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- Adverse Drug Events (ADE) (1)
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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 50 Research Studies DisplayedMa X, Chen Y, Cole SR
A hybrid Bayesian hierarchical model combining cohort and case-control studies for meta-analysis of diagnostic tests: accounting for partial verification bias.
In this paper, the authors proposed a novel hybrid Bayesian hierarchical model combining cohort and case-control studies while simultaneously correcting partial verification bias. They presented two case studies on assessing the diagnostic accuracy of gadolinium-enhanced magnetic resonance imaging in detecting lymph node metastases and of adrenal fluorine-18 fluorodeoxyglucose positron emission tomography in characterizing adrenal masses.
AHRQ-funded; HS022900.
Citation: Ma X, Chen Y, Cole SR .
A hybrid Bayesian hierarchical model combining cohort and case-control studies for meta-analysis of diagnostic tests: accounting for partial verification bias.
Stat Methods Med Res 2016 Dec;25(6):3015-37. doi: 10.1177/0962280214536703.
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Keywords: Cancer, Diagnostic Safety and Quality, Imaging, Research Methodologies
Kannampallil T, Galanter WL, Falck S
Characterizing the pain score trajectories of hospitalized adult medical and surgical patients: a retrospective cohort study.
The authors described a 1-year, retrospective, observational study to characterize pain trajectories of hospitalized adults during the first 48 hours after admission at an urban academic medical center. They found that trajectories showed differences based on race, gender, service, and initial pain score, with patients presumed to have dissimilar pain experiences having markedly different pain trajectories. Pain reduction 48 hours after admission was approximately 50% of the initial pain, while most patients' pain failed to fully resolve.
AHRQ-funded; HS021093.
Citation: Kannampallil T, Galanter WL, Falck S .
Characterizing the pain score trajectories of hospitalized adult medical and surgical patients: a retrospective cohort study.
Pain 2016 Dec;157(12):2739-46. doi: 10.1097/j.pain.0000000000000693.
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Keywords: Diagnostic Safety and Quality, Hospitalization, Pain
Sulzer SH, Muenchow E, Potvin A
Improving patient-centered communication of the borderline personality disorder diagnosis.
This study aimed to understand how clinicians communicate the diagnosis of borderline personality disorder (BPD) with patients, and compare these practices with patient communication preferences. It found that the majority of clinicians sampled did not actively share the BPD diagnosis with their patients, while the majority of patients wanted to be told that they had the disorder, as well as have their providers discuss the stigma they would face.
AHRQ-funded; HS000032.
Citation: Sulzer SH, Muenchow E, Potvin A .
Improving patient-centered communication of the borderline personality disorder diagnosis.
J Ment Health 2016;25(1):5-9. doi: 10.3109/09638237.2015.1022253.
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Keywords: Communication, Diagnostic Safety and Quality, Behavioral Health, Clinician-Patient Communication, Social Stigma
Thomas GW, Rojas-Murillo S, Hanley JM
Skill assessment in the interpretation of 3D fracture patterns from radiographs.
The researchers determined if 3D radiographic image interpretation can be reliably assessed, and whether this assessment varies by level of training. They concluded that the interpretation of radiographs to discern 3D information is a promising and a relatively unexplored area for surgical skill education and assessment.
AHRQ-funded; HS022077.
Citation: Thomas GW, Rojas-Murillo S, Hanley JM .
Skill assessment in the interpretation of 3D fracture patterns from radiographs.
Iowa Orthop J 2016;36:1-6.
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Keywords: Diagnostic Safety and Quality, Education: Continuing Medical Education, Injuries and Wounds, Imaging, Training
Brody AM, Sharma VK, Singh A
Barriers to emergency physician diagnosis and treatment of uncontrolled chronic hypertension.
This study surveyed a national sample of emergency physicians on their perceived barriers in establishing an ED diagnosis of asymptomatic hypertension (HTN) and ED treatment of such patients. It found that the most common barriers to diagnosis of HTN were uncertainty regarding the validity of ED blood pressure measurements (92 percent)and reluctance to diagnose a condition which cannot be comprehensively managed in the ED setting (29 percent).
AHRQ-funded; HS000011.
Citation: Brody AM, Sharma VK, Singh A .
Barriers to emergency physician diagnosis and treatment of uncontrolled chronic hypertension.
