National Healthcare Quality and Disparities Report
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Topics
- Arthritis (1)
- Back Health and Pain (1)
- Behavioral Health (1)
- Cancer (7)
- Cancer: Breast Cancer (5)
- Cancer: Colorectal Cancer (1)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (3)
- Cardiovascular Conditions (2)
- Caregiving (1)
- Case Study (1)
- Children/Adolescents (3)
- Chronic Conditions (3)
- Clinical Decision Support (CDS) (7)
- Clinician-Patient Communication (4)
- Communication (2)
- Comparative Effectiveness (3)
- Data (3)
- (-) Decision Making (53)
- Dementia (1)
- Diabetes (1)
- Diagnostic Safety and Quality (2)
- Disparities (2)
- Education: Patient and Caregiver (2)
- Elderly (2)
- Evidence-Based Practice (15)
- Guidelines (3)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (4)
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- Neurological Disorders (2)
- Opioids (1)
- Orthopedics (3)
- Outcomes (5)
- Pain (1)
- Palliative Care (1)
- Patient-Centered Healthcare (9)
- (-) Patient-Centered Outcomes Research (53)
- Patient and Family Engagement (6)
- Patient Experience (2)
- Patient Self-Management (1)
- Primary Care (1)
- Provider (1)
- Provider: Physician (1)
- Quality Improvement (1)
- Quality of Life (4)
- Racial and Ethnic Minorities (3)
- Registries (2)
- Research Methodologies (2)
- Risk (1)
- Screening (1)
- Sickle Cell Disease (1)
- Social Determinants of Health (2)
- Stroke (1)
- Surgery (6)
- Transplantation (2)
- Treatments (1)
- Women (2)
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 53 Research Studies DisplayedWernli KJ, Smith RE, Henderson LM
Decision quality and regret with treatment decisions in women with breast cancer: pre-operative breast MRI and breast density.
The authors evaluated self-report of decision quality and regret with breast cancer surgical treatment by pre-operative breast MRI use in women recently diagnosed with breast cancer. They found that breast MRI use in the diagnostic work-up of breast cancer does not negatively alter women's perceptions of surgical treatment decisions in early survivorship.
AHRQ-funded; HS018366.
Citation: Wernli KJ, Smith RE, Henderson LM .
Decision quality and regret with treatment decisions in women with breast cancer: pre-operative breast MRI and breast density.
Breast Cancer Res Treat 2022 Aug;194(3):607-16. doi: 10.1007/s10549-022-06648-7..
Keywords: Cancer: Breast Cancer, Cancer, Decision Making, Women, Patient-Centered Outcomes Research
Dullabh P, Sandberg SF, Heaney-Huls K
AHRQ Author: Berliner E, Dymek C, Harrison MI, Swiger J
Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan.
This AHRQ-authored horizon scan identified challenges and opportunities for advancing patient-centered clinical decision support (PC CDS) and future directions for PC CDS. The authors engaged a technical expert panel, conducted a scoping literature review, and interviewed key informants. They quantitatively analyzed literature and interview transcripts and mapped the findings to the 4 phases translating evidence into PC CDS interventions (Prioritizing, Authoring, Implementing, and Measuring) and to external factors. Twelve challenges were identified for PC CDS development with lack of patient input identified as a critical challenge. Lack of patient-centered terminology standards was viewed as a challenge in authoring PC CDS. They also found a dearth of CDS studies that measured clinical outcomes, creating significant gaps in the understanding of PC CDS’ impact.
AHRQ-authored; AHRQ-funded; 233201500023I.
Citation: Dullabh P, Sandberg SF, Heaney-Huls K .
Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan.
J Am Med Inform Assoc 2022 Jun 14;29(7):1233-43. doi: 10.1093/jamia/ocac059.
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Keywords: Clinical Decision Support (CDS), Patient-Centered Healthcare, Health Information Technology (HIT), Decision Making, Patient-Centered Outcomes Research, Evidence-Based Practice
Dullabh P, Heaney-Huls K, Hovey L
The technology landscape of patient-centered clinical decision support - where are we and what is needed?
This paper explores the technology landscape for patient-centered clinical decision support (PC CDS) and what has come out of Patient Centered Outcomes Research (PCOR) and health care delivery system transformation efforts. The authors explore what is needed to make it more shareable, standards-based, and publicly available with the goal of improving patient care and clinical outcomes. Three sources of information were used: (1) a 22-member technical expert panel; (2) a literature review of peer-reviewed and grey literature; and (3) key informant interviews with PC CDS stakeholders. Ten salient technical considerations that span all phases of PC CDS development were identified. Although significant progress has been made, challenges remain.
