National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Cancer (5)
- Cancer: Breast Cancer (1)
- (-) Cancer: Colorectal Cancer (23)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (4)
- Care Management (1)
- Case Study (1)
- Chronic Conditions (1)
- Colonoscopy (3)
- Community-Based Practice (2)
- Cultural Competence (1)
- Decision Making (4)
- Diagnostic Safety and Quality (1)
- Disparities (2)
- Education: Patient and Caregiver (1)
- Elderly (1)
- Healthcare Costs (1)
- Healthcare Utilization (1)
- Health Promotion (2)
- Heart Disease and Health (1)
- Imaging (2)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (3)
- Mortality (4)
- Outcomes (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (4)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Patient Safety (1)
- Policy (1)
- Prevention (3)
- Primary Care (1)
- Quality Improvement (1)
- Racial and Ethnic Minorities (3)
- Registries (1)
- Risk (2)
- Screening (8)
- Social Determinants of Health (1)
- Surgery (3)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (2)
- Vulnerable Populations (1)
- Workflow (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 23 of 23 Research Studies DisplayedMartens CE, Crutchfield TM, Laping JL
Why wait until our community gets cancer?: Exploring CRC screening barriers and facilitators in the Spanish-speaking community in North Carolina.
The objectives for this paper were: (1) to improve understanding of preferences regarding potential colorectal cancer (CRC) screening program characteristics, and (2) to improve understanding of the barriers and facilitators around CRC screening with the Hispanic, immigrant community in North Carolina. They found that Hispanics may have a general awareness of and interest in CRC screening, but multiple barriers prevent them from getting screened, and recommended that special attention be given to designing culturally and linguistically appropriate programs to improve access to healthcare resources, insurance, and associated costs among Hispanics.
AHRQ-funded; HS019468.
Citation: Martens CE, Crutchfield TM, Laping JL .
Why wait until our community gets cancer?: Exploring CRC screening barriers and facilitators in the Spanish-speaking community in North Carolina.
J Cancer Educ 2016 Dec;31(4):652-59. doi: 10.1007/s13187-015-0890-4.
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Keywords: Cancer: Colorectal Cancer, Cultural Competence, Racial and Ethnic Minorities, Racial and Ethnic Minorities, Screening
Volk RJ, Linder SK, Lopez-Olivo MA
Patient decision aids for colorectal cancer screening: a systematic review and meta-analysis.
This systematic review describes studies evaluating patient decision aids for colorectal cancer screening in average-risk adults and their impact on knowledge, screening intentions, and uptake. It concluded that decision aids improve knowledge and interest in screening, and lead to increased screening over no information, but their impact on screening is similar to general colorectal cancer screening information.
AHRQ-funded; HS022134.
Citation: Volk RJ, Linder SK, Lopez-Olivo MA .
Patient decision aids for colorectal cancer screening: a systematic review and meta-analysis.
Am J Prev Med 2016 Nov;51(5):779-91. doi: 10.1016/j.amepre.2016.06.022.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Education: Patient and Caregiver, Healthcare Utilization, Screening
McNellis RJ, Beswick-Escanlar V
AHRQ Author: McNellis RJ
Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer.
This case study involves a a 55-year-old man who presents to your office for a routine refill of his antihypertension medication, his 65-year-old brother who also visits you to ask about taking low-dose aspirin, and his 55-year-old wife, also your patient, who recently experienced abdominal pain,. It poses three multiple choice questions focused on the use of low-dose aspirin, together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: McNellis RJ, Beswick-Escanlar V .
Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer.
Am Fam Physician 2016 Oct 15;94(8):661-62.
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Keywords: Cancer: Colorectal Cancer, Cardiovascular Conditions, Medication, Prevention, U.S. Preventive Services Task Force (USPSTF), Case Study
Halm EA, Beaber EF, McLerran D
Association between primary care visits and colorectal cancer screening outcomes in the era of population health outreach.
The researchers assessed associations between primary care provider (PCP) visits and receipt of colorectal cancer (CRC) screening and colonoscopy after a positive fecal immunochemical (FIT) or fecal occult blood test (FOBT). They found that patients with a greater number of PCP visits had higher rates of both incident CRC screening and colonoscopy after positive FIT/FOBT, even in health systems with active population health outreach programs.
AHRQ-funded; HS022418.
