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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 13 of 13 Research Studies DisplayedMarcaccio CL, Patel PB, de Guerre L
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
The purpose of this study was to identify variations in 5-year outcomes and imaging surveillance after elective endovascular aortic aneurysm repair (EVAR) by sex, race, and ethnicity and to examine possible mechanisms contributing to these variations. The primary outcome was 5-year aneurysm rupture. Secondary outcomes were 5-year reintervention and mortality, and having no aortic imaging follow-up from 6 to 24 months after EVAR. The study found that among 16,040 patients, 73% were White males, 18% were White females, 2.6% were Black males, 1.1% were Black females, 0.9% were Asian males, 0.2% were Asian females, 1.7% were Hispanic males, and 0.4% were Hispanic females. At 5 years, Black females had the highest rupture rates at 6.4% and white males had the lowest at 2.3%. Compared with White males, rupture rates were higher in White females, Black females, and Asian females. Among other groups, Black males had higher reintervention and both Black and Hispanic males had higher rates of no imaging follow-up. In adjusted analyses, White, Black, and Asian females remained at significantly higher risk for 5-year rupture. The researchers concluded that Black females had higher 5-year aneurysm rupture, reintervention, and mortality rates after elective EVAR as compared with White male patients, whereas White females had higher rupture, mortality and loss-to-imaging-follow-up compared to White male patients. Black males had higher reintervention and no imaging follow-up, and Asian females had higher rupture rates.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, Patel PB, de Guerre L .
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
J Vasc Surg 2022 Nov;76(5):1205-15.e4. doi: 10.1016/j.jvs.2022.03.886..
Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors, Outcomes, Imaging, Heart Disease and Health, Cardiovascular Conditions
Swanson MB, Miller AC, Ward MM MM
Emergency department telemedicine consults decrease time to interpret computed tomography of the head in a multi-network cohort.
Telemedicine can improve access to emergency stroke care in rural areas, but the benefit of telemedicine across different types and models of telemedicine networks is unknown. The objectives of this study were to (1) identify the impact of telemedicine on ED stroke care, (2) identify if telemedicine impact varied by network, and (3) describe the variation in process outcomes by telemedicine across EDs.
AHRQ-funded; HS025753.
Citation: Swanson MB, Miller AC, Ward MM MM .
Emergency department telemedicine consults decrease time to interpret computed tomography of the head in a multi-network cohort.
J Telemed Telecare 2021 Jul;27(6):343-52. doi: 10.1177/1357633x19877746..
Keywords: Emergency Department, Telehealth, Health Information Technology (HIT), Imaging, Stroke, Cardiovascular Conditions
Stillman AE, Gatsonis C, Lima JAC
Coronary computed tomography angiography compared with single photon emission computed tomography myocardial perfusion imaging as a guide to optimal medical therapy in patients presenting with stable angina: the RESCUE trial.
Coronary computed tomography angiography compared with single photon emission computed tomography myocardial perfusion imaging as a guide to optimal medical therapy in patients presenting with stable angina: the RESCUE trial.
AHRQ-funded; HS019403.
Citation: Stillman AE, Gatsonis C, Lima JAC .
Coronary computed tomography angiography compared with single photon emission computed tomography myocardial perfusion imaging as a guide to optimal medical therapy in patients presenting with stable angina: the RESCUE trial.
J Am Heart Assoc 2020 Dec 15;9(24):e017993. doi: 10.1161/jaha.120.017993..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Imaging, Comparative Effectiveness, Evidence-Based Practice
Levy AE, Shah NR, Matheny ME
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
The authors investigated whether Natural Language Processing (NLP) tools could potentially help estimate myocardial perfusion imaging (MPI) risk. Subjects were VA patients who underwent stress MPI and coronary angiography 2009-11; stress test reports were randomly selected for analysis. The authors found that post-test ischemic risk was determinable but rarely reported in this sample of stress MPI reports. They conclude that this supports the potential use of NLP to help clarify risk and recommend further study of NLP in this context.
AHRQ-funded; HS022998.
Citation: Levy AE, Shah NR, Matheny ME .
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
J Nucl Cardiol 2019 Dec;26(6):1878-85. doi: 10.1007/s12350-018-1275-y..
