National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (3)
- Adverse Drug Events (ADE) (16)
- Adverse Events (38)
- Ambulatory Care and Surgery (3)
- Antibiotics (1)
- Arthritis (3)
- Behavioral Health (4)
- Blood Clots (2)
- Blood Pressure (6)
- Blood Thinners (26)
- Cancer (5)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cancer: Skin Cancer (1)
- Cardiovascular Conditions (319)
- Care Coordination (1)
- Caregiving (3)
- Care Management (6)
- Case Study (3)
- Centers for Education and Research on Therapeutics (CERTs) (1)
- Children/Adolescents (13)
- Chronic Conditions (26)
- Clinical Decision Support (CDS) (7)
- Clinician-Patient Communication (2)
- Colonoscopy (1)
- Communication (6)
- Community-Acquired Infections (1)
- Community-Based Practice (1)
- Comparative Effectiveness (27)
- Complementary and Alternative Medicine (2)
- COVID-19 (2)
- Critical Care (2)
- Data (6)
- Dementia (2)
- Depression (8)
- Diabetes (12)
- Diagnostic Safety and Quality (19)
- Dialysis (2)
- Disparities (14)
- Education: Academic (2)
- Education: Continuing Medical Education (1)
- Education: Curriculum (2)
- Education: Patient and Caregiver (2)
- Elderly (50)
- Electronic Health Records (EHRs) (13)
- Emergency Department (11)
- Emergency Medical Services (EMS) (4)
- Evidence-Based Practice (59)
- Eye Disease and Health (1)
- Family Health and History (2)
- Guidelines (16)
- Healthcare-Associated Infections (HAIs) (6)
- Healthcare Cost and Utilization Project (HCUP) (14)
- Healthcare Costs (14)
- Healthcare Delivery (10)
- Healthcare Utilization (14)
- Health Information Technology (HIT) (26)
- Health Insurance (2)
- Health Literacy (3)
- Health Promotion (1)
- Health Services Research (HSR) (1)
- Health Status (7)
- (-) Heart Disease and Health (452)
- Home Healthcare (7)
- Hospital Discharge (11)
- Hospitalization (45)
- Hospital Readmissions (31)
- Hospitals (21)
- Human Immunodeficiency Virus (HIV) (6)
- Imaging (7)
- Implementation (7)
- Injuries and Wounds (3)
- Inpatient Care (6)
- Intensive Care Unit (ICU) (7)
- Kidney Disease and Health (17)
- Labor and Delivery (1)
- Lifestyle Changes (6)
- Long-Term Care (1)
- Low-Income (2)
- Maternal Care (1)
- Medicaid (3)
- Medical Devices (36)
- Medical Errors (1)
- Medical Expenditure Panel Survey (MEPS) (2)
- Medicare (41)
- Medication (86)
- Medication: Safety (2)
- Men's Health (2)
- Mortality (45)
- Neurological Disorders (3)
- Newborns/Infants (4)
- Nursing Homes (11)
- Nutrition (5)
- Obesity (3)
- Obesity: Weight Management (3)
- Outcomes (66)
- Pain (1)
- Palliative Care (11)
- Patient-Centered Healthcare (12)
- Patient-Centered Outcomes Research (85)
- Patient Adherence/Compliance (18)
- Patient and Family Engagement (3)
- Patient Safety (21)
- Patient Self-Management (6)
- Payment (5)
- Pneumonia (6)
- Policy (2)
- Practice Improvement (3)
- Practice Patterns (16)
- Pregnancy (1)
- Prevention (27)
- Primary Care (20)
- Primary Care: Models of Care (5)
- Provider (1)
- Provider: Clinician (2)
- Provider: Health Personnel (1)
- Provider: Physician (1)
- Provider Performance (8)
- Public Health (1)
- Public Reporting (2)
- Quality Improvement (24)
- Quality Indicators (QIs) (3)
- Quality Measures (3)
- Quality of Care (27)
- Quality of Life (11)
- Racial and Ethnic Minorities (22)
- Registries (33)
- Rehabilitation (7)
- Research Methodologies (5)
- Respiratory Conditions (11)
- Risk (73)
- Rural Health (4)
- Screening (7)
- Sepsis (1)
- Sex Factors (15)
- Sexual Health (2)
- Shared Decision Making (18)
- Simulation (2)
- Sleep Problems (2)
- Social Determinants of Health (8)
- Social Media (1)
- Stress (1)
- Stroke (20)
- Surgery (50)
- Teams (3)
- Telehealth (12)
- Tobacco Use (2)
- Tobacco Use: Smoking Cessation (1)
- Training (2)
- Transitions of Care (5)
- Transplantation (4)
- Treatments (3)
- U.S. Preventive Services Task Force (USPSTF) (8)
- Uninsured (1)
- Urban Health (2)
- Women (5)
- Young Adults (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
51 to 75 of 452 Research Studies DisplayedShore S, Pienta MJ, Watt TMF
Non-patient factors associated with infections in LVAD recipients: a scoping review.
