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
7776 to 7800 of 12214 Research Studies DisplayedTeppala S, Ottenbacher KJ, Eschbach K
Variation in functional status after hip fracture: facility and regional influence on mobility and self-care.
Little is known about variation in functional outcomes after postacute rehabilitation for patients with hip fracture. The researchers examined variation in mobility and self-care after hip fracture rehabilitation across inpatient rehabilitation facilities (IRFs), hospital referral regions (HRRs) and states. Variation in functional status following postacute hip fracture rehabilitation appears to occur primarily at the level of facilities rather than geographic location.
AHRQ-funded; HS022134.
Citation: Teppala S, Ottenbacher KJ, Eschbach K .
Variation in functional status after hip fracture: facility and regional influence on mobility and self-care.
J Gerontol A Biol Sci Med Sci 2017 Oct;72(10):1376-82. doi: 10.1093/gerona/glw249.
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Keywords: Injuries and Wounds, Quality of Care, Health Status, Rehabilitation, Patient Self-Management
Boehme AK, Carr BG, Kasner SE
Sex differences in rt-PA utilization at hospitals treating stroke: the National Inpatient Sample.
The researchers sought to explore sex and race differences in the utilization of recombinant tissue plasminogen activator (rt-PA) at primary stroke centers (PSCs) compared to non-PSCs across the US. They found that women are less likely to receive rt-PA than men at both PSCs and non-PSCs. Absolute treatment rates are lowest in black women.
AHRQ-funded; HS17960; HS018362; HS013852.
Citation: Boehme AK, Carr BG, Kasner SE .
Sex differences in rt-PA utilization at hospitals treating stroke: the National Inpatient Sample.
Front Neurol 2017 Sep 27;8:500. Original Research. doi: 10.3389/fneur.2017.00500.
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Keywords: Healthcare Delivery, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Sex Factors, Stroke
Pranaat R, Mohan V, O'Reilly M
Use of simulation based on an electronic health records environment to evaluate the structure and accuracy of notes generated by medical scribes: Proof-of-concept study.
The objective of the researchers was to develop a virtual video-based simulation to demonstrate and quantify the variability and accuracy of scribes' transcribed notes in the EHR. Their high-fidelity, video-based EHR simulation was able to assess multiple performance indicators in medical scribes and demonstrate significant variability both in terms of structure and accuracy in clinical documentation.
AHRQ-funded; HS025141.
Citation: Pranaat R, Mohan V, O'Reilly M .
Use of simulation based on an electronic health records environment to evaluate the structure and accuracy of notes generated by medical scribes: Proof-of-concept study.
JMIR Med Inform 2017 Sep 20;5(3):e30. doi: 10.2196/medinform.7883.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Patient Safety, Training
Williams CN, Kirby A, Piantino J
If you build it, they will come: Initial experience with a multi-disciplinary pediatric neurocritical care follow-up clinic.
To address morbidities in Pediatric Neurocritical Care survivors, collaboration between Pediatric Neurology and Pediatric Critical Care created a multidisciplinary follow-up clinic providing specialized evaluations after discharge. Clinic referrals applied to all Pediatric Neurocritical Care patients regardless of admission severity of illness. Here, the authors report an initial case series, which revealed a population that is heterogenous in age, ranging from 1 month to 18 years, and in diagnoses.
AHRQ-funded; HS022981.
Citation: Williams CN, Kirby A, Piantino J .
If you build it, they will come: Initial experience with a multi-disciplinary pediatric neurocritical care follow-up clinic.
Children 2017 Sep 19;4(9). doi: 10.3390/children4090083.
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Keywords: Brain Injury, Critical Care, Neurological Disorders, Patient-Centered Healthcare, Children/Adolescents
Eaton EF, McDavid C, Banasiewicz MK
Patient preferences for antiretroviral therapy: effectiveness, quality of life, access and novel delivery methods.
The objective of this study was to understand patient preferences for contemporary antiretroviral therapy (ART) by focusing on three areas that have been understudied: minority patients (racial/ethnic and sexual minorities), experience with novel single-tablet regimens made available in the last 10 years, and patient concerns related to ART. It concluded that HIV-infected persons prioritize access, clinical outcomes, and quality of life when considering contemporary ART treatment.
AHRQ-funded; HS023009.
