National Healthcare Quality and Disparities Report
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Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Cancer (2)
- Cancer: Breast Cancer (1)
- Cardiovascular Conditions (1)
- Evidence-Based Practice (3)
- (-) Guidelines (6)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Utilization (1)
- Opioids (1)
- Pneumonia (1)
- Practice Patterns (2)
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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 6 of 6 Research Studies DisplayedEhlers AP, Vitous CA, Sales A
Exploration of factors associated with surgeon deviation from practice guidelines for management of inguinal hernias.
Investigators explored factors associated with surgeon choice of approach (minimally invasive vs open) in inguinal hernia repair as a tool to gain an understanding of guideline-discordant care. They found that decision-making for the approach to inguinal hernia repair was largely influenced by surgeon preference and access to resources rather than patient factors. Although a one-size-fits-all approach is not recommended, the operative approach should ideally be informed by patient factors, including hernia characteristics. They recommended addressing surgeon preference and available resources with a clinician-facing decision aid to provide an opportunity to optimize care for patients undergoing inguinal hernia repair.
AHRQ-funded; HS025778.
Citation: Ehlers AP, Vitous CA, Sales A .
Exploration of factors associated with surgeon deviation from practice guidelines for management of inguinal hernias.
JAMA Netw Open 2020 Nov 2;3(11):e2023684. doi: 10.1001/jamanetworkopen.2020.23684..
Keywords: Surgery, Guidelines, Provider: Physician, Provider, Shared Decision Making, Evidence-Based Practice
Strobel RJ, Harrington SD, Hill C
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Pneumonia is the most prevalent healthcare-associated infection after coronary artery bypass grafting (CABG), but the relative effectiveness of strategies to reduce its incidence remains unclear. In this study, the investigators evaluated the relationship between healthcare-associated infection recommendations and risk of pneumonia after CABG. These pneumonia prevention recommendations may serve as effective targets for avoiding postoperative healthcare-associated infections.
AHRQ-funded; HS022535; HS022909.
Citation: Strobel RJ, Harrington SD, Hill C .
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Ann Thorac Surg 2020 Sep;110(3):903-10. doi: 10.1016/j.athoracsur.2019.12.053..
Keywords: Pneumonia, Cardiovascular Conditions, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Prevention, Evidence-Based Practice, Guidelines, Risk
Smith ME, Vitous CA, Hughes TM
Barriers and facilitators to de-implementation of the Choosing Wisely((R)) guidelines for low-value breast cancer surgery.
The objective of this study was to understand why surgeons stop performing certain unnecessary cancer operations but not others and how best to de-implement entrenched and emerging unnecessary procedures. The investigators concluded that with a growing focus on the elimination of ineffective, unproven or low value practices, it is imperative that the behavioral determinants are understood and targeted with specific interventions to decrease utilization rapidly.
AHRQ-funded; HS026030.
Citation: Smith ME, Vitous CA, Hughes TM .
Barriers and facilitators to de-implementation of the Choosing Wisely((R)) guidelines for low-value breast cancer surgery.
Ann Surg Oncol 2020 Aug;27(8):2653-63. doi: 10.1245/s10434-020-08285-0..
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Shared Decision Making, Guidelines, Women
Howard R, Waljee J, Brummett C
Reduction in opioid prescribing through evidence-based prescribing guidelines.
The authors evaluated the effect of evidence-based postoperative prescribing guidelines in an effort to reduce overprescribing. The post-intervention group received opioid prescriptions for reduced dosages compared to the pre-intervention group. In the post-intervention group, 2.5% requested refills compared with 4.1% in the pre-intervention group. The authors indicated that this work will be used as a template for statewide practice transformation, which may serve as a platform for other states.
AHRQ-funded; HS023313.
Citation: Howard R, Waljee J, Brummett C .
Reduction in opioid prescribing through evidence-based prescribing guidelines.
JAMA Surg 2018 Mar;153(3):285-87. doi: 10.1001/jamasurg.2017.4436.
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Keywords: Evidence-Based Practice, Guidelines, Opioids, Practice Patterns, Surgery
Krell RW, Reames BN, Hendren S
Surgical referral for colorectal liver metastases: a population-based survey.
The researchers sought to understand medical oncologists’ perspectives on referral for colorectal liver metastases (CLM). They found wide variation in surgical referral patterns for CLM. Many felt that bilobar disease and tumor size were contraindications to liver-directed therapy despite a lack of supporting data.
AHRQ-funded; HS020937.
Citation: Krell RW, Reames BN, Hendren S .
Surgical referral for colorectal liver metastases: a population-based survey.
Ann Surg Oncol 2015 Jul;22(7):2179-94. doi: 10.1245/s10434-014-4318-x..
Keywords: Cancer, Surgery, Guidelines, Practice Patterns
Kerr EA, Chen J, Sussman JB
Stress testing before low-risk surgery: so many recommendations, so little overuse.
The researchers sought to determine the prevalence of cardiac stress testing before low-risk surgeries, prior to commencement of a campaign to reduce routine stress testing, in order to estimate the potential effect of the campaign on future use of resources. Their study of VA and Medicare patients found that the use of routine preoperative stress testing before low-risk surgeries was very low, suggesting that interventions to further decrease testing would minimally improve quality.
AHRQ-funded; HS018781
Citation: Kerr EA, Chen J, Sussman JB .
Stress testing before low-risk surgery: so many recommendations, so little overuse.
JAMA Intern Med. 2015 Apr;175(4):645-7. doi: 10.1001/jamainternmed.2014.7877..
Keywords: Shared Decision Making, Guidelines, Quality of Care, Healthcare Utilization, Surgery