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 Drug Events (ADE) (1)
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Antibiotics (7)
- Antimicrobial Stewardship (2)
- Anxiety (1)
- Asthma (8)
- Behavioral Health (1)
- Cancer (1)
- Caregiving (1)
- Care Management (3)
- Children/Adolescents (20)
- Chronic Conditions (14)
- Clinical Decision Support (CDS) (2)
- Clinician-Patient Communication (1)
- Communication (1)
- Community-Acquired Infections (1)
- Comparative Effectiveness (1)
- COVID-19 (8)
- Critical Care (3)
- Decision Making (3)
- Depression (1)
- Diagnostic Safety and Quality (6)
- Digestive Disease and Health (1)
- Disparities (1)
- Education: Academic (1)
- Education: Patient and Caregiver (1)
- Elderly (2)
- Emergency Department (5)
- Emergency Preparedness (1)
- Evidence-Based Practice (11)
- Guidelines (4)
- Healthcare Cost and Utilization Project (HCUP) (5)
- Healthcare Costs (4)
- Healthcare Delivery (3)
- Healthcare Utilization (5)
- Health Information Technology (HIT) (1)
- Health Literacy (1)
- Home Healthcare (2)
- Hospital Discharge (1)
- Hospitalization (7)
- Hospital Readmissions (4)
- Hospitals (6)
- Imaging (2)
- Implementation (2)
- Infectious Diseases (4)
- Influenza (2)
- Inpatient Care (7)
- Intensive Care Unit (ICU) (6)
- Kidney Disease and Health (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medicare (1)
- Medication (15)
- Neonatal Intensive Care Unit (NICU) (1)
- Neurological Disorders (2)
- Newborns/Infants (5)
- Opioids (1)
- Outcomes (5)
- Pain (1)
- Palliative Care (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (4)
- Patient Safety (1)
- Pneumonia (5)
- Practice Patterns (4)
- Pregnancy (1)
- Prevention (1)
- Primary Care (1)
- Provider (3)
- Provider: Clinician (1)
- Provider: Physician (4)
- Public Health (3)
- Quality Improvement (2)
- Quality Indicators (QIs) (1)
- Quality Measures (1)
- Quality of Care (3)
- Quality of Life (3)
- Registries (1)
- (-) Respiratory Conditions (60)
- Risk (2)
- Screening (1)
- Sepsis (2)
- Simulation (1)
- Sleep Problems (1)
- Social Determinants of Health (2)
- Substance Abuse (1)
- Surgery (2)
- Tobacco Use (3)
- Tobacco Use: Smoking Cessation (1)
- Training (2)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Urban Health (1)
- Vaccination (1)
- Vulnerable Populations (2)
- Women (1)
- Workflow (1)
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 60 Research Studies DisplayedAnesi GL, Chelluri J, Qasim ZA
Association of an emergency department-embedded critical care unit with hospital outcomes and intensive care unit use.
The purpose of this study was to evaluate the potential impact of an emergency department-embedded critical care unit (CCU) at the Hospital of the University of Pennsylvania among patients with sepsis and acute respiratory failure (ARF) admitted from the emergency department to a medical ward or ICU from January 2016 to December 2017. Findings showed that the emergency department-embedded CCU was not associated with clinical outcomes among patients admitted with sepsis or ARF. Among less sick patients with sepsis, the emergency department-embedded CCU was initially associated with reduced rates of direct ICU admission from the emergency department. Further research was recommended to further evaluate the impact and utility of the emergency department-embedded CCU model.
AHRQ-funded; HS026372.
Citation: Anesi GL, Chelluri J, Qasim ZA .
Association of an emergency department-embedded critical care unit with hospital outcomes and intensive care unit use.
Ann Am Thorac Soc 2020 Dec;17(12):1599-609. doi: 10.1513/AnnalsATS.201912-912OC..
Keywords: Emergency Department, Critical Care, Intensive Care Unit (ICU), Hospitals, Sepsis, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Healthcare Delivery
Shappell CN, Klompas M, Rhee C
Does severe acute respiratory syndrome coronavirus 2 cause sepsis?
Although some experts have unequivocally asserted that multiple organ failure arising from COVID-19 is sepsis, other case series of severe COVID-19 infections have not labeled the disease as sepsis despite the fact that patients have proven infection and organ dysfunction and therefore meet the formal definition of sepsis. In this study, the authors explore why this is the case, and whether or not it truly serves patients.
AHRQ-funded; HS025008.
Citation: Shappell CN, Klompas M, Rhee C .
Does severe acute respiratory syndrome coronavirus 2 cause sepsis?
Crit Care Med 2020 Dec;48(12):1707-09. doi: 10.1097/ccm.0000000000004601..
Keywords: COVID-19, Sepsis, Respiratory Conditions
Liu FF, Lew A, Andes E
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
The objective of this study was to share key strategies that led to successful mental health screening (MHS) implementation in one pediatric cystic fibrosis center and to report implementation and screening outcomes. Results showed that leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
AHRQ-funded; HS026393.
