National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (5)
- (-) Adverse Events (21)
- Antibiotics (2)
- Arthritis (1)
- Blood Thinners (2)
- Cancer (1)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (3)
- Cardiovascular Conditions (2)
- Chronic Conditions (1)
- (-) Comparative Effectiveness (21)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Dialysis (1)
- Elderly (1)
- Evidence-Based Practice (5)
- Healthcare-Associated Infections (HAIs) (2)
- Heart Disease and Health (1)
- Imaging (1)
- Injuries and Wounds (1)
- Kidney Disease and Health (3)
- Labor and Delivery (1)
- Maternal Care (1)
- Medication (6)
- Medication: Safety (2)
- Men's Health (1)
- Mortality (1)
- Neurological Disorders (1)
- Newborns/Infants (1)
- Outcomes (7)
- Patient-Centered Outcomes Research (13)
- Patient Safety (5)
- Pregnancy (1)
- Prevention (3)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Risk (4)
- Surgery (10)
- Treatments (3)
- Women (1)
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 21 of 21 Research Studies DisplayedHerrin J, Abraham NS, Yao X
Comparative effectiveness of machine learning approaches for predicting gastrointestinal bleeds in patients receiving antithrombotic treatment.
The purpose of this retrospective cross-sectional study was to compare the performance of 3 machine learning approaches with the commonly-used HAS-BLED (hypertension, abnormal kidney and liver function, stroke, bleeding, labile international normalized ratio, older age, and drug or alcohol use) risk score in predicting antithrombotic-related gastrointestinal bleeding (GIB). The machine-learning models were regularized Cox proportional hazards regression (RegCox), random survival forests, and extreme gradient boosting (XGBoost). Findings showed that the machine learning models revealed similar performance in identifying patients at high risk for GIB after being prescribed antithrombotic agents. Two models (RegCox and XGBoost) performed modestly better than the HAS-BLED score.
AHRQ-funded; HS025402.
Citation: Herrin J, Abraham NS, Yao X .
Comparative effectiveness of machine learning approaches for predicting gastrointestinal bleeds in patients receiving antithrombotic treatment.
JAMA Netw Open 2021 May;4(5):e2110703. doi: 10.1001/jamanetworkopen.2021.10703..
Keywords: Blood Thinners, Medication, Risk, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Patient Safety, Comparative Effectiveness
Dobler CC, Morrow AS, Beuschel B
Pharmacologic therapies in patients with exacerbation of chronic obstructive pulmonary disease: a systematic review with meta-analysis.
The authors evaluated the comparative effectiveness and adverse events of pharmacologic interventions for adults with exacerbation of COPD. Sixty-eight randomized controlled trials were selected for evaluation and data extraction. They found that antibiotics and systemic corticosteroids reduced treatment failure in adults with mild to severe exacerbation of COPD.
AHRQ-funded.
Citation: Dobler CC, Morrow AS, Beuschel B .
Pharmacologic therapies in patients with exacerbation of chronic obstructive pulmonary disease: a systematic review with meta-analysis.
Ann Intern Med 2020 Mar 17;172(6):413-23. doi: 10.7326/m19-3007..
Keywords: Respiratory Conditions, Chronic Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research, Comparative Effectiveness, Medication, Antibiotics, Treatments, Adverse Drug Events (ADE), Adverse Events
Hoffman KE, Penson DF, Zhao Z
Patient-reported outcomes through 5 years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer.
This study compared different treatment of men with favorable-risk prostate cancer and those with unfavorable-risk disease and their functional outcomes 5 years post-treatment. Treatment options for favorable-risk disease include active surveillance, nerve-sparing prostatectomy, external beam radiation therapy (EBRT), or low-dose-rate brachytherapy with prostatectomy being the most common. Treatment options for men with unfavorable-risk disease is prostatectomy or EBRT with androgen deprivation therapy (ADT). The cohort analyzed included men diagnosed with prostate cancer in 2011 through 2012, accrued from 5 Surveillance, Epidemiology and End Results Program sites and a US prostate cancer registry, using surveys through September 2017. A total of 2005 men met inclusion criteria. For men with favorable-risk disease low-dose-rate brachytherapy was associated with worse urinary irritative, and sexual and bowel function at 1 year compared with active surveillance. Nerve-sparing prostatectomy was associated with worse urinary incontinence at 5 years and sexual function at 3 years compared with active surveillance. EBRT was not associated with clinically different function changes from active surveillance at any point during the 5 years. For men with unfavorable-risk disease, EBRT with ADT was associated with lower hormonal function at 6 months, bowel function at 1 year, but better sexual function and incontinence than prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Hoffman KE, Penson DF, Zhao Z .
