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
1726 to 1750 of 12210 Research Studies DisplayedSchur C, Johnson M, Doherty J
AHRQ Author: Mistry KB
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
This AHRQ-authored paper describes key stakeholder insights focused on measure implementation and increasing the uptake of Pediatric Quality Measures (PQM). The PQMP Learning Collaborative conducted semistructured interviews with 9 key informants (KIs) presenting states, health plans, and other potential end users. The interviews focused on obtaining KIs’ perspectives on 6 research questions focused on assessing the feasibility and usability of PQM and strengthening the connection between measurement and improvement. The KIs uniformly acknowledged the complexity of the issues raised and pinpointed multiple unresolved issues.
AHRQ-authored; AHRQ-funded; 290201400003I.
Citation: Schur C, Johnson M, Doherty J .
Real-world considerations for implementing pediatric quality measures: insights from key stakeholders.
Acad Pediatr 2022 Apr;22(3S):S76-S80. doi: 10.1016/j.acap.2021.04.007..
Keywords: Children/Adolescents, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care, Implementation
Chu DK, Abrams EM, Golden BK
Risk of second allergic reaction to SARS-CoV-2 vaccines: a systematic review and meta-analysis.
The purpose of this systematic review and meta-analysis of case studies and case reports was to assess the risk of severe immediate allergic reactions to a second dose of SARS-CoV-2 mRNA vaccine in people who experienced an immediate allergic reaction to the first dose. The researchers evaluated the World Health Organization Global Coronavirus database, Web of Science, MEDLINE, and Embase from the date of inception through October 4th, 2021. The main outcomes and measures were a risk of severe immediate allergic reaction and repeated severe immediate allergic reactions with a second vaccine dose. The study found that among 22 studies of SARS-CoV-2 mRNA vaccines, 1366 individuals had immediate allergic reactions to their first vaccination. Of these, 87.8% were women with a mean age of 46.1 years. Six patients developed severe immediate allergic reactions after their second vaccination, 232 developed mild symptoms, and 1360 tolerated the dose. Among 78 persons with severe immediate allergic reactions to their first SARS-CoV-2 mRNA vaccination, 4 people had a second severe immediate reaction, and 15 had non-severe symptoms. There were no deaths. The study concluded that in a supervised setting equipped to manage severe allergic reactions, revaccination of individuals with an immediate allergic reaction to a first SARS-CoV-2 mRNA vaccine dose can be safe.
AHRQ-funded; HS026395.
Citation: Chu DK, Abrams EM, Golden BK .
Risk of second allergic reaction to SARS-CoV-2 vaccines: a systematic review and meta-analysis.
JAMA Intern Med 2022 Apr;182(4):376-85. doi: 10.1001/jamainternmed.2021.8515..
Keywords: COVID-19, Vaccination, Risk, Evidence-Based Practice, Patient-Centered Outcomes Research
Murray E, Roosevelt GE, Vogel JA
Screening for health-related social needs in the emergency department: adaptability and fidelity during the COVID-19 pandemic.
Researchers sought to evaluate a screening and referral program for health-related social needs (HRSN) in an emergency department. Using the Accountable Health Communities Screening Tool, they found that, during the COVID-19 pandemic, HRSN doubled, likely reflecting the economic impact of the pandemic.
AHRQ-funded; HS023901.
Citation: Murray E, Roosevelt GE, Vogel JA .
Screening for health-related social needs in the emergency department: adaptability and fidelity during the COVID-19 pandemic.
Am J Emerg Med 2022 Apr;54:323.e1-23.e4. doi: 10.1016/j.ajem.2021.09.071..
Keywords: COVID-19, Social Determinants of Health, Emergency Department, Screening, Public Health
Shenkman E, Mistry KB, Davis D
AHRQ Author: Mistry KB
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
The University of Florida Child Health Quality (CHeQ) initiative, funded by the Agency for Health Care Research and Quality (AHRQ)/Centers for Medicare and Medicaid Services (CMS) Pediatric Quality Measurement Program, examined measures that states use to evaluate quality of oral health care for children in Medicaid and the Children’s Health Insurance Program (CHIP). This paper discusses stakeholder engagement in bridging research and policy to improve measurement and dental care for children in Medicaid.
AHRQ-authored; AHRQ-funded; HS025298.
Citation: Shenkman E, Mistry KB, Davis D .
