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
1 to 25 of 63 Research Studies DisplayedPress A, Khan S, McCullagh L
Avoiding alert fatigue in pulmonary embolism decision support: a new method to examine 'trigger rates.'
The authors developed a new and innovative usability process named 'sensitivity and specificity trigger analysis' (SSTA) as part of a larger project around a pulmonary embolism decision support tool. They explored a unique methodology, SSTA, used to limit inaccurate triggering of a clinical decision support tool prior to integration into the electronic health record. They concluded that their methodology can be applied to other studies aiming to decrease triggering rates and increase adoption rates of previously validated clinical decision support system tools.
AHRQ-funded; HS022061.
Citation: Press A, Khan S, McCullagh L .
Avoiding alert fatigue in pulmonary embolism decision support: a new method to examine 'trigger rates.'
Evid Based Med 2016 Dec;21(6):203-07. doi: 10.1136/ebmed-2016-110440.
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Keywords: Clinical Decision Support (CDS), Respiratory Conditions, Electronic Health Records (EHRs), Provider: Health Personnel, Patient Safety
Sood A, Petersen H, Qualls C
Spirometric variability in smokers: transitions in COPD diagnosis in a five-year longitudinal study.
The researchers hypothesized that spirometrically-defined chronic obstructive pulmonary disease (COPD) states could undergo beneficial transitions. Their observational study of ever smokers, shows that spirometrically-defined COPD states, may not be uniformly progressive and can improve or resolve over time. The implication of these findings is that the spirometric diagnosis of COPD can be unstable.
AHRQ-funded; HS023093.
Citation: Sood A, Petersen H, Qualls C .
Spirometric variability in smokers: transitions in COPD diagnosis in a five-year longitudinal study.
Respir Res 2016 Nov 10;17(1):147. doi: 10.1186/s12931-016-0468-7.
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Keywords: Tobacco Use, Respiratory Conditions, Patient-Centered Outcomes Research
Murray MT, Heitkempber E, Jackson O
Direct costs of acute respiratory infections in a pediatric long-term care facility.
Acute respiratory tract infections (ARI) are a major burden in pediatric long-term care. The researchers analyzed the financial impact of ARI in 2012-2013. Costs associated with ARI during the respiratory viral season were ten times greater than during the non-respiratory viral season, $31,224 and $3,242 per 1000 patient-days, respectively.
AHRQ-funded; HS021470.
Citation: Murray MT, Heitkempber E, Jackson O .
Direct costs of acute respiratory infections in a pediatric long-term care facility.
Influenza Other Respir Viruses 2016 Jan;10(1):34-6. doi: 10.1111/irv.12350.
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Keywords: Children/Adolescents, Respiratory Conditions, Long-Term Care, Healthcare Costs, Children/Adolescents
Albrecht JS, Park Y, Hur P
Adherence to maintenance medications among older adults with chronic obstructive pulmonary disease. the role of depression.
The objective of this study was to assess the impact of depression on COPD maintenance medication adherence among of Medicare beneficiaries newly diagnosed with COPD. Average monthly adherence to COPD maintenance medications was low, peaking at 57 percent in the month after first fill and decreasing to 35 percent within 6 months. In the adjusted regression model, depression was associated with decreased adherence to COPD maintenance medications.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Park Y, Hur P .
Adherence to maintenance medications among older adults with chronic obstructive pulmonary disease. the role of depression.
Ann Am Thorac Soc 2016 Sep;13(9):1497-504. doi: 10.1513/AnnalsATS.201602-136OC.
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Keywords: Respiratory Conditions, Elderly, Medication, Patient Adherence/Compliance, Depression
Strom MA, Silverberg JI
Asthma, hay fever, and food allergy are associated with caregiver-reported speech disorders in US children.
This study sought to determine whether asthma, hay fever, and food allergy are associated with speech disorder in children and whether disease severity, sleep disturbance, or ADD/ADHD modified such associations. It concluded that childhood asthma, hay fever, and food allergy are associated with increased risk of speech disorder.
AHRQ-funded; HS023011.
Citation: Strom MA, Silverberg JI .
Asthma, hay fever, and food allergy are associated with caregiver-reported speech disorders in US children.
Pediatr Allergy Immunol 2016 Sep;27(6):604-11. doi: 10.1111/pai.12580.
