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Topics
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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 30 Research Studies DisplayedHuo T, Glueck DH, Shenkman EA
Stratified split sampling of electronic health records
Data extracted from electronic health records may require very different approaches for model building and analysis than data from clinical research. Because electronic health record data is designed for clinical use, researchers need to engage in the iterative process of defining and provide clear definitions of outcome and predictor variables and assessing associations. This process can increase Type I error rates and decrease the chance of replicability. Failure to consider subgroups may mask heterogeneous relationships between predictor and outcome by subgroups, thus decreasing the generalizability of the findings. To improve the likelihood of both replicability and generalizability, the researchers recommended utilizing a stratified split sample approach for studies using electronic health records. The researchers illustrate the approach through an electronic health record study of the relationships between socio-demographic factors and uptake of hepatic cancer screening, and potential heterogeneity of association in subgroups defined by gender, self-identified race and ethnicity, census-tract level poverty and insurance type.
AHRQ-funded; HS028283.
Citation: Huo T, Glueck DH, Shenkman EA .
Stratified split sampling of electronic health records
BMC Med Res Methodol 2023 May 25; 23(1):128. doi: 10.1186/s12874-023-01938-0..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, Health Services Research (HSR)
Burgermaster M, Rodriguez VA
Psychosocial-behavioral phenotyping: a novel precision health approach to modeling behavioral, psychological, and social determinants of health using machine learning.
The purpose of this study was to demonstrate a novel application of machine learning for psychosocial-behavioral phenotyping, which includes the identification of subgroups with similar combinations of psychosocial characteristics. The researchers conducted a secondary analysis of psychosocial and behavioral data from a community cohort (n = 5,883). The study found 20 psychosocial-behavioral phenotypes. Each phenotype suggested different contextual considerations for intervention design. The researchers concluded that psychosocial-behavioral phenotypes can identify possible targets of intervention.
AHRQ-funded; HS019853.
Citation: Burgermaster M, Rodriguez VA .
Psychosocial-behavioral phenotyping: a novel precision health approach to modeling behavioral, psychological, and social determinants of health using machine learning.
Ann Behav Med 2022 Nov 18;56(12):1258-71. doi: 10.1093/abm/kaac012..
Keywords: Social Determinants of Health, Health Information Technology (HIT), Research Methodologies
Russell LB, Huang Q, Lin Y
The electronic health record as the primary data source in a pragmatic trial: a case study.
Electronic health records are a series of overlapping and legacy systems that require time and expertise to use efficiently. Commonly measured patient characteristics are relatively easy to locate for most trial enrollees but less common characteristics are not. Acquiring essential supplementary data - in this trial, state data on hospital admission - can be a lengthy and difficult process.
AHRQ-funded; HS026372.
Citation: Russell LB, Huang Q, Lin Y .
The electronic health record as the primary data source in a pragmatic trial: a case study.
Med Decis Making 2022 Nov;42(8):975-84. doi: 10.1177/0272989x211069980..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies
Young JC, Dasgupta N, Stürmer T
Considerations for observational study design: comparing the evidence of opioid use between electronic health records and insurance claims.
The authors linked electronic health record (EHR) data from a large academic health system to Medicare insurance claims for patients undergoing surgery. When characterizing opioid exposure, they found substantial discrepancies between EHR medication orders and prescription claims data. In all time periods assessed, most patients' use was reflected only in the EHR, or only in the claims, but not both.
AHRQ-funded; HS000032.
Citation: Young JC, Dasgupta N, Stürmer T .
Considerations for observational study design: comparing the evidence of opioid use between electronic health records and insurance claims.
Pharmacoepidemiol Drug Saf 2022 Aug;31(8):913-20. doi: 10.1002/pds.5452..
Keywords: Research Methodologies, Electronic Health Records (EHRs), Health Information Technology (HIT)
Li M, Morey DA, Rayo MF
Symbiotic design application in healthcare: preventing hospital acquired infections.
The purpose of this study was to describe the researchers’ experience with the early development stages of an AI-enabled clinical decision support (CDS) tool for hospital-acquired infection (HAI) prevention. The study focuses on three central principles of a symbiotic design process that the researchers have determined to be vital for aligning goals, priorities, mental models, and techniques among a multidisciplinary team: 1) recurrent bottom-up feedback, 2) continual model alignment, and 3) openness to co-direction. The study explores the successes and challenges encountered by the team during the process and discusses how those experiences can impact the design of human-machine teams.
