National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (2)
- Blood Clots (1)
- Cancer (18)
- Cancer: Breast Cancer (2)
- (-) Cancer: Colorectal Cancer (23)
- Cancer: Lung Cancer (2)
- Cancer: Prostate Cancer (2)
- Cardiovascular Conditions (1)
- Care Coordination (1)
- Colonoscopy (4)
- Cultural Competence (1)
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- Diagnostic Safety and Quality (4)
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- Disparities (1)
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- Evidence-Based Practice (1)
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- Health Information Technology (HIT) (1)
- Health Insurance (1)
- Health Literacy (1)
- Health Promotion (1)
- Health Services Research (HSR) (1)
- Hospital Discharge (1)
- Low-Income (1)
- Medicaid (1)
- Medicare (2)
- Medication (1)
- Pain (1)
- Patient-Centered Outcomes Research (4)
- Patient Adherence/Compliance (3)
- Payment (1)
- Policy (1)
- Prevention (5)
- Primary Care (2)
- Quality Improvement (2)
- Quality of Care (2)
- Quality of Life (1)
- Racial and Ethnic Minorities (2)
- Risk (4)
- Screening (8)
- Surgery (5)
- Transitions of Care (1)
- Women (1)
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 23 of 23 Research Studies DisplayedShah SC, Itzkowitz SH
Reappraising risk factors for inflammatory bowel disease-associated neoplasia: implications for colonoscopic surveillance in IBD.
One of the most feared complications of inflammatory bowel disease [IBD]-associated colitis is colorectal cancer. An opportunity for early detection is being missed in a group that is overlooked as high-risk, as a substantial proportion of colorectal cancers are being diagnosed in individuals with colonic IBD who have disease duration shorter than when guidelines recommend surveillance initiation. In this study, the investigators discuss a viewpoint that supports a paradigm shift that will ideally result in a more effective and higher-value colorectal cancer prevention approach in IBD.
AHRQ-funded; HS026395.
Citation: Shah SC, Itzkowitz SH .
Reappraising risk factors for inflammatory bowel disease-associated neoplasia: implications for colonoscopic surveillance in IBD.
J Crohns Colitis 2020 Sep 7;14(8):1172-77. doi: 10.1093/ecco-jcc/jjaa040..
Keywords: Digestive Disease and Health, Risk, Cancer: Colorectal Cancer, Cancer, Colonoscopy, Prevention, Diagnostic Safety and Quality, Screening
Radhakrishnan A, Reyes-Gastelum D, Gay B
Primary care provider involvement in thyroid cancer survivorship care.
While prior research has examined how primary care providers (PCPs) can care for breast and colon cancer survivors, little is known about their role in thyroid cancer survivorship. The purpose of this study was to understand PCP involvement and confidence in thyroid cancer survivorship care. The investigators found that while PCPs reported being involved in long-term surveillance, gaps remained in their confidence in handling survivorship care. They indicated that thyroid cancer survivorship guidelines that delineate PCP roles present one opportunity to increase confidence about their participation.
AHRQ-funded; HS024512.
Citation: Radhakrishnan A, Reyes-Gastelum D, Gay B .
Primary care provider involvement in thyroid cancer survivorship care.
J Clin Endocrinol Metab 2020 Sep;105(9):e3300-6. doi: 10.1210/clinem/dgaa437..
Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer, Primary Care
Nelson HD, Cantor A, Wagner J
Effectiveness of patient navigation to increase cancer screening in populations adversely affected by health disparities: a meta-analysis.
This study evaluated the effectiveness of patient navigation to increase screening for colorectal, breast, and cervical cancer in populations adversely affected by health care disparities. Two of the investigators independently abstracted study data and assessed study quality and applicability using criteria adapted from the USPSTF. Findings indicated that, in populations adversely affected by disparities, colorectal, breast, and cervical cancer screening rates were higher in patients provided navigation services.
AHRQ-funded; 290201500009I.
Citation: Nelson HD, Cantor A, Wagner J .
Effectiveness of patient navigation to increase cancer screening in populations adversely affected by health disparities: a meta-analysis.
J Gen Intern Med 2020 Jul 22;35(10):3026-35. doi: 10.1007/s11606-020-06020-9..
Keywords: Cancer, Disparities, Cancer: Colorectal Cancer, Screening, Prevention, Women, Health Promotion
Kanters AE, Vu JV, Schuman AD AE, Vu JV, Schuman AD
Completeness of operative reports for rectal cancer surgery.
