National Healthcare Quality and Disparities Report
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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
26 to 50 of 83 Research Studies DisplayedCrossley JR, Tan TP, Smith KH
Review of clinical trial settings of drugs commonly used in primary care and approved between 2005 and 2012.
This study examined where clinical trial settings are conducted for drugs commonly used in primary care that were approved by the FDA between 2005 and 2012. The majority of clinical trials did not specify if the trials were conducted at a primary care facility or a specialist, however, of the principal investigators (PIs) the vast majority were specialty physicians. The authors believe that more adverse drug events would occur in clinical trials taking place at specialist offices due to more patients with comorbidities going there for treatment. An initiative called the FDA Drug Trials Snapshots was cited as a way to provide more demographic information of trial participants.
AHRQ-funded; HS022882.
Citation: Crossley JR, Tan TP, Smith KH .
Review of clinical trial settings of drugs commonly used in primary care and approved between 2005 and 2012.
J Gen Intern Med 2018 Sep;33(9):1431-32. doi: 10.1007/s11606-018-4486-7..
Keywords: Medication, Primary Care, Research Methodologies
Palmer JA, Mor V, Volandes AE
A dynamic application of PRECIS-2 to evaluate implementation in a pragmatic, cluster randomized clinical trial in two nursing home systems.
This report's objective was to apply PRagmatic Explanatory Continuum Indicator Summary-2 (PRECIS-2) in a novel manner during the actual conduct of the PRagmatic trial Of Video Education in Nursing homes (PROVEN) trial to assess how dynamic adaptations shifted implementation to either a more explanatory or a more pragmatic approach.
AHRQ-funded; HS000011.
Citation: Palmer JA, Mor V, Volandes AE .
A dynamic application of PRECIS-2 to evaluate implementation in a pragmatic, cluster randomized clinical trial in two nursing home systems.
Trials 2018 Aug 22;19(1):453. doi: 10.1186/s13063-018-2817-y..
Keywords: Health Services Research (HSR), Nursing Homes, Research Methodologies
Wiehe SE, Rosenman MB, Chartash D
A solutions-based approach to building data-sharing partnerships.
This paper aims to enhance the van Panhuis et al. framework of barriers to data sharing; the authors present a complementary solutions-based data-sharing process in order to encourage both emerging and established researchers, whether or not in academia, to engage in data-sharing partnerships.
AHRQ-funded; HS023318; HS024296.
Citation: Wiehe SE, Rosenman MB, Chartash D .
A solutions-based approach to building data-sharing partnerships.
eGEMS 2018 Aug 22;6(1):20. doi: 10.5334/egems.236..
Keywords: Data, Health Services Research (HSR), Research Methodologies
Shaffer JA, Kronish IM, Falzon L
N-of-1 randomized intervention trials in health psychology: a systematic review and methodology critique.
The purpose of this study was to assess the quality of the methods and statistics, to describe interventions and outcomes, and to explore the heterogeneity of treatment effect of health psychology N-of-1, or single-case randomized clinical trials. Researchers conducted a systematic review of N-of-1 trials by searching numerous databases from their respective inception up to June 2015; studies were included if they had health behavior or psychological outcomes and the order of interventions was randomized. Study characteristics and analytic methods were then abstracted. The results of the study indicate that N-of-1 randomized trials could become the next major advance in health psychology for precision therapeutics, but they must be conducted with more methodologic and statistical rigor as well as be transparently and fully reported.
AHRQ-funded; HS024262.
Citation: Shaffer JA, Kronish IM, Falzon L .
N-of-1 randomized intervention trials in health psychology: a systematic review and methodology critique.
Ann Behav Med 2018 Aug 16;52(9):731-42. doi: 10.1093/abm/kax026..
Keywords: Behavioral Health, Health Services Research (HSR), Research Methodologies
Cottrell EK, Gold R, Likumahuwa S
Using health information technology to bring social determinants of health into primary care: a conceptual framework to guide research.
The investigators recently proposed a conceptual framework to illustrate how health information technology can be used to bring social determinants of health information into primary care. In this paper, they describe how they are putting this conceptual model into practice within the OCHIN network of community health centers by highlighting examples of ongoing research, identifying knowledge gaps, and outlining a roadmap of future research to move the field forward.
