National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (1)
- Adverse Events (1)
- Antibiotics (2)
- Antimicrobial Stewardship (1)
- Back Health and Pain (1)
- Blood Clots (1)
- Brain Injury (1)
- Cancer (5)
- Cancer: Breast Cancer (5)
- Cardiovascular Conditions (2)
- Children/Adolescents (1)
- Clinical Decision Support (CDS) (1)
- Comparative Effectiveness (1)
- Decision Making (2)
- Diagnostic Safety and Quality (9)
- Elderly (1)
- Electronic Health Records (EHRs) (3)
- Emergency Department (7)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (1)
- Guidelines (2)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Utilization (3)
- Health Information Technology (HIT) (4)
- Heart Disease and Health (1)
- Hospital Discharge (1)
- (-) Imaging (25)
- Injuries and Wounds (1)
- Kidney Disease and Health (2)
- Medical Errors (1)
- Medication (2)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Newborns/Infants (1)
- Pain (1)
- Patient-Centered Outcomes Research (1)
- Patient Safety (4)
- Practice Patterns (1)
- Prevention (5)
- Respiratory Conditions (1)
- Risk (1)
- Rural Health (1)
- Screening (4)
- Stroke (1)
- Surgery (1)
- Tools & Toolkits (1)
- Transitions of Care (1)
- Urinary Tract Infection (UTI) (1)
- Women (5)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 25 Research Studies DisplayedVarda 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
Gupta A, Lacson R, Balthazar PC
Assessing documentation of critical imaging result follow-up recommendations in emergency department discharge instructions.
The purpose of this study was to facilitate follow-up of critical test results across transitions in patient care settings, the investigators implemented an electronic discharge module that enabled care providers to include follow-up recommendations in the discharge instructions. Implementation of a discharge module was associated with increased documentation of critical imaging finding follow-up recommendations in ED discharge instructions. However, one in four patients still did not receive adequate follow-up recommendations, suggesting further opportunities for performance improvement exist.
AHRQ-funded; HS022586.
Citation: Gupta A, Lacson R, Balthazar PC .
Assessing documentation of critical imaging result follow-up recommendations in emergency department discharge instructions.
J Digit Imaging 2018 Aug;31(4):562-67. doi: 10.1007/s10278-017-0039-6..
Keywords: Emergency Department, Health Information Technology (HIT), Hospital Discharge, Imaging, Transitions of Care
Pappadis MR, Volk RJ, Krishnan S
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
The authors explored older women's perceptions about the concept of overdetection of breast cancer and its influence on future screening intentions. Semistructured interviews were conducted with 59 English-speaking women aged 70 years or older with no prior history of breast cancer. The authors found that many older women did not understand the concept of overdetection, in addition to being suspicious of or resistant to the concept. Providing older women with descriptions of overdetection may not be sufficient to influence screening intentions.
AHRQ-funded; HS022134.
Citation: Pappadis MR, Volk RJ, Krishnan S .
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
BMJ Open 2018 Jun 14;8(6):e022138. doi: 10.1136/bmjopen-2018-022138..
Keywords: Cancer: Breast Cancer, Cancer, Elderly, Screening, Decision Making, Women, Prevention, Imaging
Graves JM, Fulton-Kehoe D, Jarvik JG
Impact of an advanced imaging utilization review program on downstream health care utilization and costs for low back pain.
Investigators researched the impact of imaging tests such as magnetic resonance imaging (MRI) for lower back pain (LBP) on utilization and duration of workers’ compensation claims. Claims from 76,119 Washington State workers with LBP from 2006 to 2014 were used to see if a policy that implemented prospective utilization review (UR) for early MRI increased costs per claim, disability duration and the proportion of workers who received benefits. Results showed there were noticeable effects from MRI tests, but not computed tomography or surgery utilization.
AHRQ-funded; HS019222.
Citation: Graves JM, Fulton-Kehoe D, Jarvik JG .
Impact of an advanced imaging utilization review program on downstream health care utilization and costs for low back pain.
Med Care 2018 Jun;56(6):520-28. doi: 10.1097/mlr.0000000000000917..
Keywords: Back Health and Pain, Healthcare Utilization, Imaging, Pain
McBride S, Thurm C, Gouripeddi R
Comparison of empiric antibiotics for acute osteomyelitis in children.
Broad-spectrum antibiotics are commonly used for the empiric treatment of acute hematogenous osteomyelitis and often target methicillin-resistant Staphylococcus aureus (MRSA) with medication-associated risk and unknown treatment benefit. In this study, the investigators aimed to compare clinical outcomes among patients with osteomyelitis who did and did not receive initial antibiotics used to target MRSA. The investigators found that, early antibiotic treatment used to target MRSA was associated with a higher rate of repeat MRI.
