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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 50 Research Studies Displayed
Hartling L, Guise JM, Kato E
AHRQ Author: Kato, E, Berliner E
A taxonomy of rapid reviews links report types and methods to specific decision-making contexts.
The researchers described characteristics of rapid reviews and examined the impact of methodological variations on their reliability and validity. They concluded that rapid products have tremendous methodological variation and that categorization based on timeframe or type of synthesis reveals patterns. The similarity across rapid products lies in the close relationship with the end user to meet time-sensitive decision-making needs.
AHRQ-authored; AHRQ-funded; 290201200013I; 290201200010I; 290201200011I; 290201200015I; 290201200007I; 290201200004C.
Citation: Hartling L, Guise JM, Kato E . A taxonomy of rapid reviews links report types and methods to specific decision-making contexts. J Clin Epidemiol 2015 Dec;68(12):1451-62.e3. doi: 10.1016/j.jclinepi.2015.05.036.
Keywords: Decision Making, Evidence-Based Practice, Data, Research Methodologies
Kuehl DR, Berdahl CT, Jackson TD
Advancing the use of administrative data for emergency department diagnostic imaging research.
This article summarizes the discussions of the breakout session on the use of administrative data for emergency imaging research at the May 2015 Academic Emergency Medicine consensus conference, "Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization." The authors describe the areas where administrative data have been applied to research evaluating the use of diagnostic imaging in the ED, the common sources for these data, and the strengths and limitations of administrative data.
Citation: Kuehl DR, Berdahl CT, Jackson TD . Advancing the use of administrative data for emergency department diagnostic imaging research. Acad Emerg Med 2015 Dec;22(12):1417-26. doi: 10.1111/acem.12827.
Keywords: Data, Emergency Department, Health Services Research (HSR), Imaging
Liang C, Gong Y
Enhancing patient safety event reporting by K-nearest neighbor classifier.
The debate on structured or unstructured data entry reveals not only a trade-off problem among data accuracy, completeness, and timeliness, but also a technical gap on text mining. The reesarchers suggested a text classification method for predicting subject categories. Their results demonstrated the feasibility of their system and indicated the advantage of such an application to raise data quality and clinical decision support in reporting patient safety events.
Citation: Liang C, Gong Y . Enhancing patient safety event reporting by K-nearest neighbor classifier. Stud Health Technol Inform 2015;218:40603.
Keywords: Adverse Events, Medical Errors, Patient Safety, Public Reporting, Clinical Decision Support (CDS), Health Information Technology (HIT), Data
Swain MJ, Kharrazi H
Feasibility of 30-day hospital readmission prediction modeling based on health information exchange data.
The researchers conducted a semi-systematic review of readmission predictive factors published prior to March 2013. They found that mapping of these variables with common HL7 segments resulted in an 89.2 percent total coverage, with the DG1 (diagnosis) segment having the highest coverage of 39.4 percent. The PID (patient identification) and OBX (observation results) segments cover 13.9 percent and 9.1 percent of the variables.
Citation: Swain MJ, Kharrazi H . Feasibility of 30-day hospital readmission prediction modeling based on health information exchange data. Int J Med Inform 2015 Dec;84(12):1048-56. doi: 10.1016/j.ijmedinf.2015.09.003.
Keywords: Health Information Exchange (HIE), Hospital Readmissions, Health Information Technology (HIT), Data
Neprash HT, Wallace J, Chernew ME
Measuring prices in health care markets using commercial claims data.
The objective of this study was to compare methods of price measurement in health care markets. It concluded that market-level price measures reflecting broad sets of services are likely to rank markets similarly. Price indices relying on individual sentinel services may be more appropriate for examining specialty- or service-specific drivers of prices.
Citation: Neprash HT, Wallace J, Chernew ME . Measuring prices in health care markets using commercial claims data. Health Serv Res 2015 Dec;50(6):2037-47. doi: 10.1111/1475-6773.12304..
Keywords: Data, Healthcare Costs, Health Insurance, Health Services Research (HSR)
Panahiazar M, Taslimitehrani V, Pereira NL
Using EHRs for heart failure therapy recommendation using multidimensional patient similarity analytics.
The authors developed a multidimensional patient similarity assessment technique that leverages multiple types of information from the electronic health records and predicts a medication plan for each new patient based on prior knowledge and data from similar patients.Their findings suggest that it is feasible to harness population-based information for an individual patient-specific assessment.
Citation: Panahiazar M, Taslimitehrani V, Pereira NL . Using EHRs for heart failure therapy recommendation using multidimensional patient similarity analytics. Stud Health Technol Inform 2015;210:369-73.
