National Healthcare Quality and Disparities Report
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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
7276 to 7300 of 12214 Research Studies DisplayedLanghan ML, Emerson BL, Nett S
End-tidal carbon dioxide use for tracheal intubation: analysis from the National Emergency Airway Registry for Children (NEAR4KIDS) Registry.
The purpose of this study was to describe the trend in waveform capnography use in emergency departments and pediatric intensive care units and assess the association between waveform capnography use and adverse tracheal intubation-associated events. The investigators found that significant variations existed in capnography use across institutions, with the use increasing over time in both emergency departments and ICUs. The use of capnography during intubation was not associated with esophageal intubation with delayed recognition or the occurrence of cardiac arrest.
AHRQ-funded; HS024511.
Citation: Langhan ML, Emerson BL, Nett S .
End-tidal carbon dioxide use for tracheal intubation: analysis from the National Emergency Airway Registry for Children (NEAR4KIDS) Registry.
Pediatr Crit Care Med 2018 Feb;19(2):98-105. doi: 10.1097/pcc.0000000000001372..
Keywords: Children/Adolescents, Emergency Department, Intensive Care Unit (ICU), Children/Adolescents
Hsu DY, Shinkai K, Silverberg JI
Epidemiology of eczema herpeticum in hospitalized U.S. children: analysis of a nationwide cohort.
This study used data from the Nationwide Inpatient Sample 2002-2012 to determine incidence, risk factors, comorbidities, costs, length of stay, and mortality in hospitalized children with Eczema herpeticum (EH). A higher risk was associated with younger age and non-white ethnicity (Asian in particular). However there was less frequency of hospitalization associated with lower income quartiles. The mortality incidence was 0.1%.
AHRQ-funded; HS023011.
Citation: Hsu DY, Shinkai K, Silverberg JI .
Epidemiology of eczema herpeticum in hospitalized U.S. children: analysis of a nationwide cohort.
J Invest Dermatol 2018 Feb;138(2):265-72. doi: 10.1016/j.jid.2017.08.039..
Keywords: Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Hospitalization, Skin Conditions
Kim SY, Flory J, Relton C
Ethics and practice of Trials within Cohorts: an emerging pragmatic trial design.
This paper discusses a new study design for randomized controlled trails called “Trials within Cohorts". It is already being used in a few countries because it is an efficient way to recruit participants, reduces subject burden, and better mimics “real-world” processes. Another advantage is that it is ethically superior to previous post-randomization designs although there could be some ethical concerns for the experimental versus control arm subjects.
AHRQ-funded; HS023898.
Citation: Kim SY, Flory J, Relton C .
Ethics and practice of Trials within Cohorts: an emerging pragmatic trial design.
Clin Trials 2018 Feb;15(1):9-16. doi: 10.1177/1740774517746620..
Keywords: Patient-Centered Outcomes Research, Research Methodologies
Weisenthal K, Karthik P, Shaw M
Evaluation of kidney stones with reduced-radiation dose CT: progress from 2011-2012 to 2015-2016-not there yet.
Researchers determined if the use of reduced-dose computed tomography (CT) for evaluation of kidney stones increased in 2015-2016 compared with that in 2011-2012. Use of reduced-radiation dose CT for evaluation of kidney stones has increased, but remains low; variability of radiation dose according to facility continues to be wide. National mean CT radiation exposure for evaluation of renal colic during 2015-2016 decreased relative to 2011-2012 values.
AHRQ-funded; HS023778.
Citation: Weisenthal K, Karthik P, Shaw M .
Evaluation of kidney stones with reduced-radiation dose CT: progress from 2011-2012 to 2015-2016-not there yet.
Radiology 2018 Feb;286(2):581-89. doi: 10.1148/radiol.2017170285.
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Keywords: Imaging, Kidney Disease and Health
Dickerson JF, Feeny DH, Clarke GN
Evidence on the longitudinal construct validity of major generic and utility measures of health-related quality of life in teens with depression.
This study examined the longitudinal construct validity in the assessment of changes in depressive symptoms of widely used utility and generic health-related quality of life (HRQL) instruments in teens. Its findings support the longitudinal construct validity of included HRQL instruments for the assessment of change in depression outcomes in teens.
AHRQ-funded; HS017720.
Citation: Dickerson JF, Feeny DH, Clarke GN .
