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)
- Behavioral Health (2)
- Cancer (1)
- Children/Adolescents (1)
- Comparative Effectiveness (1)
- Data (1)
- Diabetes (1)
- Electronic Health Records (EHRs) (1)
- Evidence-Based Practice (7)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (3)
- Health Information Technology (HIT) (1)
- (-) Health Services Research (HSR) (20)
- Hospitals (1)
- Implementation (1)
- Maternal Care (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (4)
- Policy (1)
- Pregnancy (1)
- Primary Care (1)
- Primary Care: Models of Care (1)
- (-) Research Methodologies (20)
- Risk (1)
- Social Media (2)
- Women (1)
- Young Adults (2)
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 20 of 20 Research Studies DisplayedLewis CC, Powell BJ, Brewer SK
Advancing mechanisms of implementation to accelerate sustainable evidence-based practice integration: protocol for generating a research agenda.
This article outlines the protocol for an AHRQ-funded initiative to: 1) establish priorities for an agenda to guide research on implementation mechanisms in health and public health, and 2) disseminate the agenda to research, policy, and practice audiences. The goal is to advance mechanisms of implementation to accelerate sustainable evidence-based practice integration. A network of scientific experts will be created to convene in “Deep Dive” meetings for 3 years. The research agenda will be generated through analysis and synthesis of information from 6 sources: (1) systematic reviews, (2) network members' approaches to studying mechanisms, (3) new proposals presented in implementation proposal feedback sessions, (4) working group sessions conducted in a leading implementation research training institute, (5) breakout sessions at the Society for Implementation Research Collaboration's (SIRC) 2019 conference and (6) SIRC conference abstracts. Mechanism-relevant text segments will be extracted by two members and a third member will generate statements as an input for concept mapping.
AHRQ-funded; HS025632.
Citation: Lewis CC, Powell BJ, Brewer SK .
Advancing mechanisms of implementation to accelerate sustainable evidence-based practice integration: protocol for generating a research agenda.
BMJ Open 2021 Oct 18;11(10):e053474. doi: 10.1136/bmjopen-2021-053474..
Keywords: Implementation, Evidence-Based Practice, Research Methodologies, Health Services Research (HSR)
Sood E, Wysocki T, Alderfer MA
Topical review: crowdsourcing as a novel approach to qualitative research.
The purpose of this paper was to describe a novel, five-phase approach to collecting qualitative data from hard-to-reach populations using crowdsourcing methods. The phases of crowdsourcing methodology described were: (I) Preparing; (II) Forming Crowds; (III) Collecting Crowdsourced Data; (IV) Coding and Analyzing Crowdsourced Data; and (V) Generating and Disseminating Findings. The investigators concluded that crowdsourcing is an innovative, efficient, feasible, and timely approach to engaging hard-to-reach populations in qualitative research.
AHRQ-funded; HS026393.
Citation: Sood E, Wysocki T, Alderfer MA .
Topical review: crowdsourcing as a novel approach to qualitative research.
J Pediatr Psychol 2021 Feb 19;46(2):189-96. doi: 10.1093/jpepsy/jsaa096..
Keywords: Health Services Research (HSR), Research Methodologies
Rodriguez PJ, Ward ZJ, Long MW
Applied methods for estimating transition probabilities from electronic health record data.
This study examined the usefulness of electronic health records (EHRs) in estimating transition probabilities for state-transition models. No guidelines exist on appropriate methods. The authors used 3 potential methods to estimate transition probabilities for EHR data, using pediatric eating disorders (EDs) as a case study. They mapped diagnoses to 3 ED health states: anorexia nervous, bulimia nervosa, and other specified feeding or eating disorder using data from PEDsnet, which includes 8 US children’s hospitals. They used 3 approaches: simple first-last proportions, a multistate Markov (MSM) model, and independent survival models. The first-last proportion approach estimated higher probabilities of remaining the same health state, while the other two approaches estimated higher probabilities of transitioning to a different health state. Published literature differed substantially from these estimates. Further research is needed to improve methods for using EHR data to inform transition probabilities.
