National Healthcare Quality and Disparities Report
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Topics
- Access to Care (2)
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- Blood Pressure (3)
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- Cancer: Breast Cancer (10)
- Cancer: Cervical Cancer (3)
- Cancer: Colorectal Cancer (15)
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- Cancer: Ovarian Cancer (4)
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- Decision Making (13)
- Depression (4)
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- Diagnostic Safety and Quality (13)
- Disparities (3)
- Education: Patient and Caregiver (2)
- Elderly (6)
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- Evidence-Based Practice (12)
- Eye Disease and Health (1)
- Family Health and History (4)
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- Guidelines (12)
- Healthcare Costs (6)
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- Racial and Ethnic Minorities (7)
- Respiratory Conditions (1)
- Risk (3)
- Rural Health (5)
- (-) Screening (83)
- Sexual Health (2)
- Sleep Problems (2)
- Social Determinants of Health (4)
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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 83 Research Studies DisplayedFan T, Duffy M
Screening for osteoporosis to prevent fractures.
This case study provides case questions and answers related to the U.S. Preventive Services Task Force recommendations on screening for osteoporosis to prevent fractures. It is part of the “Putting Prevention into Practice” series.
AHRQ-authored.
Citation: Fan T, Duffy M .
Screening for osteoporosis to prevent fractures.
Am Fam Physician 2018 Nov 15;98(10):593-94..
Keywords: Case Study, Injuries and Wounds, Osteoporosis, Prevention, Screening
Magrath M, Yang E, Ahn C
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
The goal of this study was to characterize guideline adherence of surveillance recommendations after implementation of an electronic medical record (EMR)-based Colonoscopy Pathology Reporting and Clinical Decision Support System (CoRS). Results showed that an EMR-based CoRS was widely used and significantly improved guideline adherence of surveillance recommendations.
AHRQ-funded; HS022418.
Citation: Magrath M, Yang E, Ahn C .
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
J Natl Compr Canc Netw 2018 Nov;16(11):1321-28. doi: 10.6004/jnccn.2018.7050..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Colonoscopy, Cancer: Colorectal Cancer, Screening, Cancer, Guidelines, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention
Lee CI, Zhu W, Onega TL
The effect of digital breast tomosynthesis adoption on facility-level breast cancer screening volume.
This study examined whether adoption of digital breast tomosynthesis (DBT) was associated with a decrease in screening mammography capacity across Breast Cancer Screening Consortium facilities. Facility characteristics and examination volume data were collected from facilities that adopted DBT from 2011 and 2014. The majority of facilities had no academic affiliation (73%), were nonprofit (80%) and were general radiology practices (66.7%). Monthly screening volumes were slightly higher after the adoption period but otherwise remained relatively stable before and after adoption of DBT.
AHRQ-funded; HS018366.
Citation: Lee CI, Zhu W, Onega TL .
The effect of digital breast tomosynthesis adoption on facility-level breast cancer screening volume.
AJR Am J Roentgenol 2018 Nov;211(5):957-63. doi: 10.2214/ajr.17.19350..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Women
Shaker M, Verma K, Greenhawt M
The health and economic outcomes of early egg introduction strategies.
This study compared the costs and benefits of early egg introduction (EEI) using simulation and Markov modeling over a 20-year horizon with data from the United States, Europe, and Canada. Per child it was more expensive to provide early screening for all children with early-onset eczema than to have a “wait and see” approach. While there would be more egg allergy diagnosis with early screening, the increased costs were too great compared to the no-screening approach.
Citation: Shaker M, Verma K, Greenhawt M .
The health and economic outcomes of early egg introduction strategies.
Allergy 2018 Nov;73(11):2214-23. doi: 10.1111/all.13565..
Keywords: Children/Adolescents, Screening, Healthcare Costs, Diagnostic Safety and Quality, Medication
Wolff T, Jadotte YJ
AHRQ Author: Wolff T
Screening for prostate cancer.
This case study describes a 57-year-old black man, non-smoker, who has a history of diabetes mellitus, currently well-controlled. He would like to discuss the prostate-specific antigen (PSA) test even though he has no family history of prostate cancer. The case study questions are based on USPSTF recommendations for prostate cancer screening.
AHRQ-authored.
Citation: Wolff T, Jadotte YJ .
