National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (15)
- Alcohol Use (1)
- Ambulatory Care and Surgery (1)
- Anxiety (1)
- Behavioral Health (1)
- Blood Clots (1)
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- Elderly (6)
- Electronic Health Records (EHRs) (2)
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- Evidence-Based Practice (1)
- Falls (3)
- Healthcare-Associated Infections (HAIs) (11)
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- Health Status (1)
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- Risk (10)
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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 37 Research Studies DisplayedOrtiz D, Perkins AJ, Fuchita M
Pre-existing anxiety and depression in injured older adults: an under-recognized comorbidity with major health implications.
The purpose of this retrospective post-hoc analysis study was to evaluate variations in baseline depression and anxiety screenings between older injured patients with pre-existing diagnoses and those without. Data from the Trauma Medical Home, a multicenter randomized controlled trial was used for analysis. The study found that almost 50% of the patients screened positive for at least mild depressive symptoms as measured by the Patient Health Questionnaire-9, and 41% of the patients screened positive for at least mild anxiety symptoms as measured by the Generalized Anxiety Disorder Scale. Female patients with a history of concurrent anxiety and depression, greater injury severity scores, and higher Charlson scores were more likely to have mild anxiety at the baseline assessment. Patients with a history of depression only, a prior history of depression and concurrent anxiety, and higher Charlson scores (greater medical comorbidity) were more likely to have experienced at least mild depression at the time of hospital discharge after traumatic injury.
AHRQ-funded; HS026390.
Citation: Ortiz D, Perkins AJ, Fuchita M .
Pre-existing anxiety and depression in injured older adults: an under-recognized comorbidity with major health implications.
Ann Surg Open 2022 Dec; 3(4):e217. doi: 10.1097/as9.0000000000000217..
Keywords: Elderly, Anxiety, Depression, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Injuries and Wounds
Eisenberg MT, Block AM, Vopat ML
Rates of infection after ACL reconstruction in pediatric and adolescent patients: a MarketScan database study of 44,501 patients.
This study’s objective was to describe and analyze the rates of surgical site infections after anterior cruciate ligament (ACL) surgery in pediatric patients. The Truven Health Analytics MarketScan Commercial Claims and Encounters database was used to access data for privately insured individuals aged 5 to 30 years old. ACL reconstruction operation records were accessed for operations performed from 2006 to 2018. The database identified 44,501 individuals up to 18 years old, and 63,495 individuals aged 18 to 30 years old that underwent arthroscopic ACL reconstruction. No differences in infection rates were found between the two groups. However, among patients younger than 18 years, patients below 15 years old had a significantly lower infection rate at 0.37% compared with adolescents 15 to 17 years old at 0.55%. Among young adults, males had a higher infection rate than females, while no differences were observed in the pediatric and adolescent population.
AHRQ-funded; HS019455.
Citation: Eisenberg MT, Block AM, Vopat ML .
Rates of infection after ACL reconstruction in pediatric and adolescent patients: a MarketScan database study of 44,501 patients.
J Pediatr Orthop 2022 Apr;42(4):e362-e66. doi: 10.1097/bpo.0000000000002080..
Keywords: Children/Adolescents, Surgery, Orthopedics, Healthcare-Associated Infections (HAIs), Adverse Events, Injuries and Wounds
Chen C, Winterstein AG, Lo-Ciganic WH
Concurrent use of prescription gabapentinoids with opioids and risk for fall-related injury among older US Medicare beneficiaries with chronic noncancer pain: a population-based cohort study.
This study compared the risk of fall-related injury in two cohorts who used gabapentinoids concurrently with opioid use and those who used opioids only. The authors created 2 cohorts based on whether concurrent users initiated gabapentinoids on the day of opioid initiation (Cohort 1) or after opioid initiation (Cohort 2). Both cohorts were identified from a sample of older Medicare beneficiaries with chronic non-cancer pain (CNCP). Four concurrent users were matched up with 1 opioid-only user. They identified 6,733 concurrent users and 27,092 matched opioid-only users in Cohort 1 and 5,709 concurrent users and 22,388 matched opioid-only users in Cohort 2. Cohort 1’s incidence rate of fall-related injury was 24.5 per 100 person-users during follow-up and was 18.0 per 100-person-years during follow-up for Cohort 2. Concurrent users had had similar risk of fall-related injury as opioid-only users in Cohort 1 but had higher risk for fall-related injury than opioid-only users in Cohort 2.
AHRQ-funded; HS027230.
Citation: Chen C, Winterstein AG, Lo-Ciganic WH .