Keywords: Imaging, Risk, Clinical Decision Support (CDS), Health Information Technology (HIT), Diagnostic Safety and Quality, Cardiovascular Conditions, Heart Disease and Health
Shah NR, Ahmed ST, Winchester DE
Facility-level variation in stress test utilization in veterans with ischemic heart disease.
The aim of this study was to quantify variation in cardiac stress test utilization across the Veterans Health Administration (VA) in patients with established ischemic heart disease (IHD). The investigators used VA datasets to identify adults with IHD (myocardial infarction, percutaneous coronary intervention, and/or coronary artery bypass grafting) with a primary care clinic visit at the VA in fiscal year 2014.
AHRQ-funded; HS022998.
Citation: Shah NR, Ahmed ST, Winchester DE .
Facility-level variation in stress test utilization in veterans with ischemic heart disease.
JACC Cardiovasc Imaging 2019 Jul;12(7 Pt 1):1292-93. doi: 10.1016/j.jcmg.2019.02.020..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality, Healthcare Utilization, Practice Patterns, Imaging
Russell FM, Ehman RR, Ferre R
Design and rationale of the B-lines lung ultrasound guided emergency department management of acute heart failure (BLUSHED-AHF) pilot trial.
Medical treatment for acute heart failure (AHF) has not changed substantially over the last four decades. Emergency department (ED)-based evidence for treatment is limited. The investigators discuss BLUSHED-AHF, a multicenter, randomized, pilot trial designed to test whether a strategy of care that utilizes a LUS-driven treatment protocol outperforms usual care for reducing pulmonary congestion in the ED.
AHRQ-funded; HS025411.
Citation: Russell FM, Ehman RR, Ferre R .
Design and rationale of the B-lines lung ultrasound guided emergency department management of acute heart failure (BLUSHED-AHF) pilot trial.
Heart Lung 2019 May - Jun;48(3):186-92. doi: 10.1016/j.hrtlng.2018.10.027..
Keywords: Emergency Department, Heart Disease and Health, Cardiovascular Conditions, Imaging, Respiratory Conditions
Strom JB, Shen C, Yeh RW
SCOT-HEART: does it live up to the PROMISE?
This paper examines the Scottish Computed Tomography of the Heart (SCOT-HEART) trial which was a prospective, openlabel, parallel group, multicenter trial that randomized 4146 adults (ages 18–75), referred for suspected angina to 12 cardiology clinics across Scotland between November 18, 2010 and September 24, 2014, to an initial strategy of computed tomographic Angiography (CTA) plus standard care or standard care alone in a 1:1 fashion.
AHRQ-funded; R01 HS024520.
Citation: Strom JB, Shen C, Yeh RW .
SCOT-HEART: does it live up to the PROMISE?
J Cardiovasc Comput Tomogr 2019 May - Jun;13(3):48-50. doi: 10.1016/j.jcct.2019.01.008..
Keywords: Imaging, Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality
Kim SC, Shah NR, Rogers JR
Assessment of coronary vascular function with cardiac PET in relation to serum uric acid.
Elevated serum uric acid (SUA) levels have been independently associated with cardiovascular disease This study evaluated the relationship between elevated serum uric acid (SUA) and positron emission tomography (PET)-measured markers of coronary vascular function. It found that higher SUA is modestly associated with worse coronary flow reserve (CFR) and stress myocardial blood flow (MBF) among patients without diabetes.
AHRQ-funded; HS022998.
Citation: Kim SC, Shah NR, Rogers JR .
Assessment of coronary vascular function with cardiac PET in relation to serum uric acid.
PLoS One. 2018 Feb 13;13(2):e0192788. doi: 10.1371/journal.pone.0192788..
Keywords: Cardiovascular Conditions, Imaging
Bravo PE, Bergmark BA, Vita T
Diagnostic and prognostic value of myocardial blood flow quantification as non-invasive indicator of cardiac allograft vasculopathy.
Cardiac allograft vasculopathy (CAV) is a leading cause of death in orthotopic heart transplant (OHT) survivors. Effective non-invasive screening methods are needed. The aim of this study was to investigate the added diagnostic and prognostic value of myocardial blood flow (MBF) to standard myocardial perfusion imaging (MPI) with positron emission tomography (PET) for CAV detection.
