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
- Antibiotics (3)
- Antimicrobial Stewardship (1)
- Arthritis (1)
- Blood Clots (1)
- Blood Pressure (1)
- Cancer (4)
- Cancer: Breast Cancer (1)
- Cancer: Prostate Cancer (2)
- Cardiovascular Conditions (2)
- Care Management (3)
- Case Study (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (2)
- Chronic Conditions (2)
- Dementia (2)
- Diagnostic Safety and Quality (2)
- Digestive Disease and Health (1)
- Education: Continuing Medical Education (1)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (4)
- Evidence-Based Practice (26)
- Eye Disease and Health (1)
- (-) Guidelines (38)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Costs (1)
- Healthcare Utilization (2)
- Health Information Technology (HIT) (1)
- Health Status (1)
- Heart Disease and Health (2)
- Home Healthcare (1)
- Hospitalization (1)
- Imaging (2)
- Implementation (1)
- Infectious Diseases (3)
- Inpatient Care (2)
- Kidney Disease and Health (1)
- Labor and Delivery (1)
- Long-Term Care (1)
- Maternal Care (1)
- Medication (7)
- Men's Health (1)
- Mortality (1)
- Neurological Disorders (5)
- Newborns/Infants (3)
- Nursing (1)
- Nutrition (1)
- Opioids (2)
- Outcomes (1)
- Pain (2)
- Patient-Centered Outcomes Research (5)
- Patient Safety (4)
- Pneumonia (2)
- Policy (1)
- Practice Patterns (2)
- Pregnancy (1)
- Prevention (8)
- Primary Care (3)
- Provider (3)
- Provider: Nurse (1)
- Provider: Physician (2)
- Provider Performance (1)
- Public Health (1)
- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (2)
- Registries (1)
- Respiratory Conditions (3)
- Screening (6)
- Sepsis (3)
- Sexual Health (1)
- Shared Decision Making (5)
- Skin Conditions (1)
- Social Determinants of Health (1)
- Stroke (1)
- Substance Abuse (1)
- Surgery (5)
- Tobacco Use (1)
- Tools & Toolkits (1)
- U.S. Preventive Services Task Force (USPSTF) (9)
- Urinary Tract Infection (UTI) (2)
- Women (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
1 to 25 of 38 Research Studies DisplayedKelly JP, DeVore AD, Wu J
Rhythm control versus rate control in patients with atrial fibrillation and heart failure with preserved ejection fraction: insights from get with the guidelines-heart failure.
Researchers analyzed the Get With The Guidelines - Heart Failure (GWTG-HF) registry linked to Medicare claims data to describe current treatments for rate versus rhythm control and subsequent outcomes in patients with heart failure with preserved ejection fraction and atrial fibrillation. They found that rhythm control in patients aged 65 and older with heart failure with preserved ejection fraction and AF was associated with a lower risk of one-year all-cause mortality. They recommended future prospective randomized studies to explore this potential benefit.
AHRQ-funded; HS021092.
Citation: Kelly JP, DeVore AD, Wu J .
Rhythm control versus rate control in patients with atrial fibrillation and heart failure with preserved ejection fraction: insights from get with the guidelines-heart failure.
J Am Heart Assoc 2019 Dec 17;8(24):e011560. doi: 10.1161/jaha.118.011560.
.
.
Keywords: Heart Disease and Health, Cardiovascular Conditions, Guidelines, Evidence-Based Practice, Registries, Patient-Centered Outcomes Research
Greenhawt M, Shaker M
Determining levers of cost-effectiveness for screening infants at high risk for peanut sensitization before early peanut introduction.
The authors sought to identify scenarios in which current early peanut introduction guidelines would be cost-effective. They found that the current screening approach to early peanut introduction could be cost-effective at a particular health utility for an in-clinic reaction, skin prick test sensitivity and specificity, and high baseline peanut allergy prevalence among high-risk infants. However, such conditions are unlikely to be plausible to achieve realistically. They recommend further research to define the health state utility associated with reaction location.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Shaker M .
Determining levers of cost-effectiveness for screening infants at high risk for peanut sensitization before early peanut introduction.