Citation: Eaton EF, McDavid C, Banasiewicz MK .
Patient preferences for antiretroviral therapy: effectiveness, quality of life, access and novel delivery methods.
Patient Prefer Adherence 2017 Sep 18;11:1585-90. doi: 10.2147/ppa.s142643.
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Keywords: Access to Care, Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Racial and Ethnic Minorities
Louisias M, Phipatanakul W
Managing asthma in low-income, underrepresented minority, and other disadvantaged pediatric populations: closing the gap.
The authors review current understanding of the epidemiology and etiology of disparities in asthma. They also highlight current and emerging literature on solutions to tackle disparities while underscoring gaps and pressing future directions. Tailored, multicomponent approaches including the home, school, and clinician-based interventions show great promise. Managing asthma in disadvantaged populations can be challenging as they tend to have disproportionately worse outcomes due to a multitude of factors.
AHRQ-funded; HS022986.
Citation: Louisias M, Phipatanakul W .
Managing asthma in low-income, underrepresented minority, and other disadvantaged pediatric populations: closing the gap.
Curr Allergy Asthma Rep 2017 Sep 15;17(10):68. doi: 10.1007/s11882-017-0734-x.
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Keywords: Asthma, Children/Adolescents, Low-Income, Racial and Ethnic Minorities, Vulnerable Populations
Fan T, Rogers A
AHRQ Author: Fan T
Screening for syphilis infection in nonpregnant adults and adolescents.
R.J. is a 27-year-old man who presents for a well-patient visit. He always keeps his appointments and likes to make sure he is healthy. R.J. has started a new relationship and asks if he should be screened for syphilis. The case study asks a series of three questions based on the USPSTF recommendation statement. Answers are provided.
AHRQ-authored.
Citation: Fan T, Rogers A .
Screening for syphilis infection in nonpregnant adults and adolescents.
Am Fam Physician 2017 Sep 15;96(6):393-94.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Shared Decision Making, Infectious Diseases, Case Study
Ong TC, Kahn MG, Kwan BM
Dynamic-ETL: a hybrid approach for health data extraction, transformation and loading.
The researchers designed and implemented a health data transformation and loading approach, which we refer to as Dynamic ETL (Extraction, Transformation and Loading) (D-ETL), that automates part of the process through use of scalable, reusable and customizable code. Their results showed that ETL rule composition methods and the D-ETL engine offer a scalable solution for health data transformation via automatic query generation to harmonize source datasets.
AHRQ-funded; HS019908; HS022956.
Citation: Ong TC, Kahn MG, Kwan BM .
Dynamic-ETL: a hybrid approach for health data extraction, transformation and loading.
BMC Med Inform Decis Mak 2017 Sep 13;17(1):134. doi: 10.1186/s12911-017-0532-3.
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Keywords: Comparative Effectiveness, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research
Bobb JF, Lee AK, Lapham GT
Evaluation of a pilot implementation to integrate alcohol-related care within primary care.
Researchers and clinical leaders at Kaiser Permanente Washington partnered to design a high-quality Program of Sustained Patient-centered Alcohol-related Care (SPARC). The authors describe the SPARC pilot implementation, evaluate its effectiveness within three large pilot sites, and describe the qualitative findings on barriers and facilitators. They found that alcohol screening increased from 8.9 percent of patients pre-implementation to 62 percent post-implementation.
AHRQ-funded; HS023173.
Citation: Bobb JF, Lee AK, Lapham GT .
Evaluation of a pilot implementation to integrate alcohol-related care within primary care.
Int J Environ Res Public Health 2017 Sep 8;14(9). doi: 10.3390/ijerph14091030.
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Keywords: Alcohol Use, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
Davidov DM, Davis SM, Zhu M
AHRQ Author: Stocks C
Intimate partner violence-related hospitalizations in Appalachia and the non-Appalachian United States.
The objective of this study was to estimate the rate of intimate partner violence -related hospitalizations in Appalachia and the non-Appalachian United States for 2007-2011 and compare hospitalizations in each region by clinical and sociodemographic factors.. After adjusting for age and rurality, Appalachian counties had a 22 percent higher hospitalization rate than non-Appalachian counties.
AHRQ-authored.
Citation: Davidov DM, Davis SM, Zhu M .
Intimate partner violence-related hospitalizations in Appalachia and the non-Appalachian United States.
