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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 10772 Research Studies Displayed
Yakovchenko V, Morgan TR, Chinman MJ
Mapping the road to elimination: a 5-year evaluation of implementation strategies associated with hepatitis C treatment in the Veterans Health Administration.
While few countries and healthcare systems are on track to meet the World Health Organization's hepatitis C virus (HCV) elimination goals, the US Veterans Health Administration (VHA) has been a leader in these efforts. In this study the investigators aimed to determine which implementation strategies were associated with successful national viral elimination implementation within the VHA. They conducted a five-year, longitudinal cohort study of the VHA Hepatic Innovation Team (HIT) Collaborative between October 2015 and September 2019.
AHRQ-funded; HS019461.
Citation:
Yakovchenko V, Morgan TR, Chinman MJ .
Mapping the road to elimination: a 5-year evaluation of implementation strategies associated with hepatitis C treatment in the Veterans Health Administration.
BMC Health Serv Res 2021 Dec 18;21(1):1348. doi: 10.1186/s12913-021-07312-4..
Keywords:
Hepatitis, Chronic Conditions, Veterans
Wurcel AG, Essien UR, Ortiz C
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
This cohort study examined antibiotics prescribed and variations by race among hospitalized patients with skin and soft tissue infections (SSTIs). A subanalysis of multisite, cross-sectional data collected through a national survey of acute care hospital groups within Vizient, Inc. considering adult inpatients treated for SSTIs was used. Of the 1242 adult inpatients included from 91 US hospitals, 45% were female, 18% were Black, and 69% were White with a mean age of 58 years. Penicillin allergy with hives was found in 23%, 19% with rash, and 18% with unknown effects, with allergy found more frequent in Black patients (23%) versus White (18%). Adjusting for multiple factors, White inpatients were at an increased risk of cefazolin use and decreased risk of clindamycin use compared with Black inpatients. Cefazolin use with less likely to be prescribed to Black inpatients than White inpatients and they were likely to be prescribed clindamycin. Cefazolin is considered a first-line SSTI treatment with clindamycin not recommended given frequent dosing and high potential for adverse effects including Clostridioides difficile infection (CDI). Although penicillin allergy is described as more prevalent among White patients, the authors observed an increased prevalence among Black inpatients compared with White inpatients treated for SSTI.
Citation:
Wurcel AG, Essien UR, Ortiz C .
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
JAMA Netw Open 2021 Dec;4(12):e2140798. doi: 10.1001/jamanetworkopen.2021.40798..
Keywords:
Antibiotics, Skin Conditions, Racial / Ethnic Minorities, Practice Patterns, Medication
Chui MA, Berbakov ME, Gilson AM
Effectiveness and sustainment of a tailored over-the-counter medication safety intervention in community pharmacies: a randomized controlled trial.
This paper is a protocol of a pilot study to address a gap in medication safety and decrease misuse of over-the-counter (OTC) medications by older adults aged 65 years or older by creating a pharmacy “Senior Section”. The study will occur in three phases: adaptation, effectiveness using a randomized controlled trial, and sustainment. The study will take place within a regional Midwest integrated health system in conjunction with administration leadership and pharmacy sites. The authors hope this project will provide a road map for pharmacy organizations to tailor and adopt the Senior Section.
AHRQ-funded; HS027737.
Citation:
Chui MA, Berbakov ME, Gilson AM .
Effectiveness and sustainment of a tailored over-the-counter medication safety intervention in community pharmacies: a randomized controlled trial.
Res Social Adm Pharm 2022 Nov;18(11):3953-63. doi: 10.1016/j.sapharm.2022.06.008..
Keywords:
Medication, Medication: Safety, Patient Safety, Provider: Pharmacist
Fraze TK, Beidler LB, Savitz LA
"It's not just the right thing . . . It's a survival tactic": disentangling leaders' motivations and worries on social care.
The purpose of this study was to understand the motivations and concerns of health care organizations when implementing activities targeted at improving patients’ social conditions, such as housing, food, and economic insecurity. The researchers conducted semi-structured interviews with the administrators of 29 health care organizations to explore their issues around their agency’s provision of social care. Participants described an interconnected set of motivations for delivering social care: 1) doing the right thing for their patients, 2) improving health outcomes, and 3) business/ financial aspects. Administrators voiced uncertainty around a) responsible for social care, b) whether health care has the capacity and abilities to provide social care, and c) whether social care activities can be sustained. The researchers concluded that administrators of health care agencies and organizations could benefit from policy-maker guidance and support on how to effectively prioritize social care activities, partner with other sectors to provide social care, and develop the workforce that would be required to do so.
