National Healthcare Quality and Disparities Report
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Topics
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- Shared Decision Making (583)
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- Simulation (49)
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- Sleep Problems (70)
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- Tobacco Use (83)
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- Tools & Toolkits (49)
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- Transitions of Care (193)
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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
9476 to 9500 of 12214 Research Studies DisplayedHeid C, Knobloch MJ, Schulz LT
Use of the health belief model to study patient perceptions of antimicrobial stewardship in the acute care setting.
The authors identified themes associated with patient perceptions of antibiotic use and the role of patients in inpatient antimicrobial stewardship. They found that general medicine inpatients receiving at least one anti-infective medication recognized antibiotic resistance as a serious public health threat but expressed low perceived susceptibility to being personally affected by antibiotic resistance. Few participants reported being offered the opportunity to engage in shared decision making while hospitalized. The researchers concluded that the likelihood of patient engagement in stewardship practices is currently limited by low perceived susceptibility and lack of cues to act.
AHRQ-funded; HS023791.
Citation: Heid C, Knobloch MJ, Schulz LT .
Use of the health belief model to study patient perceptions of antimicrobial stewardship in the acute care setting.
Infect Control Hosp Epidemiol 2016 May;37(5):576-82. doi: 10.1017/ice.2015.342.
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Keywords: Critical Care, Antimicrobial Stewardship, Antibiotics, Patient and Family Engagement, Patient Safety
Melcher ML, Roberts JP, Leichtman AB
Utilization of deceased donor kidneys to initiate living donor chains.
The authors proposed that some deceased donor kidneys be allocated to initiate nonsimultaneous extended altruistic donor chains of living donor kidney transplants. They hypothesized that a pilot program would show a positive impact on patients of all ethnicities and blood types.
AHRQ-funded; HS020610.
Citation: Melcher ML, Roberts JP, Leichtman AB .
Utilization of deceased donor kidneys to initiate living donor chains.
Am J Transplant 2016 May;16(5):1367-70. doi: 10.1111/ajt.13740.
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Keywords: Healthcare Delivery, Kidney Disease and Health, Policy, Transplantation
Bishop WP, Craddock Lee SJ, Skinner CS
Validity of single-item screening for limited health literacy in English and Spanish speakers.
The researchers evaluated 3 single-item screening measures for limited health literacy in a community-based population of English and Spanish speakers. They found that for English speakers, no difference was seen among the items. For Spanish speakers, "ability to read" identified inadequate literacy better than "help reading hospital materials."
AHRQ-funded; HS022418.
Citation: Bishop WP, Craddock Lee SJ, Skinner CS .
Validity of single-item screening for limited health literacy in English and Spanish speakers.
Am J Public Health 2016 May;106(5):889-92. doi: 10.2105/ajph.2016.303092.
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Keywords: Cultural Competence, Education: Patient and Caregiver, Health Literacy
Michelson KA, Monuteaux MC, Neuman MI
Variation and trends in anaphylaxis care in United States children's hospitals.
The authors sought to determine the extent of variation in treatment of children with anaphylaxis. They found that there is substantial variability in the use of common therapies and hospitalization rates for children cared for in U.S. children's hospitals, highlighting the need for research defining optimal care for anaphylaxis.
AHRQ-funded; HS000063.
Citation: Michelson KA, Monuteaux MC, Neuman MI .
Variation and trends in anaphylaxis care in United States children's hospitals.
Acad Emerg Med 2016 May;23(5):623-7. doi: 10.1111/acem.12922.
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Keywords: Children/Adolescents, Emergency Department, Hospitals, Care Management, Hospitalization
Bradley EH, Canavan M, Rogan E
Variation in health outcomes: the role of spending on social services, public health, and health care, 2000-09.
This study found that states with a higher ratio of social to health spending (calculated as the sum of social service spending and public health spending divided by the sum of Medicare spending and Medicaid spending) had significantly better subsequent health outcomes for the following seven measures: adult obesity; asthma; mentally unhealthy days; days with activity limitations; and mortality rates for lung cancer, acute myocardial infarction, and type 2 diabetes.
AHRQ-funded; HS017589.
Citation: Bradley EH, Canavan M, Rogan E .
Variation in health outcomes: the role of spending on social services, public health, and health care, 2000-09.