Keywords: Clinical Decision Support (CDS), Data, Electronic Health Records (EHRs), Heart Disease and Health, Patient-Centered Healthcare
Zhang R, Manohar N, Arsoniadis E
Evaluating term coverage of herbal and dietary supplements in electronic health records.
Some supplements can interact with prescription medications, potentially leading to clinically important and potentially preventable adverse reactions. Clinical notes and corresponding medication lists from an integrated healthcare system were extracted and compared with online databases. The authors found that, overall, about 40% of listed medications are supplements, most of which are included in medication lists as nutritional or miscellaneous products. They found gaps between supplement and standard medication terminologies and identified supplements which were not mentioned in the medication lists.
Citation: Zhang R, Manohar N, Arsoniadis E . Evaluating term coverage of herbal and dietary supplements in electronic health records. AMIA Annu Symp Proc 2015 Nov 5;2015:1361-70.
Keywords: Adverse Drug Events (ADE), Data, Electronic Health Records (EHRs), Medication, Vitamins and Supplements
Meeker D, Jiang X, Matheny ME
A system to build distributed multivariate models and manage disparate data sharing policies: implementation in the scalable national network for effectiveness research.
The authors’ objective was to implement infrastructure that supports the functionality of some existing research networks (e.g., cohort discovery, workflow management, and estimation of multivariate analytic models on centralized data) while adding additional important new features. They were able to implement massively parallel (map-reduce) computation methods and a new policy management system to enable each study initiated by network participants to define the ways in which data may be processed, managed, queried, and shared.
Citation: Meeker D, Jiang X, Matheny ME . A system to build distributed multivariate models and manage disparate data sharing policies: implementation in the scalable national network for effectiveness research. J Am Med Inform Assoc 2015 Nov;22(6):1187-95. doi: 10.1093/jamia/ocv017..
Keywords: Communication, Comparative Effectiveness, Data, Health Information Technology (HIT), Policy, Research Methodologies
Bhattacharyya S, Gesteland PH, Korgenski K
Cross-immunity between strains explains the dynamical pattern of paramyxoviruses.
The researchers used long-term incidence data on Respiratory Syncytial Virus (RSV), three serotypes of Human Parainfluenza Virus (HPIV), and Human Metapneumovirus to study mathematical models of different mechanisms of pathogen interaction. Their results showed a strong signal of cross-protection from RSV in controlling the timing and magnitude of HPIV outbreaks, and a stronger interaction with more closely related serotypes.
Citation: Bhattacharyya S, Gesteland PH, Korgenski K . Cross-immunity between strains explains the dynamical pattern of paramyxoviruses. Proc Natl Acad Sci U S A 2015 Oct 27;112(43):13396-400. doi: 10.1073/pnas.1516698112..
Keywords: Data, Public Health, Respiratory Conditions
Haukoos JS, Lewis RJ
The propensity score.
The authors discuss studies by Rozé et al and Huybrechts et al that used propensity score matching and propensity score stratification, respectively. They argue that although both methods are more valid in terms of balancing study groups than simple matching or stratification based on baseline characteristics, they vary in their ability to minimize bias. In general, propensity score matching minimizes bias to a greater extent than propensity score stratification.
Citation: Haukoos JS, Lewis RJ . The propensity score. JAMA 2015 Oct 20;314(15):1637-8. doi: 10.1001/jama.2015.13480..
Keywords: Research Methodologies, Data, Risk
Hazlehurst BL, Kurtz SE, Masica A
CER Hub: An informatics platform for conducting comparative effectiveness research using multi-institutional, heterogeneous, electronic clinical data.
The authors describe the CER Hub, a web-based informatics platform for developing and conducting research studies that combine comprehensive electronic clinical data from multiple health care organizations. They conclude that CER requires coordinated and scalable methods for extracting, aggregating, and analyzing complex, multi-institutional clinical data.
Citation: Hazlehurst BL, Kurtz SE, Masica A . CER Hub: An informatics platform for conducting comparative effectiveness research using multi-institutional, heterogeneous, electronic clinical data. Int J Med Inform 2015 Oct;84(10):763-73. doi: 10.1016/j.ijmedinf.2015.06.002..
Keywords: Comparative Effectiveness, Health Information Technology (HIT), Data, Web-Based
Chien AT, Kuhlthau KA, Toomey SL
Development of the children with disabilities algorithm.
The researchers developed the Children with Disabilities algorithm (CWDA), which uses International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes to identify CWD. They concluded that ICD-9-CM codes can be classified by their likelihood of indicating CWD. CWDA triangulates well with parent report and physician assessment of child disability status. CWDA is a new tool that can be used to assess care quality for CWD.
Citation: Chien AT, Kuhlthau KA, Toomey SL . Development of the children with disabilities algorithm. Pediatrics 2015 Oct;136(4):e871-8. doi: 10.1542/peds.2015-0228..
