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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 463 Research Studies DisplayedZeitler EP, Al-Khatib SM, Friedman DJ
Predicting appropriate shocks in patients with heart failure: patient level meta-analysis from SCD-HeFT and MADIT II.
The study authors sought to identify characteristics predictive of appropriate shocks in patients with a primary prevention implantable cardioverter defibrillator (ICD). In this meta-analysis of patient level data from Multicenter Automatic Defibrillator Implantation Trial II and Sudden Cardiac Death in Heart Failure Trial, higher NYHA class, lower LVEF, no beta-blocker therapy, and single chamber ICD (vs. dual chamber) were significant predictors of appropriate shocks.
AHRQ-funded; HS018505.
Citation: Zeitler EP, Al-Khatib SM, Friedman DJ .
Predicting appropriate shocks in patients with heart failure: patient level meta-analysis from SCD-HeFT and MADIT II.
J Cardiovasc Electrophysiol 2017 Nov;28(11):1345-51. doi: 10.1111/jce.13307.
Keywords: Comparative Effectiveness, Heart Disease and Health, Medical Devices, Medical Devices, Risk
Linder JA, Meeker D, Fox CR
Effects of behavioral interventions on inappropriate antibiotic prescribing in primary care 12 months after stopping interventions.
This study examines the persistence of effects 12 months after stopping behavioral interventions on inappropriate antibiotic prescribing. In the 12 months after removing behavioral interventions, inappropriate antibiotic prescribing for acute respiratory infections (ARIs) increased relative to control practices—whose inappropriate prescribing rates continued to decrease.
AHRQ-funded; HS019913.
Citation: Linder JA, Meeker D, Fox CR .
Effects of behavioral interventions on inappropriate antibiotic prescribing in primary care 12 months after stopping interventions.
JAMA 2017 Oct 10;318(14):1391-92. doi: 10.1001/jama.2017.11152.
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Keywords: Antibiotics, Practice Patterns, Primary Care, Comparative Effectiveness, Respiratory Conditions
Butler M, Epstein RA, Totten A
AHRQ series on complex intervention systematic reviews-paper 3: adapting frameworks to develop protocols.
This article identifies and describes elements of frameworks and how they can be adapted to inform the protocol and conduct of systematic reviews of complex interventions. Possible approaches to analytic frameworks for complex interventions that illustrate causal and associative linkages are outlined, including time elements, which systematic reviews of complex interventions may need to address.
AHRQ-funded; 290201200004C; 290201500008I; 290201500005I; 290201500006I; 290201500010I.
Citation: Butler M, Epstein RA, Totten A .
AHRQ series on complex intervention systematic reviews-paper 3: adapting frameworks to develop protocols.
J Clin Epidemiol 2017 Oct;90:19-27. doi: 10.1016/j.jclinepi.2017.06.013.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Braun D, Gorfine M, Parmigiani G
Propensity scores with misclassified treatment assignment: a likelihood-based adjustment.
The researchers show that misclassification of treatment assignment can impact three distinct stages of a propensity score analysis. They examine how error in the treatment assignment impacts each stage in the context of three common propensity score implementations: subclassification, matching, and inverse probability of treatment weighting (IPTW). They propose a two-step likelihood-based approach which fully adjusts for treatment misclassification bias under subclassification
AHRQ-funded; HS021991.
Citation: Braun D, Gorfine M, Parmigiani G .
Propensity scores with misclassified treatment assignment: a likelihood-based adjustment.
Biostatistics 2017 Oct 1;18(4):695-710. doi: 10.1093/biostatistics/kxx014.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Nelson HD, Denneson LM, Low AR
Suicide risk assessment and prevention: a systematic review focusing on veterans.
This article reviews studies of the accuracy of methods to identify individuals at increased risk of suicide and the effectiveness and adverse effects of health care interventions relevant to U.S. veteran and military populations in reducing suicide and suicide attempts. It concludes that risk assessment methods have been shown to be sensitive predictors of suicide and suicide attempts, but the frequency of false positives limits their clinical utility.
AHRQ-funded; HS019456.
Citation: Nelson HD, Denneson LM, Low AR .
Suicide risk assessment and prevention: a systematic review focusing on veterans.