AHRQ-funded; HS024075.
Citation:
Fraze TK, Beidler LB, Savitz LA .
"It's not just the right thing . . . It's a survival tactic": disentangling leaders' motivations and worries on social care.
Med Care Res Rev 2022 Oct;79(5):701-16. doi: 10.1177/10775587211057673..
Keywords:
Social Determinants of Health, Workforce
Hoonakker PLT, Carayon P, Brown RL
A systematic review of the Consumer Emergency Care Satisfaction Scale (CECSS).
In this study, researchers systematically reviewed the literature on the Consumer Emergency Care Satisfaction Scale (CECSS) and examined its psychometric properties. Their systematic literature search resulted in 28 articles in which the CECSS was used, demonstrating that, from a psychometric perspective, the CECSS is a valid and reliable instrument. However, their study also showed that the CECSS has several weaknesses, and they made recommendations for its improvement.
AHRQ-funded; HS026624.
Citation:
Hoonakker PLT, Carayon P, Brown RL .
A systematic review of the Consumer Emergency Care Satisfaction Scale (CECSS).
J Nurs Care Qual 2022 Oct-Dec;37(4):349-55. doi: 10.1097/ncq.0000000000000636..
Keywords:
Emergency Department, Patient Experience
Chen Z, Gleason LJ, Sanghavi P
Accuracy of pressure ulcer events in US nursing home ratings.
This study investigated the accuracy of the government website Nursing Home Compare (NHC) pressure ulcer measures, which are chief indicators of nursing home patient safety. The authors identified hospital admissions for pressure ulcers and linked them to the nursing home-reported data at the patient level using Medicare fee-for-service beneficiaries who were nursing home residents between 2011 and 2017. Percentages of pressure ulcers that were appropriately reported by stage, long-stay versus short-stay status, and race was calculated. Reporting rates were low for both short-stay (70.2%) and long-stay (59.7%) for stage 2-4 pressure ulcer hospitalizations. Black residents experienced more severe pressure ulcers than White residents. Correlations between claims-based measures and NHC ratings were found to be poor.
AHRQ-funded; HS026957.
Citation:
Chen Z, Gleason LJ, Sanghavi P .
Accuracy of pressure ulcer events in US nursing home ratings.
Med Care 2022 Oct;60(10):775-83. doi: 10.1097/mlr.0000000000001763.
AHRQ-funded; HS026957..
AHRQ-funded; HS026957..
Keywords:
Elderly, Nursing Homes, Long-Term Care, Pressure Ulcers, Quality Measures, Quality of Care, Patient Safety
Huang RJ, Epplein M, Hamashima C
An approach to the primary and secondary prevention of gastric cancer in the United States.
In 2020, a summit was convened at Stanford University to address the disparity of gastric cancer as a leading cause of mortality among certain racial, ethnic and immigrant groups in the United States, and the absence of a national strategy for addressing gastric cancer prevention. A working group was formed to conduct a structured literature review to critically evaluate the effectiveness, potential benefits, and potential harms of methods of primary and secondary prevention. The purpose of this article was to provide a consensus statement from that group. The authors found that the distribution of gastric cancer rates is highly inequitable and falls primarily on Asian, African American, Hispanic, and American Indian/Alaskan Native populations. The group concluded that there is an urgent need for cancer prevention trials in high-risk minority populations in the United States.
AHRQ-funded; HS026395.
Citation:
Huang RJ, Epplein M, Hamashima C .
An approach to the primary and secondary prevention of gastric cancer in the United States.
Clin Gastroenterol Hepatol 2022 Oct;20(10):2218-28.e2. doi: 10.1016/j.cgh.2021.09.039..
Keywords:
Cancer, Digestive Disease and Health, Prevention
Severance TS, Njuguna F, Olbara G
An evaluation of the disparities affecting the underdiagnosis of pediatric cancer in Western Kenya.
