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
11351 to 11375 of 12139 Research Studies DisplayedAngier H, Gregg J, Gold R
Understanding how low-income families prioritize elements of health care access for their children via the optimal care model.
The researchers explored low-income parents’ perspectives on accessing health care. Interviews with 29 Oregon parents revealed that affordability and limited availability were seen as barriers to care; while a continuous relationship with a health care provider helped them overcome these barriers. Parents also described the difficult decisions they made between affordability and acceptability in order to get the best care they could for their children.
AHRQ-funded; HS018569.
Citation: Angier H, Gregg J, Gold R .
Understanding how low-income families prioritize elements of health care access for their children via the optimal care model.
BMC Health Serv Res 2014 Nov 19;14:585. doi: 10.1186/s12913-014-0585-2..
Keywords: Access to Care, Children/Adolescents, Low-Income, Social Determinants of Health, Healthcare Costs
Crandall CJ, Newberry SJ, Diamant A
Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review.
This article updates a 2007 evidence review focusing on the comparative benefits and risks of short- and long-term pharmacologic treatments for low bone density. It concludes that good quality evidence supports that several medications for bone density in osteoporotic range and/or pre-existing hip or vertebral fracture reduce fracture risk.
AHRQ-funded; 290200710062I
Citation: Crandall CJ, Newberry SJ, Diamant A .
Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review.
Ann Intern Med. 2014 Nov 18;161(10):711-23. doi: 10.7326/M14-0317..
Keywords: Comparative Effectiveness, Medication, Injuries and Wounds
Heisler M, Choi H, Palmisano G
Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
This study compared outcomes between community health worker (CHW) use of a tailored, interactive, Web-based, tablet computer-delivered tool specifically developed for the study and use of printed educational materials. In a population of low-income Latino and African American adults with diabetes and relatively low levels of formal education, participants in both CHW-led interventions reported mostly similar improvements in outcomes over 3 months.
AHRQ-funded; HS019256
Citation: Heisler M, Choi H, Palmisano G .
Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
Ann Intern Med. 2014 Nov 18;161(10 Suppl):S13-22. doi: 10.7326/m13-3012..
Keywords: Health Information Technology (HIT), Diabetes, Decision Making, Outcomes, Social Determinants of Health
Davis AE, Mehrotra S, Ladner DP
Changes in geographic disparity in kidney transplantation since the final rule.
The researchers assessed the significance of changes of geographic disparities for four metrics since the 1998 adoption of HHS Final Rule’s emphasizing objective priority criteria: waiting times, transplant rates, pre-transplant mortality, and organ quality. They found that the ranges of the four metrics have worsened by approximately 30% or more after the Final Rule at both the regional and donor service area levels.
AHRQ-funded; HS021078.
Citation: Davis AE, Mehrotra S, Ladner DP .
Changes in geographic disparity in kidney transplantation since the final rule.
Transplantation 2014 Nov 15;98(9):931-6. doi: 10.1097/tp.0000000000000446..
Keywords: Transplantation, Disparities, Policy, Outcomes
Bilchick KC, Stukenborg GJ
Comparative effectiveness of cardiac resynchronization therapy in combination with implantable defibrillator in patients with heart failure and wide QRS duration.
The researchers examined the long-term outcomes among Medicare patients with cardiac resynchronization therapy defibrillators (CRT-D) compared with those receiving standard implantable cardioverter defibrillators. They found that the greatest benefit of CRT-D was in patients with guideline-based class I recommendations for CRT-D. For these patients, there was a 17 percent reduction in risk of death.
AHRQ-funded; HS017693
Citation: Bilchick KC, Stukenborg GJ .
Comparative effectiveness of cardiac resynchronization therapy in combination with implantable defibrillator in patients with heart failure and wide QRS duration.
Am J Cardiol. 2014 Nov 15;114(10):1537-42. doi: 10.1016/j.amjcard.2014.08.017..
