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
1 to 25 of 129 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
Soulsby WD, Lawson E, Pantell MS
Cumulative social disadvantage associated with childhood arthritis: a cross-sectional analysis of the National Survey of Children's Health.
The purpose of this cross-sectional analysis study was to explore cumulative social disadvantage on childhood arthritis. The researchers developed a cumulative social disadvantage score, assigning 1 point to each of the following variables with a maximum total score of 4: low guardian education (high school or less), low household income level (0-199% of federal poverty level), underinsured status (public or uninsured), and a high adverse childhood experience (ACE) score of 4 or greater. The study found that of the 131,774 surveys completed, a total of 365 children reported current arthritis. Of those 365, cumulative social disadvantage was related with an arthritis diagnosis, with the greatest odds in those with a total score of 4. Cumulative social disadvantage also was related with higher odds of moderate-to-severe arthritis severity.
AHRQ-funded; HS026383.
Citation: Soulsby WD, Lawson E, Pantell MS .
Cumulative social disadvantage associated with childhood arthritis: a cross-sectional analysis of the National Survey of Children's Health.
Arthritis Care Res 2023 Jan; 75(1):3-8. doi: 10.1002/acr.24991..
Keywords: Children/Adolescents, Arthritis, Social Determinants of Health, Low-Income
McQuillan J, Andersen JA, Berdahl TA
AHRQ Author: Berdahl TA
Associations of rheumatoid arthritis and depressive symptoms over time: are there differences by education, race/ethnicity, and gender?
The objective of this study was to examine associations between changes in Rheumatoid Arthritis symptoms and depressive symptoms and to test if these associations differed by education, or gender, or race/ethnicity. Data was taken from the National Rheumatoid Arthritis Study, 1988-98. The results indicated that people with Rheumatoid Arthritis experienced increases in depressive symptoms as well as pain, functional disability, and household work disability over the study period. There was no difference noted in the rate of change in depressive symptoms by education, gender, nor race/ethnicity, but the association of functional disability with depressive symptoms was stronger for men than women. The researchers concluded that it is important to monitor and treat both mental and physical health symptoms, and that future research should focus on the collection of data that reflects the educational, gender, and racial/ethnic diversity of people with Rheumatoid Arthritis.
AHRQ-authored.
Citation: McQuillan J, Andersen JA, Berdahl TA .
Associations of rheumatoid arthritis and depressive symptoms over time: are there differences by education, race/ethnicity, and gender?
Arthritis Care Res 2022 Dec;74(12):2050-58. doi: 10.1002/acr.24730..
Keywords: Arthritis, Depression, Behavioral Health, Racial and Ethnic Minorities, Sex Factors, Chronic Conditions
Ferucci ED, Day GM, Choromanski TL
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
This study’s objective was to evaluate outcomes and quality of care for rheumatoid arthritis (RA) in patients seen by video telemedicine compared to in-person only. Individuals in the Alaska Tribal Health System who were diagnosed with RA were recruited when seeing a rheumatologist either in person or by video telemedicine. Participants completed a Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire and a telephone medicine perception survey at the start of the survey. They also agreed to medical record review. The authors repeated the surveys by telephone and at 6 and 12 months, and medical record abstraction was performed at 12 months for quality measures. By the end of the 12-month period, about half of the 122 RA participants (52%) had ever used telemedicine for RA. Higher RAPID3 score and functional status were associated with the telemedicine group, with no statistically significant change over the 12-month period. The only quality measure that differed between the two groups at 12 months was the proportion of visits in which disease activity was documented, but it was not significantly after multivariate analysis.
AHRQ-funded; HS024540.
Citation: Ferucci ED, Day GM, Choromanski TL .
Outcomes and quality of care in rheumatoid arthritis with or without video telemedicine follow-up visits.
Arthritis Care Res 2022 Mar;74(3):484-92. doi: 10.1002/acr.24485..
Keywords: Arthritis, Chronic Conditions, Telehealth, Health Information Technology (HIT), Quality of Care, Outcomes
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
Izadi Z, Schmajuk G, Gianfrancesco M
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
This study examined performance on rheumatoid arthritis (RA) quality measures and assessed the association between practice characteristics and changes in performance over time among participating practices. The authors analyzed data from practices enrolled in the American College of Rheumatology Rheumatology Informatics System for Effectiveness (RISE) registry from 2015 to 2017. Eight quality measures in the areas of RA disease management, cardiovascular risk reduction, and patient safety were analyzed. Data from 59,986 patients from 54 practices were examined. Cohort characteristics were a mean age of 62 years, 77% female, 69% Caucasian, and most patients (46%) were seen in a single-specialty group practice. Measures related to RA functional status and disease activity assessment improved over time, with single-specialty group practices having the fastest rates of improvement across all measures.
