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
126 to 150 of 1430 Research Studies DisplayedHajizadeh N, Uhler LM, Perez Figueroa RE
Understanding patients' and doctors' attitudes about shared decision making for advance care planning.
The authors sought to gain general insights into the current practice of shared decision making (SDM) and attitudes about patient involvement, and also to gain specific insights into experience with, and attitudes about, SDM for advance care planning. They found that patients were generally open to having end-of-life discussions with their doctors, although their openness sometimes depended on the circumstance. Doctors reported engaging in end-of-life treatment decisions with their patients, although they expressed the need for conversations to take place earlier, in advance of acute illness.
AHRQ-funded; HS022061; HS019473.
Citation: Hajizadeh N, Uhler LM, Perez Figueroa RE .
Understanding patients' and doctors' attitudes about shared decision making for advance care planning.
Health Expect 2015 Dec;18(6):2054-65. doi: 10.1111/hex.12285.
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Keywords: Clinician-Patient Communication, Decision Making, Patient and Family Engagement, Patient-Centered Healthcare
Amarnath AL, Franks P, Robbins JA
Underuse and overuse of osteoporosis screening in a regional health system: a retrospective cohort study.
The researchers aimed to determine the extent to which dual-energy x-ray absorptiometry (DXA) screening is used in accordance with USPSTF recommendations within a regional health system. They concluded that DXA screening was underused in women at increased fracture risk, including women age 65 and over. Meanwhile, DXA screening was common among women at low fracture risk, such as younger women without osteoporosis risk factors.
AHRQ-funded; HS022236.
Citation: Amarnath AL, Franks P, Robbins JA .
Underuse and overuse of osteoporosis screening in a regional health system: a retrospective cohort study.
J Gen Intern Med 2015 Dec;30(12):1733-40. doi: 10.1007/s11606-015-3349-8.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Osteoporosis, Healthcare Utilization, Risk
Strope SA, Vetter J, Elliott S
Use of medical therapy and success of laser surgery and transurethral resection of the prostate for benign prostatic hyperplasia.
To assess the impact of surgery for benign prostatic hyperplasia (BPH) on use of medication (5-alpha reductase inhibitors, alpha blockers, antispasmodics), the researchers assessed preoperative and postoperative medication utilization among surgically treated men. They found that most patients experience durable improvement after surgical intervention for BPH. However, their results show a need for effective patient counseling about continued or new use of medical therapy after laser and TURP procedures.
AHRQ-funded; HS019455.
Citation: Strope SA, Vetter J, Elliott S .
Use of medical therapy and success of laser surgery and transurethral resection of the prostate for benign prostatic hyperplasia.
Urology 2015 Dec;86(6):1115-22. doi: 10.1016/j.urology.2015.07.019..
Keywords: Surgery, Medication, Patient-Centered Outcomes Research, Men's Health
Rhodes W, Olsho LE, Ward AS
AHRQ Author: Spector WD
https://link.springer.com/article/10.1007/s10742-015-0138-0
Use of Monte Carlo simulation to inform design decisions for pairwise cluster randomization.
This paper demonstrates the utility of the Monte Carlo approach in the context of a planned evaluation of an intervention to reduce falls among nursing home residents and provides recommendations for researchers on key design questions, including the choice between cluster randomization and pairwise cluster randomization, and selection of parametric or nonparametric estimators.
AHRQ-authored; AHRQ-funded; 290201000031I.
Citation: Rhodes W, Olsho LE, Ward AS .
Use of Monte Carlo simulation to inform design decisions for pairwise cluster randomization.
Health Serv Outcomes Res Method (2015) 15: 182-203. https://doi.org/10.1007/s10742-015-0138-0..
Keywords: Nursing Homes, Research Methodologies, Falls
Panahiazar M, Taslimitehrani V, Pereira NL
Using EHRs for heart failure therapy recommendation using multidimensional patient similarity analytics.
The authors developed a multidimensional patient similarity assessment technique that leverages multiple types of information from the electronic health records and predicts a medication plan for each new patient based on prior knowledge and data from similar patients.Their findings suggest that it is feasible to harness population-based information for an individual patient-specific assessment.
AHRQ-funded; HS023077.