Stakeholder engagement: bridging research and policy to improve measurement and dental care for children in Medicaid.
Acad Pediatr 2022 Apr;22(3S):S65-S67. doi: 10.1016/j.acap.2021.08.012..
Keywords: Children/Adolescents, Dental and Oral Health, Medicaid, Children's Health Insurance Program (CHIP), Quality Measures, Quality Improvement, Quality of Care
Yang P, Diaz A, Chhabra KR
Surgical quality assurance at expanding health networks: a qualitative study.
This study used qualitative methods to understand the nuances that affect the variation in network-level surgical quality assurance and provided strategies that surgical leaders can use to improve surgical quality at expanding health networks. Through semi-structured interviews, three themes emerged. Participants wanted standardized tools for quality measurement, an organizational structure that provides clear oversight over quality, and a culture shift toward quality improvement.
AHRQ-funded; HS024763.
Citation: Yang P, Diaz A, Chhabra KR .
Surgical quality assurance at expanding health networks: a qualitative study.
Surgery 2022 Apr;171(4):966-72. doi: 10.1016/j.surg.2021.09.023..
Keywords: Surgery, Quality Improvement, Quality of Care
Kenney MK, Chanlongbutra A, Fanflick PL
AHRQ Author: Chanlongbutra A
Systems of care among children and youth with special health care needs with and without adverse childhood events: National Survey of Children's Health 2016-2017.
The purpose of the study was to compare Children and Youth with Special Health Care Needs (CYSHCN) with non-CYSHCN in the likelihood of experiencing Adverse Childhood Events (ACEs), and then document the differences in receiving recommended and needed health care services among CYSHCS with and without ACEs. The researchers studied a sample of 16,304 CYSHCN from the 2016 and 2017 National Survey of Children’s Health (N=71,181). The study found that CYHSCN had a greater likelihood of having each of the measured Adverse Childhood Events, and greater likelihood of experiencing aggregated levels of ACE’s than non-CYSHCN. In addition, an increase in ACEs was related to a decrease in the likelihood of a CYSHCN having a medical home with family-centered and coordinated care. Having one or greater ACEs increased the likelihood of having unmet mental health care needs. The study concluded that the researcher’s findings extend the current understanding of the relationship between CYSHCN and ACEs, and that the need for additional work to establish care systems for this vulnerable population continues.
AHRQ-authored.
Citation: Kenney MK, Chanlongbutra A, Fanflick PL .
Systems of care among children and youth with special health care needs with and without adverse childhood events: National Survey of Children's Health 2016-2017.
Disabil Health J 2022 Apr;15(2):101226. doi: 10.1016/j.dhjo.2021.101226..
Keywords: Children/Adolescents, Disabilities, Healthcare Delivery, Vulnerable Populations
Sharara SL, Arbaje AI, Cosgrove SE
The voice of the patient: patient roles in antibiotic management at the hospital-to-home transition.
The objective of this study was to characterize tasks required for patient-performed antibiotic medication management (MM) at the hospital-to-home transition, as well as barriers to and strategies for patient-led antibiotic MM. The overall goal was to understand patients' role in managing antibiotics at the hospital-to-home transition. The investigators concluded that there are many opportunities to improve patient-led antibiotic MM at the hospital-to-home transition.
AHRQ-funded; HS026995.
Citation: Sharara SL, Arbaje AI, Cosgrove SE .
The voice of the patient: patient roles in antibiotic management at the hospital-to-home transition.
J Patient Saf 2022 Apr 1;18(3):e633-e39. doi: 10.1097/pts.0000000000000899..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Hospital Discharge, Transitions of Care, Patient Self-Management
Blakeslee-Carter J, Beck AW, Spangler EL
Type III endoleaks in complex endovascular abdominal aortic aneurysm repair within the Vascular Quality Initiative.
The objective of this national multicenter cohort study was to evaluate the occurrence of Type III endoleaks (T3ELs) after complex endovascular aneurysm repair (c-EVAR) for abdominal aortic aneurysm, identify potential procedural characteristics, and determine their impact on c-EVAR clinical outcomes. Investigators reviewed elective c-EVAR for nonruptured aneurysms within the Vascular Quality Initiative. The findings indicated that T3ELs in c-EVAR remain relatively uncommon and are identified predominately at index hospitalization. T3EL development was associated with higher device modularity and modification. The presence of T3ELs did not appear to have a statistically significant relationship with aortic reinterventions or survival, but the authors note that these findings are not definitive.