AHRQ-funded; HS025638; HS024412.
Citation: Izadi Z, Schmajuk G, Gianfrancesco M .
Significant gains in rheumatoid arthritis quality measures among RISE Registry practices.
Arthritis Care Res 2022 Feb;74(2):219-28. doi: 10.1002/acr.24444..
Keywords: Arthritis, Chronic Conditions, Quality Measures, Quality Indicators (QIs), Registries, Quality of Care
Brown TT, Hurley VB, Rodriguez HP
Association of patient engagement strategies with utilisation and spending for musculoskeletal problems in the USA: a cross-sectional analysis of Medicare patients and physician practices.
This cross-sectional study assessed the association of physician practice-level adoption of patient engagement strategies (PES), such as shared decision-making and motivational interviewing, with utilization and spending. The cohort included primary and secondary patients in 2190 practices who receiving treatment for hip (39,336), knee (48,362), and lower-back (67,940) issues who were Medicare beneficiaries that were matched to the 2017-2018 National Survey of Healthcare Organizations and Systems. Outcome measures were total knee replacement (TKR), total hip replacement (THR), 1-2 level posterior lumbar fusion (LF), total annual spending, and components of total annual spending. Spending was significantly lower in some categories for practices with relatively higher PES adoption, but did not differ for other practices. The odds of receiving THR were higher in independent practices for patients attributed to practices with moderate PES compared to patients in practices with low PES.
AHRQ-funded; HS024075.
Citation: Brown TT, Hurley VB, Rodriguez HP .
Association of patient engagement strategies with utilisation and spending for musculoskeletal problems in the USA: a cross-sectional analysis of Medicare patients and physician practices.
BMJ Open 2021 Nov 26;11(11):e053121. doi: 10.1136/bmjopen-2021-053121..
Keywords: Patient and Family Engagement, Healthcare Utilization, Healthcare Costs, Arthritis, Orthopedics
Lopez-Olivo MA, Lin H, Rizvi T
Randomized controlled trial of patient education tools for patients with rheumatoid arthritis.
This randomized controlled trial compared results of patient education tools for patients with rheumatoid arthritis using a written booklet or a written booklet along with a newly developed video tool. Outcomes were measured immediately before and after review of the materials, and 3 and 6 months later. One-hundred eleven participants received an educational video and booklet and one-hundred ten a booklet alone. Mean age of participants was 50.8 years, mean disease duration 4.8 years, 85% were female, and 24% had limited health literacy levels. Both groups had improved outcomes up to 6 months after educational materials were delivered and used, with no statistically significant difference between the two groups. Patients receiving the video and booklet were more likely to rate the presentation as “excellent".
AHRQ-funded; HS0193554.
Citation: Lopez-Olivo MA, Lin H, Rizvi T .
Randomized controlled trial of patient education tools for patients with rheumatoid arthritis.
Arthritis Care Res 2021 Oct;73(10):1470-78. doi: 10.1002/acr.24362..
Keywords: Education: Patient and Caregiver, Health Literacy, Arthritis, Patient Self-Management
Subash M, Liu LH, DeQuattro K
The Development of the Rheumatology Informatics System for Effectiveness Learning Collaborative for improving patient-reported outcome collection and patient-centered communication in adult rheumatology.
Patient-reported outcomes (PROs) are an integral part of treat-to-target approaches in managing rheumatoid arthritis (RA). In clinical practice, however, routine collection, documentation, and discussion of PROs with patients are highly variable. In this paper, the investigators discussed the Development of the Rheumatology Informatics System for Effectiveness Learning Collaborative for improving patient-reported outcome collection and patient-centered communication in adult rheumatology.
AHRQ-funded; HS025638.
Citation: Subash M, Liu LH, DeQuattro K .
The Development of the Rheumatology Informatics System for Effectiveness Learning Collaborative for improving patient-reported outcome collection and patient-centered communication in adult rheumatology.
ACR Open Rheumatol 2021 Oct;3(10):690-98. doi: 10.1002/acr2.11310..
