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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
8401 to 8425 of 12214 Research Studies DisplayedDabbous FM, Dolecek TA, Berbaum ML
Impact of a false-positive screening mammogram on subsequent screening behavior and stage at breast cancer diagnosis.
Researchers sought to examine the impact of a false positive (FP) screening mammogram on the subsequent screening mammography behavior. They found that experiencing a FP mammogram increases the risk of late stage at diagnosis compared with prior true negative (TN) mammogram Also, women with a FP mammogram were more likely to delay their subsequent screening compared with women with a TN mammogram.
AHRQ-funded; HS018366.
Citation: Dabbous FM, Dolecek TA, Berbaum ML .
Impact of a false-positive screening mammogram on subsequent screening behavior and stage at breast cancer diagnosis.
Cancer Epidemiol Biomarkers Prev 2017 Mar;26(3):397-403. doi: 10.1158/1055-9965.epi-16-0524.
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Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Diagnostic Safety and Quality, Women, Prevention
Yeung K, Basu A, Marcum ZA
Impact of a value-based formulary in three chronic disease cohorts.
This study assessed the impact of a value based formulary (VBF) on medication adherence and patient and health plan expenditures on 3 chronic disease states: diabetes, hypertension, and hyperlipidemia. The investigators measured medication expenditures from member, health plan, and member-plus-health plan (overall) perspectives and medication adherence as proportion of days covered. They conducted an exploratory analysis of medication utilization classifying medications according to whether co-payments moved up or down in the year following VBF implementation.
AHRQ-funded; HS022982.
Citation: Yeung K, Basu A, Marcum ZA .
Impact of a value-based formulary in three chronic disease cohorts.
Am J Manag Care 2017 Mar; 23(3 Suppl):S46-s53..
Keywords: Chronic Conditions, Health Insurance, Patient Adherence/Compliance, Medication, Healthcare Costs
Clark KD, Miller BF, Green LA
Implementation of behavioral health interventions in real world scenarios: managing complex change.
This paper reports the change management strategies employed by practice leaders making changes to integrate care, as observed by independent investigators. It offers an empirically based set of actionable recommendations that are relevant to a range of leaders (policymakers, medical directors) and practice members who wish to effectively manage the complex changes associated with integrated primary care.
AHRQ-funded; HS022981.
Citation: Clark KD, Miller BF, Green LA .
Implementation of behavioral health interventions in real world scenarios: managing complex change.
Fam Syst Health 2017 Mar;35(1):36-45. doi: 10.1037/fsh0000239.
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Keywords: Behavioral Health, Patient-Centered Healthcare, Primary Care, Implementation, Organizational Change, Healthcare Delivery
Marcum ZA, Hanlon JT, Murray MD
Improving medication adherence and health outcomes in older adults: an evidence-based review of randomized controlled trials.
The objective of this review was to provide an updated summary of evidence from randomized controlled studies to determine whether interventions aimed at improving medication adherence also improve the health outcomes of older adults residing in community-based settings. This evidence-based review of medication adherence interventions in older adults revealed promising strategies in the larger context of a largely mixed body of literature.
AHRQ-funded; HS022982; HS023779.
Citation: Marcum ZA, Hanlon JT, Murray MD .
Improving medication adherence and health outcomes in older adults: an evidence-based review of randomized controlled trials.
Drugs Aging 2017 Mar;34(3):191-201. doi: 10.1007/s40266-016-0433-7.
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Keywords: Elderly, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Education: Patient and Caregiver
Marcum ZA, Gellad WF
Improving medication adherence: keep your eyes on the prize.
In this commentary, the authors discuss a paper published by Reddy, et al. published in 2017 in the Journal of General Internal Medicine, entitled “Patient and partner feedback reports to improve statin medication adherence: a randomized control trial.”
AHRQ-funded; HS022982.
Citation: Marcum ZA, Gellad WF .
Improving medication adherence: keep your eyes on the prize.
J Gen Intern Med 2017 Mar;32(3):236-37. doi: 10.1007/s11606-016-3927-4..
