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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 25 of 1487 Research Studies DisplayedAustin N, Kristensen-Cabrera A, Sherman J
Analyzing the heterogeneity of labor and delivery units: a quantitative analysis of space and design.
This study evaluated the effect of space and design on labor and deliver (L&D) hospital units. A quantitative analysis was done to see if it made an impact on the risk of deliveries. The researchers recommend standardization of the space based on number of deliveries and cesarean sections.
AHRQ-funded; HS023506.
Citation: Austin N, Kristensen-Cabrera A, Sherman J .
Analyzing the heterogeneity of labor and delivery units: a quantitative analysis of space and design.
PLoS One 2018 Dec 26;13(12):e0209339. doi: 10.1371/journal.pone.0209339..
Keywords: Labor and Delivery, Pregnancy, Women
Dversdal RK, Gold JA, Richards MH
A 5-day intensive curriculum for interns utilizing simulation and active-learning techniques: addressing domains important across internal medicine practice.
In this paper, the authors describe their 5-day intensive, simulation and active learning-based curriculum for internal medicine interns to address perceived gaps in cognitive, affective and psychomotor domains. Intern confidence and self-perceived competence was assessed via survey before and after the curriculum, along with qualitative data.
AHRQ-funded; HS021367.
Citation: Dversdal RK, Gold JA, Richards MH .
A 5-day intensive curriculum for interns utilizing simulation and active-learning techniques: addressing domains important across internal medicine practice.
BMC Res Notes 2018 Dec 21;11(1):916. doi: 10.1186/s13104-018-4011-4.
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Keywords: Education: Continuing Medical Education
Cooper Z, Lilley EJ, Bollens-Lund E
High burden of palliative care needs of older adults during emergency major abdominal surgery.
The purpose of this retrospective study was to quantify preoperative illness burden in older adults undergoing emergency major abdominal surgery (EMAS), to examine the association between illness burden and postoperative outcomes, and to describe end-of-life care in the year after discharge. The investigators found that most older adults undergoing EMAS have preexisting high illness burden and experience high mortality and healthcare use in the year after surgery, particularly near the end of life.
AHRQ-funded; HS022763.
Citation: Cooper Z, Lilley EJ, Bollens-Lund E .
High burden of palliative care needs of older adults during emergency major abdominal surgery.
J Am Geriatr Soc 2018 Nov;66(11):2072-78. doi: 10.1111/jgs.15516..
Keywords: Critical Care, Elderly, Palliative Care, Surgery
Bateni SB, Gingrich AA, Stewart SL
Hospital utilization and disposition among patients with malignant bowel obstruction: a population-based comparison of surgical to medical management.
In this study, the investigators sought to compare clinically meaningful outcomes in malignant bowel obstruction (MBO) patients treated with surgical versus medical management using population-based data. In this population-based analysis, medical management was associated with less hospital utilization at 30- and 90-days, fewer in-hospital deaths, and more frequent discharges to home. The authors suggest that these data underscore the potential benefits of medical management for MBO patients at the end-of-life.
AHRQ-funded; HS022236.
Citation: Bateni SB, Gingrich AA, Stewart SL .
Hospital utilization and disposition among patients with malignant bowel obstruction: a population-based comparison of surgical to medical management.
BMC Cancer 2018 Nov 26;18(1):1166. doi: 10.1186/s12885-018-5108-9..
Keywords: Cancer, Comparative Effectiveness, Hospitalization, Palliative Care, Patient-Centered Outcomes Research, Surgery
Adisa O, Jaar BG, Masud T
Association of social worker-assessed psychosocial factors with 30-day hospital readmissions among hemodialysis patients.
In this study, the investigators examined whether social worker-assessed factors were associated with 30-day readmission among prevalent hemodialysis patients. Data on 14 factors were extracted from the first available psychosocial assessment performed by social workers at three metropolitan Atlanta dialysis centers. The authors indicated that results suggested psychosocial issues may be associated with risk of 30-day readmission among dialysis patients.
AHRQ-funded; HS025018.
Citation: Adisa O, Jaar BG, Masud T .
Association of social worker-assessed psychosocial factors with 30-day hospital readmissions among hemodialysis patients.
BMC Nephrol 2018 Dec 17;19(1):360. doi: 10.1186/s12882-018-1162-4..
