National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Autism (1)
- Behavioral Health (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (6)
- Chronic Conditions (2)
- (-) Clinical Decision Support (CDS) (13)
- Depression (1)
- Elderly (1)
- Electronic Health Records (EHRs) (3)
- Evidence-Based Practice (1)
- Falls (1)
- Health Information Exchange (HIE) (1)
- Health Information Technology (HIT) (10)
- Medication (2)
- Pain (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Practice Patterns (1)
- Prevention (3)
- (-) Primary Care (13)
- Quality Improvement (1)
- Risk (1)
- Screening (2)
- Shared Decision Making (6)
- Tobacco Use (1)
- Tobacco Use: Smoking Cessation (1)
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
1 to 13 of 13 Research Studies DisplayedRoberts MM, Marino M, Wells R
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
The objective of this cross-sectional study was to evaluate the association between population-based clinical decision support (CDS) tools and racial and sex disparities in the aspirin use, blood pressure control, cholesterol management, and smoking cessation (ABCS) care quality metrics among smaller primary care practices. Researchers used practice-level data from the EvidenceNOW initiative, from practices that submitted both survey data and electronic health record (EHR)-derived ABCS data stratified by race and sex. Their findings suggested that practices using CDS tools had small disparities but were not statistically significant; however, CDS tools were not associated with reductions in disparities. They concluded that more research was needed on effective practice-level interventions to mitigate disparities.
AHRQ-funded; HS023940.
Citation: Roberts MM, Marino M, Wells R .
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
JAMA Netw Open 2023 Aug; 6(8):e2326905. doi: 10.1001/jamanetworkopen.2023.26905..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Cardiovascular Conditions, Tobacco Use, Tobacco Use: Smoking Cessation, Primary Care, Evidence-Based Practice, Prevention
Shear K, Rice H, Garabedian PM
Usability testing of an interoperable computerized clinical decision support tool for fall risk management in primary care.
The purpose of this study was to conduct usability testing of the ASPIRE fall risk management tool for use in divergent primary care clinics. Participants recruited from two sites with different electronic health records and clinical organizations used ASPIRE across two clinical scenarios; they rated ASPIRE usability as above average, based on usability benchmarks. Time spent on tasks decreased significantly between the first and second scenarios, indicating ease of learnability. The authors conclude that ASPIRE could be integrated into diverse organizations, since it allows a tailored implementation without the need to build a new system for each organization. ASPIRE is therefore well positioned to impact the challenge of falls at scale.
AHRQ-funded; HS027557.
Citation: Shear K, Rice H, Garabedian PM .
Usability testing of an interoperable computerized clinical decision support tool for fall risk management in primary care.
Appl Clin Inform 2023 Mar;14(2):212-26. doi: 10.1055/a-2006-4936.
Keywords: Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Falls, Primary Care, Risk, Prevention
Salloum RG, Bilello L, Bian J
Study protocol for a type III hybrid effectiveness-implementation trial to evaluate scaling interoperable clinical decision support for patient-centered chronic pain management in primary care.
The objective of this 3-year project is to study the adaptation and implementation of an existing interoperable clinical decision support (CDS) tool for pain treatment shared decision making, with tailored implementation support, in new clinical settings in the OneFlorida Clinical Research Consortium. The evaluation will be organized by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, with an adaptation and tailoring of PainManager, an open source interoperable CDS tool. It is anticipated that this evaluation will establish the feasibility and obtain preliminary data in preparation for a multi-site pragmatic trial targeting the effectiveness of PainManager and tailored implementation support on shared decision making and patient-reported pain and physical function.
AHRQ-funded; R18 HS028584.
Citation: Salloum RG, Bilello L, Bian J .
Study protocol for a type III hybrid effectiveness-implementation trial to evaluate scaling interoperable clinical decision support for patient-centered chronic pain management in primary care.
Implement Sci 2022 Jul 15;17(1):44. doi: 10.1186/s13012-022-01217-4..
Keywords: Clinical Decision Support (CDS), Pain, Chronic Conditions, Primary Care, Health Information Technology (HIT), Patient-Centered Outcomes Research, Patient-Centered Healthcare
Allen KS, Danielson EC, Downs SM
Evaluating a prototype clinical decision support tool for chronic pain treatment in primary care.
