National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (4)
- (-) Adverse Events (14)
- Ambulatory Care and Surgery (1)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Blood Clots (1)
- Blood Thinners (1)
- Cancer: Breast Cancer (1)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (3)
- Critical Care (1)
- Digestive Disease and Health (2)
- Electronic Health Records (EHRs) (2)
- Falls (1)
- Healthcare Costs (1)
- Health Information Technology (HIT) (2)
- Hospitals (1)
- Imaging (1)
- Intensive Care Unit (ICU) (1)
- Medical Errors (4)
- Medication (5)
- Medication: Safety (1)
- Orthopedics (1)
- Patient-Centered Healthcare (2)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (1)
- Patient Safety (8)
- Prevention (1)
- Quality Improvement (1)
- Quality of Care (1)
- Registries (1)
- Risk (4)
- (-) Shared Decision Making (14)
- Surgery (5)
- Transplantation (1)
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 14 of 14 Research Studies DisplayedReese TJ, Del Fiol G, Morgan K
A shared decision-making tool for drug interactions between warfarin and nonsteroidal anti-inflammatory drugs: design and usability study.
Exposure to life-threatening drug-drug interactions (DDIs) occurs despite the widespread use of clinical decision support. The DDI between warfarin and nonsteroidal anti-inflammatory drugs is common and potentially life-threatening. Patients can play a substantial role in preventing harm from DDIs; however, the current model for DDI decision-making is clinician centric. This study aimed to design and examine the usability of DDInteract, a tool to support shared decision-making (SDM) between a patient and provider for the DDI between warfarin and nonsteroidal anti-inflammatory drugs.
AHRQ-funded; HS026198.
Citation: Reese TJ, Del Fiol G, Morgan K .
A shared decision-making tool for drug interactions between warfarin and nonsteroidal anti-inflammatory drugs: design and usability study.
JMIR Hum Factors 2021 Oct 26;8(4):e28618. doi: 10.2196/28618..
Keywords: Blood Thinners, Medication: Safety, Medication, Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Adverse Drug Events (ADE), Adverse Events, Patient Safety
Long S, Thomas GW, Karam MD
Surgical skill can be objectively measured from fluoroscopic images using a novel image-based Decision Error Analysis (IDEA) score.
This study introduces and evaluates a novel Image-based Decision Error Analysis (IDEA) score that captures performance during fluoroscopically assisted wire navigation. Findings showed that the fluoroscopic images obtained in the course of placing a guide wire contained a rich amount of information related to surgical skill. The IDEA scoring provided a basis for evaluating the competence of a resident. The score can be used to assess skill at key timepoints throughout residency, such as when rotating onto/off of a new surgical service and before performing certain procedures in the operating room, or as a tool for debriefing/providing feedback after a procedure is completed.
AHRQ-funded; HS022077; HS025353.
Citation: Long S, Thomas GW, Karam MD .
Surgical skill can be objectively measured from fluoroscopic images using a novel image-based Decision Error Analysis (IDEA) score.
Clin Orthop Relat Res 2021 Jun;479(6):1386-94. doi: 10.1097/corr.0000000000001623..
Keywords: Orthopedics, Surgery, Shared Decision Making, Medical Errors, Adverse Events, Imaging
Woods-Hill CZ, Koontz DW, King AF
Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a national survey.
Sending blood cultures in children at low risk of bacteremia can contribute to a cascade of unnecessary antibiotic exposure, adverse effects, and increased costs. In this study, the investigators aimed to describe practice variation, clinician beliefs, and attitudes about blood culture testing in critically ill children. They concluded that there is variation in blood culture practices in the pediatric ICU. Fear and reflexive habits are common drivers of cultures. These practices may contribute to over-testing for bacteremia.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Koontz DW, King AF .
Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a national survey.
Pediatr Crit Care Med 2020 Jan;21(1):e23-e29. doi: 10.1097/pcc.0000000000002176..
Keywords: Children/Adolescents, Critical Care, Antimicrobial Stewardship, Antibiotics, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Intensive Care Unit (ICU), Shared Decision Making
Leeds IL, DiBrito SR, Canner JK
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
This goal of this study was to assess the cost-effectiveness of extended prophylaxis in patients with Crohn's disease after abdominal surgery. A decision tree model was used to assess cost-effectiveness and cost-per-case averted with extended-duration venous thromboembolism prophylaxis following abdominal surgery. Results showed that extended prophylaxis in patients with Crohn's disease postoperatively is not cost-effective when the cumulative incidence of posthospital thrombosis remains less than 4.9%. These findings are driven by the low absolute risk of thrombosis in this population and the considerable cost of universal treatment.
AHRQ-funded; HS024547.
Citation: Leeds IL, DiBrito SR, Canner JK .
Cost-benefit limitations of extended, outpatient venous thromboembolism prophylaxis following surgery for Crohn's disease.
