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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
5776 to 5800 of 12214 Research Studies DisplayedShaker MS, Greenhawt MJ
Analysis of value-based costs of undesignated school stock epinephrine policies for peanut anaphylaxis.
Children experiencing anaphylaxis at school may lack access to a personal epinephrine device, prompting recent legislation permitting undesignated (eg, non-student specific) stock epinephrine autoinjector units at school. However, epinephrine device costs vary, and the cost-effectiveness of undesignated school stock epinephrine is uncharacterized to date. The objective of this study was to define value-based strategies for undesignated school stock epinephrine programs.
AHRQ-funded; HS024599.
Citation: Shaker MS, Greenhawt MJ .
Analysis of value-based costs of undesignated school stock epinephrine policies for peanut anaphylaxis.
JAMA Pediatr 2019 Feb;173(2):169-75. doi: 10.1001/jamapediatrics.2018.4275..
Keywords: Healthcare Costs, Education, Policy, Medication
Leeman H, Cosgrove SE, Williams D
Assessing burden of central line-associated bloodstream infections present on hospital admission.
Investigators described patients presenting to an academic medical center with central line-associated bloodstream infection present on hospital admission over 1 year. Of the 130 admissions, they found that about half presented from home infusion, followed by oncology clinic, hemodialysis, and skilled nursing facility. They concluded that efforts to reduce such infections should address patients across the entire health care system.
AHRQ-funded; HS025782.
Citation: Leeman H, Cosgrove SE, Williams D .
Assessing burden of central line-associated bloodstream infections present on hospital admission.
Am J Infect Control 2020 Feb;48(2):216-18. doi: 10.1016/j.ajic.2019.08.010..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Hospitalization, Home Healthcare, Hospitals, Infectious Diseases
Wey A, Gustafson SK, Salkowski N
Association of pretransplant and posttransplant program ratings with candidate mortality after listing.
The Scientific Registry of Transplant Recipients (SRTR) is responsible for understandable reporting of program metrics, including transplant rate, waitlist mortality, and posttransplant outcomes. SRTR developed five-tier systems for each metric to improve accessibility for the public. In this study, the researchers investigated the associations of the five-tier assignments at listing with all-cause candidate mortality after listing, for candidates listed July 12, 2011-June 16, 2014.
AHRQ-funded; HS024527.
Citation: Wey A, Gustafson SK, Salkowski N .
Association of pretransplant and posttransplant program ratings with candidate mortality after listing.
Am J Transplant 2019 Feb;19(2):399-406. doi: 10.1111/ajt.15032..
Keywords: Transplantation, Surgery, Mortality, Registries
Markham JL, Richardson T, Hall M
Association of weekend admission and weekend discharge with length of stay and 30-day readmission in children's hospitals.
Worse outcomes among adults presenting for/receiving care on weekends (ie, "the weekend effect") have been observed for many diseases. However, little is known about the overall impact of the weekend effect in hospitalized children. The purpose of this study was to determine the association between 1.) weekend admission and length of stay (LOS) and 2.) weekend discharge and 30-day all-cause readmission.
AHRQ-funded; HS024735.
Citation: Markham JL, Richardson T, Hall M .
Association of weekend admission and weekend discharge with length of stay and 30-day readmission in children's hospitals.
J Hosp Med 2019 Feb;14(2):75-82. doi: 10.12788/jhm.3085..
Keywords: Children/Adolescents, Hospitals, Hospital Readmissions, Hospital Discharge, Hospitalization
Anton NE, Mizota T, Timsina LR
Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment.
The objective of this study was to identify trainee characteristics that predict the transfer of simulator-acquired skill to the operating room. The investigators concluded that promoting automaticity, self-efficacy, and attention selectivity may help improve the transfer of simulator-acquired skill. They indicated that mental skills training and training to automaticity may therefore be valuable interventions to achieve this goal.
AHRQ-funded; HS022080.
Citation: Anton NE, Mizota T, Timsina LR .
Attentional selectivity, automaticity, and self-efficacy predict simulator-acquired skill transfer to the clinical environment.
Am J Surg 2019 Feb;217(2):266-71. doi: 10.1016/j.amjsurg.2018.11.028..
Keywords: Education: Continuing Medical Education, Patient Safety, Provider, Provider: Physician, Simulation, Surgery, Training
Lion KC, Kieran K, Desai A
Audio-recorded discharge instructions for limited English proficient parents: a pilot study.