This study evaluates a prototype decision support tool to aid primary care clinicians when caring for patients with chronic noncancer pain called The Chronic Pain Treatment Tracker (Tx Tracker). The authors conducted 12 semi-structured interviews with primary care clinicians from four Indiana health systems. The interviews were conducted in two waves, with the last 6 interviews prototype and interview guide revisions. The interviews explored the Tx Tracker using a think-aloud approach and a clinical scenario. Evaluation questions were also asked. The researchers identified several themes: the need for clinicians to be presented with a comprehensive patient history, the usefulness of Tx Tracker in patient discussions about treatment planning, potential usefulness of Tx Tracker for patients with high uncertainty or risk, potential usefulness of Tx Tracker in aggregating scattered information, variability in expectations about workflows, skepticism about underlying electronic health record data quality, interest in using Tx Tracker to annotate or update information, interest in using Tx Tracker to translate information to clinical action, desire for interface with visual cues for risks, warnings, or treatment options, and desire for interactive functionality.
AHRQ-funded; HS023306.
Citation: Allen KS, Danielson EC, Downs SM .
Evaluating a prototype clinical decision support tool for chronic pain treatment in primary care.
Appl Clin Inform 2022 May;13(3):602-11. doi: 10.1055/s-0042-1749332..
Keywords: Clinical Decision Support (CDS), Primary Care, Chronic Conditions, Health Information Technology (HIT)
Campbell NL, Holden RJ, Tang Q
Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults.
This study tested the effectiveness of a multicomponent behavioral intervention to reduce the use of high-risk anticholinergic medications in primary care older adults. Ten primary care clinics within Eskenazi Health in Indianapolis were selected to test the intervention. The intervention included provider- and patient-focused components. The provider-focused component was a computerized decision support system alerting the presence of a high-risk anticholinergic and offering dose- and indication-specific alternatives; while the patient-focused component was a story-based video providing education and modeling an interaction with a healthcare provider. The intervention occurred from April 2019 through March 2020. A total of 552 older adults had primary care visits during the study period. Only 3 out of 259 provider-focused alerts led to a medication change. Of the 276 staff alerts, 4.7% were confirmed to activate the patient-focused intervention.
AHRQ-funded; P30HS024384.
Citation: Campbell NL, Holden RJ, Tang Q .
Multicomponent behavioral intervention to reduce exposure to anticholinergics in primary care older adults.
J Am Geriatr Soc 2021 Jun;69(6):1490-99. doi: 10.1111/jgs.17121..
Keywords: Elderly, Medication, Primary Care, Clinical Decision Support (CDS), Shared Decision Making
Downs SM, Bauer NS, Saha C
Effect of a computer-based decision support intervention on autism spectrum disorder screening in pediatric primary care clinics: a cluster randomized clinical trial.
This study examined outcomes for implementation of a decision support system called CHICA (Child Health Improvement Through Computer Automation) to improve screening rates for autism in children aged 18 to 24 months. A random sample of 274 children in four urban clinics was used. Two clinics participated in the intervention, and two served as controls. Because participating clinics requested intervention be discontinued for children aged 18 months, only results for those aged 24 months was analyzed. Of the 263 children with reviewed results, 92% were enrolled in Medicaid, 52.5% were African American, and 36.5% were Hispanic. Screening rates increased from 0% at baseline to 100% in 24 months during the study period of November 2010 to November 2012. Screening results were positive for 265 of 980 children screened by CHICA in the time period, with 2 children from the intervention group positively diagnosed in the time frame of the study.
AHRQ-funded; HS018453.
Citation: Downs SM, Bauer NS, Saha C .
Effect of a computer-based decision support intervention on autism spectrum disorder screening in pediatric primary care clinics: a cluster randomized clinical trial.
JAMA Netw Open 2019 Dec 2;2(12):e1917676. doi: 10.1001/jamanetworkopen.2019.17676..
Keywords: Autism, Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Primary Care, Children/Adolescents, Screening
Etter DJ, McCord A, Ouyang F
Suicide screening in primary care: use of an electronic screener to assess suicidality and improve provider follow-up for adolescents.