Infections are the most common complication in recipients of durable left ventricular assist devices (LVAD) and are associated with increased morbidity, mortality, and expenditures. The existing literature examining factors associated with infection in LVAD recipients is limited and principally comprises single-center studies. This scoping review synthesized all available evidence related to identifying modifiable, non-patient factors associated with infections among LVAD recipients.
AHRQ-funded; HS026003.
Citation: Shore S, Pienta MJ, Watt TMF .
Non-patient factors associated with infections in LVAD recipients: a scoping review.
J Heart Lung Transplant 2022 Jan;41(1):1-16. doi: 10.1016/j.healun.2021.10.006..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Surgery, Medical Devices
Villa-Zapata L, Carhart BS, Horn JR
Serum potassium changes due to concomitant ACEI/ARB and spironolactone therapy: a systematic review and meta-analysis.
The purpose of this study was to provide evidence of serum potassium changes in individuals taking angiotensin-converting enzyme inhibitors (ACEIs) and/or angiotensin receptor blockers (ARBs) concomitantly with spironolactone compared to ACEI/ARB therapy alone. The investigators concluded that treatment with spironolactone in combination with ACEI/ARB therapy increases the mean serum potassium concentration by less than 0.20 mEq/L compared to ACEI/ARB therapy alone.
AHRQ-funded; HS025984.
Citation: Villa-Zapata L, Carhart BS, Horn JR .
Serum potassium changes due to concomitant ACEI/ARB and spironolactone therapy: a systematic review and meta-analysis.
Am J Health Syst Pharm 2021 Dec 9;78(24):2245-55. doi: 10.1093/ajhp/zxab215..
Keywords: Medication, Comparative Effectiveness, Heart Disease and Health, Cardiovascular Conditions
Williams D, Stout MJ, Rosenbloom JI
Preeclampsia predicts risk of hospitalization for heart failure with preserved ejection fraction.
Preeclampsia is associated with increased risk of future heart failure (HF), but the relationship between preeclampsia and HF subtypes are not well-established. The objective of this analysis was to identify the risk of HF with preserved ejection fraction (HFpEF) following a delivery complicated by preeclampsia/eclampsia. The investigators concluded that preeclampsia/eclampsia was an independent risk factor for future hospitalizations for HFpEF.
AHRQ-funded; HS019455.
Citation: Williams D, Stout MJ, Rosenbloom JI .
Preeclampsia predicts risk of hospitalization for heart failure with preserved ejection fraction.
J Am Coll Cardiol 2021 Dec 7;78(23):2281-90. doi: 10.1016/j.jacc.2021.09.1360..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Risk, Labor and Delivery, Pregnancy, Women
Ejem D, Steinhauser K, Dionne-Odom JN
Exploring culturally responsive religious and spirituality health care communications among African Americans with advanced heart failure, their family caregivers, and clinicians.