Keywords: Medication, Patient Adherence/Compliance
McMahon BJ, Bruden D, Townsend-Bulson L
Infection with hepatitis C virus genotype 3 is an independent risk factor for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
The researchers examined the association of 11 risk factors with adverse outcomes in a population-based prospective cohort observational study of Alaska Native/American Indian persons with chronic infection. They found those infected with HCV genotype 3 to be at high risk for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
AHRQ-funded; HS000046.
Citation: McMahon BJ, Bruden D, Townsend-Bulson L .
Infection with hepatitis C virus genotype 3 is an independent risk factor for end-stage liver disease, hepatocellular carcinoma, and liver-related death.
Clin Gastroenterol Hepatol 2017 Mar;15(3):431-37.e2. doi: 10.1016/j.cgh.2016.10.012.
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Keywords: Hepatitis, Cancer, Kidney Disease and Health, Risk, Mortality
Dunn Lopez K, Gephart SM, Raszewski R
Integrative review of clinical decision support for registered nurses in acute care settings.
To report on the state of the science of clinical decision support (CDS) for hospital bedside nurses, the researchers performed an integrative review of qualitative and quantitative peer-reviewed original research studies. They concluded that clinical support systems targeting bedside nurses have positive effects on outcomes and hold promise for improving care quality.
AHRQ-funded; HS022908.
Citation: Dunn Lopez K, Gephart SM, Raszewski R .
Integrative review of clinical decision support for registered nurses in acute care settings.
J Am Med Inform Assoc 2017 Mar 1;24(2):441-50. doi: 10.1093/jamia/ocw084.
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Keywords: Critical Care, Clinical Decision Support (CDS), Health Information Technology (HIT), Nursing, Patient Safety
Rees MA, Dunn TB, Kuhr CS
Kidney exchange to overcome financial barriers to kidney transplantation.
Organ shortage is the major limitation to kidney transplantation in the developed world. This proposal leverages the cost savings achieved through earlier transplantation over dialysis to fund the cost of kidney exchange between developed-world patient-donor pairs with immunological barriers and developing-world patient-donor pairs with financial barriers.
AHRQ-funded; HS020610.
Citation: Rees MA, Dunn TB, Kuhr CS .
Kidney exchange to overcome financial barriers to kidney transplantation.
Am J Transplant 2017 Mar;17(3):782-90. doi: 10.1111/ajt.14106.
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Keywords: Transplantation, Healthcare Costs, Policy, Kidney Disease and Health, Kidney Disease and Health
Ramsey LB, Mizuno T, Vinks AA
Learning health systems as facilitators of precision medicine.
To illustrate the concept of the Learning Health System, the authors of this paper describe the example of the ImproveCareNow Network and use a network case study to illustrate how the concept of precision medicine can be achieved through a Learning Health System in a real-world clinical environment.
AHRQ-funded; HS020024; HS016957.
Citation: Ramsey LB, Mizuno T, Vinks AA .
Learning health systems as facilitators of precision medicine.
Clin Pharmacol Ther 2017 Mar;101(3):359-67. doi: 10.1002/cpt.594..
Keywords: Learning Health Systems, Research Methodologies
Sohn H
Medicaid's lasting impressions: population health and insurance at birth.
This article examines lasting mortality improvements associated with availability of Medicaid at time and place of birth. Being born after Medicaid was associated with between 2.03 and 3.64 fewer deaths per 100,000 person-years in childhood and between 1.35 and 3.86 fewer deaths per 100,000 person-years in the thirties. The association between Medicaid at birth and mortality was the strongest in the oldest age group (36-40) in this study.
AHRQ-funded; HS000046.
Citation: Sohn H .
Medicaid's lasting impressions: population health and insurance at birth.
Soc Sci Med 2017 Mar;177:205-12. doi: 10.1016/j.socscimed.2017.01.043.
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Keywords: Access to Care, Health Insurance, Health Services Research (HSR), Medicaid, Mortality
Eifler JB, Alvarez J, Koyama T
More judicious use of expectant management for localized prostate cancer during the last 2 decades.