Screening for prostate cancer.
Am Fam Physician 2018 Oct 15;98(8):537-38..
Keywords: Cancer: Prostate Cancer, Case Study, Guidelines, Prevention, Screening
Cartmell KB, Dismuke CE, Dooley M
Effect of an evidence-based inpatient tobacco dependence treatment service on 1-year postdischarge health care costs.
In 2014, the Medical University of South Carolina (MUSC) implemented a Tobacco Dependence Treatment Service (TDTS) consistent with the Joint Commission (JC) standards recommending that hospitals screen patients for smoking, provide cessation support, and follow-up contact for relapse prevention within 1 month of discharge. This paper examined whether exposure to the TDTS influenced downstream health care charges 12 months after patients were discharged from the hospital.
AHRQ-funded; HS023863.
Citation: Cartmell KB, Dismuke CE, Dooley M .
Effect of an evidence-based inpatient tobacco dependence treatment service on 1-year postdischarge health care costs.
Med Care 2018 Oct;56(10):883-89. doi: 10.1097/mlr.0000000000000979..
Keywords: Healthcare Costs, Inpatient Care, Screening, Substance Abuse, Tobacco Use: Smoking Cessation
Lee SC, Higashi RT, Sanders JM
Effects of program scale-up on time to resolution for patients with abnormal screening mammography results.
Effects of geographic program expansion to rural areas on mammogram screening program outcomes are understudied. The authors of this study sought to determine whether time-to-resolution (TTR) varied significantly by service delivery time period, location, and participant characteristics across 19 North Texas counties.
AHRQ-funded; HS022418.
Citation: Lee SC, Higashi RT, Sanders JM .
Effects of program scale-up on time to resolution for patients with abnormal screening mammography results.
Cancer Causes Control 2018 Oct;29(10):995-1005. doi: 10.1007/s10552-018-1074-4..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Women, Rural Health, Access to Care, Prevention
Symer MM, Yeo HL
Recent advances in the management of anal cancer.
The incidence of anal cancer is gradually increasing. This article discusses the epidemiology and pathogenesis of anal cancer, and the prevention of human papilloma virus (HPV) infection as an important management principle. Screening recommendations from various sources are reviewed, and the authors note that screening for individuals at risk of anal cancer should include anal cytology and anoscopy. Current treatments and special cases are also reviewed; the authors conclude that treatments such biological therapies, therapeutic vaccination, and immunotherapy are likely to improve outcomes in patients with anal cancer.
AHRQ-funded; HS000066.
Citation: Symer MM, Yeo HL .
Recent advances in the management of anal cancer.
F1000Res 2018 Sep 28;7. doi: 10.12688/f1000research.14518.1..
Keywords: Cancer, Care Management, Diagnostic Safety and Quality, Screening
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
Predmore Z, Pannikottu J, Sharma R
Factors associated with the overuse of colorectal cancer screening: a systematic review.
The purpose of this systematic review was to examine factors associated with overuse of colorectal cancer (CRC) screening, using studies that were in English, used a U.S. population, and contained original data. The review indicates that overuse of CRC screening was greater in the Northeast/Mid-Atlantic regions and in urban areas, but was lower in academically affiliated centers. The authors conclude that, although the literature supports important overuse of CRC screening, what drives these practices remains unclear and that future research should explore these factors thoroughly.
AHRQ-funded; HS000029.
Citation: Predmore Z, Pannikottu J, Sharma R .
Factors associated with the overuse of colorectal cancer screening: a systematic review.
Am J Med Qual 2018 Sep/Oct;33(5):472-80. doi: 10.1177/1062860618764302..
Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Prevention, Screening
Kim JJ, Burger EA, Regan C
Screening for cervical cancer in primary care: a decision analysis for the US Preventive Services Task Force.
The purpose of this study was to inform the US Preventive Services Task Force by modeling the benefits and harms of various cervical cancer screening strategies. In this microsimulation modeling study, it was estimated that primary hrHPV screening may represent a reasonable balance of harms and benefits when performed every 5 years. Switching from cytology to hrHPV testing at age 30 years yielded the most efficient harm to benefit ratio when using colposcopy as a proxy for harms.
AHRQ-funded; 290-2012-00015-I.
Citation: Kim JJ, Burger EA, Regan C .