AHRQ-funded; HS013852.
Citation: Blakeslee-Carter J, Beck AW, Spangler EL .
Type III endoleaks in complex endovascular abdominal aortic aneurysm repair within the Vascular Quality Initiative.
J Vasc Surg 2022 Apr; 75(4):1172-80. doi: 10.1016/j.jvs.2021.10.038..
Keywords: Cardiovascular Conditions, Surgery, Adverse Events
Schnitzer K, Senft N, Tindle HA
Understanding engagement behaviors and rapport building in tobacco cessation telephone counseling: an analysis of audio-recorded counseling calls.
This study explored smokers’ and counselors’ engagement and rapport-building behaviors in telephone counseling for smoking cessation and patterns of these behaviors by smokers’ psychiatric symptoms. The study transcribed audio-recorded counseling calls among recently hospitalized participants enrolled in a smoking cessation randomized controlled trial (RCT). The study used baseline RCT data to explore frequencies of smokers’ behaviors among smokers who reported more symptoms of depression (PHQ8 ≥ 10) or anxiety (GAD7 ≥ 10) at study entry. A total of 37 participants were included, who were mostly female (23), White (26), with a median age of 58. At study entry many participants experienced moderate-to-severe symptoms of depression (18/37) and anxiety (22/37). Counselor-led behaviors included building off priority interaction, empathy, normalizing challenges, reframing and summarizing, validating achievements, and expressing shared experiences. Participant-led engagement behaviors occurred more often among patients with higher baseline depression and anxiety symptoms compared to those with lower symptom scores.
AHRQ-funded; HS026122.
Citation: Schnitzer K, Senft N, Tindle HA .
Understanding engagement behaviors and rapport building in tobacco cessation telephone counseling: an analysis of audio-recorded counseling calls.
J Subst Abuse Treat 2022 Apr;135:108643. doi: 10.1016/j.jsat.2021.108643..
Keywords: Tobacco Use: Smoking Cessation, Tobacco Use, Patient and Family Engagement, Lifestyle Changes
Crockett KB, Borgatti A, Tan F
Weight discrimination experienced prior to enrolling in a behavioral obesity intervention is associated with treatment response among Black and White adults in the Southeastern U.S.
This study examined the role that weight discrimination and race is associated with pre-treatment depressive symptoms. A cohort of Black and White adults were enrolled in a 16-week obesity intervention treatment (N = 271; mean BMI = 35.7 kg/m2); 59% Black; 92% women). They reported prior experiences of weight discrimination and completed the Center for Epidemiological Studies Depression (CES-D) Scale at baseline. Their weekly attendance at group sessions was recorded, and weight was measured at baseline and post-treatment. Participants with a history of weight discrimination scored 2.4 points higher on the CES-D and lost 2% less weight relative to those without weight discrimination. Race modified the association between weight discrimination and treatment session attendance, such that Black participants attended fewer sessions if they had prior experience of weight discrimination. However, this association was not true among White individuals.
AHRQ-funded; HS013852.
Citation: Crockett KB, Borgatti A, Tan F .
Weight discrimination experienced prior to enrolling in a behavioral obesity intervention is associated with treatment response among Black and White adults in the Southeastern U.S.
Int J Behav Med 2022 Apr;29(2):152-59. doi: 10.1007/s12529-021-10009-x..
Keywords: Obesity, Obesity: Weight Management, Behavioral Health, Racial and Ethnic Minorities, Depression
Herrin J, Yu H, Venkatesh AK
Identifying high-value care for Medicare beneficiaries: a cross-sectional study of acute care hospitals in the USA.
Investigators sought to define hospital value and identify the characteristics of hospitals which provide high-value care. Participants were Medicare beneficiaries with claims included in CMS Overall Star Ratings or in publicly available Medicare spending per beneficiary data. The researchers found that there are high quality hospitals that are not high value, and a number of factors are strongly associated with being low or high value. They suggested that their findings can inform efforts of policymakers and hospitals to increase the value of care.
AHRQ-funded; HS022882; HS026980.
Citation: Herrin J, Yu H, Venkatesh AK .
Identifying high-value care for Medicare beneficiaries: a cross-sectional study of acute care hospitals in the USA.