Am J Emerg Med 2016 Nov;34(11):2241-42. doi: 10.1016/j.ajem.2016.08.050.
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Keywords: Blood Pressure, Emergency Department, Diagnostic Safety and Quality, Chronic Conditions
Thomson J, Hall M, Berry JG
Diagnostic testing and hospital outcomes of children with neurologic impairment and bacterial pneumonia.
This study assessed hospital-level variability in diagnostic testing and outcomes for children with neurologic impairment hospitalized with pneumonia. For children with neurologic impairment hospitalized with pneumonia, across hospital differences in diagnostic testing were not associated with clinically meaningful differences in outcomes. High-utilizing hospitals may be able to decrease diagnostic testing for children with neurologic impairment hospitalized with pneumonia without adversely impacting outcomes.
AHRQ-funded; HS023092.
Citation: Thomson J, Hall M, Berry JG .
Diagnostic testing and hospital outcomes of children with neurologic impairment and bacterial pneumonia.
J Pediatr 2016 Nov;178:156-63.e1. doi: 10.1016/j.jpeds.2016.07.024.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Outcomes, Hospitalization
Elmore JG, Cook AJ, Bogart A
Radiologists' interpretive skills in screening vs. diagnostic mammography: are they related?
This study aimed to determine whether radiologists who perform well in screening also perform well in interpreting diagnostic mammography. It evaluated the accuracy of 468 radiologists interpreting 2,234,947 screening and 196,164 diagnostic mammograms and found a moderate correlation for radiologists' accuracy when interpreting screening versus their accuracy on diagnostic examinations.
AHRQ-funded; HS010591.
Citation: Elmore JG, Cook AJ, Bogart A .
Radiologists' interpretive skills in screening vs. diagnostic mammography: are they related?
Clin Imaging 2016 Nov - Dec;40(6):1096-103. doi: 10.1016/j.clinimag.2016.06.014.
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Keywords: Cancer: Breast Cancer, Diagnostic Safety and Quality, Screening, Imaging, Women, Provider Performance
Singh H, Zwaan L
Annals for hospitalists inpatient notes - Reducing diagnostic error-a new horizon of opportunities for hospital medicine.
The authors argue that given the importance of diagnoses in the hospital, hospitalists are well-positioned to lead efforts to promote correct and timely diagnosis. However, to reduce harms from diagnostic errors, hospitalists must first understand how these errors occur and then develop practical strategies to avoid them.
AHRQ-funded; HS022087; HS023602.
Citation: Singh H, Zwaan L .
Annals for hospitalists inpatient notes - Reducing diagnostic error-a new horizon of opportunities for hospital medicine.
Ann Intern Med 2016 Oct 18;165(8):HO2-HO4. doi: 10.7326/m16-2042.
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Keywords: Medical Errors, Diagnostic Safety and Quality, Patient Safety, Health Information Technology (HIT), Inpatient Care
Kantor R, Thyssen JP, Paller AS
Atopic dermatitis, atopic eczema, or eczema? A systematic review, meta-analysis, and recommendation for uniform use of 'atopic dermatitis'.
The authors sought to determine the most commonly-used terms for atopic dermatitis. They found that atopic dermatitis was the most commonly-used term in studies across almost all publication types, languages, and journals and appears to be increasing in popularity. They concluded by suggesting the use of the term atopic dermatitis in publications, healthcare clinician training, and patient education.
AHRQ-funded; HS023011.
Citation: Kantor R, Thyssen JP, Paller AS .
Atopic dermatitis, atopic eczema, or eczema? A systematic review, meta-analysis, and recommendation for uniform use of 'atopic dermatitis'.
Allergy 2016 Oct;71(10):1480-5. doi: 10.1111/all.12982.
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Keywords: Education: Patient and Caregiver, Diagnostic Safety and Quality, Patient-Centered Healthcare, Clinician-Patient Communication, Skin Conditions
Carmody D, Naylor RN, Bell CD
GCK-MODY in the US National Monogenic Diabetes Registry: frequently misdiagnosed and unnecessarily treated.
GCK-MODY (diabetes caused by mutations in the glucokinase (GCK) gene) leads to mildly elevated blood glucose typically not requiring therapy. It has been described in all ethnicities, but mainly in Caucasian Europeans. The researchers describe our US cohort of GCK-MODY. Their data show that a high detection rate of GCK-MODY is possible based on clinical phenotype and that prior to genetic diagnosis, a large percentage are inappropriately treated with glucose-lowering therapies.