JAMA Netw Open 2019 Dec 2;2(12):e1918041. doi: 10.1001/jamanetworkopen.2019.18041..
Keywords: Patient-Centered Outcomes Research, Newborns/Infants, Children/Adolescents, Respiratory Conditions, Skin Conditions, Screening, Healthcare Costs, Evidence-Based Practice, Guidelines
Barber CEH, Zell J, Yazdany J
2019 American College of Rheumatology recommended patient-reported functional status assessment measures in rheumatoid arthritis.
This study’s objective was to develop American College of Rheumatology (ACR) Functional Status Assessment Measures (FSAMs) for patient reporting in most clinic settings. The authors convened a workgroup to conduct a systematic literature review through March 2017. They focused on the following FSAMs: the Health Assessment Questionnaire (HAQ) and derived measures from the Patient-Reported Outcomes Measurement Information System (PROMIS) tool. Out of 11,835 articles identified in the search, 56 were included in the review. A modified Delphi process identified 7 measures which fulfilled the minimum standard for regular use, and 3 measures were recommended: the PROMIS 10-item short form, the HAQ-II, and the Multidimensional HAQ.
AHRQ-funded; HS025638.
Citation: Barber CEH, Zell J, Yazdany J .
2019 American College of Rheumatology recommended patient-reported functional status assessment measures in rheumatoid arthritis.
Arthritis Care Res 2019 Dec;71(12):1531-39. doi: 10.1002/acr.24040..
Keywords: Arthritis, Health Status, Guidelines, Evidence-Based Practice
Chapman CH, Caram MEV, Radhakrishnan A
Association between PSA values and surveillance quality after prostate cancer surgery.
This study examined the association between PSA values and posttreatment surveillance after prostate cancer surgery. Normally the treatment cutoff rate is 0.2 ng/mL but 4.0 ng/mL may be more appropriate. Data from the US Veterans Health Administration was used to perform a retrospective longitudinal cohort study for men diagnosed with nonmetastatic prostate cancer from 2005 to 2008 who underwent radical prostatectomy. Guideline concordance was high at year 1 (95%) but decreased to 79% in year 7. After adjustment, guideline concordance was lowered for the youngest and oldest, Black, and unmarried men.
AHRQ-funded; HS018726.
Citation: Chapman CH, Caram MEV, Radhakrishnan A .
Association between PSA values and surveillance quality after prostate cancer surgery.
Cancer Med 2019 Dec;8(18):7903-12. doi: 10.1002/cam4.2663..
Keywords: Cancer: Prostate Cancer, Cancer, Surgery, Screening, Guidelines, Prevention, Evidence-Based Practice
Artis KA, Dweik RA, Patel B
Performance measure development, use, and measurement of effectiveness using the guideline on mechanical ventilation in acute respiratory distress syndrome. an official American Thoracic Society workshop report.
This report summarizes the proceedings of a workshop convened to advance the American Thoracic Society’s work in performance measure development and guideline implementation. The example of a low-tidal volume ventilation performance measure created from the 2017 ATS clinical practice guideline is used to illustrate the application of the ATS performance measure development framework, including detailed explanation of the rationale for the specifications chosen, identification of areas in need of further validity testing, and a preliminary strategy for testing the performance measure.
AHRQ-funded; HS024552.
Citation: Artis KA, Dweik RA, Patel B .
Performance measure development, use, and measurement of effectiveness using the guideline on mechanical ventilation in acute respiratory distress syndrome. an official American Thoracic Society workshop report.
Ann Am Thorac Soc 2019 Dec;16(12):1463-72. doi: 10.1513/AnnalsATS.201909-665ST..
Keywords: Respiratory Conditions, Guidelines, Evidence-Based Practice, Quality Measures, Quality of Care, Provider Performance
Strassle PD, Kinlaw AC, Chaumont N
Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change.
Gastroenterology 2019 Dec;157(6):1679-81.e11. doi: 10.1053/j.gastro.2019.08.045.