Evidence on the longitudinal construct validity of major generic and utility measures of health-related quality of life in teens with depression.
Qual Life Res 2018 Feb;27(2):447-54. doi: 10.1007/s11136-017-1728-9.
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Keywords: Children/Adolescents, Depression, Genetics, Quality of Life
Pitta M, Esposito CI, Li Z
Failure after modern total knee arthroplasty: a prospective study of 18,065 knees.
The investigators sought to determine the mechanism of failure among primary total knee arthroplasties (TKAs) performed at a single high-volume institution. They found that the most common reasons for failure within 2 years after TKA were infection and stiffness. They suggested that the study identified preoperative risk factors for failure of primary TKAs, which may be useful information for developing strategies to improve outcomes following TKA.
AHRQ-funded; HS016075.
Citation: Pitta M, Esposito CI, Li Z .
Failure after modern total knee arthroplasty: a prospective study of 18,065 knees.
J Arthroplasty 2018 Feb;33(2):407-14. doi: 10.1016/j.arth.2017.09.041..
Keywords: Arthritis, Orthopedics
Sun CJ, Seloilwe ES, Magowe M
Gender differences in sexual and reproductive health protective and risk factors of Batswana adolescents: implications for parent and adolescent interventions.
The HIV epidemic continues in sub-Saharan Africa and Botswana and adolescents there have borne the brunt. This analysis assessed gender differences in sexual and reproductive health protective and risk factors in 228 Batswana adolescents. Although three-quarters of adolescents prefer to have their parents teach them about sex, it is the fourth most common source of information.
AHRQ-funded; HS022981.
Citation: Sun CJ, Seloilwe ES, Magowe M .
Gender differences in sexual and reproductive health protective and risk factors of Batswana adolescents: implications for parent and adolescent interventions.
AIDS Educ Prev 2018 Feb;30(1):35-46. doi: 10.1521/aeap.2018.30.1.35..
Keywords: Caregiving, Children/Adolescents, Human Immunodeficiency Virus (HIV), Prevention, Risk, Sex Factors, Sexual Health
Khubchandani JA, Ingraham AM, Daniel VT
Geographic diffusion and implementation of acute care surgery: an uneven solution to the national emergency general surgery crisis.
Researchers investigated geographic diffusion of acute care surgery (ACS) models of care and characterized the communities in which ACS implementation is lagging. They found that acute care surgery implementation has not been uniform. Rural regions have limited ACS access, with hospitals in counties with greater than the 75th percentile population having 5.4 times higher odds of implementing ACS than hospitals in counties with less than 25th percentile population.
AHRQ-funded; HS022694.
Citation: Khubchandani JA, Ingraham AM, Daniel VT .
Geographic diffusion and implementation of acute care surgery: an uneven solution to the national emergency general surgery crisis.
JAMA Surg 2018 Feb;153(2):150-59. doi: 10.1001/jamasurg.2017.3799.
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Keywords: Critical Care, Rural Health, Surgery
Baker LC, Bundorf MK, Devlin AM
Hospital ownership of physicians: hospital versus physician perspectives.
There has been significant interest from health services researchers and policy makers about recent trends in hospitals' ownership of physician practices, however, few studies have investigated the strengths and weaknesses of available data sources. In this article, the investigators compare results from two national surveys that have been used to assess ownership patterns, one of hospitals (the American Hospital Association survey) and one of physicians (the SK&A survey).
AHRQ-funded; HS024535.
Citation: Baker LC, Bundorf MK, Devlin AM .
Hospital ownership of physicians: hospital versus physician perspectives.
Med Care Res Rev 2018 Feb;75(1):88-99. doi: 10.1177/1077558716676018..
Keywords: Health Services Research (HSR), Hospitals, Provider
Brunwasser SM, Gillham JE
Identifying moderators of response to the Penn Resiliency Program: a synthesis study.
Researchers sought to identify moderators of a cognitive-behavioral depression prevention program's effect on depressive symptoms among youth in early adolescence. Data from three randomized controlled trials of the Penn Resiliency Program (PRP) were aggregated to maximize statistical power and sample diversity. The primary analyses suggested that PRP's effects are limited to youth whose parents are unmarried.
AHRQ-funded; HS022990.
Citation: Brunwasser SM, Gillham JE .
Identifying moderators of response to the Penn Resiliency Program: a synthesis study.
