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Search All Research Studies
Topics
- Caregiving (1)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (2)
- Communication (3)
- COVID-19 (1)
- (-) Decision Making (11)
- Diagnostic Safety and Quality (2)
- Dialysis (2)
- Education: Patient and Caregiver (2)
- Elderly (1)
- Emergency Department (3)
- Imaging (3)
- (-) Kidney Disease and Health (11)
- Medical Expenditure Panel Survey (MEPS) (1)
- Mortality (1)
- Newborns/Infants (1)
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- Transplantation (4)
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 11 of 11 Research Studies DisplayedSchoenfeld EM, Poronsky KE, Westafer LM
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Both ultrasound and CT scan can be used for diagnosis of ureterolithiasis (or renal colic, the pain from an obstructing kidney stone), but the majority of patients receive a CT scan. Diagnostic pathways utilizing ultrasound have been shown to decrease radiation exposure to patients but are potentially less accurate. The investigators developed a decision aid to facilitate SDM in this scenario. The objective of this study was to determine the effects of this decision aid, as compared to usual care, on patient knowledge, radiation exposure, engagement, safety, and healthcare utilization.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Poronsky KE, Westafer LM .
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Trials 2021 Mar 10;22(1):201. doi: 10.1186/s13063-021-05140-9..
Keywords: Emergency Department, Decision Making, Kidney Disease and Health, Imaging, Diagnostic Safety and Quality
Nair D, Malhotra S, Lupu D
Challenges in communication, prognostication and dialysis decision-making in the COVID-19 pandemic: implications for interdisciplinary care during crisis settings.
This paper uses case vignettes to highlight challenges in communication, prognostication, and medical decision-making that have been exacerbated by the COVD-19 pandemic for patients with kidney disease. The authors include best practice recommendations to mitigate those issues and conclude with implications for interdisciplinary models of care in crisis settings. Concerns about certain biomarkers, demographics, and medical comorbidities that can predict an increased risk for mortality among patients with COVID-19 and kidney disease are discussed, because there may be communication barriers related to physical exposure and conservation of personal protective equipment with those at-risk patients.
AHRQ-funded; HS026395.
Citation: Nair D, Malhotra S, Lupu D .
Challenges in communication, prognostication and dialysis decision-making in the COVID-19 pandemic: implications for interdisciplinary care during crisis settings.
Curr Opin Nephrol Hypertens 2021 Mar 1;30(2):190-97. doi: 10.1097/mnh.0000000000000689..
Keywords: COVID-19, Dialysis, Kidney Disease and Health, Decision Making, Clinician-Patient Communication, Communication, Chronic Conditions
Thorsteinsdottir B, Hickson LJ, Giblon R
Validation of prognostic indices for short term mortality in an incident dialysis population of older adults >75.
Prognosis provides critical knowledge for shared decision making between patients and clinicians. While several prognostic indices for mortality in dialysis patients have been developed, their performance among elderly patients initiating dialysis is unknown, despite great need for reliable prognostication in that context. The purpose of this study was to assess the performance of 6 previously validated prognostic indices to predict 3 and/or 6 months mortality in a cohort of elderly incident dialysis patients.
AHRQ-funded; HS025517; HS025164; HS025402.
Citation: Thorsteinsdottir B, Hickson LJ, Giblon R .
Validation of prognostic indices for short term mortality in an incident dialysis population of older adults >75.
PLoS One 2021 Jan 20;16(1):e0244081. doi: 10.1371/journal.pone.0244081..
Keywords: Elderly, Dialysis, Kidney Disease and Health, Mortality, Decision Making
Schoenfeld EM, Shieh MS, Pekow PS
Association of patient and visit characteristics with rate and timing of urologic procedures for patients discharged from the emergency department with renal colic.
Little is known about the timing of urologic interventions in patients with renal colic discharged from the emergency department. Understanding patients' likelihood of a subsequent urologic intervention could inform decision-making in this population. The objective of this study was to examine the rate and timing of urologic procedures performed after an emergency department visit for renal colic and the factors associated with receipt of an intervention.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Shieh MS, Pekow PS .
Association of patient and visit characteristics with rate and timing of urologic procedures for patients discharged from the emergency department with renal colic.
JAMA Netw Open 2019 Dec 2;2(12):e1916454. doi: 10.1001/jamanetworkopen.2019.16454..
Keywords: Emergency Department, Kidney Disease and Health, Decision Making
Vemulakonda VM, Hamer MK, Kempe A
Surgical decision-making in infants with suspected UPJ obstruction: stakeholder perspectives.
Although there are significant demographic and clinical variations in treatment decisions for infants with high-grade hydronephrosis concerning for ureteropelvic junction obstruction (UPJO), there has been little research on the roles of parents and surgeons in the surgical decision-making (DM) process. The purpose of this study was to understand parents' and surgeons' perceived roles in the surgical DM process for infants with high-grade hydronephrosis.
AHRQ-funded; HS024597.
Citation: Vemulakonda VM, Hamer MK, Kempe A .
Surgical decision-making in infants with suspected UPJ obstruction: stakeholder perspectives.
J Pediatr Urol 2019 Oct;15(5):469.e1-69.e9. doi: 10.1016/j.jpurol.2019.05.027..
Keywords: Newborns/Infants, Decision Making, Surgery, Kidney Disease and Health, Caregiving, Provider: Physician, Provider, Patient and Family Engagement
Kilambi V, Bui K, Hazen GB
Evaluation of accepting kidneys of varying quality for transplantation or expedited placement with decision trees.
