National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Events (2)
- Cancer (11)
- (-) Cancer: Breast Cancer (26)
- Cancer: Cervical Cancer (1)
- Cancer: Colorectal Cancer (1)
- Cancer: Lung Cancer (2)
- Cancer: Ovarian Cancer (2)
- Clinician-Patient Communication (1)
- Communication (1)
- Cultural Competence (1)
- Data (1)
- Decision Making (1)
- Diagnostic Safety and Quality (2)
- Disabilities (1)
- Disparities (3)
- Education: Patient and Caregiver (1)
- Elderly (3)
- Evidence-Based Practice (1)
- Family Health and History (2)
- Genetics (3)
- Guidelines (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (3)
- Healthcare Utilization (3)
- Health Information Technology (HIT) (1)
- Health Insurance (1)
- Health Status (1)
- Heart Disease and Health (1)
- Imaging (3)
- Medicaid (1)
- Medicare (1)
- Medication (3)
- Mortality (1)
- Patient-Centered Healthcare (2)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (2)
- Patient Safety (1)
- Prevention (3)
- Quality of Care (1)
- Racial and Ethnic Minorities (5)
- Registries (1)
- Research Methodologies (1)
- Risk (3)
- Rural Health (2)
- Screening (8)
- Social Determinants of Health (1)
- Surgery (4)
- Treatments (3)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Vaccination (1)
- Women (7)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 26 Research Studies DisplayedChilders CP, Childers KK, Maggard-Gibbons M
National estimates of genetic testing in women with a history of breast or ovarian cancer.
In the United States, 3.8 million women have a history of breast (BC) or ovarian cancer (OC). Up to 15 percent of cases are attributable to heritable mutations, which, if identified, provide critical knowledge for treatment and preventive care. This study found that fewer than one in five individuals with a history of BC or OC meeting select National Cancer Comprehensive Network criteria have undergone genetic testing.
AHRQ-funded; HS025079.
Citation: Childers CP, Childers KK, Maggard-Gibbons M .
National estimates of genetic testing in women with a history of breast or ovarian cancer.
J Clin Oncol 2017 Dec 1;35(34):3800-06. doi: 10.1200/jco.2017.73.6314.
.
.
Keywords: Cancer, Cancer: Breast Cancer, Cancer: Ovarian Cancer, Family Health and History, Genetics, Quality of Care, Screening, Women
Kelly G, Wang SY, Lucas G
Facilitating meaningful engagement on community advisory committees in patient-centered outcome research.
In this study, the investigators conducted a process evaluation of ongoing activities of a Patient Advisory Committee (PAC) formed around the development of an individualized decision aid for older women with early stage breast cancer. They indicated that their results suggested that engaging committee members in a process of evaluation and collective reflection during a research collaboration can break down barriers to collaboration, build relationships, create opportunities for co-learning and strengthen researchers' capacity to engage meaningfully with stakeholders.
AHRQ-funded; HS023900.
Citation: Kelly G, Wang SY, Lucas G .
Facilitating meaningful engagement on community advisory committees in patient-centered outcome research.
Prog Community Health Partnersh 2017;11(3):243-51. doi: 10.1353/cpr.2017.0029..
Keywords: Cancer, Cancer: Breast Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Research Methodologies
Rauscher GH, Dabbous F, Dolecek TA
Absence of an anticipated racial disparity in interval breast cancer within a large health care organization.
The researchers sought to estimate the extent of an anticipated racial disparity in interval breast cancer (IBC) within a single, large health care organization. Contrary to expectation, in patient-adjusted models, there was no IBC racial disparity. The sorting of patients by race across facilities appears to have mitigated an otherwise anticipated disparity in IBC.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Dabbous F, Dolecek TA .
Absence of an anticipated racial disparity in interval breast cancer within a large health care organization.
Ann Epidemiol 2017 Oct;27(10):654-58. doi: 10.1016/j.annepidem.2017.09.002.