Citation: Halm EA, Beaber EF, McLerran D .
Association between primary care visits and colorectal cancer screening outcomes in the era of population health outreach.
J Gen Intern Med 2016 Oct;31(10):1190-7. doi: 10.1007/s11606-016-3760-9..
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Patient-Centered Outcomes Research, Primary Care, Screening
Tyler Ellis C, Charlton ME, Stitzenberg KB
Patient-reported roles, preferences, and expectations regarding treatment of stage i rectal cancer in the cancer care outcomes research and surveillance consortium.
The researchers identified patient roles, preferences, and expectations as they relate to treatment decision making for patients with stage I rectal cancer. They found that, in this study of 154 adults with newly-diagnosed and surgically treated stage 1 rectal cancer, the preferred decision-making role for patients did not match the actual decision-making process. They recommended that future efforts focus on bridging the gap between the decision-making process and patient preferences regarding various treatment approaches.
AHRQ-funded; HS000032.
Citation: Tyler Ellis C, Charlton ME, Stitzenberg KB .
Patient-reported roles, preferences, and expectations regarding treatment of stage i rectal cancer in the cancer care outcomes research and surveillance consortium.
Dis Colon Rectum 2016 Oct;59(10):907-15. doi: 10.1097/dcr.0000000000000662.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Patient-Centered Outcomes Research, Patient Experience, Patient and Family Engagement
Healy MA, Grenda TR, Suwanabol PA
Colon cancer operations at high- and low-mortality hospitals.
The authors sought to evaluate causes of mortality following colon cancer operations across hospitals. They found significant variation in mortality across hospitals for colon cancer operations, reflecting a need for improved operative decision-making to enhance outcomes and quality of care.
AHRQ-funded; HS020937; HS023621; HS000053.
Citation: Healy MA, Grenda TR, Suwanabol PA .
Colon cancer operations at high- and low-mortality hospitals.
Surgery 2016 Aug;160(2):359-65. doi: 10.1016/j.surg.2016.04.035.
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Keywords: Adverse Events, Cancer: Colorectal Cancer, Mortality, Patient Safety, Surgery
Liss DT, Brown T, Lee JY
Diagnostic colonoscopy following a positive fecal occult blood test in community health center patients.
Fecal occult blood testing (FOBT) is a pragmatic screening option for many community health centers (CHCs), but FOBT screening programs will not reduce mortality if patients with positive results do not undergo diagnostic colonoscopy (DC). This study was conducted to investigate DC completion among CHC patients. It found that DC completion was low overall, which raises concerns about whether FOBT can reduce CRC mortality in practice.
AHRQ-funded; HS021141.
Citation: Liss DT, Brown T, Lee JY .
Diagnostic colonoscopy following a positive fecal occult blood test in community health center patients.
Cancer Causes Control 2016 Jul;27(7):881-7. doi: 10.1007/s10552-016-0763-0.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Community-Based Practice, Screening
John-Baptiste A, Schapira MM, Cravens C
AHRQ Author: John-Baptiste A, Cravens C, Siegel J, Lawrence W
The role of decision models in health care policy: a case study.
In 2009, the Centers for Medicare and Medicaid Services (CMS) underwent a National Coverage Determination on computed tomography colonography (CTC) to screen for colorectal cancer. The Cancer Intervention & Surveillance Network developed decision models to inform this decision. The purpose of this study was to investigate the role of models in this decision. It concluded that decision makers involved in the CTC decision believed in the adequacy of models to inform coverage decisions.
AHRQ-authored.
Citation: John-Baptiste A, Schapira MM, Cravens C .
The role of decision models in health care policy: a case study.
Med Decis Making 2016 Jul;36(5):666-79. doi: 10.1177/0272989x16646732.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Imaging, Policy
Chubak J, Whitlock EP, Williams SB
Aspirin for the prevention of cancer incidence and mortality: systematic evidence reviews for the U.S. Preventive Services Task Force.
The researchers conducted systematic reviews of aspirin and 1) total cancer mortality and incidence in persons eligible for primary prevention of cardiovascular disease (CVD) and 2) colorectal cancer (CRC) mortality and incidence in persons at average CRC risk.. Evidence from CVD primary and secondary prevention studies suggested that aspirin therapy reduces CRC incidence and perhaps mortality approximately 10 years after initiation.