This study examined the completeness of operative reports for rectal cancer surgery and whether they contain the key elements recommended by the National Accreditation Program for Rectal Cancer. Ten hospitals in Michigan submitted rectal cancer operative reports from June-December 2018. These reports were analyzed for completeness and to identify key elements in the synoptic operative template. Out of 110 reports, 31 contained all 24 elements and they all used a synoptic template. Overall, 62 reported used a synoptic template and 48 did not.
AHRQ-funded; HS000053.
Citation: Kanters AE, Vu JV, Schuman AD AE, Vu JV, Schuman AD .
Completeness of operative reports for rectal cancer surgery.
Am J Surg 2020 Jul;220(1):165-69. doi: 10.1016/j.amjsurg.2019.09.036..
Keywords: Cancer: Colorectal Cancer, Cancer, Surgery, Quality Improvement, Quality of Care
Mahmoud R, Shah SC, Torres J
Association between indefinite dysplasia and advanced neoplasia in patients with inflammatory bowel diseases undergoing surveillance.
Little is known about the clinical significance of indefinite dysplasia (IND) in patients with inflammatory bowel diseases (IBD) undergoing colonoscopic surveillance for colorectal neoplasia. The investigators conducted a retrospective cohort analysis from 2001 through 2017. They concluded that patients with IBD undergoing colorectal neoplasia surveillance with consistent histopathologic grading of dysplasia, IND was independently associated with a significant increase in risk of advanced colorectal neoplasia.
AHRQ-funded; HS026395.
Citation: Mahmoud R, Shah SC, Torres J .
Association between indefinite dysplasia and advanced neoplasia in patients with inflammatory bowel diseases undergoing surveillance.
Clin Gastroenterol Hepatol 2020 Jun;18(7):1518-27.e3. doi: 10.1016/j.cgh.2019.08.032..
Keywords: Cancer: Colorectal Cancer, Cancer, Digestive Disease and Health
De Roo AC, Morris AM, Vu JV
Characteristics of patients seeking second opinions at a multidisciplinary colorectal cancer clinic.
The purpose of this study was to describe the patient and treatment characteristics of patients seeking initial and second opinions in colorectal cancer care at a multidisciplinary colorectal cancer clinic. Findings showed that patients seeking a second opinion represent a unique subset of patients with colorectal cancer. In general, they are younger and more likely to have stage IV or recurrent disease than patients seeking an initial opinion. Although transfer of care to a multidisciplinary colorectal cancer clinic after second opinion is lower than for initial consultations, multidisciplinary colorectal cancer clinics provide an important role for patients with complex disease characteristics and treatment needs.
AHRQ-funded; HS000053.https://www.pubmed.ncbi.nlm.nih.gov/32109918
Citation: De Roo AC, Morris AM, Vu JV .
Characteristics of patients seeking second opinions at a multidisciplinary colorectal cancer clinic.
Dis Colon Rectum 2020 Jun;63(6):788-95. doi: 10.1097/dcr.0000000000001647..
Keywords: Cancer: Colorectal Cancer, Cancer, Transitions of Care
Davis SN, Wischhusen JW, Sutton SK
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
This study examined the frequency of limited health literacy and demographic and psychosocial factors associated with limited health literacy in a sample of older black Americans. The participants enrolled in a community-based intervention to promote colorectal cancer screening and completed baseline surveys that assessed their health literacy using the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test, CRC awareness, cancer fatalism, Preventive Health Model (PHM) constructs, and demographics. Findings showed that limited health literacy was associated with multiple complex factors. Recommendations include interventions to incorporate patient health literacy and low-literacy materials that can be delivered through multiple channels.
AHRQ-funded; HS026120.
Citation: Davis SN, Wischhusen JW, Sutton SK .
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
Patient Educ Couns 2020 Feb;103(2):385-91. doi: 10.1016/j.pec.2019.08.026..
Keywords: Health Literacy, Racial and Ethnic Minorities, Elderly, Screening, Cancer: Colorectal Cancer, Cancer, Prevention
Takvorian SU, Oganisian A, Mamtani R
Association of Medicaid expansion under the Affordable Care Act with insurance status, cancer stage, and timely treatment among patients with breast, colon, and lung cancer.
The effect of the Patient Protection and Affordable Care Act's Medicaid expansion on cancer care delivery and outcomes is unknown. Patients with cancer are a high-risk group for whom treatment delays are particularly detrimental. The objective of this study was to examine the association between Medicaid expansion and changes in insurance status, stage at diagnosis, and timely treatment among patients with incident breast, colon, and non-small cell lung cancer.