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Keywords: Asthma, Children/Adolescents, Respiratory Conditions
Krishnamurthy Y, Cooper LB, Parikh KS
Pulmonary hypertension in the era of mechanical circulatory support.
The researchers summarized the literature available to highlight the definition, pathogenesis, and prognosis of pulmonary hypertension (PH) due to left heart disease (LHD). Additionally, they discussed the use of mechanical circulatory support (MCS) in this population. Then, they provided recommendations regarding the management and reassessment of PH due to LHD in the specific context of MCS.
AHRQ-funded; HS021092.
Citation: Krishnamurthy Y, Cooper LB, Parikh KS .
Pulmonary hypertension in the era of mechanical circulatory support.
ASAIO J 2016 Sep-Oct;62(5):505-12. doi: 10.1097/mat.0000000000000408.
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Keywords: Comparative Effectiveness, Heart Disease and Health, Medical Devices, Respiratory Conditions
Nishi SP, Zhang W, Kuo YF
Pulmonary rehabilitation utilization in older adults with chronic obstructive pulmonary disease, 2003 to 2012.
The authors assessed the trends in pulmonary rehabilitation (PR) utilization and factors associated with its use in older adults with chronic obstructive pulmonary disease (COPD). They concluded that utilization of PR during the study period increased only 1.1% in these Medicare beneficiaries with COPD and remained low.
AHRQ-funded; HS020642; HS022134.
Citation: Nishi SP, Zhang W, Kuo YF .
Pulmonary rehabilitation utilization in older adults with chronic obstructive pulmonary disease, 2003 to 2012.
J Cardiopulm Rehabil Prev 2016 Sep-Oct;36(5):375-82. doi: 10.1097/hcr.0000000000000194.
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Keywords: Respiratory Conditions, Elderly, Patient-Centered Outcomes Research, Rehabilitation
Ritchie CS, Houston TK, Richman JS
The E-Coach technology-assisted care transition system: a pragmatic randomized trial.
The researchers sought to evaluate the impact of a technology-supported care transition support program (E-Coach) on hospitalizations, days out of the community, and mortality. for patients with congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD). They found that rehospitalization rates did not differ between E-Coach and usual care groups; however, E-Coach was associated with fewer days in the hospital with the COPD subgroup, suggesting that E-Coach may be more beneficial among those with COPD but not those with CHF.
AHRQ-funded; HS017786.
Citation: Ritchie CS, Houston TK, Richman JS .
The E-Coach technology-assisted care transition system: a pragmatic randomized trial.
Transl Behav Med 2016 Sep;6(3):428-37. doi: 10.1007/s13142-016-0422-8.
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Keywords: Respiratory Conditions, Heart Disease and Health, Hospitalization, Patient Self-Management, Telehealth
Mehta AB, Cooke CR, Wiener RS
Hospital variation in early tracheostomy in the United States: a population-based study.
The researchers determined between-hospital variation in early tracheostomy utilization and the association of early tracheostomy with patient outcomes using hierarchical regression. They concluded that early tracheostomy is potentially overused among mechanically ventilated trauma patients, with nearly half of tracheostomies performed within the first week of mechanical ventilation and large unexplained hospital variation, without clear benefits.
AHRQ-funded; HS020672.
Citation: Mehta AB, Cooke CR, Wiener RS .
Hospital variation in early tracheostomy in the United States: a population-based study.
Crit Care Med 2016 Aug;44(8):1506-14. doi: 10.1097/ccm.0000000000001674.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Practice Patterns, Respiratory Conditions, Respiratory Conditions, Outcomes
Gidengil CA, Mehrotra A, Beach S
What drives variation in antibiotic prescribing for acute respiratory infections?
This study sought to identify the underlying factors driving variation in antibiotic prescribing across clinicians and settings. The investigators concluded that poor-quality antibiotic prescribing was associated with feeling rushed, believing less strongly that antibiotics were overused, and believing that patient demand was not an issue, factors that can be assessed and addressed in future interventions.
AHRQ-funded; HS018419.
Citation: Gidengil CA, Mehrotra A, Beach S .
What drives variation in antibiotic prescribing for acute respiratory infections?
J Gen Intern Med 2016 Aug;31(8):918-24. doi: 10.1007/s11606-016-3643-0..
