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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
1 to 25 of 67 Research Studies DisplayedFranklin PD, Lewallen D, Bozic K
Implementation of patient-reported outcome measures in U.S. total joint replacement registries: rationale, status, and plans.
The authors report on the status of patient-reported outcomes (PRO) implementation as well as perceived barriers and facilitators of PRO use among five U.S. total joint replacement registries. They find that the current stage of implementation of patient-reported outcomes measures varies widely among U.S. registries.
AHRQ-funded; HS018910.
Citation: Franklin PD, Lewallen D, Bozic K .
Implementation of patient-reported outcome measures in U.S. total joint replacement registries: rationale, status, and plans.
J Bone Joint Surg Am 2014 Dec 17;96 Suppl 1:104-9. doi: 10.2106/jbjs.n.00328..
Keywords: Registries, Surgery, Comparative Effectiveness, Patient-Centered Outcomes Research
Concannon TW, Fuster M, Saunders T
A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research.
This study reviewed 70 articles on methods of stakeholder engagement in comparative effectiveness research and patient-centered outcomes research. The authors found frequent engagement with patients, modestly frequent engagement with clinicians, and infrequent engagement with other stakeholders.The roles and activities of stakeholders were highly variable across research and program reports.
AHRQ-funded; HS017726
Citation: Concannon TW, Fuster M, Saunders T .
A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research.
J Gen Intern Med. 2014 Dec;29(12):1692-701. doi: 10.1007/s11606-014-2878-x..
Keywords: Comparative Effectiveness, Clinician-Patient Communication, Shared Decision Making
Prentice JC, Conlin PR, Gellad WF
Capitalizing on prescribing pattern variation to compare medications for type 2 diabetes.
This study used observational quasi-experimental methods using instrumental variables (IVs) to compare the effect of two hypoglycemic medications, sulfonylureas (SUs) and thiazolidinediones (TZDs), on long-term outcomes. It found that individuals who used an SU as a second-line agent experienced significantly more adverse long-term health outcomes than did individuals who started on a TZD.
AHRQ-funded; HS019708.
Citation: Prentice JC, Conlin PR, Gellad WF .
Capitalizing on prescribing pattern variation to compare medications for type 2 diabetes.
Value Health 2014 Dec;17(8):854-62. doi: 10.1016/j.jval.2014.08.2674..
Keywords: Diabetes, Medication, Outcomes, Comparative Effectiveness
Chin DL, Wilson MH, Bang H
Comparing patient outcomes of academician-preceptors, hospitalist-preceptors, and hospitalists on internal medicine services in an academic medical center.
The aim of this study was to compare patient outcomes between hospitalist-preceptors and hospitalists working alone, and between hospitalist-preceptors and academician-preceptors. The researchers found that preceptor-led medicine services were associated with more readmissions within 30 days, shorter lengths of stay, and lower index admission-associated costs. However, they also found that when considering cumulative hospitalization costs, patients discharged by academician-preceptors incurred the highest cost and hospitalist-preceptors incurred the lowest cost.
AHRQ-funded; HS022236.
Citation: Chin DL, Wilson MH, Bang H .
Comparing patient outcomes of academician-preceptors, hospitalist-preceptors, and hospitalists on internal medicine services in an academic medical center.
J Gen Intern Med 2014 Dec;29(12):1672-8. doi: 10.1007/s11606-014-2982-y.
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Keywords: Comparative Effectiveness, Hospital Readmissions, Patient-Centered Outcomes Research, Teams
Boland MR, Rusanov A, So Y
From expert-derived user needs to user-perceived ease of use and usefulness: a two-phase mixed-methods evaluation framework.
This paper presents a two-phase evaluation framework involving usability experts (phase 1) and end-users (phase 2). In phase 1, a cross-system functionality alignment between expert-derived user needs and system functions was performed to inform the choice of ‘‘the best available’’ comparison system to enable a cognitive walkthrough in phase 1 and a comparative effectiveness evaluation in phase 2.
AHRQ-funded; HS019853.
Citation: Boland MR, Rusanov A, So Y .
From expert-derived user needs to user-perceived ease of use and usefulness: a two-phase mixed-methods evaluation framework.
J Biomed Inform 2014 Dec;52:141-50. doi: 10.1016/j.jbi.2013.12.004..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Research Methodologies
Curtis JR, Chen L, Bharat A
Linkage of a de-identified United States rheumatoid arthritis registry with administrative data to facilitate comparative effectiveness research.
