National Healthcare Quality and Disparities Report
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- Arthritis (3)
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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 13 of 13 Research Studies DisplayedHumbert-Droz M, Izadi Z, Schmajuk G
Development of a natural language processing system for extracting rheumatoid arthritis outcomes from clinical notes using the national rheumatology informatics system for effectiveness registry.
Researchers developed and evaluated a natural language processing pipeline for extracting outcome measures in rheumatology from free-text outpatient rheumatology notes within the ACR's Rheumatology Informatics System for Effectiveness (RISE) registry. All patients in RISE from 2015 to 2018 were included. The researchers found the pipeline to have good internal and external validity and they concluded that it could facilitate measurement of clinical and patient reported outcomes for use in both research and quality measurement.
AHRQ-funded; HS025638.
Citation: Humbert-Droz M, Izadi Z, Schmajuk G .
Development of a natural language processing system for extracting rheumatoid arthritis outcomes from clinical notes using the national rheumatology informatics system for effectiveness registry.
Arthritis Care Res 2023 Mar; 75(3):608-15. doi: 10.1002/acr.24869..
Keywords: Arthritis, Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Coley RY, Boggs JM, Beck A
Predicting outcomes of psychotherapy for depression with electronic health record data.
This study evaluated models for predicting outcomes of psychotherapy for depression in a clinical practice setting. Findings showed that prediction models did not accurately predict depression treatment outcomes despite using rich electronic health record data and advanced analytic techniques. Recommendations included caution when considering prediction models for psychiatric outcomes using baseline intake information and transparent research to evaluate performance of any model intended for clinical use.
AHRQ-funded; HS026369.
Citation: Coley RY, Boggs JM, Beck A .
Predicting outcomes of psychotherapy for depression with electronic health record data.
J Affect Disord Rep 2021 Dec;6:100198. doi: 10.1016/j.jadr.2021.100198..
Keywords: Depression, Behavioral Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research, Outcomes
Kutney-Lee A, Brooks Carthon M, Sloane DM
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Researchers examined associations between electronic health record (EHR) usability and nurse job and surgical patient outcomes. Data from the American Hospital Association, state patient discharges, and nurse surveys were linked in a cross-sectional analysis. The researchers found that employing EHR systems with suboptimal usability was associated with higher odds of adverse nurse job outcomes and surgical patient mortality and readmission.
AHRQ-funded; HS023805.
Citation: Kutney-Lee A, Brooks Carthon M, Sloane DM .
Electronic health record usability: associations with nurse and patient outcomes in hospitals.
Med Care 2021 Jul;59(7):625-31. doi: 10.1097/mlr.0000000000001536..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Surgery, Outcomes, Nursing, Provider: Nurse
Patel MR, Smith A, Leo H
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
This study assessed the effectiveness of providing physicians who use electronic health records (EHRs) education for communication strategies and its impact on patient outcomes. The evidence-based Physician Asthma Care Education (PACE) program was extended in a pilot program using 18 providers and 126 adult patients with persistent asthma. Outcomes were assessed at baseline and 3- and 6-month postintervention intervals. Providers who completed the EHR-PACE program felt more confident in communicating with their patients, but there was no significant changes in patient asthma outcomes or their perceptions of their provider’s communication skills.
AHRQ-funded; HS023786.
Citation: Patel MR, Smith A, Leo H .
Improving patient-provider communication and therapeutic practice through better integration of electronic health records in the exam room: a pilot study.
Health Educ Behav 2019 Jun;46(3):484-93. doi: 10.1177/1090198118796879..
Keywords: Asthma, Clinician-Patient Communication, Communication, Electronic Health Records (EHRs), Evidence-Based Practice, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Hannan EL, Barrett SC, Samadashvili Z
Retooling of paper-based outcome measures to electronic format: comparison of the NY State public risk model and EHR-derived risk models for CABG mortality.
