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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 47 Research Studies DisplayedMelnick ER, Probst MA, Schoenfeld E
Development and testing of shared decision making interventions for use in emergency care: a research agenda.
This article provides background on decision aids and the conclusions of the 2016 Academic Emergency Medicine consensus conference SDM in practice work group regarding "Shared Decision Making in the Emergency Department: Development of a Policy-Relevant, Patient-Centered Research Agenda."
AHRQ-funded; HS021271; HS024311.
Citation: Melnick ER, Probst MA, Schoenfeld E .
Development and testing of shared decision making interventions for use in emergency care: a research agenda.
Acad Emerg Med 2016 Dec;23(12):1346-53. doi: 10.1111/acem.13045.
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Keywords: Decision Making, Emergency Department, Emergency Medical Services (EMS), Patient-Centered Healthcare, Policy
Kessler R, Stowell JR, Vogel JA
Effect of interventional program on the utilization of PACS in point-of-care ultrasound.
The study’s objective was to determine if a simple interventional program would influence the utilization of Picture Archiving and Communication Systems (PACS) in point-of-care ultrasound. It concluded that a simple interventional program for emergency physicians can significantly increase and sustain the utilization of PACS for point-of-care ultrasound.
AHRQ-funded; HS023901.
Citation: Kessler R, Stowell JR, Vogel JA .
Effect of interventional program on the utilization of PACS in point-of-care ultrasound.
J Digit Imaging 2016 Dec;29(6):701-05. doi: 10.1007/s10278-016-9893-x.
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Keywords: Emergency Medical Services (EMS), Imaging, Healthcare Utilization, Health Information Technology (HIT)
Dodd KW, Berman A, Brown J
Funding research in emergency department shared decision making: a summary of the 2016 Academic Emergency Medicine Consensus Conference Panel Discussion.
This article summarizes a panel discussion of funding priorities and examples of successfully funded projects related to shared decision making in emergency medicine. The discussion was part of the 2016 Academic Emergency Medicine Consensus Conference, "Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda."
AHRQ-funded; HS024172.
Citation: Dodd KW, Berman A, Brown J .
Funding research in emergency department shared decision making: a summary of the 2016 Academic Emergency Medicine Consensus Conference Panel Discussion.
Acad Emerg Med 2016 Dec;23(12):1340-45. doi: 10.1111/acem.13063.
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Keywords: Emergency Department, Decision Making, Emergency Medical Services (EMS), Health Services Research (HSR)
Mueller LR, Donnelly JP, Jacobson KE
National characteristics of emergency medical services in frontier and remote areas.
This study sought to describe the national characteristics and outcomes of EMS care provided in frontier and remote (FAR) areas in the continental United States (US). It found that FAR responses were more likely to be of American Indian or Alaska Native race. Age, ethnicity, location type, and clinical impressions were similar between FAR and non-FAR responses. On-scene death was more likely in FAR than non-FAR responses.
AHRQ-funded; HS013852.
Citation: Mueller LR, Donnelly JP, Jacobson KE .
National characteristics of emergency medical services in frontier and remote areas.
Prehosp Emerg Care 2016;20(2):191-9. doi: 10.3109/10903127.2015.1086846.
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Keywords: Emergency Medical Services (EMS), Rural Health, Provider: Health Personnel, Health Services Research (HSR), Outcomes
Jarman MP, Castillo RC
Rural risk: geographic disparities in trauma mortality.
The authors sought to quantify differences in injury mortality comparing rural and nonrural residents with traumatic injuries. They concluded that rural residents are significantly more likely than nonrural residents to die after traumatic injury, a disparity that varies by trauma center designation, injury severity, and US Census region.
AHRQ-funded; HS000029.
Citation: Jarman MP, Castillo RC .
Rural risk: geographic disparities in trauma mortality.
Surgery 2016 Dec;160(6):1551-59. doi: 10.1016/j.surg.2016.06.020.
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Keywords: Access to Care, Disparities, Emergency Medical Services (EMS), Healthcare Cost and Utilization Project (HCUP), Rural Health
Grudzen CR, Anderson JR, Carpenter CR
The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.