Prev Sci 2018 Feb;19(Suppl 1):38-48. doi: 10.1007/s11121-015-0627-y.
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Keywords: Behavioral Health, Children/Adolescents, Depression, Patient-Centered Outcomes Research, Prevention
Lacson R, Desai S, Landman A
Impact of a health information technology intervention on the follow-up management of pulmonary nodules.
Recommendations to improve care for patients with pulmonary nodules require follow-up management. However, transitions in care can exacerbate failures in follow-up testing and compromise patient safety. The study authors evaluated the impact of a discharge module that included follow-up recommendations for further management of pulmonary nodules on the study outcome and follow-up management of patients with pulmonary nodules within 1 year after discharge.
AHRQ-funded; HS022586.
Citation: Lacson R, Desai S, Landman A .
Impact of a health information technology intervention on the follow-up management of pulmonary nodules.
J Digit Imaging 2018 Feb;31(1):19-25. doi: 10.1007/s10278-017-9989-y..
Keywords: Cancer: Lung Cancer, Health Information Technology (HIT), Hospital Discharge, Transitions of Care
Henke RM, Karaca Z, Moore B
AHRQ Author: Karaca Z, Wong HS
Impact of health system affiliation on hospital resource use intensity and quality of care.
This study assessed the impact of hospital affiliation, centralization, and managed care plan ownership on inpatient cost and quality. It found that hospitals affiliated with health systems had a higher cost per discharge and better quality of care compared with independent hospitals. Centralized systems in particular had the highest cost per discharge and longest stays. Independent hospitals with managed care plans had a higher cost per discharge.
AHRQ-authored.
Citation: Henke RM, Karaca Z, Moore B .
Impact of health system affiliation on hospital resource use intensity and quality of care.
Health Serv Res 2018 Feb;53(1):63-86. doi: 10.1111/1475-6773.12631..
Keywords: Healthcare Costs, Quality of Care, Health Systems, Healthcare Cost and Utilization Project (HCUP), Hospitals
Kinlaw AC, Jonsson Funk M, Conover MM
Impact of new medications and $4 generic programs on overactive bladder treatment among older adults in the United States, 2000-2015.
This study examined: (1) impacts of new medications and $4 generic programs on time trends for overactive bladder (OAB)-related medication dispensing for older adults in the United States; (2) differences by age and sex; and (3) temporal changes in OAB-related medication payments. It found that dispensing rates peaked at age 90. Women had higher rates than men at all ages.
AHRQ-funded; HS000032.
Citation: Kinlaw AC, Jonsson Funk M, Conover MM .
Impact of new medications and $4 generic programs on overactive bladder treatment among older adults in the United States, 2000-2015.
Med Care 2018 Feb;56(2):162-70. doi: 10.1097/mlr.0000000000000858.
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Keywords: Elderly, Healthcare Utilization, Medication
Anderson DJ, Knelson LP, Moehring RW
Implementation lessons learned from the Benefits of Enhanced Terminal Room (BETR) Disinfection study: process and perceptions of enhanced disinfection with ultraviolet disinfection devices.
The purpose of this article was to summarize and discuss logistic and administrative challenges encountered during the Benefits of Enhanced Terminal Room (BETR) Disinfection Study and lessons learned that are pertinent to future utilization of ultraviolet (UV) disinfection devices in other hospitals.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Knelson LP, Moehring RW .
Implementation lessons learned from the Benefits of Enhanced Terminal Room (BETR) Disinfection study: process and perceptions of enhanced disinfection with ultraviolet disinfection devices.
Infect Control Hosp Epidemiol 2018 Feb;39(2):157-63. doi: 10.1017/ice.2017.268..
Keywords: Healthcare-Associated Infections (HAIs), Prevention, Patient Safety
Tomoaia-Cotisel A, Farrell TW, Solberg LI
AHRQ Author: Harrison MI, Genevro JL
Implementation of care management: an analysis of recent AHRQ research.
This article describes care management (CM) implementation and associated lessons from 12 Agency for Healthcare Research and Quality-sponsored projects. Two rounds of data collection resulted in project-specific narratives that were analyzed using an iterative approach analogous to framework analysis. Informants also participated as coauthors. Variation emerged across practices and over time regarding CM services provided, personnel delivering these services, target populations, and setting(s).
AHRQ-authored; AHRQ-funded; HS021933; 2902007.
Citation: Tomoaia-Cotisel A, Farrell TW, Solberg LI .