Parents with limited English proficiency (LEP) demonstrate lower comprehension of discharge instructions. This study was conducted to (1) determine the feasibility of providing a greeting card with language-specific, audio-recorded discharge instructions to LEP parents; (2) describe use of and satisfaction with the cards; and (3) evaluate card effect on instruction comfort with home care and comprehension. The authors concluded that providing language-concordant, audio-recorded discharge instructions was feasible, and parents reported high satisfaction with and frequent use of the cards with multiple caregivers.
AHRQ-funded; HS024299.
Citation: Lion KC, Kieran K, Desai A .
Audio-recorded discharge instructions for limited English proficient parents: a pilot study.
Jt Comm J Qual Patient Saf 2019 Feb;45(2):98-107. doi: 10.1016/j.jcjq.2018.06.001..
Keywords: Hospital Discharge, Cultural Competence, Clinician-Patient Communication, Communication, Education: Patient and Caregiver
Wey A, Salkowski N, Kasiske BL
Comparing Scientific Registry of Transplant Recipients posttransplant program-specific outcome ratings at listing with subsequent recipient outcomes after transplant.
To improve accessibility of program-specific reports to patients, the Scientific Registry of Transplant Recipients released a 5-tier system for categorizing 1-year posttransplant program evaluations. Whether this system predicts subsequent posttransplant outcomes at the time patients are waitlisted has been questioned. IN this study, researchers investigated the association of tier at listing and the corresponding continuous score used for tier assignment, which ranges from 0 (poor outcomes) to 1 (good outcomes), with eventual 1-year posttransplant graft survival.
AHRQ-funded; HS024527.
Citation: Wey A, Salkowski N, Kasiske BL .
Comparing Scientific Registry of Transplant Recipients posttransplant program-specific outcome ratings at listing with subsequent recipient outcomes after transplant.
Am J Transplant 2019 Feb;19(2):391-98. doi: 10.1111/ajt.15038..
Keywords: Transplantation, Surgery, Mortality, Registries, Adverse Events, Risk
Forster M, Amy GL, Areba E
Cumulative psychosocial risks, internal asse, and past 30-day tobacco use among middle and high school students: the promise of internal assets.
The authors investigated whether internal assets (IAs), factors that promote healthy youth development, can mitigate the adverse effects of psychosocial risks on tobacco use. Their results indicated that every additional psychosocial risk factor was associated with an increase in the odds of using tobacco and in the estimated number of products used. IAs were inversely associated with tobacco use and attenuated the association between cumulative psychosocial risks and use. They concluded that bolstering resilience by facilitating students' IAs represents a promising direction for youth-focused prevention efforts.
AHRQ-funded; HS022236.
Citation: Forster M, Amy GL, Areba E .
Cumulative psychosocial risks, internal asse, and past 30-day tobacco use among middle and high school students: the promise of internal assets.
Addict Behav 2019 Feb;89:240-47. doi: 10.1016/j.addbeh.2018.10.014..
Keywords: Tobacco Use, Children/Adolescents, Risk, Education
Kang M, Kempker JA
Definitions, epidemiology, clinical risk factors, and health disparities in acute respiratory distress syndrome.
This case definition introduces challenges to the reliable and accurate epidemiologic study of acute respiratory distress syndrome (ARDS). Within these limitations, ARDS appears to be a condition that is relatively rare within the general population but common within the context of the intensive care unit. Furthermore, the frequency and outcomes of ARDS seem to vary between populations, with no clearly discernible temporal trends in incidence or case fatality that are uniform across studies.
AHRQ-funded; HS025240.
Citation: Kang M, Kempker JA .
Definitions, epidemiology, clinical risk factors, and health disparities in acute respiratory distress syndrome.
Semin Respir Crit Care Med 2019 Feb;40(1):3-11. doi: 10.1055/s-0039-1683884..
Keywords: Disparities, Respiratory Conditions, Chronic Conditions, Risk
Gadgil MD, Ehrlich SF, Zhu Y
Dietary quality and glycemic control among women with gestational diabetes mellitus.
Poor dietary quality, measured by the Healthy Eating Index 2010 (HEI-2010), is associated with risk of gestational diabetes mellitus (GDM) and type 2 diabetes. The aim was to investigate the association between dietary quality and glycemic control in women with GDM. The authors concluded that clinicians should be aware that even a small improvement in diet quality may be beneficial for the achievement of improved glycemic control in women with GDM.
AHRQ-funded; HS019367.
Citation: Gadgil MD, Ehrlich SF, Zhu Y .
Dietary quality and glycemic control among women with gestational diabetes mellitus.
