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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- (-) Cardiovascular Conditions (12)
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- Data (1)
- Decision Making (1)
- Dementia (1)
- Diagnostic Safety and Quality (2)
- Elderly (1)
- Health Literacy (1)
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- Medication: Safety (1)
- (-) Neurological Disorders (12)
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- Stroke (3)
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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 12 of 12 Research Studies DisplayedHuda A, Castaño A, Niyogi A
A machine learning model for identifying patients at risk for wild-type transthyretin amyloid cardiomyopathy.
Transthyretin amyloid cardiomyopathy, an often-unrecognized cause of heart failure, is now treatable with a transthyretin stabilizer. It is therefore important to identify at-risk patients who can undergo targeted testing for earlier diagnosis and treatment, prior to the development of irreversible heart failure. In this study, the investigators showed that a random forest machine learning model could identify potential wild-type transthyretin amyloid cardiomyopathy using medical claims data.
AHRQ-funded; HS026385.
Citation: Huda A, Castaño A, Niyogi A .
A machine learning model for identifying patients at risk for wild-type transthyretin amyloid cardiomyopathy.
Nat Commun 2021 May 11;12(1):2725. doi: 10.1038/s41467-021-22876-9..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Neurological Disorders, Diagnostic Safety and Quality, Risk
Sangal RB, Fodeh S, Taylor A
Identification of patients with nontraumatic intracranial hemorrhage using administrative claims data.
Nontraumatic intracranial hemorrhage (ICH) is a neurological emergency of research interest; however, unlike ischemic stroke, has not been well studied in large datasets due to the lack of an established administrative claims-based definition. In this study, the investigators aimed to evaluate both explicit diagnosis codes and machine learning methods to create a claims-based definition for this clinical phenotype.
AHRQ-funded; HS023554.
Citation: Sangal RB, Fodeh S, Taylor A .
Identification of patients with nontraumatic intracranial hemorrhage using administrative claims data.
J Stroke Cerebrovasc Dis 2020 Dec;29(12):105306. doi: 10.1016/j.jstrokecerebrovasdis.2020.105306..
Keywords: Cardiovascular Conditions, Neurological Disorders, Diagnostic Safety and Quality, Data
Sharma D
Perioperative management of aneurysmal subarachnoid hemorrhage.
This article discusses aneurysmal subarachnoid hemorrhage, an acute neurologic emergency. Extracranial manifestations of aneurysmal subarachnoid hemorrhage include cardiac dysfunction, neurogenic pulmonary edema, fluid and electrolyte imbalances, and hyperglycemia. The author indicates that prompt definitive treatment of the aneurysm by craniotomy and clipping or endovascular intervention with coils and/or stents is needed to prevent rebleeding. The author also notes that data on the impact of anesthesia on long-term neurologic outcomes of aneurysmal subarachnoid hemorrhage do not exist.
AHRQ-funded; HS026690.
Citation: Sharma D .
Perioperative management of aneurysmal subarachnoid hemorrhage.
Anesthesiology 2020 Dec;133(6):1283-305. doi: 10.1097/aln.0000000000003558..
Keywords: Cardiovascular Conditions, Neurological Disorders, Surgery, Care Management
Askew RL, Capo-Lugo CE, Sangha R
Trade-offs in quality-of-life assessment between the modified Rankin Scale and Neuro-QoL measures.
The objective of this study was to describe the physical and cognitive health of patients with differing levels of post-stroke disability as defined by modified Rankin Scale (mRS) scores. Cross-sectional correlations were also compared between the mRS and the Quality of Life in Neurological Disorders (Neuro-QoL) T-scores to longitudinal correlations of change estimates for each measure. A total of 745 patients with ischemic stroke (79%) or transient ischemic attack (21%) were enrolled in this study. There were larger differences observed in cognitive function for the severe mRS groups. Larger differences in physical function were observed in the mild-moderate mRS groups. These findings undermine the validity and utility as an outcome measure in longitudinal studies in ischemic stroke patients. But it is still efficient at capturing important differences in patient-reported quality of life, and is useful for identifying meaning cross-sectional differences among clinical subgroups.
AHRQ-funded; HS024366; HS023437; HS000078.
Citation: Askew RL, Capo-Lugo CE, Sangha R .
Trade-offs in quality-of-life assessment between the modified Rankin Scale and Neuro-QoL measures.