This study described the international collaboration to investigate disparities affecting the underdiagnosis of pediatric cancer in Western Kenya. Estimates of cancer incidence in similar populations around the world would indicate approximately 1500 patients should be diagnosed each year. However, internal review at a large tertiary hospital noted 200-250 patients were diagnosed annually, suggesting the remaining 75-80% of patients go undiagnosed and do not receive treatment. The authors reviewed 41 malaria slides at a local referring hospital that demonstrated both morphologic and genetic evidence of leukemia. This disparity suggested a lack of education and training that were the lead factors contributing to lower rates of diagnosis.
AHRQ-funded; HS026390.
Citation:
Severance TS, Njuguna F, Olbara G .
An evaluation of the disparities affecting the underdiagnosis of pediatric cancer in Western Kenya.
Pediatr Blood Cancer 2022 Oct;69(10):e29768. doi: 10.1002/pbc.29768..
Keywords:
Children/Adolescents, Cancer, Disparities, Diagnostic Safety and Quality
Glynn A, Hernandez I, Roberts ET
Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.
This study’s objective was to estimate the take-up of the Medicare Part D Low-Income Subsidy (LIS) among Medicare beneficiaries with diabetes and examine differences in out-of-pocket costs and prescription drug use between LIS enrollees and LIS-eligible non-enrollees. Data from the Health and Retirement Study linked to Medicare administrative data from 2008 to 2016 was used. The authors first estimated LIS take-up stratified by income (≤100% of the Federal Poverty Level [FPL] and >100% to ≤150% of FPL). Second, to assess the consequences of forgoing the LIS among near-poor beneficiaries (incomes >100% to ≤150% of FPL), they conducted propensity score-weighted regression analyses to compare out-of-pocket costs, prescription drug use, and cost-related medication non-adherence among LIS enrollees and LIS-eligible non-enrollees. Among Medicare beneficiaries with diabetes, 68.1% of those considered near-poor (incomes >100% to ≤150% of FPL) received the LIS, compared to 90.3% of those with incomes ≤100% of FPL. Among near-poor beneficiaries, LIS-eligible non-enrollees incurred higher annual out-of-pocket drug spending ($518], filled 7.3 fewer prescriptions for diabetes, hypertension, and hyperlipidemia drugs, and were 8.9 percentage points more likely to report skipping drugs due to cost. all compared to LIS enrollees.
AHRQ-funded; HS026727.
Citation:
Glynn A, Hernandez I, Roberts ET .
Consequences of forgoing prescription drug subsidies among low-income Medicare beneficiaries with diabetes.
Health Serv Res 2022 Oct;57(5):1136-44. doi: 10.1111/1475-6773.13990..
Keywords:
Medication, Diabetes, Chronic Conditions, Low-Income, Medicare, Healthcare Costs
Khullar D, Prasad K, Neprash H
Factors associated with patient trust in their clinicians: results from the healthy work place study.
The goal of this study was to determine workplace, clinician, and patient correlates of patient trust in their clinician. The sample used baseline data from the Healthy Work Place trial, a randomized trial of Midwest and East Coast primary care practices. Trust was found to relate mainly to several aspects of care variables (including satisfaction with explanations, overall satisfaction with provider, learning about medical conditions, and the clinician's personal manner), with lesser association with patient characteristics and clinician work conditions. Findings showed that trust was primarily related to what happens between clinicians and patients in the examination room.
AHRQ-funded; HS018160.
Citation:
Khullar D, Prasad K, Neprash H .
Factors associated with patient trust in their clinicians: results from the healthy work place study.
Health Care Manage Rev 2022 Oct-Dec;47(4):289-96. doi: 10.1097/hmr.0000000000000336..
Keywords:
Patient-Centered Healthcare, Patient Experience, Clinician-Patient Communication
Chovatiya R, Begolka WS, Thibau IJ
Financial burden and impact of atopic dermatitis out-of-pocket healthcare expenses among Black individuals in the United States.
The purpose of this study was to explain the categories and impact of out-of-pocket (OOP) healthcare expenses associated with atopic dermatitis (AD) management among black individuals. The researchers administered a voluntary online survey to 113, 502 members of the National Eczema Association. 77.3% of respondents met the participation criteria of being U.S. residents, 18 years of age and older, and self-reporting that they had AD or were the primary caregivers of individuals with AD. The study found that Blacks (74.2%) vs. non-Blacks (63.3%) reported more OOP costs for prescription medications covered (65.1%) and not covered (46.5%), by insurance, emergency room visits (22.1% vs. 11.8%), and outpatient laboratory testing (33.3% vs. 21.8%,). There was a relationship between Black race and increased household financial impact from OOP expenses, and predictors of financial impact included minimally controlled AD, systemic therapy, greater than $200 monthly OOP expenses, and Medicaid. Blacks with Medicaid had greater odds of harmful financial impact than those of black race or with Medicaid alone. The researchers concluded that there is a relationship between Black race increased OOP costs for AD, with significant financial impact to the household.
