National Healthcare Quality and Disparities Report
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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 60 Research Studies DisplayedCykert S, Keyserling TC, Pignone M
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Researchers assessed the effect of dissemination and implementation of an intervention consisting of practice facilitation and a risk-stratified, population management dashboard on cardiovascular risk reduction for patients at high risk in small, primary care practices. They found that a risk-stratified, population management dashboard combined with practice facilitation led to substantial reductions of 10-year atherosclerotic cardiovascular disease risk for patients at high risk. They recommended utilizing similar approaches to lead to effective dissemination and implementation of other new evidence, especially in rural and other under-resourced practices.
AHRQ-funded; HS023912.
Citation: Cykert S, Keyserling TC, Pignone M .
A controlled trial of dissemination and implementation of a cardiovascular risk reduction strategy in small primary care practices.
Health Serv Res 2020 Dec;55(6):944-53. doi: 10.1111/1475-6773.13571..
Keywords: Cardiovascular Conditions, Risk, Prevention, Primary Care, Implementation, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Hong MR, Lei D, Yousaf M
A real-world study of the longitudinal course of adult atopic dermatitis severity in clinical practice.
This study examined the longitudinal course of adult atopic dermatitis (AD) severity in clinical practice. Dermatology patients were assessed at approximately 6,12, 18, and 24 months by the scoring systems Eczema Area and Severity Index (EASI) and objective-Scoring Atopic Dermatitis (objective-SCORAD). At any visit, 36.2% of cases were scored as moderate, and 18.2% were severe. Among those patients, 25% and 18.6% continued to have moderate or severe scores at 1 or more follow-up visits for EASI, and 22.6% and 24.5% moderate or severe objective-SCORAD scores respectively. Many patients had fluctuating severity scores over time and a minority had persistently moderate or severe lesions over time, and most of those patients were unable to achieve persistent lesional clearance.
AHRQ-funded; HS023011.
Citation: Hong MR, Lei D, Yousaf M .
A real-world study of the longitudinal course of adult atopic dermatitis severity in clinical practice.
Ann Allergy Asthma Immunol 2020 Dec;125(6):686-92.e3. doi: 10.1016/j.anai.2020.07.005.
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Keywords: Skin Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice
Reisz PA, Laviana AA, Zhao Z
Assessing the quality of surgical care for clinically localized prostate cancer: results from the CEASAR study.
Prior studies suggest that nationally endorsed quality measures for prostate cancer care are not linked closely with outcomes. Using a prospective, population based cohort the investigators measured clinically relevant variation in structure, process and outcome measures in men undergoing radical prostatectomy. The authors did not identify and meaningful variation in quality of care across racial groups, age groups and surgeon volume strata, in this cohort, suggesting that men were receiving comparable quality of care across these strata.
AHRQ-funded; HS019356.
Citation: Reisz PA, Laviana AA, Zhao Z .
Assessing the quality of surgical care for clinically localized prostate cancer: results from the CEASAR study.
J Urol 2020 Dec;204(6):1236-41. doi: 10.1097/ju.0000000000001198..
Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Quality of Care, Quality of Life, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Rosas LG, Lv N, Xiao L
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
Identifying effective weight loss interventions for Latino adults at risk of diabetes is of critical public health importance. The purpose of this study was to determine whether a culturally adapted behavioral intervention for Latino adults was more effective than usual care for weight loss over 24 months. The investigators concluded that among Latino adults with high diabetes risk, a culturally adapted behavioral lifestyle intervention was effective for weight loss over 12 months but not 24 months.
AHRQ-funded; HS022702.
Citation: Rosas LG, Lv N, Xiao L .
Effect of a culturally adapted behavioral intervention for Latino adults on weight loss over 2 years: a randomized clinical trial.
JAMA Netw Open 2020 Dec;3(12):e2027744. doi: 10.1001/jamanetworkopen.2020.27744..
Keywords: Racial and Ethnic Minorities, Obesity: Weight Management, Obesity, Cultural Competence, Diabetes, Primary Care, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Onaitis MW, Furnary AP, Kosinski AS
Equivalent survival between lobectomy and segmentectomy for clinical stage IA lung cancer.
