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
- Adverse Events (1)
- Behavioral Health (3)
- Cancer (10)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (2)
- Cancer: Prostate Cancer (2)
- Cardiovascular Conditions (1)
- Care Management (2)
- Case Study (1)
- Children/Adolescents (1)
- Comparative Effectiveness (3)
- Depression (2)
- Elderly (2)
- Evidence-Based Practice (4)
- Genetics (2)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (3)
- Heart Disease and Health (1)
- Medical Errors (1)
- Medicare (1)
- Medication (2)
- Mortality (1)
- Outcomes (9)
- Patient-Centered Outcomes Research (5)
- Patient Safety (1)
- Practice Patterns (1)
- Primary Care (1)
- Quality Improvement (1)
- Quality of Life (1)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Sexual Health (1)
- Stress (1)
- Substance Abuse (1)
- Surgery (6)
- Trauma (1)
- (-) Treatments (19)
- Women (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
1 to 19 of 19 Research Studies DisplayedRudd BN, Last BS, Gregor C
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
The objectives of the current study are to (a) evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) delivered from 2013 to 2016 in 15 behavioral health agencies on youth PTSD as well as general mental health symptoms and functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. This study is the first benchmarking study of TF-CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF-CBT to urban community settings that serve youth in poverty.
AHRQ-funded; HS000084.
Citation: Rudd BN, Last BS, Gregor C .
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
Am J Community Psychol 2019 Dec;64(3-4):438-50. doi: 10.1002/ajcp.12370..
Keywords: Children/Adolescents, Behavioral Health, Trauma, Stress, Outcomes, Treatments
Chan B, Kondo K, Freeman M
Pharmacotherapy for cocaine use disorder-a systematic review and meta-analysis.
The authors sought a better understanding of the effectiveness of pharmacotherapy for cocaine use disorder. Their search included multiple data sources for systematic reviews and randomized controlled trials of pharmacological interventions in adults with cocaine use disorder. They found that most of the pharmacotherapies studied, including antidepressants, were not effective for treating cocaine use disorder. Bupropion, psychostimulants, and topiramate may improve abstinence, and antipsychotics may improve treatment retention. They recommend further study of contingency management and behavioral interventions along with pharmacotherapy.
AHRQ-funded; HS022981.
Citation: Chan B, Kondo K, Freeman M .
Pharmacotherapy for cocaine use disorder-a systematic review and meta-analysis.
J Gen Intern Med 2019 Dec;34(12):2858-73. doi: 10.1007/s11606-019-05074-8..
Keywords: Medication, Substance Abuse, Comparative Effectiveness, Treatments, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Mullins BT, Basak R, Broughman JR
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
This study compares the effects of different types of radical prostatectomy and radiotherapy on sexual function. A population-based cohort of 835 men with newly diagnosed prostate cancer from 2011 through 2013 was recruited in collaboration with the Rapid Case Ascertainment system of the North Carolina Central Cancer Registry. They were enrolled prior to treatment and followed retrospectively using the validated Prostate Cancer Symptom Indices (PCSI) instrument. The sexual function scores were compared among patients who received the following treatment types: external-beam RT (EBRT), EBRT with androgen deprivation therapy (ADT), brachytherapy, nerve-sparing radical prostatectomy (RP), and non-nerve-sparing RP. The cohort was surveyed at 24 months post-therapy, and RT alone was found to result in the best preservation of sexual function with brachytherapy, RT with ADT, and nerve-sparing RP yielding similar outcomes. Patients treated with non-nerve-sparing RP experienced the worst sexual function outcome.
AHRQ-funded.
Citation: Mullins BT, Basak R, Broughman JR .
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
Cancer 2019 Oct 15;125(20):3657-65. doi: 10.1002/cncr.32288..
Keywords: Quality of Life, Sexual Health, Surgery, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Cancer: Prostate Cancer, Cancer, Evidence-Based Practice
Chang X, Li HH, Kalet AM
Development and validation of a bayesian network method to detect external beam radiation therapy physician order errors.
This study investigated using a Bayesian network (BN)-based method to detect physician order errors in external beam radiation therapy. The authors extracted data from 4331 total external beam radiation orders written from 2008 to 2017 at their institution of origin. The cohort was divided into 3 groups: single prescription, concurrent boost, and sequential boost. True-positive (TPR) and false-positive (FPR) rates were determined. The investigators saw good results using the BN method.
AHRQ-funded; HS022888.
Citation: Chang X, Li HH, Kalet AM .
Development and validation of a bayesian network method to detect external beam radiation therapy physician order errors.
Int J Radiat Oncol Biol Phys 2019 Oct 1;105(2):423-31. doi: 10.1016/j.ijrobp.2019.05.034..
Keywords: Medical Errors, Patient Safety, Cancer, Treatments
Alpert A, Jacobson M
Impact of oncology drug shortages on chemotherapy treatment.