In order to address a gap in linkage methodology, the researchers sought to link a large, de-identified outpatient registry of patients with rheumatoid arthritis with national Medicare administrative claims data. The purpose of their report was to describe the methods and validity of this linkage.
AHRQ-funded; HS018517
Citation: Curtis JR, Chen L, Bharat A .
Linkage of a de-identified United States rheumatoid arthritis registry with administrative data to facilitate comparative effectiveness research.
Arthritis Care Res. 2014 Dec;66(12):1790-8. doi: 10.1002/acr.22377..
Keywords: Arthritis, Registries, Comparative Effectiveness
Dulai PS, Siegel CA, Colombel JF
Systematic review: monotherapy with antitumour necrosis factor alpha agents versus combination therapy with an immunosuppressive for IBD.
The authors discussed the efficacy and the risks of anti-TNF monotherapy versus combination therapy with an immunosuppressive in patients with IBD. They concluded that the addition of an immunosuppressive to anti-TNF therapy improves treatment efficacy for infliximab in ulcerative colitis and Crohn’s disease. Further, the use of combination therapy appears to add no significant incremental risk for serious infections above that seen with anti-TNF or immunosuppressive monotherapy in most patients.
AHRQ-funded; HS021747.
Citation: Dulai PS, Siegel CA, Colombel JF .
Systematic review: monotherapy with antitumour necrosis factor alpha agents versus combination therapy with an immunosuppressive for IBD.
Gut 2014 Dec;63(12):1843-53. doi: 10.1136/gutjnl-2014-307126.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Medication, Outcomes, Patient-Centered Outcomes Research, Treatments
Banerjee T, Kim SJ, Astor B
Vascular access type, inflammatory markers, and mortality in incident hemodialysis patients: the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) study.
The researchers investigated the association between access type and inflammatory marker levels in 583 dialysis patients. They found that central venous catheters, compared with arteriovenous fistulas, are associated with a greater state of inflammation and the association of catheter use and mortality may be mediated by access-induced inflammation.
AHRQ-funded; HS008365
Citation: Banerjee T, Kim SJ, Astor B .
Vascular access type, inflammatory markers, and mortality in incident hemodialysis patients: the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) study.
Am J Kidney Dis. 2014 Dec;64(6):954-61. doi: 10.1053/j.ajkd.2014.07.010..
Keywords: Kidney Disease and Health, Mortality, Comparative Effectiveness
Crandall CJ, Newberry SJ, Diamant A
Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review.
This article updates a 2007 evidence review focusing on the comparative benefits and risks of short- and long-term pharmacologic treatments for low bone density. It concludes that good quality evidence supports that several medications for bone density in osteoporotic range and/or pre-existing hip or vertebral fracture reduce fracture risk.
AHRQ-funded; 290200710062I
Citation: Crandall CJ, Newberry SJ, Diamant A .
Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review.
Ann Intern Med. 2014 Nov 18;161(10):711-23. doi: 10.7326/M14-0317..
Keywords: Comparative Effectiveness, Medication, Injuries and Wounds
Bilchick KC, Stukenborg GJ
Comparative effectiveness of cardiac resynchronization therapy in combination with implantable defibrillator in patients with heart failure and wide QRS duration.
The researchers examined the long-term outcomes among Medicare patients with cardiac resynchronization therapy defibrillators (CRT-D) compared with those receiving standard implantable cardioverter defibrillators. They found that the greatest benefit of CRT-D was in patients with guideline-based class I recommendations for CRT-D. For these patients, there was a 17 percent reduction in risk of death.
AHRQ-funded; HS017693
Citation: Bilchick KC, Stukenborg GJ .
Comparative effectiveness of cardiac resynchronization therapy in combination with implantable defibrillator in patients with heart failure and wide QRS duration.
Am J Cardiol. 2014 Nov 15;114(10):1537-42. doi: 10.1016/j.amjcard.2014.08.017..
Keywords: Comparative Effectiveness, Medicare, Outcomes, Cardiovascular Conditions, Medical Devices
Viswanathan M, Carey TS, Belinson SE
AHRQ Author: Berliner E, Chang SM
A proposed approach may help systematic reviews retain needed expertise while minimizing bias from nonfinancial conflicts of interest.
