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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 255 Research Studies DisplayedMills J, Duffy M
AHRQ Author: Mills J
Screening for peripheral artery disease and cardiovascular disease risk assessment with the Ankle-Brachial Index.
This paper is part of the “Putting Prevention into Practice” series. It provides case study questions and answers related to the U.S. Preventive Services Task Force recommendations for screening for peripheral artery disease and cardiovascular risk assessment with the Ankle-Brachial Index.
AHRQ-authored.
Citation: Mills J, Duffy M .
Screening for peripheral artery disease and cardiovascular disease risk assessment with the Ankle-Brachial Index.
Am Fam Physician 2018 Dec 15;98(12):754-55..
Keywords: Cardiovascular Conditions, Case Study, Prevention, Risk, U.S. Preventive Services Task Force (USPSTF)
Zhang Y, Johnson P, Jeng PJ
First opioid prescription and subsequent high-risk opioid use: a national study of privately insured and Medicare Advantage adults.
This study examined the association between a first opioid prescription and high-risk opioid use in the 18 months following the first prescription. A retrospective cohort study was conducted using data from a large commercial insurance claims database for patients aged 18-64 and also Medicare Advantage patients aged 65 or older for 2011-2014. The patients initially had not used opioids. The features the researchers were looking for were: 1) opioid or benzodiazepine prescriptions overlapping 7 days or more, 2) opioid prescriptions overlapping for 7 days or more; 3) three or more prescribers of opioids; and 4) a daily dosage exceeding 120 morphine milligram equivalents, in each of the six quarters following the first prescription. All of those features were strongly associated with high-risk use.
AHRQ-funded; HS021531.
Citation: Zhang Y, Johnson P, Jeng PJ .
First opioid prescription and subsequent high-risk opioid use: a national study of privately insured and Medicare Advantage adults.
J Gen Intern Med 2018 Dec;33(12):2156-62. doi: 10.1007/s11606-018-4628-y..
Keywords: Opioids, Substance Abuse, Medication, Risk, Medicare, Health Insurance
Fredericksen RJ, Walcott M, Yang FM
Circumstances surrounding high-risk sexual experiences among primary care patients living with and without HIV.
In this study, the investigators interviewed primary care patients living with and without HIV, regarding circumstances surrounding sexual risk behavior, to identify opportunities for providers to address and reduce STI risk. The investigators found that circumstances surrounding perceived STI exposure risk were diverse, often overlapping, and dependent on internal, environmental, and partner-related factors and inadequate communication. They suggest that meaningful care-based interventions regarding HIV/STI transmission behavior must address the diversity and interplay of these factors.
AHRQ-funded; HS022242.
Citation: Fredericksen RJ, Walcott M, Yang FM .
Circumstances surrounding high-risk sexual experiences among primary care patients living with and without HIV.
J Gen Intern Med 2018 Dec;33(12):2163-70. doi: 10.1007/s11606-018-4675-4..
Keywords: Human Immunodeficiency Virus (HIV), Primary Care, Risk, Sexual Health
Goodman KE, Simner PJ, Klein EY
How frequently are hospitalized patients colonized with carbapenem-resistant
This study evaluated whether hospitalized patients who tested positive for carbapenem-resistant Enteriobacteriaceae (CRE) were on contact precautions so that staff and other patients would not risk transmission. Since CRE colonization at admission was infrequent, there is some risk of transmission.
AHRQ-funded; HS025089.
Citation: Goodman KE, Simner PJ, Klein EY .
How frequently are hospitalized patients colonized with carbapenem-resistant
Infect Control Hosp Epidemiol 2018 Dec;39(12):1491-93. doi: 10.1017/ice.2018.236..
Keywords: Hospitalization, Hospitals, Infectious Diseases, Prevention, Risk
Borre ED, Goode A, Raitz G
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
This systematic review compared the strength of tools to predict stroke and bleeding risk in patients with atrial fibrillation (AF) taking blood thinners. Sixty-one studies were found to predict thromboembolic risk and 38 to predict bleeding risk.
AHRQ-funded; 290201500004I.
Citation: Borre ED, Goode A, Raitz G .
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
Thromb Haemost 2018 Dec;118(12):2171-87. doi: 10.1055/s-0038-1675400..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Stroke, Blood Clots, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient-Centered Outcomes Research, Evidence-Based Practice
Samples H, Williams AR, Olfson M
Risk factors for discontinuation of buprenorphine treatment for opioid use disorders in a multi-state sample of Medicaid enrollees.