Dis Colon Rectum 2019 Nov;62(11):1371-80. doi: 10.1097/dcr.0000000000001461..
Keywords: Prevention, Digestive Disease and Health, Surgery, Healthcare Costs, Adverse Events, Patient Safety, Blood Clots, Shared Decision Making, Medication
Schoenfeld EM, Mader S, Houghton C
The effect of shared decisionmaking on patients' likelihood of filing a complaint or lawsuit: a simulation study.
This study examined the effect of shared decisionmaking on the likelihood of a patient filing a complaint or lawsuit after an adverse event. A simulation experiment using clinical vignettes was conducted. The participants, adults from the US were recruited from an online crowd-sourcing platform. They were randomized to vignettes with 1-3 levels of shared decision making. A total of 804 participants were recruited. Those who were exposed to shared decisionmaking were 80% less like to report a plan to contact a lawyer than those not exposed. They also showed higher levels of physician trust, and less likely to fault their physicians for an adverse outcome.
AHRQ-funded; HS024311.
Citation: Schoenfeld EM, Mader S, Houghton C .
The effect of shared decisionmaking on patients' likelihood of filing a complaint or lawsuit: a simulation study.
Ann Emerg Med 2019 Jul;74(1):126-36. doi: 10.1016/j.annemergmed.2018.11.017..
Keywords: Adverse Events, Shared Decision Making, Medical Errors, Patient-Centered Healthcare, Patient and Family Engagement
Ellis RJ, Brock Hewitt D, Liu JB
Preoperative risk evaluation for pancreatic fistula after pancreaticoduodenectomy.
The purpose of this study was to identify risk factors for clinically relevant postoperative pancreatic fistula that are routinely available in the preoperative setting. Results showed that outcomes were best for patients with three or fewer identified risk factors. The researchers conclude that risk evaluation could be a useful tool in patient counseling and surgical planning.
AHRQ-funded; HS000078.
Citation: Ellis RJ, Brock Hewitt D, Liu JB .
Preoperative risk evaluation for pancreatic fistula after pancreaticoduodenectomy.
J Surg Oncol 2019 Jun;119(8):1128-34. doi: 10.1002/jso.25464..
Keywords: Adverse Events, Shared Decision Making, Patient Safety, Risk, Surgery
Ellis RJ, Gupta AR, Hewitt DB
Risk factors for post-pancreaticoduodenectomy delayed gastric emptying in the absence of pancreatic fistula or intra-abdominal infection.
Researchers sought to define the incidence of delayed gastric emptying (DGE) and identify risk factors for DGE in patients without pancreatic fistula or other intra-abdominal infections. They found that patients were more likely to develop DGE if they were over 74 years of age, male, had undergone pylorus-sparing pancreaticoduodenectomy (PD), or had a prolonged operative time. They conclude that the incidence of DGE after PD is notable even in patients without other abdominal complications and suggested that identification of patients at increased risk for DGE may aid patient counseling as well as decisions regarding surgical technique, enteral feeding access, and enhanced-recovery pathways.
AHRQ-funded; HS000078.
Citation: Ellis RJ, Gupta AR, Hewitt DB .
Risk factors for post-pancreaticoduodenectomy delayed gastric emptying in the absence of pancreatic fistula or intra-abdominal infection.
J Surg Oncol 2019 Jun;119(7):925-31. doi: 10.1002/jso.25398..
Keywords: Adverse Events, Shared Decision Making, Patient Safety, Risk, Surgery
Aldina S, Goldhaber-Fiebert SN, Hannenberg AA
Factors associated with the use of cognitive aids in operating room crises: a cross-sectional study of US hospitals and ambulatory surgical centers.
This study examined organizational context and implementation process factors influencing the use of cognitive aids for OR crises. It found that small facility size was associated with a fourfold increase in the odds of a facility reporting more successful implementation. Completing more implementation steps was also significantly associated with more successful implementation.
AHRQ-funded; HS024235.
Citation: Aldina S, Goldhaber-Fiebert SN, Hannenberg AA .
Factors associated with the use of cognitive aids in operating room crises: a cross-sectional study of US hospitals and ambulatory surgical centers.
Implement Sci 2018 Mar 26;13(1):50. doi: 10.1186/s13012-018-0739-4.
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Keywords: Adverse Events, Ambulatory Care and Surgery, Patient Safety, Quality Improvement, Quality of Care, Hospitals, Shared Decision Making, Clinical Decision Support (CDS)
Dulai PS, Siegel CA
Optimization of drug safety profile in inflammatory bowel disease through a personalized approach.
Treatment strategies and treatment options have changed considerably over the past decade for Inflammatory Bowel Disease (IBD). In this review the authors discuss the potential risks of therapy in IBD, opportunities to mitigate those risks, and a personalized approach to consider when using these agents in clinical practice.
AHRQ-funded; HS021747.
Citation: Dulai PS, Siegel CA .
