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
151 to 175 of 1430 Research Studies DisplayedYi H, Xiao T, Thomas PS
Barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools.
The investigators identified barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. They found that barriers barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and that facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool.
AHRQ-funded; HS019313.
Citation: Yi H, Xiao T, Thomas PS .
Barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools.
AMIA Annu Symp Proc 2015 Nov 5;2015:1352-60.
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Keywords: Cancer: Breast Cancer, Decision Making, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Clinician-Patient Communication
Eschler J, Liu LS, Vizer LM
Designing asynchronous communication tools for optimization of patient-clinician coordination.
The authors elicited narratives about patients' experiences and expectations for using asynchronous communication to address medical issues with their clinicians. They then presented opportunities for designing asynchronous communication tools to better facilitate understanding of and coordination around care activities between patients and clinicians.
AHRQ-funded; HS021590.
Citation: Eschler J, Liu LS, Vizer LM .
Designing asynchronous communication tools for optimization of patient-clinician coordination.
AMIA Annu Symp Proc 2015 Nov 5;2015:543-52.
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Keywords: Chronic Conditions, Health Information Technology (HIT), Patient Experience, Clinician-Patient Communication, Web-Based
Zhang R, Manohar N, Arsoniadis E
Evaluating term coverage of herbal and dietary supplements in electronic health records.
Some supplements can interact with prescription medications, potentially leading to clinically important and potentially preventable adverse reactions. Clinical notes and corresponding medication lists from an integrated healthcare system were extracted and compared with online databases. The authors found that, overall, about 40% of listed medications are supplements, most of which are included in medication lists as nutritional or miscellaneous products. They found gaps between supplement and standard medication terminologies and identified supplements which were not mentioned in the medication lists.
AHRQ-funded; HS022085.
Citation: Zhang R, Manohar N, Arsoniadis E .
Evaluating term coverage of herbal and dietary supplements in electronic health records.
AMIA Annu Symp Proc 2015 Nov 5;2015:1361-70.
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Keywords: Adverse Drug Events (ADE), Data, Electronic Health Records (EHRs), Medication, Vitamins and Supplements
Mohan V, Scholl G, Gold JA
Intelligent simulation model to facilitate EHR training.
The authors proposed Six Principles that are EHR-agnostic and provide the framework for the development of an intelligent simulation model that can optimize EHR training by replicating real-world clinical conditions and appropriate cognitive loads.
AHRQ-funded; HS021637.
Citation: Mohan V, Scholl G, Gold JA .
Intelligent simulation model to facilitate EHR training.
AMIA Annu Symp Proc 2015 Nov 5;2015:925-32.
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Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Patient Safety, Training, Electronic Health Records (EHRs)
Dykes PC, Stade D, Dalal A
Strategies for managing mobile devices for use by hospitalized inpatients.
The authors implemented the PROSPECT (Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication and Technology) project at Brigham and Women's Hospital. The goal of PROSPECT is to transform the hospital environment by providing a suite of e-tools to facilitate teamwork. In this paper, the authors described decisions and challenges faced and related the strategies used and lessons learned.
AHRQ-funded; HS023535.
Citation: Dykes PC, Stade D, Dalal A .
Strategies for managing mobile devices for use by hospitalized inpatients.
AMIA Annu Symp Proc 2015 Nov 5;2015:522-31.
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Keywords: Communication, Inpatient Care, Patient and Family Engagement, Patient Safety, Teams
O'Leary K, Vizer L, Eschler J
Understanding patients' health and technology attitudes for tailoring self-management interventions.
The researchers elicited attitudes toward technology use and participation in care of 40 participants in a maximum variation sample. They found three participant clusters-"Proactive Techies," "Indie Self-Managers," and "Remind Me! Non-Techies"-that represent varying attitudes toward health behaviors and technologies that were independent of race, education level, and age. Their approach provides insight into how people prioritize important values related to health participation and technology.
AHRQ-funded; HS021590.
Citation: O'Leary K, Vizer L, Eschler J .
Understanding patients' health and technology attitudes for tailoring self-management interventions.
AMIA Annu Symp Proc 2015 Nov 5;2015:991-1000.
