National Healthcare Quality and Disparities Report
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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
26 to 50 of 71 Research Studies DisplayedAshby VB, Leichtman AB, Rees MA
A kidney graft survival calculator that accounts for mismatches in age, sex, HLA, and body size.
Models were adjusted for year of transplant and donor and recipient characteristics, with particular attention to mismatches in age, sex, human leukocyte antigens (HLA), body size, and weight. These models were used to create a calculator of estimated graft survival for living donors. This calculator provides useful information to donors, candidates, and physicians of estimated outcomes and potentially in allowing candidates to choose among several living donors.
AHRQ-funded; HS020610.
Citation: Ashby VB, Leichtman AB, Rees MA .
A kidney graft survival calculator that accounts for mismatches in age, sex, HLA, and body size.
Clin J Am Soc Nephrol 2017 Jul 7;12(7):1148-60. doi: 10.2215/cjn.09330916.
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Keywords: Adverse Events, Decision Making, Registries, Risk, Transplantation
Makris UE, Alvarez CA, Wei W
Association of statin use with risk of back disorder diagnoses.
Statins may increase vulnerability to myalgias and contribute to the myopathic component often experienced with back pain. This study’s goal was to examine the association of statin use with the risk of back disorder diagnoses. Researchers retrieved health care data for patients enrolled in TRICARE in the San Antonio military area. The overall cohort included 60,455 patients. Two treatment groups were identified: Statin users who recently received a first-time prescription for a statin and had been taking it for 120 days or more; statin non-users who never used statins and current users before they were prescribed statins. The study concludes that statin use is associated with increased likelihood of back disorder diagnoses.
AHRQ-funded; HS022418.
Citation: Makris UE, Alvarez CA, Wei W .
Association of statin use with risk of back disorder diagnoses.
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Keywords: Back Health and Pain, Medication, Pain, Patient-Centered Outcomes Research, Risk
Moore BJ, White S, Washington R
AHRQ Author: Elixhauser A
Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.
The researchers extended the literature on comorbidity measurement by developing 2 indices, based on the Elixhauser Comorbidity measures, designed to predict 2 frequently reported health outcomes: in-hospital mortality and 30-day readmission in administrative data. The index scores performed as well as using all 29 Elixhauser comorbidity variables separately.
AHRQ-authored; AHRQ-funded.
Citation: Moore BJ, White S, Washington R .
Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index.
Med Care 2017 Jul;55(7):698-705. doi: 10.1097/mlr.0000000000000735.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Mortality, Risk
Galambos C, Rantz M, Back J
Older adults' perceptions of and preferences for a fall risk assessment system: exploring stages of acceptance model.
The study aim was to explore the perceptions and preferences of older adults and their family members about a fall risk assessment system. Using a qualitative approach, this study found that there was acceptance of the technology as participants adapted to it. Two themes were present across the five points in time-safety and usefulness. Five stages of acceptance emerged from the data from preinstallation to 2 years postinstallation.
AHRQ-funded; HS018477.
Citation: Galambos C, Rantz M, Back J .
Older adults' perceptions of and preferences for a fall risk assessment system: exploring stages of acceptance model.
Comput Inform Nurs 2017 Jul;35(7):331-37. doi: 10.1097/cin.0000000000000330.
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Keywords: Elderly, Falls, Risk, Patient Safety
Papaleontiou M, Hughes DT, Guo C
Population-based assessment of complications following surgery for thyroid cancer.
The researchers sought to determine thyroid cancer surgery complication rates and identify at-risk populations by using the Surveillance, Epidemiology, and End Results-Medicare database. They concluded that the rates of thyroid cancer surgery complications are higher than predicted, and patients with older age, more comorbidities, and advanced disease are at greatest risk.
AHRQ-funded; HS024512.
Citation: Papaleontiou M, Hughes DT, Guo C .
Population-based assessment of complications following surgery for thyroid cancer.
J Clin Endocrinol Metab 2017 Jul;102(7):2543-51. doi: 10.1210/jc.2017-00255.
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Keywords: Adverse Events, Cancer, Risk, Risk, Surgery
Schroeder EB, Xu S, Goodrich GK
Predicting the 6-month risk of severe hypoglycemia among adults with diabetes: development and external validation of a prediction model.