The purpose of this study was to examine duration of buprenorphine treatment for opioid use disorder (OUD) following the initiation of treatment in order to identify risk factors for early discontinuation. Researchers analyzed insurance claims from the MarketScan multi-state Medicaid database for 2013 through 2015; their sample included adults aged 18-64 years who had an OUD diagnosis 6 months before initiating buprenorphine treatment. More than 1/4 of the sample discontinued buprenorphine in the first month of treatment, and most of the sample discontinued before 180 days. Risk factors for discontinuation were associated with significantly lower odds of treatment retention for at least 180 days. The study concludes that there is need to implement treatment models that address barriers to treatment retention more effectively.
AHRQ-funded; HS021112.
Citation: Samples H, Williams AR, Olfson M .
Risk factors for discontinuation of buprenorphine treatment for opioid use disorders in a multi-state sample of Medicaid enrollees.
J Subst Abuse Treat 2018 Dec;95:9-17. doi: 10.1016/j.jsat.2018.09.001..
Keywords: Medicaid, Medication, Opioids, Risk, Substance Abuse
Vogel TR, Smith JB, Kruse RL
Risk factors for thirty-day readmissions after lower extremity amputation in patients with vascular disease.
This retrospective cohort study evaluated factors associated with all-cause 30-day readmission after lower extremity amputation procedures. The investigators asserted that the finding- that acute arterial embolism or thrombosis and a below the knee amputation during the index admission was highly associated with readmission, combined with the high rates of 30-day conversion to an above the knee amputation when readmitted- suggests these patients more often develop stump complications or may be undertreated during the initial hospitalization.
AHRQ-funded; HS022140.
Citation: Vogel TR, Smith JB, Kruse RL .
Risk factors for thirty-day readmissions after lower extremity amputation in patients with vascular disease.
PM R 2018 Dec;10(12):1321-29. doi: 10.1016/j.pmrj.2018.05.017..
Keywords: Cardiovascular Conditions, Hospital Readmissions, Risk, Surgery
Marcum ZA, Walker R, Bobb JF
Serum cholesterol and incident Alzheimer's disease: findings from the adult changes in thought study.
The purpose of this prospective population-based cohort study was to evaluate associations between high-density lipoprotein cholesterol (HDL) and non-HDL-C levels at specific ages and subsequent Alzheimer's disease (AD) risk. The investigators concluded that people with low (120 mg/dL) and high (210 mg/dL) non-HDL-C levels during their 60s and 70s had modestly higher risk of AD than those with intermediate (160 mg/dL) levels.
AHRQ-funded; HS022982.
Citation: Marcum ZA, Walker R, Bobb JF .
Serum cholesterol and incident Alzheimer's disease: findings from the adult changes in thought study.
J Am Geriatr Soc 2018 Dec;66(12):2344-52. doi: 10.1111/jgs.15581..
Keywords: Heart Disease and Health, Dementia, Elderly, Risk
Amin AP, Miller S, Rahn B
Reversing the "risk-treatment paradox" of bleeding in patients undergoing percutaneous coronary intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs.
Bleeding avoidance strategies (BAS) are effective, but are paradoxically used less often with patients at high risk of bleeding. This article describes the implementation of an intervention in a St. Louis, MO, hospital intended to reverse the bleeding risk-treatment paradox. Temporal trends in BAS use and the association of risk-concordant BAS use with bleeding as well as hospital costs of percutaneous coronary intervention were examined. Patient-centered care that aimed directly toward making treatment-related decisions based on predicted risk of bleeding led to a more risk-concordant use of BAS and a reversal of the risk-treatment paradox. The authors conclude that larger multicentered studies will be needed to corroborate these results.
AHRQ-funded; HS022481.
Citation: Amin AP, Miller S, Rahn B .
Reversing the "risk-treatment paradox" of bleeding in patients undergoing percutaneous coronary intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs.
J Am Heart Assoc 2018 Nov 6;7(21):e008551. doi: 10.1161/jaha.118.008551..
Keywords: Adverse Events, Patient Safety, Heart Disease and Health, Risk, Surgery, Cardiovascular Conditions, Healthcare Costs
Desai RJ, Wyss R, Jin Y
Extension of disease risk score-based confounding adjustments for multiple outcomes of interest: an empirical evaluation.
Use of disease risk score (DRS)-based confounding adjustment when estimating treatment effects on multiple outcomes is not well studied. In this empirical cohort study, the investigators compared dabigatran initiators and warfarin initiators with respect to risks of ischemic stroke and major bleeding in 12 sequential monitoring periods (90 days each), using data from the Truven Marketscan database (Truven Health Analytics, Ann Arbor, Michigan).