The purpose of this retrospective cohort study was to assess whether trends in elective and urgent/emergent colectomy changed after July 2006. The authors suggest that given the risks associated with elective colectomy, their findings demonstrate the need for a more evidence-based decision-making process, incorporating both patient preferences and patient-reported outcomes, for those considering elective colectomy for uncomplicated and some cases of complicated diverticulitis.
The purpose of this retrospective cohort study was to assess whether trends in elective and urgent/emergent colectomy changed after July 2006. The authors suggest that given the risks associated with elective colectomy, their findings demonstrate the need for a more evidence-based decision-making process, incorporating both patient preferences and patient-reported outcomes, for those considering elective colectomy for uncomplicated and some cases of complicated diverticulitis.
AHRQ-funded; HS026363.
Citation: Strassle PD, Kinlaw AC, Chaumont N .
Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change.
Gastroenterology 2019 Dec;157(6):1679-81.e11. doi: 10.1053/j.gastro.2019.08.045..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Healthcare Utilization, Guidelines, Shared Decision Making, Digestive Disease and Health
Henderson JT, Senger CA, Henninger M
Behavioral counseling interventions to prevent sexually transmitted infections: updated evidence report and systematic review for the US Preventive Services Task Force.
This updated evidence report and systematic review accompanied the USPSTF final recommendation for behavioral counseling interventions to prevent sexually transmitted infections (STIs) in adults and adolescents, which was published in August 2020. Studies from the previous 2014 review and literature from January 2013 through May 2019 was reviewed to find good- and fair-quality randomized and nonrandomized controlled intervention studies conducted in primary care settings. The review included 37 randomized trials and 2 nonrandomized controlled intervention studies. The study populations were mostly heterosexual adolescents and young adults, females, and racial and ethnic minorities at increased risk for STIs. Thirty-four trials reported behavioral change outcomes after interventions. The largest reductions in STI incidence were reported after group or individual counseling sessions lasting more than 2 hours. Evidence was limited on interventions of shorter duration persisting beyond 1 year.
AHRQ-funded; 2902015000017I.
Citation: Henderson JT, Senger CA, Henninger M .
Behavioral counseling interventions to prevent sexually transmitted infections: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Aug 18;324(7):682-99. doi: 10.1001/jama.2020.10371..
Keywords: U.S. Preventive Services Task Force (USPSTF), Infectious Diseases, Sexual Health, Evidence-Based Practice, Guidelines
Antunez AG, Telem DA DA, Dossett LA
Assessment of surgical specialty societies' Choosing Wisely recommendations.
This research study assesses the Choosing Wisely initiative from the American Board of Internal Medicine Foundation which aims to reduce the use of low-value practices using evidence-based recommendation. The initiative has included participation from more than 80 specialty societies. The goal of this study was to assess deimplementation recommendations from surgical specialty societies to ascertain how many are directly applicable to surgical procedures or under surgeons’ control. They reviewed the recommendations proposed by surgical societies and requested participation from the eligible ones. Seventeen surgical societies submitted 110 recommendations on their surgical specialty. Out of those recommendations, more than (55%) were identified as perioperative care decisions and not under a surgeons’ control.
AHRQ-funded; HS026030.
Citation: Antunez AG, Telem DA DA, Dossett LA .
Assessment of surgical specialty societies' Choosing Wisely recommendations.
JAMA Surg 2019 Oct;154(10):971-73. doi: 10.1001/jamasurg.2019.2309..
Keywords: Surgery, Shared Decision Making, Guidelines
Madapana N, Gonzalez G, Taneja R
Preference elicitation: obtaining gestural guidelines for PACS in neurosurgery.
The objectives of this study were to: a) Elicit gestures from neurosurgeons to analyze their preferences, b) Develop heuristics for gestural interfaces, and c) Produce a lexicon that maximizes surgeons' preferences. The elicitation study resulted in nine gesture lexicons, each comprised of 28 gestures. Results showed that neurosurgeons do agree on fundamental characteristics of gestures to perform image manipulation tasks. The proposed heuristics could potentially guide the development of future gesture-based interaction of Picture Archiving and Communication Systems for the operating room.
AHRQ-funded; HS024887.
