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
126 to 150 of 174 Research Studies DisplayedThiel DB, Platt J, Platt T
Testing an online, dynamic consent portal for large population biobank research.
Michigan's BioTrust for Health contains over 4 million samples collected without written consent. Participant-centric initiatives are IT tools that hold great promise to address the consent challenges in biobank research. The authors created and pilot tested a dynamic informed consent simulation focusing on consent for research. Pilot testers raised concerns about the process of identity verification and appeared to have little experience with sharing health information online. The authors recommended applying online, dynamic approaches to address the consent challenges raised by biobanks with legacy sample collections.
AHRQ-funded; HS000053.
Citation: Thiel DB, Platt J, Platt T .
Testing an online, dynamic consent portal for large population biobank research.
Public Health Genomics 2015;18(1):26-39. doi: 10.1159/000366128.
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Keywords: Data, Newborns/Infants, Research Methodologies, Screening
Sundararajan V, Romano PS, Quan H
Capturing diagnosis-timing in ICD-coded hospital data: recommendations from the WHO ICD-11 topic advisory group on quality and safety.
The purpose of this project was to develop a consensus opinion regarding capturing diagnosis-timing in coded hospital data. The WHO Quality and Safety Topic Advisory Group has undertaken a narrative literature review, scanned national experiences focusing on countries currently using timing flags, and held a series of meetings to derive formal recommendations regarding diagnosis-timing reporting. This paper discusses their concerns and recommendations.
AHRQ-funded; HS020543.
Citation: Sundararajan V, Romano PS, Quan H .
Capturing diagnosis-timing in ICD-coded hospital data: recommendations from the WHO ICD-11 topic advisory group on quality and safety.
Int J Qual Health Care 2015 Aug;27(4):328-33. doi: 10.1093/intqhc/mzv037..
Keywords: Patient Safety, Quality of Care, Quality Improvement, Hospitals, Data
Greenberg JK, Ladner TR, Olsen MA
Complications and resource use associated with surgery for Chiari Malformation type 1 in adults: a population perspective.
This study examined the complications and resource use associated with adult CM-1 surgery using administrative data. It concluded that complications after CM-1 surgery are common, and surgical complications are more frequent than medical complications. Also, certain comorbidities and demographic characteristics are associated with increased risk for complications.
AHRQ-funded; H0S19455.
Citation: Greenberg JK, Ladner TR, Olsen MA .
Complications and resource use associated with surgery for Chiari Malformation type 1 in adults: a population perspective.
Neurosurgery 2015 Aug;77(2):261-8. doi: 10.1227/neu.0000000000000777..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Outcomes, Data
FitzHenry F, Resnic FS, Robbins SL
Creating a common data model for comparative effectiveness with the observational medical outcomes partnership.
This case study describes the challenges and opportunities of a study specific use of the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM) by two health systems and describe three comparative effectiveness use cases developed from the CDM. It concluded that the data transformation to the CDM was time consuming and resources required were substantial, beyond requirements for collecting native source data.
AHRQ-funded; HS019913.
Citation: FitzHenry F, Resnic FS, Robbins SL .
Creating a common data model for comparative effectiveness with the observational medical outcomes partnership.
Appl Clin Inform 2015 Aug 26;6(3):536-47. doi: 10.4338/aci-2014-12-cr-0121..
Keywords: Comparative Effectiveness, Outcomes, Data
Pine M, Kowlessar NM, Salemi JL
Enhancing clinical content and race/ethnicity data in statewide hospital administrative databases: obstacles encountered, strategies adopted, and lessons learned.
Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases. The authors concluded that creation of enhanced administrative databases to support comparative effectiveness research is difficult, particularly in the face of numerous challenges with recruiting data partners such as competing demands on information technology resources.
AHRQ-funded
Citation: Pine M, Kowlessar NM, Salemi JL .
Enhancing clinical content and race/ethnicity data in statewide hospital administrative databases: obstacles encountered, strategies adopted, and lessons learned.
Health Serv Res 2015 Aug;50 Suppl 1:1300-21. doi: 10.1111/1475-6773.12330..