The investigators examined outpatient chemotherapy use during shortage periods relative to the months before and after a shortage for newly diagnosed patients. For most drugs, little impact of shortages on either the fraction of patients receiving that drug or the quantity provided was found. The investigators discussed potential explanations for these counterintuitive findings, including potential limitations of current drug shortage reporting methods.
AHRQ-funded; HS022741.
Citation: Alpert A, Jacobson M .
Impact of oncology drug shortages on chemotherapy treatment.
Clin Pharmacol Ther 2019 Aug;1-6(2):415-21. doi: 10.1002/cpt.1390..
Keywords: Cancer, Treatments, Medication
Kundi H, Popma JJ, Reynolds MR
Frailty and related outcomes in patients undergoing transcatheter valve therapies in a nationwide cohort.
In this study, the investigators sought to identify the prevalence and related outcomes of frail individuals undergoing transcatheter mitral valve repair and transcatheter aortic valve replacement (TAVR). Patients aged 65 and older were included in the study if they had at least one procedural code for transcatheter mitral valve repair or TAVR between 1 January 2016 and 31 December 2016 in the Centers for Medicare and Medicaid Services Medicare Provider and Review database.
Citation: Kundi H, Popma JJ, Reynolds MR .
Frailty and related outcomes in patients undergoing transcatheter valve therapies in a nationwide cohort.
Eur Heart J 2019 Jul 14;40(27):2231-39. doi: 10.1093/eurheartj/ehz187.
.
.
Keywords: Elderly, Heart Disease and Health, Cardiovascular Conditions, Surgery, Outcomes, Treatments
Kaderka R, Mundt RC, Li N
Automated closed- and open-loop validation of knowledge-based planning routines across multiple disease sites.
This study examined the use of knowledge-based planning (KBP) clinical implementation for treatment across multiple disease sites using volumetric modulated arc therapy. Researchers identified patients with prostate, lung, and head and neck cancers who were treated in the year right before their clinic’s broad adoption of RapidPlan. Statistically significant organ dose-volume histogram improvements were observed in the KBP cohort compared to manual planning.
AHRQ-funded; R01 HS025440.
Citation: Kaderka R, Mundt RC, Li N .
Automated closed- and open-loop validation of knowledge-based planning routines across multiple disease sites.
Pract Radiat Oncol 2019 Jul - Aug;9(4):257-65. doi: 10.1016/j.prro.2019.02.010..
Keywords: Cancer, Genetics, Treatments
Istl AC, Ruck JM, Morris CD
Call for improved design and reporting in soft tissue sarcoma studies: a systematic review and meta-analysis of chemotherapy and survival outcomes in resectable STS.
Researchers completed a meta-analysis of chemotherapy in localized STS, assessing OS, PFS, and local and distant recurrence. They found no benefit of chemotherapy over locoregional therapy alone for all-comers or site-specific STS. Recommendations to improve outcome reporting and quality indices are suggested.
AHRQ-funded; HS024736.
Citation: Istl AC, Ruck JM, Morris CD .
Call for improved design and reporting in soft tissue sarcoma studies: a systematic review and meta-analysis of chemotherapy and survival outcomes in resectable STS.
J Surg Oncol 2019 Jun;119(7):824-35. doi: 10.1002/jso.25401..
Keywords: Cancer, Treatments, Evidence-Based Practice, Mortality, Outcomes, Research Methodologies
Shaker M, Greenhawt M
Estimation of health and economic benefits of commercial peanut immunotherapy products: a cost-effectiveness analysis.
The goal of this study was to evaluate critical inputs associated with the cost-effectiveness of epicutaneous peanut immunotherapy (EPIT) and peanut oral immunotherapy (POIT) from a societal perspective. In microsimulations with Markov modeling, virtual children aged 4 years over received EPIT, POIT, or no immunotherapy treatment. The main outcomes and measures were rates of therapy-associated adverse reactions; quality-of-life improvements associated with changes in tolerated peanut doses were modeled along with quality-adjusted life-years (QALY), anaphylaxis, therapy-associated anaphylaxis, and fatalities. The findings of this simulated analysis indicate that EPIT and POIT may be cost-effective, but the authors note that further research is needed.
AHRQ-funded; HS024599.
Citation: Shaker M, Greenhawt M .
Estimation of health and economic benefits of commercial peanut immunotherapy products: a cost-effectiveness analysis.
JAMA Netw Open 2019 May 3;2(5):e193242. doi: 10.1001/jamanetworkopen.2019.3242..
Keywords: Healthcare Costs, Outcomes, Respiratory Conditions, Treatments
Ellis CT, Cole AL, Sanoff HK
Evaluating surveillance patterns after chemoradiation-only compared with conventional management for older patients with rectal cancer.