PLoS One 2017 Sep 8;12(9):e0184222. doi: 10.1371/journal.pone.0184222.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Domestic Violence, Hospitalization, Social Determinants of Health, Rural Health
Yen PY, McAlearney AS, Sieck CJ
Health information technology (HIT) adaptation: refocusing on the journey to successful HIT implementation.
Measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines. The authors propose a new focus, HIT adaptation, to illuminate factors that facilitate or hinder the connection between use of the EHR and improved quality of care.
AHRQ-funded; HS024767.
Citation: Yen PY, McAlearney AS, Sieck CJ .
Health information technology (HIT) adaptation: refocusing on the journey to successful HIT implementation.
JMIR Med Inform 2017 Sep 7;5(3):e28. doi: 10.2196/medinform.7476.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Health Information Technology (HIT)
Aarons GA, Sklar M, Mustanski B
"Scaling-out" evidence-based interventions to new populations or new health care delivery systems.
This paper introduces a new concept for implementation called "scaling-out" when evidence-based interventions are adapted either to new populations or new delivery systems, or both. Using existing external validity theories and multilevel mediation modeling, the authors provide a logical framework for determining what new empirical evidence is required for an intervention to retain its evidence-based standard in this new context.
AHRQ-funded; HS024192.
Citation: Aarons GA, Sklar M, Mustanski B .
"Scaling-out" evidence-based interventions to new populations or new health care delivery systems.
Implement Sci 2017 Sep 6;12(1):111. doi: 10.1186/s13012-017-0640-6..
Keywords: Healthcare Delivery, Evidence-Based Practice, Health Services Research (HSR)
Singal AG, Gupta S, Skinner CS
Effect of colonoscopy outreach vs fecal immunochemical test outreach on colorectal cancer screening completion: a randomized clinical trial.
Researchers compared the effectiveness of fecal immunochemical test (FIT) outreach and colonoscopy outreach to increase completion of the colorectal cancer (CRC) screening process (screening initiation and follow-up) within 3 years. Among persons aged 50 to 64 years receiving primary care at a safety-net institution, mailed outreach invitations offering FIT or colonoscopy compared with usual care increased the proportion completing CRC screening process within 3 years.
AHRQ-funded; HS022418.
Citation: Singal AG, Gupta S, Skinner CS .
Effect of colonoscopy outreach vs fecal immunochemical test outreach on colorectal cancer screening completion: a randomized clinical trial.
JAMA 2017 Sep 5;318(9):806-15. doi: 10.1001/jama.2017.11389.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Comparative Effectiveness, Patient-Centered Outcomes Research
Jonas DE, Amick HR, Wallace IF
Vision screening in children aged 6 months to 5 years: Evidence report and systematic review for the US Preventive Services Task Force.
The researchers reviewed the evidence on screening for and treatment of amblyopia, its risk factors, and refractive error in children aged 6 months to 5 years to inform the US Preventive Services Task Force. They concluded that studies directly evaluating the effectiveness of screening were limited and do not establish whether vision screening in preschool children is better than no screening.
AHRQ-funded; 290201200015I.
Citation: Jonas DE, Amick HR, Wallace IF .
Vision screening in children aged 6 months to 5 years: Evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Sep 5;318(9):845-58. doi: 10.1001/jama.2017.9900.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Eye Disease and Health, Children/Adolescents, Screening, Newborns/Infants
Franklin P, Chenok K, Lavalee D
Framework to guide the collection and use of patient-reported outcome measures in the learning healthcare system.
Web-based collection of patient-reported outcome measures (PROMs) in clinical practice is expanding rapidly as electronic health records include web portals for patients to report standardized assessments of their symptoms. As the value of PROMs in patient care expands, a framework to guide the implementation planning, collection, and use of PROs to serve multiple goals and stakeholders is needed. In this study, researchers identified diverse clinical, quality, and research settings where PROMs have been successfully integrated into care and routinely collected and analyzed drivers of successful implementation.
AHRQ-funded; HS022789.
Citation: Franklin P, Chenok K, Lavalee D .
Framework to guide the collection and use of patient-reported outcome measures in the learning healthcare system.
eGEMS 2017 Sep 4;5(1):17. doi: 10.5334/egems.227..