BMJ Open 2022 Mar 31;12(3):e053629. doi: 10.1136/bmjopen-2021-053629..
Keywords: Medicare, Quality of Care, Hospitals
D'Orazio B, Ramachandran J, Khalida C
Stakeholder engagement in a comparative effectiveness/implementation study to prevent Staphylococcus aureus infection recurrence: CA-MRSA Project (CAMP2).
The purpose of this study was to determine whether the presence and participation of a stakeholder committee would positively impact the effectiveness of the design and execution of a home-based Methicillin-resistant Staphylococcus aureus and methicillin-sensitive Staphylococcus aureus infection prevention intervention. The trial utilized community health workers to implement infection prevention protocols in participant’s homes, including home visits, sampling household surfaces at baseline and then three months, and obtaining surveillance cultures from index patients and household members. The study assembled and convened The Clinician and Patient Stakeholder Advisory Committee (CPSAC), comprised of New York-based federally qualified health centers (FQHCs) and community health emergency departments, laboratory and clinical researchers, clinicians, and patient stakeholders. The CPSAC was tasked with trial oversight and shared decision-making and troubleshooting, and convened both in person and remotely. The researchers concluded that the inclusion and engagement of the CPSAC during the trial design and implementation was highly effective in addressing and resolving challenges in both participant recruitment and home visits.
AHRQ-funded; HS021667.
Citation: D'Orazio B, Ramachandran J, Khalida C .
Stakeholder engagement in a comparative effectiveness/implementation study to prevent Staphylococcus aureus infection recurrence: CA-MRSA Project (CAMP2).
Prog Community Health Partnersh 2022;16(1):45-60. doi: 10.1353/cpr.2022.0005..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Community-Acquired Infections, Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA), Evidence-Based Practice
Scott K, Becker SJ, Helseth SA
Pharmacotherapy interventions for adolescent co-occurring substance use and mental health disorders: a systematic review.
This systematic literature review examined the impact of pharmacotherapy interventions on adolescents with substance use (SU) disorders and mental health issues. The authors included ten randomized controlled trials exploring seven pharmacotherapies in the final evaluation. All studies had low to moderate risk of bias. Four studies evaluated pharmacotherapy for co-occurring depression and SU, 3 evaluated ADHD and SU, and 3 evaluated bipolar disorder and SU. Five of the 10 studies included a behavioral intervention. They found no evidence that pharmacotherapy for co-occurring mental health diagnoses impacted SU.
AHRQ-funded; 290201500002I.
Citation: Scott K, Becker SJ, Helseth SA .
Pharmacotherapy interventions for adolescent co-occurring substance use and mental health disorders: a systematic review.
Fam Pract 2022 Mar 24;39(2):301-10. doi: 10.1093/fampra/cmab096..
Keywords: Children/Adolescents, Substance Abuse, Behavioral Health, Medication
Behr CL, Hull P, Hsu J
Geographic access to federally qualified health centers before and after the Affordable Care Act.
Funding for Federally Qualified Health Centers (FQHCs) increased with the advent of the Affordable Care Act (ACA). The purpose of this study was to define FQHC service areas based on patient use and examine the characteristics of areas that gained FQHC access post-ACA. The researchers first defined FQHC service areas using total patient counts by ZIP code from the Uniform Data System (UDS) and then compared that approach with other methods. The authors then compared the characteristics of ZIP codes from Medically Underserved Areas/ Populations (MUA/Ps) that gained access to FQHCs between 2011-2015, with MUA/P ZIP codes that did not gain access to FQHCs during that same time period. The study found that FQHC service areas based on the UDS data included a larger percentage of FQHC patients and a higher use of FQHCs among low-income residents, on average, than Primary Care Service Areas or counties. The researchers also discovered that MUA/Ps that gained access to an FQHC between 2011 and 2015 included more poor, publicly insured, uninsured, and foreign born residents than underserved areas that did not gain access. The study concluded that measures of actual patient use are a useful method of assessing FQHC service areas and access.
AHRQ-funded; HS025378.
Citation: Behr CL, Hull P, Hsu J .
Geographic access to federally qualified health centers before and after the Affordable Care Act.
BMC Health Serv Res 2022 Mar 23;22(1):385. doi: 10.1186/s12913-022-07685-0..