The authors described the current state of shared decision making in the emergency department context and provided an overview of the conference. They explained that the results of the conference published in the same journal issue provided an essential summary of the future research priorities for shared decision making to increase quality of care and patient-centered outcomes.
AHRQ-funded; HS024172.
Citation: Grudzen CR, Anderson JR, Carpenter CR .
The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.
Acad Emerg Med 2016 Dec;23(12):1313-19. doi: 10.1111/acem.13047.
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Keywords: Decision Making, Emergency Department, Emergency Medical Services (EMS), Patient-Centered Healthcare, Policy
O'Malley JP, O'Keeffe-Rosetti M, Lowe RA
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
The authors sought to assess changes in emergency department, primary care, mental and behavioral health care, and specialist care visit rates among individuals gaining Medicaid over 24 months postinsurance gain and also to evaluate the association of previous insurance with utilization. They found that primary care visit rates in both newly and returning insured individuals significantly exceeded those of the continuously insured in months 4 through 12, but were not significantly elevated in the second year. In contrast, emergency department utilization rates were significantly higher in returning insured compared with newly or continuously insured individuals and remained elevated over time. New visits to primary and specialist care were higher among those who gained Medicaid compared with the continuously insured throughout the study period. They concluded that expansion evaluations should allow for rate stabilization.
AHRQ-funded; HS021522.
Citation: O'Malley JP, O'Keeffe-Rosetti M, Lowe RA .
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
Med Care 2016 Nov;54(11):984-91. doi: 10.1097/mlr.0000000000000600.
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Keywords: Medicaid, Healthcare Delivery, Healthcare Utilization, Emergency Department, Emergency Medical Services (EMS)
Johnson SA, Shi J, Groner JI
Inter-facility transfer of pediatric burn patients from U.S. Emergency Departments.
This study described the epidemiology of pediatric burn patients seen in U.S. emergency departments (EDs) in order to determine factors associated with inter-facility transfer. It concluded that over 90 percent of pediatric burn ED patients meet ABA burn referral criteria but are not transferred from low volume hospitals.
AHRQ-funded; HS022277.
Citation: Johnson SA, Shi J, Groner JI .
Inter-facility transfer of pediatric burn patients from U.S. Emergency Departments.
Burns 2016 Nov;42(7):1413-22. doi: 10.1016/j.burns.2016.06.024.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Transitions of Care, Children/Adolescents, Emergency Medical Services (EMS), Guidelines
Goss FR, Zhou L, Weiner SG
Incidence of speech recognition errors in the emergency department.
The study’s aim was to determine the incidence and types of speech recognition (SR) errors introduced by computerized SR technology in the emergency department (ED). It found that SR errors occur commonly with annunciation errors being the most frequent. Error rates were comparable if not lower than previous studies. Fifteen percent of errors were deemed critical, potentially leading to miscommunication that could affect patient care.
AHRQ-funded; HS024264.
Citation: Goss FR, Zhou L, Weiner SG .
Incidence of speech recognition errors in the emergency department.
Int J Med Inform 2016 Sep;93:70-3. doi: 10.1016/j.ijmedinf.2016.05.005.
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Keywords: Communication, Emergency Medical Services (EMS), Health Information Technology (HIT), Patient Safety
Fleischman W, Ross JS, Melnick ER
Financial ties between emergency physicians and industry: insights from open payments data.
The authors sought to describe nonresearch, nonroyalty Open Payments made to emergency physicians in the United States. They found that nearly a third of emergency physicians received such payments from industry in 2014, and that most payments were of small monetary value and for activities related to the marketing of antithrombotic drugs.
AHRQ-funded; HS021271.
Citation: Fleischman W, Ross JS, Melnick ER .
Financial ties between emergency physicians and industry: insights from open payments data.
Ann Emerg Med 2016 Aug;68(2):153-58.e4. doi: 10.1016/j.annemergmed.2016.01.014.
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Keywords: Emergency Medical Services (EMS), Medication, Policy, Practice Patterns, Provider: Physician
Bonafide CP, Roland D, Brady PW
Rapid response systems 20 years later: new approaches, old challenges.
