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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 14 of 14 Research Studies DisplayedSchaffhausen 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
Hinson JS, Martinez DA, Cabral S
Triage performance in emergency medicine: a systematic review.
The authors synthesized existing emergency department (ED) triage literature by using a framework that enables performance comparisons and benchmarking across triage systems, with respect to clinical outcomes and reliability. They found that a substantial proportion of ED patients who die post-encounter or who are critically ill are not designated as high acuity at triage. They suggested that the opportunity exists to improve interrater reliability and triage performance in identifying patients at risk of adverse outcome.
AHRQ-funded; HS023641.
Citation: Hinson JS, Martinez DA, Cabral S .
Triage performance in emergency medicine: a systematic review.
Ann Emerg Med 2019 Jul;74(1):140-52. doi: 10.1016/j.annemergmed.2018.09.022..
Keywords: Emergency Department, Decision Making, Critical Care, Outcomes, Health Information Technology (HIT)
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
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
Skrivankova V, Heagerty PJ
Single index methods for evaluation of marker-guided treatment rules based on multivariate marker panels.
Answering the scientific challenge to identify and validate the factors that can reliably be used to target treatment and to quantify the expected treatment benefit as a function of candidate markers, the authors of this article propose to focus on a smooth, non-parametric evaluation of a canonical single-index score that estimates the expected treatment benefit associated with patient characteristics. Their methods decouple the model used to generate the treatment benefit score from the methods adopted in order to evaluate the performance of the resulting single-index score. They also demonstrate that the canonical single-index treatment benefit score can be used for selecting subsets of patients with enriched expected treatment response.
AHRQ-funded; HS019222.
Citation: Skrivankova V, Heagerty PJ .
Single index methods for evaluation of marker-guided treatment rules based on multivariate marker panels.
Biometrics 2018 Jun;74(2):663-72. doi: 10.1111/biom.12752..
Keywords: Comparative Effectiveness, Decision Making, Outcomes, Treatments
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
Levin S, Toerper M, Hamrock E
Machine-learning-based electronic triage more accurately differentiates patients with respect to clinical outcomes compared with the emergency severity index.
This study seeks to evaluate an electronic triage system (e-triage) based on machine learning that predicts likelihood of acute outcomes enabling improved patient differentiation. It concluded that E-triage more accurately classifies emergency severity index (ESI) level 3 patients and highlights opportunities to use predictive analytics to support triage decisionmaking.
AHRQ-funded; HS023641.
Citation: Levin S, Toerper M, Hamrock E .
Machine-learning-based electronic triage more accurately differentiates patients with respect to clinical outcomes compared with the emergency severity index.
Ann Emerg Med 2018 May;71(5):565-74.e2. doi: 10.1016/j.annemergmed.2017.08.005.
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Keywords: Decision Making, Health Information Technology (HIT), Health Information Technology (HIT), Outcomes
Arcia A, Woollen J, Bakken S
A systematic method for exploring data attributes in preparation for designing tailored infographics of patient reported outcomes.
Tailored visualizations of patient reported outcomes (PROs) are valuable health communication tools to support shared decision making, health self-management, and engagement with research participants, such as cohorts in the NIH Precision Medicine Initiative. The authors of the study present a systematic method to exploring data attributes, with a specific focus on application to self-reported health data. They present two case studies to illustrate how this method affected design decisions particularly with respect to outlier and non-missing zero values.
AHRQ-funded; HS019853; HS022961.
Citation: Arcia A, Woollen J, Bakken S .
A systematic method for exploring data attributes in preparation for designing tailored infographics of patient reported outcomes.
eGEMS 2018 Jan 24;6(1):2. doi: 10.5334/egems.190..
Keywords: Communication, Decision Making, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes, Data
Holland DE, Brandt C, Targonski PV
Validating performance of a hospital discharge planning decision tool in community hospitals.
The researchers aimed to determine the predictive performance of the Early Screen for Discharge Planning (ESDP) in a rural regional community hospital practice setting. Patients with high ESDP scores reported more problems after discharge, reported lower quality of life, had longer length of stays, and used post-acute care services more than patients with low ESDP scores.
AHRQ-funded; HS022923.
Citation: Holland DE, Brandt C, Targonski PV .
Validating performance of a hospital discharge planning decision tool in community hospitals.
Prof Case Manag 2017 Sep/Oct;22(5):204-13. doi: 10.1097/ncm.0000000000000233.