Keywords: Arthritis, Patient-Centered Outcomes Research, Learning Health Systems, Health Information Technology (HIT)
Kim C, Colborn KL, van Buuren S
Neighbors-based prediction of physical function after total knee arthroplasty.
The purpose of this study was to develop and test personalized predictions for functional recovery after Total Knee Arthroplasty (TKA) surgery, using a novel neighbors-based prediction approach. Findings showed that predictions were well-calibrated in out-of-sample testing. These predictions have the potential to inform care decisions both prior to and following TKA surgery.
AHRQ-funded; HS025692; HS024316.
Citation: Kim C, Colborn KL, van Buuren S .
Neighbors-based prediction of physical function after total knee arthroplasty.
Sci Rep 2021 Aug 18;11(1):16719. doi: 10.1038/s41598-021-94838-6..
Keywords: Orthopedics, Surgery, Arthritis
Izadi Z, Li J, Evans M
Socioeconomic disparities in functional status in a national sample of patients with rheumatoid arthritis.
This longitudinal study looked at the association of socioeconomic disparities and functional status in a national sample of patients with rheumatoid arthritis (RA). This study used a cohort from the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) registry from 2016 to 2018. Analyses included all adult patients with a confirmed RA diagnosis and at least 1 functional status (FS) score documented. The Area Deprivation Index (ADI), a zip code-based indicator of poverty, was used as a proxy for socioeconomic status (SES). The cohort included 83,965 patients, of which 77% were women and 72% were non-Hispanic White. Mean age was 63.4 years. The probability of functional decline was 14.1% in the highest SES quintile and 18.9% in the lowest SES quintile. By all measures FS score was worse at lower SES levels.
AHRQ-funded; HS025638; HS024412.
Citation: Izadi Z, Li J, Evans M .
Socioeconomic disparities in functional status in a national sample of patients with rheumatoid arthritis.
JAMA Netw Open 2021 Aug 2;4(8):e2119400. doi: 10.1001/jamanetworkopen.2021.19400..
Keywords: Arthritis, Chronic Conditions, Disparities, Social Determinants of Health, Quality of Life
Yi J, Wood JB, Creech CB
Clinical epidemiology and outcomes of pediatric musculoskeletal infections.
The objective of this study was to understand the epidemiology of acute hematogenous osteomyelitis and septic arthritis, including clinical and demographic features, microbiology, treatment approaches, treatment-associated complications, and outcomes. Musculoskeletal infections are challenging pediatric infections. The investigators concluded that S aureus remained the most common pathogen, with methicillin-resistant S aureus accounting for 25% of all cases. Concurrent acute hematogenous osteomyelitis/septic arthritis was associated with more severe disease and worse outcomes.
AHRQ-funded; HS026390.
Citation: Yi J, Wood JB, Creech CB .
Clinical epidemiology and outcomes of pediatric musculoskeletal infections.
J Pediatr 2021 Jul;234:236-44.e2. doi: 10.1016/j.jpeds.2021.03.028..
Keywords: Children/Adolescents, Arthritis
Griesemer I, Hausmann LR, Arbeeva L
Discrimination experiences and depressive symptoms among African Americans with osteoarthritis enrolled in a pain coping skills training randomized controlled trial.
This study evaluated the interaction between discrimination experiences and depressive symptoms among African Americans with osteoarthritis enrolled in a pain coping skills training (PCST) randomized controlled trial. The authors evaluated the interactions for 164 participants in linear regression models predicting depressive symptoms. There was a significant interaction between personal discrimination and experimental condition on depressive symptoms. Discrimination was associated with depressive symptoms among the control group but not among those who received PCST.
AHRQ-funded; HS000032.
Citation: Griesemer I, Hausmann LR, Arbeeva L .
Discrimination experiences and depressive symptoms among African Americans with osteoarthritis enrolled in a pain coping skills training randomized controlled trial.
J Health Care Poor Underserved 2021;32(1):145-55. doi: 10.1353/hpu.2021.0014..
Keywords: Racial and Ethnic Minorities, Pain, Arthritis, Orthopedics, Patient Experience, Depression
Lopez-Olivo MA, des Bordes JK, Lin H
A randomized controlled trial comparing two self-administered educational strategies for patients with knee osteoarthritis.
