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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- (-) Back Health and Pain (26)
- Chronic Conditions (8)
- Comparative Effectiveness (8)
- Data (1)
- Decision Making (1)
- Diagnostic Safety and Quality (2)
- Education: Curriculum (1)
- Elderly (10)
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- Opioids (1)
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- Pain (5)
- Patient-Centered Outcomes Research (10)
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- Patient Experience (1)
- Patient Safety (1)
- Practice Patterns (1)
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- Quality of Life (2)
- Rehabilitation (1)
- Research Methodologies (1)
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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 26 Research Studies DisplayedNayfe R, Chansard M, Hynan LS
Comparison of patient-reported outcomes measurement information system and legacy instruments in multiple domains among older veterans with chronic back pain.
This study evaluated construct (convergent and discriminant) validity and time to complete NIH's Patient Reported Outcomes Measurement Information System (PROMIS) as compared to legacy instruments. Results showed that, given time efficiency of using PROMIS, along with strong construct validity, PROMIS instruments are a practical choice for measuring multidimensional patient-reported outcomes in older Veterans with chronic low back pain for both research and clinical purposes.
AHRQ-funded; HS022418.
Citation: Nayfe R, Chansard M, Hynan LS .
Comparison of patient-reported outcomes measurement information system and legacy instruments in multiple domains among older veterans with chronic back pain.
BMC Musculoskelet Disord 2020 Sep 8;21(1):598. doi: 10.1186/s12891-020-03587-6..
Keywords: Elderly, Back Health and Pain, Pain, Chronic Conditions, Patient-Centered Outcomes Research, Research Methodologies
Rundell SD, Resnik L, Heagerty PJ
Performance of the Functional Comorbidity Index (FCI) in prognostic models for risk adjustment in patients with back pain.
The Functional Comorbidity Index (FCI) is a comorbidity measure associated with physical function and may contribute to risk adjustment models in rehabilitation settings, but an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) of the FCI has not been tested in outpatient settings. The purpose of this cohort study was to examine the ability of an ICD-9-CM- based FCI to predict function, health-related quality of life, and overall health care use.
AHRQ-funded; HS01922201; HS022972.
Citation: Rundell SD, Resnik L, Heagerty PJ .
Performance of the Functional Comorbidity Index (FCI) in prognostic models for risk adjustment in patients with back pain.
Pm r 2020 Sep;12(9):891-98. doi: 10.1002/pmrj.12315..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Quality of Life, Rehabilitation
Rundell SD, Resnik L, Heagerty PJ
Comparing the performance of comorbidity indices in predicting functional status, health-related quality of life, and total health care use in older adults with back pain.
The purpose of this prospective cohort study was to determine how well the functional comorbidity index (FCI) predicted outcomes in older adults with back pain compared to Quan's modification of the Charlson comorbidity index (Quan-Charlson comorbidity index) and the Elixhauser comorbidity index. The investigators concluded that all indices performed similarly in predicting outcomes. The authors indicated that there is still a need to develop better function-based risk-adjustment models that improve prediction of functional outcomes versus standard comorbidity indices.
AHRQ-funded; HS019222; HS022972.
Citation: Rundell SD, Resnik L, Heagerty PJ .
Comparing the performance of comorbidity indices in predicting functional status, health-related quality of life, and total health care use in older adults with back pain.
J Orthop Sports Phys Ther 2020 Mar;50(3):143-48. doi: 10.2519/jospt.2020.8764..
Keywords: Elderly, Back Health and Pain, Pain, Chronic Conditions, Quality of Life, Healthcare Utilization, Health Status
Rundell SD, Gold LS, Hansen RN
Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.
The purpose of this study was to assess if co-morbidity is associated with higher use of back-related care and adherence to back pain guidelines. The investigators found that co-morbidity burden and the presence of specific chronic conditions, such as musculoskeletal conditions, were associated with high long-term use of back-related care and care inconsistent with guidelines.
AHRQ-funded; HS022982.
Citation: Rundell SD, Gold LS, Hansen RN .
Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain.
J Eval Clin Pract 2017 Dec;23(6):1218-26. doi: 10.1111/jep.12763..