Citation: Panahiazar M, Taslimitehrani V, Pereira NL .
Using EHRs for heart failure therapy recommendation using multidimensional patient similarity analytics.
Stud Health Technol Inform 2015;210:369-73.
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Keywords: Clinical Decision Support (CDS), Data, Electronic Health Records (EHRs), Heart Disease and Health, Patient-Centered Healthcare
Schlesinger M, Grob R, Shaller D
Using patient-reported information to improve clinical practice.
The purposes of this study were to assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. It concluded that unless public policies are attentive to patients' perspectives, stronger financial incentives for clinicians can threaten aspects of care that patients most value.
AHRQ-funded.
Citation: Schlesinger M, Grob R, Shaller D .
Using patient-reported information to improve clinical practice.
Health Serv Res 2015 Dec;50 Suppl 2:2116-54. doi: 10.1111/1475-6773.12420.
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Keywords: Quality Improvement, Quality of Care, Patient Experience, Provider Performance, Policy, Payment, Public Reporting
Jones AL, Cochran SD, Leibowitz A
Usual primary care provider characteristics of a patient-centered medical home and mental health service use.
This study sought to examine qualities of a usual provider that align with the patient-centered medical home (PCMH) goals of access, comprehensiveness, and patient-centered care, It concluded that access to a usual provider is associated with increased receipt of needed mental health services. Patients who have a usual provider with PCMH qualities are more likely to receive mental health counseling.
AHRQ-funded; HS021721.
Citation: Jones AL, Cochran SD, Leibowitz A .
Usual primary care provider characteristics of a patient-centered medical home and mental health service use.
J Gen Intern Med 2015 Dec;30(12):1828-36. doi: 10.1007/s11606-015-3417-0.
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Keywords: Patient-Centered Healthcare, Behavioral Health, Primary Care
Grenda TR, Pradarelli JC, Thumma JR
Variation in hospital episode costs with bariatric surgery.
This study examined hospital variation in episode costs for a common high-risk procedure that is a prime candidate for bundled payment programs (ie, bariatric surgery). It found that mean total payments for bariatric procedures varied from $11,086 to $13,073 per episode of care, resulting in a mean difference of $1,987 (16.5 percent difference) per episode of care between the lowest and highest hospital quartiles.
AHRQ-funded; HS000053.
Citation: Grenda TR, Pradarelli JC, Thumma JR .
Variation in hospital episode costs with bariatric surgery.
JAMA Surg 2015 Dec;150(12):1109-15. doi: 10.1001/jamasurg.2015.2394.
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Keywords: Surgery, Obesity, Healthcare Costs
Okafor NG, Doshi PB, Miller SK
Voluntary medical incident reporting tool to improve physician reporting of medical errors in an emergency department.
A web-based, password-protected tool was developed by members of a quality assurance committee for ED providers to report incidents that they believe could impact patient safety. The researchers found that the utilization of this system in one residency program with two academic sites resulted in an increase from 81 reported incidents in 2009, the first year of use, to 561 reported incidents in 2012.
AHRQ-funded; HS017586.
Citation: Okafor NG, Doshi PB, Miller SK .
Voluntary medical incident reporting tool to improve physician reporting of medical errors in an emergency department.
West J Emerg Med 2015 Dec;16(7):1073-8. doi: 10.5811/westjem.2015.8.27390.
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Keywords: Emergency Department, Adverse Events, Medical Errors, Patient Safety, Public Reporting, Quality of Care
Easter JS, Haukoos JS, Meehan WP
Will neuroimaging reveal a severe intracranial injury in this adult with minor head trauma?: The rational clinical examination systematic review.
The study objective was to assess systematically the accuracy of symptoms and signs in adults with minor head trauma in order to identify those with severe intracranial injuries. It found that combinations of history and physical examination features in clinical decision rules can identify patients with minor head trauma at low risk of severe intracranial injuries.
AHRQ-funded; HS017526.
Citation: Easter JS, Haukoos JS, Meehan WP .
Will neuroimaging reveal a severe intracranial injury in this adult with minor head trauma?: The rational clinical examination systematic review.
JAMA 2015 Dec 22-29;314(24):2672-81. doi: 10.1001/jama.2015.16316..