Implementation of care management: an analysis of recent AHRQ research.
Med Care Res Rev 2018 Feb;75(1):46-65. doi: 10.1177/1077558716673459.
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Keywords: Care Coordination, Patient-Centered Healthcare, Primary Care, Implementation
Larsen E, Fong A, Wernz C
Implications of electronic health record downtime: an analysis of patient safety event reports.
Researchers sought to understand the types of clinical processes, such as image and medication ordering, that are disrupted during electronic health record (EHR) downtime periods by analyzing the narratives of patient safety event report data. They concluded that patient safety report data offer a lens into EHR downtime-related safety hazards. Important areas of risk during EHR downtime periods were patient identification and communication of clinical information.
AHRQ-funded; HS024350.
Citation: Larsen E, Fong A, Wernz C .
Implications of electronic health record downtime: an analysis of patient safety event reports.
J Am Med Inform Assoc 2018 Feb;25(2):187-91. doi: 10.1093/jamia/ocx057.
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Keywords: Adverse Events, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Patient Safety
Kerstenetzky L, Birschbach MJ, Beach KF
Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: a targeted needs assessment using the Intervention Mapping framework.
The authors of this study report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to skilled nurse facilities and long term care pharmacy staff.
AHRQ-funded; HS021984.
Citation: Kerstenetzky L, Birschbach MJ, Beach KF .
Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: a targeted needs assessment using the Intervention Mapping framework.
Res Social Adm Pharm 2018 Feb;14(2):138-45. doi: 10.1016/j.sapharm.2016.12.013..
Keywords: Adverse Drug Events (ADE), Hospital Discharge, Hospitals, Long-Term Care, Medical Errors, Medication, Medication: Safety, Nursing Homes, Patient Safety, Transitions of Care
Arms MA, Fleming J, Sangani DB
Incidence and impact of adverse drug events contributing to hospital readmissions in kidney transplant recipients.
This longitudinal cohort study examined 3 cohorts (no readmissions, readmissions not due to an adverse drug event, and adverse drug events contributing to readmissions) of adult kidney recipients transplanted between 2005 and 2010 and followed through 2013. The study results demonstrated that adverse drug events may be associated with a significant increase in the risk of hospital readmission after kidney transplant and subsequent graft loss.
AHRQ-funded; HS023754
Citation: Arms MA, Fleming J, Sangani DB .
Incidence and impact of adverse drug events contributing to hospital readmissions in kidney transplant recipients.
Surgery 2018 Feb;163(2):430-35. doi: 10.1016/j.surg.2017.09.027..
Keywords: Adverse Drug Events (ADE), Patient Safety, Hospital Readmissions, Transplantation
Cardet JC, Louisias M, King TS
Income is an independent risk factor for worse asthma outcomes.
The authors investigated whether low income, low education, and high perceived stress were independent risk factors for treatment failure and asthma exacerbations in the context of a randomized controlled trial. They found that participants with lower income were more likely to experience adverse asthma outcomes independent of education, perceived stress, race, and medication adherence.
AHRQ-funded; HS022986.
Citation: Cardet JC, Louisias M, King TS .
Income is an independent risk factor for worse asthma outcomes.
J Allergy Clin Immunol 2018 Feb;141(2):754-60.e3. doi: 10.1016/j.jaci.2017.04.036..
Keywords: Asthma, Chronic Conditions, Low-Income, Outcomes, Patient-Centered Outcomes Research, Risk, Social Determinants of Health
Hines AL, Roter D, Ghods Dinoso BK
Informed and patient-centered decision-making in the primary care visits of African Americans with depression.
This study examined the prevalence and extent of informed decision-making (IDM) and patient-centered decision-making (PCDM) in primary care visits of African Americans with depression. It concluded that the associations between IDM and PCDM with interpersonal ratings were moderated by overall patient-centeredness of the visit, which may be indicative of broader cross-cultural communication issues. Strengthening partnerships between depressed African Americans and their clinicians may improve patient-engaged decision-making.
AHRQ-funded; HS013645.
Citation: Hines AL, Roter D, Ghods Dinoso BK .
Informed and patient-centered decision-making in the primary care visits of African Americans with depression.
Patient Educ Couns 2018 Feb;101(2):233-40. doi: 10.1016/j.pec.2017.07.027.