Health Aff 2016 May;35(5):760-8. doi: 10.1377/hlthaff.2015.0814.
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Keywords: Outcomes, Social Determinants of Health, Healthcare Costs, Health Status, Public Health
Sadeghi B, Walling AM, Romano PS
A hospital-based advance care planning intervention for patients with heart failure: a feasibility study.
The purpose of this study was to evaluate the feasibility of implementing a multiple-component hospital-based intervention on completion of advance care planning (ACP) forms among heart failure (HF) patients. It concluded that a hospital-based ACP intervention using nonclinician health educators is feasible to implement and has the potential to facilitate the ACP process.
AHRQ-funded HS019311.
Citation: Sadeghi B, Walling AM, Romano PS .
A hospital-based advance care planning intervention for patients with heart failure: a feasibility study.
J Palliat Med 2016 Apr;19(4):451-5. doi: 10.1089/jpm.2015.0269.
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Keywords: Cardiovascular Conditions, Shared Decision Making, Education: Patient and Caregiver, Heart Disease and Health, Hospitals
Brach C
AHRQ Author: Brach C
Even in an emergency, doctors must make informed consent an informed choice.
When a stroke is suspected, a daughter is pressured to consent to her father's treatment without fully understanding the risks.
AHRQ-authored.
Citation: Brach C .
Even in an emergency, doctors must make informed consent an informed choice.
Health Aff 2016 Apr;35(4):739-43. doi: 10.1377/hlthaff.2015.1407.
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Keywords: Case Study, Shared Decision Making, Emergency Department, Health Literacy, Patient and Family Engagement, Stroke
Salemi JL, Pathak EB, Salihu HM
Infant outcomes after elective early-term delivery compared with expectant management.
The purpose of the study was to compare the risk of neonatal morbidity and infant mortality between elective early-term deliveries and those expectantly managed and delivered at 39 weeks of gestation or greater. It concluded that the issues surrounding the timing and reasons for delivery initiation are complicated and each pregnancy unique. Furthermore, it cautions against a general avoidance of all elective early-term deliveries.
AHRQ-funded - HS019997.
Citation: Salemi JL, Pathak EB, Salihu HM .
Infant outcomes after elective early-term delivery compared with expectant management.
Obstet Gynecol 2016 Apr;127(4):657-66. doi: 10.1097/aog.0000000000001331.
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Keywords: Newborns/Infants, Mortality, Pregnancy, Labor and Delivery, Adverse Events
Chen Y, Cai Y, Hong C
Inference for correlated effect sizes using multiple univariate meta-analyses.
The authors selected a multivariate meta-analysis approach that used standard univariate methods for the marginal effects but also provided valid joint inference for multiple parameters. Their method can directly handle missing outcomes and can provide unbiased estimates, well-estimated standard errors, and confidence intervals with good coverage probability. The method was also found to maintain high relative efficiency compared with conventional multivariate meta-analyses where the within-study correlations are known. The authors further illustrated the proposed method through two real meta-analyses.
AHRQ-funded; HS022900.
Citation: Chen Y, Cai Y, Hong C .
Inference for correlated effect sizes using multiple univariate meta-analyses.
Stat Med 2016 Apr 30;35(9):1405-22. doi: 10.1002/sim.6789.
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Keywords: Research Methodologies, Patient-Centered Outcomes Research
Lee JH, Turner DA, Kamat P
The number of tracheal intubation attempts matters! A prospective multi-institutional pediatric observational study.
The objective of this study is to determine the association between number of tracheal intubation (TI) attempts and severe desaturation (SpO2 < 70 percent) and adverse TI associated events (TIAEs). It found that the number of TI attempts was associated with desaturations and increased occurrence of TIAEs in critically ill children with acute respiratory failure.
AHRQ-funded; HS021583; HS022464.
Citation: Lee JH, Turner DA, Kamat P .
The number of tracheal intubation attempts matters! A prospective multi-institutional pediatric observational study.
BMC Pediatr 2016 Apr 29;16:58. doi: 10.1186/s12887-016-0593-y.
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Keywords: Adverse Events, Children/Adolescents, Respiratory Conditions, Patient Safety, Children/Adolescents
Bailey M, Randall EC, Costa C
Analysis of urine, oral fluid and fingerprints by liquid extraction surface analysis coupled to high resolution MS and MS/MS - opportunities for forensic and biomedical science.