AHRQ-funded; 290201200151I.
Citation: Chubak J, Whitlock EP, Williams SB .
Aspirin for the prevention of cancer incidence and mortality: systematic evidence reviews for the U.S. Preventive Services Task Force.
Ann Intern Med 2016 Jun 21;164(12):814-25. doi: 10.7326/m15-2117.
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Keywords: Cancer: Colorectal Cancer, Cardiovascular Conditions, Medication, Mortality, U.S. Preventive Services Task Force (USPSTF)
Rust G, Zhang S, Yu Z
Counties eliminating racial disparities in colorectal cancer mortality.
The researchers attempted to identify county-level variations in racial-ethnic disparities in colorectal cancer mortality rates. They found that county-level variation in social determinants, health care workforce, and health systems all were found to contribute to variations in cancer mortality disparity trend patterns from 1990 through 2010. They concluded that counties sustaining equality over time or moving from disparities to equality in cancer mortality suggest that disparities are not inevitable, and provide hope that more communities can achieve optimal and equitable cancer outcomes for all.
AHRQ-funded; HS022444.
Citation: Rust G, Zhang S, Yu Z .
Counties eliminating racial disparities in colorectal cancer mortality.
Cancer 2016 Jun 1;122(11):1735-48. doi: 10.1002/cncr.29958.
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Keywords: Cancer: Colorectal Cancer, Disparities, Mortality, Racial and Ethnic Minorities
Ellis CT, Samuel CA, Stitzenberg KB
National trends in nonoperative management of rectal adenocarcinoma.
The researchers examined the use of non-operative management (NOM) for rectal cancer over time and the patient- and facility-level factors associated with its use. They found evidence of increasing NOM use, with this increase occurring more frequently in black and uninsured/Medicaid patients, raising concern that increased NOM use may actually represent increasing disparities in rectal cancer care rather than innovation. They recommended further studies to assess survival differences by treatment strategy.
AHRQ-funded; HS000032.
Citation: Ellis CT, Samuel CA, Stitzenberg KB .
National trends in nonoperative management of rectal adenocarcinoma.
J Clin Oncol 2016 May 10;34(14):1644-51. doi: 10.1200/jco.2015.64.2066.
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Keywords: Cancer, Cancer: Colorectal Cancer, Disparities, Patient-Centered Healthcare, Treatments
Brenner AT, Gupta S, Ko LK
Development of a practical model for targeting patient decision support interventions to promote colorectal cancer screening in vulnerable populations.
The authors sought to develop a practical model for predicting probability of colorectal cancer (CRC) screening completion in a diverse safety-net population and a subsequent framework for targeting screening promotion interventions. Their model and framework may be useful for designing and delivering targeted interventions to promote CRC screening.
AHRQ-funded; HS013853.
Citation: Brenner AT, Gupta S, Ko LK .
Development of a practical model for targeting patient decision support interventions to promote colorectal cancer screening in vulnerable populations.
J Health Care Poor Underserved 2016;27(2):465-78. doi: 10.1353/hpu.2016.0090.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Health Promotion, Screening, Vulnerable Populations
Liu Z, Zhang K, Du XL
Risks of developing breast and colorectal cancer in association with incomes and geographic locations in Texas: a retrospective cohort study.
This study aimed to determine whether median household income was associated with the risk of developing breast and colorectal cancer in Texas and to identify higher cancer risks by race/ethnicity and geographic areas. It demonstrated that higher income was associated with an increased risk of breast cancer and a decreased risk of colorectal cancer in Texas.
AHRQ-funded; HS018956.
Citation: Liu Z, Zhang K, Du XL .
Risks of developing breast and colorectal cancer in association with incomes and geographic locations in Texas: a retrospective cohort study.
BMC Cancer 2016 Apr 26;16:294. doi: 10.1186/s12885-016-2324-z.
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Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Racial and Ethnic Minorities, Risk, Social Determinants of Health
Thompson KD, Connor SJ, Walls DM
Patients with ulcerative colitis are more concerned about complications of their disease than side effects of medications.
The survey’s aim was to better understand what aspects of ulcerative colitis (UC) and UC management, are most concerning to patients, and how they would like to be informed about treatment options. It found that most patients (87 percent) wanted to share treatment decision making with their doctors. Patients were most concerned about the risk of colorectal cancer (37 percent), and the possible need for an ileostomy (29 percent).
