National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Drug Events (ADE) (9)
- Adverse Events (45)
- Alcohol Use (3)
- Ambulatory Care and Surgery (6)
- Antibiotics (9)
- Antimicrobial Stewardship (4)
- Anxiety (4)
- Asthma (5)
- Autism (5)
- Back Health and Pain (5)
- Behavioral Health (25)
- Blood Clots (5)
- Blood Pressure (14)
- Blood Thinners (1)
- Brain Injury (4)
- Cancer (81)
- Cancer: Breast Cancer (22)
- Cancer: Cervical Cancer (2)
- Cancer: Colorectal Cancer (11)
- Cancer: Lung Cancer (10)
- Cancer: Prostate Cancer (4)
- Cardiovascular Conditions (26)
- Caregiving (3)
- Care Management (5)
- Case Study (7)
- Children/Adolescents (74)
- Chronic Conditions (18)
- Clinical Decision Support (CDS) (18)
- Clinician-Patient Communication (11)
- Clostridium difficile Infections (1)
- Colonoscopy (5)
- Communication (17)
- Community-Acquired Infections (2)
- Comparative Effectiveness (11)
- COVID-19 (14)
- Critical Care (13)
- Cultural Competence (2)
- Data (5)
- Dementia (9)
- Depression (19)
- Diabetes (21)
- (-) Diagnostic Safety and Quality (548)
- Digestive Disease and Health (8)
- Disparities (11)
- Domestic Violence (2)
- Education (1)
- Education: Academic (1)
- Education: Continuing Medical Education (7)
- Education: Curriculum (1)
- Education: Patient and Caregiver (4)
- Elderly (19)
- Electronic Health Records (EHRs) (51)
- Emergency Department (46)
- Emergency Medical Services (EMS) (9)
- Evidence-Based Practice (23)
- Eye Disease and Health (2)
- Falls (1)
- Family Health and History (1)
- Genetics (11)
- Guidelines (14)
- Healthcare-Associated Infections (HAIs) (8)
- Healthcare Cost and Utilization Project (HCUP) (12)
- Healthcare Costs (8)
- Healthcare Delivery (9)
- Healthcare Utilization (5)
- Health Information Technology (HIT) (71)
- Health Insurance (1)
- Health Promotion (1)
- Health Services Research (HSR) (4)
- Health Status (3)
- Health Systems (2)
- Heart Disease and Health (19)
- Home Healthcare (3)
- Hospital Discharge (1)
- Hospitalization (7)
- Hospital Readmissions (3)
- Hospitals (19)
- Human Immunodeficiency Virus (HIV) (12)
- Imaging (100)
- Implementation (1)
- Infectious Diseases (13)
- Influenza (1)
- Injuries and Wounds (9)
- Inpatient Care (6)
- Intensive Care Unit (ICU) (18)
- Kidney Disease and Health (7)
- Labor and Delivery (1)
- Learning Health Systems (1)
- Lifestyle Changes (1)
- Long-Term Care (5)
- Low-Income (2)
- Maternal Care (2)
- Medical Errors (53)
- Medical Expenditure Panel Survey (MEPS) (2)
- Medicare (8)
- Medication (19)
- Medication: Safety (4)
- Men's Health (4)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (2)
- Mortality (1)
- Neonatal Intensive Care Unit (NICU) (2)
- Neurological Disorders (22)
- Newborns/Infants (18)
- Nursing (1)
- Nursing Homes (7)
- Nutrition (2)
- Obesity (4)
- Obesity: Weight Management (1)
- Organizational Change (1)
- Orthopedics (1)
- Osteoporosis (2)
- Outcomes (10)
- Pain (5)
- Palliative Care (1)
- Patient-Centered Healthcare (5)
- Patient-Centered Outcomes Research (27)
- Patient Adherence/Compliance (2)
- Patient and Family Engagement (3)
- Patient Experience (4)
- Patient Safety (82)
- Patient Self-Management (2)
- Payment (2)
- Pneumonia (7)
- Policy (1)
- Practice Patterns (8)
- Pregnancy (6)
- Prevention (22)
- Primary Care (25)
- Primary Care: Models of Care (1)
- Provider (5)
- Provider: Clinician (6)
- Provider: Health Personnel (2)
- Provider: Nurse (2)
- Provider: Physician (6)
- Provider Performance (5)
- Public Health (1)
- Quality Improvement (29)
- Quality Indicators (QIs) (5)
- Quality Measures (8)
- Quality of Care (44)
- Quality of Life (2)
- Racial and Ethnic Minorities (15)
- Registries (1)
- Research Methodologies (9)
- Respiratory Conditions (24)
- Risk (21)
- Rural/Inner-City Residents (1)
