National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (2)
- Anxiety (1)
- Cancer (11)
- (-) Cancer: Breast Cancer (26)
- Case Study (1)
- Children/Adolescents (1)
- Clinician-Patient Communication (1)
- Comparative Effectiveness (2)
- Depression (1)
- Diagnostic Safety and Quality (1)
- Disparities (2)
- Elderly (3)
- Family Health and History (1)
- Genetics (5)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (1)
- Healthcare Utilization (3)
- Imaging (4)
- Injuries and Wounds (1)
- Medicaid (1)
- Medicare (2)
- Medication (2)
- Mortality (3)
- Obesity (1)
- Outcomes (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (6)
- Patient Adherence/Compliance (4)
- Patient Safety (1)
- Practice Patterns (2)
- Prevention (3)
- Quality of Life (1)
- Racial and Ethnic Minorities (6)
- Risk (2)
- Screening (5)
- Shared Decision Making (5)
- Social Determinants of Health (4)
- Surgery (3)
- Treatments (6)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Urban Health (1)
- Vulnerable Populations (1)
- Women (10)
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 25 of 26 Research Studies DisplayedLairson DR, Parikh RC, Cormier JN
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
The researchers assessed the cost-effectiveness of chemotherapy regimens by age and disease stage under "real-world" conditions for patients with breast cancer. They found that anthracycline-based chemotherapy was found cost-effective for elderly patients with early stage (stage I, II, IIIa) breast cancer considering the US threshold of $100,000 per QALY.
AHRQ-funded; HS018956.
Citation: Lairson DR, Parikh RC, Cormier JN .
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
Value Health 2015 Dec;18(8):1070-8. doi: 10.1016/j.jval.2015.08.008..
Keywords: Cancer: Breast Cancer, Treatments, Healthcare Costs, Elderly, Social Determinants of Health
Kohler RE, Goyal RK, Lich KH
Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program.
The objective of this study was to examine health care utilization and expenditures as a function of patient-centered medical home (PCMH) enrollment among breast cancer patients in North Carolina’s Medicaid program. It found that PCMH enrollment was significantly associated with greater outpatient service use, but there was no difference in the probability of inpatient hospitalizations or ED visits.
AHRQ-funded; HS019468.
Citation: Kohler RE, Goyal RK, Lich KH .
Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program.
Cancer 2015 Nov 15;121(22):3975-81. doi: 10.1002/cncr.29596..
Keywords: Cancer, Cancer: Breast Cancer, Healthcare Utilization, Medicaid, Patient-Centered Healthcare
Potosky AL, O'Neill SC, Isaacs C
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
The authors evaluated the relation between gene expression profiling (GEP) testing and the use of adjuvant chemotherapy by women treated in a general oncology practice. They found that adjuvant chemotherapy use after GEP testing is generally consistent with the recommended test interpretation for women with a high or low predicted risk of recurrence. Chemotherapy use in the intermediate-risk group increased with Recurrence Score values, and evidence from ongoing randomized trials may help to clarify whether this finding reflects optimal interpretation of GEP test results.
AHRQ-funded; HS022915.
Citation: Potosky AL, O'Neill SC, Isaacs C .
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
Cancer 2015 Nov 15;121(22):4062-70. doi: 10.1002/cncr.29621.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Shared Decision Making, Genetics, Practice Patterns, Women
Yi H, Xiao T, Thomas PS
Barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools.
The investigators identified barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. They found that barriers barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and that facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool.
AHRQ-funded; HS019313.
Citation: Yi H, Xiao T, Thomas PS .
Barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools.
AMIA Annu Symp Proc 2015 Nov 5;2015:1352-60.
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Keywords: Cancer: Breast Cancer, Shared Decision Making, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Clinician-Patient Communication
Dinan MA, Mi X, Reed SD
Association between use of the 21-gene recurrence score assay and receipt of chemotherapy among Medicare beneficiaries with early-stage breast cancer, 2005-2009.
The researchers examined whether adoption of the 21-Gene Recurrence Score (RS) assay in a nationally representative sample of patients with early-stage breast cancer was associated with use of chemotherapy. They found that the impact of the adoption of the RS assay on receipt of chemotherapy was strongly population dependent and was associated with relatively lower chemotherapy use in groups with high-risk disease and relatively higher chemotherapy use in patients with low-risk disease.