Patient-reported outcomes through 5 years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer.
JAMA 2020 Jan 14;323(2):149-63. doi: 10.1001/jama.2019.20675..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Treatments, Men's Health, Adverse Events, Surgery
Yuo TH, Wallace JR, Fish L
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
This study compared outcomes of different revascularization surgeries among end stage renal disease (ESRD) patients with peripheral arterial disease (PAD). There is a high risk of complications for this surgery. Outcomes of endovascular revascularization (ER) and open surgical revascularisation (OSR) were compared. Outcomes measured included mortality and major amputation. There is a lower mortality risk for ER versus OSR. OSR has better 30-day limb salvage although there are similar long-term outcomes.
AHRQ-funded; HS019486.
Citation: Yuo TH, Wallace JR, Fish L .
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
Eur J Vasc Endovasc Surg 2019 Feb;57(2):248-57. doi: 10.1016/j.ejvs.2018.09.008..
Keywords: Adverse Events, Cardiovascular Conditions, Comparative Effectiveness, Dialysis, Evidence-Based Practice, Kidney Disease and Health, Mortality, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Lowenstern A, Al-Khatib SM, Sharan L
Interventions for preventing thromboembolic events in patients with atrial fibrillation: a systematic review.
The purpose of this review was to compare the effectiveness of therapies to prevent thromboembolic events and bleeding complications in adults with nonvalvular atrial fibrillation (AF). Two independent reviewers screened citations in order to identify comparative studies of treatments to prevent stroke in adults with nonvalvular AF who reported thromboembolic or bleeding complications, then abstracted data from 220 selected articles, assessed study quality and applicability, and rated the strength of evidence. The article concludes that available direct-acting oral anticoagulants (DOACs) are at least as effective and safe as warfarin for patients with nonvalvular AF and had similar benefits across several patient subgroups.
AHRQ-funded; 290201500004I.
Citation: Lowenstern A, Al-Khatib SM, Sharan L .
Interventions for preventing thromboembolic events in patients with atrial fibrillation: a systematic review.
Ann Intern Med 2018 Dec 4;169(11):774-87. doi: 10.7326/m18-1523..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Blood Thinners, Adverse Drug Events (ADE), Adverse Events, Medication, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Shaw CA, Steelman VM, DeBerg J
Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: a systematic review and meta-analysis of randomized controlled trials.
The purpose of this review is to answer the question: Does the type of warming intervention influence the frequency or severity of inadvertent perioperative hypothermia (IPH) in surgical patients receiving neuraxial anesthesia? The review concluded that during neuraxial anesthesia, active warming (AW) reduces IPH more effectively than passive warming. Even with AW, IPH persists in some patients.
AHRQ-funded; HS021422.
Citation: Shaw CA, Steelman VM, DeBerg J .
Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: a systematic review and meta-analysis of randomized controlled trials.
J Clin Anesth 2017 May;38:93-104. doi: 10.1016/j.jclinane.2017.01.005.
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Keywords: Comparative Effectiveness, Prevention, Outcomes, Adverse Events, Patient Safety
Obremskey WT, Schmidt AH, O'Toole RV
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
The POvIV study is a prospective, multicenter, randomized trial to compare oral (PO) with intravenous (IV) antibiotic therapy in patients with postoperative wound infections after extremity fractures. This study will be the largest prospective randomized trial to evaluate the safety and effectiveness of PO antibiotic use for treatment of postoperative wound infections. Results will inform clinician decisions on antibiotic delivery in patients with postoperative wound infections.
AHRQ-funded; HS000029.
Citation: Obremskey WT, Schmidt AH, O'Toole RV .
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
J Orthop Trauma 2017 Apr;31 Suppl 1:S32-s38. doi: 10.1097/bot.0000000000000802.