The authors conducted a randomized clinical trial in patients with knee osteoarthritis to assess the efficacy of providing a video for entertainment education, in combination with two booklets, compared with providing the booklets alone. They found that, although both education strategies were associated with improved knowledge and reduced decisional conflict at 6 months, receiving the video + booklets in combination, compared with receiving the booklets alone, proved to be more effective in changing behaviors and appeared to have some advantages for Spanish speakers and those who were less educated.
AHRQ-funded; HS019354.
Citation: Lopez-Olivo MA, des Bordes JK, Lin H .
A randomized controlled trial comparing two self-administered educational strategies for patients with knee osteoarthritis.
ACR Open Rheumatol 2021 Mar;3(3):185-95. doi: 10.1002/acr2.11222..
Keywords: Arthritis, Orthopedics, Education: Patient and Caregiver, Patient Self-Management, Patient Adherence/Compliance, Decision Making, Health Promotion
Sun K, Szymonifka J, Tian H
Association of traditional Chinese medicine use with adherence to prescribed Western rheumatic medications among Chinese American patients: a cross-sectional survey.
Chinese Americans are a fast-growing immigrant group with worse rheumatic disease outcomes compared to white populations and frequently use traditional Chinese medicine (TCM). Whether TCM use is associated with lower adherence to Western rheumatic medications is unknown. The purpose of this study was to examine adherence to Western medications for systemic rheumatic diseases in the Chinese American immigrant population and its association with TCM use.
Citation: Sun K, Szymonifka J, Tian H .
Association of traditional Chinese medicine use with adherence to prescribed Western rheumatic medications among Chinese American patients: a cross-sectional survey.
Arthritis Care Res 2020 Oct;72(10):1474-80. doi: 10.1002/acr.24031..
Keywords: Medication, Complementary and Alternative Medicine, Patient Adherence/Compliance, Racial and Ethnic Minorities, Arthritis, Chronic Conditions
Ferucci ED, Holck P, Day GM
Factors associated with use of telemedicine for follow-up of rheumatoid arthritis.
The objective of this analysis was to determine factors associated with the use of video telemedicine when offered as part of usual care for follow-up of rheumatoid arthritis (RA). Participants were individuals with a diagnosis of RA recruited from the Alaska Tribal Health System when seeing a rheumatologist either in-person or via video telemedicine. Findings showed that, when offered as an option for rheumatology care, video telemedicine was more likely to be used by RA patients with higher disease activity and more positive perceptions of telemedicine, as well as by patients whose physicians used telemedicine more often.
AHRQ-funded; HS024540.
Citation: Ferucci ED, Holck P, Day GM .
Factors associated with use of telemedicine for follow-up of rheumatoid arthritis.
Arthritis Care Res 2020 Oct;72(10):1404-09. doi: 10.1002/acr.24049.
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Keywords: Telehealth, Health Information Technology (HIT), Arthritis, Healthcare Delivery
Daniel CM, Davila L, Makris UE
Ethnic disparities in atherosclerotic cardiovascular disease incidence and prevalence among rheumatoid arthritis patients in the United States: a systematic review.
In this systematic review, the authors sought to describe the incidence and prevalence of atherosclerotic cardiovascular disease (ASCVD) stratified by race/ethnicity within the US population of those with rheumatoid arthritis (RA). They found insufficient data on racially/ethnically diverse RA patients and ASCVD outcomes. They recommended that future studies report the prevalence of ASCVD in various races/ethnicities with RA in the United States, as these data would help inform clinicians on how best to manage cardiovascular disease risk in RA.
AHRQ-funded; HS022418.
Citation: Daniel CM, Davila L, Makris UE .
Ethnic disparities in atherosclerotic cardiovascular disease incidence and prevalence among rheumatoid arthritis patients in the United States: a systematic review.
ACR Open Rheumatol 2020 Sep;2(9):525-32. doi: 10.1002/acr2.11170..
Keywords: Disparities, Racial and Ethnic Minorities, Arthritis, Cardiovascular Conditions
Giardina JC, Cha T, Atlas SJ
Validation of an electronic coding algorithm to identify the primary indication of orthopedic surgeries from administrative data.