Citation: Cottrell EK, Gold R, Likumahuwa S .
Using health information technology to bring social determinants of health into primary care: a conceptual framework to guide research.
AHRQ-funded; 233201500020I..
Keywords: Health Information Technology (HIT), Primary Care, Research Methodologies, Social Determinants of Health
Zhao X, Wang W, Liu L
A flexible quantile regression model for medical costs with application to Medical Expenditure Panel Survey study.
This study applied a flexible quantile regression model for medical costs to a dataset from the Medical Expenditure Panel Survey. The model can be used to analyze medical costs.
AHRQ-funded; HS020263.
Citation: Zhao X, Wang W, Liu L .
A flexible quantile regression model for medical costs with application to Medical Expenditure Panel Survey study.
Stat Med 2018 Jul 30;37(17):2645-66. doi: 10.1002/sim.7670..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Research Methodologies
Muenks CE, Hogan PG, Burnham CD
Comparing the yield of Staphylococcus aureus recovery with static versus agitated broth incubation.
This study sought to compare the yield of Staphylococcus aureus with a broth enrichment method when incubated in agitated versus static conditions. The investigators found that when broth enrichment was used (both static and agitated), the burden of S. aureus growth was higher compared to the direct plating culture method.
AHRQ-funded; HS021736; HS024269.
Citation: Muenks CE, Hogan PG, Burnham CD .
Comparing the yield of Staphylococcus aureus recovery with static versus agitated broth incubation.
J Pathog 2018 Jul 26;2018:1462671. doi: 10.1155/2018/1462671..
Keywords: Diagnostic Safety and Quality, Research Methodologies, Infectious Diseases
Chai H, Jiang H, Lin L
A marginalized two-part Beta regression model for microbiome compositional data.
The authors of the study propose a marginalized two-part Beta regression model which captures the zero-inflation and skewness of microbiome data and also allows investigators to examine covariate effects on the marginal (unconditional) mean. They demonstrated its practical performance using simulation studies and applying the model to a real metagenomic dataset on mouse skin microbiota.
AHRQ-funded; HS020263.
Citation: Chai H, Jiang H, Lin L .
A marginalized two-part Beta regression model for microbiome compositional data.
PLoS Comput Biol 2018 Jul 23;14(7):e1006329. doi: 10.1371/journal.pcbi.1006329..
Keywords: Data, Research Methodologies
Bell SK, Etchegaray JM, Gaufberg E
A multi-stakeholder consensus-driven research agenda for better understanding and supporting the emotional impact of harmful events on patients and families.
A one-day conference of diverse stakeholder groups convened to establish a consensus-driven research agenda focused on the impact of patient and family emotional harm stemming from preventable medical error. Stakeholder groups reached consensus and designed a path forward to inform approaches that better support harmed patients and families, with both immediately actionable and longer-term research strategies.
AHRQ-funded; HS024463.
Citation: Bell SK, Etchegaray JM, Gaufberg E .
A multi-stakeholder consensus-driven research agenda for better understanding and supporting the emotional impact of harmful events on patients and families.
Jt Comm J Qual Patient Saf 2018 Jul;44(7):424-35. doi: 10.1016/j.jcjq.2018.03.007..
Keywords: Adverse Events, Medical Errors, Patient Safety, Research Methodologies
Ghaferi AA, Dimick JB
Practical guide to surgical data sets: Medicare claims data.
In this article, the authors discuss pros and cons of Medicare data and explore commonly studied categories using this data (health policy evaluation, comparative effectiveness research, and outcome variations). They conclude that it is important to frame questions carefully and to use appropriate methods to ensure scientific rigor.
AHRQ-funded; HS023621; HS024403.
Citation: Ghaferi AA, Dimick JB .
Practical guide to surgical data sets: Medicare claims data.
JAMA Surg 2018 Jul;153(7):677-78. doi: 10.1001/jamasurg.2018.0489..
Keywords: Medicare, Data, Surgery, Patient-Centered Outcomes Research, Research Methodologies
Masud A, Tu W, Yu Z
Variable selection for mixture and promotion time cure rate models.