This study assessed the feasibility of retooling the paper-based New York State coronary artery bypass graft (CABG) surgery statistical model for mortality and readmission into a model for electronic health records (EHRs). Researchers found that only 6 data elements could be extracted from the EHR, and outlier hospitals differed for readmission but was usable for mortality. They concluded that the EHR model was inferior to the NYS model, and that simplifying the EHR risk model couldn’t capture most of the risk factors in the NYS model.
AHRQ-funded; HS022647.
Citation: Hannan EL, Barrett SC, Samadashvili Z .
Retooling of paper-based outcome measures to electronic format: comparison of the NY State public risk model and EHR-derived risk models for CABG mortality.
Med Care 2019 May;57(5):377-84. doi: 10.1097/mlr.0000000000001104..
Keywords: Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Mortality, Outcomes, Risk, Cardiovascular Conditions
Norgeot B, Glicksberg BS, Trupin L
Assessment of a deep learning model based on electronic health record data to forecast clinical outcomes in patients with rheumatoid arthritis.
This study researched the use of artificial intelligence learning models to predict clinical outcomes in patients with rheumatoid arthritis (RA). Patients from a university hospital (UH) and a public safety-net hospital (SNH). The populations were quite different from each other. A total of 578 UH patients and 242 SNH patients were included in the study. Patients at the UH were seen more frequently than the SNH patients and were often prescribed high-class medications (63% vs. 28.9%). The model that was used showed a statistically random performance based on each patients’ most recent disease activity score.
AHRQ-funded; HS024412.
Citation: Norgeot B, Glicksberg BS, Trupin L .
Assessment of a deep learning model based on electronic health record data to forecast clinical outcomes in patients with rheumatoid arthritis.
JAMA Netw Open 2019 Mar;2(3):e190606. doi: 10.1001/jamanetworkopen.2019.0606..
Keywords: Arthritis, Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes
Wong J, Horwitz MM, Zhou L
Using machine learning to identify health outcomes from electronic health record data.
In this review, the authors discuss four common scenarios that researchers may find helpful for thinking critically about when and for what tasks machine learning may be used to identify health outcomes from electronic health record (EHR) data. The authors suggest that machine learning has great potential to improve the accuracy and efficiency of health outcome identification from EHR systems, especially under certain conditions.
AHRQ-funded; HS022728; HS024264; HS025375.
Citation: Wong J, Horwitz MM, Zhou L .
Using machine learning to identify health outcomes from electronic health record data.
Curr Epidemiol Rep 2018 Dec;5(4):331-42. doi: 10.1007/s40471-018-0165-9..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes
Flory JH, Keating SJ, Siscovick D
Identifying prevalence and risk factors for metformin non-persistence: a retrospective cohort study using an electronic health record.
Non-persistence may be a significant barrier to the use of metformin. The objective of this study was to assess reasons for metformin non-persistence, and whether initial metformin dosing or use of extended release (ER) formulations affect persistence to metformin therapy. The investigators concluded that their data supported the routine prescribing of low starting doses of metformin as a tool to improve persistence.
AHRQ-funded; HS023898.
Citation: Flory JH, Keating SJ, Siscovick D .
Identifying prevalence and risk factors for metformin non-persistence: a retrospective cohort study using an electronic health record.
BMJ Open 2018 Jul 23;8(7):e021505. doi: 10.1136/bmjopen-2018-021505..
Keywords: Diabetes, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Patient Adherence/Compliance, Outcomes, Patient-Centered Outcomes Research, Risk
Austrian JS, Jamin CT, Doty GR
Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.
The goal of this study was to determine if an electronic health record (EHR) based sepsis alert system could improve quality of care and clinical outcomes for patients with sepsis. A patient-level, interrupted time series study of emergency department patients with severe sepsis or septic shock was conducted, with an intervention introduced at the approximate mid-point--a system of interruptive sepsis alerts triggered by abnormal vital signs or laboratory results. Mean length of stay for patients with sepsis decreased significantly following the introduction of the alert, but the alert system had no effect on mortality or other clinical or process measures. The researchers conclude that a more sophisticated algorithm for sepsis identification is needed to improve outcomes.