AHRQ-funded; HS021747.
Citation: Thompson KD, Connor SJ, Walls DM .
Patients with ulcerative colitis are more concerned about complications of their disease than side effects of medications.
Inflamm Bowel Dis 2016 Apr;22(4):940-7. doi: 10.1097/mib.0000000000000740.
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Keywords: Adverse Drug Events (ADE), Cancer, Cancer: Colorectal Cancer, Care Management, Medication
Abdelsattar ZM, Wong SL, Regenbogen SE
Colorectal cancer outcomes and treatment patterns in patients too young for average-risk screening.
The researchers investigated the national treatment patterns and outcomes of patients younger than 50 with colorectal cancer (CRC). They found that patients with CRC diagnosed at age <50 years are more likely to present with advanced-stage disease. However, they receive more aggressive therapy and achieve longer disease-specific survival, despite the greater percentage of patients with advanced-stage disease.
AHRQ-funded; HS000053; HS020937.
Citation: Abdelsattar ZM, Wong SL, Regenbogen SE .
Colorectal cancer outcomes and treatment patterns in patients too young for average-risk screening.
Cancer 2016 Mar 15;122(6):929-34. doi: 10.1002/cncr.29716.
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Keywords: Cancer: Colorectal Cancer, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Risk, Screening
Wancata LM, Banerjee M, Muenz DG
Conditional survival in advanced colorectal cancer and surgery.
The authors evaluated the impact of cancer-directed surgery on long-term survival in patients with advanced colorectal cancer (CRC). They found that five-year disease-specific conditional survival improves dramatically over time for selected patients with advanced CRC who undergo cancer-directed surgery.
AHRQ-funded; HS020937.
Citation: Wancata LM, Banerjee M, Muenz DG .
Conditional survival in advanced colorectal cancer and surgery.
J Surg Res 2016 Mar;201(1):196-201. doi: 10.1016/j.jss.2015.10.021.
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Keywords: Cancer: Colorectal Cancer, Mortality, Outcomes, Patient-Centered Outcomes Research, Surgery
Acharya S, Fischer-Valuck BW, Kashani R
Online magnetic resonance image guided adaptive radiation therapy: first clinical applications.
The authors demonstrated the feasibility of online adaptive magnetic resonance (MR) image guided radiation therapy (MR-IGRT) with five patients with abdominopelvic malignancies. They successfully implemented online adaptive MR-IGRT with planning and quality assurance workflow suitable for routine clinical application. Clinical trials are in development to formally evaluate adaptive treatments for a variety of disease sites.
AHRQ-funded; HS022888.
Citation: Acharya S, Fischer-Valuck BW, Kashani R .
Online magnetic resonance image guided adaptive radiation therapy: first clinical applications.
Int J Radiat Oncol Biol Phys 2016 Feb;94(2):394-403. doi: 10.1016/j.ijrobp.2015.10.015.
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Keywords: Cancer, Cancer: Colorectal Cancer, Imaging, Workflow
Liss DT, French DD, Buchanan DR
Outreach for annual colorectal cancer screening: a budget impact analysis for community health centers.
This budget impact analysis investigated benefits and costs of fecal immunochemical testing (FIT) outreach-with FIT kits mailed to patients, followed by reminders and phone calls-compared with point-of-care (POC) strategies. Cost per patient screened was $20.60 for POC and $71.84 for outreach ($51.24 difference). Outreach costs decreased by approximately one fourth under optimized workflows.
AHRQ-funded; HS021141.
Citation: Liss DT, French DD, Buchanan DR .
Outreach for annual colorectal cancer screening: a budget impact analysis for community health centers.
Am J Prev Med 2016 Feb;50(2):e54-61. doi: 10.1016/j.amepre.2015.07.003.
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Keywords: Cancer: Colorectal Cancer, Community-Based Practice, Health Promotion, Prevention, Screening
Singal AG, Gupta S, Tiro JA
Outreach invitations for FIT and colonoscopy improve colorectal cancer screening rates: a randomized controlled trial in a safety-net health system.
Among a racially diverse and socioeconomically disadvantaged cohort of patients, the researchers compared the effectiveness of fecal immunochemical test (FIT) outreach and colonoscopy outreach to increase screening participation rates, compared with usual visit-based care. Mailed outreach invitations appear to significantly increase colorectal cancer screening rates among underserved populations. In the current study, FIT-based outreach was found to be more effective than colonoscopy-based outreach.
