National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (3)
- (-) Adverse Events (9)
- Blood Clots (1)
- Blood Thinners (2)
- Cardiovascular Conditions (8)
- Comparative Effectiveness (1)
- Complementary and Alternative Medicine (1)
- Diagnostic Safety and Quality (1)
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- Medication (3)
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- Outcomes (1)
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- Practice Patterns (1)
- Quality of Care (1)
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- Stroke (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 9 of 9 Research Studies DisplayedLowenstern A, Al-Khatib SM, Sharan L
Interventions for preventing thromboembolic events in patients with atrial fibrillation: a systematic review.
The purpose of this review was to compare the effectiveness of therapies to prevent thromboembolic events and bleeding complications in adults with nonvalvular atrial fibrillation (AF). Two independent reviewers screened citations in order to identify comparative studies of treatments to prevent stroke in adults with nonvalvular AF who reported thromboembolic or bleeding complications, then abstracted data from 220 selected articles, assessed study quality and applicability, and rated the strength of evidence. The article concludes that available direct-acting oral anticoagulants (DOACs) are at least as effective and safe as warfarin for patients with nonvalvular AF and had similar benefits across several patient subgroups.
AHRQ-funded; 290201500004I.
Citation: Lowenstern A, Al-Khatib SM, Sharan L .
Interventions for preventing thromboembolic events in patients with atrial fibrillation: a systematic review.
Ann Intern Med 2018 Dec 4;169(11):774-87. doi: 10.7326/m18-1523..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Blood Thinners, Adverse Drug Events (ADE), Adverse Events, Medication, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Borre ED, Goode A, Raitz G
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
This systematic review compared the strength of tools to predict stroke and bleeding risk in patients with atrial fibrillation (AF) taking blood thinners. Sixty-one studies were found to predict thromboembolic risk and 38 to predict bleeding risk.
AHRQ-funded; 290201500004I.
Citation: Borre ED, Goode A, Raitz G .
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
Thromb Haemost 2018 Dec;118(12):2171-87. doi: 10.1055/s-0038-1675400..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Stroke, Blood Clots, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient-Centered Outcomes Research, Evidence-Based Practice
Amin AP, Miller S, Rahn B
Reversing the "risk-treatment paradox" of bleeding in patients undergoing percutaneous coronary intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs.
Bleeding avoidance strategies (BAS) are effective, but are paradoxically used less often with patients at high risk of bleeding. This article describes the implementation of an intervention in a St. Louis, MO, hospital intended to reverse the bleeding risk-treatment paradox. Temporal trends in BAS use and the association of risk-concordant BAS use with bleeding as well as hospital costs of percutaneous coronary intervention were examined. Patient-centered care that aimed directly toward making treatment-related decisions based on predicted risk of bleeding led to a more risk-concordant use of BAS and a reversal of the risk-treatment paradox. The authors conclude that larger multicentered studies will be needed to corroborate these results.
AHRQ-funded; HS022481.
Citation: Amin AP, Miller S, Rahn B .
Reversing the "risk-treatment paradox" of bleeding in patients undergoing percutaneous coronary intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs.
J Am Heart Assoc 2018 Nov 6;7(21):e008551. doi: 10.1161/jaha.118.008551..
Keywords: Adverse Events, Patient Safety, Heart Disease and Health, Risk, Surgery, Cardiovascular Conditions, Healthcare Costs
Patel S, Poorjary P, Pawar S
National landscape of unplanned 30-day readmissions in patients with left ventricular assist device implantation.
This study tracked unplanned 30-day readmissions in patients who had undergone left ventricular assist device (LVAD) implantation during 2013. Data from the Healthcare Cost and Utilization Project (HCUP) National Readmission Database was used. Out of 2,235 patients who had an LVAD implantation, 29.7% had at least 1 unplanned readmission within 30 days. The top reasons for readmission were implant complications (14.9%), congestive heart failure (11.7%), and gastrointestinal bleeding (8.4%). Predictors of readmission included a prolonged length stay during the primary admission, Medicare insurance, and discharge to a short-term facility.
AHRQ-funded; HS023000.
Citation: Patel S, Poorjary P, Pawar S .
National landscape of unplanned 30-day readmissions in patients with left ventricular assist device implantation.
Am J Cardiol 2018 Jul 15;122(2):261-67. doi: 10.1016/j.amjcard.2018.03.363..
Keywords: Healthcare Cost and Utilization Project (HCUP), Heart Disease and Health, Cardiovascular Conditions, Surgery, Medical Devices, Adverse Events
Plantinga LC, King LM, Masud T
Burden and correlates of readmissions related to pulmonary edema in US hemodialysis patients: a cohort study.