AHRQ-funded; HS013853.
Citation: Rodriguez PJ, Ward ZJ, Long MW .
Applied methods for estimating transition probabilities from electronic health record data.
Med Decis Making 2021 Feb;41(2):143-52. doi: 10.1177/0272989x20985752..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Research Methodologies
Shu D, Han P, Wang R, Toh S. D, Han P, Wang R
Estimating the marginal hazard ratio by simultaneously using a set of propensity score models: a multiply robust approach.
The inverse probability weighted Cox model is frequently used to estimate the marginal hazard ratio. Its validity requires a crucial condition that the propensity score model be correctly specified. To provide protection against misspecification of the propensity score model, the investigators proposed a weighted estimation method rooted in the empirical likelihood theory. They applied the proposed method to compare the risk of postoperative hospitalization between sleeve gastrectomy and Roux-en-Y gastric bypass using data from a large medical claims and billing database.
AHRQ-funded; HS026214.
Citation: Shu D, Han P, Wang R, Toh S. D, Han P, Wang R .
Estimating the marginal hazard ratio by simultaneously using a set of propensity score models: a multiply robust approach.
Stat Med 2021 Feb;40(5):1224-42. doi: 10.1002/sim.8837..
Keywords: Research Methodologies, Health Services Research (HSR)
Norton WE, Zwarenstein M, Czajkowski S
AHRQ Author: Kato E
Building internal capacity in pragmatic trials: a workshop for program scientists at the US National Cancer Institute.
This article describes a workshop put together by the authors for program scientists at the National Cancer Institute (NCI) to help them become better researchers and stewards of research funds. The workshop got good reviews from the attendees and many felt it will help them develop funding opportunities and advise grantees.
AHRQ-authored.
Citation: Norton WE, Zwarenstein M, Czajkowski S .
Building internal capacity in pragmatic trials: a workshop for program scientists at the US National Cancer Institute.
Trials 2019 Dec 27;20(1):779. doi: 10.1186/s13063-019-3934-y..
Keywords: Research Methodologies, Health Services Research (HSR), Cancer, Healthcare Delivery
Broder-Fingert S, Kuhn J, Sheldrick RC
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol.
Researchers describe a study protocol for a large randomized controlled trial using the Multiphase Optimization Strategy (MOST), a novel framework developed to optimize interventions. They apply this framework to delivery of Family Navigation (FN), an evidence-based care management strategy designed to reduce disparities and improve access to behavioral health services, and test four components related to its implementation. In this paper, they describe how the MOST framework can be used to improve intervention delivery. These methods will be useful for future studies testing intervention delivery strategies and their impact on implementation.
AHRQ-funded; HS022242.
Citation: Broder-Fingert S, Kuhn J, Sheldrick RC .
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol.
Trials 2019 Dec 16;20(1):728. doi: 10.1186/s13063-019-3853-y..
Keywords: Research Methodologies, Health Services Research (HSR), Healthcare Delivery, Behavioral Health, Evidence-Based Practice, Access to Care
Gates A, Guitard S, Pillay J
Performance and usability of machine learning for screening in systematic reviews: a comparative evaluation of three tools.
Researchers explored the performance of three machine learning tools designed to facilitate title and abstract screening in systematic reviews (SRs) when used to eliminate irrelevant records and complement the work of a single reviewer. Using Abstrackr, DistillerSR, and RobotAnalyst, they found that the workload savings afforded in the automated simulation came with increased risk of missing relevant records. Supplementing a single reviewer's decisions with relevance predictions sometimes reduced the proportion missed, but performance varied by tool and SR. They recommend designing tools based on reviewers' self-identified preferences to improve compatibility with present workflows.
AHRQ-funded; 290201500001I.
Citation: Gates A, Guitard S, Pillay J .
Performance and usability of machine learning for screening in systematic reviews: a comparative evaluation of three tools.
Syst Rev 2019 Nov 15;8(1):278. doi: 10.1186/s13643-019-1222-2..