AHRQ-funded; HS026385.
Citation:
Chovatiya R, Begolka WS, Thibau IJ .
Financial burden and impact of atopic dermatitis out-of-pocket healthcare expenses among Black individuals in the United States.
Arch Dermatol Res 2022 Oct;314(8):739-47. doi: 10.1007/s00403-021-02282-3..
Keywords:
Skin Conditions, Healthcare Costs, Racial / Ethnic Minorities
Bucher BT, Yang M, Richards Steed R, BT, Yang M, Richards Steed R
Geographic proximity of family members and healthcare utilization after complex surgical procedures.
This retrospective cohort study sought to determine the relationship between a patient's proximal familial social support, defined as the geographic proximity of family members, and healthcare utilization after complex cardiovascular and oncologic procedures. The authors defined healthcare utilization outcomes as 30-day all-cause readmission unplanned readmission, nonindex hospital readmission, index hospital length of stay, and home discharge disposition. The number of first-degree relatives (FDRs) living within 30 miles of the patient was measured using 60,895 patients undergoing complex cardiovascular procedures or oncologic procedures. Compared with patients with 0 to 1 FDRs, patients with 6+ FDRs living in close proximity had significantly lower rates of all-cause readmission (12.1% vs 13.5%), unplanned readmission, nonindex readmission; higher rates of home discharge. A larger number of FDRs living within 30 miles of the patient was significantly associated with a lower likelihood of all-cause readmission, 30-day unplanned readmission, nonindex readmission; higher likelihood of home discharge; and shorter index length of stay.
AHRQ-funded; HS025776.
Citation:
Bucher BT, Yang M, Richards Steed R, BT, Yang M, Richards Steed R .
Geographic proximity of family members and healthcare utilization after complex surgical procedures.
Ann Surg 2022 Oct 1;276(4):720-31. doi: 10.1097/sla.0000000000005584..
Keywords:
Surgery, Hospital Discharge, Hospital Readmissions, Healthcare Utilization
Adhia AH, Feinglass JM, Schlick CJR
Hospital volume predicts guideline-concordant care in stage III esophageal cancer.
This study developed quality measures for management of stage III esophageal cancer including: utilization of neoadjuvant therapy, surgical sampling of at least 15 lymph nodes, resection within 60 days of chemotherapy or radiation, and completeness of resection to determine whether hospital volume varies measure adherence of published guidelines. A total of 1345 hospitals participating in the National Cancer Database from 2004 to 2016 were included. The authors examined association of volume, program accreditation, safety net status, geographic region, and patient travel distance on adequate adherence (≥85% of patients are adherent) using logistic regression modeling. The rate of adequate adherence was worst in nodal staging at 12.6% and highest for utilization of neoadjuvant therapy at 84.8%. Academic programs had the highest rate of adequate adherence for induction therapy (77.2%), timing of surgery (56.6%), and completeness of resection (78.5%) but lowest for nodal staging at only 4.4%. Every additional esophagectomy performed per year increased the odds of adequate adherence for induction therapy and completeness of resection but decreased for nodal staging.
AHRQ-funded; HS026385.
Citation:
Adhia AH, Feinglass JM, Schlick CJR .
Hospital volume predicts guideline-concordant care in stage III esophageal cancer.
Ann Thorac Surg 2022 Oct;114(4):1176-82. doi: 10.1016/j.athoracsur.2021.07.092..
Keywords:
Hospitals, Cancer, Guidelines, Evidence-Based Practice
Bourgoin A, Balaban R, Hochman M
Improving quality and safety for patients after hospital discharge: primary care as the lead integrator in postdischarge care transitions.
The purpose of this study was to explain primary care-based transition workflow processes for hospitalized patients. The researchers conducted interviews with primary care thought leaders, staff at 9 primary care sites, community agency staff, and recently discharged patients. The researchers found that primary care postdischarge workflows vary across the different settings, rarely include communications with the patient or the inpatient team during the hospitalization and vary widely across settings. The researchers recommended the use of principles for primary care practices to encourage active participation in the full spectrum of postdischarge care, from admission through the first postdischarge visit to primary care.