J Womens Health 2019 Feb;28(2):178-84. doi: 10.1089/jwh.2017.6788..
Keywords: Pregnancy, Diabetes, Nutrition, Women, Risk, Prevention
Gourevitch RA, Mehrotra A, Galvin G
Does comparing cesarean delivery rates influence women's choice of obstetric hospital?
This study examined whether pregnant women who use cesarean delivery rate data from hospitals influences their choice of obstetric hospital. A randomized controlled trial of 18,293 users of the Ovia Health mobile app from 2016-2017 was conducted. Enrollees were given an explanation of the cesarean rate data and were randomized to an intervention group who also were given an interactive tool to display data for the 10 closest hospitals with obstetric services. There was no significant difference between the intervention and control groups in their hospital selection.
AHRQ-funded; HS000055.
Citation: Gourevitch RA, Mehrotra A, Galvin G .
Does comparing cesarean delivery rates influence women's choice of obstetric hospital?
Am J Manag Care 2019 Feb;25(2):e33-e38..
Keywords: Pregnancy, Women, Hospitals, Maternal Care, Labor and Delivery
Wolfson AR, Zhou L, Li Y
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome identified in the electronic health record allergy module.
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but severe hypersensitivity reaction that remains poorly characterized in the United States. The objective of this study was to identify and describe DRESS syndrome cases in an integrated health care system using electronic health record (EHR) allergy module free-text searches.
AHRQ-funded; HS022728; HS025375.
Citation: Wolfson AR, Zhou L, Li Y .
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome identified in the electronic health record allergy module.
J Allergy Clin Immunol Pract 2019 Feb;7(2):633-40. doi: 10.1016/j.jaip.2018.08.013..
Keywords: Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT)
Masterson Creber RM, Grossman LV, Ryan B
Engaging hospitalized patients with personalized health information: a randomized trial of an inpatient portal.
This study examined the effects of an inpatient portal intervention on patient activation, patient satisfaction, patient engagement with health information, and 30-day hospital admissions. A randomized trial was conducted from March 2014 to May 2017 with 426 English- or Spanish-speaking patients from 2 cardiac medical-surgical units at an urban academic medical center. Patients were randomized into 3 groups: 1) usual care, 2) tablet with general Internet access, and 3) tablet with an inpatient portal. There was a difference in patient activation between the 3 groups, but the inpatient portal group had lower 30-day hospital admissions. There was also a difference with patient engagement with health information between the inpatient portal and tablet-only groups.
AHRQ-funded; HS021816.
Citation: Masterson Creber RM, Grossman LV, Ryan B .
Engaging hospitalized patients with personalized health information: a randomized trial of an inpatient portal.
J Am Med Inform Assoc 2019 Feb;26(2):115-23. doi: 10.1093/jamia/ocy146..
Keywords: Patient and Family Engagement, Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitalization, Patient Experience, Inpatient Care
Duvall SW, Lindly O, Zuckerman K
Ethical implications for providers regarding cannabis use in children with autism spectrum disorders.
In this paper, the authors present commentary on the ethical implications of cannabis use in children with autism spectrum disorder and severe self-harm behaviors. They discuss ethical analysis that includes harm reduction, health concerns, and information sharing.
AHRQ-funded; HS000063.
Citation: Duvall SW, Lindly O, Zuckerman K .
Ethical implications for providers regarding cannabis use in children with autism spectrum disorders.
Pediatrics 2019 Feb;143(2). doi: 10.1542/peds.2018-0558..
Keywords: Autism, Children/Adolescents, Complementary and Alternative Medicine, Neurological Disorders
Desai K, Carroll I, Asch S
Extremely large outlier treatment effects may be a footprint of bias in trials from less developed countries: randomized trials of gabapentinoids.
This meta-analyses looked at extremely large outlier treatment effects for clinical trials of gabapentinoids conducted in less developed countries. Researchers identified 10 meta-analyses that showed statistically significant favorable findings. In four meta-analyses, heterogeneity estimates exceeded 90% for postoperative pain. Those 4 meta-analyses showed 39 out of 77 studies with extremely favorable results and out of those 39, 33 were conducted in less developed countries with no tradition of favorable research, 22 reported no information on funding, and 20 reported no conflicts of interest. Conversely, 27 of 38 studies with unfavorable results came from developed countries.
AHRQ-funded; HS024096.
Citation: Desai K, Carroll I, Asch S .
Extremely large outlier treatment effects may be a footprint of bias in trials from less developed countries: randomized trials of gabapentinoids.