Keywords: Back Health and Pain, Guidelines, Health Services Research (HSR), Healthcare Utilization, Patient Adherence/Compliance
Bhise V, Meyer AND, Singh H
Errors in diagnosis of spinal epidural abscesses in the era of electronic health records.
With this study, the investigators set out to identify missed opportunities in diagnosis of spinal epidural abscesses to outline areas for process improvement. The investigators found that despite wide availability of clinical data, errors in diagnosis of spinal epidural abscesses were common and involved inadequate history, physical examination, and test ordering. They suggested that solutions should include renewed attention to basic clinical skills.
AHRQ-funded; HS022087.
Citation: Bhise V, Meyer AND, Singh H .
Errors in diagnosis of spinal epidural abscesses in the era of electronic health records.
Am J Med 2017 Aug;130(8):975-81. doi: 10.1016/j.amjmed.2017.03.009..
Keywords: Adverse Events, Back Health and Pain, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Patient Safety
Makris UE, Alvarez CA, Wei W
Association of statin use with risk of back disorder diagnoses.
Statins may increase vulnerability to myalgias and contribute to the myopathic component often experienced with back pain. This study’s goal was to examine the association of statin use with the risk of back disorder diagnoses. Researchers retrieved health care data for patients enrolled in TRICARE in the San Antonio military area. The overall cohort included 60,455 patients. Two treatment groups were identified: Statin users who recently received a first-time prescription for a statin and had been taking it for 120 days or more; statin non-users who never used statins and current users before they were prescribed statins. The study concludes that statin use is associated with increased likelihood of back disorder diagnoses.
AHRQ-funded; HS022418.
Citation: Makris UE, Alvarez CA, Wei W .
Association of statin use with risk of back disorder diagnoses.
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Keywords: Back Health and Pain, Medication, Pain, Patient-Centered Outcomes Research, Risk
Hanley K, Zabar S, Altshuler L
Opioid vs nonopioid prescribers: variations in care for a standardized acute back pain case.
This paper describes the design and use of an opioid-related unannounced standardized patient case (USP) used in a residency curriculum. Researchers designed and fielded an unannounced standardized patient case involving a patient with acute back pain who requested Vicodin (5/325 mg). They described residents' case management and examined whether their management decisions, including opioid prescribing, were related to their core clinical skills. The case designers found that most Vicodin prescribers did not follow prescribing guidelines, and demonstrated better communication and assessment skills than the nonprescribers. Results suggest the need to guide residents in using a systematic approach to prescribing opioids safely and to develop an acceptable alternative pain management plan when they decide against prescribing.
AHRQ-funded; HS021176.
Citation: Hanley K, Zabar S, Altshuler L .
Opioid vs nonopioid prescribers: variations in care for a standardized acute back pain case.
Subst Abus 2017 Jul-Sep;38(3):324-29. doi: 10.1080/08897077.2017.1319894..
Keywords: Back Health and Pain, Education: Curriculum, Opioids, Practice Patterns
Patel NK, Moses RA, Martin BI
Validation of using claims data to measure safety of lumbar fusion surgery.
The researchers report the accuracy of a claims-based approach for reporting repeat surgery compared with medical records abstraction as the "gold standard." They found that claims-based ascertainment of safety at a single institution was very accurate. However, accuracy depended on careful attention to the timing of outcomes, as well as the definitions and coding of repeat surgery, including how orthopedic device removal codes are classified.
AHRQ-funded; HS021695.
Citation: Patel NK, Moses RA, Martin BI .
Validation of using claims data to measure safety of lumbar fusion surgery.
Spine 2017 May 1;42(9):682-91. doi: 10.1097/brs.0000000000001879.
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Keywords: Adverse Events, Back Health and Pain, Quality Improvement, Outcomes, Surgery
Chou R, Deyo R, Friedly J
Nonpharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guideline.
The researchers systematically reviewed the current evidence on nonpharmacologic therapies for acute or chronic nonradicular or radicular low back pain. They found that several nonpharmacologic therapies for primarily chronic low back pain are associated with small to moderate, usually short-term effects on pain; findings include new evidence on mind-body interventions.
AHRQ-funded; 290201200014I.
Citation: Chou R, Deyo R, Friedly J .
Nonpharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guideline.