Researchers developed and validated two prediction models for predicting the 6-month risk of hypoglycemia. The 16-variable model had slightly better performance than the 6-variable model, but in some practice settings, use of the simpler model may be preferred.
AHRQ-funded; HS019859; HS022963.
Citation: Schroeder EB, Xu S, Goodrich GK .
Predicting the 6-month risk of severe hypoglycemia among adults with diabetes: development and external validation of a prediction model.
J Diabetes Complications 2017 Jul;31(7):1158-63. doi: 10.1016/j.jdiacomp.2017.04.004.
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Keywords: Adverse Drug Events (ADE), Diabetes, Medication, Risk
Beckman AL, Herrin J, Nasir K
Trends in cardiovascular health of US adults by income, 2005-2014.
This research letter discusses the trends in cardiovascular health of US adults by income from 2005-2014. The investigators assessed national trends in cardiovascular risk factors by income level among adults aged 25 years and older using data from the National Health and Nutrition Examination Surveys, a nationally representative, multistage probability sample of the US population, across 5 periods: 2005 to 2006, 2007 to 2008, 2009 to 2010, 2011 to 2012, and 2013 to 2014.
AHRQ-funded; HS023000.
Citation: Beckman AL, Herrin J, Nasir K .
Trends in cardiovascular health of US adults by income, 2005-2014.
JAMA Cardiol 2017 Jul;2(7):814-16. doi: 10.1001/jamacardio.2017.1654..
Keywords: Cardiovascular Conditions, Risk, Disparities, Health Status, Blood Pressure, Obesity, Diabetes, Low-Income, Tobacco Use
Goldmann E, Roberts ET, Parikh NS
Chronic physical illness burden and suicidal ideation among Dominicans in New York City.
This study used data from a community survey of 2753 Dominican adults in New York City to investigate the association between chronic illness and suicidal ideation. The investigators concluded that the association of interest did not differ significantly between younger and older adults. They suggest that screening for SI in health care practice, particularly among Dominican men with multiple chronic health conditions, may be warranted.
AHRQ-funded; HS022961.
Citation: Goldmann E, Roberts ET, Parikh NS .
Chronic physical illness burden and suicidal ideation among Dominicans in New York City.
J Immigr Minor Health 2017 Jun;19(3):616-22. doi: 10.1007/s10903-016-0477-0..
Keywords: Chronic Conditions, Depression, Behavioral Health, Racial and Ethnic Minorities, Risk
Le P, Martinez KA, Pappas MA
A decision model to estimate a risk threshold for venous thromboembolism prophylaxis in hospitalized medical patients.
To determine a threshold for prophylaxis based on risk of venous thromboembolism, the researchers constructed a decision model with a decision-tree following patients for 3 months after hospitalization, and a lifetime Markov model with 3-month cycles. They found that the prophylaxis threshold was relatively insensitive to low-molecular-weight heparin cost and bleeding risk, but very sensitive to patient age and life expectancy.
AHRQ-funded; HS022883.
Citation: Le P, Martinez KA, Pappas MA .
A decision model to estimate a risk threshold for venous thromboembolism prophylaxis in hospitalized medical patients.
J Thromb Haemost 2017 Jun;15(6):1132-41. doi: 10.1111/jth.13687.
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Keywords: Adverse Events, Clinical Decision Support (CDS), Inpatient Care, Patient Safety, Risk
Macht R, Cassidy R, Cabral H
Evaluating organizational factors associated with postoperative bariatric surgery readmissions.
This study evaluated the association between readmissions and several organizational factors, including compliance with best practices to reduce unplanned hospital visits, major complication rates, and the emergency department-sourced readmission rate. It concluded that bariatric centers with higher rates of major complications and sites with emergency departments that are less likely to treat and discharge patients are more likely to have higher readmission rates.
AHRQ-funded; HS023621.
Citation: Macht R, Cassidy R, Cabral H .
Evaluating organizational factors associated with postoperative bariatric surgery readmissions.
Surg Obes Relat Dis 2017 Jun;13(6):1004-09. doi: 10.1016/j.soard.2016.12.029.
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Keywords: Adverse Events, Surgery, Hospital Readmissions, Risk
Bowen ME, Xuan L, Lingvay I
Performance of a random glucose case-finding strategy to detect undiagnosed diabetes.