Pulmonary edema is prevalent and may be a common cause of hospital readmissions in hemodialysis patients. In this retrospective cohort study, the investigators aimed to estimate the national burden of, and identify correlates of, readmissions related to pulmonary edema among hemodialysis patients. The investigators concluded that readmissions related to pulmonary edema were common in hemodialysis patients. They suggest that interventions aimed at preventing such readmissions could have a substantial impact on readmissions overall, particularly targeted at incident hemodialysis patients with a prior history of heart failure and patients initially admitted for pulmonary edema.
AHRQ-funded; HS025018.
Citation: Plantinga LC, King LM, Masud T .
Burden and correlates of readmissions related to pulmonary edema in US hemodialysis patients: a cohort study.
Nephrol Dial Transplant 2018 Jul;33(7):1215-23. doi: 10.1093/ndt/gfx335..
Keywords: Adverse Events, Dialysis, Heart Disease and Health, Hospital Readmissions, Hospitalization, Kidney Disease and Health
Silber JH, Arriaga AF, Niknam BA
Failure-to-rescue after acute myocardial infarction.
The purpose of this study is to develop a failure-to-rescue (FTR) metric modified to analyze acute myocardial infarction (AMI) outcomes. The subjects were older Medicare beneficiaries who were admitted to short-term acute-care hospitals for AMI between 2009 and 2011. Measures included thirty-day mortality and FTR rates, as well as in-hospital complication rates. The study concludes that a modified FTR metric can be created that may aid in studying the quality of care of AMI admissions and has the advantageous properties of surgical FTR.
AHRQ-funded; HS023560.
Citation: Silber JH, Arriaga AF, Niknam BA .
Failure-to-rescue after acute myocardial infarction.
Med Care 2018 May;56(5):416-23. doi: 10.1097/mlr.0000000000000904..
Keywords: Adverse Events, Cardiovascular Conditions, Quality of Care, Mortality, Heart Disease and Health
Lopes RD, Rordorf R, De Ferrari GM
Digoxin and mortality in patients with atrial fibrillation.
This study examined whether digoxin was independently associated with mortality in patients with atrial fibrillation (AF). Digoxin is a widely used medication for AF. The association was assessed in 17,897 patients who were score-matched with control participants. Baseline digoxin was not associated with increased mortality, but patients with a serum digoxin concentration of greater or equal to 1.2 ng/ml had a 56% increased hazard of mortality.
AHRQ-funded; HS024310.
Citation: Lopes RD, Rordorf R, De Ferrari GM .
Digoxin and mortality in patients with atrial fibrillation.
J Am Coll Cardiol 2018 Mar 13;71(10):1063-74. doi: 10.1016/j.jacc.2017.12.060..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cardiovascular Conditions, Heart Disease and Health, Medication, Mortality, Risk
Spatz ES, Wang Y, Beckman AL
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
This study examined the use of traditional Chinese medicine (TCM) in patients admitted for acute myocardial infarction (AMI) in China during the first 24 hours of hospitalization. The data came from the China Patient-centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction. A chart review was done of randomly sampled patients in 2001, 2006 and 2011 in 162 Western medicine hospitals across China. Nearly all (99%) hospitals used some form of TCM, with Salvia miltiorrhiza being the most commonly prescribed. This TCM treatment (and others) was used intravenously and use has increased over the span of the study, despite lack of evidence of benefit or harm.
AHRQ-funded; HS023000.
Citation: Spatz ES, Wang Y, Beckman AL .
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
Circ Cardiovasc Qual Outcomes 2018 Mar;11(3):e004190. doi: 10.1161/circoutcomes.117.004190..
Keywords: Adverse Events, Cardiovascular Conditions, Complementary and Alternative Medicine, Heart Disease and Health, Hospitals, Mortality, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Practice Patterns, Risk
Bravo PE, Bergmark BA, Vita T
Diagnostic and prognostic value of myocardial blood flow quantification as non-invasive indicator of cardiac allograft vasculopathy.
Cardiac allograft vasculopathy (CAV) is a leading cause of death in orthotopic heart transplant (OHT) survivors. Effective non-invasive screening methods are needed. The aim of this study was to investigate the added diagnostic and prognostic value of myocardial blood flow (MBF) to standard myocardial perfusion imaging (MPI) with positron emission tomography (PET) for CAV detection.
AHRQ-funded; HS022998.
Citation: Bravo PE, Bergmark BA, Vita T .
Diagnostic and prognostic value of myocardial blood flow quantification as non-invasive indicator of cardiac allograft vasculopathy.
Eur Heart J 2018 Jan 21;39(4):316-23. doi: 10.1093/eurheartj/ehx683..
Keywords: Adverse Events, Cardiovascular Conditions, Diagnostic Safety and Quality, Evidence-Based Practice, Heart Disease and Health, Imaging, Patient-Centered Outcomes Research, Surgery