AHRQ-funded; HS022998.
Citation: Bravo PE, Bergmark BA, Vita T .
Diagnostic and prognostic value of myocardial blood flow quantification as non-invasive indicator of cardiac allograft vasculopathy.
Eur Heart J 2018 Jan 21;39(4):316-23. doi: 10.1093/eurheartj/ehx683..
Keywords: Adverse Events, Cardiovascular Conditions, Diagnostic Safety and Quality, Evidence-Based Practice, Heart Disease and Health, Imaging, Patient-Centered Outcomes Research, Surgery
Stillman AE, Gatsonis C, Lima JA
Rationale and design of the Randomized Evaluation of patients with Stable angina Comparing Utilization of noninvasive Examinations (RESCUE) trial.
This article describes the RESCUE trial, which is based on the hypothesis that coronary computed tomography angiography as a diagnostic tool is associated with no increase in cardiac risk, decreased cost, and reduced radiation exposure compared with single photon emission computed tomography myocardial perfusion imaging.
AHRQ-funded; HS019403.
Citation: Stillman AE, Gatsonis C, Lima JA .
Rationale and design of the Randomized Evaluation of patients with Stable angina Comparing Utilization of noninvasive Examinations (RESCUE) trial.
Am Heart J 2016 Sep;179:19-28. doi: 10.1016/j.ahj.2016.06.003.
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Keywords: Comparative Effectiveness, Imaging, Cardiovascular Conditions
Ladapo JA, Blecker S, O'Donnell M
Appropriate use of cardiac stress testing with imaging: a systematic review and meta-analysis.
The authors systematically reviewed studies of appropriate use criteria (AUC), evaluated trends over time, and characterized leading indications for inappropriate testing. They found that rates of appropriate use tend to be lower for stress echocardiography compared to myocardial perfusion imaging, and updated AUC reduced unclassified stress echocardiograms. They concluded that there is no conclusive evidence that AUC improved appropriate use over time.
AHRQ-funded; HS023683.
Citation: Ladapo JA, Blecker S, O'Donnell M .
Appropriate use of cardiac stress testing with imaging: a systematic review and meta-analysis.
PLoS One 2016 Aug 18;11(8):e0161153. doi: 10.1371/journal.pone.0161153.
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Keywords: Cardiovascular Conditions, Shared Decision Making, Imaging, Guidelines
Ladapo JA, Blecker S, Douglas PS
Appropriateness of cardiac stress test use among primary care physicians and cardiologists in the United States.
In this study, the researchers used nationally-representative data to examine differences in appropriate use of cardiac stress testing between cardiologists and primary care physicians (PCPs) in the US. Using permissive criteria to determine appropriateness, they found that primary care physicians are more likely to order or perform a rarely appropriate cardiac stress test than cardiologists.
AHRQ-funded; HS023683.
Citation: Ladapo JA, Blecker S, Douglas PS .
Appropriateness of cardiac stress test use among primary care physicians and cardiologists in the United States.
Int J Cardiol 2016 Jan 15;203:584-6. doi: 10.1016/j.ijcard.2015.10.238.
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Keywords: Cardiovascular Conditions, Diagnostic Safety and Quality, Imaging, Primary Care, Shared Decision Making
Patel R, Lim RP, Saric M
Diagnostic performance of cardiac magnetic resonance imaging and echocardiography in evaluation of cardiac and paracardiac masses.
The researchers evaluated the predictive value of echocardiography and cardiac magnetic resonance (CMR) imaging parameters to identify tumors and malignancy and to provide histopathologic diagnosis of cardiac masses. They found that CMR identified 6 masses missed on transthoracic echocardiography (4 of which were outside the heart) and provided significantly more correct histopathologic diagnoses compared to echocardiography (77 percent vs 43 percent).
AHRQ-funded; HS019473.
Citation: Patel R, Lim RP, Saric M .
Diagnostic performance of cardiac magnetic resonance imaging and echocardiography in evaluation of cardiac and paracardiac masses.
Am J Cardiol 2016 Jan;117(1):135-40. doi: 10.1016/j.amjcard.2015.10.014..
Keywords: Diagnostic Safety and Quality, Cardiovascular Conditions, Imaging, Cancer, Comparative Effectiveness