Keywords: Comparative Effectiveness, Medicare, Outcomes, Cardiovascular Conditions, Medical Devices
Sumner W, Stwalley DL, Asaro PV
Adding flexible temporal constraints to identify chronic comorbid conditions in ambulatory claims data.
The researchers particularly wanted to increase the temporal flexibility of comorbidity definitions in response to common documentation patterns. They report the development and testing of a chronic disease list with temporal criteria for analyzing outpatient claims data. They concluded that temporal constraints applied to ambulatory claims may improve comorbid condition categorization.
AHRQ-funded; HS019455.
Citation: Sumner W, Stwalley DL, Asaro PV .
Adding flexible temporal constraints to identify chronic comorbid conditions in ambulatory claims data.
AMIA Annu Symp Proc 2014 Nov 14;2014:1088-97..
Keywords: Chronic Conditions, Data, Health Insurance
Goss FR, Plasek JM, Lau JJ
An evaluation of a natural language processing tool for identifying and encoding allergy information in emergency department clinical notes.
This paper presents early experience and preliminary findings in developing an allergy module for a general natural language processing (NLP) system, named Medical Text Extraction, Reasoning, and Mapping System (MTERMS), to extract and encode allergy information from clinical text. The preliminary results demonstrate the feasibility using NLP to extract and encode allergy information from clinical notes.
AHRQ-funded; HS022728.
Citation: Goss FR, Plasek JM, Lau JJ .
An evaluation of a natural language processing tool for identifying and encoding allergy information in emergency department clinical notes.
AMIA Annu Symp Proc 2014 Nov 14;2014:580-8..
Keywords: Health Information Technology (HIT), Electronic Health Records (EHRs), Emergency Medical Services (EMS), Emergency Department
Sanger P, Hartzler A, Lober WB
Design considerations for post-acute care mHealth: patient perspectives.
The authors are developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Their key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. In this article, they illustrated their application of these guiding design considerations and proposed a new framework for mHealth design based on illness duration and intensity.
AHRQ-funded; HS019482.
Citation: Sanger P, Hartzler A, Lober WB .
Design considerations for post-acute care mHealth: patient perspectives.
AMIA Annu Symp Proc 2014 Nov 14;2014:1920-9.
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Keywords: Telehealth, Patient Self-Management, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Adverse Events
Kendall L, Eschler J, Lozano P
Engineering for reliability in at-home chronic disease management.
The researchers examined how individuals responsible for managing their own or others’ chronic conditions integrate reminders and notification systems into their daily routines. Based on the participants’ experiences, they contend that many self-management failures should be viewed as systems failures, rather than individual failures and non-compliance.
AHRQ-funded; HS021590.
Citation: Kendall L, Eschler J, Lozano P .
Engineering for reliability in at-home chronic disease management.
AMIA Annu Symp Proc 2014 Nov 14;2014:777-86..
Keywords: Chronic Conditions, Patient Self-Management, Home Healthcare, Patient Adherence/Compliance
Cummins MR, Crouch BI, Del Fiol G
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
The researchers analyzed audio recordings of current telephone-based communications between emergency departments (EDs) and poison control centers (PCCs) in order to describe the information requirements for health information exchange between PCCs and EDs. Their goal was to identify a focused subset of available health information, most relevant to emergency treatment of poison exposure, in order to support generalizable process re-design.
AHRQ-funded; HS018773.
Citation: Cummins MR, Crouch BI, Del Fiol G .
Information requirements for health information exchange supported communication between emergency departments and poison control centers.
AMIA Annu Symp Proc 2014 Nov 14;2014:449-56..
Keywords: Communication, Emergency Department, Emergency Medical Services (EMS), Health Information Exchange (HIE), Health Information Technology (HIT)
Prey JE, Restaino S, Vawdrey DK
Providing hospital patients with access to their medical records.
The researchers conducted two experiments to better understand clinician and patient perceptions about giving patients access to their medical records during hospital encounters. They found that increased patient information sharing in the inpatient setting is beneficial and desirable to patients, and generally acceptable to clinicians.