This study explored how religion and spirituality (R/S) impacts the ways that African Americans (AAs) cope with serious illness. In particular, this study looks at AAs with advanced heart failure and their family caregivers’ (FCGs) preferences about R/S in patient-clinician communication. Transcribed interviews were analyzed to identify emergent themes. AA patient participants (n = 15) were a mean age of 62, 40% female, and 87% had >high school diploma/GED. AA FCGs (n = 14) were a mean age of 58, 93% female, 93% had >high school diploma/GED, and 86% were unemployed. Most caregivers were patients’ spouses/partners. All participants were Protestants. Patients and FCGs perspectives differed in relation to inclusion of R/S in health care communication. Patients felt that R/S should not be discussed in clinical encounters and discussed only if patient initiated. FCGs felt that clinicians’ R/S communication is not a priority, but clinicians should openly acknowledge patients’ R/S beliefs and should engage in R/S conversations with patients.
AHRQ-funded; HS013852.
Citation: Ejem D, Steinhauser K, Dionne-Odom JN .
Exploring culturally responsive religious and spirituality health care communications among African Americans with advanced heart failure, their family caregivers, and clinicians.
J Palliat Med 2021 Dec;24(12):1798-806. doi: 10.1089/jpm.2021.0044..
Keywords: Racial and Ethnic Minorities, Communication, Heart Disease and Health, Cardiovascular Conditions, Caregiving
Pienta M, Shore S, Pagani FD
Rates and types of infections in left ventricular assist device recipients: a scoping review.
This scoping review examined rates and types of infections in left ventricular assist device (LVAD) recipients. A comprehensive literature search was done from January 2006 to February 2019. After screening 9680 titles and abstracts, 132 full text articles were included for data extraction. The most commonly studied LVAD-specific infections were driveline infections followed by pocket and pump or cannula infections. Driveline infection rates ranged from 5-56% within the first 6 months, 7-71% after the first year, and 7-65% at 2 years. Bloodstream infections were the most commonly studied LVAD-related infections with rates in the first month ranging from 2.6% to 10%, 13-20% within the first 6 months of implant, and 3-27% within 1 year of implant. Pocket infection incidence was reported in 20 studies with fairly low rates for all time periods. The authors found a substantial proportion of studies did not report according to Strengthening the Reporting of Observation Studies in Epidemiology guidelines, including demographic information of follow-up time. They also did not adhere to minimum reporting criteria and did not use standardized definitions of infections. This has implications for future investigations.
AHRQ-funded; HS026003.
Citation: Pienta M, Shore S, Pagani FD .
Rates and types of infections in left ventricular assist device recipients: a scoping review.
JTCVS Open 2021 Dec;8:405-11. doi: 10.1016/j.xjon.2021.08.005..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Healthcare-Associated Infections (HAIs)
Czosek RJ, Anderson JB, Baskar S
Predictors and outcomes of heart block during surgical stage I palliation of patients with a single ventricle: a report from the NPC-QIC.
This study investigated patient and surgical risks of heart block and its effect on 12-month transplant-free survival in children with a single ventricle. In total, 1423 patients were identified from the National Pediatric Cardiology Improvement Collaborative with and without heart block. One-year outcomes were analyzed. A very small percentage (2%) developed heart block during their surgical admission. Associated risk factors for block included heterotaxy syndrome and atrial flutter/fibrillation. Patients with complete heart block had lower 12-month survival, which wasn’t true for patients with second degree block. At 12 months of age, 43% of patients with heart block died and were more likely to experience mortality than patients without heart block.
AHRQ-funded; HS021114.
Citation: Czosek RJ, Anderson JB, Baskar S .
Predictors and outcomes of heart block during surgical stage I palliation of patients with a single ventricle: a report from the NPC-QIC.
Heart Rhythm 2021 Nov;18(11):1876-83. doi: 10.1016/j.hrthm.2021.05.019..