Keywords: Healthcare Cost and Utilization Project (HCUP), Comparative Effectiveness, Patient-Centered Outcomes Research, Data
Zingmond DS, Parikh P, Louie R
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
This study investigated new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals. It examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort in California. It concluded that comparison between reported R/E and R/E estimates using zip code level data may be a reasonable first approach to evaluate and track hospital R/E reporting.
AHRQ-funded; HS019963.
Citation: Zingmond DS, Parikh P, Louie R .
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
Health Serv Res 2015 Aug;50 Suppl 1:1372-89. doi: 10.1111/1475-6773.12324..
Keywords: Racial and Ethnic Minorities, Hospitals, Hospital Discharge, Health Services Research (HSR), Registries, Quality Improvement, Quality of Care, Data
Naessens JM, Visscher SL, Peterson SM
Incorporating the last four digits of social security numbers substantially improves linking patient data from de-identified hospital claims databases.
The study objective was to assess algorithms for linking patients across de-identified databases without compromising confidentiality. It found that addition of SSNL4 to administrative data, accompanied by appropriate data use and data release policies, can enable trusted repositories to link data with nearly perfect accuracy.
AHRQ-funded; HS020043.
Citation: Naessens JM, Visscher SL, Peterson SM .
Incorporating the last four digits of social security numbers substantially improves linking patient data from de-identified hospital claims databases.
Health Serv Res 2015 Aug;50 Suppl 1:1339-50. doi: 10.1111/1475-6773.12323..
Keywords: Data, Registries, Hospital Discharge, Health Information Technology (HIT)
DesRoches CM, Wong HS, Rich EC
AHRQ Author: Wong HS
Making the case for a new national data collection effort on physicians and their practices.
The pace of change in the U.S. health care system and the integral role played by physicians indicate a clear need for an ongoing, regular physician survey. The authors argue that the survey be designed to monitor over time the characteristics of all physicians in all specialties and the clinical, organizational, and financial contexts in which they operate.
AHRQ-authored
Citation: DesRoches CM, Wong HS, Rich EC .
Making the case for a new national data collection effort on physicians and their practices.
J Gen Intern Med 2015 Aug;30 Suppl 3:S553-4. doi: 10.1007/s11606-015-3386-3..
Keywords: Data, Practice Patterns, Provider, Provider: Physician
Fleming C, Rich E, DesRoches C
Measuring changes in the economics of medical practice.
This paper explores current issues relevant to defining and measuring the inputs and outputs of physician practice. It reviews practice inputs and outputs as typically described in the literature on the economics of medical practice, and identifies the conceptual challenges for defining these inputs and outputs in a complex and evolving health care system.
AHRQ-funded; 23320095642WC; 23337033T.
Citation: Fleming C, Rich E, DesRoches C .
Measuring changes in the economics of medical practice.
J Gen Intern Med 2015 Aug;30 Suppl 3:S562-7. doi: 10.1007/s11606-015-3368-5..
Keywords: Healthcare Delivery, Health Systems, Practice Patterns, Data
Lim E, Cheng Y, Reuschel C
Risk-adjusted in-hospital mortality models for congestive heart failure and acute myocardial infarction: Value of clinical laboratory data and race/ethnicity.
This study examined the impact of key laboratory and race/ethnicity data on the prediction of in-hospital mortality for congestive heart failure (CHF) and acute myocardial infarction (AMI). It found that adding a simple three-level summary measure based on the number of abnormal laboratory data observed to hospital administrative claims data significantly improved the model prediction for inpatient mortality.
AHRQ-funded; HS019990.
Citation: Lim E, Cheng Y, Reuschel C .
Risk-adjusted in-hospital mortality models for congestive heart failure and acute myocardial infarction: Value of clinical laboratory data and race/ethnicity.
Health Serv Res 2015 Aug;50 Suppl 1:1351-71. doi: 10.1111/1475-6773.12325..
Keywords: Heart Disease and Health, Mortality, Data, Inpatient Care
Andrews RM
AHRQ Author: Andrews RM
Statewide hospital discharge data: Collection, use, limitations, and improvements.
