated with measures of clinical effectiveness after bariatric surgery.
AHRQ-funded; HS023313.
Citation: Waljee JF, Ghaferi A, Cassidy R .
Are patient-reported outcomes correlated with clinical outcomes after surgery? A population-based study.
Ann Surg 2016 Oct;264(4):682-9. doi: 10.1097/sla.0000000000001852.
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Keywords: Surgery, Obesity, Adverse Events, Patient-Centered Outcomes Research, Patient Safety
Kamal AH, Bull J, Ritchie CS
Adherence to measuring what matters measures using point-of-care data collection across diverse clinical settings.
The purpose of this paper was to evaluate the implementation of Measuring What Matters (MWM) measures by exploring documentation of quality measure adherence across six diverse clinical settings inherent to palliative care practice. The authors found that the lowest adherence involved comprehensive assessments during the first visit in hospitalized patients in the intensive care unit and that the highest adherence across all settings involved documentation of management of moderate to severe pain. They recommended additional studies for better understanding of benchmarks and acceptable ranges for adherence tailored to various clinical settings.
AHRQ-funded; HS023681; HS022763.
Citation: Kamal AH, Bull J, Ritchie CS .
Adherence to measuring what matters measures using point-of-care data collection across diverse clinical settings.
J Pain Symptom Manage 2016 Mar;51(3):497-503. doi: 10.1016/j.jpainsymman.2015.12.313.
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Keywords: Quality Measures, Palliative Care, Patient-Centered Outcomes Research, Quality of Care, Patient Safety
Patorno E, Wang SV, Schneeweiss S
Patterns of beta-blocker initiation in patients undergoing intermediate to high-risk noncardiac surgery.
The objective of this study is to examine patterns of β-Blocker initiation among patients undergoing noncardiac elective surgery in the US. It concluded that after a period of a rapidly increasing trend, perioperative β-Blocker initiation decreased sharply in the second half of 2008 and continued to decrease afterwards.
AHRQ-funded; HS022193.
Citation: Patorno E, Wang SV, Schneeweiss S .
Patterns of beta-blocker initiation in patients undergoing intermediate to high-risk noncardiac surgery.
Am Heart J 2015 Oct;170(4):812-20.e6. doi: 10.1016/j.ahj.2015.06.028..
Keywords: Surgery, Patient-Centered Outcomes Research, Patient Safety, Medication
Downes KJ, Patil NR, Rao MB
Risk factors for acute kidney injury during aminoglycoside therapy in patients with cystic fibrosis.
The aim of this study was to identify factors associated with acute kidney injury (AKI) during intravenous aminoglycoside (AG) courses in this population. It identified receipt of an AG within 90 days prior to admission, longer duration of AG therapy, low serum albumin, and receipt of trimethoprim/ sulfamethoxazole as independent risk factors for developing AKI.
AHRQ-funded; HS021114.
Citation: Downes KJ, Patil NR, Rao MB .
Risk factors for acute kidney injury during aminoglycoside therapy in patients with cystic fibrosis.
Pediatr Nephrol 2015 Oct;30(10):1879-88. doi: 10.1007/s00467-015-3097-3..
Keywords: Adverse Events, Patient-Centered Outcomes Research, Patient Safety, Respiratory Conditions
Whicher DM, Kass NE, Audera-Lopez C
Ethical issues in patient safety research: a systematic review of the literature.
The authors provided a review of the literature related to ethics, oversight, and patient safety research; identified issues highlighted in articles as being of ethical relevance; described areas of consensus regarding how to respond to these ethical issues; and highlighted areas where additional ethical analysis and discussion are needed to provide guidance to those in the field.
AHRQ-funded; HS000029.
Citation: Whicher DM, Kass NE, Audera-Lopez C .
Ethical issues in patient safety research: a systematic review of the literature.
J Patient Saf 2015 Sep;11(3):174-84. doi: 10.1097/pts.0000000000000064.
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Keywords: Health Services Research (HSR), Patient Safety, Patient-Centered Outcomes Research
McConnochie KM, Ronis SD, Wood NE
Effectiveness and safety of acute care telemedicine for children with regular and special healthcare needs.
The authors assessed the hypothesis that effectiveness and safety of the Health-e-Access telemedicine model for care of children with special healthcare needs (CSHCN) with acute illness equaled those for care of children in regular childcare and schools (CRS). They concluded that observations support safety and effectiveness of Health-e-Access telemedicine for both CSHCN and CRS.
