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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 51 Research Studies DisplayedLamplot 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
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
Yazdany J, Dudley RA, Lin GA
Out-of-pocket costs for infliximab and its biosimilar for rheumatoid arthritis under Medicare Part D.
This paper discusses the out-of-pocket costs for infliximab and its biosimilar for rheumatoid arthritis under Medicare Part D. The investigators analyzed nationwide benefit design data for all Part D plans from the June 2017 Medicare Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files to calculate mean total cost and out-of-pocket cost requirements for infliximab-dyyb and infliximab assuming a standard 8-week dosing regimen.
AHRQ-funded; HS016772.
Citation: Yazdany J, Dudley RA, Lin GA .
Out-of-pocket costs for infliximab and its biosimilar for rheumatoid arthritis under Medicare Part D.
JAMA 2018 Sep 4;320(9):931-33. doi: 10.1001/jama.2018.7316..
Keywords: Healthcare Costs, Health Insurance, Medicare, Medication, Arthritis
Urish KL, Qin Y, Li BY
Predictors and cost of readmission in total knee arthroplasty.
The Comprehensive Care for Joint Replacement bundle was created to decrease total knee arthroplasty (TKA) cost. To help accomplish this, there is a focus on reducing TKA readmissions. The study’s authors used the Nationwide Readmission Database to examine national readmission rates, predictors of readmission, and associated readmission costs for elective TKA procedures.
AHRQ-funded; HS018726.
Citation: Urish KL, Qin Y, Li BY .
Predictors and cost of readmission in total knee arthroplasty.
J Arthroplasty 2018 Sep;33(9):2759-63. doi: 10.1016/j.arth.2018.04.008..
Keywords: Arthritis, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Orthopedics
Beukelman T, Xie F, Chen L
Risk of malignancy associated with paediatric use of tumour necrosis factor inhibitors.
The objective of the study was to determine whether tumour necrosis factor inhibitor (TNFi) use is associated with an increased rate of incident malignancy compared with no TNFi use in the treatment of juvenile idiopathic arthritis (JIA), paediatric inflammatory bowel disease (pIBD) and paediatric plaque psoriasis (pPsO). The authors concluded that children diagnosed with JIA, pIBD and pPsO had an increased rate of malignancy compared with the general population, but treatment with TNFi did not appear to significantly further increase the risk compared with no TNFi use.
AHRQ-funded; HS021110.
Citation: Beukelman T, Xie F, Chen L .
Risk of malignancy associated with paediatric use of tumour necrosis factor inhibitors.
Ann Rheum Dis 2018 Jul;77(7):1012-16. doi: 10.1136/annrheumdis-2017-212613..
Keywords: Children/Adolescents, Cancer, Patient-Centered Outcomes Research, Risk, Arthritis
Goodman SM, Mandi LA, Mehta B
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
The authors assessed the interaction between education and poverty on 2-year Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function. They found that having no college was associated with worse pain and function at baseline and 2 years and that living in a poor neighborhood was associated with worse 2-year pain and function. There was a strong interaction between individual education and community poverty with WOMAC scores at 2 years. Patients without college living in poor communities had pain scores that were ~10 points worse than those with some college; in wealthy communities, college was associated with a 1-point difference in pain. Function was similar. The authors recommended further study on how education protects those in impoverished communities.
AHRQ-funded; HS016075.
Citation: Goodman SM, Mandi LA, Mehta B .
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
Arthritis Care Res 2018 Jun;70(6):884-91. doi: 10.1002/acr.23442..
Keywords: Arthritis, Education, Low-Income, Orthopedics, Outcomes, Patient-Centered Outcomes Research, Social Determinants of Health
Favier LA, Taylor J, Loiselle Rich K
Barriers to adherence in juvenile idiopathic arthritis: a multicenter collaborative experience and preliminary results.
The purpose of our study was to design and implement a standardized approach to identifying adherence barriers for youth with juvenile idiopathic arthritis (JIA) and to assess the frequency of adherence barriers in patients and their caregivers across treatment modalities. It concluded that implementing a standardized tool assessing adherence barriers in the JIA population across multiple clinical settings is feasible.
AHRQ-funded; HS021114.
Citation: Favier LA, Taylor J, Loiselle Rich K .
