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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
101 to 125 of 419 Research Studies DisplayedToh S
Analytic and data sharing options in real-world multi-database studies of comparative effectiveness and safety of medical products.
A wide range of analytic and data sharing options are available in non-experimental multi-database studies designed to assess the real-world benefits and risks of medical products. This article reviewed available analytic and data sharing options and discussed key scientific and practical considerations when choosing among these options in multi-database studies of comparative effectiveness and safety of medical products.
AHRQ-funded; HS026214.
Citation: Toh S .
Analytic and data sharing options in real-world multi-database studies of comparative effectiveness and safety of medical products.
Clin Pharmacol Ther 2020 Apr;107(4):834-42. doi: 10.1002/cpt.1754..
Keywords: Patient-Centered Outcomes Research, Research Methodologies, Comparative Effectiveness
Ellis RP, Hsu HE, Song C
Diagnostic category prevalence in 3 classification systems across the transition to the International Classification of Diseases, Tenth Revision, Clinical Modification.
This study examined changes in prevalence of diagnostic categories of the new in 2015 International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) compared to three common diagnostic classification systems. The systems compared were World Health Organization (WHO) disease chapters, Department of Health and Human Services Hierarchical Condition Categories (HHS-HCCs), and the Agency for Healthcare Research and Quality Clinical Classification System (AHRQ-CCS). Data came from insurance claim diagnoses from the IBM MarketScan Commercial Database from January 1, 2010, to December 31, 2017, for more than 18 million people aged 0 to 64 years with private insurance. Data were analyzed from December 1, 2018, to January 21, 2020. Diagnosis changed minimally compared to the WHO classification, but diagnosis prevalence was associated with level changes of 20% or more among 20 of 127 HHS-HCCs (15.7%) and 46 of 282 AHRQ-CCS categories (16.3%) and with trend changes of 20% or more among 12 of 127 of HHS-HCCs (9.4%) and 27 of 282 of AHRQ-CCS categories (9.6%). The greatest increases was for acute myocardial infarction (AMI) and diabetes-related hypoglycemia and hyperglycemia codes, while rates for complications in pregnancy decreased compared to the HHS-HCC classification system. The latter was partly due to removing vaginal birth after cesarean delivery as a complication.
AHRQ-funded; HS026485.
Citation: Ellis RP, Hsu HE, Song C .
Diagnostic category prevalence in 3 classification systems across the transition to the International Classification of Diseases, Tenth Revision, Clinical Modification.
JAMA Netw Open 2020 Apr;3(4):e202280. doi: 10.1001/jamanetworkopen.2020.2280..
Keywords: Research Methodologies
Manojlovich M, Bedard L, Griggs JJ
Facilitators and barriers to recruiting ambulatory oncology practices into a large multisite study: mixed methods study.
The authors of this article aimed to describe the facilitators and barriers to recruiting ambulatory oncology practices into a large multisite study. They used a mixed methods design and 4 domains of the Consolidated Framework for Implementation Research to describe facilitators and barriers to recruitment. They identified numerous recruitment barriers and facilitators and devised strategies to enhance recruitment efforts. They concluded that researchers and clinicians can partner effectively to design and implement research protocols that ultimately benefit patients who are increasingly seeking care in ambulatory practices.
AHRQ-funded; HS024914.
Citation: Manojlovich M, Bedard L, Griggs JJ .
Facilitators and barriers to recruiting ambulatory oncology practices into a large multisite study: mixed methods study.
JMIR Cancer 2020 Apr 20;6(1):e14476. doi: 10.2196/14476..
Keywords: Ambulatory Care and Surgery, Health Services Research (HSR), Research Methodologies
Bucholz EM, Toomey SL, Butala NM
Suitability of elderly adult hospital readmission rates for profiling readmissions in younger adult and pediatric populations.