The authors assessed the suitability of Liquid Extraction Surface Analysis (LESA) for obtaining detailed chemical profiles of fingerprints, oral fluid, and urine, which may be used in the future for rapid medical diagnostics or metabolomics studies. They also showed how LESA can be used to detect illicit drugs and their metabolites, and they showed how LESA can be used to detect the explosive material RDX in contaminated artificial fingermarks.
AHRQ-funded; HS017487.
Citation: Bailey M, Randall EC, Costa C .
Analysis of urine, oral fluid and fingerprints by liquid extraction surface analysis coupled to high resolution MS and MS/MS - opportunities for forensic and biomedical science.
Anal Methods 2016 Apr 28;2016(16):3373-82. doi: 10.1039/c6ay00782a.
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Keywords: Diagnostic Safety and Quality
Tucker CM, Wall WA, Wippold G
Development of an inventory for health-care office staff to self-assess their patient-centered cultural sensitivity.
The researchers sought to determine the psychometric properties of the Tucker-Culturally Sensitive Health Care Office Staff Inventory-Self-Assessment Form (T-CSHCOSI-SAF). They found that this inventory has 2 factors with high internal consistency reliability. They concluded that the T-CSHCOSI-SAF is a useful inventory for health-care office staff to assess their own level of patient-centered cultural sensitivity and that it can be used in the development and implementation of trainings to promote patient-centered cultural sensitivity of health-care office staff.
AHRQ-funded; HS013151; HS010726.
Citation: Tucker CM, Wall WA, Wippold G .
Development of an inventory for health-care office staff to self-assess their patient-centered cultural sensitivity.
Health Serv Res Manag Epidemiol 2016 Apr 27;3. doi: 10.1177/2333392816629600.
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Keywords: Healthcare Delivery, Cultural Competence, Patient-Centered Healthcare, Primary Care, Provider
Bartsch SM, Hotez PJ, Hertenstein DL
Modeling the economic and epidemiologic impact of hookworm vaccine and mass drug administration (MDA) in Brazil, a high transmission setting.
The authors evaluated the potential economic and epidemiologic impact of a preventive hookworm vaccine. A pediatric hookworm vaccine drastically decreased hookworm prevalence in children. A booster in adulthood further reduced the overall prevalence and nearly eliminated hookworm infection in children. The authors conclude that a human hookworm vaccine would provide both health benefits and cost savings.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Hotez PJ, Hertenstein DL .
Modeling the economic and epidemiologic impact of hookworm vaccine and mass drug administration (MDA) in Brazil, a high transmission setting.
Vaccine 2016 Apr 27;34(19):2197-206. doi: 10.1016/j.vaccine.2016.03.018.
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Keywords: Vaccination, Healthcare Costs, Children/Adolescents, Newborns/Infants
Schulte DM, Duster M, Warrack S
Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients.
The primary aim of this pilot, randomized-controlled trial was to examine the feasibility and acceptability of a tobacco cessation intervention compared with usual care in inpatients. It found overall high levels of satisfaction with the intervention, indicating good feasibility and acceptance among patients.
AHRQ-funded; HS024039.
Citation: Schulte DM, Duster M, Warrack S .
Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients.
Subst Abuse Treat Prev Policy 2016 Apr 26;11:15. doi: 10.1186/s13011-016-0059-0.
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Keywords: Healthcare-Associated Infections (HAIs), Patient Experience, Patient Experience, Prevention, Tobacco Use
Bartsch SM, Lopman BA, Ozawa S
Global economic burden of norovirus gastroenteritis.
The researchers developed a computational simulation model to estimate the economic burden of norovirus in every country/area stratified by WHO region and globally, from the health ystem and societal perspectives. They found that globally, orovirus resulted in a total of $4.2 billion in direct health system costs and $60.3 billion in societal costs per year.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Lopman BA, Ozawa S .
Global economic burden of norovirus gastroenteritis.
PLoS One 2016 Apr 26;11(4):e0151219. doi: 10.1371/journal.pone.0151219.
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Keywords: Healthcare Costs, Public Health, Policy
Ryu E, Chamberlain AM, Pendergraft RS
Quantifying the impact of chronic conditions on a diagnosis of major depressive disorder in adults: a cohort study using linked electronic medical records.