Keywords: Children/Adolescents, Heart Disease and Health, Cardiovascular Conditions, Surgery, Palliative Care, Risk, Outcomes
Thomson MC, Allen LA, Halpern SD
Framing benefits in decision aids: effects of varying contextualizing statements on decisions about sacubitril-valsartan for heart failure.
The purpose of this study was to further understand benefit framing by testing the impact of a variety of contextualizing statements within a decision aid for the heart failure medication sacubitril-valsartan. Study participants received one of six versions of a decision aid for sacubitril-valsartan. The only factor that differed between the versions was a contextualizing statement. The participants were surveyed regarding their likelihood of taking sacubitril-valsartan at a cost of $50 per month and their perception of the benefit of the drug. The study found that 54% of the 1,873 participants were willing to take the medication at the cost of $50 per month. The researchers compared each of the 5 contextualizing statements with the baseline version; there were no significant differences in the participants’ reported likelihood of taking the medication. Higher income level, higher self-reported health status, and younger age were related with greater likelihood of taking sacubitril-valsartan. The researchers concluded that decision making was not affected by contextualizing statements tested within the decision aid.
AHRQ-funded; HS026081.
Citation: Thomson MC, Allen LA, Halpern SD .
Framing benefits in decision aids: effects of varying contextualizing statements on decisions about sacubitril-valsartan for heart failure.
MDM Policy Pract 2021 Jul-Dec;6(2):23814683211041623. doi: 10.1177/23814683211041623..
Keywords: Shared Decision Making, Heart Disease and Health, Cardiovascular Conditions
Mills J, O'Dowd N
AHRQ Author: Mills J
Healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
This “Putting Prevention into Practice: An Evidence Based Approach” paper is a case study with questions and answers related to healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
AHRQ-authored.
Citation: Mills J, O'Dowd N .
Healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
Am Fam Physician 2021 Oct 1;104(4):411-12..
Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Cardiovascular Conditions, Prevention, Lifestyle Changes, Risk, Evidence-Based Practice, Guidelines, Case Study
Mathis MR, Yule S, Wu X
The impact of team familiarity on intra and postoperative cardiac surgical outcomes.
The authors hypothesized that familiarity among cardiac surgery team members may be an important contributor to better outcomes and thus serve as a target for enhancing outcomes. They found that high team familiarity was associated with reduced cardiopulmonary bypass duration for medium-risk and high-risk patients. Increasing team familiarity was not significantly associated with the odds of major morbidity and mortality. They concluded that team familiarity, which was predictive of improved intraoperative efficiency without compromising major postoperative outcomes, may serve as a novel quality improvement target in the setting of cardiac surgery.
AHRQ-funded; HS026003.
Citation: Mathis MR, Yule S, Wu X .
The impact of team familiarity on intra and postoperative cardiac surgical outcomes.
Surgery 2021 Oct;170(4):1031-38. doi: 10.1016/j.surg.2021.05.020..
Keywords: Teams, Surgery, Heart Disease and Health, Cardiovascular Conditions, Outcomes
Wells R, Dionne-Odom JN, Azuero A
Examining adherence and dose effect of an early palliative care intervention for advanced heart failure patients.
The objective of this study was to examine the "dose" effect of PC intervention completion vs. noncompletion on quality of life (QoL) and healthcare use in patients with advanced heart failure (HF) over 32 weeks. The investigators concluded that higher intervention completion rates of an early PC intervention was associated with QoL improvements in patients with advanced HF.
AHRQ-funded; HS013852.
Citation: Wells R, Dionne-Odom JN, Azuero A .
Examining adherence and dose effect of an early palliative care intervention for advanced heart failure patients.
J Pain Symptom Manage 2021 Sep;62(3):471-81. doi: 10.1016/j.jpainsymman.2021.01.136..
Keywords: Palliative Care, Heart Disease and Health, Cardiovascular Conditions, Quality of Life, Telehealth, Health Information Technology (HIT)
Freno DR, Shipe ME, Levack MM
Modeling the impact of delaying transcatheter aortic valve replacement for the treatment of aortic stenosis in the era of COVID-19.