Psychiatr Serv 2017 Oct;68(10):1003-15. doi: 10.1176/appi.ps.201600384.
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Keywords: Comparative Effectiveness, Behavioral Health, Prevention, Risk
Landsittel DP, Kessler L, Schmid CH
Training in patient-centered outcomes research for specific researcher communities.
A number of publications have discussed approaches to training the scientific workforce in comparative effectiveness research (CER) and patient-centered outcomes research (PCOR). To extend these efforts into specific researcher communities, the AHRQ developed a Funding Opportunity Announcement that called for training for a specific researcher community in collaboration with associated program partners. This paper describes the strategies developed by the 5 subsequently funded programs, and the challenges associated with developing in-person and online programs.
AHRQ-funded; HS023214; HS023199; HS023299; HS023207; HS023185.
Citation: Landsittel DP, Kessler L, Schmid CH .
Training in patient-centered outcomes research for specific researcher communities.
J Clin Transl Sci 2017 Oct;1(5):278-84. doi: 10.1017/cts.2017.307.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies, Training
Ong TC, Kahn MG, Kwan BM
Dynamic-ETL: a hybrid approach for health data extraction, transformation and loading.
The researchers designed and implemented a health data transformation and loading approach, which we refer to as Dynamic ETL (Extraction, Transformation and Loading) (D-ETL), that automates part of the process through use of scalable, reusable and customizable code. Their results showed that ETL rule composition methods and the D-ETL engine offer a scalable solution for health data transformation via automatic query generation to harmonize source datasets.
AHRQ-funded; HS019908; HS022956.
Citation: Ong TC, Kahn MG, Kwan BM .
Dynamic-ETL: a hybrid approach for health data extraction, transformation and loading.
BMC Med Inform Decis Mak 2017 Sep 13;17(1):134. doi: 10.1186/s12911-017-0532-3.
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Keywords: Comparative Effectiveness, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research
Singal AG, Gupta S, Skinner CS
Effect of colonoscopy outreach vs fecal immunochemical test outreach on colorectal cancer screening completion: a randomized clinical trial.
Researchers compared the effectiveness of fecal immunochemical test (FIT) outreach and colonoscopy outreach to increase completion of the colorectal cancer (CRC) screening process (screening initiation and follow-up) within 3 years. Among persons aged 50 to 64 years receiving primary care at a safety-net institution, mailed outreach invitations offering FIT or colonoscopy compared with usual care increased the proportion completing CRC screening process within 3 years.
AHRQ-funded; HS022418.
Citation: Singal AG, Gupta S, Skinner CS .
Effect of colonoscopy outreach vs fecal immunochemical test outreach on colorectal cancer screening completion: a randomized clinical trial.
JAMA 2017 Sep 5;318(9):806-15. doi: 10.1001/jama.2017.11389.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Comparative Effectiveness, Patient-Centered Outcomes Research
Qian F, Zhong Y, Hannan EL
Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York.
Endeavor zotarolimus-eluting stents (E-ZES) and everolimus-eluting stents (EES) as second-generation stents were approved for use in percutaneous coronary interventions (PCIs) in 2008. The researchers aimed to evaluate the long-term outcomes of E-ZES vs. EES. They concluded that compared with patients receiving EES, patients receiving E-ZES had a significantly higher rate of 6-year all-cause mortality.
AHRQ-funded; HS022289.
Citation: Qian F, Zhong Y, Hannan EL .
Long-term comparative effectiveness of Endeavor zotarolimus-eluting and everolimus-eluting stents in New York.
Int J Cardiol 2017 Aug 15;241:437-43. doi: 10.1016/j.ijcard.2017.03.095.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Medication, Patient-Centered Outcomes Research, Heart Disease and Health
Balk EM, Lichtenstein AH
Omega-3 fatty acids and cardiovascular disease: summary of the 2016 Agency of Healthcare Research and Quality evidence review.
The authors summarize the 2016 update of the 2004 Agency of Healthcare Research and Quality's evidence review of omega-3 fatty acids and cardiovascular disease (CVD). The overall findings for the effects of marine oil supplements on intermediate CVD outcomes remain largely unchanged. The strongest effect of marine oils is on triglyceride concentrations.