Keywords: Kidney Disease and Health, Hospital Readmissions
Blanchard J, Weiss AJ, Barrett ML
State variation in opioid treatment policies and opioid-related hospital readmissions.
In this study, the investigators used 2013-2015 hospital inpatient discharge data from 13 states from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project to examine the relationship between state opioid treatment policies and 90-day opioid-related readmissions after a stay involving an opioid diagnosis. The concluded that differences in index hospitalization rates suggested that states with opioid treatment policies had a higher level of need for opioid-related intervention, which also may account for higher rates of readmission.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Blanchard J, Weiss AJ, Barrett ML .
State variation in opioid treatment policies and opioid-related hospital readmissions.
BMC Health Serv Res 2018 Dec 17;18(1):971. doi: 10.1186/s12913-018-3703-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Medication, Opioids, Substance Abuse
Farias AJ, Wu WH, Du XL
Racial differences in long-term adjuvant endocrine therapy adherence and mortality among Medicaid-insured breast cancer patients in Texas: findings from TCR-Medicaid linked data.
There are racial/ethnic disparities in breast cancer mortality that may be attributed to differences in receipt of adjuvant cancer treatment. The purpose of this article was to determine whether the mortality disparities could be explained by racial/ethnic differences in long-term adherence to adjuvant endocrine therapy (AET). The investigators concluded that long-term adherence in the Medicaid population was suboptimal and racial/ethnic differences in AET adherence may partially explain disparities in mortality.
AHRQ-funded; HS018956.
Citation: Farias AJ, Wu WH, Du XL .
Racial differences in long-term adjuvant endocrine therapy adherence and mortality among Medicaid-insured breast cancer patients in Texas: findings from TCR-Medicaid linked data.
BMC Cancer 2018 Dec 4;18(1):1214. doi: 10.1186/s12885-018-5121-z..
Keywords: Cancer: Breast Cancer, Disparities, Medicaid, Patient Adherence/Compliance, Racial and Ethnic Minorities
Mills J, Duffy M
Screening for peripheral artery disease and cardiovascular disease risk assessment with the Ankle-Brachial Index.
This paper is part of the “Putting Prevention into Practice” series. It provides case study questions and answers related to the U.S. Preventive Services Task Force recommendations for screening for peripheral artery disease and cardiovascular risk assessment with the Ankle-Brachial Index.
AHRQ-authored.
Citation: Mills J, Duffy M .
Screening for peripheral artery disease and cardiovascular disease risk assessment with the Ankle-Brachial Index.
Am Fam Physician 2018 Dec 15;98(12):754-55..
Keywords: Cardiovascular Conditions, Case Study, Prevention, Risk, U.S. Preventive Services Task Force (USPSTF)
Chan B, Edwards ST, Devoe M
The SUMMIT ambulatory-ICU primary care model for medically and socially complex patients in an urban federally qualified health center: study design and rationale.
Medically complex urban patients experiencing homelessness comprise a disproportionate number of high-cost, high-need patients. There are few studies of interventions to improve care for these populations; their social complexity makes them difficult to study and requires clinical and research collaboration. In this paper, the authors present a protocol for a trial of the streamlined unified meaningfully managed interdisciplinary team (SUMMIT) team, an ambulatory ICU (A-ICU) intervention to improve utilization and patient experience that uses control populations to address limitations of prior research.
AHRQ-funded; HS022981.
Citation: Chan B, Edwards ST, Devoe M .
The SUMMIT ambulatory-ICU primary care model for medically and socially complex patients in an urban federally qualified health center: study design and rationale.
Addict Sci Clin Pract 2018 Dec 14;13(1):27. doi: 10.1186/s13722-018-0128-y..
Keywords: Primary Care, Healthcare Delivery, Patient-Centered Healthcare, Vulnerable Populations, Chronic Conditions
De Oliveira GS, Errea M, Bialek J
The impact of health literacy on shared decision making before elective surgery: a propensity matched case control analysis.
The primary aim of this study was to evaluate a possible association between health literacy and decision conflict in surgical patients. Patients undergoing a diverse number of elective surgeries were enrolled in the study. Health literacy was measured using the Newest Vital Sign instrument and decision conflict using the low literacy version of the Decision Conflict Scale. The investigators found that poor health literacy is associated with greater decision conflict in patients undergoing elective surgical procedures.