The objective of this study was to model the short term and 2-year overall survival for intermediate-risk and low-risk patients with severe symptomatic aortic stenosis (AS) undergoing timely or delayed transcatheter aortic valve replacement during the 2019 novel coronavirus (COVID-19) pandemic. Findings showed that prompt transcatheter aortic valve replacement for both intermediate-risk and low-risk patients with severe symptomatic AS resulted in improved 2-year survival when local healthcare system resources were not significantly constrained by COVID-19.
AHRQ-funded; HS026122.
Citation: Freno DR, Shipe ME, Levack MM .
Modeling the impact of delaying transcatheter aortic valve replacement for the treatment of aortic stenosis in the era of COVID-19.
JTCVS Open 2021 Sep;7:63-71. doi: 10.1016/j.xjon.2021.06.006..
Keywords: COVID-19, Heart Disease and Health, Cardiovascular Conditions, Access to Care
Soares WE, Knee A, Gemme SR
SC, et al. A prospective evaluation of Clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients.
The HEART score is a risk stratification aid that may safely reduce chest pain admissions for emergency department patients. However, differences in interpretation of subjective components potentially alters the performance of the score. In this study, the investigators compared agreement between HEART scores determined during clinical practice with research-generated scores and estimated their accuracy in predicting 30-day major adverse cardiac events.
AHRQ-funded; HS024815.
Citation: Soares WE, Knee A, Gemme SR .
SC, et al. A prospective evaluation of Clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients.
Ann Emerg Med 2021 Aug;78(2):231-41. doi: 10.1016/j.annemergmed.2021.03.024..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Emergency Department, Diagnostic Safety and Quality, Clinical Decision Support (CDS), Health Information Technology (HIT)
Berry CA, Nguyen AM, Cuthel AM
Measuring implementation strategy fidelity in HealthyHearts NYC: a complex intervention using practice facilitation in primary care.
This study measured implementation strategy fidelity for the HealthyHearts NYC intervention program, an AHRQ-funded program that uses practice facilitation (PF) to improve adoption of cardiovascular disease evidence-based guidelines in primary care practices. Data from 257 practices measured fidelity using 4 categories: frequency, duration, content, and coverage. Almost all (94.2%) of practices received at least the 13 PF visits with an average 26.3 hours spent at each site by facilitators. Most practices (95.7%) completed all Task List items, and 71.2% were educated on all Chronic Care Models, with the majority (65.8%) receiving full coverage.
AHRQ-funded; HS023922.
Citation: Berry CA, Nguyen AM, Cuthel AM .
Measuring implementation strategy fidelity in HealthyHearts NYC: a complex intervention using practice facilitation in primary care.
Am J Med Qual 2021 Jul-Aug;36(4):270-76. doi: 10.1177/1062860620959450..
Keywords: Implementation, Heart Disease and Health, Cardiovascular Conditions, Primary Care, Practice Improvement, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care: Models of Care
Fagnan LJ, Ramsey K, Kline T
Place matters: closing the gap on rural primary care quality improvement capacity-the Healthy Hearts Northwest study.
This study compared rural independent and health system primary care practices with urban practices to external practice facilitation support in terms of recruitment, readiness, engagement, retention, and change in quality improvement (QI) capacity and quality metric performing. The Healthy Hearts Northwest quality improvement initiative consisting of 135 small or medium-sized primary care practices were used. The practices were stratified by geography, rural or urban, and by ownership. Changes in 3 clinical quality measures (CQMs): appropriate aspirin use, blood pressure (BP) control, and tobacco use screening, were measured at baseline in 2015 and follow-up in 2017. Rural practices were more likely to enroll than urban practices. Rural independent practices had the lowest QI capacity at baseline, making the largest gain in establishing a regular QI process. They made the greatest improvement in meeting the BP control CQM and the smoking cessation metric, from 72.3% to 86.7%.