J Clin Epidemiol 2019 Feb;106:80-87. doi: 10.1016/j.jclinepi.2018.10.012..
Keywords: Medication, Research Methodologies
Schnierle J, Christian-Brathwaite N, Louisias M
Implicit bias: what every pediatrician should know about the effect of bias on health and future directions.
This article discusses the role in implicit bias and its effect on health outcomes. The most highly regarded tool to measure implicit bias is the Implicit Association Test (IAT). While there is limited evidence showing an association between implicit bias and health outcomes, existing publications do show clear associations. The authors discuss the need for future research that relies on pre- and post-IAT measurements to examine the effect of bias training among healthcare providers.
AHRQ-funded; HS022986.
Citation: Schnierle J, Christian-Brathwaite N, Louisias M .
Implicit bias: what every pediatrician should know about the effect of bias on health and future directions.
Curr Probl Pediatr Adolesc Health Care 2019 Feb;49(2):34-44. doi: 10.1016/j.cppeds.2019.01.003..
Keywords: Children/Adolescents, Provider: Physician, Racial and Ethnic Minorities, Cultural Competence
Mistry RD, May LS, Pulia MS
Improving antimicrobial stewardship in pediatric emergency care: a pathway forward.
In this commentary, the authors discuss a study in this same issue. Recent multidisciplinary teams have used novel methods to successfully engage with and intervene in urgent care, pediatric, and general–emergency department antibiotic prescribing. Antibiotic stewardship programs are recommended, as well as emergency department experts continuing to collaborate and formulate thoughtful solutions to this important patient-safety and public-health issue.
AHRQ-funded; HS024342.
Citation: Mistry RD, May LS, Pulia MS .
Improving antimicrobial stewardship in pediatric emergency care: a pathway forward.
Pediatrics 2019 Feb;143(2). doi: 10.1542/peds.2018-2972..
Keywords: Antimicrobial Stewardship, Antibiotics, Children/Adolescents, Emergency Department, Medication, Patient Safety
Cerully JL, Parker AM, Rybowski L
Improving patients' choice of clinician by including roll-up measures in public healthcare quality reports: an online experiment.
The purpose of this paper was to determine how presenting quality scores at different levels of aggregation affects patients' clinician choices. A simulated clinician-choice experiment with 550 panelists was employed. The results suggested that roll-ups in healthcare quality reports, alone or as a complement to drill-downs, can help patients make better decisions.
AHRQ-funded; HS016978.
Citation: Cerully JL, Parker AM, Rybowski L .
Improving patients' choice of clinician by including roll-up measures in public healthcare quality reports: an online experiment.
J Gen Intern Med 2019 Feb;34(2):243-49. doi: 10.1007/s11606-018-4725-y..
Keywords: Shared Decision Making, Quality of Care, Provider Performance
Gartlehner G, Nussbaumer-Streit B, Wagner G
Increased risks for random errors are common in outcomes graded as high certainty of evidence.
The goal of this article was to assess the risk for random errors in outcomes graded as high certainty of evidence (CoE). Results showed that, overall, 38% of high CoE outcomes had increased risks for random errors. Outcomes assessing harms were more frequently affected than outcomes assessing benefits. Regrading of outcomes with increased random errors showed that 74% should have been downgraded based on current guidance. Recommendations included being aware that outcomes rated as high CoE often have increased risks for false-positive or false-negative findings.
AHRQ-funded; HS024749.
Citation: Gartlehner G, Nussbaumer-Streit B, Wagner G .
Increased risks for random errors are common in outcomes graded as high certainty of evidence.
J Clin Epidemiol 2019 Feb;106:50-59. doi: 10.1016/j.jclinepi.2018.10.009..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies
Warsame F, Haugen CE, Ying H
Limited health literacy and adverse outcomes among kidney transplant candidates.
More than one-third of US adults have limited health literacy, putting them at risk of adverse clinical outcomes. In this study the investigators evaluated the prevalence of limited health literacy among 1578 adult kidney transplant (KT) candidates (May 2014-November 2017) and examined its association with listing for transplant and waitlist mortality in this pilot study. The investigators concluded that limited health literacy may be a salient mechanism in access to KT; programs to aid candidates with limited health literacy may improve outcomes and reduce disparities.
AHRQ-funded; HS024600.
Citation: Warsame F, Haugen CE, Ying H .
Limited health literacy and adverse outcomes among kidney transplant candidates.
Am J Transplant 2019 Feb;19(2):457-65. doi: 10.1111/ajt.14994..