Concurrent use of prescription gabapentinoids with opioids and risk for fall-related injury among older US Medicare beneficiaries with chronic noncancer pain: a population-based cohort study.
PLoS Med 2022 Mar;19(3):e1003921. doi: 10.1371/journal.pmed.1003921..
Keywords: Elderly, Opioids, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Falls, Patient Safety, Injuries and Wounds, Pain, Chronic Conditions
Dicks KV, Baker AW, Durkin MJ
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
The purpose of this paper was to determine the association between shorter operative duration and surgical site infection (SSI) and also between surgeon median operative duration and SSI risk among first-time hip and knee arthroplasties. The researchers concluded that short operative durations were not associated with a higher SSI risk for knee or hip arthroplasty procedures in their analysis.
AHRQ-funded; HS023866.
Citation: Dicks KV, Baker AW, Durkin MJ .
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
Infect Control Hosp Epidemiol 2015 Dec;36(12):1431-6. doi: 10.1017/ice.2015.222.
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Keywords: Healthcare-Associated Infections (HAIs), Orthopedics, Patient Safety, Adverse Events, Surgery, Injuries and Wounds
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
Likosky DS, Wallace AS, Prager RL
Sources of variation in hospital-level infection rates after coronary artery bypass grafting: an analysis of the Society of Thoracic Surgeons Adult Heart Surgery Database.
This descriptive study characterized the hospital-level variability in healthcare-acquired infection (HAI) rates across hospitals participating in The Society of Thoracic Surgeons Adult Cardiac Surgery Database. It found substantial hospital-level variation exists in postoperative HAIs among patients undergoing coronary artery bypass graft surgery, driven predominantly by pneumonia.
AHRQ-funded; HS022535; HS022909.
Citation: Likosky DS, Wallace AS, Prager RL .
Sources of variation in hospital-level infection rates after coronary artery bypass grafting: an analysis of the Society of Thoracic Surgeons Adult Heart Surgery Database.
Ann Thorac Surg 2015 Nov;100(5):1570-5; discussion 75-6. doi: 10.1016/j.athoracsur.2015.05.015.
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Keywords: Healthcare-Associated Infections (HAIs), Surgery, Adverse Events, Injuries and Wounds, Registries
Kho JY, Johns BD, Thomas GW
A hybrid reality radiation-free simulator for teaching wire navigation skills.
The objective of this study was to assess the construct validity for a novel radiation-free simulator designed to teach wire navigation skills in hip fracture fixation. It found that the magnitude of improvement on successive simulator attempts was dependent on the level of expertise; tip-apex distance improved significantly in the novice group, whereas it was unchanged in the experienced group.
AHRQ-funded; HS022077.
Citation: Kho JY, Johns BD, Thomas GW .
A hybrid reality radiation-free simulator for teaching wire navigation skills.
J Orthop Trauma 2015 Oct;29(10):e385-90. doi: 10.1097/bot.0000000000000372..
Keywords: Surgery, Training, Health Information Technology (HIT), Injuries and Wounds, Patient Safety
Leland NE, Gozalo P, Christian TJ
An examination of the first 30 days after patients are discharged to the community from hip fracture postacute care.
This study examined the percentage of PAC patients who remain in the community at least 30 days after discharge (i.e., successful community discharge) after hip fracture rehabilitation and described differences among PAC facilities based on this outcome. It found that between 1999 and 2007, 57 percent of patients achieved successful community discharge. Black were less likely than similar whites to achieve successful community discharge.
AHRQ-funded; HS000011.
Citation: Leland NE, Gozalo P, Christian TJ .
An examination of the first 30 days after patients are discharged to the community from hip fracture postacute care.
Med Care 2015 Oct;53(10):879-87. doi: 10.1097/mlr.0000000000000419..
Keywords: Rehabilitation, Injuries and Wounds, Hospital Discharge, Hospital Readmissions, Outcomes
Wiseman JT, Fernandes-Taylor S, Barnes ML
Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery.
This study explored the factors that lead to postdischarge surgical site infections (SSI), investigated the differences between risk factors for in-hospital vs postdischarge SSI, and developed a scoring system to identify patients who might benefit from postdischarge monitoring of their wounds. In a comparative analysis, it found that comorbidities were the primary driver of postdischarge SSI, whereas in-hospital factors (operative time, emergency case status) and complications predicted in-hospital SSI.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Barnes ML .
Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery.
J Vasc Surg 2015 Oct;62(4):1023-31.e5. doi: 10.1016/j.jvs.2015.04.453..