Screening for cervical cancer in primary care: a decision analysis for the US Preventive Services Task Force.
JAMA 2018 Aug 21;320(7):706-14. doi: 10.1001/jama.2017.19872..
Keywords: Cancer: Cervical Cancer, Decision Making, Primary Care, Screening, U.S. Preventive Services Task Force (USPSTF)
Melnikow J, Henderson JT, Burda BU J, Henderson JT, Burda BU
Screening for cervical cancer with high-risk human papillomavirus testing: updated evidence report and systematic review for the US Preventive Services Task Force.
Cervical cancer can be prevented with detection and treatment of precancerous cell changes caused primarily by high-risk types of human papillomavirus (hrHPV), the causative agents in more than 90% of cervical cancers. The objective of this study was to systematically review benefits and harms of cervical cancer screening for hrHPV to inform the US Preventive Services Task Force.
AHRQ-funded; 290201200015I.
Citation: Melnikow J, Henderson JT, Burda BU J, Henderson JT, Burda BU .
Screening for cervical cancer with high-risk human papillomavirus testing: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2018 Aug 21;320(7):687-705. doi: 10.1001/jama.2018.10400..
Keywords: Cancer: Cervical Cancer, Evidence-Based Practice, Infectious Diseases, Screening, U.S. Preventive Services Task Force (USPSTF)
Jonas DE, Kahwati LC, Yun JDY
Screening for atrial fibrillation with electrocardiography: evidence report and systematic review for the US Preventive Services Task Force.
The objective of this study was to review the evidence on screening for nonvalvular atrial fibrillation with electrocardiography (ECG) and stroke prevention treatment in asymptomatic adults 65 years or older to inform the US Preventive Services Task Force. The authors concluded that although screening with ECG can detect previously unknown cases of atrial fibrillation, it has not been shown to detect more cases than screening focused on pulse palpation.
AHRQ-funded; 290201500011I.
Citation: Jonas DE, Kahwati LC, Yun JDY .
Screening for atrial fibrillation with electrocardiography: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2018 Aug 7;320(5):485-98. doi: 10.1001/jama.2018.4190..
Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Cardiovascular Conditions, Screening, Evidence-Based Practice, Guidelines, Prevention
Shaker M, Stukus D, Chan ES
"To screen or not to screen": comparing the health and economic benefits of early peanut introduction strategies in five countries.
This study compared the costs and benefits of early peanut introduction (EPI) using data from five countries: US, Canada, Australia, New Zealand and United Kingdom. Per child it was more expensive to provide early screening for all children with early-onset eczema and/or egg allergy than to have a “wait and see” approach. While there would be more peanut allergy diagnosis with early screening, the increased costs were too great compared to the no-screening approach.
AHRQ-funded; HS024599.
Citation: Shaker M, Stukus D, Chan ES .
"To screen or not to screen": comparing the health and economic benefits of early peanut introduction strategies in five countries.
Allergy 2018 Aug;73(8):1707-14. doi: 10.1111/all.13446..
Keywords: Children/Adolescents, Screening, Diagnostic Safety and Quality, Healthcare Costs, Medication, Medication
Srivatsan S, Guduguntla V, Young KZ
Clinical versus patient-reported measures of depression in bariatric surgery.
This study examined the relationship between traditional clinical screening tools and a novel patient-reported depression screening survey, Patient Health Questionnaire 8 (PHQ-8), in the setting of the bariatric surgery preoperative assessment. The researchers found a higher rate of clinically diagnosed depression in their cohort compared to the general population. However, when using the validated PHQ-8 survey, the rate of depression more closely approximated the national incidence.
AHRQ-funded; HS023621; HS024403.
Citation: Srivatsan S, Guduguntla V, Young KZ .
Clinical versus patient-reported measures of depression in bariatric surgery.
Surg Endosc 2018 Aug;32(8):3683-90. doi: 10.1007/s00464-018-6101-8..
Keywords: Depression, Patient Safety, Screening, Surgery
Roth JA, Carter-Harris L, Brandzel S
A qualitative study exploring patient motivations for screening for lung cancer.
The purpose of this qualitative study was to explore the motivations for screening-eligible patients to screen for lung cancer. The investigators concluded that participants in their study were primarily motivated to screen for lung cancer based on perceived benefit of early-detection, absence of safety concerns, and personal relationships. They suggest that their findings can potentially be used to improve lung cancer screening uptake and shared decision-making processes.