Citation: Liu FF, Lew A, Andes E .
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
Pediatr Pulmonol 2020 Dec;55(12):3328-36. doi: 10.1002/ppul.24951..
Keywords: Children/Adolescents, Respiratory Conditions, Chronic Conditions, Depression, Anxiety, Behavioral Health, Screening, Implementation, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Soares WE, Schoenfeld EM, Visintainer P
Safety assessment of a noninvasive respiratory protocol for adults with COVID-19.
As evidence emerged supporting noninvasive strategies for coronavirus disease 2019 (COVID-19)-related respiratory distress, the investigators implemented a noninvasive COVID-19 respiratory protocol (NCRP) that encouraged high-flow nasal cannula (HFNC) and self-proning across our healthcare system. To assess safety, the investigators conducted a retrospective chart review evaluating mortality and other patient safety outcomes after implementation of the NCRP protocol (April 3, 2020, to April 15, 2020) for adult patients hospitalized with COVID-19, compared with preimplementation outcomes (March 15, 2020, to April 2, 2020).
AHRQ-funded; HS025701.
Citation: Soares WE, Schoenfeld EM, Visintainer P .
Safety assessment of a noninvasive respiratory protocol for adults with COVID-19.
J Hosp Med 2020 Dec;15(12):734-38. doi: 10.12788/jhm.3548..
Keywords: Patient Safety, COVID-19, Respiratory Conditions, Inpatient Care, Infectious Diseases
Brady AK, Brown W, Denson JL
Variation in intensive care unit intubation practices in pulmonary critical care medicine fellowship.
This study looked at outcomes of participation of fellows for Pulmonary and Critical Medicine (PCCM) training in endotracheal intubation in the medical intensive care unit (ICU). The authors administered a survey to a convenience sample of US PCCM fellows. A total of 89 discrete US PCCM and Internal Medicine CCM training programs were represented. Almost half (43%) of PCCM fellows were “always or almost always” designed the primary operator for intubation, whereas 21% of programs had the PCCM fellow “rarely or never” the primary operator responsible for intubating in the ICU. Various influencing factors included time of day, hospital policies, attending skill or preference, ICU census and acuity, and patient factors. There was an association between location of the training program but not program size whether the PCCM fellow was the primary operator.
AHRQ-funded; HS026122.
Citation: Brady AK, Brown W, Denson JL .
Variation in intensive care unit intubation practices in pulmonary critical care medicine fellowship.
ATS Sch 2020 Dec;1(4):395-405. doi: 10.34197/ats-scholar.2020-0004OC..
Keywords: Intensive Care Unit (ICU), Respiratory Conditions, Training, Education: Academic, Critical Care
Bryan MA, Tyler A, Zhou C
Associations between quality measures and outcomes for children hospitalized with bronchiolitis.
The authors used adherence to the Pediatric Respiratory Illness Measurement System (PRIMES) indicators to evaluate the strength of associations for individual indicators with length of stay (LOS) and cost for bronchiolitis. They found that three indicators were significantly associated with shorter LOS and lower cost, while two underuse indicators were associated with higher cost. They concluded that a subset of PRIMES quality indicators for bronchiolitis were strongly associated with improved outcomes and can serve as important measures for future quality improvement efforts.
AHRQ-funded; HS026512.
Citation: Bryan MA, Tyler A, Zhou C .
Associations between quality measures and outcomes for children hospitalized with bronchiolitis.
Hosp Pediatr 2020 Nov;10(11):932-40. doi: 10.1542/hpeds.2020-0175..
Keywords: Children/Adolescents, Respiratory Conditions, Hospitals, Quality Indicators (QIs), Quality Measures, Quality of Care
Miller BJ, Carson KA, Keller S
Educating patients on unnecessary antibiotics: personalizing potential harm aids patient understanding.
Antibiotic resistance is a public health emergency fueled by inappropriate antibiotic use. Public education campaigns often focus on global antibiotic resistance or societal harm of antibiotic misuse. In this study, the investigators administered a survey at a primary care clinic in Baltimore, MD. A total of 250 participants rated 18 statements about potential harm from antibiotics on how each statement changed their likelihood to request antibiotics for an upper respiratory tract infection.
AHRQ-funded; HS025782.
Citation: Miller BJ, Carson KA, Keller S .
Educating patients on unnecessary antibiotics: personalizing potential harm aids patient understanding.
J Am Board Fam Med 2020 Nov-Dec;33(6):969-77. doi: 10.3122/jabfm.2020.06.200210..
Keywords: Antimicrobial Stewardship, Antibiotics, Education: Patient and Caregiver, Medication, Respiratory Conditions, Health Literacy
Kapoor N, Lacson R, Hammer M
Physician agreement with recommendations contained in a national guideline for the management of incidental pulmonary nodules: a case study.