The purpose of the article is to provide background information on statewide hospital discharge data and the context for the other articles in this special issue of HSR that focus on the products and lessons learned by the Enhanced State Data grantees. The author provides an overview of statewide hospital discharge data, including content and coverage, and its evolution and improvement over time.
AHRQ-authored
Citation: Andrews RM .
Statewide hospital discharge data: Collection, use, limitations, and improvements.
Health Serv Res 2015 Aug;50 Suppl 1:1273-99. doi: 10.1111/1475-6773.12343..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Discharge, Data
Salemi JL, Salinas-Miranda AA, Wilson RE
Transformative use of an improved all-payer hospital discharge data infrastructure for community-based participatory research: a sustainability pathway.
The researchers describe the use of a clinically enhanced maternal and child health (MCH) database to strengthen community-engaged research activities, and to support the sustainability of data infrastructure initiatives. The population-based, longitudinal database was used to supplement data collected from focus groups and community surveys with epidemiological and health care cost data on important MCH disparity issues in the target community.
AHRQ-funded; HS019997.
Citation: Salemi JL, Salinas-Miranda AA, Wilson RE .
Transformative use of an improved all-payer hospital discharge data infrastructure for community-based participatory research: a sustainability pathway.
Health Serv Res 2015 Aug;50 Suppl 1:1322-38. doi: 10.1111/1475-6773.12309..
Keywords: Maternal Care, Comparative Effectiveness, Hospital Discharge, Data, Quality Improvement
Bigback KM, Hoopes M, Dankovchik J
Using record linkage to improve race data quality for American Indians and Alaska Natives in two Pacific Northwest State Hospital Discharge Databases.
This study aimed to evaluate and adjust for American Indian and Alaska Native (AI/AN) racial misclassification in two hospital discharge datasets in the Pacific Northwest. It found that in Oregon, 55.4 percent of matching records were misclassified (66.5 percent miscoded white, and 22.1 percent were missing race information). Linkage increased ascertainment of AI/AN hospitalizations by 31.8 percent in Oregon and 33.9 percent in Washington.
AHRQ-funded; HS019972.
Citation: Bigback KM, Hoopes M, Dankovchik J .
Using record linkage to improve race data quality for American Indians and Alaska Natives in two Pacific Northwest State Hospital Discharge Databases.
Health Serv Res 2015 Aug;50 Suppl 1:1390-402. doi: 10.1111/1475-6773.12331..
Keywords: Racial and Ethnic Minorities, Quality Improvement, Registries, Hospital Discharge, Data
Greenberg JK, Ladner TR, Olsen MA
Validation of an International Classification of Diseases, Ninth Revision Code algorithm for identifying Chiari Malformation type 1 surgery in adults.
The purpose of this study was to validate 2 ICD-9-CM code algorithms identifying patients undergoing CM-1 decompression surgery. It concluded that the ICD-9-CM code Algorithm 2 has excellent positive predictive value and good sensitivity to identify adult CM-1 decompression surgery.
AHRQ-funded; HS019455.
Citation: Greenberg JK, Ladner TR, Olsen MA .
Validation of an International Classification of Diseases, Ninth Revision Code algorithm for identifying Chiari Malformation type 1 surgery in adults.
Neurosurgery 2015 Aug;77(2):269-73. doi: 10.1227/neu.0000000000000778..
Keywords: Data, Diagnostic Safety and Quality, Surgery
Kim KK, Joseph JG, Ohno-Machado L
Comparison of consumers' views on electronic data sharing for healthcare and research.
The researchers surveyed California consumers to learn their views of privacy, security, and consent in electronic data sharing for healthcare and research together. They found considerable concern that health information exchanges will worsen privacy (40.3 percent) and security (42.5 percent). Consumers are in favor of electronic data sharing but elements of transparency are important: individual control, who has access, and the purpose for use of data.
AHRQ-funded; HS019913.
Citation: Kim KK, Joseph JG, Ohno-Machado L .
Comparison of consumers' views on electronic data sharing for healthcare and research.