AHRQ-funded; 233201500023I.
Citation: Dullabh P, Heaney-Huls K, Hovey L .
The technology landscape of patient-centered clinical decision support - where are we and what is needed?
Stud Health Technol Inform 2022 Jun 6;290:350-53. doi: 10.3233/shti220094..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Patient-Centered Outcomes Research, Decision Making
Lin E, Uhler LM, Finley EP
Incorporating patient-reported outcomes into shared decision-making in the management of patients with osteoarthritis of the knee: a hybrid effectiveness-implementation study protocol.
This article describes a US-based 2-year, two-site hybrid type 1 study to assess clinical effectiveness and implementation of a machine learning-based patient decision aid integrating patient-reported outcomes and clinical variables to support shared decision-making for patients with knee osteoarthritis considering total knee replacement. Study results will be disseminated through conference presentations, publications and professional societies.
AHRQ-funded; HS027037.
Citation: Lin E, Uhler LM, Finley EP .
Incorporating patient-reported outcomes into shared decision-making in the management of patients with osteoarthritis of the knee: a hybrid effectiveness-implementation study protocol.
BMJ Open 2022 Feb 21;12(2):e055933. doi: 10.1136/bmjopen-2021-055933..
Keywords: Clinical Decision Support (CDS), Decision Making, Arthritis, Patient-Centered Outcomes Research, Orthopedics, Health Information Technology (HIT), Evidence-Based Practice
Chrenka EA, Solberg LI, Asche SE
Is shared decision-making associated with better patient-reported outcomes? A longitudinal study of patients undergoing total joint arthroplasty.
This study examined whether shared decision making (SDM) provides better outcomes using patients undergoing total joint arthroplasty as a test case. This observational longitudinal survey-based study surveyed patients receiving an initial THA or TKA from a large, multispecialty medical group in the Midwestern United States after they were scheduled for surgery and again at 12 months after their procedure. The majority of included patients were white (1255 of 1344) with only 3% using Medicaid benefits at the time of surgery. The three-item collaboRATE measure of SDM was added to existing patient surveys of patient-reported outcome measures (PROMs). Patient responses were analyzed in regression models to estimate the association between preoperative collaborate scores and Oxford knee or hip scores at 12 months postoperatively. There was a moderate, positive association between preoperative collaborate scores and the Oxford scores at 12 months. The association suggests that SDM could be one tool to encourage better outcomes.
AHRQ-funded; HS025618.
Citation: Chrenka EA, Solberg LI, Asche SE .
Is shared decision-making associated with better patient-reported outcomes? A longitudinal study of patients undergoing total joint arthroplasty.
Clin Orthop Relat Res 2022 Jan;480(1):82-91. doi: 10.1097/corr.0000000000001920..
Keywords: Decision Making, Patient-Centered Outcomes Research, Orthopedics, Surgery
Whitebird RR, Solberg LI, Ziegenfuss JY
Personalized outcomes for hip and knee replacement: the patients point of view.
Patient reported outcome measures (PROMs) are increasingly being incorporated into clinical and surgical care for assessing outcomes. This study examined outcomes important to patients in their decision to have hip or knee replacement surgery, their perspectives on PROMs and shared decision-making, and factors they considered important for postoperative care.
AHRQ-funded; HS025618.
Citation: Whitebird RR, Solberg LI, Ziegenfuss JY .
Personalized outcomes for hip and knee replacement: the patients point of view.
J Patient Rep Outcomes 2021 Nov 4;5(1):116. doi: 10.1186/s41687-021-00393-z..
Keywords: Orthopedics, Surgery, Patient-Centered Outcomes Research, Patient Experience, Decision Making
Murad MH, Chang SM, Fiordalisi CV
AHRQ Author: Chang SM
Improving the utility of evidence synthesis for decision makers in the face of insufficient evidence.
The authors identified and suggested strategies to make insufficient evidence ratings in systematic reviews more actionable. A workgroup comprising members from AHRQ’s Evidence-Based Practice Program convened throughout 2020. They identified five strategies for supplementing systematic review findings when evidence on benefits or harms is expected to be, or found to be, insufficient: 1) reconsider eligible study designs, 2) summarize indirect evidence, 3) summarize contextual and implementation evidence, 4) consider modelling, and 5) incorporate unpublished health system data in the evidence synthesis. While these strategies may not increase the strength of evidence, they may improve the utility of reports for decision makers.