Keywords: Surgery, Hospital Discharge, Healthcare-Associated Infections (HAIs), Patient Safety, Injuries and Wounds, Adverse Events
Hemmila MR, Osborne NH, Henke PK
Prophylactic inferior vena cava filter placement does not result in a survival benefit for trauma patients.
The researchers examined the relationship between prophylactic inferior vena cava (IVC) filter use, mortality, and venous thromboembolic events (VTE). They found that high rates of prophylactic IVC filter placement have no effect on reducing trauma patient mortality and are associated with an increase in deep venous thromboembolism (DVT) events.
AHRQ-funded; HS018728.
Citation: Hemmila MR, Osborne NH, Henke PK .
Prophylactic inferior vena cava filter placement does not result in a survival benefit for trauma patients.
Ann Surg 2015 Oct;262(4):577-85. doi: 10.1097/sla.0000000000001434..
Keywords: Blood Clots, Outcomes, Mortality, Injuries and Wounds, Prevention
Jones SM, Gell NM, Roth JA
The relationship of perceived risk and biases in perceived risk to fracture prevention behavior in older women.
The researchers compared perceived risk and biases in perceived risk for fracture to fracture preventive behavior. They found that higher perceived risk was related to lower quality of life and self-reported health, more medication and calcium use, increased bone density scan use, and less walking. Bias was only associated with less medication use. Neither perceived risk nor bias predicted medication adherence.
AHRQ-funded; HS022982.
Citation: Jones SM, Gell NM, Roth JA .
The relationship of perceived risk and biases in perceived risk to fracture prevention behavior in older women.
Ann Behav Med 2015 Oct;49(5):696-703. doi: 10.1007/s12160-015-9702-7.
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Keywords: Injuries and Wounds, Women, Risk, Prevention, Education: Patient and Caregiver
Hoopes MJ, Dankovchik J, Weiser T
Uncovering a missing demographic in trauma registries: epidemiology of trauma among American Indians and Alaska Natives in Washington state.
The objectives of this study were to evaluate racial misclassification in a statewide trauma registry and to describe the epidemiology of trauma among the Washington American Indian and Alaska Native (AI/AN) population. Linkage to a state trauma registry improved data quality by correcting racial misclassification, allowing for a comprehensive description of injury patterns for the AI/AN population. Compared to Caucasians, AI/AN sustained more severe injuries with similar postinjury outcomes.
AHRQ-funded; HS019972.
Citation: Hoopes MJ, Dankovchik J, Weiser T .
Uncovering a missing demographic in trauma registries: epidemiology of trauma among American Indians and Alaska Natives in Washington state.
Inj Prev 2015 Oct;21(5):335-43. doi: 10.1136/injuryprev-2014-041419.
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Keywords: Trauma, Registries, Racial and Ethnic Minorities, Health Status, Injuries and Wounds
Gozalo P, Leland NE, Christian TJ
Volume matters: returning home after hip fracture.
This study examined the effect of the relationship between volume (number of hip fracture admissions during the 12 months before participant’s fracture) and other facility characteristics on outcomes. It concluded that in community-dwelling persons with their first hip fracture, successful return to the community varies substantially, according to skilled nursing facility provider volume and staffing characteristics.
AHRQ-funded; HS000011.
Citation: Gozalo P, Leland NE, Christian TJ .
Volume matters: returning home after hip fracture.
J Am Geriatr Soc 2015 Oct;63(10):2043-51. doi: 10.1111/jgs.13677..
Keywords: Injuries and Wounds, Elderly, Outcomes, Hospital Discharge
LaFleur J, DuVall SL, Wilson T
Analysis of osteoporosis treatment patterns with bisphosphonates and outcomes among postmenopausal veterans.
This study evaluated bisphosphonate change behaviors (switching, discontinuing, or reinitiating) over time, as well as fractures and costs, among a large, national cohort of postmenopausal veterans. It found that most bisphosphonate patients discontinue treatment at some point, which did not significantly increase the risk of fracture in this majority non-high risk population. Bisphosphonate change behaviors were associated with significantly lower osteoporosis costs, but significantly higher total costs.
AHRQ-funded; HS018582.
Citation: LaFleur J, DuVall SL, Wilson T .
Analysis of osteoporosis treatment patterns with bisphosphonates and outcomes among postmenopausal veterans.
Bone 2015 Sep;78:174-85. doi: 10.1016/j.bone.2015.04.022..