Keywords: Antibiotics, Medication, Respiratory Conditions, Practice Patterns
Sloan CD, Gebretsadik T, Rosas-Salazar C
Seasonal timing of infant bronchiolitis, apnea and sudden unexplained infant death.
The researchers analyzed ecological associations between timing of Sudden Unexplained Infant Death (SUID) cases, bronchiolitis, and apnea healthcare visits. They found a temporal relationship between infant bronchiolitis and apnea, but no peak in SUID cases during peaks of bronchiolitis. They concluded that consistent trends between bronchiolitis, apnea, and SUID were not established due to small numbers of SUID cases.
AHRQ-funded; HS018454.
Citation: Sloan CD, Gebretsadik T, Rosas-Salazar C .
Seasonal timing of infant bronchiolitis, apnea and sudden unexplained infant death.
PLoS One 2016 Jul 12;11(7):e0158521. doi: 10.1371/journal.pone.0158521.
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Keywords: Newborns/Infants, Respiratory Conditions, Mortality
Sjoding MW, Cooke CR, Iwashyna TJ
Acute respiratory distress syndrome measurement error. Potential effect on clinical study results.
This study investigated how the degree of variability in acute respiratory distress syndrome (ARDS) measurement commonly reported in clinical studies affects study power, the accuracy of treatment effect estimates, and the measured strength of risk factor associations. It found that lower reliability measurement of ARDS during patient enrollment in randomized controlled trials seriously degraded study power and effect size estimates of clinical studies.
AHRQ-funded; HS020672.
Citation: Sjoding MW, Cooke CR, Iwashyna TJ .
Acute respiratory distress syndrome measurement error. Potential effect on clinical study results.
Ann Am Thorac Soc 2016 Jul;13(7):1123-8. doi: 10.1513/AnnalsATS.201601-072OC.
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Keywords: Diagnostic Safety and Quality, Research Methodologies, Respiratory Conditions
Muray MT, Jackson O, Cohen B
Impact of infection prevention and control initiatives on acute respiratory infections in a pediatric long-term care facility.
Researchers evaluated the collective impact of several infection prevention and control initiatives aimed at reducing acute respiratory infections (ARIs) in a pediatric long-term care facility. ARIs did not decrease overall, though the proportion of infections associated with outbreaks and average number of cases per outbreak decreased. Influenza rates decreased significantly.
AHRQ-funded; HS021470.
Citation: Muray MT, Jackson O, Cohen B .
Impact of infection prevention and control initiatives on acute respiratory infections in a pediatric long-term care facility.
Infect Control Hosp Epidemiol 2016 Jul;37(7):859-62. doi: 10.1017/ice.2016.73.
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Keywords: Healthcare-Associated Infections (HAIs), Children/Adolescents, Long-Term Care, Prevention, Respiratory Conditions
Brodsky MB, Suiter DM, Gonzalez-Fernandez M
Screening accuracy for aspiration using bedside water swallow tests: a systematic review and meta-analysis.
This study evaluated screening accuracy of bedside water swallow tests used to identify patients at risk for dysphagia-associated aspiration, finding that currently-used tests offer sufficient screening.
AHRQ-funded; HS022331.
Citation: Brodsky MB, Suiter DM, Gonzalez-Fernandez M .
Screening accuracy for aspiration using bedside water swallow tests: a systematic review and meta-analysis.
Chest 2016 Jul;150(1):148-63. doi: 10.1016/j.chest.2016.03.059.
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Keywords: Respiratory Conditions, Diagnostic Safety and Quality, Pneumonia
Ishizuka M, Rangarajan V, Sawyer TL
The development of tracheal intubation proficiency outside the operating suite during pediatric critical care medicine fellowship training: a retrospective cohort study using cumulative sum analysis.
The researchers hypothesized that both overall and first-attempt tracheal intubation success rates by pediatric critical care medicine fellows would improve over the course of training. They found that all fellows who completed 3 years of training during the study period achieved an acceptable 90% overall tracheal intubation success rate. They concluded that further investigations on a larger scale across different training programs are necessary to clarify intensity and duration of the training to achieve tracheal intubation procedural competency.
AHRQ-funded; HS021583; HS022464.
Citation: Ishizuka M, Rangarajan V, Sawyer TL .
The development of tracheal intubation proficiency outside the operating suite during pediatric critical care medicine fellowship training: a retrospective cohort study using cumulative sum analysis.