AHRQ-funded; HS023908; HS023921.
Citation: Fagnan LJ, Ramsey K, Kline T .
Place matters: closing the gap on rural primary care quality improvement capacity-the Healthy Hearts Northwest study.
J Am Board Fam Med 2021 Jul-Aug;34(4):753-61. doi: 10.3122/jabfm.2021.04.210011..
Keywords: Rural Health, Primary Care, Primary Care: Models of Care, Practice Improvement, Quality Improvement, Quality of Care, Heart Disease and Health, Cardiovascular Conditions
Moza R, Truong DT, Lambert LM
Poor weight recovery between stage 1 palliation and hospital discharge for infants with single ventricle physiology: an analysis of the NPC-QIC Phase II dataset.
The purpose of this study was to investigate change in weight-for-age z-scores (WAZ) and risk factors for impaired weight gain between stage 1 palliation (S1P) for single ventricle physiology and discharge. Data from the National Pediatric Cardiology Quality Improvement Collaborative Phase II database was analysed. Findings showed that nearly all infants lost weight after S1P, with little recovery by hospital discharge. At discharge, three-quarters of the infants were at-risk for impaired weight gain or had failure to thrive. Most risk factors associated with change in WAZ were unmodifiable or surrogates of disease severity.
AHRQ-funded; HS021114.
Citation: Moza R, Truong DT, Lambert LM .
Poor weight recovery between stage 1 palliation and hospital discharge for infants with single ventricle physiology: an analysis of the NPC-QIC Phase II dataset.
J Pediatr 2021 Jul;234:20-26.e2. doi: 10.1016/j.jpeds.2021.03.035..
Keywords: Newborns/Infants, Centers for Education and Research on Therapeutics (CERTs), Heart Disease and Health, Cardiovascular Conditions, Health Status, Risk
Amin AP, Rao SV, Seto AH
Transradial access for high-risk percutaneous coronary intervention: implications of the risk-treatment paradox.
The study’s objective was to examine whether the association between transradial percutaneous coronary intervention (PCI; TRI) use versus transfemoral PCI (TFI) and in-hospital outcomes is influenced by baseline risk. TRI was found to reduce adverse outcomes when compared with TFI. The authors analyzed 28,005 PCIs performed in a 7-hospital system between July 2009 and April 2018. TRI use increased over time. However a risk-treatment paradox for TRI use was observed not only for bleeding risk, but for acute kidney injury (AKI) and death. The absolute risk difference between TRI and TFI increased with increasing baseline risk.
AHRQ-funded; HS022481.
Citation: Amin AP, Rao SV, Seto AH .
Transradial access for high-risk percutaneous coronary intervention: implications of the risk-treatment paradox.
Circ Cardiovasc Interv 2021 Jul;14(7):e009328. doi: 10.1161/circinterventions.120.009328..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Outcomes, Patient-Centered Outcomes Research
Pham-Singer H, Onakomaiya M, Cuthel A
Using a customer relationship management system to manage a quality improvement intervention.
HealthyHearts New York City (HHNYC), one of 7 cooperatives funded through the Agency for Healthcare Research and Quality's EvidenceNOW initiative, evaluated the impact of practice facilitation on implementation of the Million Hearts guidelines for cardiovascular disease prevention and treatment. Tracking the intervention required a system to facilitate process data collection that was also user-friendly and flexible. Coupled with protocols and training, a strategically planned and customizable customer relationship management system (CRMS) was implemented to support the quality improvement intervention with 257 small independent practices.
AHRQ-funded; HS023922.
Citation: Pham-Singer H, Onakomaiya M, Cuthel A .
Using a customer relationship management system to manage a quality improvement intervention.
Am J Med Qual 2021 Jul-Aug;36(4):247-54. doi: 10.1177/1062860620953214..