AHRQ-funded; HS026116.
Citation: Takvorian SU, Oganisian A, Mamtani R .
Association of Medicaid expansion under the Affordable Care Act with insurance status, cancer stage, and timely treatment among patients with breast, colon, and lung cancer.
JAMA Netw Open 2020 Feb 5;3(2):e1921653. doi: 10.1001/jamanetworkopen.2019.21653.
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Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer, Health Insurance, Medicaid, Policy, Health Services Research (HSR)
Murphy CC, Sen A, Watson B
A systematic review of repeat fecal occult blood tests for colorectal cancer screening.
This systematic review examined the prevalence of repeat fecal occult blood tests (FOBT) for colorectal cancer screening. MEDLINE, Embase, and the Cochrane Library were searched for studies published from 1997 to 2017 and reported repeat FOBT over 2 and more screening rounds. Thirty-five articles (n=27) were identified which measured repeat FOBT as 1) proportion of Round 1 participants completing repeat FOBT in Round 2; 2) proportion completing two, consecutive FOBTs; or 3) proportion completing 3 or more rounds. The number of participants completing Round 1 ranged from 24.6% to 89.6%. Those who completed Round 2 ranged from 16.4% to 80%; and completion of 3 or more rounds ranged from 0.8% to 64.1%. Repeat FOBT was higher in mailed outreach than opportunistic screening.
AHRQ-funded; HS022418.
Citation: Murphy CC, Sen A, Watson B .
A systematic review of repeat fecal occult blood tests for colorectal cancer screening.
Cancer Epidemiol Biomarkers Prev 2020 Feb;29(2):278-87. doi: 10.1158/1055-9965.Epi-19-0775..
Keywords: Cancer: Colorectal Cancer, Cancer, Screening, Diagnostic Safety and Quality, Prevention, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Evidence-Based Practice
De Roo AC, Li Y, Abrahamse PH
Long-term functional decline after high-risk elective colorectal surgery in older adults.
This study examined the long-term risks of functional decline after elective colorectal surgery in older adults. This retrospective matched cohort study used data from the Health and Retirement Study, a nationally representative, longitudinal survey of adults >50 years of age. This survey collected data on functional status, cognition, and demographics, among other topics. The survey was linked with Medicare claims and National Death Index data from 1992 to 2012 and used patients 65 years and older. Surgery patients did experience a greater likelihood of functional decline with or without complications compared to control subjects. The older the patient, the more likelihood of a functional decline occurring after surgery.
AHRQ-funded; HS000053.
Citation: De Roo AC, Li Y, Abrahamse PH .
Long-term functional decline after high-risk elective colorectal surgery in older adults.
Dis Colon Rectum 2020 Jan;63(1):75-83. doi: 10.1097/dcr.0000000000001541..
Keywords: Elderly, Cancer: Colorectal Cancer, Cancer, Surgery, Adverse Events, Risk
Schlick CJR, Liu JY, Yang AD
Pre-operative, intra-operative, and post-operative factors associated with post-discharge venous thromboembolism following colorectal cancer resection.
Venous thromboembolism (VTE) is the most common preventable cause of 30-day post-operative mortality, with many events occurring after hospital discharge. High-level evidence supports post-discharge VTE chemoprophylaxis following abdominal/pelvic cancer resection; however, some studies support a more tailored approach. The objectives of this study were to (1) identify risk factors associated with post-discharge VTE in a large cohort of patients undergoing colorectal cancer resection and (2) develop a post-discharge VTE risk calculator.
AHRQ-funded; HS024516; HS026385.
Citation: Schlick CJR, Liu JY, Yang AD .
Pre-operative, intra-operative, and post-operative factors associated with post-discharge venous thromboembolism following colorectal cancer resection.
J Gastrointest Surg 2020 Jan;24(1):144-54. doi: 10.1007/s11605-019-04354-2..
Keywords: Cancer: Colorectal Cancer, Cancer, Surgery, Blood Clots, Adverse Events, Risk, Hospital Discharge
Kanters AE, Cleary RK, Obi SH
Uptake of total mesorectal excision and total mesorectal excision grading for rectal cancer: a statewide study.
Investigators sought to assess trends in total mesorectal excision performance and grading in Michigan hospitals. They found that the rates of total mesorectal excision performance and grade assignment were widely variable throughout the state of Michigan. Overall, grade assignment remained very low, suggesting an opportunity for quality improvement projects to increase total mesorectal excision performance and grading, involving both the surgeons and pathologists for effective implementation.
AHRQ-funded; HS000053.