AHRQ-authored; AHRQ-funded; 290201700003C; 290201500013I; 290201500008I; 290201500007I; 290201500011I; 290201500010I; 290201500002I; 290201500005I; 290201500012I; 290201500006I.
Citation: Murad MH, Chang SM, Fiordalisi CV .
Improving the utility of evidence synthesis for decision makers in the face of insufficient evidence.
J Clin Epidemiol 2021 Jul;135:170-75. doi: 10.1016/j.jclinepi.2021.02.028..
Keywords: Evidence-Based Practice, Decision Making, Patient-Centered Outcomes Research
McKinney WT, Schaffhausen CR, Schladt D
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
The Scientific Registry of Transplant Recipients provides transplant program-specific information, but it is unclear what patients and stakeholders need to know. Acceptance criteria for the candidate waitlist and donor organs vary by program and region, but there is no means to search for programs by the clinical profiles of recipients and donors. The authors examined variability in program-specific characteristics that could influence access to transplantation.
AHRQ-funded; HS026379; HS024527.
Citation: McKinney WT, Schaffhausen CR, Schladt D .
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
Clin Transplant 2021 Feb;35(2):e14183. doi: 10.1111/ctr.14183..
Keywords: Transplantation, Surgery, Heart Disease and Health, Cardiovascular Conditions, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice, Decision Making
Richardson JE, Middleton B, Platt JE
Building and maintaining trust in clinical decision support: recommendations from the Patient-Centered CDS Learning Network.
Knowledge artifacts in digital repositories for clinical decision support (CDS) can promote the use of CDS in clinical practice. However, stakeholders will benefit from knowing which they can trust before adopting artifacts from knowledge repositories. In this paper, the investigators discuss their investigation into trust for knowledge artifacts and repositories by the Patient-Centered CDS Learning Network's Trust Framework Working Group (TFWG).
AHRQ-funded; HS024849.
Citation: Richardson JE, Middleton B, Platt JE .
Building and maintaining trust in clinical decision support: recommendations from the Patient-Centered CDS Learning Network.
Learn Health Syst 2020 Apr;4(2):e10208. doi: 10.1002/lrh2.10208.
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Keywords: Clinical Decision Support (CDS), Decision Making, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Marcial LH, Blumenfeld B, Harle C
Barriers, facilitators, and potential solutions to advancing interoperable clinical decision support: multi-stakeholder consensus recommendations for the opioid use case.
These proceedings report on the AHRQ-sponsored Patient-Centered CDS Learning Network (PCCDS LN) Technical Framework Working Group (TechFWG), which was convened to identify barriers, facilitators, and potential solutions for interoperable clinical decision support, with a specific focus on addressing the opioid epidemic. The key insights were extrapolated to CDS-facilitated care improvement outside of the specific opioid use case. If applied broadly, the recommendations should help advance the availability and impact of interoperable CDS delivered at scale.
AHRQ-funded; HS024849.
Citation: Marcial LH, Blumenfeld B, Harle C .
Barriers, facilitators, and potential solutions to advancing interoperable clinical decision support: multi-stakeholder consensus recommendations for the opioid use case.
AMIA Annu Symp Proc 2020 Mar 4;2019:637-46..
Keywords: Clinical Decision Support (CDS), Decision Making, Opioids, Medication, Pain, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Killelea BK, Evans SB, Mougalian SS
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
This study examined perceptions of older women with stage I estrogen-receptor-positive breast cancer who underwent lumpectomy and were considering or receiving radiotherapy. Perceptions among 63 older women was that radiotherapy would reduce their 10-year-risk of local recurrent by an average of 18.7% although the literature showed only an 8% risk reduction. Participants who had the perception of a larger benefit were more likely to receive radiotherapy treatment.
AHRQ-funded; HS023900.
Citation: Killelea BK, Evans SB, Mougalian SS .
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
Breast J 2020 Feb;26(2):231-34. doi: 10.1111/tbj.13518..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Patient-Centered Outcomes Research, Decision Making
Schaffhausen CR, Bruin MJ, Chu S
Comparing pretransplant and posttransplant outcomes when choosing a transplant center: focus groups and a randomized survey.