Barriers to adherence in juvenile idiopathic arthritis: a multicenter collaborative experience and preliminary results.
J Rheumatol 2018 May;45(5):690-96. doi: 10.3899/jrheum.171087.
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Keywords: Caregiving, Patient Adherence/Compliance, Quality Improvement, Arthritis, Children/Adolescents
Gilbert AL, Lee J, Ehrlich-Jones L
A randomized trial of a motivational interviewing intervention to increase lifestyle physical activity and improve self-reported function in adults with arthritis.
In this study, the investigators evaluated the effect of a motivational interviewing-based lifestyle physical activity intervention on self-reported physical function in adults with knee osteoarthritis (KOA) or rheumatoid arthritis (RA). They found that participants with KOA receiving the lifestyle intervention experienced modest improvement in self-reported function and a trend toward improved pain compared to controls; there was no intervention effect for RA participants.
AHRQ-funded; HS023011.
Citation: Gilbert AL, Lee J, Ehrlich-Jones L .
A randomized trial of a motivational interviewing intervention to increase lifestyle physical activity and improve self-reported function in adults with arthritis.
Semin Arthritis Rheum 2018 Apr;47(5):732-40. doi: 10.1016/j.semarthrit.2017.10.003..
Keywords: Arthritis, Health Promotion, Lifestyle Changes, Arthritis
Wright NC, Hooker ER, Nielson CM
The epidemiology of wrist fractures in older men: the Osteoporotic Fractures in Men (MrOS) study.
The goal of this study was to calculate the frequency of and to identify risk factors for wrist fracture in the Osteoporotic Fractures in Men (MrOS) study. The researchers identified incident wrist fractures in men aged 65 or older. Potential risk factors included demographics, lifestyle, bone mineral density, selected medications, biomarkers, and physical function and performance measures. The researcher confirmed that fracture history and certain medications are predictors, and also identified novel predictors such as markers of kidney function and an inability to perform the grip strength test. They did not find associations with factors commonly associated with wrist and other osteoporosis fractures such as falls, diabetes, calcium and vitamin D intake, or alcohol intake.
AHRQ-funded; HS023009.
Citation: Wright NC, Hooker ER, Nielson CM .
The epidemiology of wrist fractures in older men: the Osteoporotic Fractures in Men (MrOS) study.
Osteoporos Int 2018 Apr;29(4):859-70. doi: 10.1007/s00198-017-4349-9..
Keywords: Arthritis, Elderly, Injuries and Wounds, Men's Health, Risk
Lopez-Olivo MA, Ingleshwar A, Volk RJ
Development and pilot testing of multimedia patient education tools for patients with knee osteoarthritis, osteoporosis, and rheumatoid arthritis.
Researched developed multimedia educational tools that incorporated videos to help patients understand their chronic diseases including osteoporosis, osteoarthritis, and rheumatoid arthritis. Tools were developed in English and Spanish. A total of 60 patients (20 per disease) were recruited to see the videos and were interviewed after all. All participants gave them a favorable rating and felt it helped them understand the disease, the importance of taking their medications, and seeing their doctor regularly. They found the videos and accompanying materials easy to use and easy to understand.
AHRQ-funded; HS019354.
Citation: Lopez-Olivo MA, Ingleshwar A, Volk RJ .
Development and pilot testing of multimedia patient education tools for patients with knee osteoarthritis, osteoporosis, and rheumatoid arthritis.
Arthritis Care Res 2018 Feb;70(2):213-20. doi: 10.1002/acr.23271..
Keywords: Arthritis, Chronic Conditions, Education: Patient and Caregiver, Osteoporosis, Health Literacy
Jafri K, Ogdie A, Qasim A
Discordance of the Framingham cardiovascular risk score and the 2013 American College of Cardiology/American Heart Association risk score in systemic lupus erythematosus and rheumatoid arthritis..
The authors of this study compared Framingham and 2013 American College of Cardiology/American Heart Association (ACC/AHA) risk scores in subjects with systemic lupus erythematosus and rheumatoid arthritis and assessed demographic, cardiovascular, and rheumatologic characteristics associated with discordant scores (high-risk ACC/AHA scores but low-risk Framingham scores).
AHRQ-funded; HS024412.