J Am Med Inform Assoc 2015 Jul;22(4):821-30. doi: 10.1093/jamia/ocv014..
Keywords: Communication, Data, Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Patient-Centered Healthcare
Wang HE, Donnelly JP, Shapiro NI
Hospital variations in severe sepsis mortality.
The authors characterized variations in severe sepsis mortality between hospitals in the United States. They used hospital discharge data from the University HealthSystem Consortium and found variations in institutional severe sepsis observed mortality rates and observed-to-expected mortality ratios.
AHRQ-funded; HS019465; HS013852.
Citation: Wang HE, Donnelly JP, Shapiro NI .
Hospital variations in severe sepsis mortality.
Am J Med Qual 2015 Jul-Aug;30(4):328-36. doi: 10.1177/1062860614534461.
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Keywords: Data, Hospitals, Mortality, Patient-Centered Outcomes Research, Sepsis
Pakyz AL, Patterson JA, Motzkus-Feagans C
Performance of the present-on-admission indicator for Clostridium difficile infection.
The researchers compared performance of a hospital- and community-onset Clostridium difficile infection definition using administrative data to a present on- admission indicator with definitions using clinical surveillance. For hospital-onset C. difficile infection, there was moderate sensitivity (68 percent) and high specificity (93 percent); for community-onset, sensitivity and specificity were high (both 85 percent).
AHRQ-funded; HS018578.
Citation: Pakyz AL, Patterson JA, Motzkus-Feagans C .
Performance of the present-on-admission indicator for Clostridium difficile infection.
Infect Control Hosp Epidemiol 2015 Jul;36(7):838-40. doi: 10.1017/ice.2015.63..
Keywords: Clostridium difficile Infections, Patient Safety, Healthcare-Associated Infections (HAIs), Data
Ross ME, Kreider AR, Huang YS
Propensity score methods for analyzing observational data like randomized experiments: challenges and solutions for rare outcomes and exposures.
The researchers expanded upon an approach to the analysis of observational data sets that mimics a sequence of randomized studies by implementing propensity score models within each trial to achieve covariate balance, using weighting and matching. Challenges included a rare outcome, a rare exposure, substantial and important differences between exposure groups, and a very large sample size.
AHRQ-funded; HS018550.
Citation: Ross ME, Kreider AR, Huang YS .
Propensity score methods for analyzing observational data like randomized experiments: challenges and solutions for rare outcomes and exposures.
Am J Epidemiol 2015 Jun 15;181(12):989-95. doi: 10.1093/aje/kwu469..
Keywords: Comparative Effectiveness, Data, Research Methodologies
Wysocki A, Thomas KS, Mor V
Functional improvement among short-stay nursing home residents in the MDS 3.0.
This study examined the completeness of the activities of daily living (ADL) items on admission and discharge assessments and the improvement in ADL performance among short-stay residents in the newly adopted Minimum Data Set (MDS) 3.0. It found that the ADL self-performance items are complete at both admission and discharge, with less than 1 percent missing for any item.
AHRQ-funded; HS000011.
Citation: Wysocki A, Thomas KS, Mor V .
Functional improvement among short-stay nursing home residents in the MDS 3.0.
J Am Med Dir Assoc 2015 Jun;16(6):470-4. doi: 10.1016/j.jamda.2014.11.018..
Keywords: Nursing Homes, Elderly, Data
Hirth RA, Gibson TB, Levy HG
New evidence on the persistence of health spending.
Using the MarketScan claims database, the researchers characterized the persistence of health care spending in the privately insured, under-65 population. They found that over a 6-year period,69.8 percent of enrollees never had annual spending in the top 10 percent of the distribution and the bottom 50 percent of spenders accounted for less than 10 percent of spending.
AHRQ-funded; HS017706.
Citation: Hirth RA, Gibson TB, Levy HG .
New evidence on the persistence of health spending.
Med Care Res Rev 2015 Jun;72(3):277-97. doi: 10.1177/1077558715572387..
Keywords: Healthcare Costs, Health Insurance, Data
Del Fiol G, Crouch BI, Cummins MR
Data standards to support health information exchange between poison control centers and emergency departments.