In response to calls for an increased focus on pretransplant outcomes and other patient-centered metrics in public reports of center outcomes, this mixed methods study evaluated how the content and presentation style of new information influenced decision-making. This mixed methods design utilized qualitative and quantitative phases where the strengths of one method helped address limitations of the other, and multiple methods facilitated comparing results. The authors concluded that the presentation of public reports influenced decision-making behavior.
AHRQ-funded; HS026379; HS024527.
Citation: Schaffhausen CR, Bruin MJ, Chu S .
Comparing pretransplant and posttransplant outcomes when choosing a transplant center: focus groups and a randomized survey.
Transplantation 2020 Jan;104(1):201-10. doi: 10.1097/tp.0000000000002809..
Keywords: Transplantation, Decision Making, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Lomotan EA, Meadows G, Michaels M
AHRQ Author: Lomotan EA
To share is human! Advancing evidence into practice through a national repository of interoperable clinical decision support.
The purpose of this study was to describe how a national repository of clinical decision support (CDS) can serve as a public resource for healthcare systems, academic researchers, and informaticists seeking to share and reuse CDS knowledge resources. AHRQ’s CDS Connect has provided a functional platform where CDS developers are actively sharing their work. CDS sharing may lead to improved implementation efficiency through numerous pathways, and further research is ongoing to quantify efficiencies gained.
AHRQ-authored; AHRQ-funded; 290201600001U; 233201500022I.
Citation: Lomotan EA, Meadows G, Michaels M .
To share is human! Advancing evidence into practice through a national repository of interoperable clinical decision support.
Appl Clin Inform 2020 Jan;11(1):112-21. doi: 10.1055/s-0040-1701253..
Keywords: Clinical Decision Support (CDS), Decision Making, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Health Information Technology (HIT)
McGinn T, Cohen S, Khan S
The high cost of low value care.
The main focus of this study was bridging the "evidence gap" between frontline decision-making in health care and the actual evidence, with the hope of reducing unnecessary diagnostic testing and treatments. From their work in pulmonary embolism (PE) and over ordering of computed tomography pulmonary angiography, the investigators integrated the highly validated Wells' criteria into the electronic health record at two of their major academic tertiary hospitals.
AHRQ-funded; HS022061.
Citation: McGinn T, Cohen S, Khan S .
The high cost of low value care.
Trans Am Clin Climatol Assoc 2019;130:60-70..
Keywords: Healthcare Costs, Evidence-Based Practice, Patient-Centered Outcomes Research, Decision Making, Comparative Effectiveness
Armstrong MJ, Gronseth GS, Day GS
Patient stakeholder versus physician preferences regarding amyloid PET testing.
Patient and caregiver perspectives on amyloid positron emission tomography (PET) use are largely unexplored, particularly as compared with clinician views. In this study, the investigators surveyed clinicians, patients, caregivers, and dementia advocates on topics relating to an evidence-based guideline on amyloid PET use. They found that patients and caregivers emphasized the importance of having a dementia diagnosis and placed more value on testing and outcomes for asymptomatic populations than clinicians.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Gronseth GS, Day GS .
Patient stakeholder versus physician preferences regarding amyloid PET testing.
Alzheimer Dis Assoc Disord 2019 Jul-Sep;33(3):246-53. doi: 10.1097/wad.0000000000000311..
Keywords: Decision Making, Dementia, Diagnostic Safety and Quality, Evidence-Based Practice, Guidelines, Imaging, Neurological Disorders, Patient-Centered Outcomes Research, Provider, Provider: Physician
Bateni SB, Davidson AJ, Arora M
Is breast-conserving therapy appropriate for male breast cancer patients? A national cancer database analysis.
The purpose of this study was to compare overall survival rates among male breast cancer patients who underwent breast-conserving therapy (BCT) versus mastectomy. A retrospective analysis identified 8445 stage I-II male breast cancer patients from the National Cancer Database and grouped them according to surgical and radiation therapy (RT). Most of the patients underwent total mastectomy, while 18.2% underwent BCT, 12.4% underwent total mastectomy with RT, and 8.2% underwent partial mastectomy alone. Partial mastectomy alone, total mastectomy alone, and total mastectomy with RT were associated with worse overall survival rates compared with BCT. The authors conclude that BCT is associated with greater survival, but the underlying mechanisms of this association warrant further study.
AHRQ-funded; HS022236.
Citation: Bateni SB, Davidson AJ, Arora M .
Is breast-conserving therapy appropriate for male breast cancer patients? A national cancer database analysis.
Ann Surg Oncol 2019 Jul;26(7):2144-53. doi: 10.1245/s10434-019-07159-4..