Keywords: Children/Adolescents, Quality of Care, Data, Children/Adolescents
Price LE, Shea K, Gephart S
The Veterans Affairs's Corporate Data Warehouse: uses and implications for nursing research and practice.
This article described the developments in research associated with the VHA's transition into the world of Big Data analytics through Corporate Data Warehouse (CDW) utilization. The authors found that the most commonly-occurring research topics are pharmacy/medications, systems issues, and weight management/obesity. They concluded that, despite the potential benefit of data mining techniques to improve patient care and services, the CDW and alternative analytical approaches are underutilized by researchers and clinicians.
Citation: Price LE, Shea K, Gephart S . The Veterans Affairs's Corporate Data Warehouse: uses and implications for nursing research and practice. Nurs Adm Q 2015 Oct-Dec;39(4):311-8. doi: 10.1097/naq.0000000000000118.
Keywords: Data, Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing, Veterans
Wang C, Dominici F, Parmigiani G
Accounting for uncertainty in confounder and effect modifier selection when estimating average causal effects in generalized linear models.
The authors propose and evaluate a Bayesian method to estimate average causal effects in studies with a large number of potential confounders, relatively few observations, likely interactions between confounders and the exposure of interest, and uncertainty on which confounders and interaction terms should be included. Their method is applicable across all exposures and outcomes that can be handled through generalized linear models.
Citation: Wang C, Dominici F, Parmigiani G . Accounting for uncertainty in confounder and effect modifier selection when estimating average causal effects in generalized linear models. Biometrics 2015 Sep;71(3):654-65. doi: 10.1111/biom.12315.
Keywords: Data, Research Methodologies
Brennan PF, Bakken S
Nursing needs big data and big data needs nursing.
Nursing science and nursing practice has much to gain from the data science initiatives. Existing approaches to large data set analysis provide a necessary but not sufficient foundation for nursing to participate in the big data revolution. Nursing’s Social Policy Statement provides a principled, ethical perspective on big data and data science.
AHRQ-funded; HS022961; HS02254.
Citation: Brennan PF, Bakken S . Nursing needs big data and big data needs nursing. J Nurs Scholarsh 2015 Sep;47(5):477-84. doi: 10.1111/jnu.12159..
Keywords: Nursing, Data, Health Information Technology (HIT)
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.
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.
Keywords: Data, Elderly, Back Health and Pain, Chronic Conditions, Outcomes
van Mourik MS, van Duijn PJ, Moons KG
Accuracy of administrative data for surveillance of healthcare-associated infections: a systematic review.
The researchers conducted a systematic review evaluating the diagnostic accuracy of administrative data for the detection of HAI. They concluded that administrative data had limited and highly variable accuracy for the detection of HAI, and their judicious use for internal surveillance efforts and external quality assessment is recommended.
Citation: van Mourik MS, van Duijn PJ, Moons KG . Accuracy of administrative data for surveillance of healthcare-associated infections: a systematic review. BMJ Open 2015 Aug 27;5(8):e008424. doi: 10.1136/bmjopen-2015-008424..
Keywords: Healthcare-Associated Infections (HAIs), Data, Patient Safety, Quality of Care
Thiel DB, Platt J, Platt T
Testing an online, dynamic consent portal for large population biobank research.
Michigan's BioTrust for Health contains over 4 million samples collected without written consent. Participant-centric initiatives are IT tools that hold great promise to address the consent challenges in biobank research. The authors created and pilot tested a dynamic informed consent simulation focusing on consent for research. Pilot testers raised concerns about the process of identity verification and appeared to have little experience with sharing health information online. The authors recommended applying online, dynamic approaches to address the consent challenges raised by biobanks with legacy sample collections.
Citation: Thiel DB, Platt J, Platt T . Testing an online, dynamic consent portal for large population biobank research. Public Health Genomics 2015;18(1):26-39. doi: 10.1159/000366128.
Keywords: Data, Newborns/Infants, Research Methodologies, Screening
Sundararajan V, Romano PS, Quan H
Capturing diagnosis-timing in ICD-coded hospital data: recommendations from the WHO ICD-11 topic advisory group on quality and safety.
The purpose of this project was to develop a consensus opinion regarding capturing diagnosis-timing in coded hospital data. The WHO Quality and Safety Topic Advisory Group has undertaken a narrative literature review, scanned national experiences focusing on countries currently using timing flags, and held a series of meetings to derive formal recommendations regarding diagnosis-timing reporting. This paper discusses their concerns and recommendations.
Citation: Sundararajan V, Romano PS, Quan H . Capturing diagnosis-timing in ICD-coded hospital data: recommendations from the WHO ICD-11 topic advisory group on quality and safety. Int J Qual Health Care 2015 Aug;27(4):328-33. doi: 10.1093/intqhc/mzv037..