AHRQ-funded; 290201500002I.
Citation: Balk EM, Lichtenstein AH .
Omega-3 fatty acids and cardiovascular disease: summary of the 2016 Agency of Healthcare Research and Quality evidence review.
Nutrients 2017 Aug 11;9(8). doi: 10.3390/nu9080865.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention
Caldieraro MA, Sylvia LG, Dufour S
Clinical correlates of acute bipolar depressive episode with psychosis.
The aim of this study was to identify the characteristics of depressed bipolar patients with current psychosis compared to those without psychosis. Results showed that psychosis was present in 10.6% of the studied depressed patients. Psychotic patients had less education, lower income, and were more frequently single and unemployed. Psychosis was also associated with a more severe depressive episode, higher suicidality, more comorbid conditions and worse functioning. Most group differences disappeared when controlling for depression severity.
AHRQ-funded; HS019371.
Citation: Caldieraro MA, Sylvia LG, Dufour S .
Clinical correlates of acute bipolar depressive episode with psychosis.
J Affect Disord 2017 Aug 1;217:29-33. doi: 10.1016/j.jad.2017.03.059.
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Keywords: Comparative Effectiveness, Diagnostic Safety and Quality, Behavioral Health, Patient-Centered Healthcare
Chen Y, Lairson DR, Chan W
Cost-effectiveness of novel agents in medicare patients with multiple myeloma: findings from a U.S. payer's perspective.
The researchers sought to determine the cost-effectiveness (measured as cost per life-year saved) of front-line novel agent-based therapy use among a cohort of elderly patients with multiple myeloma (MM) in a real-world setting. They concluded that, given the most common treatment practices in the United States, the use of novel agent-based therapy is not cost-effective at its current level of cost and effectiveness.
AHRQ-funded; HS018956.
Citation: Chen Y, Lairson DR, Chan W .
Cost-effectiveness of novel agents in medicare patients with multiple myeloma: findings from a U.S. payer's perspective.
J Manag Care Spec Pharm 2017 Aug;23(8):831-43. doi: 10.18553/jmcp.2017.23.8.831.
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Keywords: Healthcare Costs, Cancer, Comparative Effectiveness, Healthcare Costs, Medication
Reid MC, Henderson CR, Jr., Trachtenberg MA
Implementing a pain self-management protocol in home care: a cluster-randomized pragmatic trial.
The researchers sought to determine the effectiveness of a cognitive-behavioral pain self-management protocol delivered by physical therapists for use by older adults with activity-limiting pain receiving home care. Their real-world pragmatic trial found no effect of implementation of a pain self-management intervention in a home care setting.
AHRQ-funded; HS020648.
Citation: Reid MC, Henderson CR, Jr., Trachtenberg MA .
Implementing a pain self-management protocol in home care: a cluster-randomized pragmatic trial.
J Am Geriatr Soc 2017 Aug;65(8):1667-75. doi: 10.1111/jgs.14836.
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Keywords: Home Healthcare, Patient Self-Management, Pain, Elderly, Comparative Effectiveness
Tyson MD, Alvarez J, Koyama T
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
This study tested the hypothesis that treatment-related changes in urinary, bowel, sexual, and hormonal function vary by race/ethnicity. It concluded that the effect of treatment for prostate cancer on patient-reported function did not vary dramatically by race/ethnicity. Compared to white men, African-American men experienced a somewhat more pronounced decline in urinary continence after radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Tyson MD, Alvarez J, Koyama T .
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
Eur Urol 2017 Aug;72(2):307-14. doi: 10.1016/j.eururo.2016.10.036.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Racial and Ethnic Minorities, Surgery
Murtaugh CM, Deb P, Zhu C
Reducing readmissions among heart failure patients discharged to home health care: effectiveness of early and intensive nursing services and early physician follow-up.
This study compared the effectiveness of two "treatments"-early, intensive home health nursing and physician follow-up within a week-versus less intense and later postacute care in reducing readmissions among heart failure patients discharged to home health care. Neither treatment by itself had a statistically significant effect on hospital readmission. In combination, however, they reduced the probability of readmission by roughly 8 percentage points.