Keywords: Cancer, Cancer: Breast Cancer, Decision Making, Mortality, Outcomes, Patient-Centered Outcomes Research
Ahmad FS, Kallen MA, Schifferdecker KE
Development and initial validation of the PROMIS(R)-Plus-HF profile measure.
This paper describes the efforts to develop and validate the PROMIS®-Plus-HF (Patient-Reported Outcomes Measurement Information System®-Plus-Heart Failure) profile measure. The authors conducted 8 focus groups with 61 patients with HF and phone interviews with 10 HF clinicians. They tested the measure with a 600-patient sample. Validity was analyzed and confirmed using Pearson r and Spearman rho correlations with Kansas City Cardiomyopathy Questionnaire subscores. The measure consists of 86 items across 18 domains.
AHRQ-funded; HS026385.
Citation: Ahmad FS, Kallen MA, Schifferdecker KE .
Development and initial validation of the PROMIS(R)-Plus-HF profile measure.
Circ Heart Fail 2019 Jun;12(6):e005751. doi: 10.1161/circheartfailure.118.005751.
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Keywords: Patient-Centered Outcomes Research, Heart Disease and Health, Cardiovascular Conditions, Decision Making, Quality of Life, Health Status
Djulbegovic B, Reljic T, Elqayam S
Structured decision-making drives guidelines panels' recommendations "for" but not "against" health interventions.
This study examined the determinants of guideline panels’ recommendations and whether there is a difference between how they make recommendations for or against health interventions. They examined the factors considered by members of 8 panels convened by the American Society of Hematology (ASH) to develop guidelines using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. They found that “for” decisions were made using certainty in evidence, balance of benefits and harms, and variability in patients’ values and preferences. However there was less strength of recommendation (SOR) certainty when making “against” recommendations.
AHRQ-funded; HS024917.
Citation: Djulbegovic B, Reljic T, Elqayam S .
Structured decision-making drives guidelines panels' recommendations "for" but not "against" health interventions.
J Clin Epidemiol 2019 Jun;110:23-33. doi: 10.1016/j.jclinepi.2019.02.009..
Keywords: Decision Making, Guidelines, Patient-Centered Outcomes Research, Evidence-Based Practice
Pavlo AJ, O'Connell M, Olsen S
Missing ingredients in shared decision-making?
This article discusses the practice of shared decision making (SDM) for clinicians when making decisions in health care. This widespread practice is considered the best approach for person-centered care, but for individuals diagnosed with serious mental illness there are still many barriers to effective collaboration. The authors suggest that more emphasis needs to be placed on the doctor-patient relationship itself conducting SDM.
AHRQ-funded; HS023000.
Citation: Pavlo AJ, O'Connell M, Olsen S .
Missing ingredients in shared decision-making?
Psychiatr Q 2019 Jun;90(2):333-38. doi: 10.1007/s11126-019-9624-9..
Keywords: Chronic Conditions, Clinician-Patient Communication, Communication, Decision Making, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement
Gordon BE, Basak R, Carpenter WR
Factors influencing prostate cancer treatment decisions for African American and white men.
This prospective, population-based cohort study examined some possible reasons for mortality outcome differences for prostate cancer between African American (AA) and white patients. A cohort of 1170 men with nonmetastatic prostate cancer were enrolled from 2011 to 2013 before treatment in North Carolina. Participants were asked to rate their aggressiveness of their cancer, and also the importance of 10 factors their treatment decision-making process. Among low-risk patients, there was no difference in perception of their cancer as “not very aggressive”. Among high-risk patients, 54% of AA patients considered their cancer to be “not very aggressive” while only 24% of white patients did. For AA patients, cost, treatment time, and recovery time were considered very important more than white patients.
AHRQ-funded.
Citation: Gordon BE, Basak R, Carpenter WR .
Factors influencing prostate cancer treatment decisions for African American and white men.
Cancer 2019 May 15;125(10):1693-700. doi: 10.1002/cncr.31932..
Keywords: Decision Making, Cancer, Cancer: Prostate Cancer, Disparities, Men's Health, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Armstrong MJ
Developing the disorders of consciousness guideline and challenges of integrating shared decision-making into clinical practice.
The purpose of this study was to review methodology informing evidence-based guideline development and integration of guidelines into clinical care through shared decision-making (SDM) and to highlight challenges to SDM in disorders of consciousness. Recently published disorders of consciousness guideline recommendations provide strategies for clinicians to enhance quality care for these individuals and also to provide details helping clinicians partner with individuals with disorders of consciousness and their surrogates. Further research is recommended into many aspects of caring for individuals with disorders of consciousness and optimal strategies for partnering with surrogates in decision-making.