AHRQ-funded; HS024158.
Citation: De Oliveira GS, Errea M, Bialek J .
The impact of health literacy on shared decision making before elective surgery: a propensity matched case control analysis.
BMC Health Serv Res 2018 Dec 12;18(1):958. doi: 10.1186/s12913-018-3755-9..
Keywords: Decision Making, Education: Patient and Caregiver, Health Literacy, Surgery
Dombrowsky A, Borg B, Xie R
Why is hyperparathyroidism underdiagnosed and undertreated in older adults?
The purpose of this study was to determine why older patients with hyperparathyroidism were not appropriately diagnosed and referred for parathyroidectomy. They reviewed charts for a random sample of 25 patients aged 75 and older who had hyperparathyroidism and were referred for surgical evaluation, and 25 who were not referred. The investigators concluded that substantial gaps existed in processes for diagnosis and referral of patients with hyperparathyroidism that led to underdiagnosis and undertreatment.
AHRQ-funded; HS023009.
Citation: Dombrowsky A, Borg B, Xie R .
Why is hyperparathyroidism underdiagnosed and undertreated in older adults?
Clin Med Insights Endocrinol Diabetes 2018 Dec 12;11:1179551418815916. doi: 10.1177/1179551418815916..
Keywords: Diagnostic Safety and Quality, Elderly
Smith TC, Davis MF, Heaney CD
Pig movement and antimicrobial use drive transmission of livestock-associated staphylococcus aureus CC398.
Staphylococcus aureus was originally considered a hospital-associated organism, but new classes of methicillin-resistant strains have emerged outside of the hospital setting, including among livestock. This article discusses a recent study which examined the transportation of pigs on over 200 farms; the authors of this article contend that the results of the study demonstrate the importance of cooperation between occupational health services, genomics, veterinary medicine, and farmers in understanding the epidemiology of MRSAs as related to livestock.
AHRQ-funded; HS019966.
Citation: Smith TC, Davis MF, Heaney CD .
Pig movement and antimicrobial use drive transmission of livestock-associated staphylococcus aureus CC398.
MBio 2018 Dec 11;9(6). doi: 10.1128/mBio.02459-18..
Keywords: Antimicrobial Stewardship, Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA), Patient Safety, Prevention
Lin L
Quantifying and presenting overall evidence in network meta-analysis.
This article classified treatment networks into three types under different assumptions; they included networks with each treatment comparison's edge width proportional to the corresponding number of studies, sample size, and precision. In addition, three new measures (ie, the effective number of studies, the effective sample size, and the effective precision) were proposed to preliminarily quantify overall evidence gained in Network meta-analysis.
AHRQ-funded; HS024743.
Citation: Lin L .
Quantifying and presenting overall evidence in network meta-analysis.
Stat Med 2018 Dec 10;37(28):4114-25. doi: 10.1002/sim.7905..
Keywords: Evidence-Based Practice, Research Methodologies
Miller DG, Kim SYH, Li X
Ethical acceptability of postrandomization consent in pragmatic clinical trials.
The purpose of this study was to assess the attitudes of the US general public toward postrandomization informed consent for pragmatic trials and to measure potential framing and other factors associated with those attitudes. Results showed that the public's generally high rate of approval of the ethics of postrandomization informed consent for pragmatic trial designs does not appear to be affected by whether postrandomization consent design is framed using traditional randomized clinical trial terminology, regardless of the stakes of the trial. Promoting better understanding of the design may increase its acceptance by the public.
AHRQ-funded; HS023898.
Citation: Miller DG, Kim SYH, Li X .
Ethical acceptability of postrandomization consent in pragmatic clinical trials.
JAMA Netw Open 2018 Dec 7;1(8):e186149. doi: 10.1001/jamanetworkopen.2018.6149..
Keywords: Patient-Centered Outcomes Research, Research Methodologies
Rhee C, Kalil AC
Toward a more nuanced approach to the early administration of intravenous fluids in patients with sepsis.
In this paper the authors discuss an article by Lane et al., published in 2018 in JAMA Network Open, related to the early administration of intravenous fluids in patients with sepsis.
AHRQ-funded; HS025008.
Citation: Rhee C, Kalil AC .
Toward a more nuanced approach to the early administration of intravenous fluids in patients with sepsis.