Keywords: Falls, Brain Injury, Imaging, Trauma, Diagnostic Safety and Quality
Cristea AI, Ackerman VL, Swigonski NL
Physiologic findings in children previously ventilator dependent at home due to bronchopulmonary dysplasia.
Bronchopulmonary dysplasia (BPD) is the primary respiratory complication of premature birth. Little is known about spirometric indices in patients with severe BPD who were previously ventilator dependent at home. The study concluded that extreme prematurity associated with severe BPD requiring home ventilator support carries significant risks of morbidity. These patients had substantially diminished respiratory function reflecting airflow abnormalities that remained static over time.
AHRQ-funded; HS017588.
Citation: Cristea AI, Ackerman VL, Swigonski NL .
Physiologic findings in children previously ventilator dependent at home due to bronchopulmonary dysplasia.
Pediatr Pulmonol 2015 Nov;50(11):1113-8. doi: 10.1002/ppul.23129.
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Keywords: Children/Adolescents, Newborns/Infants, Newborns/Infants, Respiratory Conditions
Islam R, Weir CR, Jones M
Understanding complex clinical reasoning in infectious diseases for improving clinical decision support design.
The purpose of the study was to examine the constituents of decision complexity and explore the cognitive strategies clinicians use to control and adapt to their information environment. The following three themes emerged as the constituents of decision complexity experienced by the Infectious Diseases experts: 1) the overall clinical picture does not match the pattern, 2) a lack of comprehension of the situation and 3) dealing with social and emotional pressures such as fear and anxiety.
AHRQ-funded; HS023349.
Citation: Islam R, Weir CR, Jones M .
Understanding complex clinical reasoning in infectious diseases for improving clinical decision support design.
BMC Med Inform Decis Mak 2015 Nov 30;15:101. doi: 10.1186/s12911-015-0221-z.
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Keywords: Clinical Decision Support (CDS), Health Services Research (HSR), Practice Patterns
Lee YJ, Boden-Albala B, Jia H
The association between online health information-seeking behaviors and health behaviors among Hispanics in New York City: a community-based cross-sectional study.
The specific aim of this study was to examine the association between online health information-seeking behaviors and health behaviors (physical activity, fruit and vegetable consumption, alcohol use, and hypertension medication adherence) among Hispanics. It concluded that given the promising, although modest, associations between online health information-seeking behaviors and some health behaviors, efforts are needed to improve Hispanics' ability to access and understand health information.
AHRQ-funded; HS022961; HS019853.
Citation: Lee YJ, Boden-Albala B, Jia H .
The association between online health information-seeking behaviors and health behaviors among Hispanics in New York City: a community-based cross-sectional study.
J Med Internet Res 2015 Nov 26;17(11):e261. doi: 10.2196/jmir.4368.
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Keywords: Education: Patient and Caregiver, Web-Based, Telehealth, Patient Adherence/Compliance, Racial and Ethnic Minorities
Kerber KA, Meurer WJ, Brown DL
Stroke risk stratification in acute dizziness presentations: a prospective imaging-based study.
The researchers estimated the ability of bedside information to risk stratify stroke in acute dizziness presentations. They found that in acute dizziness presentations, the combination of ABCD(2) score, general neurologic examination, and a specialized ocular motor examination has the capacity to risk-stratify acute stroke on MRI.
AHRQ-funded; HS018334; HS017690; HS022258.
Citation: Kerber KA, Meurer WJ, Brown DL .
Stroke risk stratification in acute dizziness presentations: a prospective imaging-based study.
Neurology 2015 Nov 24;85(21):1869-78. doi: 10.1212/wnl.0000000000002141..
Keywords: Stroke, Risk, Healthcare Utilization, Decision Making
Chopra V, Saint S
Vascular catheter infections: time to get technical.
Combining technical and socioadaptive factors within a bundle of best practices has substantially reduced catheter-related bloodstream infections in the past decade, but which elements of this bundle are most responsible for reducing catheter infections? Although a key technical solution should become the standard of care to prevent vascular catheter infections, the authors recommended getting even more technical to prevent other health-care-associated infections.
AHRQ-funded; HS022835.
Citation: Chopra V, Saint S .
Vascular catheter infections: time to get technical.