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Keywords: Antibiotics, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Medication, Patient Safety, Adverse Events, Prevention, Patient-Centered Outcomes Research, Outcomes
Bosse MJ, Morshed S, Reider L
Transtibial Amputation Outcomes Study (TAOS): comparing transtibial amputation with and without a tibiofibular synostosis (Ertl) Procedure.
The TAOS is a prospective, multicenter randomized trial comparing 18-month outcomes after transtibial amputation using the Ertl versus Burgess approach among adults aged 18 to 60. The primary outcomes include surgical treatment for a complication and patient-reported function. Secondary outcomes include physical impairment, pain, and treatment cost.
AHRQ-funded; HS000029.
Citation: Bosse MJ, Morshed S, Reider L .
Transtibial Amputation Outcomes Study (TAOS): comparing transtibial amputation with and without a tibiofibular synostosis (Ertl) Procedure.
J Orthop Trauma 2017 Apr;31 Suppl 1:S63-s69. doi: 10.1097/bot.0000000000000791.
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Keywords: Adverse Events, Comparative Effectiveness, Patient-Centered Outcomes Research, Patient Safety
Barocas DA, Alvarez J, Resnick MJ
Association between radiation therapy, surgery, or observation for localized prostate cancer and patient-reported outcomes after 3 years.
This study compares functional outcomes and adverse effects associated with radical prostatectomy, external beam radiation therapy (EBRT), and active surveillance. It concluded that radical prostatectomy was associated with a greater decrease in sexual function and urinary incontinence than either EBRT or active surveillance after 3 years and was associated with fewer urinary irritative symptoms than active surveillance.
AHRQ-funded; HS019356; HS022640.
Citation: Barocas DA, Alvarez J, Resnick MJ .
Association between radiation therapy, surgery, or observation for localized prostate cancer and patient-reported outcomes after 3 years.
JAMA 2017 Mar 21;317(11):1126-40. doi: 10.1001/jama.2017.1704.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Adverse Events, Cancer: Prostate Cancer, Surgery
Simianu VV, Flum DR
Rethinking elective colectomy for diverticulitis: a strategic approach to population health.
The authors argue that a rethinking of elective colectomy should come from a patient-centered approach that considers the risks of recurrence, quality of life, patient wishes and experiences about surgical and medical treatment options as well as operative morbidity and risks.
AHRQ-funded; HS020025.
Citation: Simianu VV, Flum DR .
Rethinking elective colectomy for diverticulitis: a strategic approach to population health.
World J Gastroenterol 2014 Nov 28;20(44):16609-14. doi: 10.3748/wjg.v20.i44.16609..
Keywords: Patient-Centered Outcomes Research, Comparative Effectiveness, Surgery, Adverse Events, Risk
Eng J, Wilson RF, Subramaniam RM
Comparative effect of contrast media type on the incidence of contrast-induced nephropathy: a systematic review and meta-analysis.
This review compared contrast-induced nephropathy (CIN) risk for contrast media within and between osmolality classes in patients receiving diagnostic or therapeutic imaging procedures. No differences were found in CIN risk among types of low-osmolar contrast media (LOCM). Iodixanol had a slightly lower risk for CIN than LOCM, but the lower risk did not exceed a criterion for clinical importance.
AHRQ-funded; 290201200007I.
Citation: Eng J, Wilson RF, Subramaniam RM .
Comparative effect of contrast media type on the incidence of contrast-induced nephropathy: a systematic review and meta-analysis.
Ann Intern Med 2016 Mar 15;164(6):417-24. doi: 10.7326/m15-1402.
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Keywords: Comparative Effectiveness, Imaging, Risk, Kidney Disease and Health, Adverse Events
Subramaniam RM, Suarez-Cuervo C, Wilson RF
Effectiveness of prevention strategies for contrast-induced nephropathy: a systematic review and meta-analysis.
N-acetylcysteine, sodium bicarbonate, statins, and ascorbic acid have been studied for reducing contrast-induced nephropathy (CIN). This study evaluated the comparative effectiveness of interventions to reduce CIN in adults receiving contrast media. It concluded that the greatest reduction in CIN was seen with N-acetylcysteine plus IV saline in patients receiving LOCM and with statins plus N-acetylcysteine plus IV saline.
AHRQ-funded; 290201200007I.
Citation: Subramaniam RM, Suarez-Cuervo C, Wilson RF .
Effectiveness of prevention strategies for contrast-induced nephropathy: a systematic review and meta-analysis.