This study compared the effectiveness of lobectomy and segmentectomy for treatment of clinical stage IA (T1N0) lung cancer patients. The Society of Thoracic Surgeons General Thoracic Surgery Database was linked to Medicare data in 14,286 lung cancer patients who underwent segmentectomy (n = 1654) or lobectomy (n = 12,632) from 2002 to 2015. Survival rates were found to be similar.
AHRQ-funded; HS022279.
Citation: Onaitis MW, Furnary AP, Kosinski AS .
Equivalent survival between lobectomy and segmentectomy for clinical stage IA lung cancer.
Ann Thorac Surg 2020 Dec;110(6):1882-91. doi: 10.1016/j.athoracsur.2020.01.020..
Keywords: Cancer: Lung Cancer, Cancer, Surgery, Mortality, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Huelster Huelster, Laviana AA, Joyce DD
Radiotherapy after radical prostatectomy: effect of timing of postprostatectomy radiation on functional outcomes.
This study sought to compare patient-reported functional outcomes after radical prostatectomy (RP) and postprostatectomy radiation as well as elucidate the timing of radiation to allow optimal recovery of function. Findings showed that, in men with localized prostate cancer, post-RP radiotherapy was associated with significantly worse sexual, urinary, and bowel function domain scores at 5 years compared to RP alone. Radiation delayed for approximately 24 months after RP may be optimal for preserving erectile function compared to radiation administered closer to the time of RP.
AHRQ-funded; HS019356; HS022640.
Citation: Huelster Huelster, Laviana AA, Joyce DD .
Radiotherapy after radical prostatectomy: effect of timing of postprostatectomy radiation on functional outcomes.
Urol Oncol 2020 Dec;38(12):930.e23-30.e32. doi: 10.1016/j.urolonc.2020.06.022..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Surgery, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Comparative Effectiveness
Hu QL, Grant MC, Hornor MA
Technical evidence review for emergency major abdominal operation conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
This technical evidence review focuses on the use of enhanced recovery pathways (ERPs) for emergency major abdominal surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery (ISCR). This national ERP initiative is funded by AHRQ and implemented in 2017 through a collaboration with American College of Surgeons, and Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality. Five common emergency general surgery (EGS) procedures were focused on: perforated peptic ulcer repair, colectomy, lysis of adhesions, small bowel resection, and exploratory laparotomy. The authors identified seventeen candidate components for emergency major abdominal ERP. The components span the continuum of care from preoperative setting to hospital discharge. For every component they conducted a systematic literature review to find relevant studies. Each component was examined for rationale, evidence, and summary and recommendations. Many were supported by evidence and guidelines specific to their particular operation. Key gaps in literature were highlighted, specifically lack of evidence specific to these operations across many ERP processes.
AHRQ-funded; 233201500020I.
Citation: Hu QL, Grant MC, Hornor MA .
Technical evidence review for emergency major abdominal operation conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2020 Dec;231(6):743-64.e5. doi: 10.1016/j.jamcollsurg.2020.08.772..
Keywords: Evidence-Based Practice, Surgery, Patient Safety, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research
Hextrum S, Minhas JS, Liotta EM
Hypocapnia, ischemic lesions, and outcomes after intracerebral hemorrhage.
This research evaluated the relationship between early pCO(2) changes, ischemic lesions and outcomes in patients with intracerebral hemorrhage (ICH). This observational cohort study ran from 2006 to 2019. Arterial blood gas (ABG) measurements and mechanical ventilation settings in the first 72 hours after admission were collected. ABG data was analyzed from 220 patients. Hyperventilation occurred in 52 (28%) of cases and was not associated with clinical severity. Lower initial pCO(2) was associated with greater risk of in-hospital death. MRI images from 33 patients was used to measure the risk of developing ischemic lesions with lower pCO(2). Lower pCO(2) was also associated with a higher risk, except in patients with low initial systolic blood pressure.
AHRQ-funded; HS023437.
Citation: Hextrum S, Minhas JS, Liotta EM .
Hypocapnia, ischemic lesions, and outcomes after intracerebral hemorrhage.
J Neurol Sci 2020 Nov 15;418:117139. doi: 10.1016/j.jns.2020.117139..
Keywords: Stroke, Cardiovascular Conditions, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Fernald DH, Mullen R,, Hall T
Exemplary practices in cardiovascular care: results on clinical quality measures from the EvidenceNOW Southwest Cooperative.
