National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (5)
- Antibiotics (1)
- Arthritis (2)
- Asthma (1)
- Blood Thinners (2)
- Cardiovascular Conditions (2)
- Care Coordination (1)
- Communication (1)
- (-) Comparative Effectiveness (18)
- Data (1)
- Evidence-Based Practice (2)
- Healthcare-Associated Infections (HAIs) (5)
- Hospitals (2)
- Infectious Diseases (2)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (1)
- Kidney Disease and Health (1)
- Medical Errors (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (6)
- Medication: Safety (3)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Neurological Disorders (1)
- Nutrition (1)
- Outcomes (5)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (5)
- (-) Patient Safety (18)
- Pressure Ulcers (1)
- Prevention (5)
- Quality Improvement (2)
- Quality Indicators (QIs) (1)
- Quality of Care (2)
- Research Methodologies (1)
- Risk (2)
- Surgery (3)
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 18 of 18 Research Studies DisplayedHerrin J, Abraham NS, Yao X
Comparative effectiveness of machine learning approaches for predicting gastrointestinal bleeds in patients receiving antithrombotic treatment.
The purpose of this retrospective cross-sectional study was to compare the performance of 3 machine learning approaches with the commonly-used HAS-BLED (hypertension, abnormal kidney and liver function, stroke, bleeding, labile international normalized ratio, older age, and drug or alcohol use) risk score in predicting antithrombotic-related gastrointestinal bleeding (GIB). The machine-learning models were regularized Cox proportional hazards regression (RegCox), random survival forests, and extreme gradient boosting (XGBoost). Findings showed that the machine learning models revealed similar performance in identifying patients at high risk for GIB after being prescribed antithrombotic agents. Two models (RegCox and XGBoost) performed modestly better than the HAS-BLED score.
AHRQ-funded; HS025402.
Citation: Herrin J, Abraham NS, Yao X .
Comparative effectiveness of machine learning approaches for predicting gastrointestinal bleeds in patients receiving antithrombotic treatment.
JAMA Netw Open 2021 May;4(5):e2110703. doi: 10.1001/jamanetworkopen.2021.10703..
Keywords: Blood Thinners, Medication, Risk, Adverse Drug Events (ADE), Adverse Events, Medication: Safety, Patient Safety, Comparative Effectiveness
Yao X, Inselman JW, Ross JS
Comparative effectiveness and safety of oral anticoagulants across kidney function in patients with atrial fibrillation.
Patients with atrial fibrillation and severely decreased kidney function were excluded from the pivotal non-vitamin K antagonist oral anticoagulants (NOAC) trials, thereby raising questions about comparative safety and effectiveness in patients with reduced kidney function. This study aimed to compare oral anticoagulants across the range of kidney function in patients with atrial fibrillation.
AHRQ-funded; HS025517; HS025164; HS025402; HS022882; HS024075.
Citation: Yao X, Inselman JW, Ross JS .
Comparative effectiveness and safety of oral anticoagulants across kidney function in patients with atrial fibrillation.
Circ Cardiovasc Qual Outcomes 2020 Oct;13(10):e006515. doi: 10.1161/circoutcomes.120.006515..
Keywords: Kidney Disease and Health, Cardiovascular Conditions, Blood Thinners, Medication, Medication: Safety, Patient Safety, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Chatterjee P, Williams MD, Coppin JD
Effectiveness of copper-impregnated solid surfaces on lowering microbial bio-burden levels in an acute care hospital.
This study examined whether using novel coper-impregnated solid materials on high-touch surfaces in patient rooms lowered bacterial contamination which may lead to health care-associated infections in acute care hospitals. Sixteen rooms were installed with copper-impregnated surfaces and were compared to standard noncopper laminate surfaces in 16 rooms over a 3-day period. Samples were taken 3 times per day. A lower level of microbial contamination was found in copper-impregnated solid surfaces as compared to standard surfaces.
AHRQ-funded; HS025598.
Citation: Chatterjee P, Williams MD, Coppin JD .
Effectiveness of copper-impregnated solid surfaces on lowering microbial bio-burden levels in an acute care hospital.
Open Forum Infect Dis 2020 Aug;7(8). doi: 10.1093/ofid/ofaa238..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Comparative Effectiveness, Prevention, Evidence-Based Practice
Hsu YJ, Kosinski AS, Wallace AS
Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study.