AHRQ-funded; HS027200.
Citation: Li M, Morey DA, Rayo MF .
Symbiotic design application in healthcare: preventing hospital acquired infections.
Proc Int Symp Hum Factors Ergon Healthc 2021 Jun;10(1):211-16. doi: 10.1177/2327857921101138..
Keywords: Research Methodologies, Clinical Decision Support (CDS), Health Information Technology (HIT)
Rodriguez PJ, Ward ZJ, Long MW
Applied methods for estimating transition probabilities from electronic health record data.
This study examined the usefulness of electronic health records (EHRs) in estimating transition probabilities for state-transition models. No guidelines exist on appropriate methods. The authors used 3 potential methods to estimate transition probabilities for EHR data, using pediatric eating disorders (EDs) as a case study. They mapped diagnoses to 3 ED health states: anorexia nervous, bulimia nervosa, and other specified feeding or eating disorder using data from PEDsnet, which includes 8 US children’s hospitals. They used 3 approaches: simple first-last proportions, a multistate Markov (MSM) model, and independent survival models. The first-last proportion approach estimated higher probabilities of remaining the same health state, while the other two approaches estimated higher probabilities of transitioning to a different health state. Published literature differed substantially from these estimates. Further research is needed to improve methods for using EHR data to inform transition probabilities.
AHRQ-funded; HS013853.
Citation: Rodriguez PJ, Ward ZJ, Long MW .
Applied methods for estimating transition probabilities from electronic health record data.
Med Decis Making 2021 Feb;41(2):143-52. doi: 10.1177/0272989x20985752..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Research Methodologies
Ward TM, Skubic M, Rantz M
Human-centered approaches that integrate sensor technology across the lifespan: opportunities and challenges.
Children, parents, older adults, and caregivers routinely use sensor technology as a source of health information and health monitoring. The purpose of this paper was to describe three exemplars of research that used a human-centered approach to engage participants in the development, design, and usability of interventions that integrate technology to promote health. The exemplars were based on current research studies that integrated sensor technology into pediatric, adult, and older adult populations living with a chronic health condition.
AHRQ-funded; HS018477.
Citation: Ward TM, Skubic M, Rantz M .
Human-centered approaches that integrate sensor technology across the lifespan: opportunities and challenges.
Nurs Outlook 2020 Nov-Dec;68(6):734-44. doi: 10.1016/j.outlook.2020.05.004..
Keywords: Health Information Technology (HIT), Patient and Family Engagement, Health Services Research (HSR), Research Methodologies
Gance-Cleveland B, McDonald CC, Walker RK
Use of theory to guide development and application of sensor technologies in nursing.
In this paper, three nurse scientists summarize their presentations at the Council for the Advancement of Nursing Science 2019 Advanced Methods Conference on Expanding Science of Sensor Technology in Research discussing the theoretical underpinnings of sensor technologies development and use in nursing research and practice.
AHRQ-funded; HS024738; HS018646.
Citation: Gance-Cleveland B, McDonald CC, Walker RK .
Use of theory to guide development and application of sensor technologies in nursing.
Nurs Outlook 2020 Nov-Dec;68(6):698-710. doi: 10.1016/j.outlook.2020.04.007..
Keywords: Health Information Technology (HIT), Nursing, Health Services Research (HSR), Research Methodologies
Nuamah JK, Adapa K, Mazur L
Electronic health records (EHR) simulation-based training: a scoping review protocol.
This article describes a literature review that will be conducted on the evidence for electronic health record (EHR)-based training interventions to facilitate improved EHR use for healthcare providers. Three databases will be searched for published articles and ProQuest and Google Scholar will be searched to identify unpublished articles from inception to January 29, 2020. Two reviewers will independently screen titles and abstracts using inclusion and exclusion criteria. Based on the extracted data, research evidence will be synthesized.
AHRQ-funded; HS025597.
Citation: Nuamah JK, Adapa K, Mazur L .
Electronic health records (EHR) simulation-based training: a scoping review protocol.