.
.
Keywords: Cancer: Breast Cancer, Cancer, Disparities, Racial and Ethnic Minorities, Women, Screening, Screening, Imaging
Farias AJ, Du XL
Racial differences in adjuvant endocrine therapy use and discontinuation in association with mortality among Medicare breast cancer patients by receptor status.
The purpose of this study was to determine whether racial/ethnic differences in use and discontinuation of adjuvant endocrine therapy (AET) differed by hormone receptor status and whether discontinuation was associated with mortality. There are racial/ethnic differences in AET use and discontinuation. Discontinuing treatment was associated with higher risk of all-cause and cancer-specific mortality regardless of hormone receptor status.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Racial differences in adjuvant endocrine therapy use and discontinuation in association with mortality among Medicare breast cancer patients by receptor status.
Cancer Epidemiol Biomarkers Prev 2017 Aug;26(8):1266-75. doi: 10.1158/1055-9965.epi-17-0280.
.
.
Keywords: Cancer: Breast Cancer, Disparities, Elderly, Mortality, Racial and Ethnic Minorities
Wang SY, Kelly G, Gross C
Information needs of older women with early-stage breast cancer when making radiation therapy decisions.
The researchers identified the information older women with early-stage breast cancer need when making radiation therapy decisions, and who patients identify as the main decision maker. They found that older women consider themselves to be the main decision maker; they desire information and have more agency and input in the decision-making process than prior literature would suggest.
AHRQ-funded; HS023900.
Citation: Wang SY, Kelly G, Gross C .
Information needs of older women with early-stage breast cancer when making radiation therapy decisions.
Int J Radiat Oncol Biol Phys 2017 Jul 15;98(4):733-40. doi: 10.1016/j.ijrobp.2017.02.001.
.
.
Keywords: Cancer: Breast Cancer, Decision Making, Education: Patient and Caregiver, Treatments
Ballard TNS, Zhong L, Momoh AO
Improved rates of immediate breast reconstruction at safety net hospitals.
Although disparities in receipt of breast reconstruction persist at the patient level, the extent to which hospital factors contribute to these differences remains unclear. This study concluded that, after accounting for sociodemographic factors, women undergoing mastectomies at safety net hospitals remain less likely to undergo immediate breast reconstruction. However, the differences in rates of reconstruction between safety net and non-safety net hospitals have narrowed over time.
AHRQ-funded; HS023313.
Citation: Ballard TNS, Zhong L, Momoh AO .
Improved rates of immediate breast reconstruction at safety net hospitals.
Plast Reconstr Surg 2017 Jul;140(1):1-10. doi: 10.1097/prs.0000000000003412.
.
.
Keywords: Healthcare Cost and Utilization Project (HCUP), Cancer: Breast Cancer, Cancer, Surgery
Aliu O, Zhong L, Chetta MD
Comparing health care resource use between implant and autologous reconstruction of the irradiated breast: a national claims-based assessment.
Nationwide data were used to examine health care resource use associated with implant and autologous reconstruction. Thirty-two percent of implant reconstructions failed, compared with 5 percent of autologous cases. In aggregate, failures constituted more than 20 percent of the cumulative costs of implant reconstruction compared with less than 5 percent for autologous reconstruction.
AHRQ-funded; HS023313.
Citation: Aliu O, Zhong L, Chetta MD .
Comparing health care resource use between implant and autologous reconstruction of the irradiated breast: a national claims-based assessment.
Plast Reconstr Surg 2017 Jun;139(6):1224e-31e. doi: 10.1097/prs.0000000000003336.
.
.
Keywords: Cancer: Breast Cancer, Healthcare Costs, Surgery
Taylor C, Correa C, Duane FK
Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials.