AHRQ-funded; HS022189.
Citation: Dinan MA, Mi X, Reed SD .
Association between use of the 21-gene recurrence score assay and receipt of chemotherapy among Medicare beneficiaries with early-stage breast cancer, 2005-2009.
JAMA Oncol 2015 Nov 1;1(8):1098-109. doi: 10.1001/jamaoncol.2015.2722..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Genetics, Medicare, Women
Highfield L, Rajan SS, Valerio MA
A non-randomized controlled stepped wedge trial to evaluate the effectiveness of a multi-level mammography intervention in improving appointment adherence in underserved women.
This study evaluated a theoretically based, systematically designed implementation strategy to support adoption and implementation of a patient navigation-based intervention, called Peace of Mind Program (PMP), aimed at improving breast cancer screening among underserved women.. Any potential confounding or bias will be controlled in the analysis. Outcomes such as appointment adherence, patient referral to diagnostics, time to diagnostic referral, patient referral to treatment, time to treatment referral, and budget impact of the intervention will be assessed.
AHRQ-funded; HS023255.
Citation: Highfield L, Rajan SS, Valerio MA .
A non-randomized controlled stepped wedge trial to evaluate the effectiveness of a multi-level mammography intervention in improving appointment adherence in underserved women.
Implement Sci 2015 Oct 14;10:143. doi: 10.1186/s13012-015-0334-x.
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Keywords: Cancer: Breast Cancer, Cancer, Screening, Patient Adherence/Compliance, Women, Vulnerable Populations, Prevention, Imaging
Ning J, Peng S, Ueno N
Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?
The researchers evaluated factors associated with overall, breast cancer-specific and other-cause mortalities using contemporary population data. They concluded that breast cancer-specific mortality among older women modestly improved from 2002 to 2009 across all races, but not other-cause mortality. Racial disparity in mortality persisted, but did not widen in this period.
AHRQ-funded; HS002026.
Citation: Ning J, Peng S, Ueno N .
Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?
Ann Oncol 2015 Oct;26(10):2161-8. doi: 10.1093/annonc/mdv330.
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Keywords: Cancer, Cancer: Breast Cancer, Elderly, Mortality, Racial and Ethnic Minorities
Rosenberg SM, Partridge AH
New insights into nonadherence with adjuvant endocrine therapy among young women with breast cancer.
This editorial described endocrine therapy and reasons for nonadherence in young women with breast cancer, including side effects and fertility concerns.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Partridge AH .
New insights into nonadherence with adjuvant endocrine therapy among young women with breast cancer.
J Natl Cancer Inst 2015 Oct;107(10). doi: 10.1093/jnci/djv245.
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Keywords: Adverse Drug Events (ADE), Cancer: Breast Cancer, Medication, Patient Adherence/Compliance
Mortel M, Rauscher GH, Murphy AM
Racial and ethnic disparity in symptomatic breast cancer awareness despite a recent screen: the role of tumor biology and mammography facility characteristics.
In a racially and ethnically diverse sample of recently diagnosed urban patients with breast cancer, the researchers examined associations of patient, tumor biology, and mammography facility characteristics on the probability of symptomatic discovery of their breast cancer despite a recent prior screening mammogram. They concluded that facility resources and tumor aggressiveness explain much of the racial/ethnic disparity in symptomatic breast cancer among recently screened patients.
AHRQ-funded; HS018366.
Citation: Mortel M, Rauscher GH, Murphy AM .
Racial and ethnic disparity in symptomatic breast cancer awareness despite a recent screen: the role of tumor biology and mammography facility characteristics.
Cancer Epidemiol Biomarkers Prev 2015 Oct;24(10):1599-606. doi: 10.1158/1055-9965.epi-15-0305.
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Keywords: Cancer: Breast Cancer, Cancer, Disparities, Women, Racial and Ethnic Minorities, Screening, Prevention
Fernandes-Taylor S, Adesoye T, Bloom JR
Managing psychosocial issues faced by young women with breast cancer at the time of diagnosis and during active treatment.
This review examines recent literature on the psychosocial needs of and interventions for young women. It focuses on the active treatment period given the toxicity of treatment, the incidence of anxiety, and depressive symptoms in these women during treatment. It concluded that shared decision-making, balancing body image, fear of recurrence, and recommended treatment, and palliative care for metastasis are essential research priorities for the clinical setting.