The authors assessed the utility of using external databases for quality improvement (QI) evaluations in the context of an innovative QI collaborative aimed to reduce three infections and improve patient safety across the cardiac surgery service line. They compared changes in each outcome between 15 intervention hospitals and 52 propensity score-matched hospitals, and found that improvement trends in several outcomes among the studied intervention hospitals were not statistically different from those in comparison hospitals. They conclude that using external databases may permit comparative effectiveness assessment by providing concurrent comparison groups, additional outcome measures, and longer follow-up.
AHRQ-funded; HS019934.
Citation: Hsu YJ, Kosinski AS, Wallace AS .
Using a society database to evaluate a patient safety collaborative: the Cardiovascular Surgical Translational Study.
J Comp Eff Res 2019 Jan;8(1):21-32. doi: 10.2217/cer-2018-0051..
Keywords: Patient Safety, Quality Improvement, Quality Indicators (QIs), Quality of Care, Surgery, Cardiovascular Conditions, Comparative Effectiveness, Data, Hospitals, Research Methodologies, Patient-Centered Outcomes Research
Rizvi RF, Adam TJ, Lindemann EA
Comparing existing resources to represent dietary supplements.
Dietary supplements (DS) are widely consumed despite limited knowledge around their safety/efficacy and any well-established regulatory policies. In this pilot study, five DS resources were evaluated and compared both quantitatively and qualitatively. The authors found fragmented and inconsistent distribution of DS representation in terms of essential data elements across five resources.
AHRQ-funded; HS022085.
Citation: Rizvi RF, Adam TJ, Lindemann EA .
Comparing existing resources to represent dietary supplements.
AMIA Jt Summits Transl Sci Proc 2018 May 18;2017:207-16..
Keywords: Comparative Effectiveness, Nutrition, Patient Safety
Hung MC, Ekwueme DU, White A
Estimating health benefits and cost-savings for achieving the Healthy People 2020 objective of reducing invasive colorectal cancer.
This study aims to quantify the aggregate potential life-years (LYs) saved and healthcare cost-savings if the Healthy People 2020 objective were met to reduce invasive colorectal cancer (CRC) incidence by 15 percent. It concluded that achieving the HP2020 objective of reducing invasive CRC incidence by that amount by year 2020 would potentially save nearly 150,000 life-years and $624 million on healthcare costs.
AHRQ-funded; HS022330.
Citation: Hung MC, Ekwueme DU, White A .
Estimating health benefits and cost-savings for achieving the Healthy People 2020 objective of reducing invasive colorectal cancer.
Prev Med 2018 Jan;106:38-44. doi: 10.1016/j.ypmed.2017.09.022.
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Keywords: Medical Expenditure Panel Survey (MEPS), Comparative Effectiveness, Patient Safety
Shaw CA, Steelman VM, DeBerg J
Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: a systematic review and meta-analysis of randomized controlled trials.
The purpose of this review is to answer the question: Does the type of warming intervention influence the frequency or severity of inadvertent perioperative hypothermia (IPH) in surgical patients receiving neuraxial anesthesia? The review concluded that during neuraxial anesthesia, active warming (AW) reduces IPH more effectively than passive warming. Even with AW, IPH persists in some patients.
AHRQ-funded; HS021422.
Citation: Shaw CA, Steelman VM, DeBerg J .
Effectiveness of active and passive warming for the prevention of inadvertent hypothermia in patients receiving neuraxial anesthesia: a systematic review and meta-analysis of randomized controlled trials.
J Clin Anesth 2017 May;38:93-104. doi: 10.1016/j.jclinane.2017.01.005.
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Keywords: Comparative Effectiveness, Prevention, Outcomes, Adverse Events, Patient Safety
Obremskey WT, Schmidt AH, O'Toole RV
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
The POvIV study is a prospective, multicenter, randomized trial to compare oral (PO) with intravenous (IV) antibiotic therapy in patients with postoperative wound infections after extremity fractures. This study will be the largest prospective randomized trial to evaluate the safety and effectiveness of PO antibiotic use for treatment of postoperative wound infections. Results will inform clinician decisions on antibiotic delivery in patients with postoperative wound infections.
AHRQ-funded; HS000029.
Citation: Obremskey WT, Schmidt AH, O'Toole RV .
A prospective randomized trial to assess oral versus intravenous antibiotics for the treatment of postoperative wound infection after extremity fractures (POvIV study).
J Orthop Trauma 2017 Apr;31 Suppl 1:S32-s38. doi: 10.1097/bot.0000000000000802.
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Keywords: Antibiotics, Surgery, Injuries and Wounds, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Medication, Patient Safety, Adverse Events, Prevention, Patient-Centered Outcomes Research, Outcomes
Bosse MJ, Morshed S, Reider L
Transtibial Amputation Outcomes Study (TAOS): comparing transtibial amputation with and without a tibiofibular synostosis (Ertl) Procedure.