The researchers sought to create practical guidance on ensuring adequate clinical or content expertise while maintaining independence of judgment on systematic review teams. They discussed their approach and concluded that the feasibility and utility of this approach to ensuring needed expertise on systematic reviews and minimizing bias from nonfinancial conflicts of interest must be investigated.
AHRQ-authored.
Citation: Viswanathan M, Carey TS, Belinson SE .
A proposed approach may help systematic reviews retain needed expertise while minimizing bias from nonfinancial conflicts of interest.
J Clin Epidemiol 2014 Nov;67(11):1229-38. doi: 10.1016/j.jclinepi.2014.02.023.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Research Methodologies
Khazanie P, Hammill BG, Qualls LG
Clinical effectiveness of cardiac resynchronization therapy versus medical therapy alone among patients with heart failure: analysis of the ICD Registry and ADHERE.
The researchers examined associations between cardiac resynchronization therapy with defibrillator (CRT-D) and mortality and readmission among patients with heart failure who received CRT-D in clinical practice, compared with those who received medical therapy alone. They found that CRT-D was associated with lower risks of mortality and readmission than medical therapy alone.
AHRQ-funded; HS021092
Citation: Khazanie P, Hammill BG, Qualls LG .
Clinical effectiveness of cardiac resynchronization therapy versus medical therapy alone among patients with heart failure: analysis of the ICD Registry and ADHERE.
Circ Heart Fail. 2014 Nov;7(6):926-34. doi: 10.1161/circheartfailure.113.000838..
Keywords: Comparative Effectiveness, Heart Disease and Health, Medical Devices, Hospital Readmissions, Outcomes
Jalbert JJ, Ritchey ME, Mi X
Methodological considerations in observational comparative effectiveness research for implantable medical devices: an epidemiologic perspective.
This article discusses some of the most salient issues encountered in conducting comparative effectiveness research on implantable devices. Included in this discussion are special methodological considerations regarding the use of data sources, exposure and outcome definitions, timing of exposure, and sources of bias.
AHRQ-funded; 29020050016; HS017731
Citation: Jalbert JJ, Ritchey ME, Mi X .
Methodological considerations in observational comparative effectiveness research for implantable medical devices: an epidemiologic perspective.
Am J Epidemiol. 2014 Nov 1;180(9):949-58. doi: 10.1093/aje/kwu206..
Keywords: Comparative Effectiveness, Research Methodologies, Data
Baddley JW, Winthrop KL, Chen L
Non-viral opportunistic infections in new users of tumour necrosis factor inhibitor therapy: results of the SAfety Assessment of Biologic ThERapy (SABER) study.
The purpose of this paper was to determine, among patients with autoimmune diseases in the USA, whether the risk of non-viral opportunistic infections (OI) was increased among new users of tumour necrosis factor alpha inhibitors (TNFI), when compared to users of non-biological agents used for active disease. The investigators concluded that in the USA, the rate of non-viral OI was higher among new users of TNFI with autoimmune diseases compared to non-biological disease-modifying antirheumatic drugs users.
AHRQ-funded; HS017552; HS018517; HS017919.
Citation: Baddley JW, Winthrop KL, Chen L .
Non-viral opportunistic infections in new users of tumour necrosis factor inhibitor therapy: results of the SAfety Assessment of Biologic ThERapy (SABER) study.
Ann Rheum Dis 2014 Nov;73(11):1942-8. doi: 10.1136/annrheumdis-2013-203407..
Keywords: Arthritis, Comparative Effectiveness, Medication, Patient Safety
Spangler EL, Goodney PP, Schanzer A
Outcomes of carotid endarterectomy versus stenting in comparable medical risk patients.
The purpose of this study was to compare risk-stratified outcomes of carotid artery stenting (CAS) and carotid endarterectomy (CEA). Included in the study group were 11,336 patients who underwent isolated primary CEA and 544 who underwent primary CAS. The researchers found that asymptomatic normal- and high-risk patients do equally well after CEA or CAS. However, normal- and high-risk symptomatic patients have substantially worse outcomes with CAS compared with CEA.
AHRQ-funded; HS021581.
Citation: Spangler EL, Goodney PP, Schanzer A .
Outcomes of carotid endarterectomy versus stenting in comparable medical risk patients.
J Vasc Surg 2014 Nov;60(5):1227-31, 31.e1. doi: 10.1016/j.jvs.2014.05.044..
Keywords: Outcomes, Comparative Effectiveness, Risk, Cardiovascular Conditions, Heart Disease and Health
Blanco C, Okuda M, Wang S
Testing the drug substitution switching-addictions hypothesis. A prospective study in a nationally representative sample.