AHRQ-funded; HS020257.
Citation: Murtaugh CM, Deb P, Zhu C .
Reducing readmissions among heart failure patients discharged to home health care: effectiveness of early and intensive nursing services and early physician follow-up.
Health Serv Res 2017 Aug;52(4):1445-72. doi: 10.1111/1475-6773.12537.
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Keywords: Comparative Effectiveness, Heart Disease and Health, Home Healthcare, Hospital Readmissions, Patient-Centered Outcomes Research
Ferrada P, Callcut R, Zielinski MD
Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: an Eastern Association for the Surgery of Trauma multicenter trial.
The objective of this study was to compare loop ileostomy (LI) and total colectomy (TC) procedures in a multicentric approach to help the surgeon decide what procedure was best suited for the patient in need. In this study, the investigators found that LI carried less mortality than TC.
AHRQ-funded; HS024547.
Citation: Ferrada P, Callcut R, Zielinski MD .
Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: an Eastern Association for the Surgery of Trauma multicenter trial.
J Trauma Acute Care Surg 2017 Jul;83(1):36-40. doi: 10.1097/ta.0000000000001498..
Keywords: Clostridium difficile Infections, Comparative Effectiveness, Infectious Diseases, Surgery, Treatments
Ong T, Pradhananga R, Holve E
A framework for classification of electronic health data extraction-transformation-loading challenges in data network participation.
The researchers conducted key-informant interviews with data partner representatives to survey the Extract, Transform, Load (ETL) process challenges faced in clinical data research networks (CDRNs) and registries. The paper concluded that overcoming ETL technical challenges requires significant investments in a broad array of information technologies and human resources. Identifying these technical obstacles can inform optimal resource allocation to minimize the barriers and cost of entry for new data partners into extant networks, which in turn can expand data networks' inclusiveness and diversity.
AHRQ-funded; HS019564.
Citation: Ong T, Pradhananga R, Holve E .
A framework for classification of electronic health data extraction-transformation-loading challenges in data network participation.
eGEMS 2017 Jun 13;5(1):10. doi: 10.5334/egems.222..
Keywords: Comparative Effectiveness, Data, Health Information Technology (HIT), Patient-Centered Outcomes Research, Registries
Weitlauf AS, Sathe N, McPheeters ML
Interventions targeting sensory challenges in autism spectrum disorder: a systematic review.
This review evaluated the effectiveness and safety of interventions targeting sensory challenges in ASD. It concluded that some interventions may yield modest short-term (<6 months) improvements in sensory- and ASD symptom severity-related outcomes; the evidence base is small, and the durability of the effects is unclear. Although some therapies may hold promise, substantial needs exist for continuing improvements in methodologic rigor.
AHRQ-funded; 290201500003I.
Citation: Weitlauf AS, Sathe N, McPheeters ML .
Interventions targeting sensory challenges in autism spectrum disorder: a systematic review.
Pediatrics 2017 Jun;139(6):e20170347. doi: 10.1542/peds.2017-0347.
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Keywords: Patient-Centered Outcomes Research, Evidence-Based Practice, Comparative Effectiveness, Children/Adolescents, Autism
Halbert CH, Bellamy S, Briggs V
A comparative effectiveness education trial for lifestyle health behavior change in African Americans.
The authors of this study compared the effects of alternate behavioral interventions on obesity-related health behaviors by conducting a comparative effectiveness education trial in a community-based sample of 530 adult African Americans. The investigators suggest that education about risk factors for chronic disease and evidence-based strategies for health behavior change may be useful for addressing obesity-related behaviors among African Americans.
AHRQ-funded; HS019339.
Citation: Halbert CH, Bellamy S, Briggs V .
A comparative effectiveness education trial for lifestyle health behavior change in African Americans.
Health Educ Res 2017 Jun 1;32(3):207-18. doi: 10.1093/her/cyx039..
Keywords: Comparative Effectiveness, Education: Patient and Caregiver, Lifestyle Changes, Lifestyle Changes, Obesity, Racial and Ethnic Minorities
Mehta HB, Vargas GM, Adhikari D
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
The objectives were to determine trends in the use of chemotherapy as the initial treatment and to evaluate the comparative effectiveness of initial chemotherapy vs resection of the primary tumor on survival (intention-to-treat analysis) in Stage IV colorectal cancer (CRC). Instrumental variable analysis found that, compared with resection, chemotherapy as the initial treatment offers similar or better 2-year survival in patients with Stage IV CRC.