AHRQ-funded; HS023007.
Citation: Carmody D, Naylor RN, Bell CD .
GCK-MODY in the US National Monogenic Diabetes Registry: frequently misdiagnosed and unnecessarily treated.
Acta Diabetol 2016 Oct;53(5):703-8. doi: 10.1007/s00592-016-0859-8.
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Keywords: Diabetes, Registries, Diagnostic Safety and Quality, Genetics
Kopylov U, Boucher G, Waterman M
Genetic predictors of benign course of ulcerative colitis - a North American inflammatory bowel disease genetics consortium study.
The aim of this project was to identify the genetic predictors of benign ulcerative colitis (UC) phenotype. No single-nucleotide polymorphisms from inflammatory bowel disease susceptibility loci were found to be associated with a benign UC disease course. These findings suggested on the exploratory analysis merit extension to larger discovery cohorts.
AHRQ-funded; HS021747.
Citation: Kopylov U, Boucher G, Waterman M .
Genetic predictors of benign course of ulcerative colitis - a North American inflammatory bowel disease genetics consortium study.
Inflamm Bowel Dis 2016 Oct;22(10):2311-6. doi: 10.1097/mib.0000000000000913.
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Keywords: Diabetes, Diagnostic Safety and Quality, Genetics
Olfson M, Blanco C, Marcus SC
Treatment of adult depression in the United States.
The researchers characterized the treatment of adult depression in the United States. They concluded that most US adults who screen positive for depression did not receive treatment for depression, whereas most who were treated did not screen positive. In light of these findings, it is important to strengthen efforts to align depression care with each patient's clinical needs.
AHRQ-funded; HS02112.
Citation: Olfson M, Blanco C, Marcus SC .
Treatment of adult depression in the United States.
JAMA Intern Med 2016 Oct;176(10):1482-91. doi: 10.1001/jamainternmed.2016.5057.
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Keywords: Medication, Depression, Diagnostic Safety and Quality, Medical Expenditure Panel Survey (MEPS)
Murphy DR, Meyer AN, Bhise V
Computerized triggers of big data to detect delays in follow-up of chest imaging results.
A "trigger" algorithm was used to identify delays in follow-up of abnormal chest imaging results in a large national clinical data warehouse of electronic health record (EHR) data. In this study, the authors applied a trigger in a repository hosting EHR data from all Department of Veterans Affairs health-care facilities and analyzed data from seven facilities. The investigators concluded that application of triggers on "big" EHR data may aid in identifying patients experiencing delays in diagnostic evaluation of chest imaging results suspicious for malignancy.
Citation: Murphy DR, Meyer AN, Bhise V .
Computerized triggers of big data to detect delays in follow-up of chest imaging results.
Chest 2016 Sep;150(3):613-20. doi: 10.1016/j.chest.2016.05.001..
Keywords: Imaging, Electronic Health Records (EHRs), Health Information Technology (HIT), Data, Diagnostic Safety and Quality, Cancer
Sjoding MW, Cooke CR, Iwashyna TJ
Acute respiratory distress syndrome measurement error. Potential effect on clinical study results.
This study investigated how the degree of variability in acute respiratory distress syndrome (ARDS) measurement commonly reported in clinical studies affects study power, the accuracy of treatment effect estimates, and the measured strength of risk factor associations. It found that lower reliability measurement of ARDS during patient enrollment in randomized controlled trials seriously degraded study power and effect size estimates of clinical studies.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Cooke CR, Iwashyna TJ .
Acute respiratory distress syndrome measurement error. Potential effect on clinical study results.
Ann Am Thorac Soc 2016 Jul;13(7):1123-8. doi: 10.1513/AnnalsATS.201601-072OC.
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Keywords: Diagnostic Safety and Quality, Research Methodologies, Respiratory Conditions
Wang SY, Hsu SH, Gross CP
Association between time since cancer diagnosis and health-related quality of life: a population-level analysis.
The purpose of this paper is to examine the association between time since cancer diagnosis and health-related quality of life (HRQOL) among cancer survivors in remission. The researchers found that most cancer survivors did not experience poorer mental health, but that survivors of prostate or cervical cancer had lower mental component summary scores after 10 years of diagnosis. They concluded that the level of HRQOL among cancer survivors depends on time since cancer diagnosis and cancer type.
