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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 31 Research Studies DisplayedHong MR, Lei D, Yousaf M
A real-world study of the longitudinal course of adult atopic dermatitis severity in clinical practice.
This study examined the longitudinal course of adult atopic dermatitis (AD) severity in clinical practice. Dermatology patients were assessed at approximately 6,12, 18, and 24 months by the scoring systems Eczema Area and Severity Index (EASI) and objective-Scoring Atopic Dermatitis (objective-SCORAD). At any visit, 36.2% of cases were scored as moderate, and 18.2% were severe. Among those patients, 25% and 18.6% continued to have moderate or severe scores at 1 or more follow-up visits for EASI, and 22.6% and 24.5% moderate or severe objective-SCORAD scores respectively. Many patients had fluctuating severity scores over time and a minority had persistently moderate or severe lesions over time, and most of those patients were unable to achieve persistent lesional clearance.
AHRQ-funded; HS023011.
Citation: Hong MR, Lei D, Yousaf M .
A real-world study of the longitudinal course of adult atopic dermatitis severity in clinical practice.
Ann Allergy Asthma Immunol 2020 Dec;125(6):686-92.e3. doi: 10.1016/j.anai.2020.07.005.
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Keywords: Skin Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice
Gelfand JM, Armstrong AW, Bell S
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
This article describes the process that was used to create the first version of a guidance document for management of psoriatic disease during the COVID-19 pandemic developed by the National Psoriasis Foundation. A task force of 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care was created with supplementation by nonvoting members. A Delphi process was created, out of which 22 guidance statements were approved. All guidance statements were recommended, with 9 of them high consensus, and the remaining 13 were moderate consensus. Topics covered included how COVID-19 can impact patients, how medical care can be optimized during the pandemic, and what patients can do to lower their risk of getting infected with COVID-19. This guidance will be updated by the TF as new data emerges.
AHRQ-funded; HS026372.
Citation: Gelfand JM, Armstrong AW, Bell S .
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
J Am Acad Dermatol 2020 Dec;83(6):1704-16. doi: 10.1016/j.jaad.2020.09.001..
Keywords: Skin Conditions, Chronic Conditions, Care Management, Evidence-Based Practice, Guidelines, COVID-19
Silverberg JI, Lei D, Yousaf M
Association of itch triggers with atopic dermatitis severity and course in adults.
Atopic dermatitis (AD) is associated with heterogeneous triggers of itch, which may affect AD course and severity. The objective of this study was to characterize the triggers of itch in adult AD. The investigators concluded that itch triggers were common and affected the course of AD. They noted that itch triggers are an important end point to assess in patients with AD.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Lei D, Yousaf M .
Association of itch triggers with atopic dermatitis severity and course in adults.
Ann Allergy Asthma Immunol 2020 Nov;125(5):552-59.e2. doi: 10.1016/j.anai.2020.06.014..
Keywords: Skin Conditions, Diagnostic Safety and Quality
Silverberg JI, Lai JS, Patel KR
Measurement properties of the Patient-Reported Outcomes Information System (PROMIS(®) ) Itch Questionnaire: itch severity assessments in adults with atopic dermatitis.
This study evaluated the validity of numeric rating scales (NRS) and verbal rating scales (VRS) for itch and itch frequency for assessing itch severity in atopic dermatitis (AD). The authors evaluated the Patient-Reported Outcomes Information System (PROMIS(®) ) Itch Questionnaire (PIQ) - itch severity assessment, including multiple NRS, VRS and frequency of itch assessments, in adults with AD and compared their performance. The evaluation involved self-administered questionnaires and skin examinations performed in 410 patients with AD (aged 18-90 years) in a dermatology practice setting. PIQ NRS, VRS and frequency of itch had good content validity, strong correlations with one another and weak-to-moderate correlations with patient-oriented eczema measure (POEM), Eczema Area and Severity Index (EASI), objective SCORing AD (SCORAD) and Dermatology Life Quality Index (DLQI) and very good discriminant validity.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Lai JS, Patel KR .