The TAOS is a prospective, multicenter randomized trial comparing 18-month outcomes after transtibial amputation using the Ertl versus Burgess approach among adults aged 18 to 60. The primary outcomes include surgical treatment for a complication and patient-reported function. Secondary outcomes include physical impairment, pain, and treatment cost.
AHRQ-funded; HS000029.
Citation: Bosse MJ, Morshed S, Reider L .
Transtibial Amputation Outcomes Study (TAOS): comparing transtibial amputation with and without a tibiofibular synostosis (Ertl) Procedure.
J Orthop Trauma 2017 Apr;31 Suppl 1:S63-s69. doi: 10.1097/bot.0000000000000791.
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Keywords: Adverse Events, Comparative Effectiveness, Patient-Centered Outcomes Research, Patient Safety
Gagne JJ, Kesselheim AS, Choudhry NK
Comparative effectiveness of generic versus brand-name antiepileptic medications.
The objective of this study was to compare treatment persistence and rates of seizure-related events in patients who initiate antiepileptic drug (AED) therapy with a generic versus a brand-name product. It concluded that patients who initiated generic AEDs had fewer adverse seizure-related clinical outcomes and longer continuous treatment periods before experiencing a gap than those who initiated brand-name versions.
AHRQ-funded; HS018465.
Citation: Gagne JJ, Kesselheim AS, Choudhry NK .
Comparative effectiveness of generic versus brand-name antiepileptic medications.
Epilepsy Behav 2015 Nov;52(Pt A):14-8. doi: 10.1016/j.yebeh.2015.08.014.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Comparative Effectiveness, Medication, Medication: Safety, Neurological Disorders, Patient Safety
Wechsler ME, Yawn BP, Fuhlbrigge AL
Anticholinergic vs long-acting beta-agonist in combination with inhaled corticosteroids in Black adults with asthma: the BELT randomized clinical trial.
The researchers compared the effectiveness and safety of tiotropium vs long-acting beta agonists (LABAs), when used with inhaled corticosteroids (ICS) in black adults with asthma. They found that among black adults with asthma treated with ICS, adding a LABA did not improve time to asthma exacerbation compared with adding tiotropium. These findings were not affected by polymorphisms at the Arg16Gly locus of ADRB2.
AHRQ-funded; HS019408.
Citation: Wechsler ME, Yawn BP, Fuhlbrigge AL .
Anticholinergic vs long-acting beta-agonist in combination with inhaled corticosteroids in Black adults with asthma: the BELT randomized clinical trial.
JAMA 2015 Oct 27;314(16):1720-30. doi: 10.1001/jama.2015.13277..
Keywords: Comparative Effectiveness, Patient Safety, Asthma, Medication
Rosenbluth G, Bale JF, Starmer AJ
Variation in printed handoff documents: results and recommendations from a multicenter needs assessment.
The objective of this study was to determine whether variability exists in the content of printed handoff documents and to identify key data elements that should be uniformly included in these documents. It identified substantial variation in both the structure and content of printed handoff documents. Only 4 of 23 possible data elements (17 percent) were uniformly present in all sites’ handoff documents.
AHRQ-funded; HS019456.
Citation: Rosenbluth G, Bale JF, Starmer AJ .
Variation in printed handoff documents: results and recommendations from a multicenter needs assessment.
J Hosp Med 2015 Aug;10(8):517-24. doi: 10.1002/jhm.2380..
Keywords: Patient Safety, Medical Errors, Communication, Comparative Effectiveness, Care Coordination
Osterman MT, Haynes K, Delzell E
Effectiveness and safety of immunomodulators with anti-tumor necrosis factor therapy in Crohn's disease.
This study assessed the effectiveness and safety of immunomodulators with anti-tumor necrosis factor (anti-TNF) therapy in Crohn’s disease (CD). It found that continuation of immunomodulators after “stepping up” to anti-TNF therapy did not improve outcomes but was associated with an increased risk of opportunistic infection.
AHRQ-funded; HS018517.
Citation: Osterman MT, Haynes K, Delzell E .
Effectiveness and safety of immunomodulators with anti-tumor necrosis factor therapy in Crohn's disease.
Clin Gastroenterol Hepatol 2015 Jul;13(7):1293-301.e5; quiz e70, e72. doi: 10.1016/j.cgh.2015.02.017..
Keywords: Patient Safety, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Padula WV, Makic MB, Mishra MK
Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.