JAMA Netw Open 2018 Dec 7;1(8):e185844. doi: 10.1001/jamanetworkopen.2018.5844..
Keywords: Emergency Medical Services (EMS), Mortality, Sepsis
Kang H, Zhou S, Yao B
A prototype of knowledge-based patient safety event reporting and learning system.
In this study, a hierarchical list of contributing factors for patient falls, based on the key contributing factors defined by AHRQ Common Formats 2.0, was established by expert review and discussion. Using the list as an infrastructure, the investigators designed and developed a novel reporting system, where a strategy to identify contributing factors was intended to provide reporters knowledge support, in the form of similar cases and potential solutions.
AHRQ-funded; HS022895.
Citation: Kang H, Zhou S, Yao B .
A prototype of knowledge-based patient safety event reporting and learning system.
BMC Med Inform Decis Mak 2018 Dec 7;18(Suppl 5):110. doi: 10.1186/s12911-018-0688-5..
Keywords: Adverse Events, Patient Safety, Falls
Zhou S, Kang H, Yao B
An automated pipeline for analyzing medication event reports in clinical settings.
The article describes and evaluates an automated pipeline that is expected to improve the efficiency of analyzing medication event reports. The pipeline assists clinicians in extracting information from reports and generating feedback using classic machine-learning classifiers to compare three attributes taken from the reports: event originating stages, event types, and event causes. The pipeline identifies these attributes and calculates similarity scores based on them. A strategy to measure similarity was created and evaluated by human subjects using a questionnaire.
AHRQ-funded; HS022895.
Citation: Zhou S, Kang H, Yao B .
An automated pipeline for analyzing medication event reports in clinical settings.
BMC Med Inform Decis Mak 2018 Dec 7;18(Suppl 5):113. doi: 10.1186/s12911-018-0687-6..
Keywords: Adverse Drug Events (ADE), Quality of Care, Medication, Patient Safety
Turner AM, Osterhage KP, Taylor JO, et al.
A closer look at health information seeking by older adults and involved family and friends: design considerations for health information technologies.
Older adults are the largest consumers of healthcare. As part of a broader study of personal health information management (PHIM), the investigators interviewed older adults in King County, Washington, and their involved family and friends (FF), regarding health information (HI) sources they seek and utilize. The authors indicated that design considerations include: facilitating access to quality provider-vetted HI, incorporating older adults and FF in the design process, and creating shared spaces for communication of HI among older adults, FF, and providers.
AHRQ-funded; HS022106.
Citation: Turner AM, Osterhage KP, Taylor JO, et al..
A closer look at health information seeking by older adults and involved family and friends: design considerations for health information technologies.
AMIA Annu Symp Proc 2018 Dec 5;2018:1036-45..
Keywords: Elderly, Health Information Technology (HIT), Caregiving, Education: Patient and Caregiver, Health Literacy
Durojaiye AB, McGeorge N, Kristen W
Characterizing the utilization of the problem list for pediatric trauma care.
The EHR problem list has the potential to support care coordination among the multidisciplinary care team that cares for pediatric trauma patients. To realize this potential, the need exists to ensure appropriate utilization by formulating acceptable usage and management policy. In this regard, understanding the prevailing utilization pattern is pivotal. To this end, in this study, the investigators analyzed EHR in tandem with trauma registry data at a Level I pediatric trauma center.
AHRQ-funded; HS023837.
Citation: Durojaiye AB, McGeorge N, Kristen W .
Characterizing the utilization of the problem list for pediatric trauma care.
AMIA Annu Symp Proc 2018 Dec 5;2018:404-12..
Keywords: Care Coordination, Children/Adolescents, Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Hospitals, Registries, Trauma
Haldar S, Mishra SR, Khelifi M
Exploring the design of an inpatient peer support tool: views of adult patients.
To better understand the opportunities for an inpatient peer support tool, the investigators surveyed 100 adult patients and caregivers, and conducted follow-up, semi-structured interviews with 15 adult patients. In this paper, the investigators describe five key peer support needs that their adult patient participants expressed: (1) adjusting to the hospital environment, (2) understanding and normalizing medical care, (3) communicating with providers, (4) reporting and preventing medical errors, and (5) empowering peers.
AHRQ-funded; HS022894.
Citation: Haldar S, Mishra SR, Khelifi M .