Pediatr Crit Care Med 2016 Jul;17(7):e309-16. doi: 10.1097/pcc.0000000000000774.
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Keywords: Children/Adolescents, Critical Care, Education: Continuing Medical Education, Children/Adolescents, Respiratory Conditions
Press VG, Arora VM, Trela KC
Effectiveness of interventions to teach metered-dose and diskus inhaler techniques. A randomized trial.
This study evaluated the relative effects of two different educational strategies (teach-to-goal instruction vs. brief verbal instruction) in adults hospitalized with asthma or chronic obstructive pulmonary disease. It concluded that, Acute care events were less common among teach-to-goal participants than brief intervention participants at 30 days (17 percent vs. 36 percent,), but not at 90 days.
AHRQ-funded; HS016967.
Citation: Press VG, Arora VM, Trela KC .
Effectiveness of interventions to teach metered-dose and diskus inhaler techniques. A randomized trial.
Ann Am Thorac Soc 2016 Jun;13(6):816-24. doi: 10.1513/AnnalsATS.201509-603OC.
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Keywords: Asthma, Respiratory Conditions, Comparative Effectiveness, Health Literacy, Medication
Renati S, Linder JA
Necessity of office visits for acute respiratory infections in primary care.
The researchers measured the proportion of primary care acute respiratory infection (ARI) visits that may not require an office visit. They concluded that about two-thirds of primary care ARI visits may not be necessary for appropriate antibiotic management.
AHRQ-funded; HS018419.
Citation: Renati S, Linder JA .
Necessity of office visits for acute respiratory infections in primary care.
Fam Pract 2016 Jun;33(3):312-7. doi: 10.1093/fampra/cmw019.
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Keywords: Decision Making, Medication, Primary Care, Practice Patterns, Respiratory Conditions
Wang RC, Bent S, Weber E
The impact of clinical decision rules on computed tomography use and yield for pulmonary embolism: a systematic review and meta-analysis.
The researchers performed a systematic review of impact analyses on clinical decision rules for pulmonary embolism. They found that among participants with suspected pulmonary embolism, implementation of the Wells criteria was associated with a modest increase in CT angiography yield. They concluded that there is a lack of cluster-randomized trials to confirm the efficacy of clinical decision rules for the diagnosis of pulmonary embolism.
AHRQ-funded; HS021281.
Citation: Wang RC, Bent S, Weber E .
The impact of clinical decision rules on computed tomography use and yield for pulmonary embolism: a systematic review and meta-analysis.
Ann Emerg Med 2016 Jun;67(6):693-701.e3. doi: 10.1016/j.annemergmed.2015.11.005.
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Keywords: Clinical Decision Support (CDS), Decision Making, Imaging, Respiratory Conditions
Thompson CF, Price CP, Huang JH
A pilot study of symptom profiles from a polyp vs an eosinophilic-based classification of chronic rhinosinusitis.
Researchers hypothesized that appropriate chronic rhinosinusitis (CRS) subclassification would increase homogeneity of baseline symptoms, and identify characteristic symptoms of each subtype. They found that subclassifying CRS with symptoms alone is difficult with neither polyp status nor eosinophilia giving a distinctive clinical symptom profile. However, certain symptoms may help otolaryngologists identify CRS subtypes, which may help guide future treatments.
AHRQ-funded; HS023011.
Citation: Thompson CF, Price CP, Huang JH .
A pilot study of symptom profiles from a polyp vs an eosinophilic-based classification of chronic rhinosinusitis.
Int Forum Allergy Rhinol 2016 May;6(5):500-7. doi: 10.1002/alr.21687.
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Keywords: Chronic Conditions, Diagnostic Safety and Quality, Respiratory Conditions
Hasegawa K, Camargo CA, Jr.
Prevalence of blood eosinophilia in hospitalized patients with acute exacerbation of COPD.
In this first study to investigate the prevalence of eosinophilia among inpatients with acute exacerbation of COPD, the authors found that 17% had blood eosinophilia, and that such patients had higher frequency of readmission during a one-year follow-up period.
AHRQ-funded; HS023305.
Citation: Hasegawa K, Camargo CA, Jr. .
Prevalence of blood eosinophilia in hospitalized patients with acute exacerbation of COPD.
Respirology 2016 May;21(4):761-4. doi: 10.1111/resp.12724.