AHRQ-funded; HS023900.
Citation: Wang SY, Hsu SH, Gross CP .
Association between time since cancer diagnosis and health-related quality of life: a population-level analysis.
Value Health 2016 Jul-Aug;19(5):631-8. doi: 10.1016/j.jval.2016.02.010.
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Keywords: Cancer, Diagnostic Safety and Quality, Health Status, Patient-Centered Outcomes Research, Quality of Life
Meyer AN, Murphy DR, Singh H
Communicating findings of delayed diagnostic evaluation to primary care providers.
In this study, researchers examined the effectiveness of various communication strategies to inform primary care practitioners (PCPs) about the delayed follow-up of cancer-related abnormal or "red-flag" findings. They found that strategies (emails, phone calls, contacting clinic directors) to communicate to PCPs information on delayed follow-up of findings suspicious for cancer were useful, but not fail-safe.
AHRQ-funded; HS022901.
Citation: Meyer AN, Murphy DR, Singh H .
Communicating findings of delayed diagnostic evaluation to primary care providers.
J Am Board Fam Med 2016 Jul-Aug;29(4):469-73. doi: 10.3122/jabfm.2016.04.150363.
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Keywords: Cancer, Communication, Diagnostic Safety and Quality, Primary Care
Wiseman JT, Fernandes-Taylor S, Gunter R
Inter-rater agreement and checklist validation for postoperative wound assessment using smartphone images in vascular surgery.
The authors evaluated whether smartphone digital images can supplant in-person evaluation of postoperative vascular surgery wounds. They concluded that using smartphone digital images is a valid method for evaluating postoperative vascular surgery wounds and is comparable to in-person evaluation with regard to most wound characteristics. The inter-rater reliability for determining treatment recommendations was universally high.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Gunter R .
Inter-rater agreement and checklist validation for postoperative wound assessment using smartphone images in vascular surgery.
J Vasc Surg Venous Lymphat Disord 2016 Jul;4(3):320-28.e2. doi: 10.1016/j.jvsv.2016.02.001.
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Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Telehealth, Surgery, Health Information Technology (HIT), Diagnostic Safety and Quality
Sjoding MW, Prescott HC, Wunsch H
Longitudinal changes in ICU admissions among elderly patients in the United States.
The researchers sought to describe the changing demographics, diagnoses, and outcomes of patients admitted to critical care units in the U.S. hospitals. They ound that patients with infectious diseases increased from 8.8 percent to 17.2 percent of admissions, and explicitly labeled sepsis moved from the 11th-ranked diagnosis in 1996 to the top-ranked primary discharge diagnosis in 2010.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Prescott HC, Wunsch H .
Longitudinal changes in ICU admissions among elderly patients in the United States.
Crit Care Med 2016 Jul;44(7):1353-60. doi: 10.1097/ccm.0000000000001664.
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Keywords: Elderly, Intensive Care Unit (ICU), Hospitalization, Diagnostic Safety and Quality, Critical Care
Raebel MA, Shetterly S, Lu CY
Methods for using clinical laboratory test results as baseline confounders in multi-site observational database studies when missing data are expected.
The purpose of this paper was to quantify missing baseline laboratory results, assess predictors of missingness, and examine performance of missing data methods. The researchers used the Mini-Sentinel Distributed Database to select three exposure-outcome scenarios with laboratory results as baseline confounders. They found that missing data methods performed similarly.
AHRQ-funded; HS023898.
Citation: Raebel MA, Shetterly S, Lu CY .
Methods for using clinical laboratory test results as baseline confounders in multi-site observational database studies when missing data are expected.
Pharmacoepidemiol Drug Saf 2016 Jul;25(7):798-814. doi: 10.1002/pds.4015.
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Keywords: Adverse Drug Events (ADE), Blood Thinners, Data, Diagnostic Safety and Quality, Medication
Brodsky MB, Suiter DM, Gonzalez-Fernandez M
Screening accuracy for aspiration using bedside water swallow tests: a systematic review and meta-analysis.
This study evaluated screening accuracy of bedside water swallow tests used to identify patients at risk for dysphagia-associated aspiration, finding that currently-used tests offer sufficient screening.
AHRQ-funded; HS022331.
Citation: Brodsky MB, Suiter DM, Gonzalez-Fernandez M .
Screening accuracy for aspiration using bedside water swallow tests: a systematic review and meta-analysis.