- Rural Health (1)
- Screening (60)
- Sepsis (21)
- Sex Factors (2)
- Sexual Health (2)
- Shared Decision Making (34)
- Sickle Cell Disease (1)
- Skin Conditions (12)
- Sleep Problems (1)
- Social Determinants of Health (6)
- Social Stigma (3)
- Stroke (15)
- Substance Abuse (4)
- Surgery (15)
- Surveys on Patient Safety Culture (1)
- Teams (1)
- TeamSTEPPS (1)
- Telehealth (4)
- Tools & Toolkits (1)
- Training (8)
- Trauma (6)
- Treatments (3)
- U.S. Preventive Services Task Force (USPSTF) (4)
- Urban Health (5)
- Urinary Tract Infection (UTI) (6)
- Vulnerable Populations (4)
- Web-Based (3)
- Women (29)
- Workflow (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
101 to 125 of 548 Research Studies DisplayedMiller AC, Koeneman SH, Arakkal AT
Incidence, duration, and risk factors associated with missed opportunities to diagnose herpes simplex encephalitis: a population-based longitudinal study.
This retrospective cohort study determined the frequency and duration of diagnostic delays for herpes simplex encephalitis (HSE) that are associated with increased morbidity and mortality. Data from the IBM Marketscan Databases from 2001-2017 was used. The authors estimated the number of visits with HSE-related symptoms before diagnosis that would be expected to occur in the absence of delays and compared this estimate to the observed pattern of visits. Then a simulation-based approach was used to compute the number of visits representing a delay. They identified 2667 patients diagnosed with HSE and estimated 45.9% of patients experienced at least 1 missed opportunity, with 21.9% of patients having delays lasting >7 days. Risk factors for delays included being seen only in the emergency department, age 65 or older, or a history of sinusitis or schizophrenia.
AHRQ-funded; HS027375.
Citation: Miller AC, Koeneman SH, Arakkal AT .
Incidence, duration, and risk factors associated with missed opportunities to diagnose herpes simplex encephalitis: a population-based longitudinal study.
Open Forum Infect Dis 2021 Sep;8(9):ofab400. doi: 10.1093/ofid/ofab400..
Keywords: Infectious Diseases, Neurological Disorders, Diagnostic Safety and Quality, Risk
Goyal MK, Chamberlain JM, Webb M
Racial and ethnic disparities in the delayed diagnosis of appendicitis among children.
The objective of this 3-year multicenter retrospective cohort study of children was to determine if there are race/ethnicity differences in rates of appendiceal perforation, delayed diagnosis of appendicitis, and diagnostic imaging during prior visit(s). Delayed diagnosis was defined as having at least one emergency department (ED) visit within 7 days preceding the appendicitis diagnosis. Out of 7,298 patients diagnosed with appendicitis and documented race/ethnicity, 2,567 had appendiceal perforation. Non-Hispanic (NH) Black children had a higher likelihood of perforation (36.5% versus 34.9%) then non-Hispanic whites. They also were over twice as likely to have delayed diagnosis (4.7% versus 2.0%). Eighty-nine patients (43.2%) patients with delayed diagnosis had abdominal imaging during the prior visits. However, NH-Black children were less likely to have any imaging (28.2% versus 46.2%) or definitive imaging (10.3% versus 35.9%).
Acad Emerg Med 2021 Sep;28(9):949-56. doi: 10.1111/acem.14142.
Citation: Goyal MK, Chamberlain JM, Webb M .
Racial and ethnic disparities in the delayed diagnosis of appendicitis among children.
Acad Emerg Med 2021 Sep;28(9):949-56. doi: 10.1111/acem.14142..
Keywords: Children/Adolescents, Racial and Ethnic Minorities, Disparities, Diagnostic Safety and Quality
Kuhn J, Levinson Udhnani, MD
What happens after a positive primary care autism screen among historically underserved families? Predictors of evaluation and autism diagnosis.