AHRQ-authored; AHRQ-funded; 233201500019I/HHSP23337002T.
Citation:
Bourgoin A, Balaban R, Hochman M .
Improving quality and safety for patients after hospital discharge: primary care as the lead integrator in postdischarge care transitions.
J Ambul Care Manage 2022 Oct-Dec;45(4):310-20. doi: 10.1097/jac.0000000000000433..
Keywords:
Quality of Care, Patient Safety, Hospital Discharge, Transitions of Care, Hospitals, Workflow
Hegland TA, Owens PL, Selden TM
New evidence on geographic disparities in United States hospital capacity.
The purpose of this study was to describe hospital capacity across the United States. The researchers combined American Hospital Association Survey, Hospital Compare, and American Community Survey data with the 2017 near-census of U.S. hospital inpatient discharges from the Healthcare Cost and Utilization Project (HCUP). The study found that 0.11 more beds per 1000 population were supplied to zip codes where Non-Hispanic individuals live than zip codes where non-Hispanic White individuals live. However, the hospitals supplying this capacity have 0.36 fewer staff per bed and perform worse on many care quality measures. Zip codes in the most urban parts of America have the least hospital capacity (2.11 beds per 1000 persons) from across the rural-urban continuum. While more rural areas have higher capacity levels, urban areas have advantages in staff and capital per bed. The researchers did not find systematic differences in care quality between rural and urban areas. The study concluded that lower hospital care quality and resource intensity plays a key role in racial, ethnic, and income disparities in hospital care related outcomes.
AHRQ-authored.
Citation:
Hegland TA, Owens PL, Selden TM .
New evidence on geographic disparities in United States hospital capacity.
Health Serv Res 2022 Oct;57(5):1006-19. doi: 10.1111/1475-6773.14010..
Keywords:
Healthcare Cost and Utilization Project (HCUP), Disparities, Hospitals, Quality of Care, Racial / Ethnic Minorities
Friedman HR, Holmes GM
Rural Medicare beneficiaries are increasingly likely to be admitted to urban hospitals.
This study looked at trends in admission to urban hospitals by rural Medicare FFS beneficiaries from 2010 to 2018. The authors combined data from the 2010 to 2018 Hospital Service Area File (HSAF) and the 2010-2017 American Hospital Association (AHA) survey. They found that controlling for distance to the nearest hospitals, an increase of 1 year was associated with a 2.0% increase in the number of admissions to urban hospitals from each rural ZIP code. New system affiliation of the nearest rural hospital was associated with an increase of 1.7%.
AHRQ-funded; HS000032.
Citation:
Friedman HR, Holmes GM .
Rural Medicare beneficiaries are increasingly likely to be admitted to urban hospitals.
Health Serv Res 2022 Oct;57(5):1029-34. doi: 10.1111/1475-6773.14017..
Keywords:
Medicare, Rural Health, Hospitals, Access to Care
De Guzman KR, Pratt M, Hwang A
Patient feedback and evaluation measures of a physical activity initiative: Exercise is Medicine program.
This paper discusses patient feedback and physician documentation practices for the Exercise is Medicine (EIM) initiative to increase physical activity (PA) with the objective of preventing chronic diseases. The initiative is currently being implemented in UC San Diego Health Systems’ primary care clinics. The research included collecting and summarizing patient perceptions of EIM and its components and to identify discrepancies between patient-reported feedback and primary care provider (PCP) documentation in corresponding visit notes in the electronic medical record (EMR). A 10-item survey was distributed via MyChart to 316 patients who provided patient recall of EIM components. Patient feedback was positive with approximately 70% of patients reporting having a PA discussion with their PCP at their most recent visit. However, only 21% of these discussions were documented by PCPs using the preprogrammed smartphrase in the EMR.
AHRQ-funded; HS026517.
Citation:
De Guzman KR, Pratt M, Hwang A .
Patient feedback and evaluation measures of a physical activity initiative: Exercise is Medicine program.
Fam Pract 2022 Sep 24;39(5):813-18. doi: 10.1093/fampra/cmab178..
Keywords:
Lifestyle Changes
Gutman CK, Lion KC, Aronson P
Disparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol.