This article introduces a decision-tree methodology that analyzes a patient's dilemma: to accept a kidney offer now or reject it. The methodology calculates the survival benefit of accepting a kidney given a certain quality now and the survival benefit of rejecting it. The decision-tree tool presented could aid personalized transplant decision-making in the future by providing patients with calculated, individualized survival benefits between accepting and rejecting a kidney offer.
AHRQ-funded; HS024840.
Citation: Kilambi V, Bui K, Hazen GB .
Evaluation of accepting kidneys of varying quality for transplantation or expedited placement with decision trees.
Transplantation 2019 May;103(5):980-89. doi: 10.1097/tp.0000000000002585..
Keywords: Transplantation, Kidney Disease and Health, Decision Making
Novogrodsky E, Yaghoubian A, Connor SE
The role of media in non-directed (altruistic) living kidney donation.
This study sought to characterize how non-directed living kidney donors use media and informational resources over the course of their kidney donation journey. The investigators conducted semi-structured interviews with non-directed donors (NDDs) who initiated kidney transplant chains. The investigators concluded that media and informational resources play an important role in the process of donation for NDDs, including inspiring interest in donation through personal narratives.
AHRQ-funded; HS000029.
Citation: Novogrodsky E, Yaghoubian A, Connor SE .
The role of media in non-directed (altruistic) living kidney donation.
Health Commun 2019 Feb;34(2):259-67. doi: 10.1080/10410236.2017.1405480..
Keywords: Kidney Disease and Health, Transplantation, Decision Making, Communication, Education: Patient and Caregiver
Wey A, Salkowski N, Kremers WK
A kidney offer acceptance decision tool to inform the decision to accept an offer or wait for a better kidney.
The researchers developed a kidney offer acceptance decision tool to predict the probability of graft survival and patient survival for first-time kidney-alone candidates after an offer is accepted or declined, and they characterized the effect of restricting the donor pool with a maximum acceptable kidney donor profile index (KDPI). Donor pool restrictions were associated with worse 3-year outcomes, especially for candidates with high allocation priority.
AHRQ-funded; HS024527.
Citation: Wey A, Salkowski N, Kremers WK .
A kidney offer acceptance decision tool to inform the decision to accept an offer or wait for a better kidney.
Am J Transplant 2018 Apr;18(4):897-906. doi: 10.1111/ajt.14506.
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Keywords: Clinical Decision Support (CDS), Decision Making, Kidney Disease and Health, Medical Expenditure Panel Survey (MEPS), Transplantation
Traino HM, West SM, Nonterah CW
Communicating About Choices in Transplantation (COACH).
This article presents pilot results of the behavioral communication intervention program, Communicating about Choices in Transplantation (COACH), designed to improve transplant candidates' communication about transplantation. The authors indicate that results provided preliminary support for the program's impact. Moreover, participant evaluations of the COACH were overwhelmingly positive. They noted that a more definitive program evaluation with a larger, more diverse sample is currently underway.
AHRQ-funded; HS018113; HS021312.
Citation: Traino HM, West SM, Nonterah CW .
Communicating About Choices in Transplantation (COACH).
Prog Transplant 2017 Mar;27(1):31-38. doi: 10.1177/1526924816679844..
Keywords: Clinician-Patient Communication, Communication, Decision Making, Education: Patient and Caregiver, Kidney Disease and Health, Transplantation
Wang RC, Rodriguez RM, Moghadassi M
External validation of the STONE score, a clinical prediction rule for ureteral stone: an observational multi-institutional study.
The STONE score is a clinical decision rule that classifies patients with suspected nephrolithiasis into low-, moderate-, and high-score groups, with corresponding probabilities of ureteral stone. The researchers evaluated the STONE score compared with physician gestalt. They concluded that in its present form, the STONE score lacks sufficient accuracy to allow clinicians to defer CT scan for suspected ureteral stone.
AHRQ-funded; HS021281; HS019312.
Citation: Wang RC, Rodriguez RM, Moghadassi M .
External validation of the STONE score, a clinical prediction rule for ureteral stone: an observational multi-institutional study.
Ann Emerg Med 2016 Apr;67(4):423-32.e2. doi: 10.1016/j.annemergmed.2015.08.019.
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Keywords: Decision Making, Diagnostic Safety and Quality, Imaging, Kidney Disease and Health, Practice Patterns
Daniels B, Gross CP, Molinaro A
STONE PLUS: evaluation of emergency department patients with suspected renal colic, using a clinical prediction tool combined with point-of-care limited ultrasonography.
This study sought to determine whether renal point-of-care limited ultrasonography (PLUS) used in conjunction with the Sex, Timing, Origin, Nausea, Erythrocytes (STONE) clinical prediction score can aid identification of emergency department (ED) patients with uncomplicated ureteral stone or need for urologic intervention. It concluded that hydronephrosis on renal PLUS modestly improved risk stratification in low- and moderate-risk STONE score patients.
AHRQ-funded; HS018322.
Citation: Daniels B, Gross CP, Molinaro A .
STONE PLUS: evaluation of emergency department patients with suspected renal colic, using a clinical prediction tool combined with point-of-care limited ultrasonography.
Ann Emerg Med 2016 Apr;67(4):439-48. doi: 10.1016/j.annemergmed.2015.10.020.
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Keywords: Decision Making, Emergency Department, Imaging, Kidney Disease and Health