Measurement properties of the Patient-Reported Outcomes Information System (PROMIS(®) ) Itch Questionnaire: itch severity assessments in adults with atopic dermatitis.
Br J Dermatol 2020 Nov;183(5):891-98. doi: 10.1111/bjd.18978..
Keywords: Skin Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Lei DK, Yousaf M, Janmohamed SR
Validation of patient-reported outcomes information system sleep disturbance and sleep-related impairment in adults with atopic dermatitis.
This study examined the measurement properties of the Patient-Reported Outcomes Measurement System (PROMIS) Sleep Disturbance (SD) and Sleep-Related Impairment (SRI) questionnaires to assess sleep disturbances in adults with atopic dermatitis (AD). The authors performed a prospective dermatology-practice-based study using questionnaires and evaluation by a dermatologist (n=420). Both questionnaires showed good construct validity, internal consistency, and feasibility to assess sleep in patients with AD.
AHRQ-funded; HS023011.
Citation: Lei DK, Yousaf M, Janmohamed SR .
Validation of patient-reported outcomes information system sleep disturbance and sleep-related impairment in adults with atopic dermatitis.
Br J Dermatol 2020 Nov;183(5):875-82. doi: 10.1111/bjd.18920..
Keywords: Sleep Problems, Skin Conditions
Narla S, Silverberg JI
Multimorbidity and mortality risk in hospitalized adults with chronic inflammatory skin disease in the United States.
Chronic inflammatory skin diseases (CISD) represent a significant burden of skin disease in the United States, and a growing number of studies demonstrate that CISD are associated with multiple comorbidities. However, few studies examined multimorbidity in adults with CISD. In this study, the investigators sought to determine whether hospitalized US adults with chronic inflammatory skin disorders had increased multi-morbidity and mortality risk.
AHRQ-funded; HS023011.
Citation: Narla S, Silverberg JI .
Multimorbidity and mortality risk in hospitalized adults with chronic inflammatory skin disease in the United States.
Arch Dermatol Res 2020 Sep;312(7):507-12. doi: 10.1007/s00403-020-02043-8..
Keywords: Skin Conditions, Chronic Conditions, Mortality, Hospitalization
Silverberg JI, Lei D, Yousaf M
Comparison of Patient-Oriented Eczema Measure and Patient-Oriented Scoring Atopic Dermatitis vs Eczema Area and Severity Index and other measures of atopic dermatitis: a validation study.
Little is known about the measurement properties of Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD) in adults with atopic dermatitis (AD). Even less is known about how PO-SCORAD performs compared with the Patient-Oriented Eczema Measure (POEM). The purpose of this study was to examine the measurement properties of PO-SCORAD and compare them with those of POEM. The investigators concluded that PO-SCORAD and POEM had good construct and cross-cultural validity, reliability, and responsiveness in adults with AD and were feasible for use in clinical trials and practice.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Lei D, Yousaf M .
Comparison of Patient-Oriented Eczema Measure and Patient-Oriented Scoring Atopic Dermatitis vs Eczema Area and Severity Index and other measures of atopic dermatitis: a validation study.
Ann Allergy Asthma Immunol 2020 Jul;125(1):78-83. doi: 10.1016/j.anai.2020.03.006..
Keywords: Skin Conditions, Research Methodologies, Patient-Centered Outcomes Research
Fritz SA, Shapiro DJ, Hersh AL
National trends in incidence of purulent skin and soft tissue infections in patients presenting to ambulatory and emergency department settings, 2000-2015.
This study looked at national trends in the incidence of outpatient visits for skin infections from 2000-2015, which peaked in 2010-2013, followed by a plateau in 2014 and 2015. Cephalexin was the most frequently prescribed antibiotic at the beginning of the study, with trimethoprim-sulfamethoxazole then becoming the most frequently prescribed by the end of the study period.
AHRQ-funded; HS021736; HS024269.
Citation: Fritz SA, Shapiro DJ, Hersh AL .