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Keywords: Shared Decision Making, Depression, Patient-Centered Healthcare, Primary Care, Racial and Ethnic Minorities
Rangachari P
Innovation implementation in the context of hospital QI: lessons learned and strategies for success.
This paper conducts an integrative review of the literature on "innovation implementation" in hospitals and health systems over the last decade, since the spotlight was cast on "innovation implementation failure" in health care organizations (HCOs). It summarizes the lessons learned from the literature, discusses the relevance of management research on innovation implementation in HCOs, and identifies future research avenues.
AHRQ-funded; HS024335.
Citation: Rangachari P .
Innovation implementation in the context of hospital QI: lessons learned and strategies for success.
Innov Entrep Health 2018;5:1-14. doi: 10.2147/ieh.s151040.
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Keywords: Evidence-Based Practice, Health Systems, Health Information Technology (HIT), Implementation, Quality Improvement, Hospitals, Quality of Care
Fulton JJ, LeBlanc TW, Cutson TM
Integrated outpatient palliative care for patients with advanced cancer: a systematic review and meta-analysis.
In this study, the authors evaluated the effects of integrated outpatient palliative and oncology care for advanced cancer on patient and caregiver outcomes. The investigators found that moderately integrated palliative and oncology outpatient interventions had positive effects on short-term quality of life, symptom burden, and survival.
AHRQ-funded; HS023681.
Citation: Fulton JJ, LeBlanc TW, Cutson TM .
Integrated outpatient palliative care for patients with advanced cancer: a systematic review and meta-analysis.
Palliat Med 2018 Feb;33(2):123-34. doi: 10.1177/0269216318812633..
Keywords: Cancer, Ambulatory Care and Surgery, Palliative Care
Sjoding MW, Hofer TP, Co I
Interobserver reliability of the Berlin ARDS definition and strategies to improve the reliability of ARDS diagnosis.
This study sought to examine the interobserver reliability of the Berlin acute respiratory distress syndrome (ARDS) definition and examine strategies for improving the reliability of ARDS diagnosis. It concluded that the reliability of the Berlin ARDS definition is moderate. Combining independent reviews by multiple clinicians or improving methods to identify bilateral infiltrates on chest imaging are important strategies for improving the reliability of ARDS diagnosis.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Hofer TP, Co I .
Interobserver reliability of the Berlin ARDS definition and strategies to improve the reliability of ARDS diagnosis.
Chest 2018 Feb;153(2):361-67. doi: 10.1016/j.chest.2017.11.037.
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Keywords: Diagnostic Safety and Quality, Quality of Care, Respiratory Conditions
Greenhawt M, Oppenheimer JJ
Is the better part of valor truly discretion?
The authors argue that the current model for managing peanut allergy is broken, and this fracture is hallmarked by the rapid increase in poor quality of life and poor empowerment of patients. The risk of fatality is often overblown in the face of data that suggest food allergy fatality is exceedingly low. However, the horizon is bright for future therapies and additional risk modeling, which can better arm decision making and means to inform patients about how to personalize management of their food allergy going forward.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Oppenheimer JJ .
Is the better part of valor truly discretion?
Ann Allergy Asthma Immunol 2018 Feb;120(2):111-12. doi: 10.1016/j.anai.2017.11.003.
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Keywords: Shared Decision Making, Mortality, Patient-Centered Outcomes Research, Patient Self-Management, Quality of Life
Nix M, McNamara P, Genevro J
AHRQ Author: Nix M, McNamara P, Genevro J, Vargas N, Mistry K, Fournier A, Shofer M, Lomotan E, Miller T, Ricciardi R, Bierman AS
Learning collaboratives: Insights and a new taxonomy from AHRQ's two decades of experience.
The authors examined AHRQ's experience with learning collaboratives to characterize their attributes, identify factors that might contribute to their success or failure, and assess the challenges they encountered. Building on the literature and insights from AHRQ's experience, they propose a taxonomy that can offer guidance to decision makers and funders about the factors they should consider in developing collaboratives.
AHRQ-authored.
Citation: Nix M, McNamara P, Genevro J .
Learning collaboratives: Insights and a new taxonomy from AHRQ's two decades of experience.
Health Aff 2018 Feb;37(2):205-12. doi: 10.1377/hlthaff.2017.1144.
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Keywords: Learning Health Systems, Health Systems, Quality Improvement, Quality of Care, Healthcare Delivery