Citation: Madapana N, Gonzalez G, Taneja R .
Preference elicitation: obtaining gestural guidelines for PACS in neurosurgery.
Int J Med Inform 2019 Oct;130:103934. doi: 10.1016/j.ijmedinf.2019.07.013..
Keywords: Guidelines, Neurological Disorders, Patient Safety, Surgery
Henderson JT, Webber EM, Bean SI
Screening for asymptomatic bacteriuria in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
Investigators systematically reviewed the benefits and harms of asymptomatic bacteriuria screening and treatment in adults, including during pregnancy, to inform the US Preventive Services Task Force. They found that screening and treatment for asymptomatic bacteriuria during pregnancy was associated with reduced rates of pyelonephritis and low birth weights, while benefits of asymptomatic bacteriuria treatment in nonpregnant adult populations were not found. Trial evidence was limited.
AHRQ-funded; 290201500007.
Citation: Henderson JT, Webber EM, Bean SI .
Screening for asymptomatic bacteriuria in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Sep 24;322(12):1195-205. doi: 10.1001/jama.2019.10060..
Keywords: Evidence-Based Practice, Guidelines, Infectious Diseases, Prevention, Screening, Urinary Tract Infection (UTI), U.S. Preventive Services Task Force (USPSTF)
Nelson HD, Fu R, Zakher B
Medication use for the risk reduction of primary breast cancer in women: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this paper was to update the 2013 US Preventive Services Task Force systematic review on medications to reduce risk of primary (first diagnosis) invasive breast cancer in women. Investigators abstracted data on methods, participant characteristics, eligibility criteria, outcome ascertainment, and follow-up; individual trial results were combined using a profile likelihood random-effects model. Results showed that tamoxifen, raloxifene, and aromatase inhibitors were associated with lower risk of primary invasive breast cancer in women but also were associated with adverse effects that differed between medications. Risk stratification methods to identify patients with increased breast cancer risk demonstrated low accuracy.
AHRQ-funded; 290201500009I.
Citation: Nelson HD, Fu R, Zakher B .
Medication use for the risk reduction of primary breast cancer in women: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Sep 3;322(9):868-86. doi: 10.1001/jama.2019.5780..
Keywords: Cancer: Breast Cancer, Cancer, Medication, U.S. Preventive Services Task Force (USPSTF), Evidence-Based Practice, Guidelines, Prevention, Primary Care
Ferguson MC, O'Shea KJ, Hammer LD
The impact of following solid food feeding guides on BMI among infants: a simulation study.
The objective of this study was to determine the impact of following different feeding guidelines on weight trajectories of infants. The study team developed a computational simulation model to capture feeding behaviors, activity levels, metabolism, and body size of infants from 6 months to 1 year old; daily food intake of virtual infants was based on feeding recommendations and translated to changes in body weight. Results identified situations in which infants could reach unhealthy weights, even while following complementary feeding guidelines, suggesting that current recommended portion sizes should be tightened.
AHRQ-funded; HS023317.
Citation: Ferguson MC, O'Shea KJ, Hammer LD .
The impact of following solid food feeding guides on BMI among infants: a simulation study.
Am J Prev Med 2019 Sep;57(3):355-64. doi: 10.1016/j.amepre.2019.04.011..
Keywords: Newborns/Infants, Nutrition, Guidelines
Henrikson NB, Bowles EJ, Blasi PR
Screening for pancreatic cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors systematically reviewed the benefits and harms of screening for pancreatic adenocarcinoma in order to inform the USPSTF. They found that imaging-based screening in groups at high familial risk can detect pancreatic adenocarcinoma with limited evidence of minimal harms. However, the effect of screening on morbidity and mortality in groups at high familial risk has not been studied, and no data are available in average-risk populations. They conclude that there is limited evidence to assess benefits or harms of surgical intervention for screen-detected pancreatic adenocarcinoma.
AHRQ-funded; 2902015000071.
Citation: Henrikson NB, Bowles EJ, Blasi PR .