Keywords: Osteoporosis, Medication, Elderly, Injuries and Wounds
Wiseman JT, Fernandes-Taylor S, Barnes ML
Conceptualizing smartphone use in outpatient wound assessment: patients' and caregivers' willingness to use technology.
The researchers surveyed a vulnerable patient population to evaluate smartphone capability and willingness to adopt this technology. Their survey demonstrated that an older patient cohort with significant comorbidity is able and willing to adopt a smartphone-based postoperative monitoring program.
AHRQ-funded; HS023395.
Citation: Wiseman JT, Fernandes-Taylor S, Barnes ML .
Conceptualizing smartphone use in outpatient wound assessment: patients' and caregivers' willingness to use technology.
J Surg Res 2015 Sep;198(1):245-51. doi: 10.1016/j.jss.2015.05.011..
Keywords: Ambulatory Care and Surgery, Surgery, Telehealth, Health Information Technology (HIT), Injuries and Wounds, Adverse Events, Patient Safety, Caregiving
Durkin MJ, Dicks KV, Baker AW
Seasonal variation of common surgical site infections: does season matter?
The researchers evaluated seasonal variation in the rate of surgical site infections (SSI) following commonly performed surgical procedures. Using data from the Duke Infection Control Outreach Network, they found that the rate of SSI following commonly performed surgical procedures was higher during the summer compared with the remainder of the year.
AHRQ-funded; HS023866.
Citation: Durkin MJ, Dicks KV, Baker AW .
Seasonal variation of common surgical site infections: does season matter?
Infect Control Hosp Epidemiol 2015 Sep;36(9):1011-6. doi: 10.1017/ice.2015.121.
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Keywords: Adverse Events, Healthcare-Associated Infections (HAIs), Surgery, Patient Safety, Injuries and Wounds
Jenkins PC, Richardson CR, Norton EC
Trauma surge index: advancing the measurement of trauma surges and their influence on mortality.
The authors developed a new measure of hospital capacity strain corresponding to trauma admissions and examined the relationship between trauma surges and inpatient mortality. Their Trauma Surge Index (TSI) method can be implemented by hospitals and trauma systems to examine periods of high-capacity strain retrospectively, identify specific resources that might have been needed, and better direct future investments in an evidence-based manner.
AHRQ-funded; HS020672.
Citation: Jenkins PC, Richardson CR, Norton EC .
Trauma surge index: advancing the measurement of trauma surges and their influence on mortality.
J Am Coll Surg 2015 Sep;221(3):729-38.e1. doi: 10.1016/j.jamcollsurg.2015.05.016.
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Keywords: Emergency Preparedness, Hospitals, Injuries and Wounds, Mortality, Trauma
Leland NE, Gozalo P, Bynum J
What happens to patients when they fracture their hip during a skilled nursing facility stay?
This study characterized outcomes of patients experiencing a fall and subsequent hip fracture while in a nursing home receiving skilled nursing facility (SNF) services. In the first 90 days following hospitalization for surgical repair of the hip fracture, 24.1 percent of patients died, 7.3 percent were discharged to the community but remained fewer than 30 days, and 14.0 percent achieved successful community discharge.
AHRQ-funded; HS000011.
Citation: Leland NE, Gozalo P, Bynum J .
What happens to patients when they fracture their hip during a skilled nursing facility stay?
J Am Med Dir Assoc 2015 Sep;16(9):767-74. doi: 10.1016/j.jamda.2015.03.026..
Keywords: Nursing Homes, Falls, Injuries and Wounds, Outcomes
Cochran G, Field C, Caetano R
Changes in classes of injury-related risks and consequences of risk-level drinking: a latent transition analysis.
The researchers conducted a secondary analysis of data from a brief alcohol intervention study. They concluded that although a large portion of intervention recipients improved risks and consequences of alcohol use following discharge, more intensive intervention services may be needed for a subset of patients who showed little or no improvement.
AHRQ-funded; HS021394.
Citation: Cochran G, Field C, Caetano R .
Changes in classes of injury-related risks and consequences of risk-level drinking: a latent transition analysis.
J Behav Health Serv Res 2015 Jul;42(3):355-66. doi: 10.1007/s11414-013-9378-3.
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Keywords: Alcohol Use, Injuries and Wounds, Lifestyle Changes, Risk, Substance Abuse
Kleweno CP, O'Toole RV, Ballreich J
Does fracture care make money for the hospital? An analysis of hospital revenues and costs for treatment of common fractures.
The authors sought to determine the relative profitability for a hospital of treatment of common fractures within a state-regulated reimbursement system. They found that the factors most influencing cost included length of stay, supplies, and operating room use, and that the most profitable diagnosis was pelvic fracture.