The researchers estimated the absolute long-term risks of modern breast cancer radiotherapy. They concluded that, for long-term smokers, the absolute risks of modern radiotherapy may outweigh the benefits, yet for most nonsmokers (and ex-smokers), the benefits of radiotherapy far outweigh the risks. Hence, smoking can determine the net effect of radiotherapy on mortality, but smoking cessation substantially reduces radiotherapy risk.
AHRQ-funded; HS021681.
Citation: Taylor C, Correa C, Duane FK .
Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials.
J Clin Oncol 2017 May 20;35(15):1641-49. doi: 10.1200/jco.2016.72.0722.
.
.
Keywords: Adverse Events, Cancer: Breast Cancer, Risk, Treatments
Vyas A, Madhavan SS, Sambamoorthi U
Differences in Medicare expenditures between Appalachian and nationally representative cohorts of elderly women with breast cancer: an application of decomposition technique.
The objective of this study was to determine Medicare expenditures during the initial phase of care among women in West Virginia (WV) who were Medicare beneficiaries with BC and compare them with national estimates. It found that the difference in average Medicare expenditures between the elderly beneficiaries with BC from a rural state (WV) and their national counterparts narrowed but remained significantly lower after multivariate adjustment.
AHRQ-funded; HS018622.
Citation: Vyas A, Madhavan SS, Sambamoorthi U .
Differences in Medicare expenditures between Appalachian and nationally representative cohorts of elderly women with breast cancer: an application of decomposition technique.
J Natl Compr Canc Netw 2017 May;15(5):578-87.
.
.
Keywords: Cancer: Breast Cancer, Elderly, Healthcare Costs, Medicare, Rural Health
Inrig SJ, Higashi RT, Tiro JA
Assessing local capacity to expand rural breast cancer screening and patient navigation: an iterative mixed-method tool.
To expand rural breast cancer screening , the researchers proposed a regional hub-and-spoke model, partnering with local providers to expand access across North Texas. Their capacity assessment tool enabled the hub to establish partnerships with county organizations by tailoring support to local capacity and needs.
AHRQ-funded; HS022418.
Citation: Inrig SJ, Higashi RT, Tiro JA .
Assessing local capacity to expand rural breast cancer screening and patient navigation: an iterative mixed-method tool.
Eval Program Plann 2017 Apr;61:113-24. doi: 10.1016/j.evalprogplan.2016.11.006.
.
.
Keywords: Access to Care, Cancer: Breast Cancer, Patient-Centered Healthcare, Rural Health, Screening
Chetta MD, Aliu O, Zhong L
Reconstruction of the irradiated breast: a national claims-based assessment of postoperative morbidity.
This study aims to assess the morbidity associated with various breast reconstruction techniques in irradiated patients. It found that overall complication rates were 45.3 percent and 30.8 percent for patients with implant and autologous reconstruction, respectively. Failure of reconstruction occurred in 29.4 percent of patients with implant reconstruction compared with 4.3 percent of patients with autologous reconstruction.
AHRQ-funded; HS023313.
Citation: Chetta MD, Aliu O, Zhong L .
Reconstruction of the irradiated breast: a national claims-based assessment of postoperative morbidity.
Plast Reconstr Surg 2017 Apr;139(4):783-92. doi: 10.1097/prs.0000000000003168.
.
.
Keywords: Cancer, Cancer: Breast Cancer, Surgery, Adverse Events, Patient-Centered Outcomes Research
Kao CJ, Wurz GT, Lin YC
Repurposing ospemifene for potentiating an antigen-specific immune response.
The overall objective of the present series of preclinical studies was to evaluate the immunomodulatory activity of ospemifene in combination with a peptide cancer vaccine. The authors concluded that, taken together, ospemifene's dose response and schedule-dependent immune modulating activity offers a method of tailoring and augmenting the efficacy of previously failed antigen-specific cancer vaccines for a wide range of malignancies.
AHRQ-funded; HS022236.
Citation: Kao CJ, Wurz GT, Lin YC .
