National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Ambulatory Care and Surgery (1)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Asthma (9)
- Children/Adolescents (3)
- Chronic Conditions (3)
- Clinical Decision Support (CDS) (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (8)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Delivery (1)
- (-) Health Information Technology (HIT) (15)
- Health Literacy (1)
- Health Services Research (HSR) (1)
- Hospital Readmissions (1)
- Hospitals (1)
- Intensive Care Unit (ICU) (1)
- Medication (2)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (3)
- Obesity (1)
- Obesity: Weight Management (1)
- Outcomes (2)
- Patient-Centered Outcomes Research (1)
- Practice Patterns (1)
- Primary Care (2)
- Public Health (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- (-) Respiratory Conditions (15)
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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 15 of 15 Research Studies DisplayedLopez K, Li H, Lipkin-Moore Z
Deep learning prediction of hospital readmissions for asthma and COPD.
The purpose of this observational study was to identify Electronic Health Record (EHR) features of severe asthma and COPD exacerbations and assess the performance of four machine learning (ML) and one deep learning (DL) model in predicting readmissions using EHR data. The study included 31, 2017 patients hospitalized with asthma and COPD exacerbations. The study found that Black and Hispanic patients had a greater likelihood of readmission for asthma. Patients with COPD readmissions included a high percentage of Blacks and Hispanics. To identify patients at high risk of readmission, index hospitalization data of a subset of 2,682 patients, 777 with asthma and 1,905 with COPD, was analyzed with four ML models, and one DL model. The researchers discovered that multilayer perceptron, the DL method, had the best sensitivity and specificity compared to the four ML methods implemented in the same dataset.
AHRQ-funded; HS027626.
Citation: Lopez K, Li H, Lipkin-Moore Z .
Deep learning prediction of hospital readmissions for asthma and COPD.
Respir Res 2023 Dec 13; 24(1):311. doi: 10.1186/s12931-023-02628-7..
Keywords: Asthma, Respiratory Conditions, Hospital Readmissions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Silverstein GD, Styke SC, Kaur S
The relationship between depressive symptoms, eHealth literacy, and asthma outcomes in the context of a mobile health intervention.
This study’s objective was to evaluate the associations between health/eHealth literacy and depressive symptoms with app usage and clinical outcomes. The authors recruited adults with persistent asthma to utilize the ASTHMAXcel PRO mobile app. Participants completed the following questionnaires: Patient Health Questionnaire-9 (PHQ-9) to assess for depressive symptoms, Asthma Control Test (ACT), Mini Asthma Quality of Life (QOL) Questionnaire, and the Newest Vital Sign (NVS) tool to measure health literacy. Subsets of participant data were available on eHealth literacy (eHeals) (n = 24) and average number of app logins across 2 months (n = 40). The average participant age was 44.0 years, with 74% identifying as female. Increased depressive symptoms were associated with worse asthma control and asthma QOL, but not eHealth literacy. Higher eHealth literacy was associated with worse asthma QOL and more app logins. NVS scores weren’t associated with any measures.
AHRQ-funded; HS025645.
Citation: Silverstein GD, Styke SC, Kaur S .
The relationship between depressive symptoms, eHealth literacy, and asthma outcomes in the context of a mobile health intervention.
Psychosom Med 2023 Sep 1; 85(7):605-11. doi: 10.1097/psy.0000000000001170..
Keywords: Health Literacy, Asthma, Telehealth, Health Information Technology (HIT), Education: Patient and Caregiver, Outcomes, Respiratory Conditions, Chronic Conditions
Plombon S, Rudin RS, Sulca Flores J
Assessing equitable recruitment in a digital health trial for asthma.
This study’s objective was to assess a multipronged strategy that primarily used digital methods to recruit asthma patients into a clinical trial for a digital health intervention. Eligible patients completed a web-based eligibility questionnaire reported during a verbal consent phone call. Study team members conducted monthly sessions using a structured guide to identify recruitment barriers and facilitators. The results indicated that primarily digital strategy patients recruitment is unlikely to achieve equitable participation, even in a population overrepresented by patient portal enrollees. The authors concluded that nondigital recruitment methods that address racial and educational disparities and less active portal enrollees are necessary to ensure equity in clinical trial enrollment.