The purpose of this study was to develop and validate an algorithm to identify patients receiving four elective orthopedic surgeries to promote shared decision-making. The surgeries included were: 1) knee arthroplasty to treat knee osteoarthritis (KOA); 2) hip arthroplasty to treat hip osteoarthritis (HOA); 3) spinal surgery to treat lumbar spinal stenosis (SpS); and 4) spinal surgery to treat lumber herniated disc (HD). Electronic medical records were reviewed to ascertain a “gold standard” determination of the procedure and primary indication status. Each case had electronic algorithms consisting of ICD-10 and CPT codes for each combination and indication applied to their record. A total of 790 procedures were included in the study. The sensitivity of the algorithms ranged from 0.70 (HD) to 0.92 (KOA). Specificity ranged from 0.94 (SpS) to 0.99 (HOA, KOA).
AHRQ-funded; HS000055.
Citation: Giardina JC, Cha T, Atlas SJ .
Validation of an electronic coding algorithm to identify the primary indication of orthopedic surgeries from administrative data.
BMC Med Inform Decis Mak 2020 Aug 12;20(1):187. doi: 10.1186/s12911-020-01175-1.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Orthopedics, Surgery, Arthritis, Decision Making
Liu LH, Garrett SB, Li J
Patient and clinician perspectives on a patient-facing dashboard that visualizes patient reported outcomes in rheumatoid arthritis.
The authors’ goal was to develop a rheumatoid arthritis (RA) 'dashboard' that could facilitate conversations about patient-reported outcomes (PROs) and that would be acceptable to a wide range of patients, including English and Spanish speakers and patients with adequate or limited health literacy. Using focus groups and principles of human-centered design, they created an RA dashboard that was well-accepted among patients and clinicians. They indicated that the ability to customize the data display was important for tailoring the dashboard to patients with diverse needs and preferences, with special attention to be given to feasibility concerns voiced by clinicians.
AHRQ-funded; HS025405.
Citation: Liu LH, Garrett SB, Li J .
Patient and clinician perspectives on a patient-facing dashboard that visualizes patient reported outcomes in rheumatoid arthritis.
Health Expect 2020 Aug;23(4):846-59. doi: 10.1111/hex.13057..
Keywords: Arthritis, Health Information Technology (HIT), Patient and Family Engagement, Clinician-Patient Communication, Communication, Health Literacy
Kulhawy-Wibe SC, Zell J, Michaud K
Systematic review and appraisal of the cross-cultural validity of functional status assessment measures in rheumatoid arthritis.
Researchers conducted a systematic review and appraisal of the cross-cultural adaptation and cross-cultural validity of the Health Assessment Questionnaire and its derivatives, and of the more recent Patient-Reported Outcomes Measurement Information System (PROMIS) functional status assessment measures (FSAMs) in rheumatoid arthritis. They concluded that their review highlighted a paucity of data on the cross-cultural validity of FSAMs and the mostly poor- or fair-quality methods by which they were translated and adapted.
AHRQ-funded; HS025638.
Citation: Kulhawy-Wibe SC, Zell J, Michaud K .
Systematic review and appraisal of the cross-cultural validity of functional status assessment measures in rheumatoid arthritis.
Arthritis Care Res 2020 Jun;72(6):798-805. doi: 10.1002/acr.23904..
Keywords: Arthritis, Cultural Competence, Health Status
Gaskin DJ, Karmarkar TD, Maurer A
Potential role of cost and quality of life in treatment decisions for arthritis-related knee pain in African American and Latina women.
This study examined whether using a decision-making tool would aid Latina and African-American women over age 45 years with arthritic knee pain in making more informed treatment decisions. The researchers conducted 4 focus groups of Latina and African-American women and 2 focus groups with primary care providers who treated them for knee pain. They found that minority women and primary care providers all endorsed the use of a decision-making tool that provided information on the impact of treatment on quality of life, medical care costs, and work productivity.
AHRQ-funded; HS000029.
Citation: Gaskin DJ, Karmarkar TD, Maurer A .
Potential role of cost and quality of life in treatment decisions for arthritis-related knee pain in African American and Latina women.
Arthritis Care Res 2020 May;72(5):692-98. doi: 10.1002/acr.23903..
Keywords: Arthritis, Orthopedics, Pain, Quality of Life, Healthcare Costs, Decision Making, Racial and Ethnic Minorities, Women
Birru Talabi M, Clowse MEB, Blalock SJ
Perspectives of adult rheumatologists regarding family planning counseling and care: a qualitative study.