Screening for pancreatic cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Aug 6;322(5):445-54. doi: 10.1001/jama.2019.6190..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer, Screening, Evidence-Based Practice, Guidelines, Prevention
Ingraham AM, Ayturk MD, Kiefe CI
Adherence to 20 emergency general surgery best practices: results of a national survey.
The authors used a hybrid questionnaire to examine national adherence to emergency general surgery (EGS) best practices. They found that there was substantial room for performance improvement, and that adopting an acute care surgery model predicts better performance. They conclude that this novel overview of adherence to EGS best practices will enable surgeons and policymakers to address variations in EGS care nationally.
AHRQ-funded; HS022694.
Citation: Ingraham AM, Ayturk MD, Kiefe CI .
Adherence to 20 emergency general surgery best practices: results of a national survey.
Ann Surg 2019 Aug;270(2):270-80. doi: 10.1097/sla.0000000000002746..
Keywords: Surgery, Emergency Department, Guidelines, Quality of Care, Quality Improvement
Simon E, Miake-Lye IM, Smith SW
An evaluation of guideline-discordant ordering behavior for CT pulmonary angiography in the emergency department.
The aim of this study was to determine rates of and possible reasons for guideline-discordant ordering of CT pulmonary angiography for the evaluation of suspected pulmonary embolism (PE) in the emergency department. The investigators concluded that many of the guideline-discordant orders were placed for patients who presented with evidence-based risk factors for PE that are not included in the risk stratification scores. They suggest that guideline-discordant ordering may indicate that in the presence of these factors, the assessment of risk made by current scoring systems may not align with clinical suspicion.
AHRQ-funded; HS024376.
Citation: Simon E, Miake-Lye IM, Smith SW .
An evaluation of guideline-discordant ordering behavior for CT pulmonary angiography in the emergency department.
J Am Coll Radiol 2019 Aug;16(8):1064-72. doi: 10.1016/j.jacr.2018.12.015..
Keywords: Respiratory Conditions, Emergency Department, Guidelines, Evidence-Based Practice, Blood Clots
Jeffery MM, Hooten WM, Jena AB
Rates of physician coprescribing of opioids and benzodiazepines after the release of the Centers for Disease Control and Prevention guidelines in 2016.
Researchers sought to determine whether the release of the CDC guidelines was associated with changes in co-prescription of opioids and benzodiazepines. Their study showed a reduction in the extent, but not the intensity, of co-prescribing of benzodiazepines for patients with long-term opioid use.
AHRQ-funded; HS025164.
Citation: Jeffery MM, Hooten WM, Jena AB .
Rates of physician coprescribing of opioids and benzodiazepines after the release of the Centers for Disease Control and Prevention guidelines in 2016.
JAMA Netw Open 2019 Aug 2;2(8):e198325. doi: 10.1001/jamanetworkopen.2019.8325..
Keywords: Opioids, Medication, Practice Patterns, Pain, Evidence-Based Practice, Guidelines
Trent SA, Jarou ZJ, Havranek EP
Variation in emergency department adherence to treatment guidelines for inpatient pneumonia and sepsis: a retrospective cohort study.
Evidence-based clinical practice guidelines (CPGs) for the treatment of pneumonia and sepsis have existed for many years with multiple studies suggesting improved patient outcomes. Despite their importance, little is known about variation in emergency department (ED) adherence to these CPGs. The objectives of this study were to estimate variation in ED adherence across CPGs for pneumonia and sepsis and identify patient, provider, and environmental factors associated with adherence.
AHRQ-funded; HS022400.
Citation: Trent SA, Jarou ZJ, Havranek EP .
Variation in emergency department adherence to treatment guidelines for inpatient pneumonia and sepsis: a retrospective cohort study.
Acad Emerg Med 2019 Aug;26(8):908-20. doi: 10.1111/acem.13639.
.
.
Keywords: Emergency Department, Evidence-Based Practice, Guidelines, Inpatient Care, Pneumonia, Sepsis
Kahn JM, Davis BS, Yabes JG
Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis.