Investigators sought to determine the correlation between hospital 30-day risk-standardized readmission rates in elderly adults and those in nonelderly adults and children. Data from U.S. hospitals in the 2013-2014 Nationwide Readmissions Database were used. The researchers found that hospital readmission rates in elderly adults may reflect broader hospital readmission performance in middle-aged and young adult populations, but they are not reflective of hospital performance in pediatric populations.
AHRQ-funded; HS020513; HS025299.
Citation: Bucholz EM, Toomey SL, Butala NM .
Suitability of elderly adult hospital readmission rates for profiling readmissions in younger adult and pediatric populations.
Health Serv Res 2020 Apr;55(2):277-87. doi: 10.1111/1475-6773.13269..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Health Services Research (HSR), Research Methodologies, Children/Adolescents
Fiscella K, Sanders M, Holder T
The role of data and safety monitoring boards in implementation trials: when are they justified?
This paper examined the appropriateness of the establishment of data and safety monitoring boards (DSMBs) for all phase III clinical trials sponsored by the National Heart, Lung and Blood Institute (NHLBI). The authors reviewed the unique features of implementation trials and reflected on key questions regarding the justification for DSMBs and their potential role and monitoring targets within implementation trials.
AHRQ-funded; HS021667.
Citation: Fiscella K, Sanders M, Holder T .
The role of data and safety monitoring boards in implementation trials: when are they justified?
J Clin Transl Sci 2020 Mar 5;4(3):229-32. doi: 10.1017/cts.2020.19..
Keywords: Research Methodologies, Implementation
Taft L, Shen C
A non-parametric statistical test of null treatment effect in sub-populations.
Randomized clinical trials are designed to estimate the average treatment effect (ATE). If heterogeneity of treatment effect exists, then it is possible that there may be subjects who derive a treatment effect different from the ATE. In this study, the investigators propose a method to test the hypothesis that there exist subjects who derive benefit (or harm) against the null hypothesis that the treatment has no benefit (or harm) on each of the smallest sub-populations defined by discrete baseline covariates.
AHRQ-funded; HS024520.
Citation: Taft L, Shen C .
A non-parametric statistical test of null treatment effect in sub-populations.
J Biopharm Stat 2020 Mar;30(2):277-93. doi: 10.1080/10543406.2019.1636810..
Keywords: Research Methodologies, Patient-Centered Outcomes Research
Beam DM, Brown J, Kaji AH
Evolution of the Strategies to Innovate Emergency Care Clinical Trials Network (SIREN).
This article describes SIREN, the Strategies to Innovate Emergency Care Clinical Trials Network. The authors conclude that, through a strong collaborative research network, SIREN offers the opportunity to significantly enhance emergency care research with the aim of improvement in patient outcomes.
AHRQ-funded; HS023901.
Citation: Beam DM, Brown J, Kaji AH .
Evolution of the Strategies to Innovate Emergency Care Clinical Trials Network (SIREN).
Ann Emerg Med 2020 Mar;75(3):400-07. doi: 10.1016/j.annemergmed.2019.07.029..
Keywords: Emergency Department, Health Services Research (HSR), Research Methodologies
Krist AH, Barry MJ, Wolff TA
AHRQ Author: Wolff TA, Fan TM
Evolution of the U.S. Preventive Services Task Force's methods.
In this commentary on an article appearing in the same issue, the authors stated that the methods used by the USPSTF deliberately set a high bar for making evidence-based recommendations. They indicated that consumers of preventive service guidelines need to know concretely what is known and unknown and further need confidence that what is being recommended is not influenced by economic or political pressures or by professional opinion with a limited evidence basis.
AHRQ-authored.
Citation: Krist AH, Barry MJ, Wolff TA .
Evolution of the U.S. Preventive Services Task Force's methods.
Am J Prev Med 2020 Mar;58(3):332-35. doi: 10.1016/j.amepre.2019.11.003..
Keywords: U.S. Preventive Services Task Force (USPSTF), Guidelines, Evidence-Based Practice, Prevention, Research Methodologies
Byham-Gray LD, Peters EN, Rothpletz-Puglia P
Patient-centered model for protein-energy wasting: stakeholder deliberative panels.
