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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
1 to 25 of 62 Research Studies DisplayedSinger SJ, Sinaiko AD, Tietschert MV
Care integration within and outside health system boundaries.
The purpose of this study was to examine care integration-efforts to unify disparate parts of health care organizations to generate synergy across activities occurring within and between them-to understand whether and at which organizational level health systems impact care quality and staff experience. The investigators concluded that measures of clinical process integration related to higher staff ratings of quality and experience.
AHRQ-funded; HS024067.
Citation: Singer SJ, Sinaiko AD, Tietschert MV .
Care integration within and outside health system boundaries.
Health Serv Res 2020 Dec;55(Suppl 3):1033-48. doi: 10.1111/1475-6773.13578..
Keywords: Health Systems, Healthcare Delivery, Health Services Research (HSR), Research Methodologies
Caves Sivaraman JJ, Naumann RB
Estimating the association between mental health disorders and suicide: a review of common sources of bias and challenges and opportunities for US-based research.
The purpose of this review was 1) to illuminate prevalent methodological approaches and estimates of association between mental health diagnoses and suicide from the meta-analytic literature; 2) to discuss key internal and external validity concerns with these estimates; and 3) to highlight some of the unique attributes and challenges in US-based suicide research and opportunities to move the evidence base forward. The authors offered methodological considerations for future research and discussed opportunities made possible by the recent expansion of the US National Violent Death Reporting System to a nationwide registry.
AHRQ-funded; HS000032.
Citation: Caves Sivaraman JJ, Naumann RB .
Estimating the association between mental health disorders and suicide: a review of common sources of bias and challenges and opportunities for US-based research.
Curr Epidemiol Rep 2020 Dec;7(4):352-62. doi: 10.1007/s40471-020-00250-5..
Keywords: Behavioral Health, Research Methodologies
Gates A, Gates M, DaRosa D
Decoding semi-automated title-abstract screening: findings from a convenience sample of reviews.
The authors evaluated the benefits and risks of using the Abstrackr machine learning (ML) tool to semi-automate title-abstract screening and explored whether Abstrackr's predictions varied by review or study-level characteristics. They concluded that their screening approach saved time and may be suitable in conditions where the limited risk of missing relevant records is acceptable. Several of their findings were paradoxical, and they recommended further study to understand fully the tasks to which ML-assisted screening is best suited.
AHRQ-funded; 290201500001I.
Citation: Gates A, Gates M, DaRosa D .
Decoding semi-automated title-abstract screening: findings from a convenience sample of reviews.
Syst Rev 2020 Nov 27;9(1):272. doi: 10.1186/s13643-020-01528-x..
Keywords: Research Methodologies
Kang M, Gurbani SS, Kempker JA
The published scientific literature on COVID-19: an analysis of PubMed abstracts.
This article describes a PubMed search done on the published scientific literature on COVID-19 from first reporting of the virus in late December 2019 through Nov. 9, 2020. A total of 57,263 articles were included, with 34% ahead of print, 25.1% e-published, and 40.9% print published at the time of data extraction. There was a peak of 2277 articles the week of May 11. The origin countries of publication were United States (35.7%), followed by England (27%), and the Netherlands (8.7%). Most publications (98%) were in English followed by less than 1% each in Spanish, German, and French.
AHRQ-funded; HS025240.
Citation: Kang M, Gurbani SS, Kempker JA .
The published scientific literature on COVID-19: an analysis of PubMed abstracts.
J Med Syst 2020 Nov 25;45(1):3. doi: 10.1007/s10916-020-01678-4..
Keywords: COVID-19, Public Health, Research Methodologies, Health Services Research (HSR)
Chen Y, Liang KY, Tong P
A pseudolikelihood approach for assessing genetic association in case-control studies with unmeasured population structure.
In this paper, researchers propose a novel statistical method to estimate the association between genetic markers and diseases in case-control studies with unmeasured population substructure. The performance of the proposed method, relative to the existing methods, on bias, coverage probability, and computational time, is assessed through simulations. The method is applied to an end-stage renal disease study in African Americans population.