This study examined surveillance patterns for elderly patients who were treated only with chemoradiation (CR) as opposed to traditional treatment (chemoradiation and protectomy). In the cohort study, a total of 2,482 individuals met the inclusion criteria, with 21% receiving CR-only treatment, and 79% had conventional treatment. In comparison to patients who had traditional treatment, patients with CR-only treatment had far less follow-up during the first 2 years post-treatment. Adherence to guideline-recommended surveillance was poor for all Medicare patients, but especially for CR-only treated patients.
AHRQ-funded; HS000032.
Citation: Ellis CT, Cole AL, Sanoff HK .
Evaluating surveillance patterns after chemoradiation-only compared with conventional management for older patients with rectal cancer.
J Am Coll Surg 2019 May;228(5):782-91.e2. doi: 10.1016/j.jamcollsurg.2019.01.010..
Keywords: Cancer, Cancer: Colorectal Cancer, Care Management, Treatments, Elderly, Patient-Centered Outcomes Research
Chapman WC, Subramanian M, Jayarajan S
First, do no harm: rethinking routine diversion in sphincter-preserving rectal cancer resection.
The authors hypothesized that routine temporary diversion is not associated with decreased rates of leak or reintervention in cancer patients at large undergoing sphincter-sparing procedures. Using HCUP data from the Florida State Inpatient Database, they found no association between diversion and anastomotic leak. However, temporary diversion was associated with increased incidence of nonelective reinterventions, readmissions, and higher costs. They recommended additional study to identify which patients would benefit most from diversion.
AHRQ-funded; HS019455.
Citation: Chapman WC, Subramanian M, Jayarajan S .
First, do no harm: rethinking routine diversion in sphincter-preserving rectal cancer resection.
J Am Coll Surg 2019 Apr;228(4):547-56.e8. doi: 10.1016/j.jamcollsurg.2018.12.012..
Keywords: Healthcare Cost and Utilization Project (HCUP), Cancer: Colorectal Cancer, Cancer, Surgery, Treatments
Yin LX, Padula WV, Gadkaree S
Health care costs and cost-effectiveness in laryngotracheal stenosis.
The goal of this study was to conduct a cost-effectiveness analysis comparing open reconstruction surgery versus endoscopic dilation in the treatment of laryngotracheal stenosis (LTS). Cricotracheal/tracheal resection (CTR/TR) and endoscopic dilation were compared at a willingness-to-pay threshold of $50,000 per quality-adjusted life year (QALY) over 5 and 10 years. Annual treatment costs were derived from the Department of Otolaryngology-Head and Neck Surgery at Johns Hopkins University. The results indicate that patients with intubation-related stenosis have higher annual costs than idiopathic patients. The major risk factor for increased cost was etiology of stenosis. Although CTR/TR contributes significantly to cost in LTS, it is more cost-effective than endoscopic dilations for appropriately selected patients over the 5- and 10-year periods.
AHRQ-funded; HS000029.
Citation: Yin LX, Padula WV, Gadkaree S .
Health care costs and cost-effectiveness in laryngotracheal stenosis.
Otolaryngol Head Neck Surg 2019 Apr;160(4):679-86. doi: 10.1177/0194599818815068..
Keywords: Healthcare Costs, Surgery, Treatments
Wilkinson ST, Holtzheimer PE, Gao S
Leveraging neuroplasticity to enhance adaptive learning: the potential for synergistic somatic-behavioral treatment combinations to improve clinical outcomes in depression.
This article reviews the potential of synergistically combining plasticity-enhancing and behavioral therapies to develop translational treatment approaches for depression. After reviewing relevant neuroplasticity deficits in depression, the article surveys biological treatments that appear to reverse such deficits in humans; evidence that directly or indirectly supports the hypothesis that a robust enhancement of neuroplasticity through these methods might promote the uptake of cognitive and behavioral interventions to enhance longer-term treatment outcomes is then reviewed. The authors identify missing pieces of key evidence and discuss future directions that could enhance this line of research.
AHRQ-funded; HS023000.
Citation: Wilkinson ST, Holtzheimer PE, Gao S .
Leveraging neuroplasticity to enhance adaptive learning: the potential for synergistic somatic-behavioral treatment combinations to improve clinical outcomes in depression.
Biol Psychiatry 2019 Mar 15;85(6):454-65. doi: 10.1016/j.biopsych.2018.09.004..
Keywords: Behavioral Health, Depression, Patient-Centered Outcomes Research, Treatments
Dinan MA, Wilson LE, Reed SD
Chemotherapy costs and 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2005 to 2011.
This study examined whether associations between 21-gene recurrence score (RS) genomic testing and lower costs among patients with early-stage, estrogen receptor-positive breast cancer were observable in real-world data from the Medicare population. The investigators found that RS testing was associated with lower overall and chemotherapy-related costs in patients with high-risk disease, consistent with lower chemotherapy use among these patients. Higher overall costs for patients with intermediate-risk and low-risk disease were driven largely by non-treatment-related costs.