Ann Intern Med 2017 Apr 4;166(7):493-505. doi: 10.7326/m16-2459.
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Keywords: Back Health and Pain, Chronic Conditions, Comparative Effectiveness, Outcomes, Evidence-Based Practice
Chou R, Deyo R, Friedly J
Systemic pharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guideline.
The authors reviewed the current evidence on systemic pharmacologic therapies for acute or chronic nonradicular or radicular low back pain. They found that several systemic medications for low back pain are associated with small to moderate, primarily short-term effects on pain. New evidence suggests that acetaminophen is ineffective for acute low back pain, and duloxetine is associated with modest effects for chronic low back pain.
AHRQ-funded; 290201200014I.
Citation: Chou R, Deyo R, Friedly J .
Systemic pharmacologic therapies for low back pain: a systematic review for an American College of Physicians clinical practice guideline.
Ann Intern Med 2017 Apr 4;166(7):480-92. doi: 10.7326/m16-2458.
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Keywords: Back Health and Pain, Medication, Comparative Effectiveness, Outcomes, Evidence-Based Practice
Fritz JM, Kim M, Magel JS
Cost-effectiveness of primary care management with or without early physical therapy for acute low back pain: economic evaluation of a randomized clinical trial.
The objective of this study was to compare costs and cost-effectiveness of usual primary care management for patients with acute low back pain with or without the addition of early physical therapy. The authors suggest that their results support early physical therapy as cost-effective relative to usual primary care after 1 year for patients with acute, nonspecific lower back pain.
AHRQ-funded; HS018672.
Citation: Fritz JM, Kim M, Magel JS .
Cost-effectiveness of primary care management with or without early physical therapy for acute low back pain: economic evaluation of a randomized clinical trial.
Spine 2017 Mar;42(5):285-90. doi: 10.1097/brs.0000000000001729..
Keywords: Back Health and Pain, Healthcare Costs, Pain, Primary Care
Makris UE, Edwards TC, Lavallee DC
Patient priority weighting of the Roland Morris Disability Questionnaire does not change results of the lumbar epidural steroid injections for spinal stenosis trial.
The researchers reevaluated whether outcomes for older adults receiving epidural steroid injections with or without corticosteroid improve after using patient-prioritized Roland-Morris Disability Questionnaire (RDQ) items. Their findings provide additional evidence that epidural injection of corticosteroid + lidocaine offered minimal or no short-term benefit as compared with epidural injection of lidocaine alone for older adults with lumbar spinal stenosis.
AHRQ-funded; HS019222; HS022418.
Citation: Makris UE, Edwards TC, Lavallee DC .
Patient priority weighting of the Roland Morris Disability Questionnaire does not change results of the lumbar epidural steroid injections for spinal stenosis trial.
Spine 2017 Jan;42(1):42-48. doi: 10.1097/brs.0000000000001647.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Elderly, Back Health and Pain, Medication
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
Jarvik JG, Comstock BA, James KT
Lumbar Imaging with Reporting of Epidemiology (LIRE)--protocol for a pragmatic cluster randomized trial.
The researchers will conduct a pragmatic cluster randomized clinical trial to test the hypothesis that inserting data on the prevalence of incidental imaging findings into lumbar spine imaging reports for studies ordered by primary care providers will reduce subsequent spine-related interventions. Their primary outcome will be spine-related intervention intensity based on Relative Value Units (RVUs) during the following year.
AHRQ-funded; HS022982.
Citation: Jarvik JG, Comstock BA, James KT .
Lumbar Imaging with Reporting of Epidemiology (LIRE)--protocol for a pragmatic cluster randomized trial.
Contemp Clin Trials 2015 Nov;45(Pt B):157-63. doi: 10.1016/j.cct.2015.10.003.
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Keywords: Imaging, Back Health and Pain, Patient-Centered Outcomes Research
Fritz JM, Magel JS, McFadden M
Early physical therapy vs usual care in patients with recent-onset low back pain: a randomized clinical trial.
This study evaluated whether early physical therapy (manipulation and exercise) is more effective than usual care in improving disability for patients with LBP fitting a decision rule. It concluded that among adults with recent-onset LBP, early physical therapy resulted in statistically significant improvement in disability, but the improvement was modest and did not achieve the minimum clinically important difference compared with usual care.