AHRQ-funded; HS022982.
Citation: Roth JA, Carter-Harris L, Brandzel S .
A qualitative study exploring patient motivations for screening for lung cancer.
PLoS One 2018 Jul 5;13(7):e0196758. doi: 10.1371/journal.pone.0196758..
Keywords: Cancer: Lung Cancer, Decision Making, Healthcare Utilization, Screening
Davies L, Petitti DB, Martin L
Defining, estimating, and communicating overdiagnosis in cancer screening.
Overdiagnosis represents one harm of too much medicine, but the concept can be confusing. Because the U.S. Preventive Services Task Force (USPSTF) issues screening recommendations aimed largely at healthy persons, it has a particular interest in understanding harms related to screening, especially but not limited to overdiagnosis. In support of the USPSTF, the authors summarize the knowledge and provide guidance on defining, estimating, and communicating overdiagnosis in cancer screening.
AHRQ-funded; 290201200015I; 290201600006C.
Citation: Davies L, Petitti DB, Martin L .
Defining, estimating, and communicating overdiagnosis in cancer screening.
Ann Intern Med 2018 Jul 3;169(1):36-43. doi: 10.7326/m18-0694..
Keywords: Cancer, Communication, Diagnostic Safety and Quality, Screening, U.S. Preventive Services Task Force (USPSTF)
Lewis CL, Kistler CE, Dalton AF
A decision aid to promote appropriate colorectal cancer screening among older adults: a randomized controlled trial.
The purpose of this study was to test a patient decision aid (PtDA) to promote CRC screening in older adults. The PtDA was designed to facilitate individual decision-making to help patients understand the potential risks and benefit of CRC screening. 424 patients aged 70 – 84 who were not up to date with CRC screening participated in a double-blinded randomized controlled trial, using the PtDA or an attention control. Two outcomes - appropriate CRC screening behavior at 6 months following the initial visit or appropriate screening intent immediately after the visit - were defined as completed screening or intent for patients in good health, discussion about screening with their provider for patients in intermediate health, or no screening or intent for patients in poor health. Appropriate screening behavior at 6 months was higher in the intervention group; appropriate screening intent following the provider visit was also higher. The authors conclude that the PtDA for older adults promoted appropriate CRC screening behavior.
AHRQ-funded; HS021133.
Citation: Lewis CL, Kistler CE, Dalton AF .
A decision aid to promote appropriate colorectal cancer screening among older adults: a randomized controlled trial.
Med Decis Making 2018 Jul;38(5):614-24. doi: 10.1177/0272989x18773713..
Keywords: Cancer, Cancer: Colorectal Cancer, Decision Making, Education: Patient and Caregiver, Elderly, Prevention, Screening
Haukoos JS, Lyons MS, Rothman RE
The evolving landscape of HIV screening in the emergency department.
This article is a summary of two studies that appear in the same edition of the journal. The two studies describe the value of using targeted vs. non-targeted screening for HIV in emergency departments (EDs). New diagnosis rates were relatively small, which suggested that the use of targeted screening may be need to be refined more in terms of selection criteria.
AHRQ-funded; HS021749.
Citation: Haukoos JS, Lyons MS, Rothman RE .
The evolving landscape of HIV screening in the emergency department.
Ann Emerg Med 2018 Jul;72(1):54-56. doi: 10.1016/j.annemergmed.2018.01.041..
Keywords: Diagnostic Safety and Quality, Emergency Department, Human Immunodeficiency Virus (HIV), Prevention, Screening
Misra-Hebert AD, Hom G, Klein EA
Testing of a tool for prostate cancer screening discussions in primary care.
As prostate cancer (PCa) screening decisions often occur in outpatient primary care, a brief tool to help the PCa screening conversation in busy clinic settings is needed. This paper discusses a previously-created 9-item tool to aid (PCa) screening discussions. The study found that the brief conversation tool was well received in busy primary-care settings and improved patients' knowledge about the screening decision.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hom G, Klein EA .
Testing of a tool for prostate cancer screening discussions in primary care.
Front Oncol 2018 Jun 28;8:238. doi: 10.3389/fonc.2018.00238..