AHRQ-funded; HS024159.
Citation: Armstrong MJ .
Developing the disorders of consciousness guideline and challenges of integrating shared decision-making into clinical practice.
J Head Trauma Rehabil 2019 May/Jun;34(3):199-204. doi: 10.1097/htr.0000000000000496.
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Keywords: Decision Making, Guidelines, Evidence-Based Practice, Neurological Disorders, Patient-Centered Outcomes Research
Crosby LE, Walton A, Shook LM
Development of a hydroxyurea decision aid for parents of children with sickle cell anemia.
This study developed a decision aid for use of hydroxyurea for parents of children with sickle cell anemia. There are national evidence-based guidelines, but they do not offer strategies for implementation. A multicomponent decision aid was developed via a needs assessment, clinic observations and iterative feedback. The decision aid was considered useful by the 75 parents and 28 clinicians who participated in all phases of the study.
AHRQ-funded; HS021114.
Citation: Crosby LE, Walton A, Shook LM .
Development of a hydroxyurea decision aid for parents of children with sickle cell anemia.
J Pediatr Hematol Oncol 2019 Jan;41(1):56-63. doi: 10.1097/mph.0000000000001257..
Keywords: Caregiving, Children/Adolescents, Chronic Conditions, Decision Making, Education: Patient and Caregiver, Medication, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Sickle Cell Disease
Morrow AS, Whiteside SP, Sim LA
Developing tools to enhance the use of systematic reviews for clinical care in health systems.
The researchers’ goal was to develop tools to facilitate the uptake of evidence as summarized in systematic reviews by clinical decisionmakers in health systems. After they conducted a systematic review on the management of anxiety in children, the researchers interviewed health system representatives, clinicians and patients to gain additional information about decisionmaking. Two decision-aid tools - one for the health system and the other for the clinical encounter - were then developed using stakeholders' feedback and literature searches. The health system decision aid provided information on patients who were candidates for treatment, values and preferences, costs and resources, acceptability, impact on health equity, feasibility, drug dosing, alternative therapies, remission rates, and prognosis. The encounter decision aid was produced as a set of cards that contained information on the issues that drive treatment decisions. Health system stakeholders found the first decision aid useful, and patients, parents, and clinicians found the second to be helpful.
AHRQ-funded; 290201500013I; 29032001T.
Citation: Morrow AS, Whiteside SP, Sim LA .
Developing tools to enhance the use of systematic reviews for clinical care in health systems.
BMJ Evid Based Med 2018 Dec;23(6):206-09. doi: 10.1136/bmjebm-2018-110995..
Keywords: Children/Adolescents, Decision Making, Evidence-Based Practice, Patient-Centered Outcomes Research, Implementation
Misra-Hebert AD, Hom G, Klein EA
Testing of a tool for prostate cancer screening discussions in primary care.
As prostate cancer (PCa) screening decisions often occur in outpatient primary care, a brief tool to help the PCa screening conversation in busy clinic settings is needed. This paper discusses a previously-created 9-item tool to aid (PCa) screening discussions. The study found that the brief conversation tool was well received in busy primary-care settings and improved patients' knowledge about the screening decision.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hom G, Klein EA .
Testing of a tool for prostate cancer screening discussions in primary care.
Front Oncol 2018 Jun 28;8:238. doi: 10.3389/fonc.2018.00238..
Keywords: Cancer: Prostate Cancer, Decision Making, Patient-Centered Outcomes Research, Primary Care, Screening
Semenkovich TR, Panni RZ, Hudson JL
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
This study examined comparative effectiveness and survival rates for upfront esophagectomy versus induction chemoradiation in patients with clinical stage T2N20 esophageal cancer. A decision analysis model was created for the two treatment strategies. Results showed comparable median survival rates for both strategies. The optimal treatment strategy depended on the accuracy of endoscopic ultrasound staging.
AHRQ-funded; HS022330.
Citation: Semenkovich TR, Panni RZ, Hudson JL .
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
J Thorac Cardiovasc Surg 2018 May;155(5):2221-30.e1. doi: 10.1016/j.jtcvs.2018.01.006..
Keywords: Treatments, Cancer, Surgery, Comparative Effectiveness, Decision Making, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes, Medication