AHRQ-funded; HS021816.
Citation: Prey JE, Restaino S, Vawdrey DK .
Providing hospital patients with access to their medical records.
AMIA Annu Symp Proc 2014 Nov 14;2014:1884-93.
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Keywords: Electronic Health Records (EHRs), Inpatient Care, Patient and Family Engagement, Provider, Clinician-Patient Communication
Einbinder J, Hebel E, Wright A
The number needed to remind: a measure for assessing CDS effectiveness.
The purpose of this paper is to provide a better understanding of population based clinical decision support (CDS) performance measurement, to identify best practices for designing and implementing CDS, and to introduce two new quality measures, titled Reminder Performance (RP) and the Number Needed to Remind (NNR) for evaluating the effectiveness of clinical reminders in the context of the CDS Dashboards.
AHRQ-funded; 290200810010.
Citation: Einbinder J, Hebel E, Wright A .
The number needed to remind: a measure for assessing CDS effectiveness.
AMIA Annu Symp Proc 2014 Nov 14;2014:506-15..
Keywords: Decision Making, Clinical Decision Support (CDS), Quality Measures, Quality of Care
Zhang R, Pakhomov SV, Lee JT
Using language models to identify relevant new information in inpatient clinical notes.
The authors investigated the use of language models for identification of new information in inpatient notes and evaluated their methods using expert-derived reference standards. They found that the average proportion of redundant information was similar between inpatient and outpatient progress notes, and that advanced practice providers tended to have higher rates of redundancy in their notes compared to physicians.
AHRQ-funded; HS022085.
Citation: Zhang R, Pakhomov SV, Lee JT .
Using language models to identify relevant new information in inpatient clinical notes.
AMIA Annu Symp Proc 2014 Nov 14;2014:1268-76.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Inpatient Care
Garg N, Kuperman G, Onyile A
Validating health information exchange (HIE) data for quality measurement across four hospitals.
The study objective was to validate the secondary use of HIE data for two emergency department (ED) quality measures: identification of frequent ED users and early (72-hour) ED returns in four hospitals. It found that there was no significant difference in the total counts for frequent ED users or early ED returns for any of the four hospitals.
AHRQ-funded; HS021261.
Citation: Garg N, Kuperman G, Onyile A .
Validating health information exchange (HIE) data for quality measurement across four hospitals.
AMIA Annu Symp Proc 2014 Nov 14;2014:573-9..
Keywords: Electronic Health Records (EHRs), Emergency Department, Quality of Care, Health Information Exchange (HIE), Quality Measures
Merlin JS, Walcott M, Ritchie C
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
The researchers’ objective was to explore HIV-infected patients’ perspectives on psychological aspects of chronic pain using in-depth qualitative interviews. Key themes that emerged included the close relationship between mood and pain; mood and pain in the context of living with HIV; use of alcohol/drugs to self-medicate for pain; and the challenge of receiving prescription pain medications while dealing with substance use disorders.
AHRQ-funded; HS021694.
Citation: Merlin JS, Walcott M, Ritchie C .
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
PLoS One 2014 Nov 3;9(11):e111765. doi: 10.1371/journal.pone.0111765..
Keywords: Care Management, Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain, Patient-Centered Outcomes Research, Patient Self-Management
Qato DM, Daviglus ML, Wilder J
'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.
The authors examined whether trends in the availability of pharmacies varied across communities in Chicago with different racial or ethnic compositions and whether "pharmacy deserts," or low-access neighborhoods, were more common in segregated black and Hispanic communities than elsewhere. They found that in 2012 there were disproportionately more pharmacy deserts in segregated black communities, as well as in low-income communities and federally designated Medically Underserved Areas. These findings suggest that public policies aimed at improving access to prescription medications may need to address factors beyond insurance coverage and medication affordability.
AHRQ-funded; HS021093.
Citation: Qato DM, Daviglus ML, Wilder J .
'Pharmacy deserts' are prevalent in Chicago's predominantly minority communities, raising medication access concerns.