AHRQ-funded; HS022900.
Citation: Chen Y, Liang KY, Tong P .
A pseudolikelihood approach for assessing genetic association in case-control studies with unmeasured population structure.
Stat Methods Med Res 2020 Nov;29(11):3153-65. doi: 10.1177/0962280220921212..
Keywords: Genetics, Research Methodologies
Hernandez AV, Roman YM, White CM
Developing criteria and associated instructions for consistent and useful quality improvement study data extraction for health systems.
This paper describes AHRQ’s efforts to collate and assess quality improvement studies to support learning health systems (LHS). The authors identified quality improvement studies and evaluated the consistency of data extraction from two experienced independent reviewers at three time points: baseline, first revision, and final revision. Six investigators looked at the data extracted by the independent reviewers and determined the extent of similarity on a scale of 0 to 10. Two LHS participants were then asked to assess the relative value of their criteria. The consistency of extraction improved from a mean 1.17 score at baseline to 6.07 at first revision, and 6.81 at the final revision. There was not a significant improvement from the first to final revision. However, the LHS participants rated the value of these ratings a 9 and a 6, demonstrating that there is value in developing criteria.
AHRQ-funded; 290201500012I.
Citation: Hernandez AV, Roman YM, White CM .
Developing criteria and associated instructions for consistent and useful quality improvement study data extraction for health systems.
J Gen Intern Med 2020 Nov;35(Suppl 2):802-07. doi: 10.1007/s11606-020-06098-1..
Keywords: Quality Improvement, Quality of Care, Learning Health Systems, Health Systems, Health Services Research (HSR), Research Methodologies
Ward TM, Skubic M, Rantz M
Human-centered approaches that integrate sensor technology across the lifespan: opportunities and challenges.
Children, parents, older adults, and caregivers routinely use sensor technology as a source of health information and health monitoring. The purpose of this paper was to describe three exemplars of research that used a human-centered approach to engage participants in the development, design, and usability of interventions that integrate technology to promote health. The exemplars were based on current research studies that integrated sensor technology into pediatric, adult, and older adult populations living with a chronic health condition.
AHRQ-funded; HS018477.
Citation: Ward TM, Skubic M, Rantz M .
Human-centered approaches that integrate sensor technology across the lifespan: opportunities and challenges.
Nurs Outlook 2020 Nov-Dec;68(6):734-44. doi: 10.1016/j.outlook.2020.05.004..
Keywords: Health Information Technology (HIT), Patient and Family Engagement, Health Services Research (HSR), Research Methodologies
Anzuoni K, Field TS, Mazor KM
Recruitment challenges for low-risk health system intervention trials in older adults: a case study.
Researchers assessed factors associated with trial participation in the context of a low-risk intervention intended to reduce adverse drug events in recently hospitalized older adults. They found that recruiting older adults recently discharged from the hospital to participate in trials of low-risk, system-level interventions was challenging and may under-enroll the oldest individuals and those potentially at the highest risk for adverse events, limiting generalizability of study findings.
AHRQ-funded; HS023774.
Citation: Anzuoni K, Field TS, Mazor KM .
Recruitment challenges for low-risk health system intervention trials in older adults: a case study.
J Am Geriatr Soc 2020 Nov;68(11):2558-64. doi: 10.1111/jgs.16696..
Keywords: Elderly, Case Study, Research Methodologies, Health Services Research (HSR), Medication
Gance-Cleveland B, McDonald CC, Walker RK
Use of theory to guide development and application of sensor technologies in nursing.
In this paper, three nurse scientists summarize their presentations at the Council for the Advancement of Nursing Science 2019 Advanced Methods Conference on Expanding Science of Sensor Technology in Research discussing the theoretical underpinnings of sensor technologies development and use in nursing research and practice.
AHRQ-funded; HS024738; HS018646.
Citation: Gance-Cleveland B, McDonald CC, Walker RK .
Use of theory to guide development and application of sensor technologies in nursing.