National trends in incidence of purulent skin and soft tissue infections in patients presenting to ambulatory and emergency department settings, 2000-2015.
Clin Infect Dis 2020 Jun 10;70(12):2715-18. doi: 10.1093/cid/ciz977..
Keywords: Skin Conditions, Ambulatory Care and Surgery, Emergency Department, Antibiotics, Medication
Fishbein AB, Hamideh N, Lor J
Management of atopic dermatitis in children younger than two years of age by community pediatricians: a survey and chart review.
The authors characterized primary care providers' (PCPs) practice patterns for atopic dermatitis (AD) in children under 2 years of age and determined the need for AD guidelines for PCPs focused on this age group. They found that PCP management of AD in children under 2 years of age is different from that of older children, with possible underuse of medium/high-potency topical corticosteroids. They recommended clear guidelines for this age group.
AHRQ-funded; HS023011.
Citation: Fishbein AB, Hamideh N, Lor J .
Management of atopic dermatitis in children younger than two years of age by community pediatricians: a survey and chart review.
J Pediatr 2020 Jun;221:138-44.e3. doi: 10.1016/j.jpeds.2020.02.015..
Keywords: Children/Adolescents, Skin Conditions, Provider: Physician, Practice Patterns, Primary Care, Medication, Care Management
Baernholdt M, Yan G, Hinton ID
Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years.
This study looked at the effects of nursing care interventions aimed at preventing pressure ulcers in rural and urban hospitals over a 4-year period. This longitudinal study used unit-level data from the National Database of Nursing Quality Indicators 2010-2013. The authors analyzed 5761 units (332 rural and 5429 urban) in 772 hospitals (89 rural and 683 urban) that reported ulcer rates in two or more quarters. Outcomes from use of a three-care intervention combination was measured with decreases in pressure ulcers shown from any of those interventions (patients receiving skin assessment on admission, receiving risk assessment on admission, and receiving any risk assessment before the pressure ulcer). An increase in RN skill mix and two nurse outcomes (increase in job satisfaction and intent-to-stay) also led to decreases in ulcer rates.
AHRQ-funded; HS023147.
Citation: Baernholdt M, Yan G, Hinton ID .
Effect of preventive care interventions on pressure ulcer rates in a national sample of rural and urban nursing units: Longitudinal associations over 4 years.
Int J Nurs Stud 2020 May;105:103455. doi: 10.1016/j.ijnurstu.2019.103455..
Keywords: Pressure Ulcers, Prevention, Skin Conditions, Nursing, Practice Patterns, Provider: Nurse, Provider, Quality Indicators (QIs), Quality Measures, Quality of Care
Suh TP, Ramachandran D, Patel V
Product of Investigator Global Assessment and Body Surface Area (IGAxBSA): a practice-friendly alternative to the eczema area and severity index to assess atopic dermatitis severity in children.
Accurately documenting pediatric atopic dermatitis (AD) severity is important, but research tools, such as Eczema Area and Severity Index (EASI), are too time consuming for clinical settings. The objective of this study was to evaluate an Investigator Global Assessment and body surface area product (IGA×BSA) as an easy-to-use severity measure for pediatric AD. The investigators concluded that the IGA×BSA (using the vIGA) is a simple measure that correlates well with the EASI in patients with mild to severe pediatric AD.
AHRQ-funded; HS023011.
Citation: Suh TP, Ramachandran D, Patel V .
Product of Investigator Global Assessment and Body Surface Area (IGAxBSA): a practice-friendly alternative to the eczema area and severity index to assess atopic dermatitis severity in children.
J Am Acad Dermatol 2020 May;82(5):1187-94. doi: 10.1016/j.jaad.2020.01.023.
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Keywords: Children/Adolescents, Skin Conditions, Diagnostic Safety and Quality
Kirby JS, Butt M, King T
Severity and Area Score for Hidradenitis (SASH): a novel outcome measurement for hidradenitis suppurativa.
Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease with a large impact on patients' health-related quality of life. However, reliable and consistent outcome measures to assess body surface area (BSA) of HS have not been established. The objectives of this study were to develop and assess the reliability and validity of a novel outcome instrument for assessment of HS BSA in a clinical trial setting.