Keywords: Patient Safety, Quality of Care, Quality Improvement, Hospitals, Data
Greenberg JK, Ladner TR, Olsen MA
Complications and resource use associated with surgery for Chiari Malformation type 1 in adults: a population perspective.
This study examined the complications and resource use associated with adult CM-1 surgery using administrative data. It concluded that complications after CM-1 surgery are common, and surgical complications are more frequent than medical complications. Also, certain comorbidities and demographic characteristics are associated with increased risk for complications.
Citation: Greenberg JK, Ladner TR, Olsen MA . Complications and resource use associated with surgery for Chiari Malformation type 1 in adults: a population perspective. Neurosurgery 2015 Aug;77(2):261-8. doi: 10.1227/neu.0000000000000777..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Outcomes, Data
FitzHenry F, Resnic FS, Robbins SL
Creating a common data model for comparative effectiveness with the observational medical outcomes partnership.
This case study describes the challenges and opportunities of a study specific use of the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM) by two health systems and describe three comparative effectiveness use cases developed from the CDM. It concluded that the data transformation to the CDM was time consuming and resources required were substantial, beyond requirements for collecting native source data.
Citation: FitzHenry F, Resnic FS, Robbins SL . Creating a common data model for comparative effectiveness with the observational medical outcomes partnership. Appl Clin Inform 2015 Aug 26;6(3):536-47. doi: 10.4338/aci-2014-12-cr-0121..
Keywords: Comparative Effectiveness, Outcomes, Data
Pine M, Kowlessar NM, Salemi JL
Enhancing clinical content and race/ethnicity data in statewide hospital administrative databases: obstacles encountered, strategies adopted, and lessons learned.
Eight grant teams used Agency for Healthcare Research and Quality infrastructure development research grants to enhance the clinical content of and improve race/ethnicity identifiers in statewide all-payer hospital administrative databases. The authors concluded that creation of enhanced administrative databases to support comparative effectiveness research is difficult, particularly in the face of numerous challenges with recruiting data partners such as competing demands on information technology resources.
Citation: Pine M, Kowlessar NM, Salemi JL . Enhancing clinical content and race/ethnicity data in statewide hospital administrative databases: obstacles encountered, strategies adopted, and lessons learned. Health Serv Res 2015 Aug;50 Suppl 1:1300-21. doi: 10.1111/1475-6773.12330..
Keywords: Healthcare Cost and Utilization Project (HCUP), Comparative Effectiveness, Patient-Centered Outcomes Research, Data
Zingmond DS, Parikh P, Louie R
Improving hospital reporting of patient race and ethnicity--approaches to data auditing.
This study investigated new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals. It examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort in California. It concluded that comparison between reported R/E and R/E estimates using zip code level data may be a reasonable first approach to evaluate and track hospital R/E reporting.
Citation: Zingmond DS, Parikh P, Louie R . Improving hospital reporting of patient race and ethnicity--approaches to data auditing. Health Serv Res 2015 Aug;50 Suppl 1:1372-89. doi: 10.1111/1475-6773.12324..
Keywords: Racial / Ethnic Minorities, Hospitals, Hospital Discharge, Health Services Research (HSR), Registries, Quality Improvement, Quality of Care, Data
Naessens JM, Visscher SL, Peterson SM
Incorporating the last four digits of social security numbers substantially improves linking patient data from de-identified hospital claims databases.
The study objective was to assess algorithms for linking patients across de-identified databases without compromising confidentiality. It found that addition of SSNL4 to administrative data, accompanied by appropriate data use and data release policies, can enable trusted repositories to link data with nearly perfect accuracy.
Citation: Naessens JM, Visscher SL, Peterson SM . Incorporating the last four digits of social security numbers substantially improves linking patient data from de-identified hospital claims databases. Health Serv Res 2015 Aug;50 Suppl 1:1339-50. doi: 10.1111/1475-6773.12323..
Keywords: Data, Registries, Hospital Discharge, Health Information Technology (HIT)
DesRoches CM, Wong HS, Rich EC
AHRQ Author: Wong HS
Making the case for a new national data collection effort on physicians and their practices.
The pace of change in the U.S. health care system and the integral role played by physicians indicate a clear need for an ongoing, regular physician survey. The authors argue that the survey be designed to monitor over time the characteristics of all physicians in all specialties and the clinical, organizational, and financial contexts in which they operate.
Citation: DesRoches CM, Wong HS, Rich EC . Making the case for a new national data collection effort on physicians and their practices. J Gen Intern Med 2015 Aug;30 Suppl 3:S553-4. doi: 10.1007/s11606-015-3386-3..
Keywords: Data, Practice Patterns, Provider, Provider: Physician