The purpose of this study was to assess the feasibility of using an existing computer decision support system to screen adolescent patients for suicidality and provide follow-up guidance to clinicians in a primary care setting. The authors concluded that incorporating adolescent suicide screening and provider follow-up guidance into an existing computer decision support system in primary care was feasible and well utilized by providers.
AHRQ-funded; HS022681.
Citation: Etter DJ, McCord A, Ouyang F .
Suicide screening in primary care: use of an electronic screener to assess suicidality and improve provider follow-up for adolescents.
J Adolesc Health 2018 Feb;62(2):191-97. doi: 10.1016/j.jadohealth.2017.08.026..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Depression, Behavioral Health, Primary Care, Screening
Tannenbaum D, Doctor JN, Persell SD
Nudging physician prescription decisions by partitioning the order set: results of a vignette-based study.
The purpose of this study was to examine whether the grouping of menu items systematically affects prescribing practices among primary care providers. It found that provider treatment choice appears to be influenced by the grouping of menu options, suggesting that the layout of EHR order sets is not an arbitrary exercise.
AHRQ-funded; RC4 AG039115 (NIA/AHRQ).
Citation: Tannenbaum D, Doctor JN, Persell SD .
Nudging physician prescription decisions by partitioning the order set: results of a vignette-based study.
J Gen Intern Med 2015 Mar;30(3):298-304. doi: 10.1007/s11606-014-3051-2..
Keywords: Electronic Health Records (EHRs), Primary Care, Clinical Decision Support (CDS), Health Information Technology (HIT), Medication
Hendrix KS, Downs SM, Carroll AE
Pediatricians' responses to printed clinical reminders: does highlighting prompts improve responsiveness?
The authors tested whether selectively highlighting clinical decision support prompts in yellow would improve physicians' responsiveness. They found that highlighting reminder prompts did not increase physicians' responsiveness. They suggested possible explanations and offer alternative strategies to increasing physician responsiveness to prompts.
AHRQ-funded; HS020640; HS018453; HS017939.
Citation: Hendrix KS, Downs SM, Carroll AE .
Pediatricians' responses to printed clinical reminders: does highlighting prompts improve responsiveness?
Acad Pediatr 2015 Mar-Apr;15(2):158-64. doi: 10.1016/j.acap.2014.10.009.
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Keywords: Clinical Decision Support (CDS), Children/Adolescents, Primary Care, Practice Patterns, Quality Improvement
Carroll AE, Bauer NS, Dugan TM
Use of a computerized decision aid for developmental surveillance and screening: a randomized clinical trial.
A study to determine whether a computerized clinical decision support system is an effective approach to improve standardized developmental surveillance and screening (DSS) within primary care practices found that use of such a system significantly increased the number of children screened at 9, 18, and 30 months of age. It also increased the number of children who ultimately were diagnosed as having a developmental delay.
AHRQ-funded; HS017939
Citation: Carroll AE, Bauer NS, Dugan TM .
Use of a computerized decision aid for developmental surveillance and screening: a randomized clinical trial.
JAMA Pediatr. 2014 Sep;168(9):815-21. doi: 10.1001/jamapediatrics.2014.464..
Keywords: Health Information Technology (HIT), Clinical Decision Support (CDS), Primary Care, Children/Adolescents
Nagykaldi ZJ, Yeaman B, Jones M
HIE-i-health information exchange with intelligence.
This article reports on the development and pilot testing of an innovative approach to implement health information exchange with intelligence (HIE-i) in primary care settings. Records of 346 patients were studied in 6 primary care practices. The results suggest that coupling a geographically inclusive set of clinical data with HIE-based clinical decision support for prevention can considerably improve prospective care delivery.
AHRQ-funded; 290200710009I.
Citation: Nagykaldi ZJ, Yeaman B, Jones M .
HIE-i-health information exchange with intelligence.
J Ambul Care Manage 2014 Jan-Mar;37(1):20-31. doi: 10.1097/jac.0000000000000002..
Keywords: Clinical Decision Support (CDS), Health Information Exchange (HIE), Health Information Technology (HIT), Prevention, Primary Care
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care