This study describes a case-finding approach using non-diagnostic random glucose values to identify individuals in need of diabetes testing and compares its performance to current screening guidelines. Using random glucose >/=100 mg/dL to identify individuals in need of diabetes, it determined that screening is highly sensitive and specific, performing better than current screening guidelines. Case-finding strategies informed by random glucose data may improve diabetes detection.
AHRQ-funded; HS022418.
Citation: Bowen ME, Xuan L, Lingvay I .
Performance of a random glucose case-finding strategy to detect undiagnosed diabetes.
Am J Prev Med 2017 Jun;52(6):710-16. doi: 10.1016/j.amepre.2017.01.023.
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Keywords: Diabetes, Diagnostic Safety and Quality, Risk, Screening
Cannon CM, Musuuza JS, Barker AK
Risk of Clostridium difficile infection in hematology-oncology patients colonized with toxigenic C. difficile.
This study determined that the prevalence of colonization with toxigenic Clostridium difficile among patients with hematological malignancies and/or bone marrow transplant at admission to a 566-bed academic medical care center was 9.3 percent. Thirteen percent of colonized patients developed symptomatic disease during hospitalization. This population may benefit from targeted C. difficile infection control interventions.
AHRQ-funded; HS024039; HS023791.
Citation: Cannon CM, Musuuza JS, Barker AK .
Risk of Clostridium difficile infection in hematology-oncology patients colonized with toxigenic C. difficile.
Infect Control Hosp Epidemiol 2017 Jun;38(6):718-20. doi: 10.1017/ice.2017.48.
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Keywords: Cancer, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Risk
Jacobs BL, He C, Li BY
Variation in readmission expenditures after high-risk surgery.
The researchers sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. They found that the 30-day readmission rate was 16 percent for major chest and 22 percent for major abdominal surgery. Discharge to a skilled nursing facility was associated with higher readmission costs for both chest and abdominal surgeries.
AHRQ-funded; HS024403; HS023621.
Citation: Jacobs BL, He C, Li BY .
Variation in readmission expenditures after high-risk surgery.
J Surg Res 2017 Jun 1;213:60-68. doi: 10.1016/j.jss.2017.02.017.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Hospital Readmissions, Healthcare Costs, Risk
Taylor C, Correa C, Duane FK
Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials.
The researchers estimated the absolute long-term risks of modern breast cancer radiotherapy. They concluded that, for long-term smokers, the absolute risks of modern radiotherapy may outweigh the benefits, yet for most nonsmokers (and ex-smokers), the benefits of radiotherapy far outweigh the risks. Hence, smoking can determine the net effect of radiotherapy on mortality, but smoking cessation substantially reduces radiotherapy risk.
AHRQ-funded; HS021681.
Citation: Taylor C, Correa C, Duane FK .
Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials.
J Clin Oncol 2017 May 20;35(15):1641-49. doi: 10.1200/jco.2016.72.0722.
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Keywords: Adverse Events, Cancer: Breast Cancer, Risk, Treatments
Anderson DJ, Rojas LF, Watson S
Identification of novel risk factors for community-acquired Clostridium difficile infection using spatial statistics and geographic information system analyses.
The rate of community-acquired Clostridium difficile infection (CA-CDI) is increasing. While receipt of antibiotics remains an important risk factor for CDI, studies related to acquisition of C. difficile outside of hospitals are lacking. This study found that proximity to a livestock farm (0.01), proximity to farming raw materials services (0.02), and proximity to a nursing home (0.04) were independently associated with increased rates of CA-CDI.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Rojas LF, Watson S .
Identification of novel risk factors for community-acquired Clostridium difficile infection using spatial statistics and geographic information system analyses.
PLoS One 2017 May 16;12(5):e0176285. doi: 10.1371/journal.pone.0176285.
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Keywords: Clostridium difficile Infections, Community-Acquired Infections, Risk, Patient Safety
Blumenthal KG, Lai KH, Huang M
Adverse and hypersensitivity reactions to prescription nonsteroidal anti-inflammatory agents in a large health care system.
The researchers aimed to use electronic health record data to determine the incidence and predictors of hypersentivity reaction (HSR) to prescription nonsteroidal anti-inflammatory drugs (NSAIDs). They concluded that NSAID therapeutic use can be limited by adverse drug reactions (ADRs); about 1 in 5 NSAID ADRs is an hypersentivity reaction.