Keywords: Quality Improvement, Quality of Care, Implementation, Evidence-Based Practice, Cardiovascular Conditions, Heart Disease and Health, Primary Care
Ganguli I, Cui J, Thakore N
Downstream cascades of care following high-sensitivity troponin test implementation.
This study sought to determine the association of high-sensitivity cardiac troponin (hs-cTn) assay implementation with cascade events. The investigators found that hs-cTn assay implementation was associated with more net upfront tests yet fewer net stress tests, percutaneous coronary interventions, cardiology evaluations, and hospital admissions in patients with chest pain relative to patients with other symptoms.
AHRQ-funded; toHS023812.
Citation: Ganguli I, Cui J, Thakore N .
Downstream cascades of care following high-sensitivity troponin test implementation.
J Am Coll Cardiol 2021 Jun 29;77(25):3171-79. doi: 10.1016/j.jacc.2021.04.049..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
Huda A, Castaño A, Niyogi A
A machine learning model for identifying patients at risk for wild-type transthyretin amyloid cardiomyopathy.
Transthyretin amyloid cardiomyopathy, an often-unrecognized cause of heart failure, is now treatable with a transthyretin stabilizer. It is therefore important to identify at-risk patients who can undergo targeted testing for earlier diagnosis and treatment, prior to the development of irreversible heart failure. In this study, the investigators showed that a random forest machine learning model could identify potential wild-type transthyretin amyloid cardiomyopathy using medical claims data.
AHRQ-funded; HS026385.
Citation: Huda A, Castaño A, Niyogi A .
A machine learning model for identifying patients at risk for wild-type transthyretin amyloid cardiomyopathy.
Nat Commun 2021 May 11;12(1):2725. doi: 10.1038/s41467-021-22876-9..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Neurological Disorders, Diagnostic Safety and Quality, Risk
Feng Y, Pai CW, Seiler K
Adverse outcomes associated with inappropriate direct oral anticoagulant starter pack prescription among patients with atrial fibrillation: a retrospective claims-based study.
This retrospective analysis investigated the risk for bleeding events with higher dosing of direct oral anticoagulant (DOAC) in the first 1-3 weeks of treatment for patients with atrial fibrillation (AF). Findings showed that patients who received an inappropriate DOAC prescription were more likely to identify as Black. Rates of ED visits, hospitalizations, and deaths overall were numerically lower in patients with starter pack DOAC prescriptions. In contrast, rates of ED visits and hospitalizations related to significant bleeding were numerically higher in patients with starter pack DOAC prescriptions. Among patients with AF but without acute venous thromboembolism, those who received an inappropriate DOAC starter pack had numerically higher rates of severe bleeding leading to ED visits and hospitalizations compared to those prescribed an appropriate non-starter pack DOAC anticoagulant.
AHRQ-funded; HS026874.
Citation: Feng Y, Pai CW, Seiler K .
Adverse outcomes associated with inappropriate direct oral anticoagulant starter pack prescription among patients with atrial fibrillation: a retrospective claims-based study.
J Thromb Thrombolysis 2021 May;51(4):1144-49. doi: 10.1007/s11239-020-02358-3..
Keywords: Blood Thinners, Medication, Medication: Safety, Medical Errors, Adverse Drug Events (ADE), Adverse Events, Heart Disease and Health, Cardiovascular Conditions
Rhee TG, Kumar M, Ross JS
Age-related trajectories of cardiovascular risk and use of aspirin and statin among U.S. Adults Aged 50 or older, 2011-2018.
The purpose of this study was to examine age-related trajectories of cardiovascular risk and use of aspirin and statin among U.S. adults aged 50 or older. The investigators concluded that while adults aged ≥75 do not benefit from the use of aspirin to prevent the first CVD, many continue to take aspirin on a regular basis. In spite of the clear benefit of statin use to prevent a subsequent CVD event, many older adults in this risk category are not taking a statin.
AHRQ-funded; HS022882.
Citation: Rhee TG, Kumar M, Ross JS .