AHRQ-funded; HS019862.
Citation: McBride S, Thurm C, Gouripeddi R .
Comparison of empiric antibiotics for acute osteomyelitis in children.
Hosp Pediatr 2018 May;8(5):280-87. doi: 10.1542/hpeds.2017-0079..
Keywords: Children/Adolescents, Antibiotics, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Medication, Imaging, Patient Safety
Sun B, Lam D, Yang D
A machine learning approach to the accurate prediction of monitor units for a compact proton machine.
Physical phantom measurements are commonly employed to determine field-specific output factors (OFs) but are often subject to limited machine time, measurement uncertainties and intensive labor. The goal of this study was to develop a secondary check tool for output factors (OF) measurements and eventually eliminate patient-specific OF measurements. The study concluded that machine learning methods can be used to predict OF for double-scatter proton machines with greater prediction accuracy than the most popular semi-empirical prediction model.
AHRQ-funded; HS022888.
Citation: Sun B, Lam D, Yang D .
A machine learning approach to the accurate prediction of monitor units for a compact proton machine.
Med Phys 2018 May;45(5):2243-51. doi: 10.1002/mp.12842..
Keywords: Imaging, Patient Safety, Tools & Toolkits
Dabbous F, Dolecek TA, Friedewald SM
Performance characteristics of digital vs film screen mammography in community practice.
In this study, the investigators examined performance characteristics of digital vs film screen mammography in community practice by comparing the performance characteristics of 297 629 full field digital (FFDM) and 416 791 screen film mammograms (SFM). In their study, modest gains in performance were achieved with the introduction of FFDM as a replacement for SFM, in a large health care organization.
AHRQ-funded; HS018366.
Citation: Dabbous F, Dolecek TA, Friedewald SM .
Performance characteristics of digital vs film screen mammography in community practice.
Breast J 2018 May;24(3):369-72. doi: 10.1111/tbj.12942..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Imaging, Women, Prevention, Comparative Effectiveness, Diagnostic Safety and Quality
Shah PK, Yan PL, Dauw CA
Emergency department switching and duplicate computed tomography scans in patients with kidney stones.
The researchers measured the association between emergency department (ED) switching during a kidney stone episode and receipt of a repeat computed tomography (CT) scan. They found that 12% of patients who received a CT scan at their initial ED encounter had a revisit within 30 days of discharge. One-third of their revisits were made to a different ED than the iniital one. Duplicate CT scans were obtained at nearly 40% of all revisits. The risk of receiving a repeat CT was 12% higher if this revisit was made to a different ED. They concluded that their findings support the role of better health information exchange among providers to help reduce waste in the health-care system.
AHRQ-funded; HS024525; HS024728.
Citation: Shah PK, Yan PL, Dauw CA .
Emergency department switching and duplicate computed tomography scans in patients with kidney stones.
Urology 2018 Apr;114:41-44. doi: 10.1016/j.urology.2018.01.013.
.
.
Keywords: Emergency Department, Imaging, Kidney Disease and Health
Saber Tehrani AS, Kattah JC, Kerber KA
Diagnosing stroke in acute dizziness and vertigo: pitfalls and pearls.
Diagnosing cerebrovascular causes of acute dizziness and vertigo is both important and difficult. It is not routinely done well in current clinical ED practice. Current best evidence suggests an approach emphasizing dizziness timing and triggers, focused ocular motor examinations, and MRI, as needed. Alternative strategies to disseminate this approach may be required.
AHRQ-funded; HS022258.
Citation: Saber Tehrani AS, Kattah JC, Kerber KA .
Diagnosing stroke in acute dizziness and vertigo: pitfalls and pearls.
Stroke 2018 Mar;49(3):788-95. doi: 10.1161/strokeaha.117.016979.
.
.
Keywords: Diagnostic Safety and Quality, Imaging, Stroke
Kim SC, Shah NR, Rogers JR
Assessment of coronary vascular function with cardiac PET in relation to serum uric acid.
Elevated serum uric acid (SUA) levels have been independently associated with cardiovascular disease This study evaluated the relationship between elevated serum uric acid (SUA) and positron emission tomography (PET)-measured markers of coronary vascular function. It found that higher SUA is modestly associated with worse coronary flow reserve (CFR) and stress myocardial blood flow (MBF) among patients without diabetes.
AHRQ-funded; HS022998.
Citation: Kim SC, Shah NR, Rogers JR .
Assessment of coronary vascular function with cardiac PET in relation to serum uric acid.