In this study, the researchers aimed to quantify the relative contribution of selected chronic conditions to identify the conditions most influential to major depressive disorder (MDD) risk in adults and identify differences by age. Their results suggest that specific chronic conditions such as diabetes mellitus and rheumatoid arthritis/osteoarthritis may have greater influence than others on the risk of MDD.
AHRQ-funded; HS023077.
Citation: Ryu E, Chamberlain AM, Pendergraft RS .
Quantifying the impact of chronic conditions on a diagnosis of major depressive disorder in adults: a cohort study using linked electronic medical records.
BMC Psychiatry 2016 Apr 26;16:114. doi: 10.1186/s12888-016-0821-x.
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Keywords: Chronic Conditions, Depression, Electronic Health Records (EHRs), Primary Care
Liu Z, Zhang K, Du XL
Risks of developing breast and colorectal cancer in association with incomes and geographic locations in Texas: a retrospective cohort study.
This study aimed to determine whether median household income was associated with the risk of developing breast and colorectal cancer in Texas and to identify higher cancer risks by race/ethnicity and geographic areas. It demonstrated that higher income was associated with an increased risk of breast cancer and a decreased risk of colorectal cancer in Texas.
AHRQ-funded; HS018956.
Citation: Liu Z, Zhang K, Du XL .
Risks of developing breast and colorectal cancer in association with incomes and geographic locations in Texas: a retrospective cohort study.
BMC Cancer 2016 Apr 26;16:294. doi: 10.1186/s12885-016-2324-z.
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Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Racial and Ethnic Minorities, Risk, Social Determinants of Health
Olsen MA, Young-Xu Y, Stwalley D
The burden of Clostridium difficile infection: estimates of the incidence of CDI from U.S. administrative databases.
The researchers used comparable methods with multiple administrative databases to compare the incidence of clostridium difficile infection (CDI) in older and younger persons in the United States. They found that the incidence of CDI was 10-fold lower and the proportion of community-onset CDI was much higher in the privately insured younger LabRx population compared to the elderly Medicare population.
AHRQ-funded; HS019455.
Citation: Olsen MA, Young-Xu Y, Stwalley D .
The burden of Clostridium difficile infection: estimates of the incidence of CDI from U.S. administrative databases.
BMC Infect Dis 2016 Apr 22;16:177. doi: 10.1186/s12879-016-1501-7.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Data, Prevention
Gidengil CA, Linder JA, Beach S
Using clinical vignettes to assess quality of care for acute respiratory infections.
Overprescribing of antibiotics for acute respiratory infections (ARIs) is common. The objective of this study was to develop and validate a vignette-based method to estimate clinician ARI antibiotic prescribing. The researchers concluded that responses to 3 clinical vignettes can identify clinicians with relatively poor quality ARI antibiotic prescribing. Vignettes may be a mechanism to target clinicians for quality improvement efforts.
AHRQ-funded; HS018419.
Citation: Gidengil CA, Linder JA, Beach S .
Using clinical vignettes to assess quality of care for acute respiratory infections.
Inquiry 2016 Apr 20;53:pii: 0046958016636531. doi: 10.1177/0046958016636531..
Keywords: Antibiotics, Antimicrobial Stewardship, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Medication, Practice Patterns, Primary Care, Quality of Care, Respiratory Conditions
Smith MW, Owens PL, Andrews RM
AHRQ Author: Owens PL, Andrews RM, Steiner CA
Differences in severity at admission for heart failure between rural and urban patients: the value of adding laboratory results to administrative data.
This study’s main objective was to examine the role of laboratory test results in measuring disease severity at the time of admission for inpatients who reside in rural and urban areas. It concluded that heart failure patients from rural areas are hospitalized at lower severity levels than their urban counterparts. Laboratory test data provide insight on clinical severity and practice patterns beyond what is available in administrative discharge data.
AHRQ-authored; AHRQ-funded; 29020060009.
Citation: Smith MW, Owens PL, Andrews RM .
Differences in severity at admission for heart failure between rural and urban patients: the value of adding laboratory results to administrative data.
BMC Health Serv Res 2016 Apr 18;16(1):133. doi: 10.1186/s12913-016-1380-z.
