National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Access to Care (1)
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Asthma (2)
- Autism (1)
- Behavioral Health (3)
- Brain Injury (1)
- Care Coordination (1)
- Care Management (1)
- (-) Children/Adolescents (17)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (1)
- Critical Care (1)
- Disabilities (1)
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- (-) Evidence-Based Practice (17)
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- Health Literacy (1)
- Health Services Research (HSR) (2)
- Hepatitis (1)
- Implementation (1)
- Intensive Care Unit (ICU) (1)
- Medication (1)
- Neurological Disorders (2)
- (-) Outcomes (17)
- Patient-Centered Outcomes Research (15)
- Quality Improvement (3)
- Quality of Care (3)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Registries (3)
- Research Methodologies (1)
- Respiratory Conditions (2)
- Risk (1)
- Sepsis (1)
- Sleep Problems (2)
- Surgery (3)
- Transplantation (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 17 of 17 Research Studies DisplayedKrishnan JA, Margellos-Anast H, Kumar R
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
The purpose of this clinical trial was to compare an emergency-department- (ED) only intervention and home visits by community health workers for 6 months (ED-plus-home) and enhanced usual care (UC). The study enrolled children aged 5 to 11 years with uncontrolled asthma. The primary outcomes were change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers. The secondary outcomes included guideline-recommended ED discharge care and self-management. The study found that of the 373 children recruited, only 63% completed the 6-month follow-up visit. Differences in Asthma Impact Scores or caregivers' Satisfaction with Participation in Social Roles scores were not significant. However, in the intervention groups guideline-recommended ED discharge care improved significantly versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups.
AHRQ-funded; HS027804.
Citation: Krishnan JA, Margellos-Anast H, Kumar R .
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
J Allergy Clin Immunol Glob 2023 Aug; 2(3). doi: 10.1016/j.jacig.2023.100100..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Emergency Department, Clinical Decision Support (CDS), Health Information Technology (HIT), Racial and Ethnic Minorities
Capone CA, Emerson B, Sweberg T
Intubation practice and outcomes among pediatric emergency departments: a report from National Emergency Airway Registry for Children (NEAR4KIDS).
The purpose of this study was to describe Tracheal Intubation (TI) practice and outcomes in pediatric Emergency Departments as compared to those in intensive care units (ICUs) and use the resulting data to identify targets for quality improvement. The researchers analyzed consecutive TI encounters from pediatric EDs and ICUs in the National Emergency Airway Registry for Children (NEAR4KIDS) database from 2015 to 2018. The study found a total of 12,512 TIs in 51 pediatric/cardiac ICUs, and 756 TIs in 13 pediatric EDs and were reported. Proportion of TIs for shock (26% ED vs. 14% ICU), respiratory decompensation (52% vs. 64%), and neurologic deterioration (30% vs. 11%) also differed by location. Limited neck mobility was reported more often in the ED (16% vs. 6%). TIs in the ED were performed more often via video laryngoscopy (64% vs. 29%). Oxygen desaturation was less commonly reported in ED TIs (13.6%) than ICU TIs (17%). Among ED TIs, shock as an indication and limited mouth opening were independently associated with adverse TI-associated events (TIAEs). The study concluded that TI characteristics vary between pediatric EDs and ICUs, yet outcomes are similar.
AHRQ-funded; HS022464.
Citation: Capone CA, Emerson B, Sweberg T .
Intubation practice and outcomes among pediatric emergency departments: a report from National Emergency Airway Registry for Children (NEAR4KIDS).
Acad Emerg Med 2022 Apr;29(4):406-14. doi: 10.1111/acem.14431..
Keywords: Children/Adolescents, Emergency Department, Registries, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Critical Care, Intensive Care Unit (ICU)
Choi KR, Bhakta B, Knight EA
Patient outcomes after applied behavior analysis for autism spectrum disorder.
The purpose of this study was to examine patterns of service receipt and patient outcomes for children receiving applied behavior analysis (ABA) for autism spectrum disorder (ASD) in an integrated health care system in which commercially insured children were covered by a state autism mandate. Findings showed that, in a health system implementation of ABA for children with ASD, there were high rates of ABA discontinuation and low ABA dosing. These challenges may diminish the potential benefits of ABA, even with mandated commercial insurance coverage.
AHRQ-funded; HS026407.
Citation: Choi KR, Bhakta B, Knight EA .
Patient outcomes after applied behavior analysis for autism spectrum disorder.
J Dev Behav Pediatr 2022 Jan;43(1):9-16. doi: 10.1097/dbp.0000000000000995..