AHRQ-funded; HS016871; HS015165; HS018912.
Citation: McConnochie KM, Ronis SD, Wood NE .
Effectiveness and safety of acute care telemedicine for children with regular and special healthcare needs.
Telemed J E Health 2015 Aug;21(8):611-21. doi: 10.1089/tmj.2014.0175.
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Keywords: Critical Care, Children/Adolescents, Patient Safety, Patient-Centered Outcomes Research, Telehealth
Callaghan B, Kerber K, Langa KM
Longitudinal patient-oriented outcomes in neuropathy: importance of early detection and falls.
This study evaluated longitudinal patient-oriented outcomes in peripheral neuropathy over a 14-year time period including time before and after diagnosis. It concluded that, in older persons, differences in falls, pain, and self-rated health can be detected 3–5 years prior to peripheral neuropathy diagnosis, but only falls deteriorate more rapidly over time in neuropathy cases compared to controls.
AHRQ-funded; HS017690; HS022258.
Citation: Callaghan B, Kerber K, Langa KM .
Longitudinal patient-oriented outcomes in neuropathy: importance of early detection and falls.
Neurology 2015 Jul 7;85(1):71-9. doi: 10.1212/wnl.0000000000001714..
Keywords: Patient-Centered Outcomes Research, Neurological Disorders, Falls, Elderly, Patient Safety
Osterman MT, Haynes K, Delzell E
Effectiveness and safety of immunomodulators with anti-tumor necrosis factor therapy in Crohn's disease.
This study assessed the effectiveness and safety of immunomodulators with anti-tumor necrosis factor (anti-TNF) therapy in Crohn’s disease (CD). It found that continuation of immunomodulators after “stepping up” to anti-TNF therapy did not improve outcomes but was associated with an increased risk of opportunistic infection.
AHRQ-funded; HS018517.
Citation: Osterman MT, Haynes K, Delzell E .
Effectiveness and safety of immunomodulators with anti-tumor necrosis factor therapy in Crohn's disease.
Clin Gastroenterol Hepatol 2015 Jul;13(7):1293-301.e5; quiz e70, e72. doi: 10.1016/j.cgh.2015.02.017..
Keywords: Patient Safety, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Yun H, Xie F, Delzell E
Risk of hospitalised infection in rheumatoid arthritis patients receiving biologics following a previous infection while on treatment with anti-TNF therapy.
The researchers compare the subsequent risk of hospitalized infections associated with specific biologic agents among RA patients previously hospitalized for infection while receiving anti-tumor necrosis factor (anti-TNF) therapy. They found that among rheumatoid arthritis patients who experienced a hospitalized infection while on anti-TNF therapy, abatacept and etanercept were associated with the lowest risk of a subsequent infection compared to other biologic therapies.
AHRQ-funded; HS021694; HS023009; HS018517.
Citation: Yun H, Xie F, Delzell E .
Risk of hospitalised infection in rheumatoid arthritis patients receiving biologics following a previous infection while on treatment with anti-TNF therapy.
Ann Rheum Dis 2015 Jun;74(6):1065-71. doi: 10.1136/annrheumdis-2013-204011..
Keywords: Arthritis, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research, Patient Safety
Singh JA, Ramachandran R
Does hospital volume predict outcomes and complications after total shoulder arthroplasty in the US?
The researchers assessed the association of hospital procedure volume for total shoulder arthroplasty (TSA) with patient outcomes and complications. They found that, compared to low volume hospitals (<5, 5–9, or 10–14 procedures annually), patients receiving TSA at higher volume hospitals (15–24 or ‡25 procedures annually) had significantly lower likelihood of being discharged to an inpatient medical facility.
AHRQ-funded; HS021110.
Citation: Singh JA, Ramachandran R .
Does hospital volume predict outcomes and complications after total shoulder arthroplasty in the US?
Arthritis Care Res 2015 May;67(6):885-90. doi: 10.1002/acr.22507..
Keywords: Patient-Centered Outcomes Research, Adverse Events, Patient Safety, Quality of Care, Healthcare Cost and Utilization Project (HCUP)
Goldberger ZD, Nallamothu BK, Nichol G
Policies allowing family presence during resuscitation and patterns of care during in-hospital cardiac arrest.