Keywords: Access to Care, Uninsured, Vulnerable Populations
Dierkes AM, Aiken LH, Sloane DM
Hospital nurse staffing and sepsis protocol compliance and outcomes among patients with sepsis in the USA: a multistate cross-sectional analysis.
The timely and effective administration of sepsis treatment may improve sepsis outcomes, and those improvements may provide evidence of the need for mandated reporting of adherence to sepsis care protocol. The purpose of the study was to better understand the association between patient-to-nurse staffing ratios, sepsis protocol compliance, and patient outcomes. The researchers conducted a cross-sectional study utilizing linked data from 537 hospitals from across California, Florida, Illinois, Pennsylvania, New Jersey, and New York (representing 252,699 Medicare inpatients with sepsis present on admission), nurse and hospital surveys, and Centers for Medicare and Medicaid Services Hospital Compare and the corresponding MedPAR patient claims. The study found that every additional patient per nurse was associated with greater odds of mortality, readmission, ICU admission, and greater risk of relative duration of stay. Every 10% increase in compliance of sepsis protocol was only associated with a shorter duration of stay. The study concluded that improvements in nurse staffing and the nurse-to-patient ratios had a greater impact on sepsis infection outcomes than compliance with protocols.
AHRQ-funded; HS026232.
Citation: Dierkes AM, Aiken LH, Sloane DM .
Hospital nurse staffing and sepsis protocol compliance and outcomes among patients with sepsis in the USA: a multistate cross-sectional analysis.
BMJ Open 2022 Mar 22;12(3):e056802. doi: 10.1136/bmjopen-2021-056802..
Keywords: Sepsis, Hospitals, Provider: Nurse, Workforce
Remigio RV., Hel. H, Raimann JG
Combined effects of air pollution and extreme heat events among ESKD patients within the Northeastern United States.
Researchers investigated the impact of air pollution exposure among end-stage kidney disease (ESKD) patients and its potential modifying effect from extreme heat events (EHE). Data on daily all-cause mortality and all-cause hospital admissions was taken from Fresenius Kidney Care records from selected northeastern US counties. Their findings suggested interdependent effects of EHE and air pollution among ESKD patients for all-cause mortality risks. They recommended national level assessments in order to consider the ESKD population as a sensitive population and to inform treatment protocols during extreme heat and degraded pollution episodes.
AHRQ-funded; HS027716.
Citation: Remigio RV., Hel. H, Raimann JG .
Combined effects of air pollution and extreme heat events among ESKD patients within the Northeastern United States.
Sci Total Environ 2022 Mar 15;812:152481. doi: 10.1016/j.scitotenv.2021.152481..
Keywords: Kidney Disease and Health
Adeoye-Olatunde OA, Curran GM, Jaynes HA
Preparing for the spread of patient-reported outcome (PRO) data collection from primary care to community pharmacy: a mixed-methods study.
This study’s aim was to prepare for implementation of PatientToc™, a patient-reported outcomes (PRO) data collection software that can be used to help facilitate resolution of non-adherence to medications. The study was a two-phase operation, but this report focuses on the phase of the evaluation which was conducted at primary care practices currently using PatientToc™ and community pharmacies in Indiana, Wisconsin, and Minnesota. One-day site visits were conducted along with observations, audio-recorded contextual inquires, semi-structured interviews with staff and patients, and post-visit site observation debriefs. Nine pharmacies, two primary care practices, and 89 individuals participated. Four major barriers, four major facilitators and 14 recommendations were identified. A stakeholder panel engaged in four Evidence-Based Quality Improvement (EBQI) implementation process sessions. The panel confirmed findings and designated high priority recommendations which included: explaining PatientToc™ and its benefits clearly and simply to patients, ensuring patients can complete questionnaires within 10 minutes, providing hands-on training/resources for pharmacy teams, and providing feedback on the adapted PatientToc™ application, and finalizing toolkit items for initial community pharmacy implementation.
AHRQ-funded; HS025943.
Citation: Adeoye-Olatunde OA, Curran GM, Jaynes HA .
Preparing for the spread of patient-reported outcome (PRO) data collection from primary care to community pharmacy: a mixed-methods study.
Implement Sci Commun 2022 Mar 14;3(1):29. doi: 10.1186/s43058-022-00277-3..
Keywords: Provider: Pharmacist, Health Information Technology (HIT), Patient-Centered Outcomes Research
Mason M, Cho Y, Rayo J
Technologies for medication adherence monitoring and technology assessment criteria: narrative review.