This study examined predictors of receiving a recommended diagnostic evaluation after a recommended primary care-administered autism screen, and of those who screen positive, who is most likely to be diagnosed with autism. Participants were 309 predominantly low-income, racial/ethnic minority parents and their child aged 15-27 months who screened positive with the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F). Significant predictors of diagnostic evaluation included older parental age, being non-Hispanic and the child having private insurance, lower child communication functioning, or receiving Early Intervention services. Significant predictors of an autism diagnosis included being male, having lower child communication functioning, screening directly in the parent’s preferred language, White/non-Hispanic parent, and no parent history of mood disorder.
AHRQ-funded; HS022242.
Citation: Kuhn J, Levinson Udhnani, MD .
What happens after a positive primary care autism screen among historically underserved families? Predictors of evaluation and autism diagnosis.
J Dev Behav Pediatr 2021 Sep;42(7):515-23. doi: 10.1097/dbp.0000000000000928..
Keywords: Children/Adolescents, Autism, Screening, Vulnerable Populations, Diagnostic Safety and Quality
Mahajan P, Pai CW, Cosby KS
Identifying trigger concepts to screen emergency department visits for diagnostic errors.
The diagnostic process is a vital component of safe and effective emergency department (ED) care. There are no standardized methods for identifying or reliably monitoring diagnostic errors in the ED, impeding efforts to enhance diagnostic safety. In this study, the investigators sought to identify trigger concepts to screen ED records for diagnostic errors and describe how they can be used as a measurement strategy to identify and reduce preventable diagnostic harm.
AHRQ-funded; HS024953; HS027363.
Citation: Mahajan P, Pai CW, Cosby KS .
Identifying trigger concepts to screen emergency department visits for diagnostic errors.
Diagnosis 2021 Aug 26;8(3):340-46. doi: 10.1515/dx-2020-0122..
Keywords: Emergency Department, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety
Griffin JA, Carr K, Bersani K
Analyzing diagnostic errors in the acute setting: a process-driven approach.
In this study the authors describe an approach for analyzing failures in diagnostic processes in a small, enriched cohort of general medicine patients who expired during hospitalization and experienced medical error. Their objective was to delineate a systematic strategy for identifying frequent and significant failures in the diagnostic process to inform strategies for preventing adverse events due to diagnostic error.
AHRQ-funded; HS026613.
Citation: Griffin JA, Carr K, Bersani K .
Analyzing diagnostic errors in the acute setting: a process-driven approach.
Diagnosis 2021 Aug 23;23(9):77-88. doi: 10.1515/dx-2021-0033..
Keywords: Diagnostic Safety and Quality, Medical Errors, Adverse Events
Michelson KA, Reeves SD, Grubenhoff JA
Clinical features and preventability of delayed diagnosis of pediatric appendicitis.
In this case-control study, researchers sought to determine clinical features associated with delayed diagnosis of pediatric appendicitis, to assess the frequency of preventable delay, and to compare delay outcomes. They found that delayed appendicitis was associated with initially milder symptoms but worse outcomes. Their findings suggest that a majority of delayed diagnoses were at least possibly preventable and that many of the studied patients did not undergo indicated imaging, suggesting an opportunity to prevent delayed diagnosis of appendicitis in some children.
AHRQ-funded; HS026503.
Citation: Michelson KA, Reeves SD, Grubenhoff JA .
Clinical features and preventability of delayed diagnosis of pediatric appendicitis.
JAMA Netw Open 2021 Aug;4(8):e2122248. doi: 10.1001/jamanetworkopen.2021.22248..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Prevention
Cifra CL, Custer JW, Singh H
Diagnostic errors in pediatric critical care: a systematic review.
This study is a systematic review on the prevalence, impact, and contributing factors related to diagnostic errors in the PICU. A database search was done for literature up through December 2019. Using specific criteria, 396 abstracts were screened, and 17 studies were included. Fifteen of 17 studies had an observational research design. Autopsy studies showed a 10-23% rate of missed major diagnosis with 5-16% of the errors having a potential adverse impact on survival and would have changed care management. Retrospective record review studies reported varying rates of diagnostic error from 8% in a general PICU population to 12% among unexpected critical admissions. About a quarter of those patients were discussed at PICU morbidity and mortality conferences. Most misdiagnosed conditions were cardiovascular, infectious, congenital, or neurologic. System, cognitive, and both system and cognitive factors were associated with diagnostic error but there is limited information on the impact of misdiagnosis.
AHRQ-funded; HS026965.
Citation: Cifra CL, Custer JW, Singh H .