AHRQ-funded; HS024585.
Citation: Kirby JS, Butt M, King T .
Severity and Area Score for Hidradenitis (SASH): a novel outcome measurement for hidradenitis suppurativa.
Br J Dermatol 2020 Apr;182(4):940-48. doi: 10.1111/bjd.18244..
Keywords: Skin Conditions, Chronic Conditions, Patient-Centered Outcomes Research, Outcomes
Herb JN, Dunham LN, Ollila DW
Use of completion lymph node dissection for sentinel lymph node-positive melanoma.
This study examined the use and time trends of completion lymph node dissection (CLND) for sentinel lymph node-positive melanoma (SNPM). There has been found to be no benefit for CLND in SNPM patients. The National Cancer Database was used to find patients 18 years and older from 2012 to 2016 with SNPM. During that time period, 7,146 patients were identified with SNPM. From 2012 to 2014 the proportion of patients undergoing CLND was steady (61-63%) but decreased to 57% in 2015 and 50% in 2016. Use was less likely for women and increasing age. Higher use was more likely at high-volume centers, and associated with increased Breslow depth and ulceration.
Citation: Herb JN, Dunham LN, Ollila DW .
Use of completion lymph node dissection for sentinel lymph node-positive melanoma.
J Am Coll Surg 2020 Apr;230(4):515-24. doi: 10.1016/j.jamcollsurg.2019.12.010..
Keywords: Cancer: Skin Cancer, Cancer, Skin Conditions, Treatments
Lei D, Yousaf M, Janmohamed SR
Validation of four single-item patient-reported assessments of sleep in adult atopic dermatitis patients.
The purpose of this study was to assess the measurement properties of sleep-related items from the Patient-Oriented Eczema Measure (POEM), SCORing AD (SCORAD), 5-dimensions of itch (5D), and Itch-Related Quality of Life (ItchyQOL) in adults with atopic dermatitis (AD). Results showed modest overlap and weak to moderate concordance of responses to the different assessments. The researchers conclude that sleep-related items from POEM, SCORAD, 5D, and ItchyQOL showed good validity and responsiveness to monitor sleep disturbances in adult AD patients.
AHRQ-funded; HS023011.
Citation: Lei D, Yousaf M, Janmohamed SR .
Validation of four single-item patient-reported assessments of sleep in adult atopic dermatitis patients.
Ann Allergy Asthma Immunol 2020 Mar;124(3):261-66. doi: 10.1016/j.anai.2019.12.002..
Keywords: Sleep Problems, Skin Conditions, Quality of Life, Patient-Centered Outcomes Research
McKenzie C, Paller AS, Fishbein A
Association between the longitudinal course of AD, sleep disturbance, and overall health in US children.
Atopic dermatitis (AD) is a chronic inflammatory skin disease impacting 13% of children in the United States. It is associated with sleep disturbances. In this paper the investigators sought to examine the associations of AD onset, AD persistence, and comorbid atopic conditions with sleep disturbance and overall health in childhood. This study added to previous studies by demonstrating that comorbid atopy and AD course, particularly early-onset and more persistent AD, were associated with sleep disturbance.
AHRQ-funded; HS023011.
Citation: McKenzie C, Paller AS, Fishbein A .
Association between the longitudinal course of AD, sleep disturbance, and overall health in US children.
J Allergy Clin Immunol Pract 2020 Feb;8(2):812-14.e1. doi: 10.1016/j.jaip.2019.08.027..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions
Lee HH, Patel KR, Singam V
Associations of cutaneous and extracutaneous infections with hidradenitis suppurativa in U.S. children and adults.
The purpose of this study was to determine whether Hidradenitis suppurativa (HS) is associated with cutaneous and extracutaneous infections and related outcomes. Using data from the Nationwide Inpatient Sample, results showed that adults and children with HS had increased acute and chronic, cutaneous, extracutaneous, and systemic infections, which were associated with increased mortality and cost.