AHRQ-funded; HS023395.
Citation: Fernandes-Taylor S, Adesoye T, Bloom JR .
Managing psychosocial issues faced by young women with breast cancer at the time of diagnosis and during active treatment.
Curr Opin Support Palliat Care 2015 Sep;9(3):279-84. doi: 10.1097/spc.0000000000000161..
Keywords: Anxiety, Cancer: Breast Cancer, Shared Decision Making, Depression, Quality of Life
Rust G, Zhang S, Malhotra K
Paths to health equity: local area variation in progress toward eliminating breast cancer mortality disparities, 1990-2009.
The researchers examined county-level, age-adjusted breast cancer mortality rates for women who were 35 to 74 years old during the period of 1989-2010. They found that more than half of the counties (54%) showed persistent, unchanging disparities. Roughly 1 in 4 (24%) had a divergent pattern of worsening black/white disparities.
AHRQ-funded; HS022444.
Citation: Rust G, Zhang S, Malhotra K .
Paths to health equity: local area variation in progress toward eliminating breast cancer mortality disparities, 1990-2009.
Cancer 2015 Aug 15;121(16):2765-74. doi: 10.1002/cncr.29405..
Keywords: Cancer: Breast Cancer, Disparities, Racial and Ethnic Minorities, Mortality, Racial and Ethnic Minorities
Du XL, Zhang Y, Parikh RC
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
The purpose of this study was to compare the effectiveness of chemotherapy in prolonging survival according to age in breast and colon cancer. It found that the effectiveness of chemotherapy decreased with age in participants with breast cancer, in whom chemotherapy appears to be effective until age 79 except for the doxorubicin-cyclophosphamide combination, which was effective in participants aged 80 to 84.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Parikh RC .
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
J Am Geriatr Soc 2015 Aug;63(8):1570-82. doi: 10.1111/jgs.13523..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research
Roberts MC, Weinberger M, Dusetzina SB
Racial variation in adjuvant chemotherapy initiation among breast cancer patients receiving oncotype DX testing.
The researchers examined whether adjuvant chemotherapy initiation varied by race. No racial differences were found in adjuvant chemotherapy initiation among women receiving ODX testing. As treatment decision-making becomes increasingly targeted with the use of genetic technologies, these results provide evidence that test results may drive treatment in a similar way across racial subgroups.
AHRQ-funded; HS022189.
Citation: Roberts MC, Weinberger M, Dusetzina SB .
Racial variation in adjuvant chemotherapy initiation among breast cancer patients receiving oncotype DX testing.
Breast Cancer Res Treat 2015 Aug;153(1):191-200. doi: 10.1007/s10549-015-3518-9..
Keywords: Cancer: Breast Cancer, Treatments, Shared Decision Making, Genetics, Racial and Ethnic Minorities
Bertrand KA, Baer HJ, Orav EJ
Body fatness during childhood and adolescence and breast density in young women: a prospective analysis.
The authors examined associations of early life body fatness with adult breast density in 182 women in the Dietary Intervention Study in Children (DISC) who were ages 25-29 at follow-up. Their results support the hypothesis that body fatness during childhood and adolescence may play an important role in premenopausal breast density, independent of current BMI, and further suggest direct or indirect influences on absolute dense breast volume.
AHRQ-funded; HS019789.
Citation: Bertrand KA, Baer HJ, Orav EJ .
Body fatness during childhood and adolescence and breast density in young women: a prospective analysis.
Breast Cancer Res 2015 Jul 16;17:95. doi: 10.1186/s13058-015-0601-4.
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Keywords: Cancer: Breast Cancer, Children/Adolescents, Obesity, Women
Irvin VL, Breen N, Meissner HI
AHRQ Author: Kaplan RM
Non-normal screening mammography results, lumpectomies, and breast cancer reported by California women, 2001-2009.
This study report trends in self-reported non-normal screening mammography results, lumpectomies, and breast cancer in California women. Between 2001 and 2009, the percent of California women who reported having been diagnosed with breast cancer was relatively stable. For each of the three age groups studied, the percentage of non-normal mammography results increased and the percentages of lumpectomies decreased.
