National Healthcare Quality and Disparities Report
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- Transitions of Care (1)
- Urinary Tract Infection (UTI) (1)
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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 40 Research Studies DisplayedPeng L, Luo G, Walker A
Evaluation of federated learning variations for COVID-19 diagnosis using chest radiographs from 42 US and European hospitals.
The goals of this study were to compare a single-site, COVID-19 computer diagnosis system that used the Federated Averaging (FedAvg) algorithm with 3-client Federated learning (FL) models, and to evaluate the performance of the four FL variations. Researchers leveraged a FL healthcare collaborative that included data from five US and European healthcare systems encompassing 42 hospitals. They concluded that FedAvg could significantly improve generalization of the model in comparison with other personalization FL algorithms--FedProx, FedBN, and FedAMP--but at the cost of poor internal validity.
AHRQ-funded; HS026379.
Citation: Peng L, Luo G, Walker A .
Evaluation of federated learning variations for COVID-19 diagnosis using chest radiographs from 42 US and European hospitals.
J Am Med Inform Assoc 2022 Dec 13;30(1):54-63. doi: 10.1093/jamia/ocac188..
Keywords: COVID-19, Diagnostic Safety and Quality, Imaging, Hospitals
Kim HS, Hernaez R, Sansgiry S
Comparative effectiveness of surveillance colonoscopy intervals on colorectal cancer outcomes in a national cohort of patients with inflammatory bowel disease.
The purpose of this study was to determine the comparative effectiveness of varying colonoscopy intervals on colorectal cancer (CRC) outcomes among patients with inflammatory bowel disease (IBD). Data was from the National Veterans Health Administration. Findings showed that, in a national cohort of patients with CRC-IBD, colonoscopy within 3 years prior to CRC diagnosis was associated with early tumor stage at diagnosis, and colonoscopy within 1 year was associated with a reduced all-cause mortality compared with no colonoscopy, supporting colonoscopy intervals of 1 to 3 years in patients with IBD in order to reduce late-stage CRC and all-cause mortality.
AHRQ-funded; HS024122.
Citation: Kim HS, Hernaez R, Sansgiry S .
Comparative effectiveness of surveillance colonoscopy intervals on colorectal cancer outcomes in a national cohort of patients with inflammatory bowel disease.
Clin Gastroenterol Hepatol 2022 Dec;20(12):2848-57.e2. doi: 10.1016/j.cgh.2022.02.048..
Keywords: Cancer: Colorectal Cancer, Cancer, Digestive Disease and Health, Imaging, Screening, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research
Wu A, Wu JY, Lim M
Updates in intraoperative strategies for enhancing intra-axial brain tumor control.
This review looked at recent advances in intraoperative strategies for enhancing intra-axial brain tumor control. The authors looked at published research centered on different innovative tools and techniques, including fluorescence-guided surgery, new methods of drug delivery, and minimally invasive procedural options.
AHRQ-funded; HS028747.
Citation: Wu A, Wu JY, Lim M .
Updates in intraoperative strategies for enhancing intra-axial brain tumor control.
Neuro Oncol 2022 Nov 2;24(suppl 6):S33-S41. doi: 10.1093/neuonc/noac170..