Health Aff 2014 Nov;33(11):1958-65. doi: 10.1377/hlthaff.2013.1397.
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Keywords: Access to Care, Medication, Provider: Pharmacist, Racial and Ethnic Minorities, Urban Health
Aschbrenner KA, Pepin R, Mueser KT
A mixed methods exploration of family involvement in medical care for older adults with serious mental illness.
This study explored family involvement in medical care for older adults with serious mental illness (SMI). The investigators found that approximately 89% of older adults with SMI reported family involvement in at least one aspect of their medical care (e.g., medication reminders, medical decision making). However, many family members reported that they were rarely involved in their relative's medical visits, and most did not perceive a need to be involved during routine care.
AHRQ-funded; HS021695.
Citation: Aschbrenner KA, Pepin R, Mueser KT .
A mixed methods exploration of family involvement in medical care for older adults with serious mental illness.
Int J Psychiatry Med 2014;48(2):121-33. doi: 10.2190/PM.48.2.e..
Keywords: Caregiving, Elderly, Behavioral Health, Patient and Family Engagement
Bhavsar NA, Bream JH, Meeker AK
A peripheral circulating TH1 cytokine profile is inversely associated with prostate cancer risk in CLUE II.
The authors evaluated the association between peripheral-cytokine concentrations and prostate cancer. They found that men with a prediagnostic circulating TH1 profile and higher IL6 may have a lower risk of prostate cancer, including aggressive disease. They concluded that identifying specific inflammatory cytokines associated with prostate cancer may lead to improved prevention and treatment strategies.
AHRQ-funded; HS019488.
Citation: Bhavsar NA, Bream JH, Meeker AK .
A peripheral circulating TH1 cytokine profile is inversely associated with prostate cancer risk in CLUE II.
Cancer Epidemiol Biomarkers Prev 2014 Nov;23(11):2561-7. doi: 10.1158/1055-9965.epi-14-0010.
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Keywords: Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Risk
Bradford WD, Lastrapes WD
A prescription for unemployment? Recessions and the demand for mental health drugs.
The authors estimated the relationship between mental health drug prescriptions and the level of labor market activity in the USA. They found that the number of mental health drug prescriptions rises by about 10% when employment falls by 1% and when unemployment rises by 100 basis points, but only for patients in the Northeast region.
AHRQ-funded; HS011326.
Citation: Bradford WD, Lastrapes WD .
A prescription for unemployment? Recessions and the demand for mental health drugs.
Health Econ 2014 Nov;23(11):1301-25. doi: 10.1002/hec.2983.
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Keywords: Medication, Healthcare Utilization, Health Services Research (HSR), Behavioral Health
Viswanathan M, Carey TS, Belinson SE
AHRQ Author: Berliner E, Chang SM
A proposed approach may help systematic reviews retain needed expertise while minimizing bias from nonfinancial conflicts of interest.
The researchers sought to create practical guidance on ensuring adequate clinical or content expertise while maintaining independence of judgment on systematic review teams. They discussed their approach and concluded that the feasibility and utility of this approach to ensuring needed expertise on systematic reviews and minimizing bias from nonfinancial conflicts of interest must be investigated.
AHRQ-authored.
Citation: Viswanathan M, Carey TS, Belinson SE .
A proposed approach may help systematic reviews retain needed expertise while minimizing bias from nonfinancial conflicts of interest.
J Clin Epidemiol 2014 Nov;67(11):1229-38. doi: 10.1016/j.jclinepi.2014.02.023.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Research Methodologies
Haukoos JS, Lyons MS, White DA
Acute HIV infection and implications of fourth-generation HIV screening in emergency departments.
This editorial discusses a study in the same journal issue that contributes substantially to the understanding of HIV screening in EDs by reporting programmatic results of nontargeted opt-out screening in a high-volume, urban ED. This study is unique in that it reports, for the first time in an ED setting, the use of fourth-generation HIV testing which improves detection of acute HIV infection.
AHRQ-funded; HS021749.