Keywords: Learning Health Systems, Health Systems, Electronic Health Records (EHRs), Health Information Technology (HIT), Web-Based, Patient-Centered Healthcare
Cholan RA, Weiskopf NG, Rhoton D
From concepts and codes to healthcare quality measurement: understanding variations in value set vocabularies for a statin therapy clinical quality measure.
This study examined health care quality measures and found that the decisions Clinical Quality Measure developers make about which concepts and code groups to include or exclude in value set vocabularies can lead to inaccuracies in the measurement of quality of care.
AHRQ-funded; HS023908.
Citation: Cholan RA, Weiskopf NG, Rhoton D .
From concepts and codes to healthcare quality measurement: understanding variations in value set vocabularies for a statin therapy clinical quality measure.
eGEMS 2017 Sep 4;5(1):19. doi: 10.5334/egems.212..
Keywords: Quality of Care, Quality Measures, Quality Measures
Parker MW, Carroll M, Bolser B
Implementation of a communication bundle for high-risk patients.
This study occurs in a large pediatric hospital with a history of success in decreasing unrecognized deterioration, in which patients at higher risk of deterioration are termed "watchers." Because communication errors often contribute to unrecognized deterioration, clear and timely communication of watcher status to all team members and contingency planning was desired. The researchers sought to increase the percentage of eligible watchers with a complete communication, teamwork, and planning bundle within 2 hours of identification from 28% to 80%.
AHRQ-funded; HS023827.
Citation: Parker MW, Carroll M, Bolser B .
Implementation of a communication bundle for high-risk patients.
Hosp Pediatr 2017 Sep;7(9):523-29. doi: 10.1542/hpeds.2016-0170..
Keywords: Children/Adolescents, Communication, Healthcare Delivery, Hospitals, Inpatient Care
Khan A, Furtak SL, Melvin P
Parent-provider miscommunications in hospitalized children.
The objectives of this study were to: (1) examine characteristics of parent-provider miscommunications about hospitalized children; (2) describe associations among parent-provider miscommunications, parent-reported errors, and hospital experience; and (3) compare parent and attending physician reports of parent-provider miscommunications. The investigators found that parent-provider miscommunications were associated with parent-reported errors and suboptimal hospital experience. Parents reported parent-provider miscommunications more often than attending physicians did.
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Furtak SL, Melvin P .
Parent-provider miscommunications in hospitalized children.
Hosp Pediatr 2017 Sep;7(9):505-15. doi: 10.1542/hpeds.2016-0190..
Keywords: Adverse Events, Caregiving, Children/Adolescents, Clinician-Patient Communication, Communication, Hospitalization, Hospitals, Medical Errors, Patient Safety
Pham R, Cross S, Fernandez B
"Finding the right FIT": rural patient preferences for fecal immunochemical test (FIT) characteristics.
This community-led study was conducted to assess patient preferences for fecal immunochemical tests (FIT) characteristics and to use study findings in concert with clinical effectiveness data to inform regional FIT selection. The authors concluded that FIT characteristics influenced patient's perceptions of test acceptability and feasibility and indicated that health system leaders, payers, and clinicians should select FITs that are both clinically effective and incorporate patient preferred test characteristics.
AHRQ-funded; HS022981.
Citation: Pham R, Cross S, Fernandez B .
"Finding the right FIT": rural patient preferences for fecal immunochemical test (FIT) characteristics.
J Am Board Fam Med 2017 Sep-Oct;30(5):632-44. doi: 10.3122/jabfm.2017.05.170151..
Keywords: Cancer: Colorectal Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Rural Health, Screening
Symer MM, Abelson JS, Milsom J
A mobile health application to track patients after gastrointestinal surgery: results from a pilot study.
Many surgical readmissions are preventable. Mobile health technology can identify nascent complications and potentially prevent readmission. The researchers performed a pilot study of a new mobile health application in adults undergoing major abdominal surgery and determined the app can track patient recovery from major abdominal surgery, is easy to use, and has potential to improve outcomes.
AHRQ-funded; HS000066.
Citation: Symer MM, Abelson JS, Milsom J .
A mobile health application to track patients after gastrointestinal surgery: results from a pilot study.
J Gastrointest Surg 2017 Sep;21(9):1500-05. doi: 10.1007/s11605-017-3482-2..