Keywords: Cancer, Surgery, Imaging
Marcaccio CL, Patel PB, de Guerre L
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
The purpose of this study was to identify variations in 5-year outcomes and imaging surveillance after elective endovascular aortic aneurysm repair (EVAR) by sex, race, and ethnicity and to examine possible mechanisms contributing to these variations. The primary outcome was 5-year aneurysm rupture. Secondary outcomes were 5-year reintervention and mortality, and having no aortic imaging follow-up from 6 to 24 months after EVAR. The study found that among 16,040 patients, 73% were White males, 18% were White females, 2.6% were Black males, 1.1% were Black females, 0.9% were Asian males, 0.2% were Asian females, 1.7% were Hispanic males, and 0.4% were Hispanic females. At 5 years, Black females had the highest rupture rates at 6.4% and white males had the lowest at 2.3%. Compared with White males, rupture rates were higher in White females, Black females, and Asian females. Among other groups, Black males had higher reintervention and both Black and Hispanic males had higher rates of no imaging follow-up. In adjusted analyses, White, Black, and Asian females remained at significantly higher risk for 5-year rupture. The researchers concluded that Black females had higher 5-year aneurysm rupture, reintervention, and mortality rates after elective EVAR as compared with White male patients, whereas White females had higher rupture, mortality and loss-to-imaging-follow-up compared to White male patients. Black males had higher reintervention and no imaging follow-up, and Asian females had higher rupture rates.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, Patel PB, de Guerre L .
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
J Vasc Surg 2022 Nov;76(5):1205-15.e4. doi: 10.1016/j.jvs.2022.03.886..
Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors, Outcomes, Imaging, Heart Disease and Health, Cardiovascular Conditions
Luximon DC, Ritter T, Fields E
Development and interinstitutional validation of an automatic vertebral-body misalignment error detector for cone-beam CT-guided radiotherapy.
The purpose of this study was to develop an automatic error detection algorithm that uses a three-branch convolutional neural network error detection model (EDM) to detect off-by-one vertebral-body misalignments using planning computed tomography (CT) images and setup CBCT images. The researchers collected algorithm training and test data from 480 patients undergoing radiotherapy treatment at two radiotherapy clinics. One model (EDM(1) ) was trained solely on data from institution 1. EDM(1) was further trained on a dataset from institution 2 to produce a fine-tuned model, EDM(2) . Another model, EDM(3), was trained using a training dataset composed of data from both institutions. The study found that when applied to the combined test set, EDM(1) , EDM(2) , and EDM(3) resulted in an area under curve of 99.5%, 99.4%, and 99.5%, respectively. EDM(1) achieved a sensitivity of 96% and 88% on Institution 1 and Institution 2 test set, respectively. EDM(2) obtained a sensitivity of 95% on each institution's test set. EDM(3) achieved a sensitivity of 95% and 88% on Institution 1 and Institution 2 test set, respectively. The researchers concluded that in CBCT-guided radiotherapy, the proposed algorithm demonstrated accuracy in identifying off-by-one vertebral-body misalignments that was sufficiently high enough to justify implementation in practice.
AHRQ-funded; HS026486.
Citation: Luximon DC, Ritter T, Fields E .
Development and interinstitutional validation of an automatic vertebral-body misalignment error detector for cone-beam CT-guided radiotherapy.
Med Phys 2022 Oct;49(10):6410-23. doi: 10.1002/mp.15927..
Keywords: Imaging, Diagnostic Safety and Quality, Medical Errors, Patient Safety
Ross RL, Rubio K, Rodriguez HP
Mammography and decision aid use for breast cancer screening in older women.
This study examines the association between practice-level decision-aid use and mammography use among older women. Physician practice responses to the 2017/2018 National Survey of Healthcare Organizations and Systems were linked to 2016-17 Medicare fee-for-service beneficiary data from eligible beneficiaries aged 65-74 years. Findings showed that health information technology-enabled automation of mammography reminders and other advanced health information technology functions may support mammography, whereas breast cancer decision aids may reduce patients' propensities to be screened through the alignment of their preferences and screening decision.
AHRQ-funded; HS022241; HS024075.
Citation: Ross RL, Rubio K, Rodriguez HP .
Mammography and decision aid use for breast cancer screening in older women.
Am J Prev Med 2022 Oct;63(4):630-35. doi: 10.1016/j.amepre.2022.04.014..
Keywords: Imaging, Screening, Decision Making, Cancer: Breast Cancer, Women, Prevention, Cancer, Elderly
Holcomb J, Ferguson GM, Sun J
Stakeholder engagement in adoption, implementation, and sustainment of an evidence-based intervention to increase mammography adherence among low-income women.