In this article, the authors propose a set of recommendations for a research agenda aimed at pursuing the work of optimizing the identification of deteriorating children. They recommend that the second generation of pediatric rapid response systems continue to build on past achievements while further optimizing use of the data, tools, and people available at the bedside to take the next leap forward.
AHRQ-funded; HS023827.
Citation: Bonafide CP, Roland D, Brady PW .
Rapid response systems 20 years later: new approaches, old challenges.
JAMA Pediatr 2016 Aug;170(8):729-30. doi: 10.1001/jamapediatrics.2016.0398.
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Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Emergency Medical Services (EMS), Hospitals
Melnick ER, O'Brien EG, Kovalerchik O
The association between physician empathy and variation in imaging use.
This paper's objective was to describe empathy in a cohort of emergency physicians and evaluate its association with CT utilization. The authors found that, on the four psychometric scales used, performance was not predictive of risk-adjusted CT utilization in the emergency department. They concluded that the underlying physician-based factors that mediate interphysician variation remain to be clearly identified.
AHRQ-funded; HS021271.
Citation: Melnick ER, O'Brien EG, Kovalerchik O .
The association between physician empathy and variation in imaging use.
Acad Emerg Med 2016 Aug;23(8):895-904. doi: 10.1111/acem.13017.
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Keywords: Decision Making, Emergency Medical Services (EMS), Healthcare Utilization, Imaging, Practice Patterns
Kim HS, Monte AA
Colorado cannabis legalization and its effect on emergency care.
The authors noted that increased marijuana use after legalization has been accompanied by increases in emergency department visits and hospitalizations due to marijuana intoxication. They recommended that providers in states with impending legalization measures should become familiar with the symptoms and management of acute marijuana intoxication, as well as understand the effects on chronic diseases frequently observed in the emergency department. Further, they suggested that residency program directors should make an effort to integrate this topic into their residency curricula.
AHRQ-funded; HS000078.
Citation: Kim HS, Monte AA .
Colorado cannabis legalization and its effect on emergency care.
Ann Emerg Med 2016 Jul;68(1):71-5. doi: 10.1016/j.annemergmed.2016.01.004.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Hospitalization, Policy, Substance Abuse
Shah MP, Tate JE, Steiner CA
AHRQ Author: Steiner CA
Decline in emergency department visits for acute gastroenteritis among children in 10 US states after implementation of rotavirus vaccination, 2003-2013.
The researchers compared the rates of gastroenteritis- and rotavirus-coded ED visits among children <5 years of age in pre-rotavirus vaccine (2003 to 2006) with those in postvaccine (2008-2013) years; 2007 was excluded as a transition year They concluded that. ED visits for gastroenteritis in US children have declined since the introduction of rotavirus vaccine.
AHRQ-authored.
Citation: Shah MP, Tate JE, Steiner CA .
Decline in emergency department visits for acute gastroenteritis among children in 10 US states after implementation of rotavirus vaccination, 2003-2013.
Pediatr Infect Dis J 2016 Jul;35(7):782-6. doi: 10.1097/inf.0000000000001175.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Vaccination, Emergency Medical Services (EMS), Digestive Disease and Health
Melvin CL, Saef SH, Pierce HO
Health information exchange in the ED: what do ED clinicians think?
The researchers investigated reasons for low Carolina eHealth Alliance health information exchange (CeHA-HIE)utilization. They found that most emergency department clinicians believed the system added value to their work but preferred better integration with their electronic medical records systems.
AHRQ-funded; HS019339; HS023047.
Citation: Melvin CL, Saef SH, Pierce HO .
Health information exchange in the ED: what do ED clinicians think?
South Med J 2016 Jul;109(7):419-26. doi: 10.14423/smj.0000000000000466.
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Keywords: Health Information Exchange (HIE), Emergency Department, Electronic Health Records (EHRs), Emergency Medical Services (EMS)
Blecker S, Gavin NP, Park H
Observation units as substitutes for hospitalization or home discharge.