AHRQ-authored.
Citation: Irvin VL, Breen N, Meissner HI .
Non-normal screening mammography results, lumpectomies, and breast cancer reported by California women, 2001-2009.
AHRQ-authored..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Imaging, Women
Roberts MC, Wheeler SB, Reeder-Hayes K
Racial/Ethnic and socioeconomic disparities in endocrine therapy adherence in breast cancer: a systematic review.
The authors sought to understand factors that influence endocrine therapy (ET) adherence among racial/ethnic and socioeconomic subpopulations of breast cancer patients. They found significant underuse of ET among minority and low-income women. They further noted that both race/ethnicity and socioeconomic status are associated with ET use in most settings.
AHRQ-funded; HS021282.
Citation: Roberts MC, Wheeler SB, Reeder-Hayes K .
Racial/Ethnic and socioeconomic disparities in endocrine therapy adherence in breast cancer: a systematic review.
Am J Public Health 2015 Jul;105 Suppl 3:e4-e15. doi: 10.2105/ajph.2014.302490.
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Keywords: Cancer: Breast Cancer, Medication, Patient Adherence/Compliance, Racial and Ethnic Minorities, Social Determinants of Health
Tamirisa NP, Sheffield KM, Parmar AD
Surgeon and facility variation in the use of minimally invasive breast biopsy in Texas.
The researchers aimed to determine the variation in use attributable to the surgeon and facility and determine the patient, surgeon, and facility characteristics associated with the use of minimally invasive breast biopsy (MIBB). They found that lower surgeon and facility volume, longer surgeon years in practice, and smaller facility bed size were associated with lower rates of MIBB use.
AHRQ-funded; HS022134.
Citation: Tamirisa NP, Sheffield KM, Parmar AD .
Surgeon and facility variation in the use of minimally invasive breast biopsy in Texas.
Ann Surg 2015 Jul;262(1):171-8. doi: 10.1097/sla.0000000000000883..
Keywords: Cancer: Breast Cancer, Shared Decision Making, Patient-Centered Outcomes Research, Surgery
Pruitt SL, Lee SJ, Tiro JA
Residential racial segregation and mortality among black, white, and Hispanic urban breast cancer patients in Texas, 1995 to 2009.
The authors investigated whether residential segregation was associated with mortality among urban women with breast cancer. They found that greater black segregation and Hispanic segregation were adversely associated with cause-specific mortality and all-cause mortality.
AHRQ-funded; HS022418.
Citation: Pruitt SL, Lee SJ, Tiro JA .
Residential racial segregation and mortality among black, white, and Hispanic urban breast cancer patients in Texas, 1995 to 2009.
Cancer 2015 Jun 1;121(11):1845-55. doi: 10.1002/cncr.29282..
Keywords: Cancer: Breast Cancer, Mortality, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Urban Health
Dinan MA, Mi X, Reed SD
Initial trends in the use of the 21-gene recurrence score assay for patients with breast cancer in the Medicare population, 2005-2009.
The researchers examined trends in the use of the 21-gene recurrence score (RS) assay in routine clinical practice in a nationally representative sample of women with breast cancer. They found that the RS assay was adopted quickly in clinical practice after the Medicare coverage decision in 2006, and use appears to be consistent with guidelines and equitable across geographic and racial groups.
AHRQ-funded; HS022189.
Citation: Dinan MA, Mi X, Reed SD .
Initial trends in the use of the 21-gene recurrence score assay for patients with breast cancer in the Medicare population, 2005-2009.
JAMA Oncol 2015 May;1(2):158-66. doi: 10.1001/jamaoncol.2015.43..
Keywords: Cancer, Cancer: Breast Cancer, Genetics, Guidelines, Medicare, Practice Patterns, Women
Wang X, Du XL
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
The researchers assessed socio-demographic, geographic, and other variations in the receipt of hormone therapy among patients with hormone receptor-positive breast cancer as well as adherence to hormone therapy within 1-year follow-up. They found that found that increasing age was significantly associated with a decreased receipt of hormone therapy and aromatase inhibitors in all hormone receptor-positive breast cancer patients after adjusting for other factors regardless of whether chemotherapy was received.
AHRQ-funded; HS018956.
Citation: Wang X, Du XL .
