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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
776 to 800 of 805 Research Studies DisplayedFriedly JL, Bauer Z, Comstock BA
AHRQ Author: Zhan C, Hsia DC, Trontell A
Challenges conducting comparative effectiveness research: the Clinical and Health Outcomes Initiative in Comparative Effectiveness (CHOICE) experience.
This paper explores the collective experience of the Clinical and Health Outcomes Initiative in Comparative (CHOICE) program, which includes 12 ongoing comparative effectiveness research trials funded by AHRQ. It describes the common features of the CHOICE award studies to summarize the strategies undertaken to address the challenges in conducting comparative effectiveness pragmatic trials and observational studies from various perspectives.
AHRQ-authored; AHRQ-funded; HS019222
Citation: Friedly JL, Bauer Z, Comstock BA .
Challenges conducting comparative effectiveness research: the Clinical and Health Outcomes Initiative in Comparative Effectiveness (CHOICE) experience.
Comp Eff Res. 2014 May;4:1-12..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Osterman MT, Haynes K, Delzell E
Comparative effectiveness of infliximab and adalimumab for Crohn's disease.
This study compared the effectiveness of infliximab and adalimumab, the two most commonly used anti-tumor necrosis factor agents in patients with Crohn’s disease (CD). It found that both drugs were of similar effectiveness with respect to surgical rates, hospitalization rates, and the percentage of patients remaining on the drugs after 26 weeks.
AHRQ-funded; HS018517
Citation: Osterman MT, Haynes K, Delzell E .
Comparative effectiveness of infliximab and adalimumab for Crohn's disease.
Clin Gastroenterol Hepatol. 2014 May;12(5):811-817.e3. doi: 10.1016/j.cgh.2013.06.010..
Keywords: Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research, Treatments
Boyer DL, Nishisaki A
Evaluating patient outcomes in medical education research: mission impossible?*.
This editorial examines evaluation of the impact of pediatric supplemental crisis resource management (CRM) training among first- and second-year residents. The author suggests that increasing CRM training and using debriefing for skill retention may link this training to patient outcomes.
AHRQ-funded; HS022464
Citation: Boyer DL, Nishisaki A .
Evaluating patient outcomes in medical education research: mission impossible?*.
Pediatr Crit Care Med. 2014 May;15(4):382-4. doi: 10.1097/pcc.0000000000000116..
Keywords: Education: Continuing Medical Education, Outcomes, Children/Adolescents, Training
Cappelleri JC, Lundy JJ, Hays RD
Overview of classical test theory and item response theory for the quantitative assessment of items in developing patient-reported outcomes measures.
This article presents an overview of classical test theory and item response theory in the quantitative assessment of items and scales during the content-validity phase of patient-reported outcomes (PRO) measure development. The researchers concluded that depending on the particular type of measure and specific circumstances, either approach or both may be useful to help maximize the content validity of a PRO measure.
AHRQ-funded; HS016980
Citation: Cappelleri JC, Lundy JJ, Hays RD .
Overview of classical test theory and item response theory for the quantitative assessment of items in developing patient-reported outcomes measures.
Clin Ther. 2014 May;36(5):648-662. doi: 10.1016/j.clinthera.2014.04.006..
Keywords: Outcomes, Research Methodologies
Martin BI, Lurie JD, Tosteson AN
Indications for spine surgery: validation of an administrative coding algorithm to classify degenerative diagnoses.
The Spine Patient Outcomes Research Trial (SPORT) provided a unique opportunity to examine the validity of a claims-based algorithm for grouping patients by surgical indication. SPORT enrolled patients for lumbar disc herniation, spinal stenosis, and degenerative spondylolisthesis. The researchers found that their claims-based hierarchical coding algorithm of spine-related medical encounters correctly classified more than 90 percent of Medicare patients into their respective SPORT cohorts.
AHRQ-funded; HS018405
Citation: Martin BI, Lurie JD, Tosteson AN .
Indications for spine surgery: validation of an administrative coding algorithm to classify degenerative diagnoses.
Spine. 2014 Apr 20;39(9):769-79. doi: 10.1097/brs.0000000000000275..