AHRQ-funded; HS022189.
Citation: Dinan MA, Wilson LE, Reed SD .
Chemotherapy costs and 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2005 to 2011.
J Natl Compr Canc Netw 2019 Mar;17(3):245-54. doi: 10.6004/jnccn.2018.7097..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Genetics, Healthcare Costs, Medicare, Women
Antle BF, Owen JJ, Eells TD
Dissemination of computer-assisted cognitive-behavior therapy for depression in primary care.
Computer-assisted cognitive-behavior therapy (CCBT) for depression in primary care was evaluated in a trial with 240 patients randomly assigned to CCBT or treatment as usual (TAU). The study, described in this paper, disseminated a therapy method found to be effective in psychiatric settings into primary care - a setting in which there have been significant problems in the delivery of adequate, evidence-based treatment for depression.
AHRQ-funded; HS024047.
Citation: Antle BF, Owen JJ, Eells TD .
Dissemination of computer-assisted cognitive-behavior therapy for depression in primary care.
Contemp Clin Trials 2019 Mar;78:46-52. doi: 10.1016/j.cct.2018.11.001..
Keywords: Behavioral Health, Depression, Primary Care, Treatments
Schmidt B, Eapen RS, Cowan JE
Practice patterns of primary EBRT with and without ADT in prostate cancer treatment.
This study investigated usage of external-beam radiation therapy (EBRT), with or without neoadjuvant androgen deprivation therapy (ADT), using data from a community-based prospective disease registry (CaPSURE). Data on 1337 men diagnosed between 1990 and 2014 with localized disease who received EBRT as primary treatment was compared. The authors conclude that use of ADT in conjunction with primary EBRT has increased in frequency and duration since 1990, and that men who received ADT have higher risk characteristics than those who receive EBRT alone.
AHRQ-funded; HS019356.
Citation: Schmidt B, Eapen RS, Cowan JE .
Practice patterns of primary EBRT with and without ADT in prostate cancer treatment.
Prostate Cancer Prostatic Dis 2019 Mar;22(1):117-24. doi: 10.1038/s41391-018-0084-3..
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research, Practice Patterns, Evidence-Based Practice, Comparative Effectiveness, Outcomes, Treatments
Childers CP, Dworsky JQ, Maggard-Gibbons M
The contemporary appendectomy for acute uncomplicated appendicitis in adults.
Epidemiologic data related to the surgical management of appendicitis are out of date. In this study, the authors contemplated the role of nonoperative therapy in uncomplicated appendicitis and developed a contemporary profile of the risks and benefits of operative appendectomy by merging the 2016 National Surgical Quality Improvement Program essential and appendectomy-targeted participant use files.
AHRQ-funded; HS025079.
Citation: Childers CP, Dworsky JQ, Maggard-Gibbons M .
The contemporary appendectomy for acute uncomplicated appendicitis in adults.
Surgery 2019 Mar;165(3):593-601. doi: 10.1016/j.surg.2018.09.009..
Keywords: Care Management, Quality Improvement, Surgery, Treatments
Kitay BM, Katz RB, Wilkinson ST
The successful use of electroconvulsive therapy in a patient with cerebral aneurysms and a pituitary lesion.
This letter to the editor describes a case study in which a 52-year old women with a history of cerebral aneurysms and a pituitary lesion received electroconvulsive therapy (ECT) after unsuccessful treatment for recurrent severe major depressive disorder with psychosis and catatonia. After extensive workup and consultations with other specialists, 14 total treatments were given at 2-week intervals. The treatments were considered successful, and the woman returned to the community and continues to receive outpatient treatment. No other complications occurred.
AHRQ-funded; HS023000.
Citation: Kitay BM, Katz RB, Wilkinson ST .
The successful use of electroconvulsive therapy in a patient with cerebral aneurysms and a pituitary lesion.
J ECT 2019 Mar;35(1):e4-e5. doi: 10.1097/yct.0000000000000516..
Keywords: Case Study, Outcomes, Treatments
Gani F, Conca-Cheng AM, Nettles B
Trends in outcomes after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.
The goal of this study was to describe temporal trends in clinical outcomes among patients undergoing cytoreductive surgery or hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Operative time, postoperative morbidity, and length of stay after CRS/HIPEC were observed to improve over the study period. Careful patient selection may result in favorable outcomes for select patients undergoing CRS/HIPEC.
AHRQ-funded; HS024736.
Citation: Gani F, Conca-Cheng AM, Nettles B .
Trends in outcomes after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.
J Surg Res 2019 Feb;234:240-48. doi: 10.1016/j.jss.2018.09.032..
Keywords: Adverse Events, Treatments, Cancer, Surgery, Outcomes