AHRQ-funded; HS022418.
Citation: Singal AG, Gupta S, Tiro JA .
Outreach invitations for FIT and colonoscopy improve colorectal cancer screening rates: a randomized controlled trial in a safety-net health system.
Cancer 2016 Feb 1;122(3):456-63. doi: 10.1002/cncr.29770.
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Keywords: Cancer: Colorectal Cancer, Cancer, Screening, Prevention
Killian JT, Holcomb CN, Graham LA
Delays in surgery for patients with coronary stents placed after diagnosis of colorectal cancer.
The researchers sought to determine whether the presence of a coronary stent affected the timing of colorectal cancer resection and the postoperative outcomes. They found that the median time from diagnosis to surgery was 100 days for patients who received a stent after a colonoscopy and 42 days for patients whose stent was present at the time of the colonoscopy.
AHRQ-funded; HS013852.
Citation: Killian JT, Holcomb CN, Graham LA .
Delays in surgery for patients with coronary stents placed after diagnosis of colorectal cancer.
JAMA Surg 2016 Jan;151(1):86-8. doi: 10.1001/jamasurg.2015.3130..
Keywords: Cancer: Colorectal Cancer, Cardiovascular Conditions, Colonoscopy, Heart Disease and Health, Surgery
Garcia-Albeniz X, Hsu J, Lipsitch M
Infective endocarditis and cancer in the elderly.
The researchers investigated the magnitude of the association between infective endocarditis and cancer, and the natural history of cancer patients with concomitant diagnosis of infective endocarditis. They found that in this elderly population, the incidence of infective endocarditis around a colorectal cancer diagnosis was substantially higher than around the diagnosis of lung, breast and prostate cancers.
AHRQ-funded; HS023128.
Citation: Garcia-Albeniz X, Hsu J, Lipsitch M .
Infective endocarditis and cancer in the elderly.
Eur J Epidemiol 2016 Jan;31(1):41-9. doi: 10.1007/s10654-015-0111-9.
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Keywords: Cancer, Cancer: Colorectal Cancer, Cardiovascular Conditions, Elderly, Cancer: Prostate Cancer
Machlin SR, Soni A
AHRQ Author: Machlin SR, Soni A
Health care expenditures for adults with multiple treated chronic conditions: estimates from the Medical Expenditure Panel Survey, 2009.
The authors illustrated the usefulness of MEPS data for examining variations in medical expenditures for people with multiple chronic conditions (MCC). They found that the proportion of adults treated for MCC increased with age, with white non-Hispanic adults most likely and Hispanic and Asian adults least likely to be treated for MCC. Regardless of age or sex, hypertension and hyperlipidemia was the most common dyad among adults treated for MCC, and diabetes in conjunction with these 2 conditions was a common triad. They concluded that MEPS has the capacity to produce national estimates of health care expenditures associated with MCC.
AHRQ-authored.
Citation: Machlin SR, Soni A .
Health care expenditures for adults with multiple treated chronic conditions: estimates from the Medical Expenditure Panel Survey, 2009.
Prev Chronic Dis 2013 Apr 25;10:E63. doi: 10.5888/pcd10.120172.
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Keywords: Cancer: Colorectal Cancer, Chronic Conditions, Healthcare Costs, Medical Expenditure Panel Survey (MEPS)
Merkow RP, Kmiecik TE, Bentrem DJ
Effect of including cancer-specific variables on models examining short-term outcomes.
The objectives of this paper were 1) to examine differences between existing American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) variables and cancer registry variables, and 2) to determine whether the addition of cancer-specific variables improves modeling of short-term outcomes. The researchers found that, although advanced disease stage and neoadjuvant therapy variables were predictors of short-term outcomes, their inclusion did not improve the models.
AHRQ-funded; HS021857.
Citation: Merkow RP, Kmiecik TE, Bentrem DJ .
Effect of including cancer-specific variables on models examining short-term outcomes.
Cancer 2013 Apr 1;119(7):1412-9. doi: 10.1002/cncr.27891.
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Keywords: Cancer: Colorectal Cancer, Outcomes, Quality Improvement, Registries