Ann Intern Med 2016 Mar 15;164(6):406-16. doi: 10.7326/m15-1456.
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Keywords: Adverse Events, Comparative Effectiveness, Kidney Disease and Health, Patient-Centered Outcomes Research, Prevention
Mehta HB, Dimou F, Adhikari D
Comparison of comorbidity scores in predicting surgical outcomes.
The purpose of this study was to compare diagnosis-based and prescription-based comorbidity scores for predicting surgical outcomes. It concluded that the Centers for Medicare and Medicaid Services-Hierarchical Condition Categories had superior performance in predicting surgical outcomes. Prescription-based scores, alone or in addition to diagnosis-based scores, were not better than any diagnosis-based scoring system.
AHRQ-funded; HS022134.
Citation: Mehta HB, Dimou F, Adhikari D .
Comparison of comorbidity scores in predicting surgical outcomes.
Med Care 2016 Feb;54(2):180-7. doi: 10.1097/mlr.0000000000000465..
Keywords: Comparative Effectiveness, Surgery, Research Methodologies, Diagnostic Safety and Quality, Adverse Events
O'Neil B, Koyama T, Alvarez J
The comparative harms of open and robotic prostatectomy in population based samples.
Using population cohort data,the researchers examined sexual and urinary function in men undergoing open radical prostatectomy vs those undergoing robotic assisted radical prostatectomy. They found that men undergoing robotic assisted radical prostatectomy likely experience less decline in early urinary continence and sexual function than those undergoing open radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: O'Neil B, Koyama T, Alvarez J .
The comparative harms of open and robotic prostatectomy in population based samples.
J Urol 2016 Feb;195(2):321-9. doi: 10.1016/j.juro.2015.08.092.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Surgery, Adverse Events
Gagne JJ, Kesselheim AS, Choudhry NK
Comparative effectiveness of generic versus brand-name antiepileptic medications.
The objective of this study was to compare treatment persistence and rates of seizure-related events in patients who initiate antiepileptic drug (AED) therapy with a generic versus a brand-name product. It concluded that patients who initiated generic AEDs had fewer adverse seizure-related clinical outcomes and longer continuous treatment periods before experiencing a gap than those who initiated brand-name versions.
AHRQ-funded; HS018465.
Citation: Gagne JJ, Kesselheim AS, Choudhry NK .
Comparative effectiveness of generic versus brand-name antiepileptic medications.
Epilepsy Behav 2015 Nov;52(Pt A):14-8. doi: 10.1016/j.yebeh.2015.08.014.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Comparative Effectiveness, Medication, Medication: Safety, Neurological Disorders, Patient Safety
Dahabreh IJ, Steele DW, Shah N
Oral mechanical bowel preparation for colorectal surgery: systematic review and meta-analysis.
The purpose of this review was to synthesize the evidence on the comparative effectiveness and safety of oral mechanical bowel preparation versus no preparation or enema. It found weak evidence suggesting that oral mechanical bowel preparation has similar effectiveness compared with no preparation with respect to all-cause mortality, anastomotic leakage, wound infection, and peritonitis for patients undergoing elective surgery for colorectal cancer.
AHRQ-funded; 290201200012I.
Citation: Dahabreh IJ, Steele DW, Shah N .
Oral mechanical bowel preparation for colorectal surgery: systematic review and meta-analysis.
Dis Colon Rectum 2015 Jul;58(7):698-707. doi: 10.1097/dcr.0000000000000375..
Keywords: Comparative Effectiveness, Surgery, Outcomes, Adverse Events
LoVerde ZJ, Mandl LA, Johnson BK
Rheumatoid arthritis does not increase risk of short-term adverse events after total knee arthroplasty: a retrospective case-control study.
More adverse events (AE) are reported after total knee arthroplasty (TKA) for patients with rheumatoid arthritis (RA) than for patients with osteoarthritis (OA). This study evaluates 6-month postoperative AE in a high-volume center in a contemporary RA cohort. It found that in a high-volume center, with high RA-specific experience, RA does not increase postoperative AE.
AHRQ-funded; HS016075.
Citation: LoVerde ZJ, Mandl LA, Johnson BK .
Rheumatoid arthritis does not increase risk of short-term adverse events after total knee arthroplasty: a retrospective case-control study.