Citation: Kanters AE, Cleary RK, Obi SH .
Uptake of total mesorectal excision and total mesorectal excision grading for rectal cancer: a statewide study.
Dis Colon Rectum 2020 Jan;63(1):53-59. doi: 10.1097/dcr.0000000000001526..
Keywords: Cancer: Colorectal Cancer, Cancer, Surgery, Quality Improvement, Quality of Care
Du XL, Zhang Y
Risks of venous thromboembolism, stroke, heart disease, and myelodysplastic syndrome associated with hematopoietic growth factors in a large population-based cohort of patients with colorectal cancer.
This study sought to determine the relationship between the receipt of colony-stimulating factors (CSFs) with erythropoiesis-stimulating agents (ESAs) and the risk of developing venous thromboembolism (VTE), stroke, heart disease, and myelodysplastic syndrome (MDS) in patients with colorectal cancer. It found that the use of ESAs was significantly associated with a substantially increased risk of MDS in patients with colorectal cancer.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y .
Risks of venous thromboembolism, stroke, heart disease, and myelodysplastic syndrome associated with hematopoietic growth factors in a large population-based cohort of patients with colorectal cancer.
Clin Colorectal Cancer 2015 Dec;14(4):e21-31. doi: 10.1016/j.clcc.2015.05.007.
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Keywords: Adverse Drug Events (ADE), Cancer: Colorectal Cancer, Cardiovascular Conditions, Patient-Centered Outcomes Research, Risk
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
Murphy DR, Wu L, Thomas EJ
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
The researchers tested whether prospective use of electronic health record-based trigger algorithms to identify patients at risk of diagnostic delays could prevent delays in diagnostic evaluation for cancer. They found that electronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up.
AHRQ-funded; HS017820.
Citation: Murphy DR, Wu L, Thomas EJ .
Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial.
J Clin Oncol 2015 Nov 1;33(31):3560-7. doi: 10.1200/jco.2015.61.1301..
Keywords: Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer: Prostate Cancer, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Liu H, Mattke S, Predmore ZS
Medicare coverage of anesthesia services during screening colonoscopies for patients at low risk of sedation-related complications.
The authors examined the costs and potential benefit of the Medicare rule change that waived patient cost sharing for anesthesia services during screening colonoscopies. Their results cast doubt on the value associated with Medicare coverage of anesthesia services during screening colonoscopies for patients at low risk of sedation-related complications. They recommended that payers create payment bundles for endoscopy procedures that include anesthesia services in a fixed fee.
AHRQ-funded; HS000029.
Citation: Liu H, Mattke S, Predmore ZS .
Medicare coverage of anesthesia services during screening colonoscopies for patients at low risk of sedation-related complications.
JAMA Intern Med 2015 Nov;175(11):1848-50. doi: 10.1001/jamainternmed.2015.4585.
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Keywords: Adverse Drug Events (ADE), Cancer: Colorectal Cancer, Colonoscopy, Medicare, Medication
Kahn B, Freeland Z, Gopal P
Predictors of guideline concordance for surveillance colonoscopy recommendations in patients at a safety-net health system.
The aim of this study was to quantify and identify predictors for guideline-concordant surveillance recommendations after adenoma polypectomy. It found that underuse recommendations were more likely in patients with C3 adenomas; overuse recommendations were more likely in patients with high-grade dysplasia or fair prep quality and less likely in those with piecemeal resection, C3 adenomas, age>65, or Hispanic ethnicity.
AHRQ-funded; HS022418.
Citation: Kahn B, Freeland Z, Gopal P .
Predictors of guideline concordance for surveillance colonoscopy recommendations in patients at a safety-net health system.
Cancer Causes Control 2015 Nov;26(11):1653-60. doi: 10.1007/s10552-015-0661-x..
Keywords: Cancer: Colorectal Cancer, Colonoscopy, Guidelines, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Baker DW, Brown T, Goldman SN
Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers.
After an earlier outreach intervention achieved 82 percent annual adherence to colorectal cancer (CRC) screening with fecal occult blood testing (FOBT), this study assessed adherence to FOBT after a second outreach. It found that a total of 88.7 percent of patients completed a fecal immunochemical test within 6 months of their second outreach.
AHRQ-funded; HS021141.
Citation: Baker DW, Brown T, Goldman SN .
Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers.
Cancer Causes Control 2015 Nov;26(11):1685-90. doi: 10.1007/s10552-015-0650-0..
Keywords: Cancer, Cancer: Colorectal Cancer, Patient Adherence/Compliance, Prevention, Screening
Abdelsattar ZM, Birkmeyer JD, Wong SL
Variation in Medicare payments for colorectal cancer surgery.