The purpose of this document review study was to create a conceptual framework to guide stakeholder engagement in an evidence-based intervention to increase mammography appointment adherence in underserved and low-income women. The document review results were aligned with the constructs of the conceptual framework and an application of stakeholder engagement in an evidence-based mammography intervention. The researchers concluded that both the conceptual framework constructs and the stakeholder engagement strategies can be utilized across a range of organizations, programs, and settings.
AHRQ-funded; HS023255.
Citation: Holcomb J, Ferguson GM, Sun J .
Stakeholder engagement in adoption, implementation, and sustainment of an evidence-based intervention to increase mammography adherence among low-income women.
J Cancer Educ 2022 Oct;37(5):1486-95. doi: 10.1007/s13187-021-01988-2..
Keywords: Evidence-Based Practice, Screening, Imaging, Women, Low-Income, Patient Adherence/Compliance
Mattioli DD, Thomas GW, Long SA
Minimally trained analysts can perform fast, objective assessment of orthopedic technical skill from fluoroscopic images.
The purpose of this study was to test a new system designed to facilitate rapid, inexpensive, repeatable, and precise analysis of intraoperative fluoroscopic images by minimally trained analysts as a means of objectively assessing orthopedic surgical skills. The study included 4 expert and 4 novice analysts who independently measured one objective metric for skill using both the custom analysis software and a commercial alternative. The study found that in comparison to the expert analysts utilizing the commercial software, the novice analysts were able to measure the objective metric three times faster when utilizing the custom software, and without a practical difference in accuracy.
AHRQ-funded; HS025353.
Citation: Mattioli DD, Thomas GW, Long SA .
Minimally trained analysts can perform fast, objective assessment of orthopedic technical skill from fluoroscopic images.
IISE Trans Healthc Syst Eng 2022;12(3):212-20. doi: 10.1080/24725579.2022.2035022..
Keywords: Orthopedics, Imaging
Odeh Couvertier V, Patterson Patterson, Zayas-Cabán G
Association between advanced image ordered in the emergency department on subsequent imaging for abdominal pain patients.
The purpose of this retrospective, observational study was to evaluate abdominal pain patients discharged from the ED to determine the association between advanced emergency department (ED) imaging on subsequent outpatient imaging and on revisits. The researchers utilized the electronic health records of Medicare patients who presented with a complaint of abdominal pain at a United States academic emergency department. The study found that participants who were not imaged at the ED had significantly higher adjusted odds of being imaged outside of the ED within 7, 14, and 28 days of being discharged, and had a significantly higher adjusted odds of returning to the study ED and visiting any ED within 30 days of being discharged. The study concluded that receiving abdominal imaging services in the ED was related with significantly lower imaging use after discharge.
AHRQ-funded; HS024558.
Citation: Odeh Couvertier V, Patterson Patterson, Zayas-Cabán G .
Association between advanced image ordered in the emergency department on subsequent imaging for abdominal pain patients.
Acad Emerg Med 2022 Sep;29(9):1078-83. doi: 10.1111/acem.14541..
Keywords: Imaging, Emergency Department, Diagnostic Safety and Quality, Hospital Readmissions
Golmakani MK, Hubbard RA, Miglioretti DL
Nonhomogeneous Markov chain for estimating the cumulative risk of multiple false positive screening tests.
This study addressed the general challenge of estimating the cumulative risk of multiple false positive test results. The authors proposed a nonhomogeneous multistate model to describe the screening process including competing events and developed alternative approaches for estimating the cumulative risk of multiple false positive results using this multistate model based on existing estimators for the cumulative risk of a single false positive. The multistate model was based on existing estimators for the cumulative risk of a single false positive. They compared the performance of the newly proposed models through simulation studies and illustrated model performance using data on screening mammography from the Breast Cancer Surveillance Consortium. They found that in the context of screening mammography that the cumulative risk of multiple false positive results is high. For a high-risk individual, the cumulative probability of at least two false positive mammography results after 10 rounds of annual screening is 40.4.