AHRQ-funded; HS000029.
Citation: Kleweno CP, O'Toole RV, Ballreich J .
Does fracture care make money for the hospital? An analysis of hospital revenues and costs for treatment of common fractures.
J Orthop Trauma 2015 Jul;29(7):e219-24. doi: 10.1097/bot.0000000000000263.
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Keywords: Injuries and Wounds, Healthcare Costs, Hospitals, Orthopedics
Padula WV, Valuck RJ, Makic MB
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
The purpose of this study was to identify wound care nurse perceptions of the primary factors that influenced, the overall reduction of pressure ulcers (PUs). It found that several internal factors influenced evidence-based practice: hospital prevention campaigns; the availability of nursing specialists; and the level of preventive knowledge among hospital staff. External influential factors included financial concerns and data sharing among peer institutions.
AHRQ-funded; HS023710.
Citation: Padula WV, Valuck RJ, Makic MB .
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
J Wound Ostomy Continence Nurs 2015 Jul-Aug;42(4):327-30. doi: 10.1097/won.0000000000000145..
Keywords: Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Prevention
Rhee SM, Valle MF, Wilson LM
Negative pressure wound therapy technologies for chronic wound care in the home setting: a systematic review.
The researchers conducted a systematic review on the efficacy and safety of negative pressure wound therapy (NPWT) for the treatment of chronic wounds in the home setting. Data were limited by variability in the types of comparator groups, methodological limitations, and poor reporting of outcomes. The researchers were unable to draw conclusions about the efficacy or safety of NPWT for the treatment of chronic wounds in the home setting due to the insufficient evidence.
AHRQ-funded; 290201200007I.
Citation: Rhee SM, Valle MF, Wilson LM .
Negative pressure wound therapy technologies for chronic wound care in the home setting: a systematic review.
Wound Repair Regen 2015 Jul-Aug;23(4):506-17. doi: 10.1111/wrr.12295..
Keywords: Injuries and Wounds, Home Healthcare, Comparative Effectiveness, Treatments, Chronic Conditions
Durkin MJ, Dicks KV, Baker AW
Postoperative infection in spine surgery: does the month matter?
The authors evaluated for seasonal variation of surgical site infection (SSI) following spine surgery in a network of nonteaching community hospitals. They found that the rate of SSI following fusion or spinal laminectomy/laminoplasty was higher during the summer in this network of community hospitals, most likely due to S. aureus rather than the July effect.
AHRQ-funded; HS023866.
Citation: Durkin MJ, Dicks KV, Baker AW .
Postoperative infection in spine surgery: does the month matter?
J Neurosurg Spine 2015 Jul;23(1):128-34. doi: 10.3171/2014.10.spine14559.
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Keywords: Surgery, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Hospitals, Outcomes, Quality of Care
Snider C, Jiang D, Logsetty S
Wraparound care for youth injured by violence: study protocol for a pilot randomised control trial.
In Winnipeg, Canada, 20% of youth who visit an emergency department with an injury due to violence have a second visit for a subsequent violent injury within 1 year. This study protocol describes a wraparound care model delivered by a support worker with experience with violence, supported by social workers and links to multiple community partners. It has been developed using an integrated knowledge translation approach.
AHRQ-funded; HS016444.
Citation: Snider C, Jiang D, Logsetty S .
Wraparound care for youth injured by violence: study protocol for a pilot randomised control trial.
BMJ Open 2015 May 19;5(5):e008088. doi: 10.1136/bmjopen-2015-008088.
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Keywords: Children/Adolescents, Emergency Department, Injuries and Wounds
LaFleur J, Steenhoek CL, Horne J
Comparing fracture absolute risk assessment (FARA) tools: an osteoporosis clinical informatics tool to improve identification and care of men at high risk of first fracture.
The researchers compared 2 fracture absolute risk assessment (FARA) tools for use with electronic health records (EHRs) to determine which would more accurately identify patients known to be high risk for fracture. They found that absolute fracture risk estimation with the VA-FARA is more predictive of a first fracture than the WHO’s eFRAX in male veterans when used in an EHR-based population screening tool.
AHRQ-funded; HS018582.
Citation: LaFleur J, Steenhoek CL, Horne J .
Comparing fracture absolute risk assessment (FARA) tools: an osteoporosis clinical informatics tool to improve identification and care of men at high risk of first fracture.
Ann Pharmacother 2015 May;49(5):506-14. doi: 10.1177/1060028015572819..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Injuries and Wounds, Osteoporosis, Risk