Keywords: Comparative Effectiveness, Surgery, Outcomes, Medicare
Jarvik JG, Comstock BA, Heagerty PJ
Back pain in seniors: the Back pain Outcomes using Longitudinal Data (BOLD) cohort baseline data.
Back pain, function, and health-related quality of life varied by demographic and geographic factors among seniors, based on data in the Back pain Outcomes using Longitudinal Data (BOLD) Registry. Lower education, female sex, black race, and older age were linked to worse disability.
AHRQ-funded; HS019222
Citation: Jarvik JG, Comstock BA, Heagerty PJ .
Back pain in seniors: the Back pain Outcomes using Longitudinal Data (BOLD) cohort baseline data.
BMC Musculoskelet Disord. 2014 Apr 23;15:134. doi: 10.1186/1471-2474-15-134..
Keywords: Back Health and Pain, Elderly, Outcomes, Registries
Bressler B, Siegel CA
Beware of the swinging pendulum: anti-tumor necrosis factor monotherapy vs combination therapy for inflammatory bowel disease.
An editorial commenting on a study in the same issue by Osterman, et al. in the context of related studies concludes that it is more reasonable to consider slightly modifying the approach to anti-tumor necrosis factor combination therapy as opposed to a full pendulum swing back to monotherapy.
AHRQ-funded; HS021747
Citation: Bressler B, Siegel CA .
Beware of the swinging pendulum: anti-tumor necrosis factor monotherapy vs combination therapy for inflammatory bowel disease.
Gastroenterolog.y 2014 Apr;146(4):884-7. doi: 10.1053/j.gastro.2014.02.018..
Keywords: Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research, Medication, Chronic Conditions
Jones WS, Dolor RJ, Hasselblad V
Comparative effectiveness of endovascular and surgical revascularization for patients with peripheral artery disease and critical limb ischemia: systematic review of revascularization in critical limb ischemia.
This systematic review found that there is no difference in clinical outcomes for patients with critical limb ischemia treated with endovascular or surgical revascularization. This review of 23 studies found no differences in overall death, amputation, or amputation-free survival at 2 or more years following treatment.
AHRQ-funded; 290200710066I
Citation: Jones WS, Dolor RJ, Hasselblad V .
Comparative effectiveness of endovascular and surgical revascularization for patients with peripheral artery disease and critical limb ischemia: systematic review of revascularization in critical limb ischemia.
Am Heart J. 2014 Apr;167(4):489-498.e7. doi: 10.1016/j.ahj.2013.12.012..
Keywords: Comparative Effectiveness, Outcomes, Surgery, Mortality
Shah TR, Rockman CB, Adelman MA
Nationwide comparative impact of thoracic endovascular aortic repair of acute uncomplicated type B aortic dissections.
The objective of this study was to evaluate the impact of thoracic endovascular aortic repair (TEVAR) on mortality, morbidity, length of stay (LOS), and discharge status on patients with acute uncomplicated Type B aortic dissections (TBAD). It found that TEVAR for acute uncomplicated TBAD was associated with similar in-hospital mortality and renal failure as compared to medical management.
AHRQ-funded; HS019473.
Citation: Shah TR, Rockman CB, Adelman MA .
Nationwide comparative impact of thoracic endovascular aortic repair of acute uncomplicated type B aortic dissections.
Vasc Endovascular Surg. 2014 Apr;48(3):230-3. doi: 10.1177/1538574413518122..
Keywords: Comparative Effectiveness, Outcomes, Cardiovascular Conditions, Healthcare Cost and Utilization Project (HCUP)
Schwenk H, Ramirez-Avila L, Sheu SH
Progressive multifocal leukoencephalopathy in pediatric patients: case report and literature review.
Progressive multifocal leukoencephalopathy is a rare, demyelinating disease of the central nervous system caused by JC virus. Fewer than 30 cases have been reported in HIV- and non-infected children. The researchers report the case of a 15-year-old girl with progressive multifocal leukoencephalopathy and AIDS who presented with nystagmus, dysarthria and ataxia. They also include a literature review.
AHRQ-funded; HS019485.
Citation: Schwenk H, Ramirez-Avila L, Sheu SH .