Repurposing ospemifene for potentiating an antigen-specific immune response.
Menopause 2017 Apr;24(4):437-51. doi: 10.1097/gme.0000000000000776.
.
.
Keywords: Cancer: Breast Cancer, Cancer: Lung Cancer, Medication, Vaccination
Dabbous FM, Dolecek TA, Berbaum ML
Impact of a false-positive screening mammogram on subsequent screening behavior and stage at breast cancer diagnosis.
Researchers sought to examine the impact of a false positive (FP) screening mammogram on the subsequent screening mammography behavior. They found that experiencing a FP mammogram increases the risk of late stage at diagnosis compared with prior true negative (TN) mammogram Also, women with a FP mammogram were more likely to delay their subsequent screening compared with women with a TN mammogram.
AHRQ-funded; HS018366.
Citation: Dabbous FM, Dolecek TA, Berbaum ML .
Impact of a false-positive screening mammogram on subsequent screening behavior and stage at breast cancer diagnosis.
Cancer Epidemiol Biomarkers Prev 2017 Mar;26(3):397-403. doi: 10.1158/1055-9965.epi-16-0524.
.
.
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Diagnostic Safety and Quality, Women, Prevention
Harowicz MR, Robinson TJ, Dinan MA
Algorithms for prediction of the Oncotype DX recurrence score using clinicopathologic data: a review and comparison using an independent dataset.
This study analyzed 305 patients with invasive breast cancer who had Oncotype DX recurrence scores (ODX RS) available. Five equations were selected that provide a surrogate measure of ODX by Klein (Magee equations 1-3), Gage et al., and Tang et al. Although commonly available surrogates for ODX appear to predict high-risk ODX RS, the study was unable to reliably rule out the presence of patients with intermediate-risk disease by ODX.
AHRQ-funded; HS022189.
Citation: Harowicz MR, Robinson TJ, Dinan MA .
Algorithms for prediction of the Oncotype DX recurrence score using clinicopathologic data: a review and comparison using an independent dataset.
Breast Cancer Res Treat 2017 Feb;162(1):1-10. doi: 10.1007/s10549-016-4093-4.
.
.
Keywords: Cancer, Cancer: Breast Cancer, Genetics, Women
Farias AJ, Du XL
Association between out-of-pocket costs, race/ethnicity, and adjuvant endocrine therapy adherence among Medicare patients with breast cancer.
This study aimed to determine whether there are racial/ethnic differences in 1-year adherence to adjuvant endocrine therapy (AET) and whether out-of-pocket costs explain the racial/ethnic disparities in adherence. It concluded that racial/ethnic disparities in AET adherence were largely explained by women's differences in socioeconomic status and out-of-pocket medication costs.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Association between out-of-pocket costs, race/ethnicity, and adjuvant endocrine therapy adherence among Medicare patients with breast cancer.
J Clin Oncol 2017 Jan;35(1):86-95.
.
.
Keywords: Cancer: Breast Cancer, Healthcare Costs, Patient Adherence/Compliance, Racial and Ethnic Minorities, Social Determinants of Health
Vyas A, Madhavan S, Sambamoorthi U
Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.
The objective of this study is to determine the association between persistence with mammography screening and stage at breast cancer (BC) diagnosis among elderly women. It found that, as compared to women who were not persistent with mammography screening, women who were persistent with mammography screening were significantly more likely to be diagnosed at earlier stages of BC.
AHRQ-funded; HS018622.
Citation: Vyas A, Madhavan S, Sambamoorthi U .
Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.
Breast Cancer Res Treat 2014 Dec;148(3):645-54. doi: 10.1007/s10549-014-3204-3..
Keywords: Cancer, Cancer: Breast Cancer, Diagnostic Safety and Quality, Elderly, Prevention, Screening, Women
Wheeler SB, Kohler RE, Reeder-Hayes KE
Endocrine therapy initiation among Medicaid-insured breast cancer survivors with hormone receptor-positive tumors.