The researchers tested whether remission from a substance use disorder (SUD) would increase the probability of new onset of an SUD. In a national sample of 34,653 adults, they found that contrary to a common clinical perception, remission from an SUD decreases rather than increases the risk of onset of another SUD.
AHRQ-funded; HS021112
Citation: Blanco C, Okuda M, Wang S .
Testing the drug substitution switching-addictions hypothesis. A prospective study in a nationally representative sample.
JAMA Psychiatry. 2014 Nov;71(11):1246-53. doi: 10.1001/jamapsychiatry.2014.1206..
Keywords: Comparative Effectiveness, Substance Abuse, Behavioral Health
Curtis JR, Zhang J, Xie F
Use of oral and subcutaneous methotrexate in rheumatoid arthritis patients in the United States.
The researchers aimed to examine the epidemiology of methotrexate (MTX) use among rheumatoid arthritis patients initiating MTX, including dosing, method of administration (oral versus subcutaneous (SC)) , and persistence. They also compare the effectiveness of 2 strategies in regard to delaying or avoiding use of biologic agents: switching to SC MTX or adding another nonbiologic disease-modifying antirheumatic drug.
AHRQ-funded; HS018517
Citation: Curtis JR, Zhang J, Xie F .
Use of oral and subcutaneous methotrexate in rheumatoid arthritis patients in the United States.
Arthritis Care Res. 2014 Nov;66(11):1604-11. doi: 10.1002/acr.22383..
Keywords: Arthritis, Comparative Effectiveness, Medication
Goode AP, Shi XA, Gracely RH
Associations between pressure-pain threshold, symptoms, and radiographic knee and hip osteoarthritis.
The researchers sought to determine the association between generalized evoked pressure pain sensitivity with distal pressure–pain threshold and the presence, severity, or number of involved knee/hip joints with radiographic osteoarthritis or related symptoms. They found that as a participant’s sensitivity for pressure pain decreased, there were several significant associations with presence, severity, and number of joints with symptoms, regardless of the knee or hip joint.
AHRQ-funded; HS019479
Citation: Goode AP, Shi XA, Gracely RH .
Associations between pressure-pain threshold, symptoms, and radiographic knee and hip osteoarthritis.
Arthritis Care Res. 2014 Oct;66(10):1513-9. doi: 10.1002/acr.22321.
Keywords: Arthritis, Pain, Comparative Effectiveness
Ramnath VR, Khazeni N
Centralized monitoring and virtual consultant models of tele-ICU care: a side-by-side review.
This side-by-side review directly compares the Centralized Monitoring and Virtual Consultant tele-ICU Models. The Centralized Monitoring tele-ICU Model showed improved mortality and/or length of stay and staff acceptance, particularly in rural or specific patient populations, but with high costs and unclear savings. The Virtual Consultant Model could not be adequately evaluated for effects on clinical outcomes or staff acceptance given minimal data; however, it can be both portable and implemented at a lower cost profile. Improved compliance with clinical practice guidelines was seen in both models. Further study is recommended.
AHRQ-funded; HS019816.
Citation: Ramnath VR, Khazeni N .
Centralized monitoring and virtual consultant models of tele-ICU care: a side-by-side review.
Telemed J E Health 2014 Oct;20(10):962-71. doi: 10.1089/tmj.2014.0024.
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Keywords: Critical Care, Comparative Effectiveness, Quality of Care, Intensive Care Unit (ICU), Telehealth
Ramnath VR, Ho L, Maggio LA
Centralized monitoring and virtual consultant models of tele-ICU care: a systematic review.
This systematic literature review compares the Centralized Monitoring and Virtual Consultant tele-ICU Models. Compared with the Virtual Consultant tele-ICU Model, studies addressing the Centralized Monitoring Model of tele-ICU care were greater in quantity and sample size, with qualitative conclusions of clinical outcomes, staff satisfaction and workload, and financial sustainability largely consistent with past systematic reviews.
AHRQ-funded; HS019816.
Citation: Ramnath VR, Ho L, Maggio LA .
Centralized monitoring and virtual consultant models of tele-ICU care: a systematic review.
Telemed J E Health 2014 Oct;20(10):936-61. doi: 10.1089/tmj.2013.0352.