Citation: Jafri K, Ogdie A, Qasim A .
Discordance of the Framingham cardiovascular risk score and the 2013 American College of Cardiology/American Heart Association risk score in systemic lupus erythematosus and rheumatoid arthritis..
Clin Rheumatol 2018 Feb;37(2):467-74. doi: 10.1007/s10067-017-3860-x..
Keywords: Cardiovascular Conditions, Arthritis, Risk
Pitta M, Esposito CI, Li Z
Failure after modern total knee arthroplasty: a prospective study of 18,065 knees.
The investigators sought to determine the mechanism of failure among primary total knee arthroplasties (TKAs) performed at a single high-volume institution. They found that the most common reasons for failure within 2 years after TKA were infection and stiffness. They suggested that the study identified preoperative risk factors for failure of primary TKAs, which may be useful information for developing strategies to improve outcomes following TKA.
AHRQ-funded; HS016075.
Citation: Pitta M, Esposito CI, Li Z .
Failure after modern total knee arthroplasty: a prospective study of 18,065 knees.
J Arthroplasty 2018 Feb;33(2):407-14. doi: 10.1016/j.arth.2017.09.041..
Keywords: Arthritis, Orthopedics
Gianfrancesco MA, Yazdany J, Schmajuk G
The impact of smoking on disease measures in rheumatoid arthritis: the need for appropriate adjustment of time-varying confounding.
In a recent publication, Quintana-Dunque et al. studied patients with early onset rheumatoid arthritis (RA) and showed that baseline smoking status was inversely associated with disease activity and disability at 36 months. This paper argues that the authors failed to highlight several limitations of study design and analysis, including time-varying confounding, which may have had a direct impact on results and corresponding conclusions.
AHRQ-funded; HS024412.
Citation: Gianfrancesco MA, Yazdany J, Schmajuk G .
The impact of smoking on disease measures in rheumatoid arthritis: the need for appropriate adjustment of time-varying confounding.
Rheumatol Int 2018 Feb;38(2):313-14. doi: 10.1007/s00296-017-3902-3.
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Keywords: Health Status, Lifestyle Changes, Arthritis, Tobacco Use
Palmsten K, Hulugalle A, Bandoli G
Agreement between maternal report and medical records during pregnancy: medications for rheumatoid arthritis and asthma.
This study examined the agreement between maternal report and medical records during pregnancy for rheumatoid arthritis and asthma-related medications. The investigators concluded that agreement was higher for medications typically used continuously than sporadically. Information on medication use from medical records alone may not be adequate when studying the impact of intermittently used medications during pregnancy on perinatal outcomes.
AHRQ-funded; HS018474.
Citation: Palmsten K, Hulugalle A, Bandoli G .
Agreement between maternal report and medical records during pregnancy: medications for rheumatoid arthritis and asthma.
Paediatr Perinat Epidemiol 2018 Jan;32(1):68-77. doi: 10.1111/ppe.12415..
Keywords: Asthma, Medication, Pregnancy, Arthritis
Bove AM, Smith KJ, Bise CG
Exercise, manual therapy, and booster sessions in knee osteoarthritis: cost-effectiveness analysis from a multicenter randomized controlled trial.
The study objective was to compare the cost-effectiveness of 4 different combinations of exercise, manual therapy, and booster sessions for individuals with knee osteoarthritis (OA). The authors found that spacing exercise-based physical therapy sessions over 12 months using periodic booster sessions was less costly and more effective over 2 years than strategies not containing booster sessions for individuals with knee OA.
AHRQ-funded; HS019642.
Citation: Bove AM, Smith KJ, Bise CG .
Exercise, manual therapy, and booster sessions in knee osteoarthritis: cost-effectiveness analysis from a multicenter randomized controlled trial.
Phys Ther 2018 Jan;98(1):16-27. doi: 10.1093/ptj/pzx104..
Keywords: Arthritis, Comparative Effectiveness, Healthcare Costs, Outcomes
Schmajuk G, Yazdany J
Leveraging the electronic health record to improve quality and safety in rheumatology.
In the coming years, developing and leveraging tools within the electronic health record (EHR) will be the key to making the next big strides in improving the health of patients with rheumatoid arthritis and other rheumatic diseases, including building EHR infrastructure to capture patient outcomes and developing automated methods to retrieve information from free text of clinical notes.