Keywords: Patient-Centered Outcomes Research, Health Services Research (HSR), Research Methodologies, Evidence-Based Practice, Comparative Effectiveness
Gartlehner G, Wagner G, Lux L
Assessing the accuracy of machine-assisted abstract screening with DistillerAI: a user study.
The goal of this project was to conduct a case study to explore a screening approach that temporarily replaces a human screener with a semi-automated screening tool. The authors used DistillerAI as a semi-automated screening tool, and a published comparative effectiveness review served as their reference standard. They found that the accuracy of DistillerAI was not yet adequate to replace a human screener temporarily during abstract screening for systematic reviews.
AHRQ-funded; 290201500011I.
Citation: Gartlehner G, Wagner G, Lux L .
Assessing the accuracy of machine-assisted abstract screening with DistillerAI: a user study.
Syst Rev 2019 Nov 15;8(1):277. doi: 10.1186/s13643-019-1221-3..
Keywords: Patient-Centered Outcomes Research, Health Services Research (HSR), Research Methodologies, Evidence-Based Practice
Boudreaux M, Gangopadhyaya A, Long SK
AHRQ Author: Karaca Z
Using data from the Healthcare Cost and Utilization Project for state health policy research.
Investigators describe the opportunities and challenges of using HCUP data to conduct state health policy research and to provide empirical examples of what can go wrong when using the national HCUP data inappropriately. Analyzing cesarean delivery rates, discharges per capita, and discharges by the payer, they found that state-level estimates are volatile and often provide misleading policy conclusions. They conclude that the Nationwide Inpatient Sample should not be used for state-level research and specified that AHRQ provides resources to assist analysts with state-specific studies using State Inpatient Database files.
AHRQ-authored.
Citation: Boudreaux M, Gangopadhyaya A, Long SK .
Using data from the Healthcare Cost and Utilization Project for state health policy research.
Med Care 2019 Nov;57(11):855-60. doi: 10.1097/mlr.0000000000001196..
Keywords: Healthcare Cost and Utilization Project (HCUP), Policy, Health Services Research (HSR), Healthcare Costs, Data, Research Methodologies
Vanderlaan J, Dunlop A, Rochat R
Methodology for sampling women at high maternal risk in administrative data.
This study compared the net benefits of using the Obstetric Comorbidity Index (OCI) to identify women at high maternal risk compared to conventional risk identification methods. Hospitalization discharge and vital records data for women experience singleton births in George from 2008 to 2012 was used. Results found there was a small but positive net benefit in using the OCI and conventional risk identification methods actually performed worse than using no risk identification methods at all. The researchers suggest that using OCI helps reduce misclassification.
AHRQ-funded; HS024655.
Citation: Vanderlaan J, Dunlop A, Rochat R .
Methodology for sampling women at high maternal risk in administrative data.
BMC Pregnancy Childbirth 2019 Oct 21;19(1):364. doi: 10.1186/s12884-019-2500-7..
Keywords: Research Methodologies, Health Services Research (HSR), Pregnancy, Maternal Care, Risk, Women
Everson J, Hollingsworth JM, Adler-Milstein J
Comparing methods of grouping hospitals.
The purpose of this study was to compare the performance of widely used approaches for defining groups of hospitals and a new approach based on network analysis of shared patient volume. Results showed that community detection algorithm-defined hospital groups offer high validity, reliability to different specifications, and generalizability to many uses when compared to approaches in widespread use today. They may offer a better choice for efforts seeking to analyze the behaviors and dynamics of groups of hospitals. Measures of modularity, shared information, inclusivity, and shared behavior can be used to evaluate different approaches to grouping providers.
AHRQ-funded; HS024525; HS024728; HS024454.
Citation: Everson J, Hollingsworth JM, Adler-Milstein J .
Comparing methods of grouping hospitals.
Health Serv Res 2019 Oct;54(5):1090-98. doi: 10.1111/1475-6773.13188..