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Keywords: Chronic Conditions, Health Information Technology (HIT), Patient and Family Engagement, Clinician-Patient Communication
Cutting EM, Overby CL, Banchero M
Using workflow modeling to identify areas to improve genetic test processes in the University of Maryland Translational Pharmacogenomics Project.
The researchers used information gained from focus groups in order to illustrate the current process of delivering genetic test results to clinicians. They proposed a business process model and notation (BPMN) representation of this process for a Translational Pharmacogenomics Project being implemented at the University of Maryland Medical Center. They found that the current process could be improved to reduce input errors, better inform and notify clinicians about the implications of certain genetic tests, and make results more easily understood. They demonstrated theiruse of BPMN to improve this important clinical process for CYP2C19 genetic testing.
AHRQ-funded; HS023390.
Citation: Cutting EM, Overby CL, Banchero M .
Using workflow modeling to identify areas to improve genetic test processes in the University of Maryland Translational Pharmacogenomics Project.
AMIA Annu Symp Proc 2015 Nov 5;2015:466-74.
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Keywords: Genetics, Diagnostic Safety and Quality, Medication, Workflow, Quality Improvement, Quality of Care, Organizational Change
Whittle HJ, Palar K, Napoles T
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
The researchers investigated the perceived effects of food insecurity on risky sexual behaviors among a population of low-income people living with HIV/AIDS (PLHIV) in San Francisco and Alameda County, California. Their study demonstrated that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among men who have sex with men.
AHRQ-funded; HS000046.
Citation: Whittle HJ, Palar K, Napoles T .
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
J Int AIDS Soc 2015 Nov 4;18:20293. doi: 10.7448/ias.18.1.20293..
Keywords: Human Immunodeficiency Virus (HIV), Nutrition, Lifestyle Changes, Low-Income, Social Determinants of Health
Melnick ER
How to make less more: empathy can fill the gap left by reducing unnecessary care.
The author argues that regardless of how overuse of medical services is curtailed, it must be replaced with empathic care. Empathy in patient care is the “cognitive attribute that involves an understanding of patients’ experiences, concerns, and perspectives combined with a capacity to communicate this understanding. Empathic engagement with patients has many benefits. Patients who are engaged by their clinician feel more informed, and more accurately understand the potential benefits and harms of appropriate clinical options.
AHRQ-funded; HS021271.
Citation: Melnick ER .
How to make less more: empathy can fill the gap left by reducing unnecessary care.
BMJ 2015 Nov 4;351:h5831. doi: 10.1136/bmj.h5831..
Keywords: Clinician-Patient Communication, Patient Safety, Patient Experience
Sanghavi P, Jena Newhouse, JP
Outcomes of basic versus advanced life support for out-of-hospital medical emergencies.
The researchers compared outcomes after advanced life support (ALS) and basic life support (BLS) in out-of-hospital medical emergencies. They found that advanced life support is associated with substantially higher mortality for several acute medical emergencies than BLS.
AHRQ-funded; HS022798.
Citation: Sanghavi P, Jena Newhouse, JP .
Outcomes of basic versus advanced life support for out-of-hospital medical emergencies.
Ann Intern Med 2015 Nov 3;163(9):681-90. doi: 10.7326/m15-0557..
Keywords: Elderly, Medicare, Emergency Medical Services (EMS), Outcomes
Spatz ES, Curry LA, Masoudi FA
The variation in recovery: role of gender on outcomes of young AMI Patients (VIRGO) classification system: a taxonomy for young women with acute myocardial infarction.
The authors developed a novel taxonomy among adults up to age 55 with acute myocardial infarction (AMI) enrolled in the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study. They found that approximately 1 in 8 young women with AMI is unclassified by the Universal Definition of MI. They proposed a more inclusive taxonomy that could serve as a framework for understanding biological disease mechanisms, therapeutic efficacy, and prognosis in this population.
AHRQ-funded; HS023000.
Citation: Spatz ES, Curry LA, Masoudi FA .
The variation in recovery: role of gender on outcomes of young AMI Patients (VIRGO) classification system: a taxonomy for young women with acute myocardial infarction.