Lancet 2015 Nov 21;386(10008):2034-36. doi: 10.1016/s0140-6736(15)00245-7.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Michelson KA, Ho T, Pelletier A
A mobile, collaborative, real time task list for inpatient environments.
The researchers created a mobile, collaborative, real-time task list application on the iOS platform. They then described their experience designing and piloting the application with an inpatient pediatric ward team at an academic pediatric hospital. They found that physicians preferred the immediacy and familiarity of paper, and did not experience an efficiency benefit when using the electronic tasklist.
AHRQ-funded; HS000063.
Citation: Michelson KA, Ho T, Pelletier A .
A mobile, collaborative, real time task list for inpatient environments.
Appl Clin Inform 2015 Nov 18;6(4):677-83. doi: 10.4338/aci-2015-05-cr-0050.
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Keywords: Care Management, Communication, Health Information Technology (HIT), Inpatient Care, Health Information Technology (HIT)
Desai NR, Bradley SM, Parzynski CS
Appropriate use criteria for coronary revascularization and trends in utilization, patient selection, and appropriateness of percutaneous coronary intervention.
The researchers examined trends in percutaneous coronary intervention (PCI) utilization, patient selection, and procedural appropriateness following the introduction of Appropriate Use Criteria. They concluded that there have been significant reductions in the volume of nonacute PCI. The proportion of nonacute PCIs classified as inappropriate has declined, although hospital-level variation in inappropriate PCI persists.
AHRQ-funded; HS023000.
Citation: Desai NR, Bradley SM, Parzynski CS .
Appropriate use criteria for coronary revascularization and trends in utilization, patient selection, and appropriateness of percutaneous coronary intervention.
JAMA 2015 Nov 17;314(19):2045-53. doi: 10.1001/jama.2015.13764.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Healthcare Utilization
Miligkos M, Bannuru RR, Alkofide H
Leukotriene-receptor antagonists versus placebo in the treatment of asthma in adults and adolescents: a systematic review and meta-analysis.
The purpose of this study was to determine the benefits and harms of leukotriene-receptor antagonists (LTRAs) as monotherapy or in combination with inhaled corticosteroids compared with placebo in adults and adolescents with asthma. It found that leukotriene-receptor antagonists as monotherapy improved asthma control compared with placebo, but which patients are most likely to respond to treatment with LTRAs remains unclear.
AHRQ-funded; HS021396.
Citation: Miligkos M, Bannuru RR, Alkofide H .
Leukotriene-receptor antagonists versus placebo in the treatment of asthma in adults and adolescents: a systematic review and meta-analysis.
Ann Intern Med 2015 Nov 17;163(10):756-67. doi: 10.7326/m15-1059.
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Keywords: Asthma, Children/Adolescents, Medication, Comparative Effectiveness
Kohler RE, Goyal RK, Lich KH
Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program.
The objective of this study was to examine health care utilization and expenditures as a function of patient-centered medical home (PCMH) enrollment among breast cancer patients in North Carolina’s Medicaid program. It found that PCMH enrollment was significantly associated with greater outpatient service use, but there was no difference in the probability of inpatient hospitalizations or ED visits.
AHRQ-funded; HS019468.
Citation: Kohler RE, Goyal RK, Lich KH .
Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program.
Cancer 2015 Nov 15;121(22):3975-81. doi: 10.1002/cncr.29596..
Keywords: Cancer, Cancer: Breast Cancer, Healthcare Utilization, Medicaid, Patient-Centered Healthcare
Yaghi S, Herber C, Willey JZ
Itemized NIHSS subsets predict positive MRI strokes in patients with mild deficits.
The researchers' aim was to identify predictors of MRI-positive stroke from the itemized NIHSS. They concluded that NIHSS score subsets predict diffusion-weighted imaging positivity in mild strokes, and the presence of neglect or visual field deficits on the NIHSS subsets is most likely to have an MRI correlate even in patients with low NIHSS.
AHRQ-funded; HS013852.
Citation: Yaghi S, Herber C, Willey JZ .
Itemized NIHSS subsets predict positive MRI strokes in patients with mild deficits.
J Neurol Sci 2015 Nov 15;358(1-2):221-5. doi: 10.1016/j.jns.2015.08.1548.