Keywords: Children/Adolescents, Autism, Behavioral Health, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Paul R, Niedner M, Brilli R
Metric development for the multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative.
A 56 US hospital collaborative, Improving Pediatric Sepsis Outcomes (IPSO), has developed variables, metrics and a data analysis plan to track quality improvement (QI)-based patient outcomes over time. Improving Pediatric Sepsis Outcomes expands on previous pediatric sepsis QI efforts by improving electronic data capture and uniformity across sites. This paper describes the metric development for the multicenter IPSO Collaborative.
AHRQ-funded; HS025696.
Citation: Paul R, Niedner M, Brilli R .
Metric development for the multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative.
Pediatrics 2021 May;147(5):e2020017889. doi: 10.1542/peds.2020-017889..
Keywords: Children/Adolescents, Sepsis, Quality Improvement, Quality of Care, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Kemme S, Stahl M, Brigham D
Outcomes of severe seronegative hepatitis-associated aplastic anemia: a pediatric case series.
Hepatitis-associated aplastic anemia (HAAA) is a potentially life-threatening diagnosis without clear treatment guidelines. The goal of the study was to characterize the presentation, evaluation, histopathology, and outcomes of therapy in children with HAAA to guide future research and to develop standardized care guidelines for this rare disease. The investigators found that ATG-based IST induced remission of hepatitis in patients with steroid-refractory HAAA.
AHRQ-funded; HS026510.
Citation: Kemme S, Stahl M, Brigham D .
Outcomes of severe seronegative hepatitis-associated aplastic anemia: a pediatric case series.
J Pediatr Gastroenterol Nutr 2021 Feb;72(2):194-201. doi: 10.1097/mpg.0000000000002940..
Keywords: Children/Adolescents, Hepatitis, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Guidelines
Ing C, Jackson WM, Zaccariello MJ
Prospectively assessed neurodevelopmental outcomes in studies of anaesthetic neurotoxicity in children: a systematic review and meta-analysis.
This systematic review and meta-analysis tried to answer the question whether exposure to a single general anesthetic (GA) in early childhood causes long-term neurodevelopmental problems. Databases searched from inception to October 2019 were PubMed/MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Library. Outcomes common to at least three studies were evaluated using a random-effects meta-analyses. A total of 841 out of 1644 children who had a single exposure to GA were evaluated. Findings were that there were statistically significant increases in parent reports of behavioral problems but no difference in general intelligence.
AHRQ-funded; HS026493.
Citation: Ing C, Jackson WM, Zaccariello MJ .
Prospectively assessed neurodevelopmental outcomes in studies of anaesthetic neurotoxicity in children: a systematic review and meta-analysis.
Br J Anaesth 2021 Feb;126(2):433-44. doi: 10.1016/j.bja.2020.10.022..
Keywords: Children/Adolescents, Neurological Disorders, Medication, Adverse Drug Events (ADE), Adverse Events, Evidence-Based Practice, Outcomes
Luther M, Poppert Cordts KM, Williams CN
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
This is a systematic review to quantify sleep wake disturbances (SWD) after pediatric traumatic brain injury (TBI). These SWD can place children at risk for worse outcomes since sleep is needed for brain development and healing after injury. They also evaluated interventions for SWD and the association between SWD and other post-traumatic outcomes. Literature was searched from 1999-2019 evaluating sleep or fatigue in children hospitalized for TBI. Two independent reviewers assessed quality of the studies using the Newcastle-Ottowa Score for observational studies. Out of 966 identified articles, 126 full text articles were reviewed and 24 studies were included. Studies showed at least 20% of children with TBI had some degree of SWD including trouble falling or staying asleep, fatigue, daytime fatigue, and nightmares. SWD was negatively correlated with cognitive, behavioral, and quality of life outcomes. There was moderate-high risk of bias for all studies due to small sample size and lack of validated or objective SWD measures.
AHRQ-funded; HS022981.
Citation: Luther M, Poppert Cordts KM, Williams CN .
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
Sleep 2020 Oct;43(10):zsaa083. doi: 10.1093/sleep/zsaa083..
Keywords: Children/Adolescents, Sleep Problems, Brain Injury, Neurological Disorders, Trauma, Risk, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Evidence-Based Practice
Lindly O, Crossman M, Eaves M
Health literacy and health outcomes among children with developmental disabilities: a systematic review.