AHRQ-funded; HS024412.
Citation: Schmajuk G, Yazdany J .
Leveraging the electronic health record to improve quality and safety in rheumatology.
Rheumatol Int 2017 Oct;37(10):1603-10. doi: 10.1007/s00296-017-3804-4.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Patient Safety, Quality Improvement, Arthritis
Pellegrini CA, Song J, Semanik PA
Patients less likely to lose weight following a knee replacement: results from the osteoarthritis initiative.
The purpose of this study was to examine weight change patterns preoperatively and postoperatively among overweight/obese knee replacement patients. Overweight and obese patients initially lost weight during the interval including knee replacement; however, they were less likely to lose more than 2.5% of their weight in the 1 to 2 years immediately after the surgery.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Song J, Semanik PA .
Patients less likely to lose weight following a knee replacement: results from the osteoarthritis initiative.
J Clin Rheumatol 2017 Oct;23(7):355-60. doi: 10.1097/rhu.0000000000000579..
Keywords: Obesity: Weight Management, Arthritis, Patient-Centered Outcomes Research, Surgery
Herbert MS, Goodin BR, Bulls HW
Ethnicity, cortisol, and experimental pain responses among persons with symptomatic knee osteoarthritis.
This study aimed to examine the relationship between cortisol and pain responses during a cold-pressor task (CPT) among African American (AA) and non-Hispanic White (NHW) adults with knee osteoarthritis (OA). Consistent with previous findings in young healthy adults, cold-pressor pain responses are related to pre-CPT cortisol concentrations in NHW persons with knee OA but not in their AA counterparts.
AHRQ-funded; HS013852.
Citation: Herbert MS, Goodin BR, Bulls HW .
Ethnicity, cortisol, and experimental pain responses among persons with symptomatic knee osteoarthritis.
Clin J Pain 2017 Sep;33(9):820-26. doi: 10.1097/ajp.0000000000000462.
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Keywords: Arthritis, Pain, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Treatments
Li W, Ayers DC, Lewis CG
Functional gain and pain relief after total joint replacement according to obesity status.
The researchers examined the changes between preoperative and postoperative function and pain in a large representative U.S. cohort to determine if there was a relationship to obesity status. They found that six months after total joint replacement, severely or morbidly obese patients reported excellent pain relief and substantial functional gain that was similar to the findings in other patients.
AHRQ-funded; HS018910.
Citation: Li W, Ayers DC, Lewis CG .
Functional gain and pain relief after total joint replacement according to obesity status.
J Bone Joint Surg Am 2017 Jul 19;99(14):1183-89. doi: 10.2106/jbjs.16.00960.
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Keywords: Obesity, Surgery, Pain, Arthritis, Patient-Centered Outcomes Research
Gandek B, Ware JE, Jr.
Validity and responsiveness of the knee injury and osteoarthritis outcome score: a comparative study among total knee replacement patients.
The researchers evaluated validity and responsiveness of the Knee Injury and Osteoarthritis Outcome Score (KOOS) in relation to other patient-reported outcome measures before and after total knee replacement (TKR). They concluded that KOOS scales were valid and responsive in a cohort of 1,143 US TKR patients. KOOS QOL performed particularly well in capturing aggregate knee-specific outcomes.
AHRQ-funded; HS018910; HS024632.
Citation: Gandek B, Ware JE, Jr. .
Validity and responsiveness of the knee injury and osteoarthritis outcome score: a comparative study among total knee replacement patients.
Arthritis Care Res 2017 Jun;69(6):817-25. doi: 10.1002/acr.23193.
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Keywords: Arthritis, Surgery, Patient-Centered Outcomes Research, Outcomes, Injuries and Wounds
Singh JA, Hossain A, Mudano AS
Biologics or tofacitinib for people with rheumatoid arthritis naive to methotrexate: a systematic review and network meta-analysis.
The researchers performed a systematic review to compare the benefits and harms of biologics and small molecule tofacitinib versus comparator (methotrexate (MTX) and other disease-modifying antirheumatic drugs) in patients with rheumatoid arthritis (RA) who are naive to methotrexate. They concluded that in MTX-naive RA participants, there was moderate-quality evidence that, compared with MTX alone, biologics with MTX were associated with absolute and relative clinically meaningful benefits in three of the efficacy outcomes.