Failure-time data with cured patients are common in clinical studies. Data from these studies are typically analyzed with cure rate models. Variable selection methods have not been well developed for cure rate models. In this research, the investigators propose two least absolute shrinkage and selection operators based methods, for variable selection in mixture and promotion time cure models with parametric or nonparametric baseline hazards.
AHRQ-funded; HS024384.
Citation: Masud A, Tu W, Yu Z .
Variable selection for mixture and promotion time cure rate models.
Variable selection for mixture and promotion time cure rate models..
Keywords: Research Methodologies
Simon KC, Tideman S, Hillman L
Design and implementation of pragmatic clinical trials using the electronic medical record and an adaptive design.
The purpose of this study was to demonstrate the feasibility of pragmatic clinical trials comparing the effectiveness of treatments using the electronic medical record (EMR) and an adaptive assignment design. The authors suggest that the demonstration of successful pragmatic clinical trials based on a customized EMR and adaptive design is an important next step in achieving personalized medicine and provides a framework for future studies of comparative effectiveness.
AHRQ-funded; HS024057.
Citation: Simon KC, Tideman S, Hillman L .
Design and implementation of pragmatic clinical trials using the electronic medical record and an adaptive design.
JAMIA Open 2018 Jul;1(1):99-106. doi: 10.1093/jamiaopen/ooy017..
Keywords: Comparative Effectiveness, Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, System Design
Sander AM, Lequerica AH, Ketchum JM
Race/ethnicity and retention in traumatic brain injury outcomes research: a traumatic brain injury model systems national database study.
The purpose of this study was to investigate the contribution of race/ethnicity to retention in traumatic brain injury (TBI) research at 1 to 2 years postinjury. The findings emphasized the importance of investigating retention rates separately for blacks and Hispanics rather than combining them or grouping either with other races or ethnicities. The results also suggested the need for implementing procedures to increase retention of Hispanics in longitudinal TBI research.
AHRQ-funded; HS022134.
Citation: Sander AM, Lequerica AH, Ketchum JM .
Race/ethnicity and retention in traumatic brain injury outcomes research: a traumatic brain injury model systems national database study.
J Head Trauma Rehabil 2018 Jul/Aug;33(4):219-27. doi: 10.1097/htr.0000000000000395..
Keywords: Brain Injury, Racial and Ethnic Minorities, Outcomes, Patient-Centered Outcomes Research, Research Methodologies
Weller SC, Vickers B, Bernard HR
Open-ended interview questions and saturation.
Sample size determination for open-ended questions or qualitative interviews relies primarily on custom and finding the point where little new information is obtained (thematic saturation). In this paper, the authors propose and test a refined definition of saturation as obtaining the most salient items in a set of qualitative interviews (where items can be material things or concepts, depending on the topic of study) rather than attempting to obtain all the items.
AHRQ-funded; HS022134.
Citation: Weller SC, Vickers B, Bernard HR .
Open-ended interview questions and saturation.
PLoS One 2018 Jun 20;13(6):e0198606. doi: 10.1371/journal.pone.0198606..
Keywords: Health Services Research (HSR), Research Methodologies
Bennett WL, Wilson RF, Zhang A
Methods for evaluating natural experiments in obesity: a systematic review.
The researchers identified studies that report effects of programs, policies, or built environment changes on obesity prevention and control and described their methods. They found many methodologically diverse natural experiments and experimental studies that reported effects of U.S. and non-U.S. programs, policies, or built environment changes on obesity prevention and control, reinforcing the need for methodological and analytic advances to strengthen evaluations of obesity prevention and control initiatives.
AHRQ-funded; 290201200007I.
Citation: Bennett WL, Wilson RF, Zhang A .
Methods for evaluating natural experiments in obesity: a systematic review.
Ann Intern Med 2018 Jun 5;168(11):791-800. doi: 10.7326/m18-0309.
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Keywords: Obesity, Patient-Centered Outcomes Research, Prevention, Research Methodologies
Chou R, Baker WL, Banez LL
Agency for Healthcare Research and Quality Evidence-based Practice Center methods provide guidance on prioritization and selection of harms in systematic reviews.