Keywords: Health Services Research (HSR), Hospitals, Research Methodologies
Ji X, Shen HW, Ritter A
Visual exploration of neural document embedding in information retrieval: semantics and feature selection.
Researchers proposed visual exploration of neural document embedding to gain insights into the underlying embedding space and to promote the utilization in prevalent information retrieval applications. They demonstrated the usefulness and effectiveness of their application-driven view and presented inspiring findings in use cases. They indicated that their work will help designers/developers of downstream applications gain insights and confidence in neural document embedding.
AHRQ-funded; HS025047.
Citation: Ji X, Shen HW, Ritter A .
Visual exploration of neural document embedding in information retrieval: semantics and feature selection.
IEEE Trans Vis Comput Graph 2019 Jun;25(6):2181-92. doi: 10.1109/tvcg.2019.2903946..
Keywords: Health Services Research (HSR), Research Methodologies
Wisk LE, Nelson EB, Magane KM
Clinical trial recruitment and retention of college students with type 1 diabetes via social media: an implementation case study.
The purpose of this study was to quantify the efficiency and acceptability of Internet-based recruitment for engaging college-students with type 1 diabetes (T1D) and to describe the approach used for implementing a health-related trial entirely online using off-the-shelf Internet tools. Young people aged 17-25 years with T1D were recruited through social media platforms and other outreach channels; Facebook was the highest yield recruitment source. Demographics differed by platform. Response rate and participant characteristics were quantified and engagement metrics tracked via Google Analytics and participant survey data. The researchers conclude that recruitment of college students with T1D for a trial via social media is feasible, efficient, acceptable, and yields a sample that represents the user-base from which they were drawn.
AHRQ-funded; HS022986.
Citation: Wisk LE, Nelson EB, Magane KM .
Clinical trial recruitment and retention of college students with type 1 diabetes via social media: an implementation case study.
J Diabetes Sci Technol 2019 May;13(3):445-56. doi: 10.1177/1932296819839503..
Keywords: Diabetes, Health Services Research (HSR), Research Methodologies, Social Media, Young Adults
Marshall IJ, Marshall R, Wallace BC
Rapid reviews may produce different results to systematic reviews: a meta-epidemiological study.
Researchers analyzed the difference in results between systematic reviews and rapid reviews. They stimulated searching only PubMed, excluding older articles, smaller trials, and using the largest trial only. They examined percentage changes in pooled odds ratios (ORs), statistical significance, and biases between systematic reviews and rapid reviews. A total of 2,512 systematic reviews were included. Using only PubMed had the smallest risk of changed ORs. There were also changes in statistical significance but no evidence of bias. They concluded that rapid reviews can be considered where approximately 10% risk of the primary outcome or by changing greater than 20% could be tolerated.
AHRQ-funded; HS025024.
Citation: Marshall IJ, Marshall R, Wallace BC .
Rapid reviews may produce different results to systematic reviews: a meta-epidemiological study.
J Clin Epidemiol 2019 May;109:30-41. doi: 10.1016/j.jclinepi.2018.12.015..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Adrian M, Moreno M, Nicodimos S
Research strategy for health sciences: Facebook friend request is non-differentially accepted in a diverse, young adult population.
The aim of this study was to report on overall success of recruiting young adults in diverse settings, with respect to education and employment, into a study using Facebook (FB). The investigators assert that friending through FB is a feasible way to reach young adults involved in health and behavioral research, and could be a way to expand the populations that are studied in health science research to maximize generalizability of the conclusions drawn.
AHRQ-funded; HS022982.
Citation: Adrian M, Moreno M, Nicodimos S .
Research strategy for health sciences: Facebook friend request is non-differentially accepted in a diverse, young adult population.
Nurs Health Sci 2019 Mar;21(1):71-77. doi: 10.1111/nhs.12557..
Keywords: Health Services Research (HSR), Research Methodologies, Social Media, Young Adults
Gartlehner G, Nussbaumer-Streit B, Wagner G
Increased risks for random errors are common in outcomes graded as high certainty of evidence.