Urologists have been criticized for overtreating men with low risk prostate cancer and for passively observing older men with higher risk disease. Proponents of active surveillance for low risk disease and critics of watchful waiting for higher risk disease have advocated for more judicious use of observation. In this study, the investigator compared 2 population based cohorts to determine how expectant management has evolved during the last 2 decades.
AHRQ-funded; HS019356; HS022640.
Citation: Eifler JB, Alvarez J, Koyama T .
More judicious use of expectant management for localized prostate cancer during the last 2 decades.
J Urol 2017 Mar;197(3 Pt 1):614-20. doi: 10.1016/j.juro.2016.10.067..
Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Diagnostic Safety and Quality, Men's Health
Roman LC, Ancker JS, Johnson SB
Navigation in the electronic health record: a review of the safety and usability literature.
The purpose of this literature review was to improve access to navigation-related research in usability. Specifically, the investigators aimed to (1) assess the prevalence of navigation-related topics within the EHR usability and safety research literature, (2) categorize types of navigation actions within the EHR, (3) capture relationships between these navigation actions and usability principles, and (4) collect terms and concepts related to EHR navigation.
AHRQ-funded; HS023708.
Citation: Roman LC, Ancker JS, Johnson SB .
Navigation in the electronic health record: a review of the safety and usability literature.
J Biomed Inform 2017 Mar;67:69-79. doi: 10.1016/j.jbi.2017.01.005..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety
Balasubramanian BA, Cohen DJ, Jetelina KK
Outcomes of integrated behavioral health with primary care.
The objective of this study was to evaluate the effects of integrated care, adapted to local contexts, on depression severity and patients' experience of care. It found that integrating behavioral health and primary care, when adapted to fit into community practices, reduced depression severity and enhanced patients' experience of care.
AHRQ-funded; HS022981.
Citation: Balasubramanian BA, Cohen DJ, Jetelina KK .
Outcomes of integrated behavioral health with primary care.
J Am Board Fam Med 2017 Mar-Apr;30(2):130-39. doi: 10.3122/jabfm.2017.02.160234.
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Keywords: Behavioral Health, Community Partnerships, Patient-Centered Outcomes Research, Primary Care
Goldman JL, Richardson T, Newland JG
Outpatient parenteral antimicrobial therapy in pediatric Medicaid enrollees.
The study’s objective was to characterize outpatient parenteral antimicrobial therapy (OPAT) use and clinical outcomes for a large population of pediatric Medicaid enrollees treated with OPAT. It found that ceftriaxone and vancomycin were the most commonly prescribed antimicrobials. An emergency department visit or hospital admission occurred during 38 percent of OPAT episodes, among which 61 percent were OPAT-related.
AHRQ-funded; HS023320.
Citation: Goldman JL, Richardson T, Newland JG .
Outpatient parenteral antimicrobial therapy in pediatric Medicaid enrollees.
J Pediatric Infect Dis Soc 2017 Mar 1;6(1):65-71. doi: 10.1093/jpids/piv106.
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Keywords: Antibiotics, Children/Adolescents, Medicaid, Ambulatory Care and Surgery, Patient-Centered Outcomes Research
Boss EF, Links AR, Saxton R
Parent experience of care and decision making for children who snore.
The researchers identified factors associated with parental experience and decision making in pediatric sleep-disordered breathing (SDB) and adenotonsillectomy (AT) surgery. They found that while clinical factors were influential for decision making, interpersonal factors helped parents feel comfortable and influenced their overall experience
AHRQ-funded; HS022932.
Citation: Boss EF, Links AR, Saxton R .
Parent experience of care and decision making for children who snore.
JAMA Otolaryngol Head Neck Surg 2017 Mar;143(3):218-25. doi: 10.1001/jamaoto.2016.2400.
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Keywords: Children/Adolescents, Sleep Problems, Caregiving, Patient Experience, Shared Decision Making, Clinician-Patient Communication
Farvardin S, Patel J, Khambaty M
Patient-reported barriers are associated with lower hepatocellular carcinoma surveillance rates in patients with cirrhosis.