Circulation 2015 Nov 3;132(18):1710-8. doi: 10.1161/circulationaha.115.016502.
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Keywords: Diagnostic Safety and Quality, Heart Disease and Health, Sex Factors
Storch EA, Salloum A, King MA
A randomized controlled trial in community mental health centers of computer-assisted cognitive behavioral therapy versus treatment as usual for children with anxiety.
This study aimed to examine the real-world effectiveness of a computer-assisted cognitive behavioral therapy (CBT) protocol relative to treatment as usual (TAU) among anxious children presenting at community mental health centers. It found that relative to TAU, computer-assisted CBT was associated with greater reductions in parent-rated child impairment and internalizing symptoms, but not child-rated impairment and anxiety and depressive symptoms.
AHRQ-funded; HS018665.
Citation: Storch EA, Salloum A, King MA .
A randomized controlled trial in community mental health centers of computer-assisted cognitive behavioral therapy versus treatment as usual for children with anxiety.
Depress Anxiety 2015 Nov;32(11):843-52. doi: 10.1002/da.22399.
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Keywords: Anxiety, Children/Adolescents, Health Information Technology (HIT), Community-Based Practice, Patient-Centered Outcomes Research
Meeker D, Jiang X, Matheny ME
A system to build distributed multivariate models and manage disparate data sharing policies: implementation in the scalable national network for effectiveness research.
The authors’ objective was to implement infrastructure that supports the functionality of some existing research networks (e.g., cohort discovery, workflow management, and estimation of multivariate analytic models on centralized data) while adding additional important new features. They were able to implement massively parallel (map-reduce) computation methods and a new policy management system to enable each study initiated by network participants to define the ways in which data may be processed, managed, queried, and shared.
AHRQ-funded; HS019913.
Citation: Meeker D, Jiang X, Matheny ME .
A system to build distributed multivariate models and manage disparate data sharing policies: implementation in the scalable national network for effectiveness research.
J Am Med Inform Assoc 2015 Nov;22(6):1187-95. doi: 10.1093/jamia/ocv017..
Keywords: Communication, Comparative Effectiveness, Data, Health Information Technology (HIT), Policy, Research Methodologies
Zhou M, Chang HY, Segal JB
Adherence to a novel oral anticoagulant among patients with atrial fibrillation.
The researchers examined adherence and persistence to dabigatran among adults with atrial fibrillation. Among those using dabigatran alone (n = 2,713), 41 percent were nonadherent with therapy, and 32 percent had gaps of 60 days or greater. Among those observed for 9 months who used dabigatran alone, rates of nonadherence were 47 percent, whereas 48 percent discontinued therapy during follow-up.
AHRQ-funded; HS018960.
Citation: Zhou M, Chang HY, Segal JB .
Adherence to a novel oral anticoagulant among patients with atrial fibrillation.
J Manag Care Spec Pharm 2015 Nov;21(11):1054-62. doi: 10.18553/jmcp.2015.21.11.1054.
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Keywords: Blood Thinners, Patient Adherence/Compliance, Heart Disease and Health, Cardiovascular Conditions, Medication
Sutkowi-Hemstreet A, Vu M, Harris R
Adult patients' perspectives on the benefits and harms of overused screening tests: a qualitative study.
This study determined how patients think about the harms and benefits of overused screening tests and how they consider these and other factors when making decisions. It found that many patients could not name a harm of screening. When they did name harms, patients often focused on only the harms of the screening test itself and rarely mentioned harms further along the screening cascade.
AHRQ-funded; HS021133.
Citation: Sutkowi-Hemstreet A, Vu M, Harris R .
Adult patients' perspectives on the benefits and harms of overused screening tests: a qualitative study.
J Gen Intern Med 2015 Nov;30(11):1618-26. doi: 10.1007/s11606-015-3283-9.
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Keywords: Prevention, Screening, Patient Experience, Elderly, Education: Patient and Caregiver
El-Shami K, Oeffinger KC, Erb NL
American Cancer Society colorectal cancer survivorship care guidelines.
Communication and coordination of care between the treating oncologist and the primary care clinician is critical to effectively and efficiently manage the long-term care of colorectal cancer (CRC) survivors. The guidelines in this article are intended to assist primary care clinicians in delivering risk-based health care for CRC survivors who have completed active therapy.