AHRQ-funded; HS023011.
Citation: Lee HH, Patel KR, Singam V .
Associations of cutaneous and extracutaneous infections with hidradenitis suppurativa in U.S. children and adults.
Br J Dermatol 2020 Feb;182(2):327-34. doi: 10.1111/bjd.18093..
Keywords: Healthcare Cost and Utilization Project (HCUP), Skin Conditions, Children/Adolescents
Baxa J, McCreary E, Schulz L
Finding the niche: an interprofessional approach to defining oritavancin use criteria in the emergency department.
This study’s purpose was to identify a population of emergency department (ED) patients with cellulitis who would be the most appropriate to receive oritavancin which is a novel, broad-spectrum antibiotic. This antibiotic is given in one dose for the entire treatment course. A retrospective cohort study of cellulitis patients was conducted at a Midwest healthcare system with 2 EDs. All adult patients admitted from the ED to an inpatient ward were reviewed over a 1-year period. Potentially avoidable admissions (PAAs) were identified and characterized. Out of 86 patients, nine were deemed a PAA. The majority had at last one risk factor for treatment failure (55% with diabetes mellitus) and they were significantly younger than the non-PAA group. In other respects there was no difference between the two groups for non-age demographics and other risk factors or length of stay.
AHRQ-funded; HS024342.
Citation: Baxa J, McCreary E, Schulz L .
Finding the niche: an interprofessional approach to defining oritavancin use criteria in the emergency department.
Am J Emerg Med 2020 Feb;38(2):321-24. doi: 10.1016/j.ajem.2019.158442..
Keywords: Emergency Department, Skin Conditions, Antibiotics, Medication
Pembroke M, Nemeth LS
Instruments to evaluate self-management of radiation dermatitis in patients with breast cancer.
Radiation dermatitis (RD) is a side effect of radiation to the breast and chest wall. Healthcare providers routinely grade the severity of RD without assessing its impact on quality of life. This study investigates instruments to identify a patient's ability and confidence to self-manage RD. Findings showed that using a validated instrument to assess patients' needs and ability to self-manage RD will promote personalized care plans tailored to each patient. These findings can be used to implement a patient-reported outcome measure into clinical practice, to develop educational programs for RD management, and to create personalized care plans.
AHRQ-funded.
Citation: Pembroke M, Nemeth LS .
Instruments to evaluate self-management of radiation dermatitis in patients with breast cancer.
Oncol Nurs Forum 2020 Jan;47(1):101-11. doi: 10.1188/20.Onf.101-111..
Keywords: Patient Self-Management, Cancer: Breast Cancer, Cancer, Skin Conditions
Sarfo A, Butt M, Kirby JS
Periodic worsening, or flare, in hidradenitis suppurativa: the perspective of people with hidradenitis.
Hidradenitis suppurativa (HS) is an inflammatory skin disease described as chronic and recurrent, with intermittent periods of worsening, also described as ‘flares’. The aim of this qualitative study was to explore the patient perspective of HS flare. The investigators indicated that the findings from this study illuminate the impact of HS flares on patients’ lives and may help to inform the development of a precise and measurable definition of HS for use in clinical studies and practice.
AHRQ-funded; HS024585.
Citation: Sarfo A, Butt M, Kirby JS .
Periodic worsening, or flare, in hidradenitis suppurativa: the perspective of people with hidradenitis.
Br J Dermatol 2020 Jan;182(1):218-19. doi: 10.1111/bjd.18210..
Keywords: Skin Conditions
Kantor R, Kim A, Thyssen JP
Association of atopic dermatitis with smoking: a systematic review and meta-analysis.
The authors examined the association between atopic dermatitis (AD) and exposure to tobacco smoke. They found that a diagnosis of AD was associated with higher odds of active smoking and exposure to passive smoke but not to maternal smoking during pregnancy, and concluded that active and passive tobacco smoke exposure are associated with increased AD prevalence.
AHRQ-funded; HS023011.