J Rheumatol 2015 Jul;42(7):1123-30. doi: 10.3899/jrheum.141251..
Keywords: Adverse Events, Arthritis, Surgery, Comparative Effectiveness, Patient-Centered Outcomes Research
Frasier LL, Leverson G, Gosain A
Laparoscopic versus open Ladd's procedure for intestinal malrotation in adults.
This study was designed to investigate outcomes for adults undergoing laparoscopic surgery vs. open Ladd’s repair for malrotation. It found no significant differences in complication rates, need for re-operation, or symptom resolution. There was a statistically significant decrease in length of stay following laparoscopy compared to open surgery.
AHRQ-funded; HS022403.
Citation: Frasier LL, Leverson G, Gosain A .
Laparoscopic versus open Ladd's procedure for intestinal malrotation in adults.
Surg Endosc 2015 Jun;29(6):1598-604. doi: 10.1007/s00464-014-3849-3..
Keywords: Surgery, Outcomes, Patient-Centered Outcomes Research, Adverse Events, Comparative Effectiveness
Camelo Castillo W, Boggess K, Sturmer T
Association of adverse pregnancy outcomes with glyburide vs insulin in women with gestational diabetes.
The purpose of this study was to estimate the risks of adverse pregnancy outcomes among women receiving glyburide compared with insulin for the treatment of gestational diabetes mellitus (GDM) in a US population-based cohort. It found an association between glyburide (compared with insulin) and elevated risk of NICU admission, neonatal hypoglycemia, respiratory distress, birth injury, and large for gestational age in women with GDM.
AHRQ-funded; HS017950.
Citation: Camelo Castillo W, Boggess K, Sturmer T .
Association of adverse pregnancy outcomes with glyburide vs insulin in women with gestational diabetes.
JAMA Pediatr 2015 May;169(5):452-8. doi: 10.1001/jamapediatrics.2015.74..
Keywords: Adverse Drug Events (ADE), Adverse Events, Comparative Effectiveness, Diabetes, Labor and Delivery, Maternal Care, Medication, Newborns/Infants, Outcomes, Pregnancy, Women
Malhotra J, Mhango G, Gomez JE
Adjuvant chemotherapy for elderly patients with stage I non-small-cell lung cancer >/=4 cm in size: an SEER-Medicare analysis.
The researchers compared overall survival and rates of serious adverse events (defined as those requiring admission to hospital) between patients treated with resection alone, platinum-based adjuvant chemotherapy, or postoperative radiation (PORT) with or without adjuvant chemotherapy. Platinum-based adjuvant chemotherapy is associated with reduced mortality and increased serious adverse events in elderly patients with stage I non-small-cell lung cancer ≥4 cm in size.
AHRQ-funded; HS019670.
Citation: Malhotra J, Mhango G, Gomez JE .
Adjuvant chemotherapy for elderly patients with stage I non-small-cell lung cancer >/=4 cm in size: an SEER-Medicare analysis.
Ann Oncol 2015 Apr;26(4):768-73. doi: 10.1093/annonc/mdv008..
Keywords: Cancer: Lung Cancer, Elderly, Treatments, Adverse Events, Comparative Effectiveness
Vogel JA, Haukoos JS, Erickson CL
Is long-axis view superior to short-axis view in ultrasound-guided central venous catheterization?
The authors evaluated whether using long-axis or short-axis view during ultrasound-guided internal jugular and subclavian central venous catheterization results in fewer skin breaks, decreased time to cannulation, and fewer posterior wall penetrations. They found the long-axis view for the internal jugular more efficient than the short-axis view with fewer redirections; the long-axis view for subclavian central venous catheterization more efficient with decreased time to cannulation and fewer redirections; the long-axis approach to subclavian central venous catheterization associated with fewer posterior wall penetrations; and the long-axis view for subclavian central venous catheterization and avoiding posterior wall penetrations resulting in fewer central venous catheter-related complications.
AHRQ-funded; HS017526.
Citation: Vogel JA, Haukoos JS, Erickson CL .
Is long-axis view superior to short-axis view in ultrasound-guided central venous catheterization?
Crit Care Med 2015 Apr;43(4):832-9. doi: 10.1097/ccm.0000000000000823.
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Keywords: Adverse Events, Comparative Effectiveness, Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Patient-Centered Outcomes Research