Progressive multifocal leukoencephalopathy in pediatric patients: case report and literature review.
Pediatr Infect Dis J 2014 Apr;33(4):e99-105. doi: 10.1097/inf.0000000000000237..
Keywords: Comparative Effectiveness, Children/Adolescents, Case Study, Outcomes
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
Li L, Vollmer WM, Butler MG
A comparison of confounding adjustment methods for assessment of asthma controller medication effectiveness.
Using three confounding adjustment procedures—covariate-adjusted regression, propensity score regression, and high-dimemsional propensity score regression—on a population of 24,680 children with asthma, researchers found that patients treated with leukotriene antagonists were no more likely than those treated with inhaled corticosteroids to experience adverse outcomes.
AHRQ-funded; HS019669
Citation: Li L, Vollmer WM, Butler MG .
A comparison of confounding adjustment methods for assessment of asthma controller medication effectiveness.
Am J Epidemiol. 2014 Mar 1;179(5):648-59. doi: 10.1093/aje/kwt323..
Keywords: Comparative Effectiveness, Outcomes, Children/Adolescents, Asthma, Medication
Kim DH, Lin Y, Goytizolo EA
Adductor canal block versus femoral nerve block for total knee arthroplasty: a prospective, randomized, controlled trial.
In a study of pain relief for patients recovering from a total knee arthroplasty, researchers found that adductor canal block (ACB) results in less motor impairment for quadriceps muscles after surgery than femoral nerve block (FNB) and it provides a comparable level of pain relief. The prospective, randomized, controlled study included 46 patients receiving ACB and 47 receiving FNB.
AHRQ-funded; HS021734
Citation: Kim DH, Lin Y, Goytizolo EA .
Adductor canal block versus femoral nerve block for total knee arthroplasty: a prospective, randomized, controlled trial.
Anesthesiology. 2014 Mar;120(3):540-50. doi: 10.1097/ALN.0000000000000119..
Keywords: Medication, Opioids, Outcomes, Pain, Surgery
Ballesca MA, LaGuardia JC, Le PC
An electronic order set for acute myocardial infarction is associated with improved patient outcomes through better adherence to clinical practice guidelines.
The researchers investigated the association between the use of an evidence-based, electronic order set (OS) for acute myocardial infarction (AMI) and better adherence to clinical practice guidelines among 5,789 patients hospitalized with AMI. They found that use of the electronic OS is associated with increased adherence to evidence-based therapies and lower 30-day mortality.
AHRQ-funded; HS018480
Citation: Ballesca MA, LaGuardia JC, Le PC .
An electronic order set for acute myocardial infarction is associated with improved patient outcomes through better adherence to clinical practice guidelines.
J Hosp Med 2014 Mar;9(3):155-61. doi: 10.1002/jhm.2149..
Keywords: Health Information Technology (HIT), Heart Disease and Health, Outcomes, Guidelines, Critical Care
Al-Khatib SM, Han JY, Edwards R
Do patients with a left ventricular ejection fraction between 30% and 35% benefit from a primary prevention implantable cardioverter defibrillator?
The researchers used data from randomized clinical trials involving patients with systolic heart failure who had received implantable cardioverter-defibrillators and compared outcomes for those whose left ventricular ejection fractions (LVEFs) was between 30 percent and 35 percent with those whose LVEF was less than 30 percent. The sample size was too small to permit any important conclusions.
AHRQ-funded; HS018505
Citation: Al-Khatib SM, Han JY, Edwards R .
Do patients with a left ventricular ejection fraction between 30% and 35% benefit from a primary prevention implantable cardioverter defibrillator?
Int J Cardiol. 2014 Mar 1;172(1):253-4. doi: 10.1016/j.ijcard.2013.12.278..
Keywords: Comparative Effectiveness, Outcomes, Medical Devices, Heart Disease and Health, Chronic Conditions
Dahlke AR, Chung JW, Holl JL
Evaluation of initial participation in public reporting of American College of Surgeons NSQIP surgical outcomes on Medicare's Hospital Compare website.
The objective of this paper was to compare CMS-National Surgical Quality Improvement Program (CMS-NSQIP) participating hospitals with American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) hospitals that elected not to participate in Hospital Compare. The researchers found few measurable differences between CMS-NSQIP participating and nonparticipating hospitals.