Nurs Outlook 2020 Nov-Dec;68(6):698-710. doi: 10.1016/j.outlook.2020.04.007..
Keywords: Health Information Technology (HIT), Nursing, Health Services Research (HSR), Research Methodologies
Armstrong MJ, Gamez N, Alliance S
Research priorities of caregivers and individuals with dementia with Lewy bodies: an interview study.
The authors investigated the research priorities of individuals and caregivers living with dementia with Lewy bodies (DLB). Through telephone interviews, they found that individuals with DLB and caregivers identified research needs and highlighted DLB symptoms needing additional research. They recommended that funding be informed by the priorities of all relevant stakeholders and support research investigating causes, natural history, biomarkers, and treatment in addition to research targeting themes regarding living with disease.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Gamez N, Alliance S .
Research priorities of caregivers and individuals with dementia with Lewy bodies: an interview study.
PLoS One 2020 Oct 7;15(10):e0239279. doi: 10.1371/journal.pone.0239279..
Keywords: Caregiving, Dementia, Neurological Disorders, Patient and Family Engagement, Elderly, Research Methodologies
Santry HP, Strassels SA, Ingraham AM
Identifying the fundamental structures and processes of care contributing to emergency general surgery quality using a mixed-methods Donabedian approach.
Acute Care Surgery (ACS) was developed as a structured, team-based approach to providing round-the-clock emergency general surgery (EGS) care for adult patients needing treatment for diseases such as cholecystitis, gastrointestinal perforation, and necrotizing fasciitis. In this study, the investigators sought to use a Donabedian approach to elucidate potential EGS structures and processes that might be associated with improved outcomes as an initial step in designing the optimal model of acute care surgery care for EGS patients.
AHRQ-funded; HS022694.
Citation: Santry HP, Strassels SA, Ingraham AM .
Identifying the fundamental structures and processes of care contributing to emergency general surgery quality using a mixed-methods Donabedian approach.
BMC Med Res Methodol 2020 Oct 2;20(1):247. doi: 10.1186/s12874-020-01096-7..
Keywords: Surgery, Critical Care, Healthcare Delivery, Health Services Research (HSR), Research Methodologies
Callejo-Black A, Wagner DV, Ramanujam K
A systematic review of external validity in pediatric integrated primary care trials.
This study used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to conduct a systematic review of external validity reporting in integrated primary care (IPC) interventions for mental health concerns. A literature search was conducted to identify relevant literature from 1998 to 2018 reporting on open, randomized or quasi-randomized trials of IPC interventions that targeted child (ages 0-18 years) psychological symptoms. The authors included 39 publications describing 25 studies in the review. Publications rarely reported indicators of external validity, including the representatives of participants (12%), rate of adoption clinics or providers (16%), cost of implementation (8%), or evidence of maintenance (16%). Few studies also included key pragmatic factors such as cost or organizational change processes related to implementation and maintenance.
AHRQ-funded; HS022981.
Citation: Callejo-Black A, Wagner DV, Ramanujam K .
A systematic review of external validity in pediatric integrated primary care trials.
J Pediatr Psychol 2020 Oct 1;45(9):1039-52. doi: 10.1093/jpepsy/jsaa068..
Keywords: Children/Adolescents, Primary Care, Behavioral Health, Healthcare Delivery, Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Nayfe R, Chansard M, Hynan LS
Comparison of patient-reported outcomes measurement information system and legacy instruments in multiple domains among older veterans with chronic back pain.
This study evaluated construct (convergent and discriminant) validity and time to complete NIH's Patient Reported Outcomes Measurement Information System (PROMIS) as compared to legacy instruments. Results showed that, given time efficiency of using PROMIS, along with strong construct validity, PROMIS instruments are a practical choice for measuring multidimensional patient-reported outcomes in older Veterans with chronic low back pain for both research and clinical purposes.
AHRQ-funded; HS022418.
Citation: Nayfe R, Chansard M, Hynan LS .
Comparison of patient-reported outcomes measurement information system and legacy instruments in multiple domains among older veterans with chronic back pain.