Optimization of drug safety profile in inflammatory bowel disease through a personalized approach.
Curr Drug Targets 2018;19(7):740-47. doi: 10.2174/1389450118666170525114939..
Keywords: Adverse Drug Events (ADE), Adverse Events, Shared Decision Making, Digestive Disease and Health, Medication, Patient-Centered Healthcare
Milata JL, Otte JL, Carpenter JS
Oral endocrine therapy nonadherence, adverse effects, decisional support, and decisional needs in women with breast cancer.
Adverse effects contribute to breast cancer survivors’ decisions to stop oral endocrine therapy (OET), yet there has been little investigation of the process through which that occurs. This review serves as a call to action for providers to provide support to breast cancer survivors experiencing OET adverse effects and facing decisions related to nonadherence.
AHRQ-funded; HS024241.
Citation: Milata JL, Otte JL, Carpenter JS .
Oral endocrine therapy nonadherence, adverse effects, decisional support, and decisional needs in women with breast cancer.
Cancer Nurs 2018 Jan/Feb;41(1):E9-E18. doi: 10.1097/ncc.0000000000000430..
Keywords: Adverse Events, Cancer: Breast Cancer, Shared Decision Making, Medication, Patient Adherence/Compliance
Ashby VB, Leichtman AB, Rees MA
A kidney graft survival calculator that accounts for mismatches in age, sex, HLA, and body size.
Models were adjusted for year of transplant and donor and recipient characteristics, with particular attention to mismatches in age, sex, human leukocyte antigens (HLA), body size, and weight. These models were used to create a calculator of estimated graft survival for living donors. This calculator provides useful information to donors, candidates, and physicians of estimated outcomes and potentially in allowing candidates to choose among several living donors.
AHRQ-funded; HS020610.
Citation: Ashby VB, Leichtman AB, Rees MA .
A kidney graft survival calculator that accounts for mismatches in age, sex, HLA, and body size.
Clin J Am Soc Nephrol 2017 Jul 7;12(7):1148-60. doi: 10.2215/cjn.09330916.
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Keywords: Adverse Events, Shared Decision Making, Registries, Risk, Transplantation
Horsky J, Aarts J, Verheul L
Clinical reasoning in the context of active decision support during medication prescribing.
The purpose of this study was to describe and analyze reasoning patterns of clinicians responding to drug-drug interaction alerts in order to understand the role of patient-specific information in the decision-making process about the risks and benefits of medication therapy. The investigators found that declining an alert suggestion was preceded by sometimes brief but often complex reasoning, prioritizing different aspects of care quality and safety, especially when the perceived risk was higher.
AHRQ-funded; HS021094.
Citation: Horsky J, Aarts J, Verheul L .
Clinical reasoning in the context of active decision support during medication prescribing.
Int J Med Inform 2017 Jan;97:1-11. doi: 10.1016/j.ijmedinf.2016.09.004..
Keywords: Adverse Drug Events (ADE), Adverse Events, Clinical Decision Support (CDS), Shared Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Medication, Patient Safety
Reiter-Palmon R, Kennel V, Allen JA
Naturalistic decision making in after-action review meetings: the implementation of and learning from post-fall huddles.
In this study, the authors added to our understanding of Naturalistic Decision Making (NDM) in healthcare and how After Action Reviews (AARs) can be utilized as a learning tool to reduce errors. They found that the use of self-guided post-fall huddles increased over the time of the project, the types of errors identified as contributing to the patient fall changed, and the proportion of falls with less adverse effects increased during the project time period. They concluded that , over time, self-guided AARs can be useful for some aspects of learning from errors.
AHRQ-funded; HS021429.
Citation: Reiter-Palmon R, Kennel V, Allen JA .
Naturalistic decision making in after-action review meetings: the implementation of and learning from post-fall huddles.
J Occup Organ Psychol 2015 Jun;88(2):322-40. doi: 10.1111/joop.12084.
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Keywords: Adverse Events, Falls, Shared Decision Making, Medical Errors, Patient Safety
Dahlke AR, Merkow RP, Chung JW
Comparison of postoperative complication risk prediction approaches based on factors known preoperatively to surgeons versus patients.
The objective of this paper was to compare three estimation models: (1) the All Information Model; (2) the Surgeon Assessment Model; and (3) the Patient-Entered Model. The investigators observed a small decline in model performance that they suggest may not be clinically meaningful. They concluded that the Surgeon Assessment and Patient-Entered models with fewer predictors can be used with relative confidence to predict a patient's risk.
AHRQ-funded; HS021857.
Citation: Dahlke AR, Merkow RP, Chung JW .
Comparison of postoperative complication risk prediction approaches based on factors known preoperatively to surgeons versus patients.
Surgery 2014 Jul;156(1):39-45. doi: 10.1016/j.surg.2014.03.002.
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Keywords: Adverse Events, Shared Decision Making, Risk, Surgery