A growing number of hospitals have begun to implement policies allowing for family presence during resuscitation (FPDR). However, the overall safety of these policies and their effect on resuscitation care is unknown. This study suggests that hospitals with an FPDR policy generally have no statistically significant differences in outcomes and processes of care as hospitals without this policy.
AHRQ-funded; HS020672.
Citation: Goldberger ZD, Nallamothu BK, Nichol G .
Policies allowing family presence during resuscitation and patterns of care during in-hospital cardiac arrest.
Circ Cardiovasc Qual Outcomes 2015 May;8(3):226-34. doi: 10.1161/circoutcomes.114.001272..
Keywords: Cardiovascular Conditions, Patient Safety, Patient-Centered Outcomes Research, Inpatient Care
Yun H, Xie F, Delzell E
Risks of herpes zoster in patients with rheumatoid arthritis according to biologic disease-modifying therapy.
This study evaluated whether the risks of herpes zoster (HZ) differed by biologic agents with different mechanisms of action (MOAs) in older rheumatoid arthritis (RA) patients. Using Medicare data from 2006–2011, the researchers found that among RA patients, the rate and adjusted hazard ratios of HZ were similar among biologic agents, including those with non–tumor necrosis factor mechanisms of action.
AHRQ-funded; HS021694; HS018517.
Citation: Yun H, Xie F, Delzell E .
Risks of herpes zoster in patients with rheumatoid arthritis according to biologic disease-modifying therapy.
Arthritis Care Res 2015 May;67(5):731-6. doi: 10.1002/acr.22470..
Keywords: Arthritis, Risk, Patient Safety, Patient-Centered Outcomes Research
Martin BI, Lurie JD, Tosteson AN
Use of bone morphogenetic protein among patients undergoing fusion for degenerative diagnoses in the United States, 2002 to 2012.
The authors examined whether published concerns about the safety of bone morphogenetic protein (BMP) altered clinical practice. They found that use of BMP in spinal fusion surgery declined subsequent to published safety concerns and revelations of financial conflicts of interest for investigators involved in the pivotal clinical trials.
AHRQ-funded; HS021695.
Citation: Martin BI, Lurie JD, Tosteson AN .
Use of bone morphogenetic protein among patients undergoing fusion for degenerative diagnoses in the United States, 2002 to 2012.
Spine J 2015 Apr;15(4):692-9. doi: 10.1016/j.spinee.2014.12.010.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Patient Safety, Patient-Centered Outcomes Research, Practice Patterns, Surgery
Goode AP, Richardson WJ, Schectman RM
Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions.
The authors sought to determine the 1-year risk of complications, cervical revision fusions, hospital readmissions, and health care services utilization after bone morphogenetic protein (BMP) use with cervical spine fusions. They found that patients receiving BMP were 29% more likely to have a complication and a nervous system complication; cervical revision fusions were more likely among patients receiving BMP; the risk of 30-day readmission was greater with BMP use; and readmission occurred 27.4% sooner on an average. Additionally, patients receiving BMP were more likely to receive computed tomography scans and epidurals with anterior surgical approaches.
AHRQ-funded; HS019479.
Citation: Goode AP, Richardson WJ, Schectman RM .
Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions.
Spine J 2014 Sep;14(9):2051-9. doi: 10.1016/j.spinee.2013.11.042.
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Keywords: Adverse Events, Hospital Readmissions, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Surgery, Treatments
Maggard-Gibbons M
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
This review summarized the history of American College of Surgeons National Surgical Quality Improvement Project and its components, and described the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety.
AHRQ-funded; 2902007100621.
Citation: Maggard-Gibbons M .
The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program.
BMJ Qual Saf 2014 Jul;23(7):589-99. doi: 10.1136/bmjqs-2013-002223..
Keywords: Quality Improvement, Quality Indicators (QIs), Quality Measures, Quality of Care, Surgery, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Provider Performance
Meddings J, Rogers MA, Krein SL
Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.
The authors updated a prior systematic review and a meta-analysis regarding interventions prompting urinary catheter (UC) removal by reminders or stop orders. They found that UC reminders and stop orders appear to reduce catheter-associated urinary tract infection rates and should be used to improve patient safety.
AHRQ-funded; 290200710062I; HS019767; HS018344.
Citation: Meddings J, Rogers MA, Krein SL .
Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review.
BMJ Qual Saf 2014 Apr;23(4):277-89. doi: 10.1136/bmjqs-2012-001774.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Patient-Centered Outcomes Research, Prevention, Quality Improvement, Urinary Tract Infection (UTI)