The purpose of this proposed study is to explore the role of implicit racial bias in inequitable implementation of emergency care clinical guidelines for low-risk febrile infants. The researchers will conduct a cross-sectional study of low-risk febrile infants treated in the emergency departments (ED) of 42 participating sites from the Pediatric Emergency Medicine Collaborative Research Committee. The study will evaluate the relationship between 1) race and ethnicity and 2) limited English proficiency with the primary outcome, discharge to home without lumbar puncture or antibiotics. Simultaneously, the researchers will conduct individual semi-structured interviews with 1) minority parents of febrile infants and 2) pediatric ED physicians. The data will be reviewed to assess disparities and bias in communication and medical decision-making.
AHRQ-funded; HS026006.
Citation:
Gutman CK, Lion KC, Aronson P .
Disparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol.
BMJ Open 2022 Sep 20;12(9):e063611. doi: 10.1136/bmjopen-2022-063611..
Keywords:
Newborns/Infants, Disparities
Donohue JM, Cole ES, James CV
The US Medicaid program: coverage, financing, reforms, and implications for health equity.
This article is a literature review of the Medicaid program focusing on Medicaid eligibility, enrollment, and spending and examined areas of Medicaid policy, including managed care, payment, and delivery system reforms; Medicaid expansion; racial and ethnic health disparities; and the potential to achieve health equity. The authors included peer-reviewed articles and reports published between January 2003 and February 2022. Medicaid covered approximately 80.6 million people per month in 2022, representing 16.3% of US health spending. Managed care plans run by states enrolled 69.5% of Medicaid beneficiaries in 2019 and adopted 139 delivery system reforms from 2003 to 2019. Over half (56.4%) of Medicaid beneficiaries were from racial and ethnic minority groups in 2019, and disparities in access, quality, and outcomes are common among these groups within Medicaid. The authors felt that additional Medicaid reforms are needed to reduce health disparities by race and ethnicity and to achieve equity in access, quality, and outcomes.
AHRQ-funded; HS026727.
Citation:
Donohue JM, Cole ES, James CV .
The US Medicaid program: coverage, financing, reforms, and implications for health equity.
JAMA 2022 Sep 20;328(11):1085-99. doi: 10.1001/jama.2022.14791..
Keywords:
Medicaid, Healthcare Costs, Policy, Health Insurance
Edwards JK, Cole SR, Breger TL
Five-year mortality for adults entering human immunodeficiency virus care under universal early treatment compared with the general US population.
This study examined 5-year mortality for adults entering human immunodeficiency virus (HIV) care under universal early treatment compared with the general US population. A total of 82,766 adults entering HIV treatment at North American AIDS Cohort Collaboration clinical sites in the United States were used to compute mortality over 5 years. The authors used NCHS data to construct a cohort representing a subset of the US population matched to study participants on key characteristics. For the study period of 1999 to 2017, the 5-year mortality among adults with HIV was 7.9% higher than expected based on the US general population. Under universal early treatment, the elevation in mortality for people with HIV would have been 7.2%. During the most recent calendar period examined (2011-2017) the elevation in mortality for people with HIV was 2.6% under observed treatment patterns and 2.1% under universal early treatment.
AHRQ-funded; 90047713.
Citation:
Edwards JK, Cole SR, Breger TL .
Five-year mortality for adults entering human immunodeficiency virus care under universal early treatment compared with the general US population.
Clin Infect Dis 2022 Sep 14;75(5):867-74. doi: 10.1093/cid/ciab1030..
Keywords:
Human Immunodeficiency Virus (HIV), Mortality, Outcomes
Jonas DE, Vander Schaaf EB, Riley S
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to explore the evidence on the benefits and harms of screening children and adolescents for prediabetes and type 2 diabetes to inform the US Preventive Services Task Force (USPSTF). The researchers utilized references; experts; literature surveillance, and PubMed/MEDLINE, Cochrane Library, and trial registries. The final review included 8 publications with 856 participants with a mean age of 14 years. The researchers found that none of the eligible studies directly assessed the benefits or harms of preventive screening. The limited eligible clinical trials reported few health outcomes and found no difference between groups.
AHRQ-funded; 290201500007I.
Citation:
Jonas DE, Vander Schaaf EB, Riley S .
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Sep 13;328(10):968-79. doi: 10.1001/jama.2022.7957..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Prevention, Evidence-Based Practice, Guidelines
Dutta S, McEvoy DS, Rubins DM
Clinical decision support improves blood culture collection before intravenous antibiotic administration in the emergency department.