AHRQ-funded; HS022134.
Citation: Mehta HB, Vargas GM, Adhikari D .
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
Colorectal Dis 2017 Jun;19(6):O210-o18. doi: 10.1111/codi.13659.
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Keywords: Cancer: Colorectal Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Surgery
Garcia-Albeniz X, Hsu J, Hernan MA
The value of explicitly emulating a target trial when using real world evidence: an application to colorectal cancer screening.
Researchers reviewed a recent observational analysis that explicitly emulated a target trial of screening colonoscopy using insurance claims from U.S. Medicare. They then compared this explicit emulation with alternative, simpler observational analyses. This empirical comparison suggests that lack of an explicit emulation of the target trial leads to biased estimates, and shows that allowing for repeated eligibility increases the statistical efficiency of the estimates.
AHRQ-funded; HS023128.
Citation: Garcia-Albeniz X, Hsu J, Hernan MA .
The value of explicitly emulating a target trial when using real world evidence: an application to colorectal cancer screening.
Eur J Epidemiol 2017 Jun;32(6):495-500. doi: 10.1007/s10654-017-0287-2.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Comparative Effectiveness, Evidence-Based Practice, Research Methodologies
Meystre S, Gouripeddi R, Tieder J
Enhancing comparative effectiveness research with automated pediatric pneumonia detection in a multi-institutional clinical repository: a PHIS+ pilot study.
The aim of this study was to develop an automated, scalable, and accurate method to determine the presence or absence of pneumonia in children using chest imaging reports. It found that, when compared with each of the domain experts manually annotating these reports, the new Natural Language Processing (NLP) application developed by the researchers allowed for significantly higher sensitivity (.71 vs .527) and similar positive predictive value and specificity.
AHRQ-funded; HS019862.
Citation: Meystre S, Gouripeddi R, Tieder J .
Enhancing comparative effectiveness research with automated pediatric pneumonia detection in a multi-institutional clinical repository: a PHIS+ pilot study.
J Med Internet Res 2017 May 15;19(5):e162. doi: 10.2196/jmir.6887.
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Keywords: Children/Adolescents, Community-Acquired Infections, Comparative Effectiveness, Health Information Technology (HIT), Pneumonia
Singh JA, Hossain A, Mudano AS
Biologics or tofacitinib for people with rheumatoid arthritis naive to methotrexate: a systematic review and network meta-analysis.
The researchers performed a systematic review to compare the benefits and harms of biologics and small molecule tofacitinib versus comparator (methotrexate (MTX) and other disease-modifying antirheumatic drugs) in patients with rheumatoid arthritis (RA) who are naive to methotrexate. They concluded that in MTX-naive RA participants, there was moderate-quality evidence that, compared with MTX alone, biologics with MTX were associated with absolute and relative clinically meaningful benefits in three of the efficacy outcomes.
AHRQ-funded; HS021110.
Citation: Singh JA, Hossain A, Mudano AS .
Biologics or tofacitinib for people with rheumatoid arthritis naive to methotrexate: a systematic review and network meta-analysis.
Cochrane Database Syst Rev 2017 May 8;5:CD012657. doi: 10.1002/14651858.cd012657.
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Keywords: Comparative Effectiveness, Medication, Arthritis, Patient-Centered Outcomes Research, Evidence-Based Practice
Jayadevappa R, Chhatre S, Wong YN
Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant).
This review analyzed the comparative effectiveness of prostate cancer (PCa) treatments through systematic review and meta-analysis with a focus on outcomes that matter most to newly diagnosed localized PCa patients. The studies provided moderate data for the patient-centered outcome of mortality. Radical prostatectomy demonstrated mortality benefit compared to watchful waiting and radiation therapy.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S, Wong YN .
Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant).
Medicine 2017 May;96(18):e6790. doi: 10.1097/md.0000000000006790.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer, Cancer: Prostate Cancer
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