Citation: Kantor R, Kim A, Thyssen JP .
Association of atopic dermatitis with smoking: a systematic review and meta-analysis.
J Am Acad Dermatol 2016 Dec;75(6):1119-25.e1. doi: 10.1016/j.jaad.2016.07.017.
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Keywords: Skin Conditions, Tobacco Use, Risk, Evidence-Based Practice
Strom MA, Fishbein AB, Paller AS
Association between atopic dermatitis and attention deficit hyperactivity disorder in US children and adults.
The researchers sought to determine if childhood and adult atopic dermatitis (AD) and AD severity are associated with ADD/ADHD and to delineate the factors contributing to such an association. It found that AD was most strongly associated with severe ADHD. AD unaccompanied by other allergic disease, was also associated with increased risk of ADD/ADHD in children.
AHRQ-funded; HS023011.
Citation: Strom MA, Fishbein AB, Paller AS .
Association between atopic dermatitis and attention deficit hyperactivity disorder in US children and adults.
Br J Dermatol 2016 Nov;175(5):920-29. doi: 10.1111/bjd.14697.
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Keywords: Skin Conditions, Behavioral Health, Risk
Kantor R, Thyssen JP, Paller AS
Atopic dermatitis, atopic eczema, or eczema? A systematic review, meta-analysis, and recommendation for uniform use of 'atopic dermatitis'.
The authors sought to determine the most commonly-used terms for atopic dermatitis. They found that atopic dermatitis was the most commonly-used term in studies across almost all publication types, languages, and journals and appears to be increasing in popularity. They concluded by suggesting the use of the term atopic dermatitis in publications, healthcare clinician training, and patient education.
AHRQ-funded; HS023011.
Citation: Kantor R, Thyssen JP, Paller AS .
Atopic dermatitis, atopic eczema, or eczema? A systematic review, meta-analysis, and recommendation for uniform use of 'atopic dermatitis'.
Allergy 2016 Oct;71(10):1480-5. doi: 10.1111/all.12982.
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Keywords: Education: Patient and Caregiver, Diagnostic Safety and Quality, Patient-Centered Healthcare, Clinician-Patient Communication, Skin Conditions
Kirby JS, Sisic M, Tan J
Exploring coping strategies for patients with hidradenitis suppurativa.
The authors explored the coping strategies of individuals with hidradenitis suppurativa (HS). They found that negative coping included behavioral disengagement and social isolation, while positive coping included use of humor and positive reframing as well as the support of others.
AHRQ-funded; HS024585.
Citation: Kirby JS, Sisic M, Tan J .
Exploring coping strategies for patients with hidradenitis suppurativa.
JAMA Dermatol 2016 Oct;152(10):1166-67. doi: 10.1001/jamadermatol.2016.1942.
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Keywords: Health Status, Quality of Life, Patient Self-Management, Skin Conditions
Kathuria P, Silverberg JI
Association of pollution and climate with atopic eczema in US children.
The authors sought to determine the relationship between childhood eczema, environmental pollutants, and climate. They found that pollutants, in conjunction with climate factors, may differentially impact eczema prevalence and severity.
AHRQ-funded; HS023011.
Citation: Kathuria P, Silverberg JI .
Association of pollution and climate with atopic eczema in US children.
Pediatr Allergy Immunol 2016 Aug;27(5):478-85. doi: 10.1111/pai.12543.
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Keywords: Children/Adolescents, Children/Adolescents, Skin Conditions
Silverberg JI, Song J, Pinto D
Atopic dermatitis is associated with less physical activity in US adults.
The authors sought to use objective measures to confirm whether adults with atopic dermatitis (AD) have decreased vigorous physical activity. Their results confirmed and expanded on previous studies that found less self-reported vigorous physical activity among adults with AD.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Song J, Pinto D .
Atopic dermatitis is associated with less physical activity in US adults.
J Invest Dermatol 2016 Aug;136(8):1714-6. doi: 10.1016/j.jid.2016.04.025.
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Keywords: Lifestyle Changes, Risk, Skin Conditions