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Keywords: Critical Care, Comparative Effectiveness, Quality of Care, Intensive Care Unit (ICU), Telehealth
Lairson DR, Parikh RC, Cormier JN
Cost-utility analysis of chemotherapy regimens in elderly patients with stage III colon cancer.
The authors investigated community-level evidence on the effectiveness and cost effectiveness of treatment for stage III colon cancer for elderly patients among those receiving no chemotherapy, 5-fluorouracil (5-FU), and FOLFOX (5-FU + oxaliplatin). They concluded that FOLFOX appears more effective and cost effective than other strategies for colon cancer treatment of older patients, with results being sensitive to age.
AHRQ-funded; HS018956.
Citation: Lairson DR, Parikh RC, Cormier JN .
Cost-utility analysis of chemotherapy regimens in elderly patients with stage III colon cancer.
Pharmacoeconomics 2014 Oct;32(10):1005-13. doi: 10.1007/s40273-014-0180-8.
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Keywords: Cancer: Colorectal Cancer, Comparative Effectiveness, Healthcare Costs, Elderly, Patient-Centered Outcomes Research
Septimus EJ, Hayden MK, Kleinman K
Does chlorhexidine bathing in adult intensive care units reduce blood culture contamination? A pragmatic cluster-randomized trial.
The investigators determined rates of blood culture contamination comparing 3 strategies to prevent intensive care unit (ICU) infections: screening and isolation, targeted decolonization, and universal decolonization. They demonstrated that universal decolonization with mupirocin and chlorhexidine bathing resulted in a significant reduction in blood culture contamination.
AHRQ-funded; 290201000008I; 290032007T.
Citation: Septimus EJ, Hayden MK, Kleinman K .
Does chlorhexidine bathing in adult intensive care units reduce blood culture contamination? A pragmatic cluster-randomized trial.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S17-22. doi: 10.1086/677822.
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Keywords: Comparative Effectiveness, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA), Sepsis
Cook EA, Schneider KM, Robinson J
Field methods in medical record abstraction: assessing the properties of comparative effectiveness estimates.
Comparative effectiveness studies using Medicare claims data are vulnerable to treatment selection biases and supplemental data from a sample of patients has been recommended for examining the magnitude of this bias. The investigators collected medical record data from a subsample of patients to assess the validity of assumptions and to aid in the interpretation of our estimates. In this paper, they sought to describe and document the process used to collect and validate this supplemental information.
AHRQ-funded; HS018381.
Citation: Cook EA, Schneider KM, Robinson J .
Field methods in medical record abstraction: assessing the properties of comparative effectiveness estimates.
BMC Health Serv Res 2014 Sep 15;14:391. doi: 10.1186/1472-6963-14-391..
Keywords: Comparative Effectiveness, Medicare, Evidence-Based Practice, Research Methodologies
Parmar AD, Coutin MD, Vargas GM
Cost-effectiveness of elective laparoscopic cholecystectomy versus observation in older patients presenting with mild biliary disease.
The objective was to determine the threshold for probability of recurrent symptoms at which elective cholecystectomy became the most effective and cost-effective options for older patients with mild biliary disease. This procedure was more effective than observation when the probability of continued symptoms exceeded 45.3 percent; when the probability exceeded 82.7 percent, the procedure became more cost-effective as well.
AHRQ-funded; HS022134
Citation: Parmar AD, Coutin MD, Vargas GM .
Cost-effectiveness of elective laparoscopic cholecystectomy versus observation in older patients presenting with mild biliary disease.
J Gastrointest Surg. 2014 Sep;18(9):1616-22. doi: 10.1007/s11605-014-2570-9..
Keywords: Comparative Effectiveness, Healthcare Costs, Elderly, Surgery
Dood RL, Gracia CR, Sammel MD
Endometrial cancer after endometrial ablation vs medical management of abnormal uterine bleeding.
The authors investigated whether endometrial ablation is associated with increased risk or delayed diagnosis of endometrial cancer compared with medical management of abnormal uterine bleeding. They observed no difference in endometrial cancer rates, nor was there a delay in diagnosis when comparing endometrial ablation vs medical management.
AHRQ-funded; HS021336.
Citation: Dood RL, Gracia CR, Sammel MD .
Endometrial cancer after endometrial ablation vs medical management of abnormal uterine bleeding.
J Minim Invasive Gynecol 2014 Sep-Oct;21(5):744-52. doi: 10.1016/j.jmig.2014.02.012.
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Keywords: Cancer, Comparative Effectiveness, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Women