BMC Musculoskelet Disord 2020 Sep 8;21(1):598. doi: 10.1186/s12891-020-03587-6..
Keywords: Elderly, Back Health and Pain, Pain, Chronic Conditions, Patient-Centered Outcomes Research, Research Methodologies
Li X, Lewis KH, Callaway K
Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?
The authors assessed the availability and validity of claims-based weight-related diagnosis codes among bariatric surgery patients who underwent adjusted gastric banding, Roux-en-Y gastric bypass, or sleeve gastrectomy. They found that claims-based weight-related diagnosis codes had excellent validity before and after bariatric surgical operation but suboptimal availability after operation. Claims databases can be used for bariatric surgery studies of non-weight-related effectiveness and safety outcomes that are well-captured.
AHRQ-funded; HS026214.
Citation: Li X, Lewis KH, Callaway K .
Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?
BMC Med Res Methodol 2020 Sep 7;20(1):225. doi: 10.1186/s12874-020-01106-8..
Keywords: Obesity: Weight Management, Obesity, Surgery, Health Services Research (HSR), Research Methodologies
O'Malley AJ, Park S
A novel cluster sampling design that couples multiple surveys to support multiple inferential objectives.
The authors of this paper designed a new sampling methodology for complex health systems that own practices or hospitals to assess the relationship between health organization factors and health outcomes. These complex organizations complicate the construction of optimal survey designs. The authors developed an alternative approach based on constraining the sampling design to satisfy desired statistical properties. They illustrated the new sampling methodology by developing the constraints and solving the ensuing systems of equations to obtain the sampling design for the National Survey of United States Health Care Systems, Hospitals and Practices. They used what they called “coupled” sampling by comparing the proportion of eligible systems for whom the corporate owner and both a hospital and a practice can be used for.
AHRQ-funded; HS024075.
Citation: O'Malley AJ, Park S .
A novel cluster sampling design that couples multiple surveys to support multiple inferential objectives.
Health Serv Outcomes Res Methodol 2020 Sep;20(2-3):85-110. doi: 10.1007/s10742-020-00210-y..
Keywords: Research Methodologies, Health Services Research (HSR)
Cuthel A, Rogers E, Daniel F
Barriers and facilitators in the recruitment and retention of more than 250 small independent primary care practices for EvidenceNOW.
This study examined barriers and facilitators in the recruitment and retention of small independent practices (SIPs) to participate in research studies. The authors used qualitative data from the HealthyHearts New York City program, part of the EvidenceNOW initiative. This randomized controlled trial took place from 2015 through 2018 across 5 boroughs in NYC. A total of 257 SIPs (<5 full-time clinicians) were recruited originally. The three main factors that facilitated rapid recruitment were: 1) a prior well-established relationship with the local health department; 2) alignment of project goals with practice priorities, and 3) having appropriate monetary incentives. Specific strategies that enhance recruitment of SIPS and fills gaps in knowledge about factors that influence retention are identified.
AHRQ-funded; HS023922.
Citation: Cuthel A, Rogers E, Daniel F .
Barriers and facilitators in the recruitment and retention of more than 250 small independent primary care practices for EvidenceNOW.
Am J Med Qual 2020 Sep/Oct;35(5):388-96. doi: 10.1177/1062860619893422..
Keywords: Primary Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Landes SJ, Kerns SEU, Pilar MR
Proceedings of the Fifth Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2019: where the rubber meets the road: the intersection of research, policy, and practice - part 1.
This paper offers a compilation of the abstracts of the oral and poster presentations from the 2019 Society for Implementation Research Collaboration (SIRC) Conference entitled “Where the Rubber Meets the Road: The Intersection of Research, Policy, and Practice” held in Seattle from 12-14 September. The society had evolved following a NIMH-funded conference grant and is now an international society. The conference included 432 attendees. Highlights of the conference are described.
AHRQ-funded; HS025632.
Citation: Landes SJ, Kerns SEU, Pilar MR .