The authors identified practice characteristics associated with high performance on four cardiovascular disease cardiovascular clinical quality measures (CQMs). They found that multiple strategies - registries, prompts and protocols, patient self-management support, and patient-team partnership activities - were associated with delivering high-quality cardiovascular care over time, measured by CQMs.
AHRQ-funded; HS023904.
Citation: Fernald DH, Mullen R,, Hall T .
Exemplary practices in cardiovascular care: results on clinical quality measures from the EvidenceNOW Southwest Cooperative.
J Gen Intern Med 2020 Nov;35(11):3197-204. doi: 10.1007/s11606-020-06094-5..
Keywords: Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care
Nijhawan AE, Bhattatiry M, Chansard M
HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South.
Hospitalization represents an opportunity to re-engage out-of-care individuals, improve HIV outcomes, and reduce health disparities. The authors reviewed electronic health records of HIV-positive individuals hospitalized at an urban, public hospital between September 2013 and December 2015. They found that hospitalized patients with HIV had low rates of engagement in care, retention in care, and virologic suppression, though all three outcomes improved after hospitalization. A multidisciplinary transitions team improved care engagement and virologic suppression in those who received the intervention.
AHRQ-funded; HS022418.
Citation: Nijhawan AE, Bhattatiry M, Chansard M .
HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South.
AIDS Care 2020 Nov;32(11):1343-52. doi: 10.1080/09540121.2019.1698704.
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Keywords: Human Immunodeficiency Virus (HIV), Transitions of Care, Inpatient Care, Teams, Hospitalization, Patient and Family Engagement, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Silverberg JI, Lai JS, Patel KR
Measurement properties of the Patient-Reported Outcomes Information System (PROMIS(®) ) Itch Questionnaire: itch severity assessments in adults with atopic dermatitis.
This study evaluated the validity of numeric rating scales (NRS) and verbal rating scales (VRS) for itch and itch frequency for assessing itch severity in atopic dermatitis (AD). The authors evaluated the Patient-Reported Outcomes Information System (PROMIS(®) ) Itch Questionnaire (PIQ) - itch severity assessment, including multiple NRS, VRS and frequency of itch assessments, in adults with AD and compared their performance. The evaluation involved self-administered questionnaires and skin examinations performed in 410 patients with AD (aged 18-90 years) in a dermatology practice setting. PIQ NRS, VRS and frequency of itch had good content validity, strong correlations with one another and weak-to-moderate correlations with patient-oriented eczema measure (POEM), Eczema Area and Severity Index (EASI), objective SCORing AD (SCORAD) and Dermatology Life Quality Index (DLQI) and very good discriminant validity.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Lai JS, Patel KR .
Measurement properties of the Patient-Reported Outcomes Information System (PROMIS(®) ) Itch Questionnaire: itch severity assessments in adults with atopic dermatitis.
Br J Dermatol 2020 Nov;183(5):891-98. doi: 10.1111/bjd.18978..
Keywords: Skin Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Yao X, Inselman JW, Ross JS
Comparative effectiveness and safety of oral anticoagulants across kidney function in patients with atrial fibrillation.
Patients with atrial fibrillation and severely decreased kidney function were excluded from the pivotal non-vitamin K antagonist oral anticoagulants (NOAC) trials, thereby raising questions about comparative safety and effectiveness in patients with reduced kidney function. This study aimed to compare oral anticoagulants across the range of kidney function in patients with atrial fibrillation.
AHRQ-funded; HS025517; HS025164; HS025402; HS022882; HS024075.
Citation: Yao X, Inselman JW, Ross JS .
Comparative effectiveness and safety of oral anticoagulants across kidney function in patients with atrial fibrillation.
Circ Cardiovasc Qual Outcomes 2020 Oct;13(10):e006515. doi: 10.1161/circoutcomes.120.006515..
Keywords: Kidney Disease and Health, Cardiovascular Conditions, Blood Thinners, Medication, Medication: Safety, Patient Safety, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Zullo AR, Riester MR, Erqou S
Comparative effectiveness of angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors in older nursing home residents after myocardial infarction: a retrospective cohort study.