AHRQ-funded; HS021857.
Citation: Dahlke AR, Chung JW, Holl JL .
Evaluation of initial participation in public reporting of American College of Surgeons NSQIP surgical outcomes on Medicare's Hospital Compare website.
J Am Coll Surg 2014 Mar;218(3):374-80, 80.e1-5. doi: 10.1016/j.jamcollsurg.2013.11.022.
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Keywords: Hospitals, Outcomes, Public Reporting, Quality Improvement, Surgery
Mooney TK, Gibbons MB, Gallop R
Psychotherapy credibility ratings: patient predictors of credibility and the relation of credibility to therapy outcome.
The researchers examined the relation between credibility ratings for adult psychotherapies and various patient factors as well as the relation between credibility ratings and subsequent symptom change. Their findings indicate that patient beliefs after a brief exposure to treatment may influence symptom improvement. Age and education may influence the patient’s beliefs about the credibility of a treatment.
AHRQ-funded; HS022124.
Citation: Mooney TK, Gibbons MB, Gallop R .
Psychotherapy credibility ratings: patient predictors of credibility and the relation of credibility to therapy outcome.
Psychother Res 2014;24(5):565-77. doi: 10.1080/10503307.2013.847988..
Keywords: Anxiety, Depression, Behavioral Health, Outcomes, Patient-Centered Outcomes Research
Spector WD
AHRQ Author: Spector WD
Response to letter to the editor regarding the paper "potentially avoidable hospitalization for elderly long-stay residents in nursing homes".
The author argues against the strategy than is implied by Dr. Powers’ letter to the editor. Rather than adding one aspect of care organization at a time to administrative data, he states that we should identify a small set of easily collected measures that generally modify the effects of care organization innovations. With these in place, we can then add measures like consistent assignment to better understand how it improves clinical outcomes.
AHRQ-authored
Citation: Spector WD .
Response to letter to the editor regarding the paper "potentially avoidable hospitalization for elderly long-stay residents in nursing homes".
Med Care 2014 Jan;52(1):93-4. doi: 10.1097/mlr.0000000000000072..
Keywords: Hospitalization, Elderly, Outcomes, Long-Term Care, Nursing Homes
Rosenberg JH, Albrecht JS, Fromme EK
Antimicrobial use for symptom management in patients receiving hospice and palliative care: a systematic review.
This systematic review found that limited data are available on the use of antimicrobial therapy for symptom management among patients receiving palliative or hospice care. The lack of comparison between patients who did and did not receive antimicrobial therapy means that there is no accurate estimate of the effectiveness of antimicrobial therapy.
AHRQ-funded; HS021068
Citation: Rosenberg JH, Albrecht JS, Fromme EK .
Antimicrobial use for symptom management in patients receiving hospice and palliative care: a systematic review.
J Palliat Med. 2013 Dec;16(12):1568-74. doi: 10.1089/jpm.2013.0276..
Keywords: Comparative Effectiveness, Antimicrobial Stewardship, Long-Term Care, Palliative Care, Outcomes
Sarraj A, Albright K, Barreto AD
Optimizing prediction scores for poor outcome after intra-arterial therapy in anterior circulation acute ischemic stroke.
The researchers sought to optimize a score that combines clinical and imaging variables to more accurately predict poor outcome after intra-arterial therapy (IAT) in anterior circulation occlusions. They concluded that the Houston IAT2 score, which combines clinical and imaging variables, performed better than all previous scores in predicting poor outcome after IAT for anterior circulation large artery occlusions.
AHRQ-funded; HS013852.
Citation: Sarraj A, Albright K, Barreto AD .
Optimizing prediction scores for poor outcome after intra-arterial therapy in anterior circulation acute ischemic stroke.
Stroke 2013 Dec;44(12):3324-30. doi: 10.1161/strokeaha.113.001050..
Keywords: Stroke, Outcomes, Cardiovascular Conditions
Mariscalco MW, Flanigan DC, Mitchell J
The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study.