This paper discusses the outcomes of using a clinical decision support (CDS) tool that was implemented in emergency departments (EDs) for sepsis patients to remind healthcare staff to take blood cultures before administration of intravenous (IV) antibiotics. The study compared timely blood culture collection outcomes prior to IV antibiotics for 54,538 adult ED patients 1 year before and after a CDS intervention implementation in the electronic health record. The baseline phase found that 46.1% had blood cultures prior to IV antibiotics, compared to 58.8% after the intervention. The CDS improved blood culture collection rates without increasing overutilization.
AHRQ-funded; HS02717.
Citation:
Dutta S, McEvoy DS, Rubins DM .
Clinical decision support improves blood culture collection before intravenous antibiotic administration in the emergency department.
J Am Med Inform Assoc 2022 Sep 12;29(10):1705-14. doi: 10.1093/jamia/ocac115..
Keywords:
Clinical Decision Support (CDS), Health Information Technology (HIT), Antibiotics, Emergency Department, Medication, Sepsis
Corby S, Ash JS, Whittaker K
Translating ethnographic data into knowledge, skills, and attitude statements for medical scribes: a modified Delphi approach.
This paper describes the curricular framework that was developed for standardized scribe training including desired core knowledge, skills, and attitudes (KSAs). First an ethnographic study was performed at 5 varied health care organizations in the US to gather qualitative data about knowledge, skills, and attitudes. Preliminary KSA related themes were generated from the team’s analysis, followed by a modified Delphi study to finalize the KSA lists. The team identified 90 descriptions of scribe-related KSAs with three lists ultimately defined as: (1) Hands-On Learning KSA list with 47 items amenable to simulation training, (2) Didactic KSA list consisting of 32 items appropriate for didactic lecture teaching, and (3) Prerequisite KSA list consisting of 11 items centered around items scribes should learn prior to being hired or soon after being hired.
AHRQ-funded; 290200810010.
Citation:
Corby S, Ash JS, Whittaker K .
Translating ethnographic data into knowledge, skills, and attitude statements for medical scribes: a modified Delphi approach.
J Am Med Inform Assoc 2022 Sep 12;29(10):1679-87. doi: 10.1093/jamia/ocac091..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT)
Kakiuchi S, Livorsi DJ, Perencevich EN
Days of antibiotic spectrum coverage: a novel metric for inpatient antibiotic consumption.
The purpose of this study was to develop a novel metric for antibiotic consumption, days of antibiotic spectrum coverage (DASC), to address the limitations of the current benchmarking metric days of therapy (DOT). The researchers developed their spectrum scoring system by assessing 77 antibiotics in 16 categories of antibacterial activity and creating a cumulative daily antibiotic spectrum coverage (ASC) score. To compare hospital benchmarking using DOT and DASC, the researchers conducted a retrospective cohort study of adult patients admitted to acute care units within the Veterans Health Administration system in 2018. The study found little relationship between DOT per 1000 and DASC per DOT, suggesting that lower antibiotic consumption at a hospital does not necessarily mean more frequent use of narrow-spectrum antibiotics. The researchers concluded that DASC is a potential replacement for DOT.
AHRQ-funded; HS027472.
Citation:
Kakiuchi S, Livorsi DJ, Perencevich EN .
Days of antibiotic spectrum coverage: a novel metric for inpatient antibiotic consumption.
Clin Infect Dis 2022 Sep 10;75(4):567-76. doi: 10.1093/cid/ciab1034..
Keywords:
Antibiotics, Medication, Antimicrobial Stewardship
Bradford A, Shofer M, Singh H
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
This paper discusses Measure Dx, a new AHRQ resource that translates knowledge from diagnostic measurement research into actionable recommendations. This resource guides healthcare organizations to detect, analyze, and learn from diagnostic safety events as part of a continuous learning and feedback cycle. The goal of Measure Dx is to advance new frontiers in reducing preventable diagnostic harm to patients.
AHRQ-authored; AHRQ-funded; 233201500022I; HS027363.
Citation:
Bradford A, Shofer M, Singh H .
Measure Dx: implementing pathways to discover and learn from diagnostic errors.
Int J Qual Health Care 2022 Sep 10;34(3). doi: 10.1093/intqhc/mzac068..
Keywords:
Diagnostic Safety and Quality, Patient Safety, Quality Improvement, Quality of Care, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Systems, Learning Health Systems