The goal of this article was to assess the risk for random errors in outcomes graded as high certainty of evidence (CoE). Results showed that, overall, 38% of high CoE outcomes had increased risks for random errors. Outcomes assessing harms were more frequently affected than outcomes assessing benefits. Regrading of outcomes with increased random errors showed that 74% should have been downgraded based on current guidance. Recommendations included being aware that outcomes rated as high CoE often have increased risks for false-positive or false-negative findings.
AHRQ-funded; HS024749.
Citation: Gartlehner G, Nussbaumer-Streit B, Wagner G .
Increased risks for random errors are common in outcomes graded as high certainty of evidence.
J Clin Epidemiol 2019 Feb;106:50-59. doi: 10.1016/j.jclinepi.2018.10.009..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies
Hunter SR, Applegate EA, Arora V
An introduction to multiobjective simulation optimization.
The authors provide an introduction to multiobjective simulation optimization at the advanced tutorial level, aimed at researchers and practitioners who wish to begin working in this area. Their introduction includes an overview of existing theory, methods, and provably convergent algorithms. Key open questions that remain in this emerging field are also discussed.
AHRQ-funded; HS024384.
Citation: Hunter SR, Applegate EA, Arora V .
An introduction to multiobjective simulation optimization.
ACM Trans. Model. Comput. Simul. 2019 Feb;29(1):1-36. doi: 10.1145/3299872..
Keywords: Health Services Research (HSR), Research Methodologies
Lin L, Xing A, Kofler MJ
Borrowing of strength from indirect evidence in 40 network meta-analyses.
This study investigated the use of network meta-analysis (NMA) in providing clinicians with direct and indirect evidence when comparing multiple treatment options. Researchers analyzed 915 possible treatment combinations although 53% had no direct evidence. They concluded that the potential to provide more precise results only reliably occurs when at least two head-to-head studies are available and the treatments are well connected.
AHRQ-funded; HS024743.
Citation: Lin L, Xing A, Kofler MJ .
Borrowing of strength from indirect evidence in 40 network meta-analyses.
J Clin Epidemiol 2019 Feb;106:41-49. doi: 10.1016/j.jclinepi.2018.10.007..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Research Methodologies
Riley AR, Freeman KA
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
This commentary discusses the role that behavioral analysts can have in partnership with pediatric medicine. There have been advances, but there has been limited impact for the daily practice of pediatrics. The authors discuss why behavioral pediatrics has failed to gain traction in primary care, describe possible opportunities for an expanded portfolio of research, and identify several examplars from the behavior analytic literature that has influenced pediatric primary care, and make further recommendations for producing influential data.
AHRQ-funded; HS022981.
Citation: Riley AR, Freeman KA .
Impacting pediatric primary care: opportunities and challenges for behavioral research in a shifting healthcare landscape.
Behav Anal 2019 Feb;19(1):23-38. doi: 10.1037/bar0000114..
Keywords: Behavioral Health, Children/Adolescents, Health Services Research (HSR), Healthcare Delivery, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care, Primary Care: Models of Care, Research Methodologies
Li F, Thomas LE, Li F
Addressing extreme propensity scores via the overlap weights.
This article examines the overlap weighting method, which mitigates the issues of biased estimates and excessive variance from extreme propensity scores in the probability weighting method. Overlap weighting emphasizes the target population with the most overlap in observed characteristics between treatments, continuously down-weighting the units in the tails of the propensity score distribution. The authors of this study use simulations to compare overlap weighting to standard inverse probability weighting in terms of bias, variance, and 95% confidence interval coverage. A consistent estimator for standard error of treatment effect, estimated using overlap weighting, is also provided to facilitate practical implementation.
AHRQ-funded; HS024310.
Citation: Li F, Thomas LE, Li F .
Addressing extreme propensity scores via the overlap weights.
Am J Epidemiol 2019 Jan;188(1):250-57. doi: 10.1093/aje/kwy201..
Keywords: Health Services Research (HSR), Research Methodologies