Chest 2016 Jul;150(1):148-63. doi: 10.1016/j.chest.2016.03.059.
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Keywords: Respiratory Conditions, Diagnostic Safety and Quality, Pneumonia
Al-Mutairi A, Meyer AN, Thomas EJ
Accuracy of the safer Dx instrument to identify diagnostic errors in primary care.
The researchers aimed to test the accuracy of an instrument to help detect presence or absence of diagnostic error through record reviews. They found that their Safer Dx Instrument helped quantify the likelihood of diagnostic error in primary care visits, achieving a high degree of accuracy for measuring their presence or absence.
AHRQ-funded; HS022087.
Citation: Al-Mutairi A, Meyer AN, Thomas EJ .
Accuracy of the safer Dx instrument to identify diagnostic errors in primary care.
J Gen Intern Med 2016 Jun;31(6):602-8. doi: 10.1007/s11606-016-3601-x.
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Keywords: Primary Care, Diagnostic Safety and Quality, Medical Errors, Patient Safety, Quality Improvement
Goldberg EM, Levy PD
New approaches to evaluating and monitoring blood pressure.
The authors reviewed the current literature on mobile health technologies and novel diagnostic and management protocols and made recommendations on how to incorporate these innovations into practice. They recommend collaboration between device designers and clinical researchers to develop rigorous clinical trials to test cardiovascular outcomes associated with emerging technologies.
AHRQ-funded; HS000011.
Citation: Goldberg EM, Levy PD .
New approaches to evaluating and monitoring blood pressure.
Curr Hypertens Rep 2016 Jun;18(6):49. doi: 10.1007/s11906-016-0650-9.
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Keywords: Blood Pressure, Telehealth, Health Information Technology (HIT), Diagnostic Safety and Quality
Satchidanand N, Withiam-Leitch M, Dickinson M
Positive predictive value of a single assessment of estimated GFR in the diagnosis of chronic kidney disease.
The authors' objective was to determine the positive predictive value (PPV) of a single assessment of estimated glomerular filtration rate (eGFR) among adults with at least one eGFR less than 60 mL/min in their lifetime. Using the Distributed Area Research and Therapeutics Network CKD natural history dataset, they found a cutpoint of less than 45 mL/min, yielding a PPV of 93% with a sensitivity of 28% and a specificity of 94%, thus identifying a valid cutpoint to screen for chronic kidney disease.
AHRQ-funded; HS023656.
Citation: Satchidanand N, Withiam-Leitch M, Dickinson M .
Positive predictive value of a single assessment of estimated GFR in the diagnosis of chronic kidney disease.
South Med J 2016 Jun;109(6):351-5. doi: 10.14423/smj.0000000000000474.
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Keywords: Chronic Conditions, Kidney Disease and Health, Diagnostic Safety and Quality
Lewandowski RE, O'Connor B, Bertagnolli A
Screening for and diagnosis of depression among adolescents in a large health maintenance organization.
The researchers determined changes in patterns of depression screening and diagnosis over three years in primary and specialty mental health care in a large HMO. They found that the rate of depression screening in primary care increased over the study period, corresponding to an increase in the number of depression diagnoses made in primary care and a shift in the location in which depression diagnoses were made, from the mental health department to primary care.
AHRQ-funded; HS020503.
Citation: Lewandowski RE, O'Connor B, Bertagnolli A .
Screening for and diagnosis of depression among adolescents in a large health maintenance organization.
Psychiatr Serv 2016 Jun;67(6):636-41. doi: 10.1176/appi.ps.201400465.
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Keywords: Children/Adolescents, Depression, Diagnostic Safety and Quality, Behavioral Health, Screening
Jindai K, Sterkel AK, Reed KD
Limb embolism in a 52-year-old woman.
In response to a photo quiz, the authors make the following diagnosis: arterial thrombus caused by Histoplasma capsulatum deriving from native valve endocarditis caused by the same organism. Various aspects of the case are discussed.
AHRQ-funded; HS022465; HS023779.
Citation: Jindai K, Sterkel AK, Reed KD .
Limb embolism in a 52-year-old woman.
Clin Infect Dis 2016 May 15;62(10):1320-1. doi: 10.1093/cid/ciw081.
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Keywords: Blood Clots, Care Management, Case Study, Diagnostic Safety and Quality, Patient Safety