Diagnostic errors in pediatric critical care: a systematic review.
Pediatr Crit Care Med 2021 Aug;22(8):701-12. doi: 10.1097/pcc.0000000000002735..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety, Intensive Care Unit (ICU), Critical Care
Patterson BW, Johnson J, Ward MD
Effect of a split-flow physician in triage model on abdominal CT ordering rate and yield.
The objective of this study was to compare the rate and clinical yield of computed tomography (CT) imaging between patients presenting with abdominal pain initially seen by a physician in triage (PIT) versus those seen only by physicians working in the main emergency department (ED). For patients with abdominal pain, the investigators found no significant differences in rates of CT ordering or CT yield for patients seen in a PIT vs. traditional models.
AHRQ-funded; HS024558.
Citation: Patterson BW, Johnson J, Ward MD .
Effect of a split-flow physician in triage model on abdominal CT ordering rate and yield.
Am J Emerg Med 2021 Aug;46:160-64. doi: 10.1016/j.ajem.2020.05.119..
Keywords: Imaging, Emergency Department, Practice Patterns, Diagnostic Safety and Quality
Choi DT, Davila JA, Sansgiry S
Factors associated with delay of diagnosis of hepatocellular carcinoma in patients with cirrhosis.
Researchers examined the frequency of and factors associated with delays in diagnosis of hepatocellular carcinoma (HCC) in a cohort of patients with cirrhosis in the Veterans Health Administration (VHA). Data was collected and analyzed from VHA electronic health records. They found that nearly half of veterans with cirrhosis have delays in diagnosis of HCC of 60 days or more after a red flag, defined by guidelines. They recommended interventions to improve timely follow-up of red flags and adherence to guidelines in order to increase early detection of HCC.
AHRQ-funded; HS027363.
Citation: Choi DT, Davila JA, Sansgiry S .
Factors associated with delay of diagnosis of hepatocellular carcinoma in patients with cirrhosis.
Clin Gastroenterol Hepatol 2021 Aug;19(8):1679-87. doi: 10.1016/j.cgh.2020.07.026..
Keywords: Cancer, Diagnostic Safety and Quality
Mayampurath A, Parnianpour Z, Richards CT
Improving prehospital stroke diagnosis using natural language processing of paramedic reports.
Accurate prehospital diagnosis of stroke by emergency medical services (EMS) can increase treatments rates, mitigate disability, and reduce stroke deaths. IN this study, the investigators aimed to develop a model that utilized natural language processing of EMS reports and machine learning to improve prehospital stroke identification. The investigators conducted a retrospective study of patients transported by the Chicago EMS to 17 regional primary and comprehensive stroke centers.
AHRQ-funded; HS025359; HS027264.
Citation: Mayampurath A, Parnianpour Z, Richards CT .
Improving prehospital stroke diagnosis using natural language processing of paramedic reports.
Stroke 2021 Aug;52(8):2676-79. doi: 10.1161/strokeaha.120.033580..
Keywords: Stroke, Cardiovascular Conditions, Diagnostic Safety and Quality, Health Information Technology (HIT), Emergency Medical Services (EMS)
Silverberg JI, Lai Cella, D D
Reliability and meaningful change of the Patient-Reported Outcomes Measurement Information System(®) Itch Questionnaire (PIQ) item banks in adults with atopic dermatitis.
The Patient-Reported Outcomes Measurement Information System Itch Questionnaire (PIQ), includes a suite of patient-reported outcome measures to assess the burden of itch in adults. In this study, the investigators sought to determine the smallest detectable change (SDC), threshold for meaningful improvement and test–retest reliability of PIQ item banks for assessing the burden of itch in adult AD.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Lai Cella, D D .
Reliability and meaningful change of the Patient-Reported Outcomes Measurement Information System(®) Itch Questionnaire (PIQ) item banks in adults with atopic dermatitis.
Br J Dermatol 2021 Aug;185(2):438-39. doi: 10.1111/bjd.20066..
Keywords: Skin Conditions, Patient-Centered Outcomes Research, Outcomes, Diagnostic Safety and Quality
Soares WE, Knee A, Gemme SR
SC, et al. A prospective evaluation of Clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients.
The HEART score is a risk stratification aid that may safely reduce chest pain admissions for emergency department patients. However, differences in interpretation of subjective components potentially alters the performance of the score. In this study, the investigators compared agreement between HEART scores determined during clinical practice with research-generated scores and estimated their accuracy in predicting 30-day major adverse cardiac events.