PLoS One. 2018 Feb 13;13(2):e0192788. doi: 10.1371/journal.pone.0192788..
Keywords: Cardiovascular Conditions, Imaging
Fu Y, Liu S, Li HH
An adaptive motion regularization technique to support sliding motion in deformable image registration.
To accurately model and estimate sliding tissue motion, an adaptive direction-dependent DVF regularization technique was developed in this study to model the sliding tissue motion of the thoracic and abdominal organs. The overall motion estimation accuracy was improved especially near the chest wall and abdominal wall where large organ sliding motion occurs.
AHRQ-funded; HS022888.
Citation: Fu Y, Liu S, Li HH .
An adaptive motion regularization technique to support sliding motion in deformable image registration.
Med Phys 2018 Feb;45(2):735-47. doi: 10.1002/mp.12734..
Keywords: Diagnostic Safety and Quality, Imaging, Patient Safety
Murphy DR, Meyer AND, Vaghani V
Electronic triggers to identify delays in follow-up of mammography: harnessing the power of big data in health care.
Because of the unique clinical, logistic, and legal aspects of mammography, this study was conducted to evaluate the effectiveness of a trigger to flag delayed follow-up on mammography. The investigators found that care delays appeared to continue despite federal laws requiring patient notification of mammographic results within 30 days. They suggest that clinical application of mammography-related triggers could help detect these delays.
AHRQ-funded; HS022901.
Citation: Murphy DR, Meyer AND, Vaghani V .
Electronic triggers to identify delays in follow-up of mammography: harnessing the power of big data in health care.
J Am Coll Radiol 2018 Feb;15(2):287-95. doi: 10.1016/j.jacr.2017.10.001..
Keywords: Cancer: Breast Cancer, Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT), Imaging, Diagnostic Safety and Quality, Prevention, Women
Weisenthal K, Karthik P, Shaw M
Evaluation of kidney stones with reduced-radiation dose CT: progress from 2011-2012 to 2015-2016-not there yet.
Researchers determined if the use of reduced-dose computed tomography (CT) for evaluation of kidney stones increased in 2015-2016 compared with that in 2011-2012. Use of reduced-radiation dose CT for evaluation of kidney stones has increased, but remains low; variability of radiation dose according to facility continues to be wide. National mean CT radiation exposure for evaluation of renal colic during 2015-2016 decreased relative to 2011-2012 values.
AHRQ-funded; HS023778.
Citation: Weisenthal K, Karthik P, Shaw M .
Evaluation of kidney stones with reduced-radiation dose CT: progress from 2011-2012 to 2015-2016-not there yet.
Radiology 2018 Feb;286(2):581-89. doi: 10.1148/radiol.2017170285.
.
.
Keywords: Imaging, Kidney Disease and Health
Huhdanpaa HT, Tan WK, Rundell SD
Using natural language processing of free-text radiology reports to identify type 1 modic endplate changes.
This study’s goal was to determine the feasibility of using natural language processing (NLP) to convert text from electronic medical records reports of magnetic resonance (MR) imaging results into variables to identify patients with Type 1 Modic endplate changes in the spine. Those patients with Type 1 Modic endplace changes may be eligible for clinical trials. Using a rule-based algorithm in Java they found the prevalence was 10%. The results showed that specificity was higher than recall due to the high number of keywords used in lumbar spine reporting.
AHRQ-funded; HS022972.
Citation: Huhdanpaa HT, Tan WK, Rundell SD .
Using natural language processing of free-text radiology reports to identify type 1 modic endplate changes.
J Digit Imaging 2018 Feb;31(1):84-90. doi: 10.1007/s10278-017-0013-3..
Keywords: Electronic Health Records (EHRs), Imaging, Health Information Technology (HIT)
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
Sharp AL, Huang BZ, Tang T
Implementation of the Canadian CT Head Rule and Its association with use of computed tomography among patients with head injury.
The researchers evaluated the association of implementation of the Canadian CT Head Rule on head computed tomography (CT) imaging in community emergency departments (EDs). They found that a multicomponent implementation of the Canadian CT Head Rule was associated with a modest reduction in CT use and an increased diagnostic yield of head CTs for adult trauma encounters in community EDs.
AHRQ-funded; HS021271.
Citation: Sharp AL, Huang BZ, Tang T .
Implementation of the Canadian CT Head Rule and Its association with use of computed tomography among patients with head injury.
Ann Emerg Med 2018 Jan;71(1):54-63.e2. doi: 10.1016/j.annemergmed.2017.06.022.
.
.
Keywords: Brain Injury, Clinical Decision Support (CDS), Decision Making, Emergency Department, Guidelines, Healthcare Utilization, Imaging