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Keywords: Diagnostic Safety and Quality, Imaging, Stroke
Potosky AL, O'Neill SC, Isaacs C
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
The authors evaluated the relation between gene expression profiling (GEP) testing and the use of adjuvant chemotherapy by women treated in a general oncology practice. They found that adjuvant chemotherapy use after GEP testing is generally consistent with the recommended test interpretation for women with a high or low predicted risk of recurrence. Chemotherapy use in the intermediate-risk group increased with Recurrence Score values, and evidence from ongoing randomized trials may help to clarify whether this finding reflects optimal interpretation of GEP test results.
AHRQ-funded; HS022915.
Citation: Potosky AL, O'Neill SC, Isaacs C .
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
Cancer 2015 Nov 15;121(22):4062-70. doi: 10.1002/cncr.29621.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Decision Making, Genetics, Practice Patterns, Women
Lee KC, Payne CB
AHRQ Author: Lee KC
Screening for speech and language delay and disorders in children five years and younger.
This case study involves a two-year-old girl presenting for a well-child visit. The three multiple choice questions concern risk factors and interventions for children with language delays and disorders.
AHRQ-authored.
Citation: Lee KC, Payne CB .
Screening for speech and language delay and disorders in children five years and younger.
Am Fam Physician 2015 Nov 15;92(10):923-4.
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Keywords: Case Study, Children/Adolescents, Evidence-Based Practice, Screening, U.S. Preventive Services Task Force (USPSTF)
Weiner BJ, Pignone MP, DuBard CA
Advancing heart health in North Carolina primary care: the Heart Health NOW study protocol.
The objective of Heart Health NOW (HHN) is to determine if primary care practice support a comprehensive evidence-based quality improvement strategy involving practice facilitation, academic detailing, technology support, and regional learning collaboratives—accelerates widespread dissemination and implementation of evidence-based guidelines for cardiovascular disease (CVD) prevention in small- to medium-sized primary care practices.
AHRQ-funded; HS023912.
Citation: Weiner BJ, Pignone MP, DuBard CA .
Advancing heart health in North Carolina primary care: the Heart Health NOW study protocol.
Implement Sci 2015 Nov 14;10:160. doi: 10.1186/s13012-015-0348-4..
Keywords: Cardiovascular Conditions, Evidence-Based Practice, Prevention, Primary Care
Curtis JR, Sarsour K, Napalkov P
Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor alpha agents, a retrospective cohort study.
Interstitial lung disease (ILD) is a common extra-articular condition in rheumatoid arthritis (RA), but few studies have systematically investigated its incidence and risk factors in patients receiving anti-tumor necrosis factor-alpha (anti-TNFα) agents or alternate mechanisms of action (MOAs). After examining 13,795 episodes of biologic exposure in 11,219 patients, researchers found no significant differences in the risk of ILD and its related complications between RA patients receiving anti-TNFα agents and those receiving alternate MOA agents.
AHRQ-funded; HS018517.
Citation: Curtis JR, Sarsour K, Napalkov P .
Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor alpha agents, a retrospective cohort study.
Arthritis Res Ther 2015 Nov 11;17:319. doi: 10.1186/s13075-015-0835-7..
Keywords: Arthritis, Comparative Effectiveness, Medication, Respiratory Conditions, Risk
Cooper LB, Hammill BG, Peterson ED
Consistency of laboratory monitoring during initiation of mineralocorticoid receptor antagonist therapy in patients with heart failure.
No large studies have examined whether laboratory monitoring occurs routinely in community practice. The researchers observed low rates of monitoring in clinical practice: after initiation of mineralocorticoid receptor antagonist therapy in a large cohort, only 1,384 patients (13.3 percent) and 3,122 patients (29.9 percent) received appropriate testing in early and extended follow-up, respectively.
AHRQ-funded; HS021092.
Citation: Cooper LB, Hammill BG, Peterson ED .
Consistency of laboratory monitoring during initiation of mineralocorticoid receptor antagonist therapy in patients with heart failure.
JAMA 2015 Nov 10;314(18):1973-5. doi: 10.1001/jama.2015.11904..
Keywords: Heart Disease and Health, Cardiovascular Conditions