AHRQ-funded; HS018672.
Citation: Fritz JM, Magel JS, McFadden M .
Early physical therapy vs usual care in patients with recent-onset low back pain: a randomized clinical trial.
JAMA 2015 Oct 13;314(14):1459-67. doi: 10.1001/jama.2015.11648..
Keywords: Back Health and Pain, Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research
Chou R, Hashimoto R, Friedly J
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
The researchers reviewed evidence on the benefits and harms of epidural corticosteroid injections in adults with radicular low back pain or spinal stenosis of any duration. They concluded that epidural corticosteroid injections for radiculopathy were associated with immediate reductions in pain and function. However, benefits were small and not sustained, and there was no effect on long-term surgery risk.
AHRQ-funded; 290201200014I.
Citation: Chou R, Hashimoto R, Friedly J .
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
Ann Intern Med 2015 Sep 1;163(5):373-81. doi: 10.7326/m15-0934.
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Keywords: Medication, Back Health and Pain, Chronic Conditions, Comparative Effectiveness, Evidence-Based Practice
Suri P, Pashova H, Heagerty PJ
Short-term improvements in disability mediate patient satisfaction after epidural corticosteroid injections for symptomatic lumbar spinal stenosis.
The researchers sought to identify mediators of the effect of lumbar epidural injections of corticosteroid plus lidocaine on patient satisfaction at 6 weeks postinjection in patients with lumbar spinal stenosis. Three-week change in disability was a significant mediator of the effects of lumbar epidural corticosteroid injections on patient satisfaction at 6 weeks, explaining 48 percent to 60 percent of the treatment effect on satisfaction.
AHRQ-funded; HS019222; HS022972.
Citation: Suri P, Pashova H, Heagerty PJ .
Short-term improvements in disability mediate patient satisfaction after epidural corticosteroid injections for symptomatic lumbar spinal stenosis.
Spine 2015 Sep 01;40(17):1363-70. doi: 10.1097/brs.0000000000001000.
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Keywords: Medication, Patient-Centered Outcomes Research, Back Health and Pain, Patient Experience
Deyo RA, Bryan M, Comstock BA
Trajectories of symptoms and function in older adults with low back disorders.
The researchers sought to determine whether there are distinct trajectories of back pain and function among older adults and to identify characteristics that distinguish among patients with substantially different prognoses. They found that, although most patients remained relatively stable over a year, latent class analysis identified small groups with major improvement in pain, function, or both.
AHRQ-funded; HS019222.
Citation: Deyo RA, Bryan M, Comstock BA .
Trajectories of symptoms and function in older adults with low back disorders.
Spine 2015 Sep 1;40(17):1352-62. doi: 10.1097/brs.0000000000000975.
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Keywords: Data, Elderly, Back Health and Pain, Chronic Conditions, Outcomes
Rundell SD, Gellhorn AC, Comstock BA
Clinical outcomes of early and later physical therapist services for older adults with back pain.
The purpose of this study was to compare clinical outcomes of patients receiving early or later PT services with those not receiving PT among older adults presenting to primary care for a new visit for back pain. It found that among older adults early referral to PT resulted in no or minimal differences in pain, function, or health-related quality at 3, 6, or 12 months compared with a matched group that did not receive early PT.
AHRQ-funded; HS019222.
Citation: Rundell SD, Gellhorn AC, Comstock BA .
Clinical outcomes of early and later physical therapist services for older adults with back pain.
Spine J 2015 Aug;15(8):1744-55. doi: 10.1016/j.spinee.2015.04.001..
Keywords: Back Health and Pain, Elderly, Primary Care, Comparative Effectiveness, Patient-Centered Outcomes Research
Skolasky RL, Maggard AM, Li D
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: improvement in rehabilitation engagement and functional outcomes.
This study examined whether a brief motivational interviewing-based health behavior change counseling (HBCC) intervention increased patient participation in physical therapy and/or home exercise programs (HEPs), reduced disability, and improved health status after surgery for degenerative lumbar spinal stenosis. It found that HBCC can improve outcomes after spine surgery through improved rehabilitation participation.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Li D .
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: improvement in rehabilitation engagement and functional outcomes.