BMJ Open 2020 Aug 11;10(8):e036884. doi: 10.1136/bmjopen-2020-036884..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, Simulation
Powell KR, Alexander GL. KR, Alexander GL
Qualitative validation of the nursing home IT maturity staging model.
The goal of the current study was to qualitatively explore issues of validity, specificity, and sensitivity regarding the nursing home (NH) information technology (IT) maturity survey and staging model. Participants who completed the NH IT maturity survey were recruited during pilot testing of the survey and staging model. Cognitive interviewing was used to collect qualitative data.
AHRQ-funded; HS022497.
Citation: Powell KR, Alexander GL. KR, Alexander GL .
Qualitative validation of the nursing home IT maturity staging model.
AHRQ-funded; HS022497..
Keywords: Nursing Homes, Long-Term Care, Health Information Technology (HIT), Research Methodologies
Di Tosto G, McAlearney AS, Fareed N
Metrics for outpatient portal use based on log file analysis: algorithm development.
This study’s goal was to document the functionality of an outpatient portal in the context of outpatient care by mining portal usage data and to provide insights into how patients use this tool. The authors developed a taxonomy of functions and actions and computed analytic metrics, including frequency and comprehensiveness of use. They found that function use was comprehensive at the patient level, while each session was instead limited to the use of one specific function. They hope to promote the replicability of their study at other institutions and to contribute to the establishment of best practices that can facilitate the adoption of behavioral metrics that enable the measurement of patient engagement based on the outpatient portal use.
AHRQ-funded; HS024091; HS024349; HS024379.
Citation: Di Tosto G, McAlearney AS, Fareed N .
Metrics for outpatient portal use based on log file analysis: algorithm development.
J Med Internet Res 2020 Jun 12;22(6):e16849. doi: 10.2196/16849..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Health Services Research (HSR), Research Methodologies
Weng Y, Tian L, Tedesco D
Trajectory analysis for postoperative pain using electronic health records: a nonparametric method with robust linear regression and K-medians cluster analysis.
Postoperative pain scores are widely monitored and collected in the electronic health record, yet current methods fail to fully leverage the data with fast implementation. This article describes a trajectory analysis for postoperative pain using electronic health records. A robust linear regression was fitted to describe the association between the log-scaled pain score and time from discharge after total knee replacement.
AHRQ-funded; HS024096.
Citation: Weng Y, Tian L, Tedesco D .
Trajectory analysis for postoperative pain using electronic health records: a nonparametric method with robust linear regression and K-medians cluster analysis.
Health Informatics J 2020 Jun;26(2):1404-18. doi: 10.1177/1460458219881339..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Pain, Surgery, Orthopedics, Research Methodologies, Health Services Research (HSR)
Vemulakonda VM, Bush RA, Kahn MG
"Minimally invasive research?" Use of the electronic health record to facilitate research in pediatric urology.
This literature study examined the use of electronic health records (EHRs) to facilitate research in pediatric urology. The use of EHRs has been strongly encouraged by US federal agencies, including AHRQ. The researchers found that EHR use for research has strengths and weaknesses and more collaboration is needed to identify the method that best suits incorporation of research-oriented data collection into routine pediatric urologic clinical practice.
AHRQ-funded; HS024597; HS022404.
Citation: Vemulakonda VM, Bush RA, Kahn MG .
"Minimally invasive research?" Use of the electronic health record to facilitate research in pediatric urology.
J Pediatr Urol 2018 Oct;14(5):374-81. doi: 10.1016/j.jpurol.2018.04.033..
Keywords: Electronic Health Records (EHRs), Children/Adolescents, Health Information Technology (HIT), Health Services Research (HSR), Research Methodologies
Cottrell EK, Gold R, Likumahuwa S
Using health information technology to bring social determinants of health into primary care: a conceptual framework to guide research.
The investigators recently proposed a conceptual framework to illustrate how health information technology can be used to bring social determinants of health information into primary care. In this paper, they describe how they are putting this conceptual model into practice within the OCHIN network of community health centers by highlighting examples of ongoing research, identifying knowledge gaps, and outlining a roadmap of future research to move the field forward.
Citation: Cottrell EK, Gold R, Likumahuwa S .
Using health information technology to bring social determinants of health into primary care: a conceptual framework to guide research.
AHRQ-funded; 233201500020I..