Keywords: Health Literacy, Transplantation, Adverse Events, Patient-Centered Outcomes Research, Outcomes, Surgery, Mortality, Kidney Disease and Health
Egan M, Yin HS, Greenhawt M
Low caregiver health literacy among pediatric food-allergic patients is associated with poorer food allergy management knowledge.
In this paper, the authors discuss how lower health literacy in caregivers of children with food allergies is associated with deficiencies in demonstrating correct use of an epinephrine autoinjector, increased reactions to foods in the past 12 months, and knowledge gaps on treatment of allergic reactions.
AHRQ-funded; HS024599.
Citation: Egan M, Yin HS, Greenhawt M .
Low caregiver health literacy among pediatric food-allergic patients is associated with poorer food allergy management knowledge.
J Allergy Clin Immunol Pract 2019 Feb;7(2):655-58. doi: 10.1016/j.jaip.2018.05.021..
Keywords: Caregiving, Health Literacy, Children/Adolescents, Education: Patient and Caregiver
Jones CD, Jones J, Bowles KH
Patient, caregiver, and clinician perspectives on expectations for home healthcare after discharge: a qualitative case study.
The objective of this study was to evaluate and compare expectations for skilled home health care (HHC) from the patient, caregiver, and HHC perspectives after hospital discharge. Results showed that unclear expectations occurred when the patient and/or caregiver expectations were uncertain or misaligned with the services received; in most such cases, the patient and caregiver did not have prior experience with HHC. Recommendations to improve HHC transitions included actively engaging both patients and caregivers in the hospital and HHC settings to provide education about HHC services and assess and address additional care needs.
AHRQ-funded; HS024569.
Citation: Jones CD, Jones J, Bowles KH .
Patient, caregiver, and clinician perspectives on expectations for home healthcare after discharge: a qualitative case study.
J Hosp Med 2019 Feb;14(2):90-95. doi: 10.12788/jhm.3140..
Keywords: Caregiving, Health Services Research (HSR), Home Healthcare, Patient Experience, Provider, Provider: Clinician, Transitions of Care
Pogorzelska-Maziarz M, de Cordova PB, Herzig M, de Cordova PB, Herzig CTA
Perceived impact of state-mandated reporting on infection prevention and control departments.
Currently, most US states have adopted legislation requiring hospitals to submit health care-associated infection (HAI) data. In this study, the authors evaluated the perceived impact of state HAI laws on infection prevention and control (IPC) departments. They concluded that respondents in states with laws reported negative effects on their IPC department, beyond what was required by federal mandates.
AHRQ-funded; HS024339.
Citation: Pogorzelska-Maziarz M, de Cordova PB, Herzig M, de Cordova PB, Herzig CTA .
Perceived impact of state-mandated reporting on infection prevention and control departments.
Am J Infect Control 2019 Feb;47(2):118-22. doi: 10.1016/j.ajic.2018.08.012..
Keywords: Public Reporting, Policy, Public Health, Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Hospitals
Mehra R, Cunningham SD, Lewis JB
Recommendations for the pilot expansion of Medicaid coverage for doulas in New York state.
AHRQ-funded; HS017589.
Citation: Mehra R, Cunningham SD, Lewis JB .
Recommendations for the pilot expansion of Medicaid coverage for doulas in New York state.
Am J Public Health 2019 Feb;109(2):217-19. doi: 10.2105/ajph.2018.304797..
Keywords: Medicaid, Pregnancy, Maternal Care, Health Insurance, Healthcare Costs, Prevention, Women, Disparities
Schiff GD, Klinger E, Salazar A
Screening for adverse drug events: a randomized trial of automated calls coupled with phone-based pharmacist counseling.
In this study, the investigators evaluated an automated telephone surveillance system coupled with transfer to a live pharmacist- to screen potentially drug-related symptoms after newly starting medications for four common primary care conditions: hypertension, diabetes, depression, and insomnia. Systematic automated telephone outreach monitoring coupled with real-time phone referral to a pharmacist identified a substantial number of previously unidentified potentially drug-related symptoms, many of which were validated as probably or possibly related to the drug by the pharmacist or their physicians.
AHRQ-funded; HS021094.
Citation: Schiff GD, Klinger E, Salazar A .
Screening for adverse drug events: a randomized trial of automated calls coupled with phone-based pharmacist counseling.
J Gen Intern Med 2019 Feb;34(2):285-92. doi: 10.1007/s11606-018-4672-7..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Health Information Technology (HIT), Provider: Pharmacist, Provider, Patient Safety