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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 11 of 11 Research Studies DisplayedLacson R, Cochon L, Ching PR
Integrity of clinical information in radiology reports documenting pulmonary nodules.
Researchers sought to quantify the integrity, measured as completeness and concordance with a thoracic radiologist, of documenting pulmonary nodule characteristics in CT reports, and to assess impact on making follow-up recommendations. Their retrospective cohort study was performed at an academic medical center and natural language processing was used on radiology reports of CT scans of chest, abdomen, or spine to assess presence of pulmonary nodules. They found that essential pulmonary nodule characteristics were under-reported, potentially impacting recommendations for pulmonary nodule follow-up. They concluded that the lack of documentation of pulmonary nodule characteristics in radiology reports was common, with the potential for compromising patient care and clinical decision support tools.
AHRQ-funded; HS024722.
Citation: Lacson R, Cochon L, Ching PR .
Integrity of clinical information in radiology reports documenting pulmonary nodules.
J Am Med Inform Assoc 2021 Jan 15;28(1):80-85. doi: 10.1093/jamia/ocaa209..
Keywords: Imaging, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Lacson R, Healey MJ, Cochon LR
Unscheduled radiologic examination orders in the electronic health record: a novel resource for targeting ambulatory diagnostic errors in radiology.
The purpose of this study was to assess the prevalence of unscheduled radiologic examination orders in an electronic health record and to assess the proportion of unscheduled orders that are clinically necessary. Unscheduled radiologic examination orders were retrieved for seven modalities: computed tomography, magnetic resonance imaging, ultrasound, obstetric ultrasound, bone densitometry, mammography, and fluoroscopy. Findings showed that large numbers of radiologic examination orders remain unscheduled in the electronic health record. Identifying and performing clinically necessary unscheduled radiologic examination orders may help reduce diagnostic errors related to diagnosis and treatment delays and enhance patient safety.
AHRQ-funded; HS024722.
Citation: Lacson R, Healey MJ, Cochon LR .
Unscheduled radiologic examination orders in the electronic health record: a novel resource for targeting ambulatory diagnostic errors in radiology.
J Am Coll Radiol 2020 Jun;17(6):765-72. doi: 10.1016/j.jacr.2019.12.021..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality, Imaging, Patient Safety
Zhou Y, Abel GA, Hamilton W
Imaging activity possibly signalling missed diagnostic opportunities in bladder and kidney cancer: a longitudinal data-linkage study using primary care electronic health records.
Sub-optimal use or interpretation of imaging investigations prior to diagnosis of certain cancers may be associated with less timely diagnosis, but pre-diagnostic imaging activity for urological cancer is unknown. In this study, the investigators analysed linked data derived from primary and secondary care records and cancer registration to evaluate the use of clinically relevant imaging tests pre-diagnosis, in patients with bladder and kidney cancer diagnosed in 2012-15 in England.
AHRQ-funded; HS022087.
Citation: Zhou Y, Abel GA, Hamilton W .
Imaging activity possibly signalling missed diagnostic opportunities in bladder and kidney cancer: a longitudinal data-linkage study using primary care electronic health records.
Cancer Epidemiol 2020 Jun;66:101703. doi: 10.1016/j.canep.2020.101703..
Keywords: Cancer, Diagnostic Safety and Quality, Imaging, Primary Care, Electronic Health Records (EHRs), Health Information Technology (HIT)
Lacson R, Gujrathi I, Healey M
Closing the loop on unscheduled diagnostic imaging orders: a systems-based approach.
This study looked at the impact of implementing a tool called SCORE (System for Coordinating Orders for Radiology Exams), whose objective is to manage unscheduled orders for outpatient diagnostic imaging in an electronic health record (EHR) with embedded computerized physician order entry. The rate of unscheduled imaging orders was compared before SCORE (October 2017 to September 2018) and after (October 2018 to June 2019). There was a 49% reduction in unscheduled orders after SCORE implementation at a large academic institution.
AHRQ-funded; HS024722.
Citation: Lacson R, Gujrathi I, Healey M .
Closing the loop on unscheduled diagnostic imaging orders: a systems-based approach.
J Am Coll Radiol 2021 Jan;18(1 Pt A):60-67. doi: 10.1016/j.jacr.2020.09.031..
Keywords: Imaging, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Kang SK, Garry K, Chung R
Natural language processing for identification of incidental pulmonary nodules in radiology reports.
The authors developed natural language processing (NLP) to identify incidental lung nodules (ILNs) in radiology reports for assessment of management recommendations using the electronic health records for patients who underwent chest CT before and after implementation of a department-wide dictation macro of the Fleischner Society recommendations. They concluded that NLP reliably automates identification of ILNs in unstructured reports, pertinent to quality improvement efforts for ILN management.
AHRQ-funded; HS024376.
Citation: Kang SK, Garry K, Chung R .
Natural language processing for identification of incidental pulmonary nodules in radiology reports.
J Am Coll Radiol 2019 Nov;16(11):1587-94. doi: 10.1016/j.jacr.2019.04.026..
Keywords: Imaging, Diagnostic Safety and Quality, Health Information Technology (HIT), Electronic Health Records (EHRs), Quality Improvement, Quality of Care
Deng F, Li MD, Wong A
Quality of documentation of contrast agent allergies in electronic health records.