Arch Phys Med Rehabil 2015 Jul;96(7):1200-7. doi: 10.1016/j.apmr.2015.03.009..
Keywords: Back Health and Pain, Surgery, Patient Adherence/Compliance
Skolasky RL, Maggard AM, Li D
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: Patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.
This study sought to determine the effect of health behavior change counseling (HBCC) on patient activation and the influence of patient activation on rehabilitation engagement, and to identify common barriers to engagement among individuals undergoing surgery for degenerative lumbar spinal stenosis. It found that the influence of HBCC on rehabilitation engagement was mediated by patient activation. Despite improvements in patient activation, one-third of patients reported low rehabilitation engagement.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Li D .
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: Patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.
Arch Phys Med Rehabil 2015 Jul;96(7):1208-14. doi: 10.1016/j.apmr.2015.02.031..
Keywords: Back Health and Pain, Surgery, Patient Adherence/Compliance
Edwards TC, Lavallee DC, Bauer Z
Problem areas identified as important to older adults with lumbar spinal stenosis.
The purpose of this study was to determine what outcomes are most important to older adults with spinal stenosis and how well frequently used patient-reported outcomes reflect what is most important to them. It found that older adults with spinal stenosis rated problems related to pain and physical function as the most important outcomes to them.
AHRQ-funded; HS022972.
Citation: Edwards TC, Lavallee DC, Bauer Z .
Problem areas identified as important to older adults with lumbar spinal stenosis.
Spine J 2015 Jul;15(7):1636-44. doi: 10.1016/j.spinee.2015.03.008..
Keywords: Elderly, Back Health and Pain, Patient-Centered Outcomes Research
Makris UE, Higashi RT, Marks EG
Ageism, negative attitudes, and competing co-morbidities--why older adults may not seek care for restricting back pain: a qualitative study.
The objective of this study was to understand older adults’ beliefs and perspectives regarding care-seeking for restricting back pain (back pain that restricts activity). Using data from a diverse sample of 93 older adults who reported restricting back pain, it found that illness perceptions (including pain-related beliefs), and interactions with providers may influence older adults’ willingness to seek care for restricting back pain.
AHRQ-funded; HS020648.
Citation: Makris UE, Higashi RT, Marks EG .
Ageism, negative attitudes, and competing co-morbidities--why older adults may not seek care for restricting back pain: a qualitative study.
BMC Geriatr 2015 Apr 8;15:39. doi: 10.1186/s12877-015-0042-z..
Keywords: Elderly, Back Health and Pain, Chronic Conditions
Jarvik JG, Gold LS, Comstock BA
Association of early imaging for back pain with clinical outcomes in older adults.
This study compared function and pain at the 12-month follow-up visit among older adults who received early imaging with those who did not receive early imaging after a new primary care visit for back pain without radiculopathy. It found that early imaging was not associated with better 1-year outcomes. The researchers concluded that the value of early diagnostic imaging in older adults for back pain with radiculopathy is uncertain.
AHRQ-funded; HS019222, HS022972
Citation: Jarvik JG, Gold LS, Comstock BA .
Association of early imaging for back pain with clinical outcomes in older adults.
JAMA. 2015 Mar 17;313(11):1143-53. doi: 10.1001/jama.2015.1871..
Keywords: Back Health and Pain, Elderly, Primary Care, Outcomes, Diagnostic Safety and Quality, Imaging
Rundell SD, Sherman KJ, Heagerty PJ
The clinical course of pain and function in older adults with a new primary care visit for back pain.
This study reports the clinical course of older adults presenting for a new primary care visit for back pain, with no healthcare visit for back pain within the prior 6 months, by describing pain intensity, disability, pain interference, and resolution of back pain over 12 months. It found that improvements in disability and interference with activity over 12 months differed according to age, duration of back pain, symptoms of depression and anxiety, and expectation for recovery.
AHRQ-funded; HS019222.
Citation: Rundell SD, Sherman KJ, Heagerty PJ .
The clinical course of pain and function in older adults with a new primary care visit for back pain.
J Am Geriatr Soc 2015 Mar;63(3):524-30. doi: 10.1111/jgs.13241..
Keywords: Elderly, Primary Care, Back Health and Pain, Comparative Effectiveness, Outcomes