This narrative review summarizes the technical features, data capture methods, and various advantages and limitations of medication adherence monitoring technology along with proposed criteria for assessing medication adherence monitoring technologies. Technology assessment criteria were identified and organized into the following five categories: development information, technology features, adherence to data collection and management, feasibility and implementation, and acceptability and usability.
AHRQ-funded; R01 HS027846.
Citation: Mason M, Cho Y, Rayo J .
Technologies for medication adherence monitoring and technology assessment criteria: narrative review.
JMIR Mhealth Uhealth 2022 Mar 10;10(3):e35157. doi: 10.2196/35157..
Keywords: Medication, Patient Adherence/Compliance, Telehealth, Health Information Technology (HIT)
Behr CL, Joynt Maddox KE, Meara E
Anti-SARS-CoV-2 monoclonal antibody distribution to high-risk Medicare beneficiaries, 2020-2021.
The authors assessed how the limited supply of monoclonal antibodies (mAbs) therapy was allocated to patients at highest risk of severe disease. They found that, among non-hospitalized Medicare beneficiaries with a COVID-19 diagnosis between November 2020 and August 2021, only 7.2% received mAb therapy. In many cases, patients at the highest risk of severe disease were the least likely to receive mAb therapy, with extreme variation geographically. Their analysis did not account for patient vaccination status or observed disease severity, which could influence clinicians’ decisions.
AHRQ-funded; HS024075.
Citation: Behr CL, Joynt Maddox KE, Meara E .
Anti-SARS-CoV-2 monoclonal antibody distribution to high-risk Medicare beneficiaries, 2020-2021.
JAMA 2022 Mar 8;327(10):980-83. doi: 10.1001/jama.2022.1243..
Keywords: COVID-19, Medicare, Medication
Koh MJ, Merrill MH, Koh MJ
Comparative outcomes for mature T and NK/T-cell lymphomas in people with and without HIV and to AIDS-defining lymphomas.
Citation: Koh MJ, Merrill MH, Koh MJ .
Comparative outcomes for mature T and NK/T-cell lymphomas in people with and without HIV and to AIDS-defining lymphomas.
Blood Adv 2022 Mar 8;6(5):1420-31. doi: 10.1182/bloodadvances.2021006208.
AHRQ-funded; 90051652..
AHRQ-funded; 90051652..
Keywords: Human Immunodeficiency Virus (HIV), Comparative Effectiveness, Outcomes, Evidence-Based Practice
Bartsch SM, O'Shea KJ, Chin KL
Maintaining face mask use before and after achieving different COVID-19 vaccination coverage levels: a modelling study.
This study’s objective was to assess the value of maintaining face mask use indoors according to different COVID-19 vaccination coverage levels in the US. This computational simulation-model study used a Monte Carlo simulation model representing the US population and SARS CoV-2 spread. The investigation found that maintaining face mask use until and a short time after achieving various final vaccination coverage levels can not only be cost-effective, but even cost saving. In all scenarios, it was estimated cost-effective to maintain face mask use for about 2-10 weeks beyond the date of target vaccination coverage achievement.
AHRQ-funded; HS028165.
Citation: Bartsch SM, O'Shea KJ, Chin KL .
Maintaining face mask use before and after achieving different COVID-19 vaccination coverage levels: a modelling study.
Lancet Public Health 2022 Mar 8;7(4):e356-e65. doi: 10.1016/s2468-2667(22)00040-8..
Keywords: COVID-19, Public Health
Commodore-Mensah Y, Loustalot F, Himmelfarb CD CD
AHRQ Author: McNellis R
Proceedings from a National Heart, Lung, and Blood Institute and the Centers for Disease Control and Prevention workshop to control hypertension.
In order to address the rapid decline in hypertension control, the National Heart, Lung, and Blood Institute and the Division for Heart Disease and Stroke Prevention of the Centers for Disease Control and Prevention convened a virtual workshop with multidisciplinary national experts. The presentations and discussions included potential reasons for the decline and challenges in hypertension control, possible "big ideas," and multisector approaches that could reverse the current trend while addressing knowledge gaps and research priorities.
AHRQ-authored.
Citation: Commodore-Mensah Y, Loustalot F, Himmelfarb CD CD .