The purpose of this study was to evaluate the association between New York State sepsis regulations and the outcomes of patients hospitalized with sepsis. Results showed that, in New York State, mandated protocolized sepsis care was associated with a greater decrease in sepsis mortality compared with sepsis mortality in control states (Florida, Maryland, Massachusetts, and New Jersey) that did not implement sepsis regulations. The authors add that, because baseline mortality rates differ between New York and the comparison states, it is uncertain whether these findings will be generalizable to other states.
AHRQ-funded; HS025146.
Citation: Kahn JM, Davis BS, Yabes JG .
Association between state-mandated protocolized sepsis care and in-hospital mortality among adults with sepsis.
JAMA 2019 Jul 16;322(3):240-50. doi: 10.1001/jama.2019.9021..
Keywords: Guidelines, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Mortality, Outcomes, Policy, Sepsis
Bierman AS, Nix MP
AHRQ Author: Bierman AS, Nix MP
Disappearance of the National Guideline Clearinghouse.
This letter was written in response to a 2018 article on the discontinuation of funding and closing down of the website of the National Guidance Clearinghouse (NGC). The letter was written by Dr. Arlene Bierman and Mary Nix of AHRQ in regards to a new AHRQ-funded 12-month pilot project to be done by MITRE to help identify new models for disseminating and accessing evidence-based clinical practice guidelines. It is intended to build on AHRQ’s previous support for the NGC.
AHRQ-authored.
Citation: Bierman AS, Nix MP .
Disappearance of the National Guideline Clearinghouse.
Ann Intern Med 2019 Jul 2;171(1):71-72. doi: 10.7326/l19-0152..
Keywords: Guidelines, Evidence-Based Practice
Paje D, Rogers MAM, Conlon A
Use of peripherally inserted central catheters in patients with advanced chronic kidney disease: a prospective cohort study.
Existing guidelines, including Choosing Wisely recommendations, endorse avoiding placement of peripherally inserted central catheters (PICCs) in patients with chronic kidney disease (CKD). The purpose of this study was to describe the frequency of and characteristics associated with PICC use in hospitalized patients with stage 3b or greater CKD (glomerular filtration rate [GFR] <45 mL/min/1.73 m2).
AHRQ-funded; HS025891.
Citation: Paje D, Rogers MAM, Conlon A .
Use of peripherally inserted central catheters in patients with advanced chronic kidney disease: a prospective cohort study.
Ann Intern Med 2019 Jul 2;171(1):10-18. doi: 10.7326/m18-2937..
Keywords: Kidney Disease and Health, Guidelines, Evidence-Based Practice, Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs)
Armstrong MJ, Gronseth GS, Day GS
Patient stakeholder versus physician preferences regarding amyloid PET testing.
Patient and caregiver perspectives on amyloid positron emission tomography (PET) use are largely unexplored, particularly as compared with clinician views. In this study, the investigators surveyed clinicians, patients, caregivers, and dementia advocates on topics relating to an evidence-based guideline on amyloid PET use. They found that patients and caregivers emphasized the importance of having a dementia diagnosis and placed more value on testing and outcomes for asymptomatic populations than clinicians.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Gronseth GS, Day GS .
Patient stakeholder versus physician preferences regarding amyloid PET testing.
Alzheimer Dis Assoc Disord 2019 Jul-Sep;33(3):246-53. doi: 10.1097/wad.0000000000000311..
Keywords: Shared Decision Making, Dementia, Diagnostic Safety and Quality, Evidence-Based Practice, Guidelines, Imaging, Neurological Disorders, Patient-Centered Outcomes Research, Provider, Provider: Physician
Livingston CJ, Allison RD, Niebuhr DW
AHRQ Author: Niebuhr DW
Preventive medicine physicians and the Centers for Disease Control and Prevention's 6|18 Initiative.