AHRQ-funded; HS024815.
Citation: Soares WE, Knee A, Gemme SR .
SC, et al. A prospective evaluation of Clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients.
Ann Emerg Med 2021 Aug;78(2):231-41. doi: 10.1016/j.annemergmed.2021.03.024..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Emergency Department, Diagnostic Safety and Quality, Clinical Decision Support (CDS), Health Information Technology (HIT)
Byhoff E, Paulus JK, Guardado R
Healthcare workers' perspectives on coronavirus testing availability: a cross sectional survey.
This article describes a survey that was conducted during the first wave of the COVID pandemic during March-August 2020 of hospital workers on their perceptions of, access to, and receipt of COVID testing. A survey was given to all hospital employees in a single academic medical center in Boston, Massachusetts. A total of 2543 employees responded to the survey. Respondents were mostly female (76%), white (55%), with the mean age being 40 years. They were nurses (27%), administrators (22%), and patient support roles (22%) of which 56% of respondents wanted COVID testing. Age, full-time status, employment tenure, changes in quality of life, changes in job duties, and worries about enough sick paid leave were associated with testing. Nurses were more likely to want testing than administrators and patient support staff.
AHRQ-funded; HS026008.
Citation: Byhoff E, Paulus JK, Guardado R .
Healthcare workers' perspectives on coronavirus testing availability: a cross sectional survey.
BMC Health Serv Res 2021 Jul 21;21(1):719. doi: 10.1186/s12913-021-06741-5..
Keywords: COVID-19, Diagnostic Safety and Quality, Provider: Health Personnel, Public Health
Cifra CL, Sittig DF, Singh H
Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes.
This paper discusses challenges to the development of systems for effective patient outcome feedback to improve diagnosis and proposes the application of a sociotechnical approach using health information technology (HIT) to support the implementation of such systems. It discusses current barriers to effective clinician feedback, reasons for them, and features of potential IT solutions. Evaluation and implementation of the feedback process within a sociotechnical health system are then discussed. The authors use an eight-dimension sociotechnical model for studying health IT by authors Sittig and Singh. The eight dimensions are hardware and software; clinical content; human–computer interface; people; workflow and communication; organisational policies and procedures; external rules, regulations and pressures; and system measurement and monitoring. A table is included that shows the potential considerations for each dimension.
AHRQ-funded; 33201500022I; HS027363.
Citation: Cifra CL, Sittig DF, Singh H .
Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes.
BMJ Qual Saf 2021 Jul;30(7):591-97. doi: 10.1136/bmjqs-2020-012464..
Keywords: Health Information Technology (HIT), Diagnostic Safety and Quality, Patient Safety, Quality Improvement, Quality of Care
Shipe ME, Haddad DN, Deppen SA
Modeling the impact of delaying the diagnosis of non-small cell lung cancer during COVID-19
The novel coronavirus (COVID-19) pandemic has led surgical societies to recommend delaying diagnosis and treatment of suspected lung cancer for lesions less than 2 cm. The COVID-19 infection rate at which immediate operative risk exceeds benefit is unknown. Delaying diagnosis can lead to disease progression, but the impact of this delay on mortality is unknown. In this study, the investigators sought to model immediate versus delayed surgical resection in a suspicious lung nodule less than 2 cm.
AHRQ-funded; HS026122.
Citation: Shipe ME, Haddad DN, Deppen SA .
Modeling the impact of delaying the diagnosis of non-small cell lung cancer during COVID-19
Ann Thorac Surg 2021 Jul;112(1):248-54. doi: 10.1016/j.athoracsur.2020.08.025..
Keywords: COVID-19, Cancer: Lung Cancer, Cancer, Diagnostic Safety and Quality, Case Study, Risk
Thomas TW, Golin C, Samuel-Hodge CD
Race and gender differences in abnormal blood glucose screening and clinician response to prediabetes: a mixed-methods assessment.
The projected three-fold increase in diabetes burden by 2060 in the United States will affect certain race and gender groups disproportionately. The objective of this mixed-methods study was to assess differences in prediabetes screening and clinician response to prediabetes by patient race and gender. The investigators found that qualitatively, physicians reported a non-systematic approach to prediabetes screening and follow-up care related to: 1) System-level barriers to screening and treatment; 2) Implicit bias; 3) Patient factors; and 4) Physician preferences for prediabetes treatment.