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Keywords: Heart Disease and Health, Hospitalization, Healthcare Cost and Utilization Project (HCUP), Diagnostic Safety and Quality, Rural Health
Tilson H, Hines LE, McEvoy G
AHRQ Author: Helwig AL
Recommendations for selecting drug-drug interactions for clinical decision support.
A work group consisting of 20 experts in pharmacology, drug information, and clinical decision support (CDS) from academia, government agencies, health information vendors, and healthcare organizations was convened. It recommended a transparent, systematic, and evidence-driven process with graded recommendations by a consensus panel of experts and oversight by a national organization.
AHRQ-authored.
Citation: Tilson H, Hines LE, McEvoy G .
Recommendations for selecting drug-drug interactions for clinical decision support.
Am J Health Syst Pharm 2016 Apr 15;73(8):576-85. doi: 10.2146/ajhp150565.
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Keywords: Clinical Decision Support (CDS), Adverse Drug Events (ADE), Medication: Safety, Medication, Health Information Technology (HIT)
Burda BU, Holmer HK, Norris SL
Limitations of A Measurement Tool to Assess Systematic Reviews (AMSTAR) and suggestions for improvement.
A Measurement Tool to Assess Systematic Reviews (AMSTAR) is a commonly used tool to assess the quality of systematic reviews; however, modifications are needed to improve its usability, reliability, and validity. In this commentary, the authors summarize their experience and the experiences of others who have used AMSTAR and provide suggestions for its improvement.
AHRQ-funded; HS018500.
Citation: Burda BU, Holmer HK, Norris SL .
Limitations of A Measurement Tool to Assess Systematic Reviews (AMSTAR) and suggestions for improvement.
Syst Rev 2016 Apr 12;5:58. doi: 10.1186/s13643-016-0237-1.
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Keywords: Research Methodologies, Data, Evidence-Based Practice, Guidelines, Quality Measures
Khan A, Furtak SL, Melvin P
Parent-reported errors and adverse events in hospitalized children.
The researchers sought to determine the frequency with which parents experience patient safety incidents and the proportion of reported incidents that meet standard definitions of medical errors and preventable adverse events (AEs). They found that parents frequently reported errors and preventable AEs, many of which were not otherwise documented in the medical record.
AHRQ-funded; HS022986.
Citation: Khan A, Furtak SL, Melvin P .
Parent-reported errors and adverse events in hospitalized children.
JAMA Pediatr 2016 Apr 4;170(4):e154608. doi: 10.1001/jamapediatrics.2015.4608..
Keywords: Children/Adolescents, Hospitalization, Patient Safety, Adverse Events, Medical Errors
Khan MJ, Massad LS, Kinney W
A common clinical dilemma: Management of abnormal vaginal cytology and human papillomavirus test results.
The researchers reviewed the literature on vaginal cytology and high-risk HPV testing and developed guidance for the management of abnormal vaginal screening tests. Since vaginal cancer is rare, the authors suggested that asymptomatic low-risk women not be screened. They further proposed an algorithm based on expert opinion for managing women with abnormal vaginal test results.
AHRQ-funded; HS023009.
Citation: Khan MJ, Massad LS, Kinney W .
A common clinical dilemma: Management of abnormal vaginal cytology and human papillomavirus test results.
J Low Genit Tract Dis 2016 Apr;20(2):119-25. doi: 10.1097/lgt.0000000000000185.
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Keywords: Cancer, Care Management, Infectious Diseases, Sexual Health, Women
Donovan JL, Kanaan AO, Gurwitz JH
A pilot health information technology-based effort to increase the quality of transitions from skilled nursing facility to home: compelling evidence of high rate of adverse outcomes.
The authors investigated whether or not patients transferred from skilled nursing facilities to home may be at risk for adverse outcomes. They tracked rehospitalization within 30 days after discharge and adverse drug events within 45 days. They concluded that older adults discharged from skilled nursing facilities are at high risk of adverse outcomes immediately following discharge.
AHRQ-funded; HS017817.
Citation: Donovan JL, Kanaan AO, Gurwitz JH .
A pilot health information technology-based effort to increase the quality of transitions from skilled nursing facility to home: compelling evidence of high rate of adverse outcomes.
J Am Med Dir Assoc 2016 Apr;17(4):312-7. doi: 10.1016/j.jamda.2015.11.008.
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Keywords: Health Information Technology (HIT), Transitions of Care, Adverse Events, Elderly, Hospital Readmissions