This study characterized the association between hepatocellular carcinoma (HCC) surveillance receipt and patient knowledge, attitudes, and perceived barriers in a racially diverse and socioeconomically disadvantaged cohort of patients with cirrhosis. It found that patients with cirrhosis are knowledgeable and interested in HCC surveillance; however, patient-reported barriers are associated with lower surveillance rates in clinical practice and represent potential intervention targets to improve HCC surveillance effectiveness.
AHRQ-funded; HS022418.
Citation: Farvardin S, Patel J, Khambaty M .
Patient-reported barriers are associated with lower hepatocellular carcinoma surveillance rates in patients with cirrhosis.
Hepatology 2017 Mar;65(3):875-84. doi: 10.1002/hep.28770.
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Keywords: Cancer, Education: Patient and Caregiver, Social Determinants of Health, Diagnostic Safety and Quality
Green TC, Case P, Fiske H
Perpetuating stigma or reducing risk? Perspectives from naloxone consumers and pharmacists on pharmacy-based naloxone in 2 states.
This study examined perceptions and experiences of pharmacy naloxone from people with opioid use disorder, patients taking chronic opioids for pain, caregivers of opioid users, and pharmacists. It found that consumer groups differed in awareness of naloxone and availability at pharmacies, but all groups expressed support for the pharmacist's role and preferences for a universal offer of naloxone based on clear criteria.
AHRQ-funded; HS024021.
Citation: Green TC, Case P, Fiske H .
Perpetuating stigma or reducing risk? Perspectives from naloxone consumers and pharmacists on pharmacy-based naloxone in 2 states.
J Am Pharm Assoc 2017 Mar - Apr;57(2s):S19-S27.e4. doi: 10.1016/j.japh.2017.01.013.
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Keywords: Opioids, Provider: Pharmacist, Social Stigma, Substance Abuse
Diaz KM, Booth JN, 3rd, Seals SR
Physical activity and incident hypertension in African Americans: the Jackson Heart Study.
The purpose of this study was to examine the association of physical activity with incident hypertension among African Americans. It found no statistically significant associations observed for overall physical activity, or work, active living, and household-related physical activities. Results suggest that regular moderate-vigorous physical activity or sport/exercise-related physical activity may reduce the risk of developing hypertension in African Americans.
AHRQ-funded; HS023009.
Citation: Diaz KM, Booth JN, 3rd, Seals SR .
Physical activity and incident hypertension in African Americans: the Jackson Heart Study.
Hypertension 2017 Mar;69(3):421-27. doi: 10.1161/hypertensionaha.116.08398.
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Keywords: Blood Pressure, Lifestyle Changes, Racial and Ethnic Minorities, Risk
Tucker JS, Shadel WG, Galvan FH
Pilot evaluation of a brief intervention to improve nicotine patch adherence among smokers living with HIV/AIDS.
This article presents results from a pilot evaluation of a brief smoking cessation treatment to improve adherence to the nicotine patch among Latino smokers living with HIV/AIDS. Although this small pilot was conducted to estimate effect sizes and was not powered to detect group differences, results were promising and suggested that adding a 10-min module focused on nicotine patch adherence to a standard 5 As protocol could increase abstinence rates.
AHRQ-funded; HS000062.
Citation: Tucker JS, Shadel WG, Galvan FH .
Pilot evaluation of a brief intervention to improve nicotine patch adherence among smokers living with HIV/AIDS.
Psychol Addict Behav 2017 Mar;31(2):148-53. doi: 10.1037/adb0000221.
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Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Racial and Ethnic Minorities, Tobacco Use
Francis DO, Fonnesbeck C, Sathe N
Postoperative bleeding and associated utilization following tonsillectomy in children.
This review assessed posttonsillectomy hemorrhage (PTH), associated nonoperative readmissions/revisits, and reoperations in children. It concluded that PTH occurred in roughly 4 percent of tonsillectomies. Although studies typically did not report bleeding severity or amount, relatively few episodes of PTH necessitated reoperation for hemostasis. Frequency of PTH across techniques was similar; thus, it cannot be concluded that a given technique is superior.
AHRQ-funded; 290201500003I.
Citation: Francis DO, Fonnesbeck C, Sathe N .
Postoperative bleeding and associated utilization following tonsillectomy in children.