AHRQ-funded; HS023683.
Citation: Austrian JS, Jamin CT, Doty GR .
Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.
J Am Med Inform Assoc 2018 May;25(5):523-29. doi: 10.1093/jamia/ocx072..
Keywords: Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Hospitals, Mortality, Outcomes, Quality Improvement, Quality of Care, Sepsis
Yao Y, Ahn H, Stifter J
Continuity index measures in the acute care hospital setting: an analytic review and tests using electronic health record data and computer simulation.
This study examined continuity index measures in the acute care hospital setting. These measures can be used to examine the influence of nurse staffing patterns on patient outcomes. The researchers examined the behavior of continuity indexes as applied to clinical practice data that were collected with the Hands-On Automated Nursing Data System (HANDS) and data from computer simulation. The findings provided a deep understanding of the conceptual foundations and properties of various continuity measures.
AHRQ-funded; HS015054; HS023072.
Citation: Yao Y, Ahn H, Stifter J .
Continuity index measures in the acute care hospital setting: an analytic review and tests using electronic health record data and computer simulation.
J Nurs Meas 2018 Apr 1;26(1):20-35. doi: 10.1891/1061-3749.26.1.20..
Keywords: Transitions of Care, Care Coordination, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse, Provider, Hospitals, Outcomes
Smith AB, Basch E
Role of patient-reported outcomes in postsurgical monitoring in oncology.
This article describes the benefits of electronic patient-reported outcomes (ePROs) in postsurgical symptom monitoring for surgical oncology patients; ePROs can identify at-risk patients, provide closer monitoring, and provide a mechanism to identify and treat complications before they worsen. The article also summarizes the literature of ePRO use in surgical oncology.
AHRQ-funded; HS024134.
Citation: Smith AB, Basch E .
Role of patient-reported outcomes in postsurgical monitoring in oncology.
J Oncol Pract 2017 Aug;13(8):535-38. doi: 10.1200/jop.2017.023838..
Keywords: Cancer, Care Management, Health Information Technology (HIT), Electronic Health Records (EHRs), Surgery, Outcomes
Yazdany J, Robbins M, Schmajuk G
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
The researchers sought to develop and test electronic clinical quality measures for rheumatoid arthritis. Disease activity assessment, functional status assessment, disease-modifying antirheumatic durg use, and tuberculosis screening measures have achieved national endorsement and are recommended for use in federal quality reporting programs.
AHRQ-funded; HS024412.
Citation: Yazdany J, Robbins M, Schmajuk G .
Development of the American College of Rheumatology's rheumatoid arthritis electronic clinical quality measures.
Arthritis Care Res 2016 Nov;68(11):1579-90. doi: 10.1002/acr.22984.
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Keywords: Electronic Health Records (EHRs), Medication, Quality Measures, Arthritis, Outcomes
Juckett DA, Davis FN, Gostine M
Patient-reported outcomes in a large community-based pain medicine practice: evaluation for use in phenotype modeling.
The researchers aimed to build a phenotype-to-outcome model targeting chronic pain to be used to drive clinical decision support for pain medicine in the community setting. Exploratory factor analysis of the intake Pain Health Assessment revealed 15 orthogonal factors representing pain levels; physical, social, and emotional functions; the effects of pain on these functions; vitality and health; and measures of outcomes and satisfaction.
AHRQ-funded; HS022335.
Citation: Juckett DA, Davis FN, Gostine M .
Patient-reported outcomes in a large community-based pain medicine practice: evaluation for use in phenotype modeling.
BMC Med Inform Decis Mak 2015 May 28;15:41. doi: 10.1186/s12911-015-0164-4..
Keywords: Care Management, Chronic Conditions, Community-Based Practice, Electronic Health Records (EHRs), Health Information Technology (HIT), Outcomes, Pain