AHRQ-funded; HS025561; HS000032.
Citation: Thomas TW, Golin C, Samuel-Hodge CD .
Race and gender differences in abnormal blood glucose screening and clinician response to prediabetes: a mixed-methods assessment.
Prev Med 2021 Jul;148:106587. doi: 10.1016/j.ypmed.2021.106587..
Keywords: Diabetes, Racial and Ethnic Minorities, Screening, Diagnostic Safety and Quality
Reddy P, Mencin A, Lebwohl B
Risk factors for suboptimal bowel preparation for colonoscopy in pediatric patients.
Suboptimal bowel cleansing is common in children and can impact diagnostic and therapeutic outcomes. In this retrospective study, the investigators aimed to identify risk factors for suboptimal bowel preparation for colonoscopy in pediatric patients. The investigators concluded that Medicaid status and English as a second language were risk factors. They highlighted distinct associations from those reported in the adult literature including failure to thrive and younger age.
AHRQ-funded; HS026121.
Citation: Reddy P, Mencin A, Lebwohl B .
Risk factors for suboptimal bowel preparation for colonoscopy in pediatric patients.
J Pediatr Gastroenterol Nutr 2021 Jul;73(1):e1-e6. doi: 10.1097/mpg.0000000000003114..
Keywords: Children/Adolescents, Colonoscopy, Risk, Diagnostic Safety and Quality
Ganguli I, Cui J, Thakore N
Downstream cascades of care following high-sensitivity troponin test implementation.
This study sought to determine the association of high-sensitivity cardiac troponin (hs-cTn) assay implementation with cascade events. The investigators found that hs-cTn assay implementation was associated with more net upfront tests yet fewer net stress tests, percutaneous coronary interventions, cardiology evaluations, and hospital admissions in patients with chest pain relative to patients with other symptoms.
AHRQ-funded; toHS023812.
Citation: Ganguli I, Cui J, Thakore N .
Downstream cascades of care following high-sensitivity troponin test implementation.
J Am Coll Cardiol 2021 Jun 29;77(25):3171-79. doi: 10.1016/j.jacc.2021.04.049..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
Adams LB, Baxter SLK, Lightfoot AF
Refining Black men's depression measurement using participatory approaches: a concept mapping study.
This study’s goal was to look at why prevalence of depression is lower for Black males despite cumulative socioeconomic disadvantage and risk factors. For Black men, emotional vulnerability is often seen as a sign of weakness which may potentially mask the timely identification of mental health needs in this population. The authors use concept mapping, which is a structured mixed methods approach to determine how stakeholders of Black men’s health conceptualize their depressive symptoms. Thirty-six stakeholders comprised of Black men, Black women, and primary care providers participated in separate stakeholder groups in 2018. Participants generated 68 characteristics of Black men’s depression reflected in six conceptual clusters: 1) physical states; 2) emotional states; 3) diminished drive; 4) internal conflicts; 5) communication with others; and 6) social pressures. Using a content analysis approach, they found that items comprising the “social pressures” cluster were not reflected in any common depression scales.
AHRQ-funded; HS000032.
Citation: Adams LB, Baxter SLK, Lightfoot AF .
Refining Black men's depression measurement using participatory approaches: a concept mapping study.
BMC Public Health 2021 Jun 22;21(1):1194. doi: 10.1186/s12889-021-11137-5..
Keywords: Men's Health, Racial and Ethnic Minorities, Depression, Behavioral Health, Diagnostic Safety and Quality
Zhu Y, Simon GJ, Wick EC
Applying machine learning across sites: external validation of a surgical site infection detection algorithm.
Surgical complications have tremendous consequences and costs. Complication detection is important for quality improvement, but traditional manual chart review is burdensome. Automated mechanisms are needed to make this more efficient. The purpose of the study was to understand the generalizability of a machine learning algorithm between sites; automated surgical site infection (SSI) detection algorithms developed at one center were tested at another distinct center.
AHRQ-funded; HS024532.
Citation: Zhu Y, Simon GJ, Wick EC .
Applying machine learning across sites: external validation of a surgical site infection detection algorithm.
J Am Coll Surg 2021 Jun;232(6):963-71.e1. doi: 10.1016/j.jamcollsurg.2021.03.026..