The purpose of this study was to evaluate the effect of graft size on patient-reported outcomes and revision risk after anterior cruciate ligament (ACL) reconstruction. It found that smaller hamstring autograft size is a predictor of poorer Knee Injury and Osteoarthritis Outcome Score (sport/recreation subscale function) 2 years after primary ACL reconstruction.
AHRQ-funded; HS016075.
Citation: Mariscalco MW, Flanigan DC, Mitchell J .
The influence of hamstring autograft size on patient-reported outcomes and risk of revision after anterior cruciate ligament reconstruction: a Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study.
Arthroscopy 2013 Dec;29(12):1948-53. doi: 10.1016/j.arthro.2013.08.025.
Keywords: Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Surgery
Srinivas SK, Fager C, Lorch SA
Variations in postdelivery infection and thrombosis by hospital teaching status.
The researchers examined hospital-level variation overall and by teaching status in 2 maternal outcomes, postpartum infections, and thrombosis. They found substantial variation in infection and thrombosis rates among hospitals both overall and by teaching status, suggesting that these 2 outcomes may be useful measures of inpatient obstetric quality.
AHRQ-funded; HS015696.
Citation: Srinivas SK, Fager C, Lorch SA .
Variations in postdelivery infection and thrombosis by hospital teaching status.
Am J Obstet Gynecol 2013 Dec;209(6):567.e1-7. doi: 10.1016/j.ajog.2013.08.002..
Keywords: Pregnancy, Labor and Delivery, Outcomes, Quality of Care
Neugebauer R, Fireman B, Roy JA
Impact of specific glucose-control strategies on microvascular and macrovascular outcomes in 58,000 adults with type 2 diabetes.
This study used comparative effectiveness research methods to compare the effect of four distinct glucose-control strategies on subsequent myocardial infarction and nephropathy in type 2 diabetes. It found that in a large group of adults with type 2 diabetes, more aggressive glucose-control strategies have mixed short-term effects on microvascular complications and do not reduce the myocardial infarction rate over 4 years of follow-up.
AHRQ-funded; 29020050033I.
Citation: Neugebauer R, Fireman B, Roy JA .
Impact of specific glucose-control strategies on microvascular and macrovascular outcomes in 58,000 adults with type 2 diabetes.
Diabetes Care 2013 Nov;36(11):3510-6. doi: 10.2337/dc12-2675..
Keywords: Comparative Effectiveness, Diabetes, Outcomes, Patient-Centered Outcomes Research, Treatments
Navarro-Millán I, Sattui SE, Curtis JR
Systematic review of tumor necrosis factor inhibitor discontinuation studies in rheumatoid arthritis.
The objective of this article is to conduct a systematic review of the available literature on discontinuation of anti-tumor necrosis factor (anti-TNF) agents in rheumatoid arthritis (RA) patients and the associated features of study designs, including eligibility criteria, outcome definitions, and outcomes of discontinuation. The authors concluded that discontinuation of anti-TNF therapy is achievable for many RA patients who start in clinical remission or low disease activity.
AHRQ-funded; HS018517
Citation: Navarro-Millán I, Sattui SE, Curtis JR .
Systematic review of tumor necrosis factor inhibitor discontinuation studies in rheumatoid arthritis.
Clin Ther. 2013 Nov;35(11):1850-61.e1. doi: 10.1016/j.clinthera.2013.09.015..
Keywords: Comparative Effectiveness, Outcomes, Arthritis, Medication, Chronic Conditions
Hanlon JT, Schmader KE
The medication appropriateness index at 20: where it started, where it has been, and where it may be going.
The objective of this narrative review is to describe finding regarding the reliability of the Medication Appropriateness Index (MAI), a comparison of the MAI with other quality measures of potentially inappropriate prescribing, the predictive value of the MAI with important health outcomes, and the responsiveness of the MAI to change within the framework of randomized controlled trials.
AHRQ-funded; HS018721
Citation: Hanlon JT, Schmader KE .
The medication appropriateness index at 20: where it started, where it has been, and where it may be going.
Drugs Aging. 2013 Nov;30(11):893-900. doi: 10.1007/s40266-013-0118-4..
Keywords: Quality of Care, Medication, Outcomes, Quality Measures, Medication: Safety