Otolaryngol Head Neck Surg 2017 Mar;156(3):442-55. doi: 10.1177/0194599816683915.
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Keywords: Children/Adolescents, Surgery, Adverse Events, Hospital Readmissions, Patient-Centered Outcomes Research
Schnall R, Cho H, Webel A
Predictors of willingness to use a smartphone for research in underserved persons living with HIV.
The purpose of this study was to assess factors associated with persons living with HIV (PLVH) for participation in research using smartphones. It concluded that future mHealth interventions targeting PLWH should take into account the inverse relationship between smartphone use and age, HIV stigma, and social isolation, and other predictor variables.
AHRQ-funded; HS023963.
Citation: Schnall R, Cho H, Webel A .
Predictors of willingness to use a smartphone for research in underserved persons living with HIV.
Int J Med Inform 2017 Mar;99:53-59. doi: 10.1016/j.ijmedinf.2017.01.002.
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Keywords: Human Immunodeficiency Virus (HIV), Patient Self-Management, Social Stigma, Telehealth, Vulnerable Populations
Takyi H, Watzlaf V, Matthews JT
Privacy and security in multi-user health kiosks.
Preservation of privacy and security are an integral part of health technology development. This paper provides a guide, based on the Office for Civil Rights (OCR) audit protocol, for creating and maintaining an audit checklist for multi-user health kiosks. Implementation of selected audit elements for a multi-user health kiosk designed for use by community-residing older adults illustrates how the guide can be applied.
AHRQ-funded; HS022889.
Citation: Takyi H, Watzlaf V, Matthews JT .
Privacy and security in multi-user health kiosks.
Int J Telerehabil 2017 Spring;9(1):3-14. doi: 10.5195/ijt.2017.6217.
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Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT)
Snyder GM, McCoy C, D'Agata EM
Quantifying antimicrobial exposure: hazards in populations with end-stage renal disease.
Using a rigorously collected data set of antimicrobial use among patients receiving chronic hemodialysis, antimicrobial use was calculated using 3 different methodologies: daily defined dose, days of therapy, and start-stop days. Estimates of antimicrobial use varied by as much as 10-fold, depending on the type of antimicrobial.
AHRQ-funded; HS021666.
Citation: Snyder GM, McCoy C, D'Agata EM .
Quantifying antimicrobial exposure: hazards in populations with end-stage renal disease.
Infect Control Hosp Epidemiol 2017 Mar;38(3):360-63. doi: 10.1017/ice.2016.290.
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Keywords: Adverse Drug Events (ADE), Antimicrobial Stewardship, Dialysis, Kidney Disease and Health, Patient Safety
Hartman ME, Saeed MJ, Bennett T
Readmission and late mortality after critical illness in childhood.
Researchers sought to understand risks for hospital readmission and trends in mortality during the year following ICU discharge. They found that, in multivariate analysis, risk of nonelective readmission for children without cancer was higher with longer index ICU admission length of stay, younger age, and several chronic and acute conditions. Mortality in the year after ICU discharge was low overall.
AHRQ-funded; HS019455.
Citation: Hartman ME, Saeed MJ, Bennett T .
Readmission and late mortality after critical illness in childhood.
Pediatr Crit Care Med 2017 Mar;18(3):e112-e21. doi: 10.1097/pcc.0000000000001062.
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Keywords: Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Mortality, Hospital Readmissions
Robinson JC, Brown TT, Whaley C
Reference pricing changes the 'choice architecture' of health care for consumers.
This article summarizes reference pricing's impacts to date on patient choice, provider prices, surgical complications, and employer spending and estimates its potential impacts if expanded to more services and a broader population. Reference pricing induces consumers to select lower-price alternatives for all of the forms of care studied, leading to significant reductions in prices paid and spending incurred by insurers and employers.
AHRQ-funded; HS022098.
Citation: Robinson JC, Brown TT, Whaley C .
Reference pricing changes the 'choice architecture' of health care for consumers.
Health Aff 2017 Mar;36(3):524-30. doi: 10.1377/hlthaff.2016.1256.
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Keywords: Shared Decision Making, Education: Patient and Caregiver, Healthcare Costs, Healthcare Delivery