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AHRQ Research Studies Date
Topics
- Access to Care (1)
- Back Health and Pain (1)
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- Clinical Decision Support (CDS) (1)
- Decision Making (2)
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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 11 of 11 Research Studies DisplayedVila PM, Olsen MA, Piccirillo JF
Rates of sialoendoscopy and sialoadenectomy in 5,111 adults with private insurance.
The purpose of this study was to determine frequencies and trends in sialoendoscopy and sialoadenectomy for the treatment of obstructive, non-neoplastic submandibular salivary gland disease. Researchers conducted an epidemiologic study of insurance claims from 2006 to 2013 in a large, private insurance claims database; 5,111 adults with sialadenitis who had a sialoendoscopy or submandibular gland excision were included. The results of this study indicate that the use of sialoendoscopy procedures has increased over time, while the overall rate of sialoadenectomy has decreased, but the authors conclude that both procedures are safe for the treatment of patients with sialadenitis and sialolithiasis.
AHRQ-funded; HS019455.
Citation: Vila PM, Olsen MA, Piccirillo JF .
Rates of sialoendoscopy and sialoadenectomy in 5,111 adults with private insurance.
Laryngoscope 2019 Dec 16;129(3):602-06. doi: 10.1002/lary.27243..
Keywords: Healthcare Utilization, Health Insurance, Surgery
Vu JV, Gunaseelan V, Dimick JB
Mechanisms of age and race differences in receiving minimally invasive inguinal hernia repair.
Black patients and older adults are less likely to receive minimally invasive hernia repair. In this study, the investigators explored the association between race, age, and surgeon utilization of minimally invasive surgery (MIS) with the likelihood of receiving MIS inguinal hernia repair. The investigators concluded that race differences were explained by surgeon MIS utilization, implicating access to MIS-performing surgeon as a mediator. Conversely, age disparity was independent of MIS utilization, even after adjusting for comorbidities, indicating some degree of provider bias against performing MIS repair in older patients.
AHRQ-funded; HS025778.
Citation: Vu JV, Gunaseelan V, Dimick JB .
Mechanisms of age and race differences in receiving minimally invasive inguinal hernia repair.
Surg Endosc 2019 Dec;33(12):4032-37. doi: 10.1007/s00464-019-06695-0..
Keywords: Racial and Ethnic Minorities, Surgery, Elderly, Access to Care, Healthcare Utilization
Strassle PD, Kinlaw AC, Chaumont N
Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change.
Gastroenterology 2019 Dec;157(6):1679-81.e11. doi: 10.1053/j.gastro.2019.08.045.
The purpose of this retrospective cohort study was to assess whether trends in elective and urgent/emergent colectomy changed after July 2006. The authors suggest that given the risks associated with elective colectomy, their findings demonstrate the need for a more evidence-based decision-making process, incorporating both patient preferences and patient-reported outcomes, for those considering elective colectomy for uncomplicated and some cases of complicated diverticulitis.
The purpose of this retrospective cohort study was to assess whether trends in elective and urgent/emergent colectomy changed after July 2006. The authors suggest that given the risks associated with elective colectomy, their findings demonstrate the need for a more evidence-based decision-making process, incorporating both patient preferences and patient-reported outcomes, for those considering elective colectomy for uncomplicated and some cases of complicated diverticulitis.
AHRQ-funded; HS026363.
Citation: Strassle PD, Kinlaw AC, Chaumont N .
Rates of elective colectomy for diverticulitis continued to increase after 2006 guideline change.
Gastroenterology 2019 Dec;157(6):1679-81.e11. doi: 10.1053/j.gastro.2019.08.045..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Healthcare Utilization, Guidelines, Decision Making, Digestive Disease and Health
Subramanian MP, Liu J, Chapman WC
Utilization trends, outcomes, and cost in minimally invasive lobectomy.
The objective of this study was to compare outcomes and hospitalization costs among patients undergoing open, video-assisted thoracoscopic surgery (VATS) and RATS lobectomy. The investigators concluded that minimally invasive approaches were associated to improved clinical outcomes compared with open lobectomy. However, only robotic-assisted lobectomy has had rapid growth in utilization. Despite additional cost, RATS lobectomy appeared to provide a viable minimally invasive alternative for general thoracic procedures.
AHRQ-funded; HS019455.
Citation: Subramanian MP, Liu J, Chapman WC .
Utilization trends, outcomes, and cost in minimally invasive lobectomy.
Ann Thorac Surg 2019 Dec;108(6):1648-55. doi: 10.1016/j.athoracsur.2019.06.049..
Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Healthcare Costs, Healthcare Utilization, Outcomes
Wissel BD, Greiner HM, Glauser TA
Investigation of bias in an epilepsy machine learning algorithm trained on physician notes.
Racial disparities in the utilization of epilepsy surgery are well documented, but it is unknown whether a natural language processing (NLP) algorithm trained on physician notes would produce biased recommendations for epilepsy presurgical evaluations. To assess this, an NLP algorithm was trained to identify potential surgical candidates using 1097 notes from 175 epilepsy patients with a history of resective epilepsy surgery and 268 patients who achieved seizure freedom without surgery (total N = 443 patients).
AHRQ-funded; HS024977.
Citation: Wissel BD, Greiner HM, Glauser TA .
Investigation of bias in an epilepsy machine learning algorithm trained on physician notes.
Epilepsia 2019 Sep;60(9):e93-e98. doi: 10.1111/epi.16320..
Keywords: Neurological Disorders, Surgery, Clinical Decision Support (CDS), Healthcare Utilization, Health Information Technology (HIT), Decision Making
Ganguli I, Lupo C, Mainor AJ
Prevalence and cost of care cascades after low-value preoperative electrocardiogram for cataract surgery in fee-for-service Medicare beneficiaries.