Evidence regarding differences in outcomes between angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) among older nursing home (NH) residents after acute myocardial infarction (AMI) is limited. The purpose of this study was to estimate the post-AMI effects of ARBs versus ACEIs on mortality, rehospitalization, and functional decline outcomes in this important population.
AHRQ-funded; HS022998.
Citation: Zullo AR, Riester MR, Erqou S .
Comparative effectiveness of angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors in older nursing home residents after myocardial infarction: a retrospective cohort study.
Drugs Aging 2020 Oct;37(10):755-66. doi: 10.1007/s40266-020-00791-w..
Keywords: Elderly, Nursing Homes, Heart Disease and Health, Medication, Evidence-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Presley C, Agne A, Shelton T
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
This study compared the effectiveness of a community-based diabetes self-management education (DSME) plus mobile health (mHealth)-enhanced peer support intervention to community-based DSME alone for African American adults with poorly controlled type 2 diabetes. This randomized controlled trial took place in Jefferson County, Alabama within a safety-net healthcare system with a group diagnosed with type 2 diabetes and hemoglobin A1C ≥ 7.5%. The intervention group reviewed community-based DSME plus 6 months of mHealth-enhanced peer support, including 12 weekly phone calls, then 3 monthly calls from community health workers. The control group received community based DSME only. Primary outcomes were lower A1C and secondary outcomes were lower diabetes distress, depressive symptoms, self-efficacy or confidence in their ability to manage diabetes, and social support. Of 120 participants selected, 97 completed the study. Both groups experienced clinical meaning reduction in A1C. Participants in the intervention group experienced a significantly larger reduction in diabetes distress compared to the control group.
AHRQ-funded; HS019465.
Citation: Presley C, Agne A, Shelton T .
Mobile-enhanced peer support for African Americans with Type 2 diabetes: a randomized controlled trial.
J Gen Intern Med 2020 Oct;35(10):2889-96. doi: 10.1007/s11606-020-06011-w..
Keywords: Telehealth, Health Information Technology (HIT), Patient Self-Management, Diabetes, Chronic Conditions, Racial and Ethnic Minorities, Community-Based Practice, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Education: Patient and Caregiver
Luther M, Poppert Cordts KM, Williams CN
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
This is a systematic review to quantify sleep wake disturbances (SWD) after pediatric traumatic brain injury (TBI). These SWD can place children at risk for worse outcomes since sleep is needed for brain development and healing after injury. They also evaluated interventions for SWD and the association between SWD and other post-traumatic outcomes. Literature was searched from 1999-2019 evaluating sleep or fatigue in children hospitalized for TBI. Two independent reviewers assessed quality of the studies using the Newcastle-Ottowa Score for observational studies. Out of 966 identified articles, 126 full text articles were reviewed and 24 studies were included. Studies showed at least 20% of children with TBI had some degree of SWD including trouble falling or staying asleep, fatigue, daytime fatigue, and nightmares. SWD was negatively correlated with cognitive, behavioral, and quality of life outcomes. There was moderate-high risk of bias for all studies due to small sample size and lack of validated or objective SWD measures.
AHRQ-funded; HS022981.
Citation: Luther M, Poppert Cordts KM, Williams CN .
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
Sleep 2020 Oct;43(10):zsaa083. doi: 10.1093/sleep/zsaa083..
Keywords: Children/Adolescents, Sleep Problems, Brain Injury, Neurological Disorders, Trauma, Risk, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Evidence-Based Practice
Cuthel A, Rogers E, Daniel F
Barriers and facilitators in the recruitment and retention of more than 250 small independent primary care practices for EvidenceNOW.
This study examined barriers and facilitators in the recruitment and retention of small independent practices (SIPs) to participate in research studies. The authors used qualitative data from the HealthyHearts New York City program, part of the EvidenceNOW initiative. This randomized controlled trial took place from 2015 through 2018 across 5 boroughs in NYC. A total of 257 SIPs (<5 full-time clinicians) were recruited originally. The three main factors that facilitated rapid recruitment were: 1) a prior well-established relationship with the local health department; 2) alignment of project goals with practice priorities, and 3) having appropriate monetary incentives. Specific strategies that enhance recruitment of SIPS and fills gaps in knowledge about factors that influence retention are identified.
AHRQ-funded; HS023922.
Citation: Cuthel A, Rogers E, Daniel F .