Value Health 2020 Oct;23(10):1366-72. doi: 10.1016/j.jval.2020.06.011..
Keywords: Quality of Life, Stroke, Outcomes, Neurological Disorders, Cardiovascular Conditions
Kole MJ, Shea P, Albrecht JS
Utility of the Hijdra sum score in predicting risk of aneurysm in patients with subarachnoid hemorrhage: a single-center experience with 550 patients.
This study’s objective was to generate a model to assist in predicting risk of aneurysm in patients with subarachnoid hemorrhage (SAH). A retrospective cohort study was conducted of all patients 18 years and older admitted to a single center from March 2008 to March 2018 with non-traumatic SAH (n = 550). Risk factors examined included female sex, higher modified Fisher or Hijdra score, nonperimesencephalic location, presence of intracerebral hemorrhage, World Federation of Neurological Societies (WFNS) score ≥3, need for cerebrospinal fluid diversion on admission, and history of tobacco use. Greater modified Fisher, greater Hijdra score, WFNS ≥3, and hydrocephalus present on admission presented a significantly greater risk of an aneurysm. The authors concluded a simple scoring tool based on patient sex, SAH location and SAH burden can assist in predicting the presence of an aneurysm in patients with nontraumatic SAH.
AHRQ-funded; HS024560.
Citation: Kole MJ, Shea P, Albrecht JS .
Utility of the Hijdra sum score in predicting risk of aneurysm in patients with subarachnoid hemorrhage: a single-center experience with 550 patients.
Neurosurgery 2020 Jun;86(6):783-91. doi: 10.1093/neuros/nyz346.
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Keywords: Cardiovascular Conditions, Neurological Disorders, Risk
Nadkarni MA, Maas MB, Batra A
Elevated cerebrospinal fluid protein is associated with unfavorable functional outcome in spontaneous subarachnoid hemorrhage.
Subarachnoid hemorrhage (SAH) is a devastating neurologic event for which markers to assess poor outcome are needed. Elevated cerebrospinal fluid (CSF) protein may result from inflammation and blood-brain barrier (BBB) disruption that occurs during SAH. In this study, the investigators sought to determine if CSF protein level is associated with functional outcome after SAH.
AHRQ-funded; HS023437.
Citation: Nadkarni MA, Maas MB, Batra A .
Elevated cerebrospinal fluid protein is associated with unfavorable functional outcome in spontaneous subarachnoid hemorrhage.
J Stroke Cerebrovasc Dis 2020 Apr;29(4):104605. doi: 10.1016/j.jstrokecerebrovasdis.2019.104605..
Keywords: Stroke, Cardiovascular Conditions, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research
Pinto D, Prabhakaran S, Tipton E
Why physicians prescribe prophylactic seizure medications after intracerebral hemorrhage: an adaptive conjoint analysis.
Seizures are a morbid complication of intracerebral hemorrhage (ICH) and increase the risk for herniation, status epilepticus, and worse patient outcomes. Prophylactic levetiracetam is administered to approximately 40% of patients with ICH. It is unclear which patients are consciously selected for treatment by physicians. In this study, the investigators sought to determine how patients are selected for treatment with prophylactic levetiracetam after ICH.
AHRQ-funded; HS023437.
Citation: Pinto D, Prabhakaran S, Tipton E .
Why physicians prescribe prophylactic seizure medications after intracerebral hemorrhage: an adaptive conjoint analysis.
J Stroke Cerebrovasc Dis 2020 Apr;29(4):104628. doi: 10.1016/j.jstrokecerebrovasdis.2019.104628..
Keywords: Neurological Disorders, Medication, Prevention, Cardiovascular Conditions, Stroke, Decision Making
Sterling MR, Jannat-Khah D, Bryan J
The prevalence of cognitive impairment among adults with incident heart failure: the "Reasons for Geographic and Racial Differences in Stroke" (REGARDS) study.
The REGARDS study determined the prevalence of cognitive impairment (CI) among adults aged 45 and older with incident heart failure (HF) in order to improve understanding of cognition in HF. Cognitive function was assessed using the Six-Item Screener, and the prevalence of CI among those with incident HF was compared with the prevalence of CI among a matching cohort without HF. The study results indicated that 14.9 percent of the adults with incident HF had CI, suggesting that the majority of cognitive decline occurs after HF diagnosis. The authors suggest that increased awareness of CI among newly diagnosed patients and ways to mitigate it in the context of HF management are warranted.