AHRQ-funded; HS022728.
Citation: Blumenthal KG, Lai KH, Huang M .
Adverse and hypersensitivity reactions to prescription nonsteroidal anti-inflammatory agents in a large health care system.
J Allergy Clin Immunol Pract 2017 May-Jun;5(3):737-43. doi: 10.1016/j.jaip.2016.12.006.
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Keywords: Electronic Health Records (EHRs), Medication, Risk, Health Systems, Adverse Drug Events (ADE)
Banerji A, Blumenthal KG, Lai KH
Epidemiology of ACE inhibitor angioedema utilizing a large electronic health record.
The objective of this study was to identify the incidence of and risk factors for angioedema caused by angiotensin-converting enzyme inhibitors (ACEIs) using a large integrated electronic health record (EHR). It concluded that the incidence of ACEI angioedema within a large EHR is consistent with large clinical trial data. A history of nonsteroidal anti-inflammatory drug allergy was identified as a risk factor for patients with ACEI angioedema.
AHRQ-funded; HS022728.
Citation: Banerji A, Blumenthal KG, Lai KH .
Epidemiology of ACE inhibitor angioedema utilizing a large electronic health record.
J Allergy Clin Immunol Pract 2017 May - Jun;5(3):744-49. doi: 10.1016/j.jaip.2017.02.018.
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Keywords: Electronic Health Records (EHRs), Medication, Risk, Health Information Technology (HIT), Adverse Drug Events (ADE)
Horwitz LI, Bernheim SM, Ross JS
Hospital characteristics associated with risk-standardized readmission rates.
This national study using Medicare data examined the independent association of 8 hospital characteristics with hospital-wide 30-day risk-standardized readmission rate (RSRR). Overall, larger, urban, academic facilities had modestly higher RSRRs than smaller, suburban, community hospitals, although there was a wide range of performance. The strong regional effect suggests that local practice patterns are an important influence.
AHRQ-funded; HS022882.
Citation: Horwitz LI, Bernheim SM, Ross JS .
Hospital characteristics associated with risk-standardized readmission rates.
Med Care 2017 May;55(5):528-34. doi: 10.1097/mlr.0000000000000713.
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Keywords: Hospitals, Hospital Readmissions, Medicaid, Risk, Quality of Care
Makam AN, Nguyen OK, Clark C
Incidence, predictors, and outcomes of hospital-acquired anemia.
This study examined the incidence, predictors, and postdischarge outcomes associated with hospital-acquired anemia (HAA). Most patients with severe HAA (85 percent) underwent a major procedure, had a discharge diagnosis of hemorrhage, and/or a discharge diagnosis of hemorrhagic disorder. Severe HAA is associated with increased odds for 30-day mortality and readmission after discharge; however, it is uncertain whether severe HAA is preventable.
AHRQ-funded; HS022418.
Citation: Makam AN, Nguyen OK, Clark C .
Incidence, predictors, and outcomes of hospital-acquired anemia.
J Hosp Med 2017 May;12(5):317-22. doi: 10.12788/jhm.2723
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Keywords: Electronic Health Records (EHRs), Hospital Readmissions, Hospitalization, Patient-Centered Outcomes Research, Risk
Macmadu A, Carroll JJ, Hadland SE
Prevalence and correlates of fentanyl-contaminated heroin exposure among young adults who use prescription opioids non-medically.
Researchers examined risk factors for exposure to fentanyl-contaminated heroin (FCH) and experiences with FCH use among young adult non-medical prescription opioids (NMPO) users. Several drug use patterns and risk behaviors were associated with FCH exposure, including: regular heroin and cocaine use; diverted pharmaceutical fentanyl use in the prior six months; NMPO use to avoid withdrawal symptoms; regular injection drug use; and prior overdose.
AHRQ-funded; HS024021.
Citation: Macmadu A, Carroll JJ, Hadland SE .
Prevalence and correlates of fentanyl-contaminated heroin exposure among young adults who use prescription opioids non-medically.
Addict Behav 2017 May;68:35-38. doi: 10.1016/j.addbeh.2017.01.014.