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Keywords: Respiratory Conditions, Elderly, Hospitalization, Outcomes, Hospital Readmissions
Shirley DK, Kaner RJ, Glesby MJ
Screening for chronic obstructive pulmonary disease (COPD) in an urban HIV clinic: a pilot study.
This study aimed to determine the predictive value of a COPD screening strategy validated in the general population and to identify HIV-related factors associated with decreased lung function. It found that questionnaire and peak flow together had low sensitivity, but abnormal peak flow shows potential as a screening tool for COPD in HIV/AIDS. These data suggest that lung function may be influenced by HIV-related factors.
AHRQ-funded; HS000066.
Citation: Shirley DK, Kaner RJ, Glesby MJ .
Screening for chronic obstructive pulmonary disease (COPD) in an urban HIV clinic: a pilot study.
AIDS Patient Care STDS 2015 May;29(5):232-9. doi: 10.1089/apc.2014.0265..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Chronic Conditions, Respiratory Conditions, Urban Health
Iyer AS, Dransfield MT
Serum eosinophils as a COPD biomarker: ready for prime time?
The authors discuss a study by Watz showing a robust association between the withdrawal of inhaled corticosteroids and an increased risk of moderate-to-severe acute exacerbations of chronic obstructive pulmonary disease (COPD) in patients with relatively high baseline serum eosinophil counts. They argue that, when combined with similar findings from other recent reports, serum eosinophils as a COPD biomarker are ready for prime time use.
AHRQ-funded; HS013852.
Citation: Iyer AS, Dransfield MT .
Serum eosinophils as a COPD biomarker: ready for prime time?
Lancet Respir Med 2016 May;4(5):341-3. doi: 10.1016/s2213-2600(16)30040-6.
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Keywords: Respiratory Conditions, Medication
Lee JH, Turner DA, Kamat P
The number of tracheal intubation attempts matters! A prospective multi-institutional pediatric observational study.
The objective of this study is to determine the association between number of tracheal intubation (TI) attempts and severe desaturation (SpO2 < 70 percent) and adverse TI associated events (TIAEs). It found that the number of TI attempts was associated with desaturations and increased occurrence of TIAEs in critically ill children with acute respiratory failure.
AHRQ-funded; HS021583; HS022464.
Citation: Lee JH, Turner DA, Kamat P .
The number of tracheal intubation attempts matters! A prospective multi-institutional pediatric observational study.
BMC Pediatr 2016 Apr 29;16:58. doi: 10.1186/s12887-016-0593-y.
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Keywords: Adverse Events, Children/Adolescents, Respiratory Conditions, Patient Safety, Children/Adolescents
Gidengil CA, Linder JA, Beach S
Using clinical vignettes to assess quality of care for acute respiratory infections.
Overprescribing of antibiotics for acute respiratory infections (ARIs) is common. The objective of this study was to develop and validate a vignette-based method to estimate clinician ARI antibiotic prescribing. The researchers concluded that responses to 3 clinical vignettes can identify clinicians with relatively poor quality ARI antibiotic prescribing. Vignettes may be a mechanism to target clinicians for quality improvement efforts.
AHRQ-funded; HS018419.
Citation: Gidengil CA, Linder JA, Beach S .
Using clinical vignettes to assess quality of care for acute respiratory infections.
Inquiry 2016 Apr 20;53:pii: 0046958016636531. doi: 10.1177/0046958016636531..
Keywords: Antibiotics, Antimicrobial Stewardship, Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Medication, Practice Patterns, Primary Care, Quality of Care, Respiratory Conditions
Singh G, Zhang W, Kuo YF
Association of psychological disorders with 30-day readmission rates in patients with COPD.
Using a 5 percent sample of Medicare beneficiaries, the researchers examined the association of psychological disorders such as depression, anxiety, psychosis, alcohol abuse and drug abuse with early readmission for patients with COPD. They found that psychological disorders like depression, anxiety, psychosis, alcohol abuse and drug abuse are independently associated with higher all-cause 30-day readmission rates for Medicare beneficiaries with COPD.
AHRQ-funded; HS020642; HS022134.
Citation: Singh G, Zhang W, Kuo YF .
Association of psychological disorders with 30-day readmission rates in patients with COPD.
Chest 2016 Apr;149(4):905-15. doi: 10.1378/chest.15-0449..
Keywords: Behavioral Health, Hospital Readmissions, Medicare, Respiratory Conditions