This systematic literature review focused on the impact of health literacy on health outcomes of children with developmental disabilities (DDs). A review of the literature of most of the major scientific databases was conducted. Out of 2,768 unique records identified, 53 full text articles were reviewed and four articles were included. The associations of family health literacy with health outcomes among children with DDs were mixed. Future research was recommended.
AHRQ-funded; HS000063.
Citation: Lindly O, Crossman M, Eaves M .
Health literacy and health outcomes among children with developmental disabilities: a systematic review.
Am J Intellect Dev Disabil 2020 Sep 1;125(5):389-407. doi: 10.1352/1944-7558-125.5.389..
Keywords: Children/Adolescents, Health Literacy, Disabilities, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Mogul DB, Perito ER, Wood N
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
In December 2018, UNOS approved an allocation scheme based on recipients' geographic distance from a deceased donor ("acuity circles"). Previous analyses suggested acuity circles (AC) would reduce waitlist mortality overall, but their impact on pediatric subgroups was not considered. In this study, the investigators applied Scientific Registry of Transplant Recipients data from 2011-2016 towards the Liver Simulated Allocation Model (LSAM) to compare outcomes by age and illness severity for the UNOS-approved AC and the existing Donor Service Area (DSA)/Region-based allocation schemes.
AHRQ-funded; HS023876.
Citation: Mogul DB, Perito ER, Wood N .
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
Transplantation 2020 Aug;104(8):1627-32. doi: 10.1097/tp.0000000000003079..
Keywords: Children/Adolescents, Transplantation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Surgery, Access to Care
Kaiser SV, Johnson MD, Walls TA
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
This quality improvement study’s aim was to determine the effects of pediatric asthma pathway implementation in a diverse, national sample of emergency departments (EDs). Desired outcomes included systemic corticosteroid administration within 60 minutes (primary), assessment of severity at ED triage, chest radiograph use, hospital admission or transfer for higher level of care, and ED length of stay. Charts were reviewed each month by EDs for children ages 2-17 years with a primary diagnosis of asthma. A total of 83 EDs were enrolled, with 37 of them children’s hospitals, and 46 community hospitals. Seventy-three percent completed the study (n = 22,963). There was a significant increase in systematic corticosteroid administration within 60 minutes of arrival as well as increased odds of severity assessment at triage and decreased rate of change in odds of hospital admission/transfer. Chest radiograph or ED length of stay was not associated with pathway implementation.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Johnson MD, Walls TA .
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
J Pediatr 2020 Aug;223:100-07.e2. doi: 10.1016/j.jpeds.2020.02.080..
Keywords: Children/Adolescents, Emergency Department, Asthma, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Bowring MG, Massie AB, Chu NM
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
Researchers aimed to use national registry data and parametric models to project 20- and 30-year post-transplant outcomes for recently transplanted pediatric liver transplant (LT) recipients. Using Scientific Registry of Transplant Recipients data, they found that projected long-term outcomes for recently transplanted pediatric LT recipients are excellent, reflective of substantial improvements in medical care, and informative for physician-patient education and decision making in the current era.
AHRQ-funded; HS023876.
Citation: Bowring MG, Massie AB, Chu NM .
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
J Pediatr Gastroenterol Nutr 2020 Mar;70(3):356-63. doi: 10.1097/mpg.0000000000002592..
Keywords: Children/Adolescents, Transplantation, Patient-Centered Outcomes Research, Outcomes, Surgery, Registries, Evidence-Based Practice
Adrian M, McCauley E, Berk MS
Predictors and moderators of recurring self-harm in adolescents participating in a comparative treatment trial of psychological interventions.
This study compared outcomes for treatment of adolescents who have engaged in self-harm including suicide attempts and nonsuicidal self-injury. This randomized controlled tiral compared results with dialectical behavior therapy (DBT) to treatment with individual/group supportive therapy (IGST). 173 adolescents were randomized to receive 6 months of DBT or IGST. Assessments were made at baseline, midtreatment (3 months), and end of treatment at 6 months using the Suicide Attempt and Self –Injury Interview. Overall, DBT showed better rates of improvement than IGST. These was especially true of adolescents with higher levels of emotion dysregulation and parental psychopathology.
AHRQ-funded; HS022982.
Citation: Adrian M, McCauley E, Berk MS .
Predictors and moderators of recurring self-harm in adolescents participating in a comparative treatment trial of psychological interventions.
J Child Psychol Psychiatry 2019 Oct;60(10):1123-32. doi: 10.1111/jcpp.13099..
Keywords: Children/Adolescents, Behavioral Health, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Family Health and History, Outcomes
Adrian M, Zeman J, Erdley C
Trajectories of non-suicidal self-injury in adolescent girls following inpatient hospitalization.