A workgroup of methodologists from Evidence-based Practice Centers (EPCs) developed consensus-based guidance on selection and prioritization of harms in systematic reviews. Ten recommendations were developed on selection and prioritization of harms, including routinely focusing on serious as well as less serious but frequent or bothersome harms; and routinely engaging stakeholders and using literature searches and other data sources to identify important harms.
AHRQ-authored; AHRQ-funded; HS022998.
Citation: Chou R, Baker WL, Banez LL .
Agency for Healthcare Research and Quality Evidence-based Practice Center methods provide guidance on prioritization and selection of harms in systematic reviews.
J Clin Epidemiol 2018 Jun;98:98-104. doi: 10.1016/j.jclinepi.2018.01.007.
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Keywords: Adverse Events, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Roumie CL, Patel NJ, Munoz D
Design and outcomes of the Patient Centered Outcomes Research Institute coronary heart disease cohort study.
The objective was to electronically identify, recruit, and survey coronary heart disease (CHD) patients and describe their characteristics and willingness to participate in future research. The majority reported that their health was good or very good, while 40 percent reported that their general and physical health were fair or poor. A patient sample was provided with a trial summary which would randomize their aspirin dose; and 63 percent reported that they would consider participating.
AHRQ-funded; HS022990.
Citation: Roumie CL, Patel NJ, Munoz D .
Design and outcomes of the Patient Centered Outcomes Research Institute coronary heart disease cohort study.
Contemp Clin Trials Commun 2018 Jun;10:42-49. doi: 10.1016/j.conctc.2018.03.001.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Patient-Centered Outcomes Research, Research Methodologies
Tian L, Fu H, Ruberg SJ
Efficiency of two sample tests via the restricted mean survival time for analyzing event time observations.
This article assesses the relative efficiency of the hazard ratio (HR) and restricted means survival time or t-year mean survival time (t-MST) tests with respect to the statistical power under various proportional hazards (PH) and non-PH models, both theoretically and empirically. The results indicate that when the PH assumption is valid, the t-MST test performs almost as well as the HR test, but for non-PH models, the t-MST test can substantially outperform its HR counterpart. The authors discuss issues and implications regarding their sample tests.
AHRQ-funded; HS022193.
Citation: Tian L, Fu H, Ruberg SJ .
Efficiency of two sample tests via the restricted mean survival time for analyzing event time observations.
Biometrics 2018 Jun;74(2):694-702. doi: 10.1111/biom.12770..
Keywords: Comparative Effectiveness, Research Methodologies
Engelgau MM, Narayan KMV, Ezzati M
AHRQ Author: Meyers D
Implementation research to address the United States health disadvantage: report of a National Heart, Lung, and Blood Institute workshop.
This paper discusses the meeting of a panel of national and international health experts and stakeholders for a Think Tank meeting to explore the U.S. health disadvantage and to seek specific recommendations for implementation research opportunities for heart, lung, blood, and sleep disorders, convened by the National Heart, Lung, and Blood Institute.
AHRQ-authored.
Citation: Engelgau MM, Narayan KMV, Ezzati M .
Implementation research to address the United States health disadvantage: report of a National Heart, Lung, and Blood Institute workshop.
Glob Heart 2018 Jun;13(2):65-72. doi: 10.1016/j.gheart.2018.03.003.
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Keywords: Cardiovascular Conditions, Guidelines, Research Methodologies
Hoffman SR, Vines AI, Halladay JR
Optimizing research in symptomatic uterine fibroids with development of a computable phenotype for use with electronic health records.
The objective of the study was to develop an electronic health record-based algorithm to identify women with symptomatic uterine fibroids for a comparative effectiveness study of medical or surgical treatments on quality-of-life measures. The study concluded that an electronic health record-based algorithm is capable of identifying cases of symptomatic uterine fibroids with moderate positive predictive value and may be an efficient approach for large-scale study recruitment.
AHRQ-funded; HS023418.
Citation: Hoffman SR, Vines AI, Halladay JR .
Optimizing research in symptomatic uterine fibroids with development of a computable phenotype for use with electronic health records.