AHRQ-funded; HS026432.
Citation: Plombon S, Rudin RS, Sulca Flores J .
Assessing equitable recruitment in a digital health trial for asthma.
Appl Clin Inform 2023 Aug; 14(4):620-31. doi: 10.1055/a-2090-5745..
Keywords: Asthma, Respiratory Conditions, Health Information Technology (HIT)
Krishnan JA, Margellos-Anast H, Kumar R
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
The purpose of this clinical trial was to compare an emergency-department- (ED) only intervention and home visits by community health workers for 6 months (ED-plus-home) and enhanced usual care (UC). The study enrolled children aged 5 to 11 years with uncontrolled asthma. The primary outcomes were change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers. The secondary outcomes included guideline-recommended ED discharge care and self-management. The study found that of the 373 children recruited, only 63% completed the 6-month follow-up visit. Differences in Asthma Impact Scores or caregivers' Satisfaction with Participation in Social Roles scores were not significant. However, in the intervention groups guideline-recommended ED discharge care improved significantly versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups.
AHRQ-funded; HS027804.
Citation: Krishnan JA, Margellos-Anast H, Kumar R .
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
J Allergy Clin Immunol Glob 2023 Aug; 2(3). doi: 10.1016/j.jacig.2023.100100..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Emergency Department, Clinical Decision Support (CDS), Health Information Technology (HIT), Racial and Ethnic Minorities
Rudin RS, Qureshi N, Foer D
Toward an asthma patient-reported outcome measure for use in digital remote monitoring.
The purpose of this study was to create a patient-reported outcome measure (PROM) and evaluate its suitability for digital remote asthma symptom monitoring to identify uncontrolled asthma. The researchers modified the asthma control measure (ACM), an existing, non-licensed PROM, and tested it with the asthma control questionnaire (ACQ-5) on 498 individuals with asthma, all of whom were recruited through an online platform. The study concluded that the modified ACM can be used in digital remote monitoring, does not require a license, and is able to differentiate between patients with uncontrolled asthma and patients with well-controlled asthma.
AHRQ-funded; HS026432.
Citation: Rudin RS, Qureshi N, Foer D .
Toward an asthma patient-reported outcome measure for use in digital remote monitoring.
J Asthma 2022 Aug;59(8):1697-702. doi: 10.1080/02770903.2021.1955378..
Keywords: Asthma, Respiratory Conditions, Telehealth, Health Information Technology (HIT)
Kan K, Shaunfield S, Kanaley M
Health provider perspectives of electronic medication monitoring in outpatient asthma care: a qualitative investigation using the consolidated framework for implementation research.
This study’s objective was to quantitatively explore the experience of health providers using electronic medication monitoring (EMM) in pediatric outpatient asthma care. The authors conducted interviews with 10 health providers using the Consolidated Framework of Implementation Research (CFIR) on their EMM experience with asthma patients from 5 primary care or specialty clinics. The EMM tracked albuterol and inhaled corticosteroid (ICS) use. Health providers called parents whenever ICS adherence waned, or albuterol use increased. The interviews were audio-recorded, transcribed, and deductively analyzed. Most providers felt the intervention improved care delivery, but implementation of the intervention model would require additional employees to handle the increased administrative and clinical workload.
AHRQ-funded; HS026385.
Citation: Kan K, Shaunfield S, Kanaley M .
Health provider perspectives of electronic medication monitoring in outpatient asthma care: a qualitative investigation using the consolidated framework for implementation research.
J Asthma 2022 Feb;59(2):342-51. doi: 10.1080/02770903.2020.1846745..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Medication, Ambulatory Care and Surgery
Rudin RA, Perez S, Rodriguez JA
User-centered design of a scalable, electronic health record-integrated remote symptom monitoring intervention for patients with asthma and providers in primary care.
The objective of this study was to determine user and electronic health records (EHR) integration requirements for a scalable remote symptom monitoring intervention for asthma patients and their providers. Using the NASSS framework to guide their user-centered design process, the investigators identified patient and provider requirements for scaling an EHR-integrated remote symptom monitoring intervention in primary care.
AHRQ-funded; HS026432.