Exploring the design of an inpatient peer support tool: views of adult patients.
AMIA Annu Symp Proc 2018 Dec 5;2018:1282-91..
Keywords: Inpatient Care, Patient and Family Engagement
Ancker JS, Stabile C, Carter J
Informing, reassuring, or alarming? Balancing patient needs in the development of a postsurgical symptom reporting system in cancer.
After ambulatory surgeries, patients who recover at home have multiple questions about wound healing, symptoms and medication side effects, and recovery expectations. In this study, the investigators conducted user testing and rapid application development of a symptom reporting system that supports home-based recovery by inviting patients to self-report symptoms in the days after surgery and receive an immediate feedback report giving context for their reported symptoms.
AHRQ-funded; HS021531.
Citation: Ancker JS, Stabile C, Carter J .
Informing, reassuring, or alarming? Balancing patient needs in the development of a postsurgical symptom reporting system in cancer.
AMIA Annu Symp Proc 2018 Dec 5;2018:166-74..
Keywords: Adverse Events, Ambulatory Care and Surgery, Cancer, Education: Patient and Caregiver, Health Information Technology (HIT), Patient Safety, Surgery
Quintana Y, Fahy D, Crotty B
InfoSAGE: Supporting elders and families through online family networks.
With an increasingly elderly population, families are finding it increasingly challenging to coordinate care for their older family members. This paper reports on the findings of InfoSAGE, an online private social network that has tools for communication and care coordination for elders and their families.
AHRQ-funded; HS021495; HS024869.
Citation: Quintana Y, Fahy D, Crotty B .
InfoSAGE: Supporting elders and families through online family networks.
AMIA Annu Symp Proc 2018 Dec 5;2018:932-41..
Keywords: Elderly, Caregiving, Health Information Technology (HIT), Communication, Clinician-Patient Communication, Care Coordination
Yang Y, Bass EJ, Sockolow PS
Knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization.
Researchers elicit knowledge related to expert decision-making processes to inform information technology design and related interventions. In this study, the investigators examine knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization. The investigators concluded that the data collection and validation methodology showed promise for knowledge elicitation in time-constrained situations.
AHRQ-funded; HS024537.
Citation: Yang Y, Bass EJ, Sockolow PS .
Knowledge elicitation of homecare admission decision making processes via focus group, member checking and data visualization.
AMIA Annu Symp Proc 2018 Dec 5;2018:1127-36..
Keywords: Home Healthcare, Decision Making, Health Information Technology (HIT), Data
Gu Y, Leroy G, Pettygrove S
Optimizing corpus creation for training word embedding in low resource domains: a case study in Autism Spectrum Disorder (ASD).
Automating the extraction of behavioral criteria indicative of Autism Spectrum Disorder (ASD) in electronic health records (EHRs) can contribute significantly to the effort to monitor the condition. Word embedding algorithms such as Word2Vec can encode semantic meanings of words in vectors and assist in automated vocabulary discovery from EHRs. However, text available for training word embeddings for ASD is miniscule compared to the billions of tokens typically used. In this study, the investigators evaluated the importance of corpus specificity versus size and hypothesized that for specific domains small corpora can generate excellent word embeddings.
AHRQ-funded; HS024988.
Citation: Gu Y, Leroy G, Pettygrove S .
Optimizing corpus creation for training word embedding in low resource domains: a case study in Autism Spectrum Disorder (ASD).
AMIA Annu Symp Proc 2018 Dec 5;2018:508-17..
Keywords: Autism, Electronic Health Records (EHRs), Health Information Technology (HIT)
Grossman LV, Masterson Creber RM, Ryan B
Providers' perspectives on sharing health information through acute care patient portals.
Engaging healthcare providers in acute care patient portal implementation is critical to ensure productive use. However, few studies have assessed provider's perceptions of an acute care portal after implementation. In this study, the investigators surveyed 63 nurses, physicians, and physician assistants following a 3-year randomized trial of an acute care portal. The survey assessed providers' perceptions of the portal and its impact on care delivery.
AHRQ-funded; HS021816.
Citation: Grossman LV, Masterson Creber RM, Ryan B .
Providers' perspectives on sharing health information through acute care patient portals.
AMIA Annu Symp Proc 2018 Dec 5;2018:1273-81..
Keywords: Health Information Technology (HIT), Provider