The researchers identified and assessed a set of data standards to enable a standards-based health information exchange process between emergency departments (EDs) and poison control centers (PCCs). They determined that four Consolidated Clinical Document Architecture document types were necessary to support the PCC–ED information exchange process: History & Physical Note, Consultation Note, Progress Note, and Discharge Summary.
AHRQ-funded; HS021472.
Citation: Del Fiol G, Crouch BI, Cummins MR .
Data standards to support health information exchange between poison control centers and emergency departments.
J Am Med Inform Assoc 2015 May;22(3):519-28. doi: 10.1136/amiajnl-2014-003127..
Keywords: Data, Emergency Department, Emergency Medical Services (EMS), Health Information Exchange (HIE), Health Information Technology (HIT)
Margulis AV, Palmsten K, Andrade SE
Beginning and duration of pregnancy in automated health care databases: review of estimation methods and validation results.
The authors describe methods reported in the literature to estimate the beginning or duration of pregnancy in automated health care data, and to present results of validation exercises where available. They concluded that a number of methods of varying complexity are available to estimate them. Validation studies have been performed for many of them and can serve as a guide for method selection for a particular study.
AHRQ-funded; HS018533.
Citation: Margulis AV, Palmsten K, Andrade SE .
Beginning and duration of pregnancy in automated health care databases: review of estimation methods and validation results.
Pharmacoepidemiol Drug Saf 2015 Apr;24(4):335-42. doi: 10.1002/pds.3743..
Keywords: Pregnancy, Comparative Effectiveness, Data
Brouwer ES, Moga DC, Eron JJ
Evaluating the incident user design in the HIV population: incident use versus naive?
Through linkage to a comprehensive HIV clinical cohort, the researchers aimed to quantify and describe the truly naïve patients in an incident use population identified in Medicaid administrative claims. In their sample, they found that 34 percent of the Medicaid incident users were naïve based on medical record abstraction of antiretroviral use.
AHRQ-funded; HS018731.
Citation: Brouwer ES, Moga DC, Eron JJ .
Evaluating the incident user design in the HIV population: incident use versus naive?
Pharmacoepidemiol Drug Saf 2015 Mar;24(3):297-300. doi: 10.1002/pds.3705..
Keywords: Human Immunodeficiency Virus (HIV), Research Methodologies, Comparative Effectiveness, Data, Medicaid
Neff JM, Clifton H, Popalisky J
Stratification of children by medical complexity.
The investigators stratified children using the software, Clinical Risk Groups (CRGs), in a tertiary children's hospital and a state's Medicaid claims data into 3 condition groups: complex chronic disease; noncomplex chronic disease, and nonchronic disease. They concluded that CRGs can be used to stratify children receiving care at a tertiary care hospital according to complexity in both hospital and Medicaid administrative data.
AHRQ-funded; HS020506.
Citation: Neff JM, Clifton H, Popalisky J .
Stratification of children by medical complexity.
Acad Pediatr 2015 Mar-Apr;15(2):191-6. doi: 10.1016/j.acap.2014.10.007.
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Keywords: Children/Adolescents, Chronic Conditions, Data, Electronic Health Records (EHRs), Children/Adolescents
Neugebauer R, Schmittdiel JA, Zhu Z
High-dimensional propensity score algorithm in comparative effectiveness research with time-varying interventions.
The authors described the application and performance of the hdPS algorithm to improve covariate selection in CER with time-varying interventions based on inverse probability weighting estimation and explored stabilization of the resulting estimates using Super Learning. Their evaluation was based on both the analysis of electronic health records data in a real-world CER study of adults with type 2 diabetes and a simulation study.
AHRQ-funded; 29020050016I.
Citation: Neugebauer R, Schmittdiel JA, Zhu Z .
High-dimensional propensity score algorithm in comparative effectiveness research with time-varying interventions.
Stat Med 2015 Feb 28;34(5):753-81. doi: 10.1002/sim.6377..
Keywords: Comparative Effectiveness, Data, Research Methodologies