AHRQ-funded; HS022193.
Citation: Desai RJ, Wyss R, Jin Y .
Extension of disease risk score-based confounding adjustments for multiple outcomes of interest: an empirical evaluation.
Am J Epidemiol 2018 Nov;187(11):2439-48. doi: 10.1093/aje/kwy130.
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Keywords: Blood Thinners, Cardiovascular Conditions, Medication, Outcomes, Research Methodologies, Risk, Stroke
Akinboyo IC, Voskertchian A, Gorfu G
Epidemiology and risk factors for recurrent Staphylococcus aureus colonization following active surveillance and decolonization in the NICU.
In this single center retrospective cohort study, the investigators sought to examine neonatal risk factors associated with recurrent Staphylococcus aureus colonization and to determine the genetic relatedness of S. aureus strains cultured from neonates before and after decolonization.
AHRQ-funded; HS022872.
Citation: Akinboyo IC, Voskertchian A, Gorfu G .
Epidemiology and risk factors for recurrent Staphylococcus aureus colonization following active surveillance and decolonization in the NICU.
Infect Control Hosp Epidemiol 2018 Nov;39(11):1334-39. doi: 10.1017/ice.2018.223..
Keywords: Healthcare-Associated Infections (HAIs), Neonatal Intensive Care Unit (NICU), Newborns/Infants, Risk
Leeds IL, Rosenblum AJ, Wise PE
Eye of the beholder: risk calculators and barriers to adoption in surgical trainees.
This study examined barriers to surgical trainees in using risk calculator tools before surgery. A total of 124 surgical residents responded to a survey and most still favored more traditional methods for risk calculation including direct verbal communication, sketch diagrams, and brochures. Only about half or less were familiar with more contemporary tools such as best-worst case scenario framing, case-specific risk calculators, and all-procedure calculators.
AHRQ-funded; HS024736.
Citation: Leeds IL, Rosenblum AJ, Wise PE .
Eye of the beholder: risk calculators and barriers to adoption in surgical trainees.
Surgery 2018 Nov;164(5):1117-23. doi: 10.1016/j.surg.2018.07.002..
Keywords: Clinical Decision Support (CDS), Decision Making, Education: Continuing Medical Education, Risk, Surgery
Noureldin M, Hass Z, Abrahamson K
Fall risk, supports and services, and falls following a nursing home discharge.
The purpose of this study was to examine whether the presence of supports and services have an impact on the relationship between fall-related risk factors and fall occurrence following a nursing-home discharge. The study sample was comprised of 1459 participants in the Minnesota Return to Community Initiative, who had been assisted in achieving a community discharge; 15 percent of participants fell within 30 days of nursing-home discharge. A structural equation model was used to determine relationship between emerging latent variables and falls. Results indicated that use of high-risk medications and fall concerns/history had a direct, positive effect on falling. Receiving supports/services did not have a direct effect on falls, but the authors note that it reduced the effect of high-risk medication use on falling.
AHRQ-funded; HS020224.
Citation: Noureldin M, Hass Z, Abrahamson K .
Fall risk, supports and services, and falls following a nursing home discharge.
Gerontologist 2018 Nov 3;58(6):1075-84. doi: 10.1093/geront/gnx133..
Keywords: Adverse Events, Elderly, Falls, Nursing Homes, Risk
Brennan MB, Guihan M, Budiman-Mak E
Increasing SBP variability is associated with an increased risk of developing incident diabetic foot ulcers.
This study evaluated the relationship between increased systolic blood pressure (SBP) variability and risk of incident diabetic foot ulceration using a nested case-control design. The investigators found a graded relationship between SBP variability and risk of diabetic foot ulceration, providing a potential new and modifiable target to reduce this common complication.
AHRQ-funded; HS018542.
Citation: Brennan MB, Guihan M, Budiman-Mak E .
Increasing SBP variability is associated with an increased risk of developing incident diabetic foot ulcers.
J Hypertens 2018 Nov;36(11):2177-84. doi: 10.1097/hjh.0000000000001783..
Keywords: Adverse Events, Diabetes, Risk
Lamplot JD, Bansal A, Nguyen JT
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
The purpose of this study using HCUP data was to determine how demographic and other patient-specific factors are associated with the risk of subsequent joint replacement in the contralateral or a different joint following an index joint replacement for osteoarthritis. Results showed a relatively high risk of subsequent replacement of the contralateral joint and a relatively low risk of subsequent replacement of a different joint within 5 to 8 years after an index total hip arthroplasty, total knee arthroplasty, or total shoulder arthroplasty. Obesity was associated with a higher risk of subsequent replacement of the contralateral joint or a different joint.