Citation: Rudin RA, Perez S, Rodriguez JA .
User-centered design of a scalable, electronic health record-integrated remote symptom monitoring intervention for patients with asthma and providers in primary care.
J Am Med Inform Assoc 2021 Oct 12;28(11):2433-44. doi: 10.1093/jamia/ocab157..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Asthma, Respiratory Conditions, Primary Care
Kern-Goldberger AS, Rasooly IR, Luo B
EHR-integrated monitor data to measure pulse oximetry use in bronchiolitis.
This study’s objective was to determine if electronic health record (EHR) data can accurately estimate the extent of actual oxygen saturation monitoring use in bronchiolitis. The study included infants aged 8 weeks through 23 months who were hospitalized with bronchiolitis. Findings showed that EHR-integrated monitor data were a valid measure of actual oxygen saturation monitoring use that may help hospitals more efficiently identify opportunities to de-implement guideline-inconsistent use.
AHRQ-funded; HS026620.
Citation: Kern-Goldberger AS, Rasooly IR, Luo B .
EHR-integrated monitor data to measure pulse oximetry use in bronchiolitis.
Hosp Pediatr 2021 Oct;11(10):1073-82. doi: 10.1542/hpeds.2021-005894..
Keywords: Newborns/Infants, Respiratory Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Joseph CLM, Alexander GL, Lu M
Pilot study of a brief provider and EMR-based intervention for overweight teens with asthma.
The authors piloted an electronic medical record-based tailored discussion guide (TDG) and a brief provider training to address weight management in overweight teens with asthma. They observed modest improvements in patient-reported asthma outcomes and health behaviors. They found strong evidence that the TDG supports provider discussion of weight and asthma to create a more patient-centered conversation from the perspective of participating teens. They recommended addressing challenges to recruitment and clinic adaptation prior to advancing to a full-scale trial.
AHRQ-funded; HS022417.
Citation: Joseph CLM, Alexander GL, Lu M .
Pilot study of a brief provider and EMR-based intervention for overweight teens with asthma.
Pilot Feasibility Stud 2021 Aug 30;7(1):167. doi: 10.1186/s40814-021-00848-6..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Asthma, Chronic Conditions, Respiratory Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Doshi H, Hsia B, Shahani J
Impact of technology-based interventions on patient-reported outcomes in asthma: a systematic review.
This systematic review’s goal was to identify which technology-based interventions (TBIs) for asthma management have been formally evaluated using patient-reported outcomes (PROs). The authors aimed to: 1) identify the TBIs that have been evaluated in clinical trials using PROs; 2) identify the most commonly used PROs in these trials; and 3) determine the impact of TBIs on PROs in the management of chronic asthma. PubMed and Clinicaltrials.gov databases were searched for English-language studies published between January 2000 and February 2020. The final analysis included 14 clinical trials with 1 to 3 arms. Five different TBI types were identified, most commonly involving multimedia education. Four different categories of PROs were identified. At least 1 PRO domain with positive outcomes were reported by patients in 12 of 14 studies.
AHRQ-funded; R18 HS025645.
Citation: Doshi H, Hsia B, Shahani J .
Impact of technology-based interventions on patient-reported outcomes in asthma: a systematic review.
J Allergy Clin Immunol Pract 2021 Jun;9(6):2336-41. doi: 10.1016/j.jaip.2021.01.027..
Keywords: Asthma, Respiratory Conditions, Chronic Conditions, Telehealth, Health Information Technology (HIT)
Li KY, Zhu Z, Ng S
Direct-to-consumer telemedicine visits for acute respiratory infections linked to more downstream visits.
The authors compared downstream care utilization data from a large, commercial payer for the period 2016-19. They found that the telemedicine cohort had fewer emergency department visits but more subsequent office, urgent care, and telemedicine visits. These findings suggest that potential savings from shifting initial care to a direct-to-consumer telemedicine setting should be balanced against the potential for higher spending on downstream care.
AHRQ-funded; HS027632.
Citation: Li KY, Zhu Z, Ng S .
Direct-to-consumer telemedicine visits for acute respiratory infections linked to more downstream visits.
Health Affairs 2021 Apr;40(4):596-602. doi: 10.1377/hlthaff.2020.01741..