AHRQ-funded; HS021110.
Citation: Singh JA, Hossain A, Mudano AS .
Biologics or tofacitinib for people with rheumatoid arthritis naive to methotrexate: a systematic review and network meta-analysis.
Cochrane Database Syst Rev 2017 May 8;5:CD012657. doi: 10.1002/14651858.cd012657.
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Keywords: Comparative Effectiveness, Medication, Arthritis, Patient-Centered Outcomes Research, Evidence-Based Practice
Zheng H, Tulu B, Choi W
Using mHealth app to support treatment decision-making for knee arthritis: patient perspective.
The authors explored patient preferences on content and design of a mobile health app to facilitate daily symptom capture and summary feedback reporting, in order to inform treatment decisions, including use of total knee replacement surgery (TKR). The authors suggest that user input can inform the design and implementation of mHealth technology to meet patient needs for their treatment decisions. Patient priorities must be considered through patient-centered app design.
AHRQ-funded; HS018910.
Citation: Zheng H, Tulu B, Choi W .
Using mHealth app to support treatment decision-making for knee arthritis: patient perspective.
eGEMS 2017 Apr 20;5(2):7. doi: 10.13063/2327-9214.1284..
Keywords: Arthritis, Decision Making, Health Information Technology (HIT), Surgery
Kathuria P, Gordon KB, Silverberg JI
Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures.
This study investigated whether psoriasis (Pso) and psoriatic arthritis (PsA) are associated with osteoporosis and fractures in US adults. Using records of 183,725 persons with Pso and 28,765 with PsA from the 2006-2012 National Emergency Department Sample, including 20 percent of the emergency care visits throughout the United States, it found that Pso and PsA were associated with osteopenia, osteoporosis, ankylosing spondylitis, and pathologic fractures.
AHRQ-funded; HS023011.
Citation: Kathuria P, Gordon KB, Silverberg JI .
Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures.
J Am Acad Dermatol 2017 Mar 14;76(6):1045-53.e3. doi: 10.1016/j.jaad.2016.11.046.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Osteoporosis, Injuries and Wounds, Arthritis
Singh JA, Hossain A, Tanjong Ghogomu E
Biologics or tofacitinib for people with rheumatoid arthritis unsuccessfully treated with biologics: a systematic review and network meta-analysis.
This review is focused on biologic or tofacitinib therapy in people with rheumatoid arthritis (RA) who had previously been treated unsuccessfully with biologics. Biologic (with or without methotrexate (MTX)) or tofacitinib (with MTX) use was associated with clinically meaningful and statistically significant benefits compared to placebo or an active comparator (MTX/other traditional disease-modifying anti-rheumatic drugs) among people with RA previously unsuccessfully treated with biologics.
AHRQ-funded; HS021110.
Citation: Singh JA, Hossain A, Tanjong Ghogomu E .
Biologics or tofacitinib for people with rheumatoid arthritis unsuccessfully treated with biologics: a systematic review and network meta-analysis.
Cochrane Database Syst Rev 2017 Mar 10;3:CD012591. doi: 10.1002/14651858.cd012591.
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Keywords: Comparative Effectiveness, Medication, Arthritis, Patient-Centered Outcomes Research, Evidence-Based Practice
Curtis JR, Chen L, Greenberg JD
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights.
Treat to target guidelines recommend achieving remission or low disease activity in rheumatoid arthritis (RA). However, the reduction in adverse events and costs associated with lower disease activity is unclear. This study found that leveraging the benefits of linking registry and administrative data together, lower disease activity in RA was associated with incrementally reduced risks of all-cause hospitalization, ED visits, mortality, and medical costs in a dose-dependent fashion.
AHRQ-funded; HS021694.
Citation: Curtis JR, Chen L, Greenberg JD .
The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights.
Pharmacoepidemiol Drug Saf 2017 Mar;26(3):310-19. doi: 10.1002/pds.4126.
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Keywords: Patient-Centered Outcomes Research, Registries, Arthritis, Healthcare Costs, Guidelines