Keywords: Health Information Technology (HIT), Primary Care, Research Methodologies, Social Determinants of Health
Simon KC, Tideman S, Hillman L
Design and implementation of pragmatic clinical trials using the electronic medical record and an adaptive design.
The purpose of this study was to demonstrate the feasibility of pragmatic clinical trials comparing the effectiveness of treatments using the electronic medical record (EMR) and an adaptive assignment design. The authors suggest that the demonstration of successful pragmatic clinical trials based on a customized EMR and adaptive design is an important next step in achieving personalized medicine and provides a framework for future studies of comparative effectiveness.
AHRQ-funded; HS024057.
Citation: Simon KC, Tideman S, Hillman L .
Design and implementation of pragmatic clinical trials using the electronic medical record and an adaptive design.
JAMIA Open 2018 Jul;1(1):99-106. doi: 10.1093/jamiaopen/ooy017..
Keywords: Comparative Effectiveness, Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, System Design
Hultman G, McEwan R, Pakhomov S
Usability evaluation of an unstructured clinical document query tool for researchers.
This study aimed to conduct a user-centered analysis with clinical researchers to gain insight into Natural Language Processing - Patient Information Extraction for Researchers (NLP-PIER) usability and to gain an understanding of the needs of clinical researchers when using an application for searching clinical notes.
AHRQ-funded; HS022085.
Citation: Hultman G, McEwan R, Pakhomov S .
Usability evaluation of an unstructured clinical document query tool for researchers.
AMIA Jt Summits Transl Sci Proc 2018 May 18;2018:84-93..
Keywords: Data, Health Information Technology (HIT), Research Methodologies
Wilbanks J
Design issues in e-consent.
Informed consent has not been implemented as a relationship, but instead as a single-point transaction that must be completed in order to enroll participants. This paper discusses e-consent and notes that it is an opportunity to: truly inform research participants about clinical protocols; provide a meaningful choice architecture to support a potential participant’s decision making about whether or not to enroll; and serve as the beginning of an ongoing ethical relationship with study participants.
AHRQ-funded; HS022789.
Citation: Wilbanks J .
Design issues in e-consent.
J Law Med Ethics 2018 Mar;46(1):110-18. doi: 10.1177/1073110518766025..
Keywords: Shared Decision Making, Health Information Technology (HIT), Patient-Centered Outcomes Research, Research Methodologies
Wang L, Topaz M, Plasek JM
Content and trends in medical informatics publications over the past two decades.
This study aims to identify subject content and trends in the medical informatics literature in order to shed light on the past, current, and future directions of diverse education and research activities. It found 73 core topics and 72 new topics of medical informatics within three relevant MeSH categories (informatics, techniques, and healthcare).
AHRQ-funded; HS022728; HS024264.
Citation: Wang L, Topaz M, Plasek JM .
Content and trends in medical informatics publications over the past two decades.
Stud Health Technol Inform 2017;245:968-72.
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Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Health Information Technology (HIT), Research Methodologies
Cohen KB, Goss FR, Zweigenbaum P
Translational morphosyntax: distribution of negation in clinical records and biomedical journal articles.
This paper describes the distribution of negation in two types of biomedical texts: scientific journal articles and progress notes. Two types of negation are examined: explicit negation at the syntactic level and affixal negation at the sub-word level. The data show that the distribution of negation is significantly different in the two document types.
AHRQ-funded; HS024541.
Citation: Cohen KB, Goss FR, Zweigenbaum P .
Translational morphosyntax: distribution of negation in clinical records and biomedical journal articles.
Stud Health Technol Inform 2017;245:346-50.
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Keywords: Data, Health Information Technology (HIT), Research Methodologies
Kim KK, Sankar P, Wilson MD
Factors affecting willingness to share electronic health data among California consumers.
The objective of the study is to explore factors that affect consumers' willingness to share electronic health information for healthcare and research. It concluded that consumers' choices about electronically sharing health information are affected by their attitudes toward EHRs as well as beliefs about research benefit and individual control.
AHRQ-funded; HS019913.
Citation: Kim KK, Sankar P, Wilson MD .
Factors affecting willingness to share electronic health data among California consumers.
BMC Med Ethics 2017 Apr 4;18(1):25. doi: 10.1186/s12910-017-0185-x.