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Keywords: Opioids, Medication, Risk, Substance Abuse, Young Adults
Hoffman GJ, Hays RD, Wallace SP
Depressive symptomatology and fall risk among community-dwelling older adults.
The directionality of observed relationship between falls and depressive symptoms (DS) is in need of elaboration given that cross-sectional study designs can yield biased estimates of the DS-falls relationship. This study found that the DS-falls relationship was not significant when use of psychiatric medications, which was positively associated with falls, was included in the model.
AHRQ-funded; HS000046.
Citation: Hoffman GJ, Hays RD, Wallace SP .
Depressive symptomatology and fall risk among community-dwelling older adults.
Soc Sci Med 2017 Apr;178:206-13. doi: 10.1016/j.socscimed.2017.02.020.
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Keywords: Depression, Elderly, Falls, Patient Safety, Risk
Bhattacharjee P, Churpek MM, Snyder A
Detecting sepsis: are two opinions better than one?
Researchers conducted a study to characterize the agreement between different providers' suspicion of infection and the correlation with patient outcomes using prospective data from a general medicine ward. They concluded that provider disagreement regarding suspected infection is common, with RNs suspecting infection more often, suggesting that a collaborative model for sepsis detection may improve timing and accuracy.
AHRQ-funded; HS000078.
Citation: Bhattacharjee P, Churpek MM, Snyder A .
Detecting sepsis: are two opinions better than one?
J Hosp Med 2017 Apr;12(4):256-58. doi: 10.12788/jhm.2721.
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Keywords: Diagnostic Safety and Quality, Nursing, Risk, Sepsis
Stepanikova I, Oates GR, Bateman LB
Does one size fit all? The role of body mass index and waist circumference in systemic inflammation in midlife by race and gender.
This study investigated the associations of body mass index (BMI) and waist circumference (WC) with markers of systemic inflammation in midlife by race and gender. Compared to White men, Black women have higher BMI and higher levels of all four inflammation markers; White women have lower BMI, lower WC, and lower E-selectin and fibrinogen but higher C-reactive protein, and Black men have higher fibrinogen.
AHRQ-funded; HS023009.
Citation: Stepanikova I, Oates GR, Bateman LB .
Does one size fit all? The role of body mass index and waist circumference in systemic inflammation in midlife by race and gender.
Ethn Health 2017 Apr;22(2):169-83. doi: 10.1080/13557858.2016.1235681.
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Keywords: Health Status, Racial and Ethnic Minorities, Risk, Sex Factors
Palta P, Huang ES, Kalyani RR
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
In this paper, the investigators sought to estimate the risk of mortality by HbA1c levels among older adults with and without diabetes. They concluded that an HbA1c >8.0% was associated with increased risk of all-cause and cause-specific mortality in older adults with diabetes. The investigators suggest that their results support the idea that better glycemic control is important for reducing mortality; however, they also indicate that there is a need for individualized glycemic targets for older adults with diabetes depending on their demographics, duration of diabetes, and existing comorbidities.
AHRQ-funded; HS018542.
Citation: Palta P, Huang ES, Kalyani RR .
Hemoglobin A1c and mortality in older adults with and without diabetes: Results from the National Health and Nutrition Examination Surveys (1988-2011).
Diabetes Care 2017 Apr;40(4):453-60. doi: 10.2337/dci16-0042.
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Keywords: Cancer, Cardiovascular Conditions, Diabetes, Elderly, Mortality, Risk
Masterson Creber RM, Fleck E, Liu J
Identifying the complexity of multiple risk factors for obesity among urban Latinas.
The prevalence of obesity is rising rapidly among Hispanics/Latinas. Researchers evaluated the prevalence of being obese or overweight and associated risk factors among 630 low-income, Latina women. They found that being obese was strongly associated with having hypertension, pre-hypertension, diabetes and moderate/moderately severe/severe depression. Women who reported that finding time was a barrier to physical activity were also more likely to be obese.
AHRQ-funded; HS019853.
Citation: Masterson Creber RM, Fleck E, Liu J .
Identifying the complexity of multiple risk factors for obesity among urban Latinas.
J Immigr Minor Health 2017 Apr;19(2):275-84. doi: 10.1007/s10903-016-0433-z.
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Keywords: Racial and Ethnic Minorities, Obesity, Risk, Racial and Ethnic Minorities, Urban Health