AHRQ-funded; HS018366.
Citation: Golmakani MK, Hubbard RA, Miglioretti DL .
Nonhomogeneous Markov chain for estimating the cumulative risk of multiple false positive screening tests.
Biometrics 2022 Sep;78(3):1244-56. doi: 10.1111/biom.13484..
Keywords: Research Methodologies, Screening, Imaging, Cancer: Breast Cancer, Cancer
Williams JP, Nathanson R, LoPresti CM
Current use, training, and barriers in point-of-care ultrasound in hospital medicine: a national survey of VA hospitals.
This study aimed to characterize current point-of-care ultrasound (POCUS) use, training needs, and barriers to use among hospital medicine groups (HMGs). This prospective observation study looked at all Veterans Affairs (VA) medical centers from August 2019 to March 2020 using a web-based survey sent to all chiefs of HMGs. There was a 90% response rate from 117 HMGs. Procedural POCUS use decreased by 19% from 2015 to 2020 but increased for diagnostic use for cardiac (8%), pulmonary (7%), and abdominal (8%) applications. The most common barrier to POCUS use was lack of training (89%), with only 34% of HMGs having access to POCUS training. Access to ultrasound equipment was the least common barrier at 57%, however with the proportion of HMGs with ≥1 ultrasound machine increasing from 29% to 71% from 2015 to 2020. In 2020 an average of 3.6 ultrasound devices per HMG was available, and 45% were handheld devices.
AHRQ-funded; HS025979.
Citation: Williams JP, Nathanson R, LoPresti CM .
Current use, training, and barriers in point-of-care ultrasound in hospital medicine: a national survey of VA hospitals.
J Hosp Med 2022 Aug;17(8):601-08. doi: 10.1002/jhm.12911..
Keywords: Imaging, Training, Hospitals, Diagnostic Safety and Quality, Provider: Clinician
Sun J, Peng L, Li T
Performance of a chest radiograph AI diagnostic tool for COVID-19: a prospective observational study.
The purpose of this observational study was to evaluate the real-time performance of an interpretable artificial intelligence (AI) model to detect COVID-19 on chest radiographs. The researchers utilized 95,363 chest radiographs for model training, external validation, and real-time validation. There were 5,335 real-time predictions and a COVID-19 prevalence of 4.8%. The study found that participants positive for COVID-19 had higher COVID-19 diagnostic scores than participants negative for COVID-19. Real-time model performance remained the same during the 19 weeks of implementation. Model sensitivity was higher in men than in women, but model specificity was higher in women. Sensitivity was higher for Asian and Black participants compared with White participants. The COVID-19 AI diagnostic system had worse accuracy compared with radiologist predictions. The researchers concluded that AI tools underperform when compared with radiologist results.
AHRQ-funded; HS026379.
Citation: Sun J, Peng L, Li T .
Performance of a chest radiograph AI diagnostic tool for COVID-19: a prospective observational study.
Radiol Artif Intell 2022 Jul;4(4):e210217. doi: 10.1148/ryai.210217..
Keywords: COVID-19, Imaging, Diagnostic Safety and Quality, Health Information Technology (HIT)
Kerlikowske K, Su YR, Sprague BL
Association of screening with digital breast tomosynthesis vs digital mammography with risk of interval invasive and advanced breast cancer.