Proceedings of the Fifth Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2019: where the rubber meets the road: the intersection of research, policy, and practice - part 1.
Implement Sci 2020 Sep 30;15(Suppl 3):76. doi: 10.1186/s13012-020-01034-7..
Keywords: Implementation, Health Services Research (HSR), Evidence-Based Practice, Policy, Research Methodologies
Nuamah JK, Adapa K, Mazur L
Electronic health records (EHR) simulation-based training: a scoping review protocol.
This article describes a literature review that will be conducted on the evidence for electronic health record (EHR)-based training interventions to facilitate improved EHR use for healthcare providers. Three databases will be searched for published articles and ProQuest and Google Scholar will be searched to identify unpublished articles from inception to January 29, 2020. Two reviewers will independently screen titles and abstracts using inclusion and exclusion criteria. Based on the extracted data, research evidence will be synthesized.
AHRQ-funded; HS025597.
Citation: Nuamah JK, Adapa K, Mazur L .
Electronic health records (EHR) simulation-based training: a scoping review protocol.
BMJ Open 2020 Aug 11;10(8):e036884. doi: 10.1136/bmjopen-2020-036884..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Research Methodologies, Simulation
O'Neil ME, Harik JM, McDonagh MS
Development of the PTSD-repository: a publicly available repository of randomized controlled trials for posttraumatic stress disorder.
This paper describes the development of a posttraumatic stress disorder (PTSD) repository of randomized controlled trials that will be publicly available for clinical, research, and policy stakeholders. The authors created a preliminary dataset which is maintained by the National Center for PTSD (NCPTSD). They searched multiple databases for studies published 1980 to 2018. A total of 318 RCTS of PTSD interventions that enrolled almost 25,000 participants were included. They abstracted 337 variables across all studies. This paper describes their methods, defines data elements, and explains coding challenges. The data is now publicly available on the NCPTSD website.
AHRQ-funded; 290201500009I.
Citation: O'Neil ME, Harik JM, McDonagh MS .
Development of the PTSD-repository: a publicly available repository of randomized controlled trials for posttraumatic stress disorder.
J Trauma Stress 2020 Aug;33(4):410-19. doi: 10.1002/jts.22520..
Keywords: Behavioral Health, Research Methodologies, Registries
Kirby JS, Thorlacius L, Villumsen B L, Villumsen B
The Hidradenitis Suppurativa Quality of Life (HiSQOL) score: development and validation of a measure for clinical trials.
The authors sought to develop and validate the Hidradenitis Suppurativa Quality Of Life (HiSQOL©) scale, for clinical trial measurement of hidradenitis suppurativa (HS)-specific health-related quality of life (HRQOL). They found that the HiSQOL is a reliable and valid instrument to measure HS-specific HRQOL in clinical trials.
AHRQ-funded; HS024585.
Citation: Kirby JS, Thorlacius L, Villumsen B L, Villumsen B .
The Hidradenitis Suppurativa Quality of Life (HiSQOL) score: development and validation of a measure for clinical trials.
Br J Dermatol 2020 Aug;183(2):340-48. doi: 10.1111/bjd.18692..
Keywords: Quality of Life, Research Methodologies
Riggs K, Richman J, Kertesz S
Trial design for ineffectiveness research: a mixed-methods survey.
High-quality research demonstrating a lack of effectiveness may facilitate the 'de-adoption' of ineffective health services. However, there has been little debate on the optimal design for ineffectiveness research-studies exploring the research hypothesis that an intervention is ineffective. The aim of this study was to explore investigators' preferences for trial design for ineffectiveness research. The investigators conducted a mixed-methods online survey with principle investigators identified from clinicaltrials.gov.
AHRQ-funded; HS023009.
Citation: Riggs K, Richman J, Kertesz S .
Trial design for ineffectiveness research: a mixed-methods survey.
BMJ Evid Based Med 2020 Aug;25(4):143-44. doi: 10.1136/bmjebm-2019-111276..