Integrating the patient's voice into research prioritization is essential for solving problems that patients care the most about in terms of health, symptom management, and survival. In this study, the investigators used deliberative processes for adapting the existing model of protein-energy wasting (PEW) to one that included stakeholder priorities, addressing gaps from the initial concept.
AHRQ-funded; HS023434.
Citation: Byham-Gray LD, Peters EN, Rothpletz-Puglia P .
Patient-centered model for protein-energy wasting: stakeholder deliberative panels.
J Ren Nutr 2020 Mar;30(2):137-44. doi: 10.1053/j.jrn.2019.06.001..
Keywords: Patient-Centered Healthcare, Patient-Centered Outcomes Research, Evidence-Based Practice, Patient and Family Engagement, Research Methodologies
Hade EM, Nattino G, Frey HA
Propensity score matching for treatment delay effects with observational survival data.
In this paper, the investigators discuss how propensity score matching for treatment delay effects with observational survival data. In observational studies with a survival outcome, treatment initiation may be time dependent, which is likely to be affected by both time-invariant and time-varying covariates. The investigators concluded that their simulation study showed that, in the presence of treatment delay effects, the matching-based analyses clearly outperformed the conventional regression analysis using the naive Cox proportional hazards model.
AHRQ-funded; HS024263.
Citation: Hade EM, Nattino G, Frey HA .
Propensity score matching for treatment delay effects with observational survival data.
Stat Methods Med Res 2020 Mar;29(3):695-708. doi: 10.1177/0962280219877908..
Keywords: Research Methodologies
Munger Clary HM, Croxton RD, Allan J
Who is willing to participate in research? A screening model for an anxiety and depression trial in the epilepsy clinic.
This study assessed the willingness of epilepsy patients positively screened for anxiety and/or depression to participate in a research study. A total of 199 patients screened positively during a routine epilepsy screening visit and 154 (77.4%) opted-in for further research assessment. Nearly half of those 199 individuals were already being treated for anxiety and/or depression, with 46.7% receiving neither antidepressants or therapy. Higher depression scores and current treatment were independently associated with opting in. One-quarter reported a past psychiatric hospitalization, but only half of those individuals were currently receiving mental health specialty care.
AHRQ-funded; HS025723.
Citation: Munger Clary HM, Croxton RD, Allan J .
Who is willing to participate in research? A screening model for an anxiety and depression trial in the epilepsy clinic.
Epilepsy Behav 2020 Mar;104(Pt A):106907. doi: 10.1016/j.yebeh.2020.106907..
Keywords: Anxiety, Depression, Behavioral Health, Neurological Disorders, Chronic Conditions, Screening, Diagnostic Safety and Quality, Health Services Research (HSR), Research Methodologies
Gaynes BN, Lux L, Gartlehner G
Defining treatment-resistant depression.
The authors conducted a review for the Centers for Medicare & Medicaid Services and AHRQ to clarify how experts and investigators have defined treatment-resistant depression (TRD) and to review systematically how well this definition comports with TRD definitions in clinical trials through July 5, 2019. They found that no consensus definition existed for TRD. While depressive outcomes and clinical global impressions were commonly measured, functional impairment and quality-of-life tools were rarely used. They recommend stronger approaches to designing and conducting TRD research in order to foster better evidence to translate into clearer guidelines for treating patients with TRD.
AHRQ-funded; 290201500011I.
Citation: Gaynes BN, Lux L, Gartlehner G .
Defining treatment-resistant depression.
Depress Anxiety 2020 Feb;37(2):134-45. doi: 10.1002/da.22968..
Keywords: Depression, Behavioral Health, Evidence-Based Practice, Implementation, Research Methodologies
Squires A, Sadarangani T, Jones S
Strategies for overcoming language barriers in research.