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
Med Oncol 2015 May;32(5):154. doi: 10.1007/s12032-015-0599-6..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Social Determinants of Health
Kadakia A, Rajan SS, Abughosh S
CMF-regimen preferred as first-course chemotherapy for older and sicker women with breast cancer: findings from a SEER-Medicare-based population study.
This study aimed to determine the utilization of Cyclophosphamide, Methotrexate, and 5-Fluorouracil (CMF) as first-course chemotherapy in recent years, and identify the sociodemographic and clinical characteristics associated with its prescription. It found that older and sicker women, living in census tracts with lower average education, and diagnosed with advanced stage, hormone receptor-negative tumors have a higher probability of CMF administration.
AHRQ-funded; HS018956.
Citation: Kadakia A, Rajan SS, Abughosh S .
CMF-regimen preferred as first-course chemotherapy for older and sicker women with breast cancer: findings from a SEER-Medicare-based population study.
Am J Clin Oncol 2015 Apr;38(2):165-73. doi: 10.1097/COC.0b013e31828f5b01..
Keywords: Cancer: Breast Cancer, Treatments, Elderly, Social Determinants of Health
Drake BF, Abadin SS, Lyons S
Mammograms on-the-go-predictors of repeat visits to mobile mammography vans in St Louis, Missouri, USA: a case-control study.
The purpose of this study was to determine the extent to which women use mobile mammography vans for breast cancer screening and what factors are associated with repeat visits to these vans. Women who were aged 50–65, uninsured, or African-American had higher odds of a repeat visit to the mobile mammography van compared with women who were aged 40–50, insured, or Caucasian.
AHRQ-funded; HS022330.
Citation: Drake BF, Abadin SS, Lyons S .
Mammograms on-the-go-predictors of repeat visits to mobile mammography vans in St Louis, Missouri, USA: a case-control study.
BMJ Open 2015 Mar 20;5(3):e006960. doi: 10.1136/bmjopen-2014-006960..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Screening, Women, Healthcare Utilization, Imaging
Gidengil CA, Predmore Z, Mattke S
Breast implant-associated anaplastic large cell lymphoma: a systematic review.
The purpose of this study was to identify and analyze recently published cases of breast implant-associated anaplastic large cell lymphoma (ALCL), with an emphasis on diagnosis, staging, treatment, and outcomes. The researchers found that, of 54 cases, most patients presented with a seroma, approximately half were associated with the capsule, most presented as stage IE, and all but one case were ALK-negative. Most patients received chemotherapy and radiation therapy, and 11 percent received stem cell transplants. Approximately one-quarter recurred, and 9 percent died.
AHRQ-funded; HS000029.
Citation: Gidengil CA, Predmore Z, Mattke S .
Breast implant-associated anaplastic large cell lymphoma: a systematic review.
Plast Reconstr Surg 2015 Mar;135(3):713-20. doi: 10.1097/prs.0000000000001037.
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Keywords: Adverse Events, Cancer: Breast Cancer, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Surgery
Lee CI, Gold LS, Nelson HD
Comparative effectiveness of imaging modalities to determine metastatic breast cancer treatment response.
This literature review evaluates studies regarding the effectiveness of different imaging modalities in evaluating treatment response among metastatic breast cancer patients. The review of the literature demonstrates a current paucity of evidence regarding the use of imaging for treatment evaluation of metastatic lesions among breast cancer patients.
AHRQ-funded; 290201200014I.
Citation: Lee CI, Gold LS, Nelson HD .
Comparative effectiveness of imaging modalities to determine metastatic breast cancer treatment response.
Breast 2015 Feb;24(1):3-11. doi: 10.1016/j.breast.2014.11.009..
Keywords: Cancer: Breast Cancer, Comparative Effectiveness, Imaging, Outcomes
Lee K, Rossi C
AHRQ Author: Lee K
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women.
L.M. is a 37-year-old nonsmoking woman who is not taking any medications and has no significant past medical problems. As breast cancer runs in her family, she is interested in genetic testing for breast cancer. This case study poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Lee K, Rossi C .
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women.
Am Fam Physician 2015 Jan 15;91(2):119-20.
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Keywords: Cancer, Cancer: Breast Cancer, Case Study, Family Health and History, Genetics, Prevention, Risk, Screening, U.S. Preventive Services Task Force (USPSTF), Women