AHRQ-funded; HS020937.
Citation: El-Shami K, Oeffinger KC, Erb NL .
American Cancer Society colorectal cancer survivorship care guidelines.
CA Cancer J Clin 2015 Nov-Dec;65(6):428-55. doi: 10.3322/caac.21286.
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Keywords: Cancer, Cancer: Colorectal Cancer, Care Coordination, Guidelines, Primary Care
Yamada NK, Yaeger KA, Halamek LP
Analysis and classification of errors made by teams during neonatal resuscitation.
This study was performed to determine and characterize common deviations from The Neonatal Resuscitation Program (NRP) algorithm during neonatal resuscitation. It concluded that errors of commission, especially when performing advanced life support interventions such as positive pressure ventilation, intubation, and chest compressions, are common during neonatal resuscitation and are sources of potential harm.
AHRQ-funded; HS012022.
Citation: Yamada NK, Yaeger KA, Halamek LP .
Analysis and classification of errors made by teams during neonatal resuscitation.
Resuscitation 2015 Nov;96:109-13. doi: 10.1016/j.resuscitation.2015.07.048.
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Keywords: Medical Errors, Newborns/Infants, Newborns/Infants, Guidelines
Dinan MA, Mi X, Reed SD
Association between use of the 21-gene recurrence score assay and receipt of chemotherapy among Medicare beneficiaries with early-stage breast cancer, 2005-2009.
The researchers examined whether adoption of the 21-Gene Recurrence Score (RS) assay in a nationally representative sample of patients with early-stage breast cancer was associated with use of chemotherapy. They found that the impact of the adoption of the RS assay on receipt of chemotherapy was strongly population dependent and was associated with relatively lower chemotherapy use in groups with high-risk disease and relatively higher chemotherapy use in patients with low-risk disease.
AHRQ-funded; HS022189.
Citation: Dinan MA, Mi X, Reed SD .
Association between use of the 21-gene recurrence score assay and receipt of chemotherapy among Medicare beneficiaries with early-stage breast cancer, 2005-2009.
JAMA Oncol 2015 Nov 1;1(8):1098-109. doi: 10.1001/jamaoncol.2015.2722..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Genetics, Medicare, Women
Goyal A, de Lemos JA, Peng SA
Association of patient enrollment in Medicare Part D with outcomes after acute myocardial infarction.
The researchers investigated whether enrollment versus nonenrollment in Medicare's prescription drug plan (Part D) is associated with better outcomes after acute myocardial infarction (AMI). They found that only half of Medicare-insured patients with AMI were enrolled in Part D by hospital discharge, and their 30-day and 1-year adjusted outcomes did not differ substantially from nonenrollees.
AHRQ-funded; HS021092.
Citation: Goyal A, de Lemos JA, Peng SA .
Association of patient enrollment in Medicare Part D with outcomes after acute myocardial infarction.
Circ Cardiovasc Qual Outcomes 2015 Nov;8(6):567-75. doi: 10.1161/circoutcomes.115.001650.
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Keywords: Heart Disease and Health, Medicare, Patient-Centered Outcomes Research, Medication, Patient Adherence/Compliance
Robinson JC, Brown TT, Whaley C
Association of reference payment for colonoscopy with consumer choices, insurer spending, and procedural complications.
The researchers ascertained the effect of reference payment on facility choice, insurer spending, consumer cost sharing, and procedural complications for colonoscopy. They concluded that Implementation of reference payment for colonoscopy was associated with reduced spending and no change in complications.
AHRQ-funded; HS022098.
Citation: Robinson JC, Brown TT, Whaley C .
Association of reference payment for colonoscopy with consumer choices, insurer spending, and procedural complications.
JAMA Intern Med 2015 Nov;175(11):1783-9. doi: 10.1001/jamainternmed.2015.4588..
Keywords: Colonoscopy, Healthcare Costs, Adverse Events, Health Insurance
Anderson GF, Ballreich J, Bleich S
Attributes common to programs that successfully treat high-need, high-cost individuals.