This study synthesized methodological recommendations for cross-language research studies with the goal to improve the quality of future research and expand the evidence-base for clinical practice. Clear methodological recommendations were generated that can improve research rigor and quality of cross-language qualitative and quantitative studies. The authors suggest that the recommendations generated in their paper have the potential to have an impact on the health and well-being of migrants around the world.
AHRQ-funded; HS023593.
Citation: Squires A, Sadarangani T, Jones S .
Strategies for overcoming language barriers in research.
J Adv Nurs 2020 Feb;76(2):706-14. doi: 10.1111/jan.14007..
Keywords: Health Services Research (HSR), Research Methodologies, Communication, Cultural Competence
Lin L, Shi L, Chu H
The magnitude of small-study effects in the Cochrane Database of Systematic Reviews: an empirical study of nearly 30 000 meta-analyses.
The authors’ goal was to provide rules of thumb for interpreting measures to quantify small-study effects' magnitude. They used six measures to evaluate small-study effects in 29,932 meta-analyses from the Cochrane Database of Systematic Reviews. They presented the empirical distributions of the six measures and proposed a rough guide to interpret the measures' magnitude. They suggested that their proposed rules of thumb may help evidence users grade the certainty in evidence as impacted by small-study effects.
AHRQ-funded; HS024743.
Citation: Lin L, Shi L, Chu H .
The magnitude of small-study effects in the Cochrane Database of Systematic Reviews: an empirical study of nearly 30 000 meta-analyses.
BMJ Evid Based Med 2020 Feb;25(1):27-32. doi: 10.1136/bmjebm-2019-111191..
Keywords: Research Methodologies, Evidence-Based Practice
Turner AM, Engelsma T, Taylor JO
Recruiting older adult participants through crowdsourcing platforms: Mechanical Turk versus Prolific Academic.
Recruiting older adults (OA) into research is challenging. OBJECThe objective of this study was to assess the feasibility of using two crowdsourcing platforms, Amazon's Mechanical Turk (MTurk) and Prolific Academic (ProA), as efficient and low-cost venues for recruiting survey participants aged 65 and older. The investigators developed an online survey to investigate and compare the demographics, technology use, and motivations for research participation of OA on MTurk and ProA.
AHRQ-funded; HS022106.
Citation: Turner AM, Engelsma T, Taylor JO .
Recruiting older adult participants through crowdsourcing platforms: Mechanical Turk versus Prolific Academic.
AMIA Annu Symp Proc 2020 Jan 25;2020:1230-38..
Keywords: Elderly, Research Methodologies
Keeney T, Belanger E, Jones RN
High-need phenotypes in Medicare beneficiaries: drivers of variation in utilization and outcomes.
The goal of this study was to identify distinct clinical phenotypes present within high-need Medicare beneficiaries and to examine differences in outcomes between phenotypes. Researchers identified five phenotypes and concluded that their findings represented a first step toward classifying the heterogeneity among high-need Medicare beneficiaries. They recommend further work to identify modifiable utilization patterns between phenotypes to improve the value of healthcare provided to these subpopulations.
AHRQ-funded; HS000011.
Citation: Keeney T, Belanger E, Jones RN .
High-need phenotypes in Medicare beneficiaries: drivers of variation in utilization and outcomes.
J Am Geriatr Soc 2020 Jan;68(1):70-77. doi: 10.1111/jgs.16146..
Keywords: Medicare, Research Methodologies, Outcomes, Health Services Research (HSR)
Wang J, Zhang S, Ahn C
Sample size calculation for count outcomes in cluster randomization trials with varying cluster sizes.
In this paper, the authors derive a closed-form sample size formula for count outcomes accounting for the variability in cluster size. They compare the performance of the proposed method with the average cluster size method through simulation. They concluded that the simulation study showed that the proposed method had a better performance with empirical powers and type I errors closer to the nominal levels.
AHRQ-funded; HS022418.
Citation: Wang J, Zhang S, Ahn C .
Sample size calculation for count outcomes in cluster randomization trials with varying cluster sizes.