The researchers sought to characterize endocrine therapy (ET) use in a low-income Medicaid-insured population in North Carolina. They found that, of 222 women meeting the inclusion criteria, only 50 percent filled a prescription for ET. Results suggest substantial underutilization of ET in this population.
AHRQ-funded; HS019468.
Citation: Wheeler SB, Kohler RE, Reeder-Hayes KE .
Endocrine therapy initiation among Medicaid-insured breast cancer survivors with hormone receptor-positive tumors.
J Cancer Surviv 2014 Dec;8(4):603-10. doi: 10.1007/s11764-014-0365-3..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Medicaid, Medication, Patient-Centered Outcomes Research
Wen KY, Hu A, Ma GX
Information and communication needs of Chinese American breast cancer patients: perspectives on survivorship care planning.
The researchers conducted a qualitative study to examine the information and communication needs as well as survivorship care preferences of Chinese American breast cancer survivors. The main themes identified through analysis of interview transcripts were: the need for evidence-based and culturally and linguistically appropriate health information; the role of language or communication barriers and culture in accessing care and communicating with providers; and preferences for care plan elements and format.
AHRQ-funded; HS019001.
Citation: Wen KY, Hu A, Ma GX .
Information and communication needs of Chinese American breast cancer patients: perspectives on survivorship care planning.
J Community Support Oncol 2014 Dec;12(12):439-45. doi: 10.12788/jcso.0095..
Keywords: Cancer: Breast Cancer, Cultural Competence, Clinician-Patient Communication, Racial and Ethnic Minorities
Thompson CA, Gomez SL, Chan A
Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.
The researchers performed multivariable modeling to evaluate potential predictors (at the provider- and patient-level) of screening completion among Asian patients. They concluded that language- and gender-concordant primary care providers and culturally tailored online health resources may help improve preventive cancer screening in Asian patient populations.
AHRQ-funded; HS019815.
Citation: Thompson CA, Gomez SL, Chan A .
Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.
Cancer Epidemiol Biomarkers Prev 2014 Nov;23(11):2208-17. doi: 10.1158/1055-9965.epi-14-0487..
Keywords: Cancer: Breast Cancer, Cancer: Cervical Cancer, Cancer: Colorectal Cancer, Healthcare Utilization, Screening
Vilhauer RP
Computer-mediated and face-to-face communication in metastatic cancer support groups.
This study compared the experiences of women with metastatic breast cancer (MBC) in computer-mediated and face-to-face support groups. Themes examined included convenience, level of support, intimacy, ease of expression, range of information, and dealing with debilitation and dying. Computer-mediated support groups (CMSGs) may provide a sense of control and a greater level of support. Intimacy may take longer to develop in a CMSG, but women may have more opportunities to get to know each other.
AHRQ-funded; HS010565.
Citation: Vilhauer RP .
Computer-mediated and face-to-face communication in metastatic cancer support groups.
Palliat Support Care 2014 Aug;12(4):287-97. doi: 10.1017/s1478951513000126..
Keywords: Cancer: Breast Cancer, Communication, Health Information Technology (HIT)
Davidoff AJ, Gardner LD, Zuckerman IH
AHRQ Author: Davidoff AJ
Validation of disability status, a claims-based measure of functional status for cancer treatment and outcomes studies.
The researchers implemented and validated a disability status (DS) measure in 4 cohorts of cancer patients. They found that the DS measure is a significant independent predictor of cancer-directed treatment, but unobserved factors continue to play a role in determining treatments.
AHRQ-authored.
Citation: Davidoff AJ, Gardner LD, Zuckerman IH .
Validation of disability status, a claims-based measure of functional status for cancer treatment and outcomes studies.
Med Care 2014 Jun;52(6):500-10. doi: 10.1097/mlr.0000000000000122.
.
.