AHRQ-funded; HS019455.
Citation: Lamplot JD, Bansal A, Nguyen JT .
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
J Bone Joint Surg Am 2018 Oct 17;100(20):1750-56. doi: 10.2106/jbjs.17.00948..
Keywords: Arthritis, Healthcare Cost and Utilization Project (HCUP), Risk, Surgery, Orthopedics, Healthcare Utilization
Li D, Haritunians T, Landers C
Late-onset Crohn's Disease is a subgroup distinct in genetic and behavioral risk factors with UC-like characteristics.
Age of onset is linked to variations in clinical phenotypes and natural history in Crohn's disease (CD). In this study, the investigators aimed to define etiologically more homogenous subgroups in CD based on ages of onset. The investigators concluded that late-onset CD was subgroup distinct in genetic and behavioral risk factors with UC-like characteristics.
AHRQ-funded; HS021747.
Citation: Li D, Haritunians T, Landers C .
Late-onset Crohn's Disease is a subgroup distinct in genetic and behavioral risk factors with UC-like characteristics.
Inflamm Bowel Dis 2018 Oct 12;24(11):2413-22. doi: 10.1093/ibd/izy148..
Keywords: Digestive Disease and Health, Risk, Genetics
Makris UE, Alvarez CA, Mortensen EM
Association of statin use with increased risk of musculoskeletal conditions: a retrospective cohort study.
This study examined the association between statin use and the risk of being diagnosed with non-traumatic arthropathies, use-related injury, and undergoing rehabilitation in a cohort with longitudinal follow-up. Statin use was associated with a significant increased risk of non-traumatic arthropathies and use-related injury. The results provide additional data that can inform patient and clinician conversations about the benefits and risks of statin use.
AHRQ-funded; HS022418.
Citation: Makris UE, Alvarez CA, Mortensen EM .
Association of statin use with increased risk of musculoskeletal conditions: a retrospective cohort study.
Drug Saf 2018 Oct;41(10):939-50. doi: 10.1007/s40264-018-0682-y..
Keywords: Arthritis, Medication, Risk
Fredericksen RJ, Mayer KH, Gibbons LE
Development and content validation of a patient-reported sexual risk measure for use in primary care.
The objective of this study was to develop the Sexual Risk Behavior Inventory (SRBI), a brief computer-administered patient-reported measure. The SRBI is a brief, skip-patterned, clinically relevant measure that ascertains sexual risk behavior across sex, sexual orientation, gender identity, partner HIV serostatus, and partner treatment status, furnishing providers with context to determine gradations of risk for HIV/STI.
AHRQ-funded; HS022242.
Citation: Fredericksen RJ, Mayer KH, Gibbons LE .
Development and content validation of a patient-reported sexual risk measure for use in primary care.
J Gen Intern Med 2018 Oct;33(10):1661-68. doi: 10.1007/s11606-018-4496-5..
Keywords: Primary Care, Risk, Sexual Health
Dworsky JQ, Childers CP, Maggard-Gibbons M
High-risk colorectal surgery: what are the outcomes for geriatric patients?
This study examines the national burden and age-specific outcomes of previously defined high-risk colorectal procedures (HRCP) in geriatric patients using the 2014 National Inpatient Sample. The authors found that outcomes after HRCP are worse for older patients and for nonelective cases. They suggest that this information can inform preoperative counseling and targeted quality improvement projects.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Childers CP, Maggard-Gibbons M .
High-risk colorectal surgery: what are the outcomes for geriatric patients?
Am Surg 2018 Oct;84(10):1650-54..
Keywords: Elderly, Healthcare Cost and Utilization Project (HCUP), Outcomes, Risk, Surgery
Kumar V, Encinosa W, Thakur K
AHRQ Author: Encinosa W
Just living with obese family members increases your risk of type 2 diabetes.
Although diabetes has been associated with the incidence of obesity, many diabetes patients are not obese. In this paper the authors discuss how just living in a household with one or more obese biologically related family members is a major risk factor for diabetes, even after accounting for all the other traditional risk factors.
AHRQ-authored.
Citation: Kumar V, Encinosa W, Thakur K .
Just living with obese family members increases your risk of type 2 diabetes.
Clin Diabetes 2018 Oct;36(4):305-11. doi: 10.2337/cd17-0091..
Keywords: Diabetes, Obesity, Risk
Tracer H, Jadotte YT
AHRQ Author: Tracer H
Screening for cardiovascular disease risk with electrocardiography.