Barriers and facilitators in the recruitment and retention of more than 250 small independent primary care practices for EvidenceNOW.
Am J Med Qual 2020 Sep/Oct;35(5):388-96. doi: 10.1177/1062860619893422..
Keywords: Primary Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Lindly O, Crossman M, Eaves M
Health literacy and health outcomes among children with developmental disabilities: a systematic review.
This systematic literature review focused on the impact of health literacy on health outcomes of children with developmental disabilities (DDs). A review of the literature of most of the major scientific databases was conducted. Out of 2,768 unique records identified, 53 full text articles were reviewed and four articles were included. The associations of family health literacy with health outcomes among children with DDs were mixed. Future research was recommended.
AHRQ-funded; HS000063.
Citation: Lindly O, Crossman M, Eaves M .
Health literacy and health outcomes among children with developmental disabilities: a systematic review.
Am J Intellect Dev Disabil 2020 Sep 1;125(5):389-407. doi: 10.1352/1944-7558-125.5.389..
Keywords: Children/Adolescents, Health Literacy, Disabilities, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Shoemaker-Hunt SJ, Wyant BE
The effect of opioid stewardship interventions on key outcomes: a systematic review.
In this study, the investigators sought to identify potential patient safety practices to reduce high-risk opioid prescribing. They conducted a systematic review of the literature to identify opioid stewardship (OS) strategies implemented in primary care and other settings. The investigators concluded that the strength of the evidence was low to moderate that OS efforts decreased numbers of opioid prescriptions, proportion of patients on long-term opioids, or days' supply. The strength of the evidence for OS initiatives producing significant reductions in opioid dosages was moderate.
AHRQ-funded; 233201500013I.
Citation: Shoemaker-Hunt SJ, Wyant BE .
The effect of opioid stewardship interventions on key outcomes: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S36-s41. doi: 10.1097/pts.0000000000000710..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Substance Abuse, Prevention
Gale BM, Hall KK
The use of patient monitoring systems to improve sepsis recognition and outcomes: a systematic review.
This systematic review’s aim was to determine the impact of automated patient monitoring systems (PMSs) on sepsis recognition and outcomes. The review was conducted using articles published from 2008 through 2018. Nineteen articles were identified for inclusion with 4 systematic reviews and 15 individual studies. Study results for outcome measures were mixed, with more than half the studies showing a significant improvement in at least one outcome measure (eg mortality, intensive care unit length of stay, ICU transfer). Evidence for process measure improvement was of moderate strength across multiple hospital units.
AHRQ-funded; 233201500013I.
Citation: Gale BM, Hall KK .
The use of patient monitoring systems to improve sepsis recognition and outcomes: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S8-s11. doi: 10.1097/pts.0000000000000750..
Keywords: Clinical Decision Support (CDS), Sepsis, Diagnostic Safety and Quality, Screening, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Hall KK, Lim A, Gale B
The use of rapid response teams to reduce failure to rescue events: a systematic review.
This systematic review looked at studies on the evidence on the impact of rapid response teams (RRTs) on failure to rescue events. Articles from 2008 to 2018 were found on the impact of RRTs on failure to rescue events, including hospital mortality and in-hospital cardiac arrest events. Ten articles were identified for inclusion. Patient outcomes included hospital mortality (8 studies), in-hospital cardiac arrests (9 studies) and ICU transfer rates (5 studies). Moderate evidence was found linking the implementation of RRTs with decreased mortality and non-ICU cardiac arrest rates. Results linking RRTs to ICU transfer rates were inconclusive. Benefits of RRTs may take some time after implementation to be realized.
AHRQ-funded; 233201500013I.
Citation: Hall KK, Lim A, Gale B .
The use of rapid response teams to reduce failure to rescue events: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S3-s7. doi: 10.1097/pts.0000000000000748..
Keywords: Teams, Inpatient Care, Hospitals, Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research
Mogul DB, Perito ER, Wood N
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
In December 2018, UNOS approved an allocation scheme based on recipients' geographic distance from a deceased donor ("acuity circles"). Previous analyses suggested acuity circles (AC) would reduce waitlist mortality overall, but their impact on pediatric subgroups was not considered. In this study, the investigators applied Scientific Registry of Transplant Recipients data from 2011-2016 towards the Liver Simulated Allocation Model (LSAM) to compare outcomes by age and illness severity for the UNOS-approved AC and the existing Donor Service Area (DSA)/Region-based allocation schemes.