The purpose of this study is to determine the effect of the availability of observation units on hospitalizations and discharges to home for emergency department (ED) patients. The authors concluded that half of ED visits for chest pain that resulted in an observation unit admission were made by patients who may have been discharged home had the observation unit not been available.
AHRQ-funded; HS023683.
Citation: Blecker S, Gavin NP, Park H .
Observation units as substitutes for hospitalization or home discharge.
Ann Emerg Med 2016 Jun;67(6):706-13.e2. doi: 10.1016/j.annemergmed.2015.10.025.
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Keywords: Hospitalization, Hospital Discharge, Emergency Department, Emergency Medical Services (EMS)
Berian JR, Paruch JL, Cohen ME
Does performance vary within the same hospital when separately examining different patient subgroups?
The researchers sought to determine whether performance differs within a given hospital for 6 contrasting patient subgroups and to identify the percentage of hospitals with greater than chance differences in performance. They found that overall quality differed for elderly vs nonelderly, renal insufficiency vs normal renal function patients, cancer vs noncancer, and emergency vs nonemergency. They concluded that quality programs can consider separate reports for these subgroups to identify opportunities for quality improvement.
AHRQ-funded; HS021857.
Citation: Berian JR, Paruch JL, Cohen ME .
Does performance vary within the same hospital when separately examining different patient subgroups?
J Am Coll Surg 2016 May;222(5):790-97.e1. doi: 10.1016/j.jamcollsurg.2016.01.057.
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Keywords: Emergency Medical Services (EMS), Hospitals, Outcomes, Quality Improvement, Social Determinants of Health
Byczkowski TL, Gillespie GL, Kennebeck SS
Family-centered pediatric emergency care: a framework for measuring what parents want and value.
The objective of this study was to identify dimensions of family-centered care important to parents in pediatric emergency care and compare them to those currently defined. The authors concluded that the resulting dimensions provide a framework for measuring and improving the delivery of family-centered pediatric emergency care.
AHRQ-funded; HS019037.
Citation: Byczkowski TL, Gillespie GL, Kennebeck SS .
Family-centered pediatric emergency care: a framework for measuring what parents want and value.
Acad Pediatr 2016 May-Jun;16(4):327-35. doi: 10.1016/j.acap.2015.08.011.
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Keywords: Healthcare Delivery, Children/Adolescents, Emergency Medical Services (EMS), Patient Experience, Children/Adolescents
Hodell E, Hughes SD, Corry M
Paramedic perspectives on barriers to prehospital acute stroke recognition.
The researchers aimed to understand systematically the challenges and barriers faced by paramedics in recognizing stroke presentations in the field. They concluded that while challenges to stroke recognition in the field were slightly different for rural and urban emergency medical service providers, participants concurred that timely, systematic feedback on individual patients and case-based training would strengthen early stroke recognition skills.
AHRQ-funded; HS017965.
Citation: Hodell E, Hughes SD, Corry M .
Paramedic perspectives on barriers to prehospital acute stroke recognition.
Prehosp Emerg Care 2016 May-Jun;20(3):415-24. doi: 10.3109/10903127.2015.1115933.
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Keywords: Diagnostic Safety and Quality, Emergency Medical Services (EMS), Healthcare Delivery, Stroke, Training
Flottemesch TJ, Raetzman S, Heslin KC
AHRQ Author: Heslin KC
Age-related disparities in trauma center access for severe head injuries following the release of the updated field triage guidelines.
Reflecting perceived undertriage to trauma centers (TCs) for older adults, the American College of Surgeons' Committee on Trauma and the Center for Disease Control revised field triage guidelines in 2011 with additional emphasis on direct transport to a Level I or II trauma center. Researchers examined whether age-based disparities in TC care for severe head injury decreased. Although patterns of increased TC treatment for all groups with severe head trauma indicate improvements, age-based disparities persisted.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Flottemesch TJ, Raetzman S, Heslin KC .
Age-related disparities in trauma center access for severe head injuries following the release of the updated field triage guidelines.
Acad Emerg Med 2016 Apr;24(4):447-57. doi: 10.1111/acem.13150.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Elderly, Brain Injury, Emergency Medical Services (EMS)
Leyenaar JK, Lagu T, Lindenauer PK
Direct admission to the hospital: an alternative approach to hospitalization.