This study was conducted to determine the comparative effectiveness of quality improvement interventions associated with reduced hospital-acquired pressure ulcer rates. The effect size analysis identified five effective interventions that each reduced pressure ulcer rates: leadership initiatives, visual tools, pressure ulcer staging, skin care, and patient nutrition.
AHRQ-funded; HS023710.
Citation: Padula WV, Makic MB, Mishra MK .
Comparative effectiveness of quality improvement interventions for pressure ulcer prevention in academic medical centers in the United States.
Jt Comm J Qual Patient Saf 2015 Jun;41(6):246-5..
Keywords: Comparative Effectiveness, Healthcare-Associated Infections (HAIs), Patient Safety, Pressure Ulcers, Prevention, Quality Improvement
Curtis JR, Xie F, Yun H
Risk of hospitalized infection among rheumatoid arthritis patients concurrently treated with a biologic agent and denosumab.
The researchers evaluated rates of hospitalized infection among patients treated with biologic agents for RA who subsequently initiated denosumab in order to assess whether rates of infection were increased with concurrent biologic agent use for RA. They found that the rate of hospitalized infection among RA patients receiving denosumab concurrently with biologic agents for RA was not increased compared to those receiving zoledronate.
AHRQ-funded; HS018517
Citation: Curtis JR, Xie F, Yun H .
Risk of hospitalized infection among rheumatoid arthritis patients concurrently treated with a biologic agent and denosumab.
Arthritis Rheumatol. 2015 Jun;67(6):1456-64. doi: 10.1002/art.39075..
Keywords: Arthritis, Healthcare-Associated Infections (HAIs), Risk, Patient Safety, Comparative Effectiveness
Lee MJ, Shonnard N, Farrokhi F
The Spine Surgical Care and Outcomes Assessment Program (Spine SCOAP): a surgeon-led approach to quality and safety.
The researchers sought to identify variation in utilization, processes of care, and outcomes in spine surgery to improve statewide quality and safety. They found significant variability in the indications, process of care, and outcomes related to spine surgery. This variability indicates the need for continued surveillance initiatives and point to opportunities for quality improvement and research.
AHRQ-funded; HS020025.
Citation: Lee MJ, Shonnard N, Farrokhi F .
The Spine Surgical Care and Outcomes Assessment Program (Spine SCOAP): a surgeon-led approach to quality and safety.
Spine 2015 Mar 1;40(5):332-41. doi: 10.1097/brs.0000000000000750..
Keywords: Surgery, Quality of Care, Patient Safety, Comparative Effectiveness, Outcomes
Baddley JW, Winthrop KL, Chen L
Non-viral opportunistic infections in new users of tumour necrosis factor inhibitor therapy: results of the SAfety Assessment of Biologic ThERapy (SABER) study.
The purpose of this paper was to determine, among patients with autoimmune diseases in the USA, whether the risk of non-viral opportunistic infections (OI) was increased among new users of tumour necrosis factor alpha inhibitors (TNFI), when compared to users of non-biological agents used for active disease. The investigators concluded that in the USA, the rate of non-viral OI was higher among new users of TNFI with autoimmune diseases compared to non-biological disease-modifying antirheumatic drugs users.
AHRQ-funded; HS017552; HS018517; HS017919.
Citation: Baddley JW, Winthrop KL, Chen L .
Non-viral opportunistic infections in new users of tumour necrosis factor inhibitor therapy: results of the SAfety Assessment of Biologic ThERapy (SABER) study.
Ann Rheum Dis 2014 Nov;73(11):1942-8. doi: 10.1136/annrheumdis-2013-203407..
Keywords: Arthritis, Comparative Effectiveness, Medication, Patient Safety
Huang SS, Septimus E, Kleinman K
Targeted versus universal decolonization to prevent ICU infection.
In this pragmatic, cluster-randomized trial the authors compared targeted versus universal decolonization of patients in intensive care units (ICUs) as strategies for preventing health care-associated infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA). They found that in routine ICU practice, universal decolonization was more effective than targeted decolonization or screening and isolation in reducing rates of MRSA clinical isolates and bloodstream infection from any pathogen.
AHRQ-funded; 290201000008I.
Citation: Huang SS, Septimus E, Kleinman K .
Targeted versus universal decolonization to prevent ICU infection.
N Engl J Med 2013 Jun 13;368(24):2255-65. doi: 10.1056/NEJMoa1207290..
Keywords: Comparative Effectiveness, Infectious Diseases, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Intensive Care Unit (ICU), Patient-Centered Healthcare, Patient Safety, Prevention