Age-related trajectories of cardiovascular risk and use of aspirin and statin among U.S. Adults Aged 50 or older, 2011-2018.
J Am Geriatr Soc 2021 May;69(5):1272-82. doi: 10.1111/jgs.17038..
Keywords: Elderly, Blood Thinners, Cardiovascular Conditions, Heart Disease and Health, Risk, Medication
Savitz ST, Falk K, Stearns SC
Coronary revascularization outcomes in relation to skilled nursing facility use following hospital discharge.
Observational analyses comparing coronary artery bypass surgery (CABG) and percutaneous coronary intervention (PCI) among elderly or frail patients are likely biased by treatment selection. PCI is typically chosen for frail patients, while CABG is more common for patients with good recovery potential. In this study. The investigators hypothesized that skilled nursing facility (SNF) use after revascularization was a measure of relative frailty associated with outcomes following coronary revascularization.
AHRQ-funded; HS000032.
Citation: Savitz ST, Falk K, Stearns SC .
Coronary revascularization outcomes in relation to skilled nursing facility use following hospital discharge.
Clin Cardiol 2021 May;44(5):627-35. doi: 10.1002/clc.23583..
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions, Surgery, Outcomes, Nursing Homes
Hollingsworth JM, Yu X, Yan PL
Provider care team segregation and operative mortality following coronary artery bypass grafting.
The purpose of this study was to examine whether provider care team segregation within hospitals contributes to the higher mortality rate of Black patients following coronary artery bypass grafting compared to their White counterparts. Using national Medicare data, findings showed that Black patients who undergo coronary artery bypass grafting at a hospital with a higher level of provider care team segregation die more frequently after surgery than Black patients treated at a hospital with a lower level.
AHRQ-funded; HS026908.
Citation: Hollingsworth JM, Yu X, Yan PL .
Provider care team segregation and operative mortality following coronary artery bypass grafting.
Circ Cardiovasc Qual Outcomes 2021 May;14(5):e007778. doi: 10.1161/circoutcomes.120.007778..
Keywords: Surgery, Heart Disease and Health, Cardiovascular Conditions, Mortality, Teams, Healthcare Delivery, Racial and Ethnic Minorities
Walunas TL, Ye J, Bannon J
Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study.
Practice facilitation is a multicomponent implementation strategy used to improve the capacity for practices to address care quality and implementation gaps. In this study, the investigators sought to assess whether practice facilitators use of coaching strategies aimed at improving self-sufficiency were associated with improved implementation of quality improvement (QI) interventions in the Healthy Hearts in the Heartland Study.
AHRQ-funded; HS023921.
Citation: Walunas TL, Ye J, Bannon J .
Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study.
Implement Sci 2021 Mar 31;16(1):33. doi: 10.1186/s13012-021-01100-8..
Keywords: Practice Improvement, Quality Improvement, Quality of Care, Implementation, Heart Disease and Health, Cardiovascular Conditions
Bush M, Kucharska-Newton A, Simpson RJ
Effect of initiating cardiac rehabilitation after myocardial infarction on subsequent hospitalization in older adults.
Outpatient cardiac rehabilitation (CR) participation after myocardial infarction (MI) reduces all-cause mortality; however, less is known about effects of CR on post-MI hospitalization. The objective of this study was to investigate effects of CR on hospitalization following acute MI among older adults. The investigators concluded that this study provided evidence that CR could reduce the 1-yr risk of cardiovascular and all-cause hospital admissions in Medicare aged MI survivors.
AHRQ-funded; HS000032.
Citation: Bush M, Kucharska-Newton A, Simpson RJ .
Effect of initiating cardiac rehabilitation after myocardial infarction on subsequent hospitalization in older adults.
J Cardiopulm Rehabil Prev 2020 Mar;40(2):87-93. doi: 10.1097/hcr.0000000000000452..
Keywords: Elderly, Rehabilitation, Heart Disease and Health, Cardiovascular Conditions, Hospitalization