The authors identified 8 attributes common to programs that successfully treat high-need, high-cost individuals. They then illustrated these attributes with specific examples.
AHRQ-funded; HS000029.
Citation: Anderson GF, Ballreich J, Bleich S .
Attributes common to programs that successfully treat high-need, high-cost individuals.
Am J Manag Care 2015 Nov;21(11):e597-600.
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Keywords: Healthcare Costs, Patient-Centered Healthcare
Pezzin LE, Pollak RA, Schone BS
AHRQ Author: Schone BS
Bargaining power, parental caregiving, and intergenerational coresidence.
The researchers examined the effect of changes in parent–child coresidence on caregiving decisions of non-resident siblings over a 5-year period while controlling for characteristics of the elderly parent and adult children in the family network. They found that find that children whose parent and sibling begin coresiding during the study period are less likely to provide care and provide fewer hours of care than children whose parents never coresided with a child.
AHRQ-authored.
Citation: Pezzin LE, Pollak RA, Schone BS .
Bargaining power, parental caregiving, and intergenerational coresidence.
J Gerontol B Psychol Sci Soc Sci 2015 Nov;70(6):969-80. doi: 10.1093/geronb/gbu079..
Keywords: Caregiving, Elderly
Wolfe H, Maltese MR, Niles DE
Blood pressure directed booster trainings improve intensive care unit provider retention of excellent cardiopulmonary resuscitation skills.
The authors incorporated arterial blood pressure (ABP) tracings into Booster Trainings, hypothesizing that ABP-directed CPR Booster Trainings would improve intensive care unit (ICU) provider 3-month retention of excellent CPR skills without need for interval retraining. They found that the ABP-directed CPR booster trainings improved ICU provider 3-month retention of excellent CPR skills without the need for interval retraining.
AHRQ-funded; HS022469; HS022464.
Citation: Wolfe H, Maltese MR, Niles DE .
Blood pressure directed booster trainings improve intensive care unit provider retention of excellent cardiopulmonary resuscitation skills.
Pediatr Emerg Care 2015 Nov;31(11):743-7. doi: 10.1097/pec.0000000000000394.
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Keywords: Blood Pressure, Education: Continuing Medical Education, Intensive Care Unit (ICU), Patient Safety, Training
Crandall CJ, Hovey KM, Andrews CA
Bone mineral density as a predictor of subsequent wrist fractures: findings from the Women's Health Initiative Study.
This paper's objective was to examine associations between the Fracture Risk Assessment Tool (FRAX)-predicted risk of major osteoporotic fracture (MOF), bone mineral density (BMD), BMD change, and wrist fracture. Results showed that lumbar spine and femoral neck BMDs were associated with incident wrist fracture, but the FRAX threshold recommended to identify screening candidates did not identify the majority of women who subsequently experienced wrist fracture.
AHRQ-funded; HS023009.
Citation: Crandall CJ, Hovey KM, Andrews CA .
Bone mineral density as a predictor of subsequent wrist fractures: findings from the Women's Health Initiative Study.
J Clin Endocrinol Metab 2015 Nov;100(11):4315-24. doi: 10.1210/jc.2015-2568.
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Keywords: Injuries and Wounds, Osteoporosis, Risk, Women
Turner JA, Comstock BA, Standaert CJ
Can patient characteristics predict benefit from epidural corticosteroid injections for lumbar spinal stenosis symptoms?
The study’s aim was to identify patient characteristics associated with benefits from epidural injections of corticosteroid with lidocaine versus epidural injections of lidocaine only for lumbar spinal stenosis symptoms. It found that among 21 baseline patient characteristics examined, none, including clinician rated spinal stenosis severity, were consistent predictors of benefit from epidural injections of lidocain corticosteroid versus lidocaine only.
AHRQ-funded; HS019222; HS022972.
Citation: Turner JA, Comstock BA, Standaert CJ .
Can patient characteristics predict benefit from epidural corticosteroid injections for lumbar spinal stenosis symptoms?
Spine J 2015 Nov;15(11):2319-31. doi: 10.1016/j.spinee.2015.06.050..
Keywords: Patient-Centered Outcomes Research, Decision Making, Medication, Back Health and Pain, Chronic Conditions