The purpose of this study was to compare digital breast tomosynthesis (DBT) with digital mammography to determine whether DBT was correlated with lower rates of internal invasive cancer and advanced breast cancer, taking into consideration breast density and breast cancer risk. From 2011 through 2018, the researchers studied a cohort of 504,427 women between the ages of 40 and 79 who underwent 375,189 screening DBT exams and 1,003,900 screening digital mammography exams, and who were then followed up for cancer diagnoses between 2011 and 2019 after being identified via linkage to state or regional cancer registries. The median age at the time of screening was 58 years (IQR 50-65 years) and the diagnostic screenings took place at 44 Breast Cancer Surveillance Consortium (BCSC) facilities in the United States. The study found that among women at low to average risk, or at high risk with almost entirely fatty, scattered fibroglandular densities, or heterogeneously dense breasts, advanced cancer rates were not significantly different for DBT vs digital mammography. There was no significant difference between DBT and digital mammography for interval cancer rates per 1000 exams. Interval invasive cancer rates were also not significantly different among the 413,061 examinations with BCSC 5-year risk of 1.67% or higher (high risk) across breast density categories, or among all the 836,250 examinations with BCSC 5-year risk less than 1.67% (low to average-risk). For the 3.6% of women with extremely dense breasts and at high risk of breast cancer (13,291 examinations in the DBT group and 31,300 in the digital mammography group) advanced cancer rates per 1000 examinations were significantly lower for DBT vs digital mammography, but not for women at low to average risk (10,611 examinations in the DBT group and 37,796 in the digital mammography group). The researchers reported that there was no significant difference in the 96.4% of women with extremely dense breasts not at high risk, heterogeneously dense breasts, or nondense breasts, and concluded that screening with DBT vs digital mammography was associated with a significantly lower risk of advanced breast cancer among the 3.6% of women with extremely dense breasts and at high risk of breast cancer, and was not associated with a significant difference in risk of interval invasive cancer.
AHRQ-funded; HS018366.
Citation: Kerlikowske K, Su YR, Sprague BL .
Association of screening with digital breast tomosynthesis vs digital mammography with risk of interval invasive and advanced breast cancer.
JAMA 2022 Jun 14;327(22):2220-30. doi: 10.1001/jama.2022.7672..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Women, Imaging, Risk
Lacson R, Khorasani R, Fiumara K
Collaborative case review: a systems-based approach to patient safety event investigation and analysis.
The objectives of this study were to assess a system-based approach to event investigation and analysis--collaborative case reviews (CCRs)--and to measure impact of clinical specialty on strength of action items prescribed. The institutional review board-approved study describes the program, including a percentage of CCR from an institutional Electronic Safety Reporting System. Findings showed that an integrated multispecialty CCR co-led by the radiology department and an institutional patient safety program was associated with a higher proportion of CCR, stronger action items, and higher action item completion rate versus other hospital departments.
AHRQ-funded; HS024722.
Citation: Lacson R, Khorasani R, Fiumara K .
Collaborative case review: a systems-based approach to patient safety event investigation and analysis.
J Patient Saf 2022 Mar 1;18(2):e522-e27. doi: 10.1097/pts.0000000000000857..
Keywords: Patient Safety, Adverse Events, Diagnostic Safety and Quality, Imaging
Tice JA, Gard CC, Miglioretti DL
Comparing mammographic density assessed by digital breast tomosynthesis or digital mammography: the Breast Cancer Surveillance Consortium.
This study’s purpose was to assess the consistency of Breast Imaging Reporting and Data System (BI-RADS) breast density reporting comparing digital breast tomosynthesis (DBT) with digital mammography (DM) and to evaluate density as a breast cancer risk factor when assessed using DM versus DBT. A secondary analysis of data from the Breast Cancer Surveillance Consortium was used from 342,149 women aged 40-79 years who underwent at least two screening mammography examinations less than 36 months apart. There were no significant differences in breast density assessment in pairs consisting of one DM and one DBT examination (57,516 of 74,729 [77%]), two DM examinations (238,678 of 301,743 [79%]), and two DBT examinations (20,763 of 26,854). Results were similar when pair analysis was restricted to readings by the same radiologist. The breast cancer hazard ratios (HRs) for breast density were similar for DM and DBT. The HRs for density acquired using DM and DBT, respectively, were 0.55 and 0.37 for almost entirely fat, 1.47 and 1.36 for heterogeneously dense, and 1.72 and 2.05 for extremely dense breasts.