Keywords: Cancer: Prostate Cancer, Decision Making, Patient-Centered Outcomes Research, Primary Care, Screening
Fan T, Uptegraft C
AHRQ Author: Fan T
Screening for ovarian cancer.
This case study addresses the U.S. Preventive Health Service Task Force recommendations and offers a scenario, questions, and answers related to screening for ovarian cancer.
AHRQ-authored.
Citation: Fan T, Uptegraft C .
Screening for ovarian cancer.
Am Fam Physician 2018 Jun 15;97(12):813-14..
Keywords: Cancer: Ovarian Cancer, Case Study, Prevention, Screening, U.S. Preventive Services Task Force (USPSTF)
Pappadis MR, Volk RJ, Krishnan S
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
The authors explored older women's perceptions about the concept of overdetection of breast cancer and its influence on future screening intentions. Semistructured interviews were conducted with 59 English-speaking women aged 70 years or older with no prior history of breast cancer. The authors found that many older women did not understand the concept of overdetection, in addition to being suspicious of or resistant to the concept. Providing older women with descriptions of overdetection may not be sufficient to influence screening intentions.
AHRQ-funded; HS022134.
Citation: Pappadis MR, Volk RJ, Krishnan S .
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
BMJ Open 2018 Jun 14;8(6):e022138. doi: 10.1136/bmjopen-2018-022138..
Keywords: Cancer: Breast Cancer, Cancer, Elderly, Screening, Decision Making, Women, Prevention, Imaging
Luckenbaugh AN, Holllenbeck BK, Kaufman SR
Impact of accountable care organizations on diagnostic testing for prostate cancer.
The researchers sought to determine if Accountable Care Organizations (ACOs) have the potential to accelerate the impact of prostate cancer screening recommendations. They concluded that the rate of PSA testing was not differentially affected by ACO participation. Conversely, there was an increase in the rate of prostate biopsy among patients of ACO-aligned physicians.
AHRQ-funded; HS024728; HS025707; HS024525.
Citation: Luckenbaugh AN, Holllenbeck BK, Kaufman SR .
Impact of accountable care organizations on diagnostic testing for prostate cancer.
Urology 2018 Jun;116:68-75. doi: 10.1016/j.urology.2018.01.056.
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Keywords: Cancer: Prostate Cancer, Health Services Research (HSR), Screening
Childers KK, Maggard-Gibbons M, Macinko J
National distribution of cancer genetic testing in the United States: evidence for a gender disparity in hereditary breast and ovarian cancer.
Identifying mutation carriers is critical for treatment decisions, cancer prevention, and early detection. This study analyzed the 2015 US National Health Interview Survey (NHIS), a cross-sectional in-person interview gathering self-reported health data for the US population. The study found that while cancer genetic testing seems to reach a broad geographic and sociodemographic population in the national survey, there remain underrepresented groups, including Hispanics, the uninsured, noncitizens, and those with less education.
AHRQ-funded; HS025079.
Citation: Childers KK, Maggard-Gibbons M, Macinko J .
National distribution of cancer genetic testing in the United States: evidence for a gender disparity in hereditary breast and ovarian cancer.
JAMA Oncol 2018 Jun;4(6):876-79. doi: 10.1001/jamaoncol.2018.0340..
Keywords: Cancer, Cancer: Breast Cancer, Cancer: Ovarian Cancer, Genetics, Racial and Ethnic Minorities, Screening, Social Determinants of Health, Women
Housten AJ, Pappadis MR, Krishnan S
Resistance to discontinuing breast cancer screening in older women: a qualitative study.
Screening mammography is associated with reduced breast cancer-specific mortality; however, among older women, evidence suggests that the potential harms of screening may outweigh the benefits. This study used a qualitative approach to examine the willingness of older women from different racial/ethnic groups to discontinue breast cancer screening. The authors found that among older women who planned to continue screening, intentions to continue breast cancer screening appear to be highly resilient and resistant to recommendations from physicians or expert/government panels.
AHRQ-funded; HS022134.
Citation: Housten AJ, Pappadis MR, Krishnan S .
Resistance to discontinuing breast cancer screening in older women: a qualitative study.
Psychooncology 2018 Jun;27(6):1635-41. doi: 10.1002/pon.4708..
Keywords: Cancer: Breast Cancer, Elderly, Screening, Prevention, Women