This paper describes the American College of Preventive Medicine (ACPM) and Centers for Disease Control and Prevention (CDC) work done as part of the cooperative 5-year agreement called the 6|18 Initiative to improve population health through primary care and public health integration. This initiative is called 6|18 because its’ aim was to target six common and high-cost health behaviors/conditions with 18 proven interventions. CDC created three different buckets to describe the preventions. The six health behaviors/conditions targeted included reducing tobacco use, control high blood pressure, improve antibiotic use, control asthma, prevent unintended pregnancy, and prevent type 2 diabetes. The initiative aligned recommendations from national and professional societies and focused the guidelines from the U.S. Preventive Services Task Force (USPSTF). After six telephone-moderated discussions of the authors, three themes were developed as to how physicians may perceive the 6|18 interventions. The problems included lack of knowledge/awareness, variations in financial incentives and operational challenges such as time constraints.
AHRQ-authored.
Citation: Livingston CJ, Allison RD, Niebuhr DW .
Preventive medicine physicians and the Centers for Disease Control and Prevention's 6|18 Initiative.
Am J Prev Med 2019 Jul;57(1):127-33. doi: 10.1016/j.amepre.2019.02.014..
Keywords: Prevention, Primary Care, Public Health, Evidence-Based Practice, U.S. Preventive Services Task Force (USPSTF), Guidelines, Chronic Conditions
Advanced Analytics Group of Pediatric Urology, ORC Personalized Medicine Group
Targeted workup after initial febrile urinary tract infection: using a novel machine learning model to identify children most likely to benefit from voiding cystourethrogram.
The authors sought to develop a model to predict the probability of recurrent urinary tract infection associated vesicoureteral reflux in children after an initial urinary tract infection. Their predictive model provided a promising performance to facilitate individualized treatment of children with an initial urinary tract infection and to identify those most likely to benefit from voiding cystourethrogram after the initial urinary tract infection. They conclude that this model would allow for more selective test application and increase yield while minimizing overuse.
AHRQ-funded; HS000063.
Citation: Advanced Analytics Group of Pediatric Urology, ORC Personalized Medicine Group .
Targeted workup after initial febrile urinary tract infection: using a novel machine learning model to identify children most likely to benefit from voiding cystourethrogram.
J Urol 2019 Jul;202(1):144-52. doi: 10.1097/ju.0000000000000186..
Keywords: Antibiotics, Care Management, Children/Adolescents, Guidelines, Medication, Urinary Tract Infection (UTI)
Djulbegovic B, Reljic T, Elqayam S
Structured decision-making drives guidelines panels' recommendations "for" but not "against" health interventions.
This study examined the determinants of guideline panels’ recommendations and whether there is a difference between how they make recommendations for or against health interventions. They examined the factors considered by members of 8 panels convened by the American Society of Hematology (ASH) to develop guidelines using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. They found that “for” decisions were made using certainty in evidence, balance of benefits and harms, and variability in patients’ values and preferences. However there was less strength of recommendation (SOR) certainty when making “against” recommendations.
AHRQ-funded; HS024917.
Citation: Djulbegovic B, Reljic T, Elqayam S .
Structured decision-making drives guidelines panels' recommendations "for" but not "against" health interventions.
J Clin Epidemiol 2019 Jun;110:23-33. doi: 10.1016/j.jclinepi.2019.02.009..
Keywords: Shared Decision Making, Guidelines, Patient-Centered Outcomes Research, Evidence-Based Practice
Simpson KR, Lyndon A, Spetz J
Adherence to the AWHONN staffing guidelines as perceived by labor nurses.
Labor and delivery nurses were surveyed to determine if their units adhere to Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) staffing guidelines. Labor nurses in selected hospitals in California, Michigan and New Jersey were invited via email to participate in the study. Their nurse leaders facilitated the invitations. A total of 615 labor nurses from 67 hospitals participated. Most nurses did report that staffing guidelines were adhered to. The hospitals with smaller annual birth volumes (500-999 range) were significantly more like to be perceived as compliant than hospitals with 2,500 or more annual births.
AHRQ-funded; HS025715.
Citation: Simpson KR, Lyndon A, Spetz J .
Adherence to the AWHONN staffing guidelines as perceived by labor nurses.
Nurs Womens Health 2019 Jun;23(3):217-23. doi: 10.1016/j.nwh.2019.03.003..
Keywords: Care Management, Guidelines, Labor and Delivery, Maternal Care, Patient Safety, Pregnancy, Provider, Provider: Nurse, Women