AHRQ-funded; HS018366.
Citation: Tice JA, Gard CC, Miglioretti DL .
Comparing mammographic density assessed by digital breast tomosynthesis or digital mammography: the Breast Cancer Surveillance Consortium.
Radiology 2022 Feb; 302(2):286-92. doi: 10.1148/radiol.2021204579..
Keywords: Cancer: Breast Cancer, Cancer, Women, Imaging, Screening, Diagnostic Safety and Quality
Varda BK, Finkelstein JB, Wang HH
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
This study examined whether the routine use of continuous antibiotic prophylaxis (CAP) before initial postnatal imaging is effective to prevent urinary tract infection (UTI) in infants with a history of antenatal urinary tract dilation (AUTD). A single-institution, retrospective cohort study of infants with a history of AUTD was conducted. A random sample of 500 infants was selected with six excluded for other congenital anomalies. Of the 494 remaining, 157 (32%) received CAP. There was no difference found in UTI incidence among those treated with CAP and those who were not.
AHRQ-funded; HS000063.
Citation: Varda BK, Finkelstein JB, Wang HH .
The association between continuous antibiotic prophylaxis and UTI from birth until initial postnatal imaging evaluation among newborns with antenatal hydronephrosis.
J Pediatr Urol 2018 Dec;14(6):539.e1-39.e6. doi: 10.1016/j.jpurol.2018.04.022..
Keywords: Antibiotics, Antimicrobial Stewardship, Urinary Tract Infection (UTI), Newborns/Infants, Imaging, Medication, Prevention
Repplinger MD, Bracken RL, Patterson BW
Downstream imaging utilization after mr angiography versus CT angiography for the initial evaluation of pulmonary embolism.
This single-center, retrospective, observational study examined the use of chest CT or MR for ED patients with MR angiography (MRA) negative for PE during April 2008 to March 2013. The investigators concluded that when comparing patients initially undergoing MRA versus CTA for the evaluation of PE, there was no difference in downstream chest CT or MR use at 1 year.
AHRQ-funded; HS024558; HS024342.
Citation: Repplinger MD, Bracken RL, Patterson BW .
Downstream imaging utilization after mr angiography versus CT angiography for the initial evaluation of pulmonary embolism.
J Am Coll Radiol 2018 Dec;15(12):1692-97. doi: 10.1016/j.jacr.2018.04.017..
Keywords: Blood Clots, Emergency Department, Imaging
Lacson R, Laroya R, Wang A
Integrity of clinical information in computerized order requisitions for diagnostic imaging.
This study compared the integrity of electronic health record (EHR) imaging order requisitions with EHR provider notes and their potential impact on order inaccuracies and interpretation of results. This retrospective study was conducted at a tertiary academic medical center using MRI lumbar spine and CT abdomen/pelvis orders performed from April 1 to May 31, 2016. Results showed that requisition indications were more likely to be incomplete than provider notes. Researchers recommended that relevant documentation be more readily available in EHRs.
Citation: Lacson R, Laroya R, Wang A .
Integrity of clinical information in computerized order requisitions for diagnostic imaging.
J Am Med Inform Assoc 2018 Dec;25(12):1651-56. doi: 10.1093/jamia/ocy133..
Keywords: Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT), Imaging
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
Fu Y, Mazur TR, Wu X
A novel MRI segmentation method using CNN-based correction network for MRI-guided adaptive radiotherapy.
The purpose of this study was to expedite the contouring process for MRI-guided adaptive radiotherapy (MR-IGART), a convolutional neural network (CNN) deep-learning (DL) model is proposed to accurately segment the liver, kidneys, stomach, bowel and duodenum in 3D MR images. The investigators suggest that the proposed method can automatically segment the liver, kidneys, stomach, bowel, and duodenum in 3D MR images with good accuracy.
AHRQ-funded; HS022888.