This paper presents a case study, along with questions and answers, related to the U.S. Preventive Services Task Force (USPSTF) recommendations for screening for cardiovascular disease risk with electrocardiography.
AHRQ-authored.
Citation: Tracer H, Jadotte YT .
Screening for cardiovascular disease risk with electrocardiography.
Am Fam Physician 2018 Sep 15;98(6):375-76..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Screening, Risk, Prevention, Guidelines, Evidence-Based Practice, Case Study
Hirayama A, Goto T, Shimada YJ
Acute exacerbation of chronic obstructive pulmonary disease and subsequent risk of emergency department visits and hospitalizations for atrial fibrillation.
Although emerging evidence has suggested the relationship of chronic obstructive pulmonary disease with atrial fibrillation (AF), little is known about whether acute exacerbation of chronic obstructive pulmonary disease (AECOPD) increases the risk of repeated AF-related healthcare utilization. The investigators found that among patients with existing AF, AECOPD was associated with a higher risk of AF-related ED visit or hospitalization in the first 90-day post-AECOPD period.
AHRQ-funded; HS023305.
Citation: Hirayama A, Goto T, Shimada YJ .
Acute exacerbation of chronic obstructive pulmonary disease and subsequent risk of emergency department visits and hospitalizations for atrial fibrillation.
Circ Arrhythm Electrophysiol 2018 Sep;11(9):e006322. doi: 10.1161/circep.118.006322..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Respiratory Conditions, Heart Disease and Health, Cardiovascular Conditions, Chronic Conditions, Hospitalization, Risk, Healthcare Utilization
Wahl TS, Graham LA, Morris MS
Association between preoperative proteinuria and postoperative acute kidney injury and readmission.
This retrospective cohort study investigated whether preoperative proteinuria is associated with surgical outcomes including postoperative acute kidney injury (AKI) and readmission. The cohort used were undergoing elective inpatient surgery at 119 Veterans Affairs facilities from October 2007 to September 2014. The data collected was for a 7-month period in 2016. A higher probability of 30-day unplanned readmission was associated with preoperative proteinuria and postoperative AKI.
AHRQ-funded; HS013852.
Citation: Wahl TS, Graham LA, Morris MS .
Association between preoperative proteinuria and postoperative acute kidney injury and readmission.
JAMA Surg 2018 Sep;153(9):e182009. doi: 10.1001/jamasurg.2018.2009..
Keywords: Kidney Disease and Health, Injuries and Wounds, Adverse Events, Surgery, Risk, Hospital Readmissions, Outcomes
Koziatek CA, Simon E, Horwitz LI
Automated pulmonary embolism risk classification and guideline adherence for computed tomography pulmonary angiography ordering.
The objective of this study was to measure the performance of automated, structured data-only versions of the Wells and revised Geneva risk scores in emergency department encounters during which a computed tomography pulmonary angiography was ordered. The hypothesis was that such an automated method would classify a patient's pulmonary embolism risk with high accuracy compared to manual chart review.
AHRQ-funded; HS024376.
Citation: Koziatek CA, Simon E, Horwitz LI .
Automated pulmonary embolism risk classification and guideline adherence for computed tomography pulmonary angiography ordering.
Acad Emerg Med 2018 Sep;25(9):1053-61. doi: 10.1111/acem.13442..
Keywords: Respiratory Conditions, Risk, Diagnostic Safety and Quality, Emergency Department, Imaging, Guidelines
Grundmeier RW, Xiao R, Ross RK
Grundmeier RW, Xiao R, Ross RK, Ramos MJ, Karavite DJ, Michel JJ, Gerber JS, et al. Identifying surgical site infections in electronic health data using predictive models,.
The objective of this study was to prospectively derive and validate a prediction rule for detecting cases warranting investigation for surgical site infections (SSI) after ambulatory surgery. The investigators concluded that electronic health record data can facilitate SSI surveillance with adequate sensitivity and positive predictive value.
AHRQ-funded; HS020921.
Citation: Grundmeier RW, Xiao R, Ross RK .
Grundmeier RW, Xiao R, Ross RK, Ramos MJ, Karavite DJ, Michel JJ, Gerber JS, et al. Identifying surgical site infections in electronic health data using predictive models,.
J Am Med Inform Assoc 2018 Sep;25(9):1160-66. doi: 10.1093/jamia/ocy075..
Keywords: Healthcare-Associated Infections (HAIs), Injuries and Wounds, Surgery, Electronic Health Records (EHRs), Health Information Technology (HIT), Risk, Patient Safety, Adverse Events, Ambulatory Care and Surgery