Commun Stat Theory Methods 2020;49(1):116-24. doi: 10.1080/03610926.2018.1532004..
Keywords: Research Methodologies
Jarrin OF, Nyandege AN, Grafova IB
Validity of race and ethnicity codes in Medicare administrative data compared with gold-standard self-reported race collected during routine home health care visits.
The authors compared the validity of two race/ethnicity variables found in Medicare administrative data against a gold-standard source also available in the Medicare data warehouse. They found that the race/ethnicity variables contained in Medicare administrative data for minority health disparities research can be improved through the use of self-reported race/ethnicity data. They conclude that future work to improve the accuracy of Medicare beneficiaries' race/ethnicity data should incorporate and augment the self-reported race/ethnicity data contained in assessment and survey data, available within the Medicare data warehouse.
AHRQ-funded; HS022406.
Citation: Jarrin OF, Nyandege AN, Grafova IB .
Validity of race and ethnicity codes in Medicare administrative data compared with gold-standard self-reported race collected during routine home health care visits.
Med Care 2020 Jan;58(1):e1-e8. doi: 10.1097/mlr.0000000000001216..
Keywords: Racial and Ethnic Minorities, Home Healthcare, Medicare, Data, Disparities, Research Methodologies
Norton WE, Zwarenstein M, Czajkowski S
AHRQ Author: Kato E
Building internal capacity in pragmatic trials: a workshop for program scientists at the US National Cancer Institute.
This article describes a workshop put together by the authors for program scientists at the National Cancer Institute (NCI) to help them become better researchers and stewards of research funds. The workshop got good reviews from the attendees and many felt it will help them develop funding opportunities and advise grantees.
AHRQ-authored.
Citation: Norton WE, Zwarenstein M, Czajkowski S .
Building internal capacity in pragmatic trials: a workshop for program scientists at the US National Cancer Institute.
Trials 2019 Dec 27;20(1):779. doi: 10.1186/s13063-019-3934-y..
Keywords: Research Methodologies, Health Services Research (HSR), Cancer, Healthcare Delivery
Kuhn J, Sheldrick RC, Broder-Fingert S
Simulation and minimization: technical advances for factorial experiments designed to optimize clinical interventions.
This study examined the best way to maximize the Multiphase Optimization Strategy (MOST) which is designed to maximize the impact of clinical healthcare interventions. Computer simulations were run to empirically test five subject allocation procedures. Simple and stratified randomization performed the poorest; while maximum tolerated imbalance, minimal sufficient balance, and minimization were more successful in achieving balanced sample sizes and equivalence across a large number of covariates. Minimization was recommended for further research studies.
AHRQ-funded; 2T32HS022242.
Citation: Kuhn J, Sheldrick RC, Broder-Fingert S .
Simulation and minimization: technical advances for factorial experiments designed to optimize clinical interventions.
BMC Med Res Methodol 2019 Dec 16;19(1):239. doi: 10.1186/s12874-019-0883-9..
Keywords: Research Methodologies
Predmore Z, Hatef E, Weiner JP
Integrating social and behavioral determinants of health into population health analytics: a conceptual framework and suggested road map.
There is growing recognition that social and behavioral risk factors impact population health outcomes. Interventions that target these risk factors can improve health outcomes. This study presents a review of existing literature and proposes a conceptual framework for the integration of social and behavioral data into population health analytics platforms. The authors describe several use cases for these platforms at the patient, health system, and community levels, and align these use cases with the different types of prevention identified by the Centers for Disease Control and Prevention.
AHRQ-funded; HS000029.
Citation: Predmore Z, Hatef E, Weiner JP .
Integrating social and behavioral determinants of health into population health analytics: a conceptual framework and suggested road map.
Popul Health Manag 2019 Dec;22(6):488-94. doi: 10.1089/pop.2018.0151..