Proceedings from a National Heart, Lung, and Blood Institute and the Centers for Disease Control and Prevention workshop to control hypertension.
Am J Hypertens 2022 Mar 8;35(3):232-43. doi: 10.1093/ajh/hpab182..
Keywords: Blood Pressure, Prevention, Evidence-Based Practice, Cardiovascular Conditions
Barreto EF, May HP, Schreier DJ
Development and feasibility of a multidisciplinary approach to AKI survivorship in care transitions: research letter.
The purpose of this study was to observe and describe the development and feasibility of a multidisciplinary approach to caring for acute kidney injury (AKI) survivors at care transitions (ACT). The studied population were adults with stage 3 AKI who were not discharging on dialysis and were established with a primary care provider at the authors’ academic medical center in the U.S. Preliminary data indicated that AKI survivors of interest could primarily be identified, educated, and followed up with using the multidisciplinary approach model, which also maximized the unique expertise of each team member. The authors concluded that this multidisciplinary ACT workflow supported by clinical decision support was feasible, scalable, and addressed gaps in existing care transition models.
AHRQ-funded; HS028060.
Citation: Barreto EF, May HP, Schreier DJ .
Development and feasibility of a multidisciplinary approach to AKI survivorship in care transitions: research letter.
Can J Kidney Health Dis 2022 Mar 6; 9:20543581221081258. doi: 10.1177/20543581221081258..
Keywords: Kidney Disease and Health, Transplantation, Transitions of Care
Kostick-Quenet KM, Cohen IG, Gerke S
Mitigating racial bias in machine learning.
This article discusses the challenges in applying existing guidelines for mitigating algorithmic bias in a machine learning (ML) and/or artificial intelligence (AI) tool for real-world clinical decisions making by physicians and patients. The authors then discuss the existing legal regulation of ML/AI racial bias and future directions. Their team developed a decision support framework for patients with severe heart failure that includes a prognostic ML algorithm to calculate personalized estimates for patients about their likely outcomes after receiving a left ventricular-assist device (LVAD). Their goal is to identify the potential for racial bias in the tool’s algorithm identified practical challenges regarding algorithmic bias that other developers may face. The algorithms’ training data base was examined to review data quality. The authors also examined other comorbidities and their role in predicting LVAD outcomes. Existing and proposed initiatives to address algorithmic bias through regulation is also discussed in detail. The authors, who are mostly bioethics experts recommend that developers seeking to mitigate bias in ML use their algorithms as leverage to call upon stakeholders who are responsible for generating relevant datasets to make a concerted effort to document race and associated variables to enable systematic inquiries into sources of potential racial bias.
AHRQ-funded; HS027784.
Citation: Kostick-Quenet KM, Cohen IG, Gerke S .
Mitigating racial bias in machine learning.
J Law Med Ethics 2022;50(1):92-100. doi: 10.1017/jme.2022.13..
Keywords: Racial and Ethnic Minorities, Health Information Technology (HIT)
Aboumatar H, Pitts S, Sharma R
Patient engagement strategies for adults with chronic conditions: an evidence map.
Existing research indicates that patient and family engagement (PFE) in health care is necessary for improving outcomes. The purpose of this study was to explore the evidence on PFE strategies for adults with chronic conditions and identify the areas where additional research is needed. The authors searched existing databases, including CINAHL, Cochrane, EMBASE, and PubMed, for data between January 2015 and September 2021, to identify systematic reviews on strategies for engaging patients with chronic conditions. The study also included their caregivers. Strategies were categorized into the following levels: direct patient care, health system, and community-policy. The authors discovered 131 reviews of direct patient care strategies, 5 reviews of health system strategies, and no reviews of community-policy strategies. The study concluded that there is much more available evidence on the effects of direct patient care strategies on PFE than on the effects of the health system or community policy strategies. In addition, the evidence map created by the researchers focused on reviews which did not provide details of individual chronic disease interventions. The authors concluded that the evidence map created provides awareness of the research gaps related to efforts to improve patient and family engagement for patients with chronic conditions.
AHRQ-funded; 290201500006I.
Citation: Aboumatar H, Pitts S, Sharma R .
Patient engagement strategies for adults with chronic conditions: an evidence map.
Syst Rev 2022 Mar 5;11(1):39. doi: 10.1186/s13643-021-01873-5..
Keywords: Patient and Family Engagement, Chronic Conditions, Evidence-Based Practice