Citation: Haukoos JS, Lyons MS, White DA .
Acute HIV infection and implications of fourth-generation HIV screening in emergency departments.
Ann Emerg Med 2014 Nov;64(5):547-51. doi: 10.1016/j.annemergmed.2014.07.004..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Emergency Department, Urban Health
Berliner E
AHRQ Author: Berliner E
Adopting medical technology.
This editorial described a study by Gold and colleagues within this issue concerning the treatment accelerated partial breast irradiation (APBI), which was incorporated into clinical practice with few data on its benefits and risks. Berliner recommends a coordinated approach to evidence generation.
AHRQ-authored.
Citation: Berliner E .
Adopting medical technology.
Med Decis Making 2014 Nov;34(8):948-50. doi: 10.1177/0272989x14546378.
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Keywords: Evidence-Based Practice, Medical Devices
Guise JM, Chang C, Viswanathan M
AHRQ Author: Chang C, Berliner E
Agency for Healthcare Research and Quality Evidence-based Practice Center methods for systematically reviewing complex multicomponent health care interventions.
The purpose of this AHRQ EPC methods white paper was to outline approaches to conducting systematic reviews of complex multicomponent health care interventions. It provided a framework for synthesizing studies of multicomponent interventions and also provided an initial list of critical reporting elements for such studies in order to help systematic reviewers understand the options and tradeoffs available for such reviews.
AHRQ-authored; AHRQ-funded; 290201200010I; 290201200012I; 290201200011I; 290201200015I; 290201200008I; 290201200004C.
Citation: Guise JM, Chang C, Viswanathan M .
Agency for Healthcare Research and Quality Evidence-based Practice Center methods for systematically reviewing complex multicomponent health care interventions.
J Clin Epidemiol 2014 Nov;67(11):1181-91. doi: 10.1016/j.jclinepi.2014.06.010.
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Keywords: Evidence-Based Practice, Healthcare Delivery, Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies
Segal CG, Waller DK, Tilley B
An evaluation of differences in risk factors for individual types of surgical site infections after colon surgery.
The authors developed four independent, multivariate, predictive models to assess the unique associations between risk factors and each surgical site infection (SSI) group: superficial, deep, organ space, and an aggregate of all 3 types of SSIs. They found that unique risks for superficial SSIs include diabetes, chronic obstructive pulmonary disease, and dyspnea; deep SSIs had the greatest magnitude of association with BMI and the greatest incidence of wound disruption; and organ space SSIs were often owing to anastomotic leaks and were uniquely associated with disseminated cancer, preoperative dialysis, preoperative radiation treatment, and a bleeding disorder. They concluded that more effective prevention strategies may be developed by reporting and examining each type of SSI separately.
AHRQ-funded; HS021857.
Citation: Segal CG, Waller DK, Tilley B .
An evaluation of differences in risk factors for individual types of surgical site infections after colon surgery.
Surgery 2014 Nov;156(5):1253-60. doi: 10.1016/j.surg.2014.05.010.
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Keywords: Risk, Healthcare-Associated Infections (HAIs), Adverse Events, Surgery, Patient Safety
Finnerty M, Neese-Todd S, Bilder S
Best practices: MEDNET: a multistate policy maker-researcher collaboration to improve prescribing practices.
The authors describe the Medicaid/ Mental Health Network for Evidence-Based Treatment (MEDNET), the first multistate Medicaid QI collaborative to focus on improving psychotropic prescribing. In particular, this article includes the development, infrastructure challenges, and early evidence of success of this public-academic partnership.
AHRQ-funded; HSO19937; HS021112.
Citation: Finnerty M, Neese-Todd S, Bilder S .
Best practices: MEDNET: a multistate policy maker-researcher collaboration to improve prescribing practices.
Psychiatr Serv 2014 Nov 1;65(11):1297-9. doi: 10.1176/appi.ps.201400343..
Keywords: Behavioral Health, Evidence-Based Practice, Medication, Medicaid, Practice Patterns