Keywords: Telehealth, Health Information Technology (HIT), Respiratory Conditions, Healthcare Delivery
Beam KS, Lee M, Hirst K
Specificity of International Classification of Diseases codes for bronchopulmonary dysplasia: an investigation using electronic health record data and a large insurance database.
This study analyzed the accuracy of International Classification of Diseases (ICD) codes to identify bronchopulmonary dysplasia (BPD) in newborns. A retrospective cohort study in a single-center NICU (n=166) was conducted to evaluate sensitivity and specificity of ICD-10 codes for BPD diagnosis. The sensitivity of any BPD-related codes ranged from 0.82 to 0.95, while specificity range was 0.25 to 0.36. The most common date of BPD diagnosis was the day of birth, which is inconsistent with the clinical definition. The authors conclude that the ICD codes for BPD are unlikely to accurately reflect the current clinical definition and should be interpreted with caution.
AHRQ-funded; HS000063.
Citation: Beam KS, Lee M, Hirst K .
Specificity of International Classification of Diseases codes for bronchopulmonary dysplasia: an investigation using electronic health record data and a large insurance database.
J Perinatol 2021 Apr;41(4):764-71. doi: 10.1038/s41372-021-00965-3..
Keywords: Newborns/Infants, Respiratory Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT)
Rossol SL, Yang JK, Toney-Noland C
Non-contact video-based neonatal respiratory monitoring.
Respiratory rate (RR) has been shown to be a reliable predictor of cardio-pulmonary deterioration, but standard RR monitoring methods in the neonatal intensive care units (NICU) with contact leads have been related to iatrogenic complications. This iterative design study developed a novel algorithm that produced RR from footage analyzed from stable NICU patients in open cribs with corrected gestational ages ranging from 33 to 40 weeks. The final algorithm used a proprietary technique of micromotion and stationarity detection to model background noise to be able to amplify and record respiratory motions.
AHRQ-funded; HS023506.
Citation: Rossol SL, Yang JK, Toney-Noland C .
Non-contact video-based neonatal respiratory monitoring.
Children 2020 Oct 6;7(10). doi: 10.3390/children7100171..
Keywords: Newborns/Infants, Health Information Technology (HIT), Respiratory Conditions, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU)
Ji W, McKenna C, Ochoa A
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
The authors sought to propose and assess potentially objective, efficient, and reproducible surveillance definitions for non-ventilator hospital-acquired pneumonia (NV-HAP) using routine clinical data stored in electronic health record systems. They found that objective surveillance for NV-HAP using electronically computable definitions that incorporate common clinical criteria is feasible and generates incidence, mortality, and adjusted odds ratios for hospital mortality similar to estimates from manual surveillance. They concluded that these definitions have the potential to facilitate widespread, automated surveillance for NV-HAP and thus inform the development and evaluation of prevention programs.
AHRQ-funded; HS025008.
Citation: Ji W, McKenna C, Ochoa A .
Development and assessment of objective surveillance definitions for nonventilator hospital-acquired pneumonia.
JAMA Netw Open 2019 Oct 2;2(10):e1913674. doi: 10.1001/jamanetworkopen.2019.13674..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Respiratory Conditions, Public Health, Electronic Health Records (EHRs), Health Information Technology (HIT)
Gidengil CA, Linder JA, Beach S
Using clinical vignettes to assess quality of care for acute respiratory infections.
Overprescribing of antibiotics for acute respiratory infections (ARIs) is common. The objective of this study was to develop and validate a vignette-based method to estimate clinician ARI antibiotic prescribing. The researchers concluded that responses to 3 clinical vignettes can identify clinicians with relatively poor quality ARI antibiotic prescribing. Vignettes may be a mechanism to target clinicians for quality improvement efforts.
AHRQ-funded; HS018419.
Citation: Gidengil CA, Linder JA, Beach S .
Using clinical vignettes to assess quality of care for acute respiratory infections.
Inquiry 2016 Apr 20;53:pii: 0046958016636531. doi: 10.1177/0046958016636531..
Keywords: Antibiotics, Antimicrobial Stewardship, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Medication, Practice Patterns, Primary Care, Quality of Care, Respiratory Conditions