Keywords: Healthcare-Associated Infections (HAIs), Surgery, Adverse Events, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Michelson KA, Neuman MI, Pruitt CM
Height of fever and invasive bacterial infection.
This study evaluated the association of higher fevers with invasive bacterial infection (IBI) among febrile infants ≤60 days of age. Maximum temperatures of febrile infants with IBI were compared to infants without IBI. The median temperature was higher for infants with IBI (38.8°C) compared to those without IBI (38.4°C). Temperatures ranges of 39°C-39.4°C and 39.5°C-39.9°C were associated with a higher likelihood of IBI, although 30.4% of febrile infants with IBI had maximum temperatures <38.5°C.
AHRQ-funded; HS026006; HS026503.
Citation: Michelson KA, Neuman MI, Pruitt CM .
Height of fever and invasive bacterial infection.
Arch Dis Child 2021 Jun;106(6):594-96. doi: 10.1136/archdischild-2019-318548..
Keywords: Newborns/Infants, Infectious Diseases, Diagnostic Safety and Quality, Risk
Enayati M, Sir M, Zhang X
Monitoring diagnostic safety risks in emergency departments: protocol for a machine learning study.
This study’s objective will be to identify variables associated with diagnostic errors in emergency departments using large-scale EHR data and machine learning techniques. It will use trigger algorithms with electronic health record (EHR) data repositories to generate a large data set of records that are labeled trigger-positive or trigger-negative, depending on if they meet certain criteria. This study will be conducted by 2 academic medical centers with affiliated community hospitals.
AHRQ-funded; HS027363; HS026622.
Citation: Enayati M, Sir M, Zhang X .
Monitoring diagnostic safety risks in emergency departments: protocol for a machine learning study.
JMIR Res Protoc 2021 Jun 14;10(6):e24642. doi: 10.2196/24642..
Keywords: Emergency Department, Diagnostic Safety and Quality, Patient Safety, Risk, Electronic Health Records (EHRs), Health Information Technology (HIT)
Levis B, Benedetti A, Ioannidis JPA
Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis.
The authors compared PHQ-9 ≥10 prevalence to Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) major depression prevalence and assessed whether an alternative PHQ-9 cutoff could more accurately estimate prevalence. They found that PHQ-9 ≥10 substantially overestimated depression prevalence, as there was too much heterogeneity to correct statistically in individual studies.
AHRQ-funded; HS018246.
Citation: Levis B, Benedetti A, Ioannidis JPA .
Patient Health Questionnaire-9 scores do not accurately estimate depression prevalence: individual participant data meta-analysis.
J Clin Epidemiol 2020 Jun;122:115-28.e1. doi: 10.1016/j.jclinepi.2020.02.002..
Keywords: Depression, Behavioral Health, Diagnostic Safety and Quality
Cifra Cifra, CL Dukes, KC Ayres, et al.
Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: a pilot ethnography.
This pilot study’s goal was to determine the feasibility of using focused ethnography to understand the relationship between referral communication and the diagnostic process for critically ill children. Findings showed that focused ethnography in the pediatric intensive care unit is feasible to investigate relationships between clinician referral communication and the diagnostic process for critically ill children.
AHRQ-funded; HS026965.
Citation: Cifra Cifra, CL Dukes, KC Ayres, et al..
Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: a pilot ethnography.
J Crit Care 2021 Jun;63:246-49. doi: 10.1016/j.jcrc.2020.09.011..
Keywords: Children/Adolescents, Communication, Critical Care, Intensive Care Unit (ICU), Diagnostic Safety and Quality
Zachrison KS, Li S, Reeves MJ
Strategy for reliable identification of ischaemic stroke, thrombolytics and thrombectomy in large administrative databases.
Administrative data are frequently used in stroke research. Ensuring accurate identification of patients who had an ischaemic stroke, and those receiving thrombolysis and endovascular thrombectomy (EVT) is critical to ensure representativeness and generalisability. In this study, the investigators examined differences in patient samples based on mode of identification, and proposed a strategy for future patient and procedure identification in large administrative databases.
AHRQ-funded; HS024561.
Citation: Zachrison KS, Li S, Reeves MJ .
Strategy for reliable identification of ischaemic stroke, thrombolytics and thrombectomy in large administrative databases.
Stroke Vasc Neurol 2021 Jun;6(2):194-200. doi: 10.1136/svn-2020-000533..
Keywords: Stroke, Cardiovascular Conditions, Diagnostic Safety and Quality