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Keywords: Decision Making, Hospital Discharge, Outcomes, Rural Health, Tools & Toolkits
Frasier LL, Holden S, Holden T
Temporal trends in postmastectomy radiation therapy and breast reconstruction associated with changes in national comprehensive cancer network guidelines.
The researchers sought to determine whether revised guidelines have increased postmastectomy radiation therapy (PMRT) and affected receipt of breast reconstruction. They found that changes in NCCN guidelines have been associated with an increase in PMRT among patients with tumors 5 cm or smaller and 1 to 3 positive nodes without an associated decrease in receipt of reconstruction.
AHRQ-funded; HS022403.
Citation: Frasier LL, Holden S, Holden T .
Temporal trends in postmastectomy radiation therapy and breast reconstruction associated with changes in national comprehensive cancer network guidelines.
JAMA Oncol 2016 Jan;2(1):95-101. doi: 10.1001/jamaoncol.2015.3717.
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Keywords: Cancer: Breast Cancer, Healthcare Delivery, Decision Making, Guidelines, Outcomes
Pho MT, Jensen DM, Meltzer DO
Clinical impact of treatment timing for chronic hepatitis C infection: a decision model.
The researchers developed a decision model to quantify the trade-offs between immediate, interferon-containing therapy and delayed, interferon-free therapy for patients with chronic, genotype 1 HCV infection. They found that compared to one-time immediate treatment with the interferon-containing regimen, delayed treatment with the interferon-free regimen in 1 year resulted in longer life expectancy.
AHRQ-funded; HS022433.
Citation: Pho MT, Jensen DM, Meltzer DO .
Clinical impact of treatment timing for chronic hepatitis C infection: a decision model.
J Viral Hepat 2015 Aug;22(8):630-8. doi: 10.1111/jvh.12412..
Keywords: Clinical Decision Support (CDS), Decision Making, Hepatitis, Medication, Outcomes
Kerlin MP, Harhay MO, Kahn JM
Nighttime intensivist staffing, mortality, and limits on life support: a retrospective cohort study.
This study assesses whether the relationships between nighttime staffing models and clinical outcomes are mediated by differences in end-of-life decision-making. It found little evidence that nighttime physician staffing models affect patient outcomes. ICUs without physicians at night may exhibit reduced hospital mortality that is possibly attributable to differences in end-of-life care practices.
AHRQ-funded; HS018406.
Citation: Kerlin MP, Harhay MO, Kahn JM .
Nighttime intensivist staffing, mortality, and limits on life support: a retrospective cohort study.
Chest 2015 Apr;147(4):951-8. doi: 10.1378/chest.14-0501..
Keywords: Decision Making, Mortality, Outcomes, Workforce
Heisler M, Choi H, Palmisano G
Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
This study compared outcomes between community health worker (CHW) use of a tailored, interactive, Web-based, tablet computer-delivered tool specifically developed for the study and use of printed educational materials. In a population of low-income Latino and African American adults with diabetes and relatively low levels of formal education, participants in both CHW-led interventions reported mostly similar improvements in outcomes over 3 months.
AHRQ-funded; HS019256
Citation: Heisler M, Choi H, Palmisano G .
Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
Ann Intern Med. 2014 Nov 18;161(10 Suppl):S13-22. doi: 10.7326/m13-3012..
Keywords: Health Information Technology (HIT), Diabetes, Decision Making, Outcomes, Social Determinants of Health
Salihu HM, Salemi JL, Nash MC
Assessing the economic impact of paternal involvement: a comparison of the generalized linear model versus decision analysis trees.
The authors illustrated a methodological comparison of decision analysis modeling and generalized linear modeling (GLM) techniques using a case study that assesses the cost-effectiveness of potential father involvement interventions. They found that lack of paternal involvement was associated with higher rates of preterm birth, small-for-gestational age, and infant morbidity and mortality, concluding that healthcare costs could be significantly reduced through enhanced father involvement during pregnancy.
AHRQ-funded; HS019997.
Citation: Salihu HM, Salemi JL, Nash MC .
Assessing the economic impact of paternal involvement: a comparison of the generalized linear model versus decision analysis trees.
Matern Child Health J 2014 Aug;18(6):1380-90. doi: 10.1007/s10995-013-1372-0.
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Keywords: Family Health and History, Newborns/Infants, Outcomes, Pregnancy, Case Study, Decision Making