Keywords: Research Methodologies, Comparative Effectiveness, Evidence-Based Practice
Lin D, Lapen K, Sherer MV
A systematic review of contouring guidelines in radiation oncology: analysis of frequency, methodology, and delivery of consensus recommendations.
Clinical trials have described variation in radiation therapy plan quality, of which contour delineation is a key component, and linked this to inferior patient outcomes. In response, consensus guidelines have been developed to standardize contour delineation. This investigation assessed trends in contouring guidelines and examined the methodologies used to generate and deliver recommendations. The investigators concluded that this review highlighted an increase in consensus contouring recommendations over time.
AHRQ-funded; HS026881.
Citation: Lin D, Lapen K, Sherer MV .
A systematic review of contouring guidelines in radiation oncology: analysis of frequency, methodology, and delivery of consensus recommendations.
Int J Radiat Oncol Biol Phys 2020 Jul 15;107(4):827-35. doi: 10.1016/j.ijrobp.2020.04.011..
Keywords: Guidelines, Evidence-Based Practice, Research Methodologies
Goz V, Martin BI, Donnally CJ
Potential selection bias in observational studies comparing cervical disc arthroplasty to anterior cervical discectomy and fusion.
This retrospective cohort study looked at potential selection bias for spinal patients undergoing cervical disc arthroplasty (CDA) or anterior cervical discectomy and fusion (ACDF). A total of ACDF or CDA 290,419 procedures were identified in adults from 2004-2014 using ICD-9-CM diagnosis and procedure codes. The vast majority (98.2%) underwent ACDF. CDA patients were younger and healthier with a higher socioeconomic status than ACDF patients. CDA was also $574 more expensive in the fully specified model. There was no statistically significant difference in terms of complications between the two procedures.
AHRQ-funded; HS024714.
Citation: Goz V, Martin BI, Donnally CJ .
Potential selection bias in observational studies comparing cervical disc arthroplasty to anterior cervical discectomy and fusion.
Spine 2020 Jul 15;45(14):960-67. doi: 10.1097/brs.0000000000003427..
Keywords: Surgery, Orthopedics, Research Methodologies
Silverberg JI, Lei D, Yousaf M
Comparison of Patient-Oriented Eczema Measure and Patient-Oriented Scoring Atopic Dermatitis vs Eczema Area and Severity Index and other measures of atopic dermatitis: a validation study.
Little is known about the measurement properties of Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD) in adults with atopic dermatitis (AD). Even less is known about how PO-SCORAD performs compared with the Patient-Oriented Eczema Measure (POEM). The purpose of this study was to examine the measurement properties of PO-SCORAD and compare them with those of POEM. The investigators concluded that PO-SCORAD and POEM had good construct and cross-cultural validity, reliability, and responsiveness in adults with AD and were feasible for use in clinical trials and practice.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Lei D, Yousaf M .
Comparison of Patient-Oriented Eczema Measure and Patient-Oriented Scoring Atopic Dermatitis vs Eczema Area and Severity Index and other measures of atopic dermatitis: a validation study.
Ann Allergy Asthma Immunol 2020 Jul;125(1):78-83. doi: 10.1016/j.anai.2020.03.006..
Keywords: Skin Conditions, Research Methodologies, Patient-Centered Outcomes Research
Thomas LE, Yang S, Wojdyla D
Matching with time-dependent treatments: a review and look forward.
Observational studies of treatment effects attempt to mimic a randomized experiment by balancing the covariate distribution in treated and control groups, thus removing biases related to measured confounders. In this paper, the authors define a class of longitudinal matching methods and provide a review of existing variations, with guidance regarding study design, execution, and analysis. They identify avenues for future research and highlight the relevance of this methodology to high-quality comparative effectiveness studies in the era of big data.
AHRQ-funded; HS24310.
Citation: Thomas LE, Yang S, Wojdyla D .
Matching with time-dependent treatments: a review and look forward.
Stat Med 2020 Jul;39(17):2350-70. doi: 10.1002/sim.8533..
Keywords: Research Methodologies, Evidence-Based Practice, Comparative Effectiveness