Keywords: Cancer, Cancer: Breast Cancer, Disabilities, Health Status, Cancer: Lung Cancer
Yaghjyan L, Wolin K, Chang SH
Racial disparities in healthy behaviors and cancer screening among breast cancer survivors and women without cancer: National Health Interview Survey 2005.
This study aimed to compare healthy behaviors and cancer screening practices among breast cancer survivors and respondents without cancer separately in Caucasian, African American, and Hispanic women. It found that most differences were suggestive and do not differ by race.
AHRQ-funded; HS022330.
Citation: Yaghjyan L, Wolin K, Chang SH .
Racial disparities in healthy behaviors and cancer screening among breast cancer survivors and women without cancer: National Health Interview Survey 2005.
Cancer Causes Control. 2014 May;25(5):605-14. doi: 10.1007/s10552-014-0365-7..
Keywords: Cancer: Breast Cancer, Cancer, Racial and Ethnic Minorities, Women, Disparities, Screening
Nelson HD, Pappas M, Zakher B
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: a systematic review to update the U.S. Preventive Services Task Force recommendation.
This systematic review was done in support of the U.S. Preventive Services Task Force (USPSTF) updated recommendation on the benefit and harms of risk assessment, genetic testing, and genetic counseling for BRCA-related cancer in women. A systematic review was done on literature from 2004 to July 30, 2013 from MEDLINE, PsycINFO, the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Health Technology Assessment, Scopus, and reference lists. Data on the participants, study design, analysis, follow-up, and results was extracted and a second investigator confirmed key data. The studies were rated on study quality and applicability. The analysis found women with high-risk for breast cancer had decreased risk of breast cancer by 85% to 100% by having a mastectomy, and risk of mortality by 81% to 100% compared to women without surgery. There was also a lower risk of breast and ovarian cancer after having salpingo-oopherectomy surgery.
AHRQ-funded; 290200710057
Citation: Nelson HD, Pappas M, Zakher B .
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: a systematic review to update the U.S. Preventive Services Task Force recommendation.
Ann Intern Med 2014 Feb 18;160(4):255-66. doi: 10.7326/m13-1684..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer: Ovarian Cancer, Cancer, Genetics, Screening, Prevention, Guidelines, Evidence-Based Practice, Women, Risk, Family Health and History
Ezaz G, Long JB, Gross CP
Risk prediction model for heart failure and cardiomyopathy after adjuvant trastuzumab therapy for breast cancer.
The investigators sought to develop a clinical risk score that identifies older women with breast cancer who are at higher risk of heart failure or cardiomyopathy after trastuzumab. That found that a 7-factor risk score was able to stratify 3-year risk of heart failure/cardiomyopathy after trastuzumab between the lowest and highest risk groups by more than 2-fold in a Medicare population.
AHRQ-funded; HS018781.
Citation: Ezaz G, Long JB, Gross CP .
Risk prediction model for heart failure and cardiomyopathy after adjuvant trastuzumab therapy for breast cancer.
J Am Heart Assoc 2014 Feb;3(1):e000472. doi: 10.1161/jaha.113.000472.
.
.
Keywords: Cancer: Breast Cancer, Heart Disease and Health, Medication, Patient Safety, Risk
Pan IW, Smith BD, Shih YC
Factors contributing to underuse of radiation among younger women with breast cancer.
This study explores factors associated with noncompliance of RT among insured young patients. It found that competing demands from child care, especially the presence of a young child in the home, can constitute a barrier to complete guideline-concordant breast cancer therapy.
AHRQ-funded; HS018535.
Citation: Pan IW, Smith BD, Shih YC .
Factors contributing to underuse of radiation among younger women with breast cancer.
J Natl Cancer Inst 2014 Jan;106(1):djt340. doi: 10.1093/jnci/djt340..
Keywords: Cancer: Breast Cancer, Health Insurance, Patient Adherence/Compliance, Surgery, Treatments