The purpose of this study was to describe and appraise contrast agent allergy documentation in the electronic health record (EHR). The investigators concluded that contrast allergy records in EHRs were diverse and commonly low quality. They suggest that continued EHR enhancements and training are needed to support contrast allergy documentation to facilitate improved patient care and medical research.
AHRQ-funded; HS025375.
Citation: Deng F, Li MD, Wong A .
Quality of documentation of contrast agent allergies in electronic health records.
J Am Coll Radiol 2019 Aug;16(8):1027-35. doi: 10.1016/j.jacr.2019.01.027..
Keywords: Adverse Drug Events (ADE), Adverse Events, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Imaging
Lacson R, Laroya R, Wang A
Integrity of clinical information in computerized order requisitions for diagnostic imaging.
This study compared the integrity of electronic health record (EHR) imaging order requisitions with EHR provider notes and their potential impact on order inaccuracies and interpretation of results. This retrospective study was conducted at a tertiary academic medical center using MRI lumbar spine and CT abdomen/pelvis orders performed from April 1 to May 31, 2016. Results showed that requisition indications were more likely to be incomplete than provider notes. Researchers recommended that relevant documentation be more readily available in EHRs.
Citation: Lacson R, Laroya R, Wang A .
Integrity of clinical information in computerized order requisitions for diagnostic imaging.
J Am Med Inform Assoc 2018 Dec;25(12):1651-56. doi: 10.1093/jamia/ocy133..
Keywords: Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Imaging
Murphy DR, Meyer AND, Vaghani V
Electronic triggers to identify delays in follow-up of mammography: harnessing the power of big data in health care.
Because of the unique clinical, logistic, and legal aspects of mammography, this study was conducted to evaluate the effectiveness of a trigger to flag delayed follow-up on mammography. The investigators found that care delays appeared to continue despite federal laws requiring patient notification of mammographic results within 30 days. They suggest that clinical application of mammography-related triggers could help detect these delays.
AHRQ-funded; HS022901.
Citation: Murphy DR, Meyer AND, Vaghani V .
Electronic triggers to identify delays in follow-up of mammography: harnessing the power of big data in health care.
J Am Coll Radiol 2018 Feb;15(2):287-95. doi: 10.1016/j.jacr.2017.10.001..
Keywords: Cancer: Breast Cancer, Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT), Imaging, Diagnostic Safety and Quality, Prevention, Women
Huhdanpaa HT, Tan WK, Rundell SD
Using natural language processing of free-text radiology reports to identify type 1 modic endplate changes.
This study’s goal was to determine the feasibility of using natural language processing (NLP) to convert text from electronic medical records reports of magnetic resonance (MR) imaging results into variables to identify patients with Type 1 Modic endplate changes in the spine. Those patients with Type 1 Modic endplace changes may be eligible for clinical trials. Using a rule-based algorithm in Java they found the prevalence was 10%. The results showed that specificity was higher than recall due to the high number of keywords used in lumbar spine reporting.
AHRQ-funded; HS022972.
Citation: Huhdanpaa HT, Tan WK, Rundell SD .
Using natural language processing of free-text radiology reports to identify type 1 modic endplate changes.
J Digit Imaging 2018 Feb;31(1):84-90. doi: 10.1007/s10278-017-0013-3..
Keywords: Electronic Health Records (EHRs), Imaging, Health Information Technology (HIT)
Murphy DR, Meyer AN, Bhise V
Computerized triggers of big data to detect delays in follow-up of chest imaging results.
A "trigger" algorithm was used to identify delays in follow-up of abnormal chest imaging results in a large national clinical data warehouse of electronic health record (EHR) data. In this study, the authors applied a trigger in a repository hosting EHR data from all Department of Veterans Affairs health-care facilities and analyzed data from seven facilities. The investigators concluded that application of triggers on "big" EHR data may aid in identifying patients experiencing delays in diagnostic evaluation of chest imaging results suspicious for malignancy.
Citation: Murphy DR, Meyer AN, Bhise V .
Computerized triggers of big data to detect delays in follow-up of chest imaging results.
Chest 2016 Sep;150(3):613-20. doi: 10.1016/j.chest.2016.05.001..
Keywords: Imaging, Electronic Health Records (EHRs), Health Information Technology (HIT), Data, Diagnostic Safety and Quality, Cancer
Murphy DR, Thomas EJ, Meyer AN
Development and validation of electronic health record-based triggers to detect delays in follow-up of abnormal lung imaging findings.
In this study, the researchers developed an electronic health record (EHR)-based trigger algorithm to identify delays in follow-up evaluation of patients with imaging findings suggestive of lung cancer. After validating the trigger with retrospective data, they concluded that EHR-based triggers can be used to identify patients with suspicious imaging findings in whom follow-up diagnostic evaluation was delayed.
AHRQ-funded; HS017820.
Citation: Murphy DR, Thomas EJ, Meyer AN .
Development and validation of electronic health record-based triggers to detect delays in follow-up of abnormal lung imaging findings.
Radiology 2015 Oct;277(1):81-7. doi: 10.1148/radiol.2015142530..
Keywords: Cancer: Lung Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Imaging