This study examined the use and outcomes of preoperative electrocardiogram (EKG) for cataract surgery recipients on Medicare. The outcomes measured were cascade events if the EKG results were problematic. The study compared 110,183 cataract surgery recipients with 97,775 non-surgery participants (63.1% female). For the recipient group, 12,408 (11.3%) received a preoperative EKG (65.6% of them were female). Of those, 1978 (15.9%) had at least 1 potential cascade event. Additional tests, treatments, and cardiology visits added an additional estimated $35 million in addition to the $3.2 million spent on preoperative EKGs. Preoperative EKG recipients who were older, had more chronic conditions, lived in more cardiologist-dense areas, or had their EKG performed by a cardiac specialist rather than a primary care physician were more likely to experience a cascade event.
AHRQ-funded; HS023812.
Citation: Ganguli I, Lupo C, Mainor AJ .
Prevalence and cost of care cascades after low-value preoperative electrocardiogram for cataract surgery in fee-for-service Medicare beneficiaries.
JAMA Intern Med 2019 Sep;179(9):1157-308. doi: 10.1001/jamainternmed.2019.1739..
Keywords: Healthcare Costs, Medicare, Healthcare Utilization, Surgery, Elderly
Desai VB, Wright JD, Lin H
Laparoscopic hysterectomy route, resource use, and outcomes: change after power morcellation warning.
The purpose of this study was to examine changes in utilization of different types of laparoscopic hysterectomy, as well as their associated resource use and surgical outcomes, after the U.S. Food and Drug Administration (FDA) safety statement in April 2014 regarding power morcellation. They found rates of laparoscopic supracervical hysterectomy fell in association with power morcellation safety warnings, whereas rates of other laparoscopic hysterectomies continued to rise.
AHRQ-funded; HS024702.
Citation: Desai VB, Wright JD, Lin H .
Laparoscopic hysterectomy route, resource use, and outcomes: change after power morcellation warning.
Obstet Gynecol 2019 Aug;134(2):227-38. doi: 10.1097/aog.0000000000003375..
Keywords: Healthcare Utilization, Outcomes, Surgery, Women
Kirk PS, Borza T, Caram MEV
Characterising potential bone scan overuse amongst men treated with radical prostatectomy.
The authors characterized bone scan use after radical prostatectomy (RP) using data from a large, national integrated delivery system. They found a substantial rate of bone scan utilization after RP. The majority were performed for prostate-specific antigen levels in which the likelihood of a positive test was low. They recommended more judicious use of imaging in the post-RP setting.
AHRQ-funded; HS025707.
Citation: Kirk PS, Borza T, Caram MEV .
Characterising potential bone scan overuse amongst men treated with radical prostatectomy.
BJU Int 2019 Jul;124(1):55-61. doi: 10.1111/bju.14551..
Keywords: Cancer: Prostate Cancer, Cancer, Surgery, Imaging, Healthcare Utilization
Dy CJ, Brown DS, Maryam H
Two-state comparison of total joint arthroplasty utilization following Medicaid expansion.
The aim of this study was to determine whether Medicaid expansion was associated with increased utilization rates of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in Illinois (which expanded Medicaid) relative to Missouri (which did not expand Medicaid). The investigators concluded that their study demonstrated that Medicaid expansion in Illinois was associated with increased utilization of THA and TKA. They suggested that further study is needed to understand the impact of Medicaid expansion in other states and for other procedures.
AHRQ-funded; HS019455.
Citation: Dy CJ, Brown DS, Maryam H .
Two-state comparison of total joint arthroplasty utilization following Medicaid expansion.
J Arthroplasty 2019 Apr;34(4):619-25.e1. doi: 10.1016/j.arth.2018.12.019..
Keywords: Healthcare Utilization, Medicaid, Orthopedics, Surgery
Martin BI, Mirza SK, Spina N
Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015.
This study analyzed trends in lumbar fusion procedure rates for degenerative spinal diseases in the US from 2004 to 2015 as well as associated hospital costs. Spinal fusion is considered an appropriate procedure for spinal deformity and instability, but has limited evidence of effectiveness for primary disc herniation and spinal stenosis without instability. The analysis showed that aggregate hospital costs increased 177% during the analysis period with disc degeneration, herniation and stenosis accounted for 42.3% of the elective surgery. The largest increases in the elective surgery were for spondylolisthesis and scoliosis and has slightly decreased for those procedures with less evidence of effectiveness.
AHRQ-funded; HS024714.
Citation: Martin BI, Mirza SK, Spina N .
Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015.
Spine 2019 Mar 1;44(5):369-76. doi: 10.1097/brs.0000000000002822..
Keywords: Back Health and Pain, Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Healthcare Utilization, Surgery
Ross WT, Meister MR, Shepherd JP
Utilization of apical vaginal support procedures at time of inpatient hysterectomy performed for benign conditions: a national estimate.
The researchers sought to estimate trends and factors associated with use of apical support procedures at time of inpatient hysterectomy for benign indications in a large national database. Their study demonstrated that apical support procedures are not routinely performed at time of inpatient hysterectomy regardless of presence of prolapse diagnosis.
AHRQ-funded; HS019455.
Citation: Ross WT, Meister MR, Shepherd JP .
Utilization of apical vaginal support procedures at time of inpatient hysterectomy performed for benign conditions: a national estimate.
Am J Obstet Gynecol 2017 Oct;217(4):436.e1-36.e8. doi: 10.1016/j.ajog.2017.07.010.
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Keywords: Healthcare Utilization, Practice Patterns, Surgery, Women