This qualitative study sought to assess rheumatologists' perspectives, attitudes, and practices regarding family planning counseling and reproductive health care (FPCC). A geographically diverse sample of U.S. rheumatologists were interviewed and the transcripts of the interviews developed into a code book based on their content. Findings showed that rheumatologists feel a sense of responsibility to provide some aspects of FPCC to reproductive-age female patients. However, their own apprehensions about managing complicated pregnancies may negatively influence how they advise patients about pregnancy planning or avoidance. Future work should focus on eliminating barriers and identifying solutions that support rheumatologists' efforts to provide high-quality FPCC to patients.
AHRQ-funded; HS022989.
Citation: Birru Talabi M, Clowse MEB, Blalock SJ .
Perspectives of adult rheumatologists regarding family planning counseling and care: a qualitative study.
Arthritis Care Res 2020 Mar;72(3):452-58. doi: 10.1002/acr.23872..
Keywords: Arthritis, Pregnancy, Sexual Health, Provider: Physician, Women
Gandrup J, Li J, Izadi Z
Three quality improvement initiatives and performance of rheumatoid arthritis disease activity measures in electronic health records: results from an interrupted time series study.
This study evaluated the effect of 3 HIT initiatives on the performance of rheumatoid arthritis (RA) disease activity measures and outcomes in an academic rheumatology clinic. The three initiatives implemented to facilitate performance of the Clinical Disease Activity Index (CDAI) were: 1) an EHR flowsheet to input scores, 2) peer performance reports, and 3) an EHR Smartform including a CDAI calculator. Data from 995 patients with 8,040 encounters between 2012 and 2017 was included. Electronic capture of CDAI scores increased from 0% to 64%. Peer performance reporting and the SmartForm kept performance stable. Physician satisfaction increased after SmartForm implementation.
AHRQ-funded; HS025638.
Citation: Gandrup J, Li J, Izadi Z .
Three quality improvement initiatives and performance of rheumatoid arthritis disease activity measures in electronic health records: results from an interrupted time series study.
Arthritis Care Res 2020 Feb;72(2):283-91. doi: 10.1002/acr.23848..
Keywords: Arthritis, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Lange JK, DiSegna ST, Yang W
Using cluster analysis to identify patient factors linked to differential functional gains after total knee arthroplasty.
This study used cluster analysis to identify patient factors linked to different outcomes following total knee arthroplasty (TKA). The study analyzed Short Form 36 Physical Component Score (PCS) trajectories of 656 patients at 3 time points over a 1-year period. The MultiExperiment View (MeV) built-in bootstrapping method was used to assess statistical significance of the clusters. They found two distinct clusters: Cluster 1 included 550 patients (84%) who demonstrated persistent improvement at 6 and 12 months. The remainder of patients consisted of Cluster 2 who demonstrated decline in PCS at 6 months but improved by 12 months. Cluster 1 was found to have higher baseline mental health scores, lower baseline PCS, and a significantly higher proportion of non-Hispanic Whites compared to Cluster 2.
AHRQ-funded; HS018910.
Citation: Lange JK, DiSegna ST, Yang W .
Using cluster analysis to identify patient factors linked to differential functional gains after total knee arthroplasty.
J Arthroplasty 2020 Jan;35(1):121-26.e6. doi: 10.1016/j.arth.2019.08.039..
Keywords: Orthopedics, Surgery, Arthritis, Outcomes, Chronic Conditions
Barber CEH, Zell J, Yazdany J
2019 American College of Rheumatology recommended patient-reported functional status assessment measures in rheumatoid arthritis.
This study’s objective was to develop American College of Rheumatology (ACR) Functional Status Assessment Measures (FSAMs) for patient reporting in most clinic settings. The authors convened a workgroup to conduct a systematic literature review through March 2017. They focused on the following FSAMs: the Health Assessment Questionnaire (HAQ) and derived measures from the Patient-Reported Outcomes Measurement Information System (PROMIS) tool. Out of 11,835 articles identified in the search, 56 were included in the review. A modified Delphi process identified 7 measures which fulfilled the minimum standard for regular use, and 3 measures were recommended: the PROMIS 10-item short form, the HAQ-II, and the Multidimensional HAQ.
AHRQ-funded; HS025638.
Citation: Barber CEH, Zell J, Yazdany J .
2019 American College of Rheumatology recommended patient-reported functional status assessment measures in rheumatoid arthritis.
Arthritis Care Res 2019 Dec;71(12):1531-39. doi: 10.1002/acr.24040..
Keywords: Arthritis, Health Status, Guidelines, Evidence-Based Practice