Keywords: Telehealth, Health Information Technology (HIT), Hospital Readmissions, Surgery, Adverse Events, Patient Safety, Digestive Disease and Health, Prevention
Adelman JS, Berger MA, Rai A
A national survey assessing the number of records allowed open in electronic health records at hospitals and ambulatory sites.
To reduce the risk of wrong-patient errors, safety experts recommend limiting the number of patient records providers can open at once in electronic health records (EHRs). However, it is unknown whether health care organizations follow this recommendation or what rationales drive their decisions. To address this gap, researchers conducted an electronic survey via 2 national listservs. Results demonstrate no consensus on the number of records to be allowed open at once in EHRs.
AHRQ-funded; HS023704.
Citation: Adelman JS, Berger MA, Rai A .
A national survey assessing the number of records allowed open in electronic health records at hospitals and ambulatory sites.
J Am Med Inform Assoc 2017 Sep 1;24(5):992-95. doi: 10.1093/jamia/ocx034.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Hospitals
Mortensen ML, Adam GP, Trikalinos TA
An exploration of crowdsourcing citation screening for systematic reviews.
This study explored the use of crowdsourcing (distributing tasks to untrained workers via the web) to reduce the cost of screening citations. Crowdworkers completed screening in 4 to 17 days, costing $460 to $2220, a cost reduction of up to 88 percent compared to trained experts. Crowdsourcing may represent a useful approach to reducing the cost of identifying literature for systematic reviews.
AHRQ-funded; HS025024.
Citation: Mortensen ML, Adam GP, Trikalinos TA .
An exploration of crowdsourcing citation screening for systematic reviews.
Res Synth Methods 2017 Sep;8(3):366-86. doi: 10.1002/jrsm.1252.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Nagykaldi ZJ, Scheid D, Zhao D
An innovative community-based model for improving preventive care in rural counties.
This quasi-experimental pilot study aimed to implement and evaluate a sustainable, rural community-based patient outreach model for preventive care provided through primary care practices (PCPs) located in a rural county in Oklahoma. Six of the 7 PCPs in the county expressed interest in the project with the result that three of these practices fully implemented the 1-year outreach program starting in mid-2015.
AHRQ-funded; HS023237.
Citation: Nagykaldi ZJ, Scheid D, Zhao D .
An innovative community-based model for improving preventive care in rural counties.
J Am Board Fam Med 2017 Sep-Oct;30(5):583-91. doi: 10.3122/jabfm.2017.05.170035.
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Keywords: Community Partnerships, Patient-Centered Healthcare, Prevention, Primary Care, Rural Health
Wang S, Mosher C, Gao S
Antidepressant use and depressive symptoms in intensive care unit survivors.
Nearly 30% of intensive care unit (ICU) survivors have depressive symptoms 2-12 months after hospital discharge. In this study, the investigators examined the prevalence of depressive symptoms and risk factors for depressive symptoms in 204 patients at their initial evaluation in the Critical Care Recovery Center (CCRC), an ICU survivor clinic based at Eskenazi Hospital in Indianapolis, Indiana.
AHRQ-funded; HS024384.
Citation: Wang S, Mosher C, Gao S .
Antidepressant use and depressive symptoms in intensive care unit survivors.
J Hosp Med 2017 Sep;12(9):731-34. doi: 10.12788/jhm.2814..
Keywords: Medication, Depression, Intensive Care Unit (ICU), Behavioral Health
Monroe AK, Fleishman JA, Voss CC
AHRQ Author: Fleishman JA
Assessing antiretroviral use during gaps in HIV primary care using multisite Medicaid claims and clinical data.
Some individuals who appear poorly retained by clinic visit-based retention measures are using antiretroviral therapy (ART) and maintaining viral suppression. Researchers examined whether individuals with a gap in HIV primary care (>/=180 days between HIV outpatient clinic visits) obtained ART during that gap after 180 days. They found that Medicaid-insured individuals commonly receive ART during gaps in HIV primary care, but almost half do not.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Monroe AK, Fleishman JA, Voss CC .
Assessing antiretroviral use during gaps in HIV primary care using multisite Medicaid claims and clinical data.
J Acquir Immune Defic Syndr 2017 Sep 1;76(1):82-89. doi: 10.1097/qai.0000000000001469.
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Keywords: Access to Care, Human Immunodeficiency Virus (HIV), Primary Care