The authors discussed the role of hospital medicine in the changing epidemiology of hospital admissions, the potential risks and benefits of direct admission to the hospital, and the need for research to evaluate the safety and effectiveness of this admission approach. They proposed that transitions of care research and quality improvement be expanded to address transitions into the hospital.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Lagu T, Lindenauer PK .
Direct admission to the hospital: an alternative approach to hospitalization.
J Hosp Med 2016 Apr;11(4):303-5. doi: 10.1002/jhm.2512.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Hospitalization, Transitions of Care
Dimou FM, Adhikari D, Mehta HB
Trends in follow-up of patients presenting to the emergency department with symptomatic cholelithiasis.
To better understand underuse of cholecystectomy, the researchers examined physician follow-up patterns after emergency department (ED) visits for symptomatic gallstones. They found that fewer than half of patients were evaluated by a surgeon after an initial ED visit for symptomatic gallstones. Patients who did not have physician follow-up were most likely to require emergent cholecystectomy, suggesting inappropriate ED discharge and highlighting the need for timely follow-up.
AHRQ-funded; HS022134.
Citation: Dimou FM, Adhikari D, Mehta HB .
Trends in follow-up of patients presenting to the emergency department with symptomatic cholelithiasis.
J Am Coll Surg 2016 Apr;222(4):377-84. doi: 10.1016/j.jamcollsurg.2015.12.011.
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Keywords: Elderly, Emergency Medical Services (EMS), Patient-Centered Outcomes Research, Practice Patterns
Donnelly JP, Franco RA, Wang HE
Emergency department screening for hepatitis C virus: geographic reach and spatial clustering in central Alabama.
Hepatitis C virus (HCV) infection is a growing problem, disproportionately affecting those born between 1945 and 1965. Here, we demonstrate the wide geographic reach and surveillance potential of emergency department-based screening and identify areas of elevated HCV infection in central Alabama that were socioeconomically disadvantaged compared with surrounding communities.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Franco RA, Wang HE .
Emergency department screening for hepatitis C virus: geographic reach and spatial clustering in central Alabama.
Clin Infect Dis 2016 Mar 1;62(5):613-6. doi: 10.1093/cid/civ984.
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Keywords: Hepatitis, Screening, Emergency Department, Emergency Medical Services (EMS)
Taylor RA, Pare JR, Venkatesh AK
Prediction of in-hospital mortality in emergency department patients with sepsis: A local big data-driven, machine learning approach.
In this proof-of-concept study, a local, big data-driven, machine learning approach is compared to existing clinical decision rules (CDRs) and traditional analytic methods using the prediction of sepsis in-hospital mortality as the use case. It concluded that this approach outperformed existing CDRs as well as traditional analytic techniques for predicting in-hospital mortality of ED patients with sepsis.
AHRQ-funded; HS021271.
Citation: Taylor RA, Pare JR, Venkatesh AK .
Prediction of in-hospital mortality in emergency department patients with sepsis: A local big data-driven, machine learning approach.
Acad Emerg Med 2016 Mar;23(3):269-78. doi: 10.1111/acem.12876.
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Keywords: Emergency Medical Services (EMS), Mortality, Clinical Decision Support (CDS), Sepsis, Health Information Technology (HIT)
Chen LY, Crum RM, Strain EC
Prescriptions, nonmedical use, and emergency department visits involving prescription stimulants.
Little is known regarding the temporal trends in prescriptions, nonmedical use, and emergency department (ED) visits involving prescription stimulants in the United States. The study examined these 3 national trends involving dextroamphetamine-amphetamine and methylphenidate in adults and adolescents. It found that trends in prescriptions for stimulants do not correspond to trends in reports of nonmedical use and ED visits.
AHRQ-funded; HS0189960.
Citation: Chen LY, Crum RM, Strain EC .
Prescriptions, nonmedical use, and emergency department visits involving prescription stimulants.
J Clin Psychiatry 2016 Mar;77(3):e297-304. doi: 10.4088/JCP.14m09291.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Medication, Substance Abuse