AHRQ-funded; HS000066.
Citation: Sterling MR, Jannat-Khah D, Bryan J .
The prevalence of cognitive impairment among adults with incident heart failure: the "Reasons for Geographic and Racial Differences in Stroke" (REGARDS) study.
J Card Fail 2019 Feb;25(2):130-36. doi: 10.1016/j.cardfail.2018.12.006..
Keywords: Cardiovascular Conditions, Dementia, Heart Disease and Health, Neurological Disorders
Trivedi LU, Alvarez CA, Mansi IA
Association of statin therapy with risk of epilepsy in 2 propensity score-matched cohorts.
The objective of this study was to examine the association between statin use and epilepsy risk in a general population and in a healthy population (individuals with no severe comorbidities). The study did not demonstrate a significant beneficial or deleterious effect of statin use on risk of being diagnosed with epilepsy. The authors assert that clinicians should not withhold statins, whenever indicated, in patients with epilepsy.
AHRQ-funded; HS022418.
Citation: Trivedi LU, Alvarez CA, Mansi IA .
Association of statin therapy with risk of epilepsy in 2 propensity score-matched cohorts.
Ann Pharmacother 2018 Jun;52(6):546-53. doi: 10.1177/1060028018756650..
Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Neurological Disorders, Risk
Sterling MR, Safford MM, Goggins K
Numeracy, health literacy, cognition, and 30-day readmissions among patients with heart failure.
Numeracy, health literacy, and cognition are important for chronic disease management. Prior studies have found them to be associated with poorer selfcare and worse clinical outcomes, but limited data exists in the context of heart failure (HF), a condition that requires patients to monitor their weight, fluid intake, and dietary salt, especially in the post hospitalization period. The purpose of this study was to examine the relationship between numeracy, health literacy, and cognition with 30-day readmissions among patients hospitalized for acute decompensated HF (ADHF).
AHRQ-funded; HS000066.
Citation: Sterling MR, Safford MM, Goggins K .
Numeracy, health literacy, cognition, and 30-day readmissions among patients with heart failure.
J Hosp Med 2018 Mar;13(3):145-51. doi: 10.12788/jhm.2932..
Keywords: Health Literacy, Hospital Readmissions, Hospitalization, Heart Disease and Health, Cardiovascular Conditions, Neurological Disorders, Risk
Fink HA, Hemmy LS, MacDonald R
Intermediate- and long-term cognitive outcomes after cardiovascular procedures in older adults: a systematic review.
This study summarized evidence about cognitive outcomes in adults aged 65 years or older at least 3 months after coronary or carotid revascularization, cardiac valve procedures, or ablation for atrial fibrillation. It concluded that intermediate- and long-term cognitive impairment in older adults attributable to the studied cardiovascular procedures may be uncommon.
AHRQ-funded; 2902007100641.
Citation: Fink HA, Hemmy LS, MacDonald R .
Intermediate- and long-term cognitive outcomes after cardiovascular procedures in older adults: a systematic review.
Ann Intern Med 2015 Jul 21;163(2):107-17. doi: 10.7326/m14-2793..
Keywords: Cardiovascular Conditions, Elderly, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Albrecht JS, Marcantonio ER, Roffey DM
Stability of postoperative delirium psychomotor subtypes in individuals with hip fracture.
This paper's objectives were to determine the stability of psychomotor subtypes of delirium over time and to identify characteristics associated with delirium psychomotor subtypes in individuals undergoing surgical repair of hip fracture. The Transfusion Trigger Trial for Functional Outcomes in Cardiovascular Patients Undergoing Surgical Hip Fracture Repair Cognitive Ancillary Study was conducted. Results showed that psychomotor subtypes of delirium often fluctuated from assessment to assessment, rather than representing fixed categories of delirium. Hypoactive delirium was the most common presentation of delirium but the least likely to be documented by healthcare providers.
AHRQ-funded; HS021068.
Citation: Albrecht JS, Marcantonio ER, Roffey DM .
Stability of postoperative delirium psychomotor subtypes in individuals with hip fracture.
J Am Geriatr Soc 2015 May;63(5):970-6. doi: 10.1111/jgs.13334.
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Keywords: Adverse Events, Cardiovascular Conditions, Injuries and Wounds, Neurological Disorders, Surgery