Keywords: Social Determinants of Health, Risk, Research Methodologies
Krist AH, Davidson KW, Ngo-Metzger Q
AHRQ Author: Ngo-Metzger Q, Mills J
Social determinants as a preventive service: U.S. Preventive Services Task Force methods considerations for research.
The authors offer a brief review of the social determinants of health that may be germane to the USPSTF, the methods the USPSTF uses to evaluate relevant evidence, and current evidence gaps for social risks. Their road map for research is intended to spark ingenuity and purpose in the next generation of research studies, thereby ensuring that future recommendations to address and prevent social risks in primary care are informed by high-quality evidence.
AHRQ-authored; AHRQ-funded; HS026664.
Citation: Krist AH, Davidson KW, Ngo-Metzger Q .
Social determinants as a preventive service: U.S. Preventive Services Task Force methods considerations for research.
Am J Prev Med 2019 Dec;57(6s1):S6-s12. doi: 10.1016/j.amepre.2019.07.013..
Keywords: U.S. Preventive Services Task Force (USPSTF), Social Determinants of Health, Research Methodologies, Evidence-Based Practice, Prevention
Saldanha IJ, Smith BT, Ntzani E
The Systematic Review Data Repository (SRDR): descriptive characteristics of publicly available data and opportunities for research.
Funded by the US Agency for Healthcare Research and Quality (AHRQ), the Systematic Review Data Repository (SRDR) is a free, web-based, open-source, data management and archival platform for reviews. The objectives of this study were to describe (1) the current extent of usage of SRDR and (2) the characteristics of all projects with publicly available data on the SRDR website.
AHRQ-funded; HHSA290201500002I_HHSA29032012T.
Citation: Saldanha IJ, Smith BT, Ntzani E .
The Systematic Review Data Repository (SRDR): descriptive characteristics of publicly available data and opportunities for research.
Syst Rev 2019 Dec 20;8(1):334. doi: 10.1186/s13643-019-1250-y..
Keywords: Evidence-Based Practice, Data, Research Methodologies, Registries
Broder-Fingert S, Kuhn J, Sheldrick RC
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol.
Researchers describe a study protocol for a large randomized controlled trial using the Multiphase Optimization Strategy (MOST), a novel framework developed to optimize interventions. They apply this framework to delivery of Family Navigation (FN), an evidence-based care management strategy designed to reduce disparities and improve access to behavioral health services, and test four components related to its implementation. In this paper, they describe how the MOST framework can be used to improve intervention delivery. These methods will be useful for future studies testing intervention delivery strategies and their impact on implementation.
AHRQ-funded; HS022242.
Citation: Broder-Fingert S, Kuhn J, Sheldrick RC .
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol.
Trials 2019 Dec 16;20(1):728. doi: 10.1186/s13063-019-3853-y..
Keywords: Research Methodologies, Health Services Research (HSR), Healthcare Delivery, Behavioral Health, Evidence-Based Practice, Access to Care
Gates A, Guitard S, Pillay J
Performance and usability of machine learning for screening in systematic reviews: a comparative evaluation of three tools.
Researchers explored the performance of three machine learning tools designed to facilitate title and abstract screening in systematic reviews (SRs) when used to eliminate irrelevant records and complement the work of a single reviewer. Using Abstrackr, DistillerSR, and RobotAnalyst, they found that the workload savings afforded in the automated simulation came with increased risk of missing relevant records. Supplementing a single reviewer's decisions with relevance predictions sometimes reduced the proportion missed, but performance varied by tool and SR. They recommend designing tools based on reviewers' self-identified preferences to improve compatibility with present workflows.
AHRQ-funded; 290201500001I.
Citation: Gates A, Guitard S, Pillay J .
Performance and usability of machine learning for screening in systematic reviews: a comparative evaluation of three tools.
Syst Rev 2019 Nov 15;8(1):278. doi: 10.1186/s13643-019-1222-2..
Keywords: Patient-Centered Outcomes Research, Health Services Research (HSR), Research Methodologies, Evidence-Based Practice, Comparative Effectiveness