Citation: Fu Y, Mazur TR, Wu X .
A novel MRI segmentation method using CNN-based correction network for MRI-guided adaptive radiotherapy.
Med Phys 2018 Nov;45(11):5129-37. doi: 10.1002/mp.13221..
Keywords: Imaging
Cochon L, Lacson R, Wang A
Assessing information sources to elucidate diagnostic process errors in radiologic imaging - a human factors framework.
The purpose of this study was to assess information sources that may elucidate errors related to radiologic diagnostic imaging, quantify the incidence of potential safety events from each source, and quantify the number of steps involved from diagnostic imaging chain and socio-technical factors. Information sources can elucidate errors in various steps within the diagnostic imaging workflow and can provide insight into socio-technical factors that impact patient safety in the diagnostic process.
AHRQ-funded; HS024722.
Citation: Cochon L, Lacson R, Wang A .
Assessing information sources to elucidate diagnostic process errors in radiologic imaging - a human factors framework.
J Am Med Inform Assoc 2018 Nov;25(11):1507-15. doi: 10.1093/jamia/ocy103..
Keywords: Diagnostic Safety and Quality, Imaging, Medical Errors, Patient Safety
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
Koziatek CA, Simon E, Horwitz LI
Automated pulmonary embolism risk classification and guideline adherence for computed tomography pulmonary angiography ordering.
The objective of this study was to measure the performance of automated, structured data-only versions of the Wells and revised Geneva risk scores in emergency department encounters during which a computed tomography pulmonary angiography was ordered. The hypothesis was that such an automated method would classify a patient's pulmonary embolism risk with high accuracy compared to manual chart review.
AHRQ-funded; HS024376.
Citation: Koziatek CA, Simon E, Horwitz LI .
Automated pulmonary embolism risk classification and guideline adherence for computed tomography pulmonary angiography ordering.
Acad Emerg Med 2018 Sep;25(9):1053-61. doi: 10.1111/acem.13442..
Keywords: Respiratory Conditions, Risk, Diagnostic Safety and Quality, Emergency Department, Imaging, Guidelines
Gyftopoulos S, Smith SW, Simon E
Qualitative study to understand ordering of CT angiography to diagnose pulmonary embolism in the emergency room setting.
The purpose of the study was to better understand, using semi-structured interviews, the decision making behind the ordering of CT pulmonary angiography (CTPA) for the diagnosis of pulmonary embolism (PE) in the emergency department. The authors found that EM providers were the main drivers of CTPA ordering, and there was a marginalized role for the radiologist. Experience- and gestalt-based heuristics were the main influencers of CTPA ordering.
AHRQ-funded; HS024376.
Citation: Gyftopoulos S, Smith SW, Simon E .
Qualitative study to understand ordering of CT angiography to diagnose pulmonary embolism in the emergency room setting.
J Am Coll Radiol 2018 Sep;15(9):1276-84. doi: 10.1016/j.jacr.2017.08.022..
Keywords: Diagnostic Safety and Quality, Emergency Department, Emergency Medical Services (EMS), Imaging
Yun BJ, Borczuk P, Zachrison KS
Utilization of head CT during injury visits to United States emergency departments: 2012-2015.
This study examined national trends in utilization of head computed tomography (CT) imaging in emergency department (ED) patients presenting with an injury-related visit. Data from the US National Hospital Ambulatory Medical Care Survey from 2012 to 2015 was used to find ED patients who had at least one head CT. Overall there was an increase (11.7-13.23%) but it was not statistically significant.
AHRQ-funded; HS024561.
Citation: Yun BJ, Borczuk P, Zachrison KS .
Utilization of head CT during injury visits to United States emergency departments: 2012-2015.
Am J Emerg Med 2018 Aug;36(8):1463-66. doi: 10.1016/j.ajem.2018.05.018..
Keywords: Healthcare Utilization, Emergency Department, Imaging, Injuries and Wounds, Practice Patterns