This study explored the growth of non-suicidal self-injury (NSSI) frequency over 2.5 years in a clinical sample of adolescent girls. The investigators concluded that their findings highlighted the stable nature of NSSI and the contribution of emotion dysregulation and internalizing symptoms to NSSI patterns. The investigators asserted that developing interventions targeting these NSSI predictors early in girls' development may prevent the emergence and maintenance of NSSI.
AHRQ-funded; HS022982.
Citation: Adrian M, Zeman J, Erdley C .
Trajectories of non-suicidal self-injury in adolescent girls following inpatient hospitalization.
Clin Child Psychol Psychiatry 2019 Oct;24(4):831-46. doi: 10.1177/1359104519839732..
Keywords: Children/Adolescents, Evidence-Based Practice, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
I Auerbach, M Badaki-Makun, O
AHRQ Author: Barata
A research agenda to advance pediatric emergency care through enhanced collaboration across emergency departments.
In 2018, the Society for Academic Emergency Medicine and the journal Academic Emergency Medicine (AEM) convened a consensus conference entitled, "Academic Emergency Medicine Consensus Conference: Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps." This article is the product of the breakout session, "Emergency Department Collaboration-Pediatric Emergency Medicine in Non-Children's Hospital."
AHRQ-funded; HS026101.
Citation: I Auerbach, M Badaki-Makun, O .
A research agenda to advance pediatric emergency care through enhanced collaboration across emergency departments.
Acad Emerg Med 2018 Dec;25(12):1415-26. doi: 10.1111/acem.13642..
Keywords: Care Coordination, Children/Adolescents, Emergency Department, Evidence-Based Practice, Health Services Research (HSR), Outcomes, Quality of Care, Quality Improvement
Adelgais KM, Hansen M, Lerner EB
Establishing the key outcomes for pediatric emergency medical services research.
The evidence supporting best practices when treating children in the prehospital setting or even the effect emergency medical services (EMS) has on patient outcomes is limited. This article describes a consensus process among stakeholders in the pediatric emergency medicine and EMS community that identified the critical outcomes for EMS care in five clinical areas (traumatic brain injury, general injury, respiratory disease/failure, sepsis, and seizures).
AHRQ-funded; HS026101.
Citation: Adelgais KM, Hansen M, Lerner EB .
Establishing the key outcomes for pediatric emergency medical services research.
Acad Emerg Med 2018 Dec;25(12):1345-54. doi: 10.1111/acem.13637..
Keywords: Children/Adolescents, Emergency Medical Services (EMS), Evidence-Based Practice, Health Services Research (HSR), Outcomes, Patient-Centered Outcomes Research
Ishimine P, Adelgais K, Barata I
Executive summary: the 2018 Academic Emergency Medicine Consensus Conference: Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps.
Emergency care providers share a compelling interest in developing an effective patient-centered, outcomes-based research agenda that can decrease variability in pediatric outcomes. The 2018 Academic Emergency Medicine Consensus Conference "Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps (AEMCC)" aimed to fulfill this role. This paper discusses the conference which convened major thought leaders and stakeholders to introduce a research, scholarship, and innovation agenda for pediatric emergency care specifically to reduce health outcome gaps.
AHRQ-funded; HS026101.
Citation: Ishimine P, Adelgais K, Barata I .
Executive summary: the 2018 Academic Emergency Medicine Consensus Conference: Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps.
Acad Emerg Med 2018 Dec;25(12):1317-26. doi: 10.1111/acem.13667..
Keywords: Implementation, Evidence-Based Practice, Patient-Centered Outcomes Research, Children/Adolescents, Emergency Department, Outcomes, Research Methodologies
Chinnadurai S, Jordan AK, Sathe NA
Tonsillectomy for obstructive sleep-disordered breathing: a meta-analysis.
This meta-analysis compared sleep, cognitive or behavioral, and health outcomes of tonsillectomy versus watchful waiting with supportive care in children with sleep-disordered breathing. It determined that, relative to watchful waiting, most studies reported better sleep-related outcomes in children who had a tonsillectomy.
AHRQ-funded; 290201500003I.
Citation: Chinnadurai S, Jordan AK, Sathe NA .
Tonsillectomy for obstructive sleep-disordered breathing: a meta-analysis.
Pediatrics 2017 Feb;139(2). doi: 10.1542/peds.2016-3491.
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Keywords: Children/Adolescents, Sleep Problems, Surgery, Evidence-Based Practice, Respiratory Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes