National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Access to Care (2)
- Adverse Events (1)
- Cardiovascular Conditions (1)
- Comparative Effectiveness (2)
- Diagnostic Safety and Quality (2)
- Disabilities (1)
- Disparities (2)
- Emergency Department (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Hospitalization (1)
- Imaging (1)
- Medicare (1)
- Medication (1)
- Medication: Safety (1)
- Mortality (1)
- Outcomes (3)
- Patient-Centered Outcomes Research (2)
- Patient Safety (1)
- Racial and Ethnic Minorities (2)
- Rehabilitation (1)
- Risk (3)
- Sex Factors (1)
- Shared Decision Making (1)
- Sleep Problems (1)
- Social Determinants of Health (2)
- (-) Stroke (13)
- Women (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 DisplayedMullen MT, Wiebe DJ, Bowman A
Disparities in accessibility of certified primary stroke centers.
These authors examined the proportion of the U.S. population with less than 60-minute access to Primary Stroke Centers (PSCs). They found significant geographic disparities in access to the PSCs. Stroke belt States have a higher burden of stroke and more limited access to PSCs.
AHRQ-funded; HS013852; HS017960; HS010914
Citation: Mullen MT, Wiebe DJ, Bowman A .
Disparities in accessibility of certified primary stroke centers.
Stroke. 2014 Nov;45(11):3381-8. doi: 10.1161/strokeaha.114.006021..
Keywords: Stroke, Access to Care, Disparities
Adeoye O, Albright KC, Carr BG
Geographic access to acute stroke care in the United States.
In this article the authors describe access of the US population to all facilities that actually provide intravenous recombinant tissue-type plasminogen activator (r-tPA) or endovascular therapy for acute ischemic stroke. The investigators concluded that more than half of the US population has geographic access to hospitals that actually deliver acute stroke care but treatment rates remain low.
AHRQ-funded; HS013852.
Citation: Adeoye O, Albright KC, Carr BG .
Geographic access to acute stroke care in the United States.
Stroke 2014 Oct;45(10):3019-24. doi: 10.1161/strokeaha.114.006293.
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Keywords: Access to Care, Stroke
Boehme AK, Rawal PV, Lyerly MJ
Investigating the utility of previously developed prediction scores in acute ischemic stroke patients in the stroke belt.
The researchers compared several scoring systems among patients receiving systemic and endovascular treatments. They concluded that their study demonstrated that although highly predictive of outcome in the original study design treatment groups, prediction scores may not generalize to all patient samples, highlighting the importance of validating prediction scores in diverse samples.
AHRQ-funded; HS013852.
Citation: Boehme AK, Rawal PV, Lyerly MJ .
Investigating the utility of previously developed prediction scores in acute ischemic stroke patients in the stroke belt.
J Stroke Cerebrovasc Dis 2014 Sep;23(8):2001-6. doi: 10.1016/j.jstrokecerebrovasdis.2014.02.003.
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Keywords: Shared Decision Making, Diagnostic Safety and Quality, Risk, Stroke
Petrov ME, Howard VJ, Kleindorfer D
Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.
The authors investigated the relation between sleep medication use and incident stroke. At the sleep assessment, 9.6% of the participants used prescription sleep medication and 11.1% used over-the-counter sleep aids. Over an average follow-up of 3.3 ± 1.0 years, 297 stroke events occurred. The authors found that over-the-counter sleep medication use was associated with increased risk of incident stroke; however, there was no significant association with prescription sleep medications. They concluded that over-the-counter sleep medication use may independently increase the risk of stroke beyond other risk factors in middle-aged to older individuals with no history of stroke.
AHRQ-funded; HS013852.
Citation: Petrov ME, Howard VJ, Kleindorfer D .
Over-the-counter and prescription sleep medication and incident stroke: the REasons for Geographic and Racial Differences in Stroke study.
J Stroke Cerebrovasc Dis 2014 Sep;23(8):2110-6. doi: 10.1016/j.jstrokecerebrovasdis.2014.03.025.
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Keywords: Medication: Safety, Medication, Risk, Sleep Problems, Stroke, Cardiovascular Conditions, Racial and Ethnic Minorities
Lyerly MJ, Houston JT, Boehme AK
Safety of intravenous tissue plasminogen activator administration with computed tomography evidence of prior infarction.
The researchers sought to determine if the presence of a previous stroke on pretreatment computed tomography (CT) is a predictor of hemorrhagic complications and functional outcomes after the administration of intravenous (IV) tissue plasminogen activator (tPA). Their data suggest that a prior stroke on CT should not be viewed as a reason to withhold this treatment unless it occurred within the last 3 months.
AHRQ-funded; HS013852.
Citation: Lyerly MJ, Houston JT, Boehme AK .
Safety of intravenous tissue plasminogen activator administration with computed tomography evidence of prior infarction.
J Stroke Cerebrovasc Dis 2014 Jul;23(6):1657-61. doi: 10.1016/j.jstrokecerebrovasdis.2014.01.011..
Keywords: Stroke, Risk, Outcomes, Imaging
Kumamaru H, Judd SE, Curtis JR
Validity of claims-based stroke algorithms in contemporary Medicare data: reasons for geographic and racial differences in stroke (REGARDS) study linked with medicare claims.
The researchers assessed the validity of diagnostic coding algorithms for identifying stroke in the Medicare population by linking data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study to Medicare claims. They found that claims-based algorithms to identify stroke in a contemporary Medicare cohort had high positive predictive value and specificity, supporting their use as outcomes for etiologic and comparative effectiveness studies in similar populations.
AHRQ-funded; HS017731; HS018517.
Citation: Kumamaru H, Judd SE, Curtis JR .
Validity of claims-based stroke algorithms in contemporary Medicare data: reasons for geographic and racial differences in stroke (REGARDS) study linked with medicare claims.
Circ Cardiovasc Qual Outcomes 2014 Jul;7(4):611-9. doi: 10.1161/circoutcomes.113.000743..
Keywords: Stroke, Medicare, Comparative Effectiveness, Outcomes
Newman-Toker DE, Moy E, Valente E
AHRQ Author: Moy E
Missed diagnosis of stroke in the emergency department: a cross-sectional analysis of a large population-based sample.
The authors sought to estimate the frequency of missed stroke and examine associations with patient, emergency department (ED), and hospital characteristics. They estimated 15,000-165,000 misdiagnosed cerebrovascular events annually in US EDs, disproportionately presenting with headache or dizziness. They recommended that physicians evaluating these symptoms be particularly attuned to the possibility of stroke in younger, female, and non-White patients.
AHRQ-authored; AHRQ-funded; HS019252.
Citation: Newman-Toker DE, Moy E, Valente E .
Missed diagnosis of stroke in the emergency department: a cross-sectional analysis of a large population-based sample.
Diagnosis 2014 Jun;1(2):155-66. doi: 10.1515/dx-2013-0038.
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Keywords: Diagnostic Safety and Quality, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Patient Safety, Stroke
Bates BE, Xie D, Kwong PL
One-year all-cause mortality after stroke: a prediction model.
Using data from Department of Veterans Affairs (VA) national databases, the researchers present and internally validate a 1-year all-cause mortality prediction index after hospitalization for acute stroke. They conclude that a simple index using readily available data that stratifies stroke patients at the time of discharge according to low, moderate, high, and highest likelihood of all-cause 1-year mortality is feasible.
AHRQ-funded; HS018540.
Citation: Bates BE, Xie D, Kwong PL .
One-year all-cause mortality after stroke: a prediction model.
PM R 2014 Jun;6(6):473-83. doi: 10.1016/j.pmrj.2013.11.006..
Keywords: Stroke, Mortality, Hospitalization
Boehme AK, Kapoor N, Albright KC
Predictors of systemic inflammatory response syndrome in ischemic stroke undergoing systemic thrombolysis with intravenous tissue plasminogen activator.
This study investigated predictors of systemic inflammatory response syndrome (SIRS) in acute ischemic stroke (AIS) patients treated with intravenous (IV) tissue plasminogen activator (tPA). The investigators indicated that in their sample of IV tPA-treated AIS patients, clinical and laboratory characteristics available on presentation were able to identify patients likely to develop SIRS during their acute hospitalization.
AHRQ-funded; HS013852.
Citation: Boehme AK, Kapoor N, Albright KC .
Predictors of systemic inflammatory response syndrome in ischemic stroke undergoing systemic thrombolysis with intravenous tissue plasminogen activator.
J Stroke Cerebrovasc Dis 2014 Apr;23(4):e271-6. doi: 10.1016/j.jstrokecerebrovasdis.2013.11.022..
Keywords: Adverse Events, Stroke
Boehme AK, Siegler JE, Mullen MT
Racial and gender differences in stroke severity, outcomes, and treatment in patients with acute ischemic stroke.
This study sought to determine the association of race and gender on initial stroke severity, thrombolysis, and functional outcome after acute ischemic stroke (AIS). The investigators concluded that race and gender were not significantly associated with short-term outcome, although black women were significantly less likely to be treated with tissue plasminogen activator (tPA). Black women had more tPA exclusions than any other group. The primary reason for tPA exclusion in this study was not arriving within 3 hours of stroke symptom onset.
AHRQ-funded; HS013852.
Citation: Boehme AK, Siegler JE, Mullen MT .
Racial and gender differences in stroke severity, outcomes, and treatment in patients with acute ischemic stroke.
J Stroke Cerebrovasc Dis 2014 Apr;23(4):e255-61. doi: 10.1016/j.jstrokecerebrovasdis.2013.11.003..
Keywords: Racial and Ethnic Minorities, Outcomes, Sex Factors, Stroke
Bettger JP, Zhao X, Bushnell C
The association between socioeconomic status and disability after stroke: findings from the Adherence eValuation After Ischemic stroke Longitudinal (AVAIL) registry.
The authors examined the association of three indicators of SES--educational attainment, working status, and perceived adequacy of household income--with disability 3-months following an acute ischemic stroke. They found that 58% of the Adherence eValuation After Ischemic stroke--Longitudinal study patients had a high school or less education, 61% were not working, and 27% perceived their household income as inadequate prior to their stroke. Thirty five percent of patients were disabled at 3-months. They concluded that, in this cohort of stroke survivors, socioeconomic status was associated with disability following acute ischemic stroke.
AHRQ-funded; HS019479; HS016964.
Citation: Bettger JP, Zhao X, Bushnell C .
The association between socioeconomic status and disability after stroke: findings from the Adherence eValuation After Ischemic stroke Longitudinal (AVAIL) registry.
BMC Public Health 2014 Mar 26;14:281. doi: 10.1186/1471-2458-14-281.
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Keywords: Disabilities, Patient-Centered Outcomes Research, Social Determinants of Health, Stroke
Bushnell CD, Reeves MJ, Zhao X
Sex differences in quality of life after ischemic stroke.
This study compared quality of life (QOL) in men and women at 3 and 12 months after stroke, and the change in QOL over time between men and women. It found that women have worse QOL than men up to 12 months after stroke, even after adjusting for important sociodemographic variables and stroke severity.
AHRQ-funded; HS016964.
Citation: Bushnell CD, Reeves MJ, Zhao X .
Sex differences in quality of life after ischemic stroke.
Neurology 2014 Mar 18;82(11):922-31. doi: 10.1212/wnl.0000000000000208..
Keywords: Stroke, Disparities, Women, Social Determinants of Health
Stineman MG, Xie D, Kurichi JE
Comprehensive versus consultative rehabilitation services postacute stroke: outcomes differ.
The researchers compared outcomes of veteran patients provided with comprehensive rehabilitation with those provided with consultative rehabilitation services after acute stroke using propensity scores. They found that comprehensive rehabilitation services are associated with greater recovery of physical and cognitive independence, improved home discharge likelihood, and improved 1 yr. survival.
AHRQ-funded; HS018540.
Citation: Stineman MG, Xie D, Kurichi JE .
Comprehensive versus consultative rehabilitation services postacute stroke: outcomes differ.
J Rehabil Res Dev 2014;51(7):1143-54. doi: 10.1682/jrrd.2014.03.0084..
Keywords: Comparative Effectiveness, Rehabilitation, Stroke, Patient-Centered Outcomes Research