Am J Obstet Gynecol 2018 Jun;218(6):610.e1-10.e7. doi: 10.1016/j.ajog.2018.02.002..
Keywords: Comparative Effectiveness, Electronic Health Records (EHRs), Research Methodologies, Women
Horiguchi M, Tian L, Uno H
Quantification of long-term survival benefit in a comparative oncology clinical study.
The authors discuss the quantification of long-term survival benefit in a comparative oncology clinical study. They assert that from the perspective of cost-risk-benefit, using a long-term survival benefit criterion for selecting anticancer therapies may be more appropriate.
AHRQ-funded; HS022193.
Citation: Horiguchi M, Tian L, Uno H .
Quantification of long-term survival benefit in a comparative oncology clinical study.
JAMA Oncol 2018 Jun;4(6):881-82. doi: 10.1001/jamaoncol.2018.0518..
Keywords: Cancer, Comparative Effectiveness, Outcomes, Research Methodologies
Villani J, Ngo-Metzger Q, Vincent IS
AHRQ Author: Ngo-Metzger Q
Sources of funding for research in evidence reviews that inform recommendations of the US Preventive Services Task Force.
This study characterizes the sources of funding for the scientific evidence base used by the USPSTF. One or more funding sources were identified for 79 percent of the 1,650 research articles. Government agencies provided support for 931 articles (56 percent). The remaining support came from nonprofits or universities (530 articles, 32 percent) and industry (282 articles, 17 percent).The sources of funding varied by recommendation topic.
AHRQ-authored.
Citation: Villani J, Ngo-Metzger Q, Vincent IS .
Sources of funding for research in evidence reviews that inform recommendations of the US Preventive Services Task Force.
JAMA 2018 May 22;319(20):2132-33. doi: 10.1001/jama.2018.5404.
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Keywords: Evidence-Based Practice, Guidelines, Prevention, Research Methodologies, U.S. Preventive Services Task Force (USPSTF)
Lu B, Cai D, Tong X
Testing causal effects in observational survival data using propensity score matching design.
The researchers proposed a strategy to test for survival function differences based on the matching design and explored sensitivity of the P-values to assumptions about unmeasured confounding. Next, they applied their method to an observational cohort of chronic liver disease patients from a Mayo Clinic study. Results showed evidence of a significant treatment effect. They recommended caution, however, as the sensitivity analysis reveals that the P-value becomes non-significant if there exists an unmeasured confounder with a small impact.
AHRQ-funded; HS024263.
Citation: Lu B, Cai D, Tong X .
Testing causal effects in observational survival data using propensity score matching design.
Stat Med 2018 May 20;37(11):1846-58. doi: 10.1002/sim.7599.
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Keywords: Data, Health Services Research (HSR), Research Methodologies
Hultman G, McEwan R, Pakhomov S
Usability evaluation of an unstructured clinical document query tool for researchers.
This study aimed to conduct a user-centered analysis with clinical researchers to gain insight into Natural Language Processing - Patient Information Extraction for Researchers (NLP-PIER) usability and to gain an understanding of the needs of clinical researchers when using an application for searching clinical notes.
AHRQ-funded; HS022085.
Citation: Hultman G, McEwan R, Pakhomov S .
Usability evaluation of an unstructured clinical document query tool for researchers.
AMIA Jt Summits Transl Sci Proc 2018 May 18;2018:84-93..
Keywords: Data, Health Information Technology (HIT), Research Methodologies
Uno H, Claggett B, Tian L
Adding a new analytical procedure with clinical interpretation in the tool box of survival analysis.
The authors discuss the measures that are routinely used to quantify survival time in long-term comparative oncology trials. They discuss progression-free survival or overall survival time which is often the study endpoint, as well as the hazard ratio (HR) which has been utilized to quantify the between-group difference in survival analysis.
AHRQ-funded; HS022193.
Citation: Uno H, Claggett B, Tian L .
Adding a new analytical procedure with clinical interpretation in the tool box of survival analysis.
Ann Oncol 2018 May;29(5):1092-94. doi: 10.1093/annonc/mdy109..
Keywords: Research Methodologies, Cancer