AHRQ-funded; HS023876.
Citation: Mogul DB, Perito ER, Wood N .
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
Transplantation 2020 Aug;104(8):1627-32. doi: 10.1097/tp.0000000000003079..
Keywords: Children/Adolescents, Transplantation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Surgery, Access to Care
Kaiser SV, Johnson MD, Walls TA
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
This quality improvement study’s aim was to determine the effects of pediatric asthma pathway implementation in a diverse, national sample of emergency departments (EDs). Desired outcomes included systemic corticosteroid administration within 60 minutes (primary), assessment of severity at ED triage, chest radiograph use, hospital admission or transfer for higher level of care, and ED length of stay. Charts were reviewed each month by EDs for children ages 2-17 years with a primary diagnosis of asthma. A total of 83 EDs were enrolled, with 37 of them children’s hospitals, and 46 community hospitals. Seventy-three percent completed the study (n = 22,963). There was a significant increase in systematic corticosteroid administration within 60 minutes of arrival as well as increased odds of severity assessment at triage and decreased rate of change in odds of hospital admission/transfer. Chest radiograph or ED length of stay was not associated with pathway implementation.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Johnson MD, Walls TA .
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
J Pediatr 2020 Aug;223:100-07.e2. doi: 10.1016/j.jpeds.2020.02.080..
Keywords: Children/Adolescents, Emergency Department, Asthma, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Villa Zapata L, Hansten PD, Panic J
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Warfarin use can trigger the occurrence of bleeding independently or as a result of a drug-drug interaction when used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs). This article examines the risk of bleeding in individuals exposed to concomitant warfarin and NSAID compared with those taking warfarin alone. The investigators concluded that risk of bleeding was significantly increased among persons taking warfarin and a NSAID or COX-2 inhibitor together as compared with taking warfarin alone.
AHRQ-funded; HS025984.
Citation: Villa Zapata L, Hansten PD, Panic J .
Risk of bleeding with exposure to warfarin and nonsteroidal anti-inflammatory drugs: a systematic review and meta-analysis.
Thromb Haemost 2020 Jul;120(7):1066-74. doi: 10.1055/s-0040-1710592..
Keywords: Blood Thinners, Medication, Medication: Safety, Risk, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Shah SC, Dai Zhu, X
Associations between calcium and magnesium intake and the risk of incident gastric cancer: a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study.
Gastric cancer remains a leading cause of cancer-related mortality. Identifying dietary and other modifiable disease determinants has important implications for risk attenuation in susceptible individuals. The primary aim of the investigators was to estimate the association between dietary and supplemental intakes of calcium and magnesium and the risk of incident gastric cancer. They conducted a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons Diet and Health Study.
AHRQ-funded; HS026395.
Citation: Shah SC, Dai Zhu, X .
Associations between calcium and magnesium intake and the risk of incident gastric cancer: a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study.
Int J Cancer 2020 Jun 1;146(11):2999-3010. doi: 10.1002/ijc.32659..
Keywords: Cancer, Digestive Disease and Health, Risk, Prevention, Nutrition, Patient-Centered Outcomes Research, Evidence-Based Practice
Erim DO, Bennett AV, Gaynes BN
Associations between prostate cancer-related anxiety and health-related quality of life.
This study followed prostate cancer patients who were enrolled in the cohort study North Cancer Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCess) from January 2011 and June 2013. A 1-year follow-up survey was done to assess prostate cancer-related anxiety (PCRA) in the cohort. The researchers were interested in the association between PCRA and health-related quality of life (HRQOL). The risk of probable depression was significantly higher in participants with clinically significant PCRA compared with those without it.
AHRQ-funded; 29020050040I.
Citation: Erim DO, Bennett AV, Gaynes BN .
Associations between prostate cancer-related anxiety and health-related quality of life.
Cancer Med 2020 Jun;9(12):4467-73. doi: 10.1002/cam4.3069..
Keywords: Cancer: Prostate Cancer, Cancer, Anxiety, Quality of Life, Men's Health, Patient-Centered Outcomes Research, Depression, Evidence-Based Practice