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Keywords: Communication, Electronic Health Records (EHRs), Health Information Exchange (HIE), Health Information Technology (HIT), Research Methodologies
Sockolow P, Dowding D, Randell R
Using mixed methods in health information technology evaluation.
The authors illustrated some of the benefits and challenges of using mixed methods in evaluation. The diversity of the informatics scholars' research experience provides a broad overview of approaches in combining robust analysis of outcome data with qualitative methods that provide an understanding of the processes through which, and the contexts in which, those outcomes are achieved.
AHRQ-funded; HS021008.
Citation: Sockolow P, Dowding D, Randell R .
Using mixed methods in health information technology evaluation.
Stud Health Technol Inform 2016;225:83-7.
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Keywords: Health Information Technology (HIT), Health Services Research (HSR), Research Methodologies
Liu Y, Chen Y, Scheet P
A meta-analytic framework for detection of genetic interactions.
The researchers propose a new procedure for detecting gene-by-gene interactions through heterogeneity in estimated low-order (e.g., marginal) effect sizes by leveraging population structure, or ancestral differences, among studies in which the same phenotypes were measured. They implement this approach in a meta-analytic framework, which offers numerous advantages, such as robustness and computational efficiency, and is necessary when data-sharing limitations restrict joint analysis.
AHRQ-funded; HS022900.
Citation: Liu Y, Chen Y, Scheet P .
A meta-analytic framework for detection of genetic interactions.
Genet Epidemiol 2016 Nov;40(7):534-43. doi: 10.1002/gepi.21996.
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Keywords: Genetics, Research Methodologies, Health Information Technology (HIT)
Cato KD, Bockting W, Larson E
Did I tell you that? Ethical issues related to using computational methods to discover non-disclosed patient characteristics.
Using the Belmont Report's principles of respect for persons, beneficence, and justice as a framework, the authors examined the ethical issues posed by electronic phenotyping. Ethical issues identified include the ability of the patient to consent for the use of their information, the ability to suppress pediatric information, and ensuring that the potential benefits justify the risks of harm to patients.
AHRQ-funded; HS022961.
Citation: Cato KD, Bockting W, Larson E .
Did I tell you that? Ethical issues related to using computational methods to discover non-disclosed patient characteristics.
J Empir Res Hum Res Ethics 2016 Jul;11(3):214-9. doi: 10.1177/1556264616661611.
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Keywords: Clinician-Patient Communication, Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research, Registries, Research Methodologies
Wong AF, Pielmeier U, Haug PJ
An in silico method to identify computer-based protocols worthy of clinical study: an insulin infusion protocol use case.
In this paper, the authors compared two existing computer-based insulin infusion protocols: eProtocol-insulin from Utah, USA, and Glucosafe from Denmark. They concluded that preclinical in silico comparison analytical framework allows rapid and inexpensive identification of computer-based protocol care strategies that justify expensive and burdensome clinical trials.
AHRQ-funded; HS006594.
Citation: Wong AF, Pielmeier U, Haug PJ .
An in silico method to identify computer-based protocols worthy of clinical study: an insulin infusion protocol use case.
J Am Med Inform Assoc 2016 Mar;23(2):283-8. doi: 10.1093/jamia/ocv067.
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Keywords: Health Information Technology (HIT), Medication, Research Methodologies
Wiley LK, Tarczy-Hornoch P, Denny JC
Harnessing next-generation informatics for personalizing medicine: a report from AMIA's 2014 health policy invitational meeting.
The American Medical Informatics Association convened the 2014 Health Policy Invitational Meeting to develop recommendations for updates to current policies and to establish an informatics research agenda for personalizing medicine. In particular, the meeting focused on discussing informatics challenges related to personalizing care through the integration of genomic or other high-volume biomolecular data with data from clinical systems to make health care more efficient and effective.
AHRQ-funded; HS021825.
Citation: Wiley LK, Tarczy-Hornoch P, Denny JC .
Harnessing next-generation informatics for personalizing medicine: a report from AMIA's 2014 health policy invitational meeting.
J Am Med Inform Assoc 2016 Mar;23(2):413-9. doi: 10.1093/jamia/ocv111.
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Keywords: Health Information Technology (HIT), Policy, Research Methodologies