The researchers assessed the contributions of index hospitalization, physician services, readmissions, and postacute care to the overall variation in payment for colorectal cancer surgery (CRC). They concluded that Medicare spending in the first year after CRC surgery varies across hospitals even after case-mix adjustment and price standardization. Variation is largely driven by postacute care and not the index surgical hospitalization.
AHRQ-funded; HS020937; HS000053.
Citation: Abdelsattar ZM, Birkmeyer JD, Wong SL .
Variation in Medicare payments for colorectal cancer surgery.
J Oncol Pract 2015 Sep;11(5):391-5. doi: 10.1200/jop.2015.004036.
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Keywords: Cancer, Cancer: Colorectal Cancer, Payment, Medicare, Surgery
Brenner AT, Ko LK, Janz N
Race/ethnicity and primary language: health beliefs about colorectal cancer screening in a diverse, low-income population.
The purpose of this paper was to explore whether health belief model (HBM) constructs pertaining to colorectal cancer (CRC) screening differ by race/ethnicity and primary language. Understanding how different populations think about CRC screening may be critical in promoting screening in diverse populations.
AHRQ-funded; HS013853.
Citation: Brenner AT, Ko LK, Janz N .
Race/ethnicity and primary language: health beliefs about colorectal cancer screening in a diverse, low-income population.
J Health Care Poor Underserved 2015 Aug;26(3):824-38. doi: 10.1353/hpu.2015.0075.
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Keywords: Cancer: Colorectal Cancer, Cultural Competence, Low-Income, Racial and Ethnic Minorities, Screening
Kenzik K, Pisu M, Johns SA
Unresolved pain interference among colorectal cancer survivors: Implications for patient care and outcomes.
This study describes pain interference (PI) prevalence across the cancer continuum; 2) identifies demographic and clinical factors associated with PI and changes in PI; and 3) examines PI’s relationship with survivors’ job changes. It concluded that almost half of survivors with PI during the initial phase of care had continued PI into posttreatment. Comorbidities, especially cardiovascular and pulmonary conditions, contributed to continued PI.
AHRQ-funded; HS013852.
Citation: Kenzik K, Pisu M, Johns SA .
Unresolved pain interference among colorectal cancer survivors: Implications for patient care and outcomes.
Pain Med 2015 Jul;16(7):1410-25. doi: 10.1111/pme.12727..
Keywords: Cancer, Cancer: Colorectal Cancer, Quality of Life, Pain, Patient-Centered Outcomes Research
Gallego CJ, Shirts BH, Bennette CS
Next-generation sequencing panels for the diagnosis of colorectal cancer and polyposis syndromes: a cost-effectiveness analysis.
The researchers evaluated the cost effectiveness of next-generation sequencing (NGS) panels for the diagnosis of colorectal cancer and polyposis (CRCP) syndromes in patients referred to cancer genetics clinics. They concluded that the use of an NGS panel that includes genes associated with highly penetrant CRCP syndromes in addition to Lynch syndrome genes as a first-line test is likely to provide meaningful clinical benefits in a cost-effective manner.
AHRQ-funded; HS021686.
Citation: Gallego CJ, Shirts BH, Bennette CS .
Next-generation sequencing panels for the diagnosis of colorectal cancer and polyposis syndromes: a cost-effectiveness analysis.
J Clin Oncol 2015 Jun 20;33(18):2084-91. doi: 10.1200/jco.2014.59.3665..
Keywords: Cancer, Cancer: Colorectal Cancer, Decision Making, Diagnostic Safety and Quality, Genetics, Healthcare Costs, Screening
Elstad EA, Sutkowi-Hemstreet A, Sheridan SL
Clinicians' perceptions of the benefits and harms of prostate and colorectal cancer screening.
The researchers sought to understand clinicians’ perceptions of the benefits and harms of two screening tests (colonoscopy and prostate-specific antigen (PSA) testing) that differ in their balance of potential benefits and harms. Clinicians perceived PSA testing to have a greater likelihood of harm as well as a lower likelihood of lengthening life relative to colonoscopy.
AHRQ-funded; HS000032; HS021133
Citation: Elstad EA, Sutkowi-Hemstreet A, Sheridan SL .
Clinicians' perceptions of the benefits and harms of prostate and colorectal cancer screening.
Med Decis Making. 2015 May;35(4):467-76. doi: 10.1177/0272989x15569780..
Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Cancer: Prostate Cancer, Screening