This survey of physicians was used to determine agreement with recommendations in the national guideline for the management of incidental pulmonary nodules from the 2017 Fleischner Society Guidelines for Management of Incident Pulmonary Nodules (FSG). The FSG contains 18 unique recommendations which were codified into a clinical evidence logic statement (CELS) for this study. The FSG also included ratings for strength of evidence based on the American Society of Chest Physicians grading system. In order to internally grade the strength of evidence behind each recommendation, two medical librarians from the Harvard Library of Evidence analyzed each CELS independently and graded the recommendations based on the supporting clinical studies using the Oxford Centre for Evidence-Based levels of evidence and the US Preventive Service Task Force I-scores. Nine physicians from a single large academic institution were then surveyed via SurveyMonkey to assess agreement with each of the 18 CELS. Agreement on each recommendation ranged from 0 to 100%. This study was meant to be exploratory and to test the hypothesis that guideline nonadherence may be partly affected by lack of physician agreement with guideline component recommendations.
AHRQ-funded; HS024722.
Citation: Kapoor N, Lacson R, Hammer M .
Physician agreement with recommendations contained in a national guideline for the management of incidental pulmonary nodules: a case study.
J Am Coll Radiol 2020 Nov;17(11):1437-42. doi: 10.1016/j.jacr.2020.07.020..
Keywords: U.S. Preventive Services Task Force (USPSTF), Guidelines, Evidence-Based Practice, Respiratory Conditions, Practice Patterns, Provider: Physician, Provider
Haessler S, Lindenauer PK, Zilberberg MD
Blood cultures versus respiratory cultures: 2 different views of pneumonia.
This study examined characteristics and outcomes of patients with positive cultures for pneumonia by site. The authors compared results from blood and respiratory cultures to see if organisms and resistance patterns differed by site. They studied adult patients discharged from July 2010 to June 2015 with principal diagnoses of pneumonia, respiratory failure, acute respiratory distress syndrome, respiratory arrest, or sepsis with a secondary diagnosis of pneumonia. Out of 138,651 hospitalizations of patients with pneumonia, 9.3% yielded positive cultures with 6438 from respiratory culture and 5992 blood cultures, and 45 both respiratory and blood cultures. Isolates from respiratory samples were often more resistant than were isolates from blood. Patients with positive cultures in both sites had higher case-fatality, longer lengths of stay and higher costs than patients who only had one culture site positive. Among respiratory cultures, the most common pathogens identified were Staphylococcus aureus (34%) and Pseudomonas aeruginosa (17%), whereas blood cultures most commonly grew Streptococcus pneumoniae (33%), followed by S. aureus (22%).
AHRQ-funded; HS024277.
Citation: Haessler S, Lindenauer PK, Zilberberg MD .
Blood cultures versus respiratory cultures: 2 different views of pneumonia.
Clin Infect Dis 2020 Oct 23;71(7):1604-12. doi: 10.1093/cid/ciz1049..
Keywords: Pneumonia, Community-Acquired Infections, Respiratory Conditions, Infectious Diseases
Chou R, Dana T, Jungbauer R
Masks for prevention of respiratory virus infections, including SARS-CoV-2, in health care and community settings : a living rapid review.
This study examined the effectiveness of N95, surgical, and cloth masks in community and health care settings for preventing respiratory virus infections, including coronavirus. The effects of reuse or extended use of N95 masks was also studied. The authors used multiple electronic databases, including the World Health Organization COVID-19 database and medRxiv preprint server (2003 through 2020), and reference lists. Randomized trials of masks and risks for respiratory virus infection were included. The studies were abstracted and methodological limitations were assessed by one reviewer, with a second reviewer providing verification. Thirty-nine studies with 33,867 participants were included. No studies were found that evaluated reuse or extended use of N95 masks. The studies showed that COVID-19 and MERS probably decreased with use versus nonuse and possibly decreased with N95 versus surgical mask use. Random trials in community settings found not much difference between N95 versus surgical masks. The studies’ findings were not definitive.
AHRQ-funded; 290201500009I.
Citation: Chou R, Dana T, Jungbauer R .
Masks for prevention of respiratory virus infections, including SARS-CoV-2, in health care and community settings : a living rapid review.
Ann Intern Med 2020 Oct 6;173(7):542-55. doi: 10.7326/m20-3213..
Keywords: COVID-19, Respiratory Conditions, Infectious Diseases, Prevention, Public Health, Evidence-Based Practice
Rossol SL, Yang JK, Toney-Noland C
Non-contact video-based neonatal respiratory monitoring.
Respiratory rate (RR) has been shown to be a reliable predictor of cardio-pulmonary deterioration, but standard RR monitoring methods in the neonatal intensive care units (NICU) with contact leads have been related to iatrogenic complications. This iterative design study developed a novel algorithm that produced RR from footage analyzed from stable NICU patients in open cribs with corrected gestational ages ranging from 33 to 40 weeks. The final algorithm used a proprietary technique of micromotion and stationarity detection to model background noise to be able to amplify and record respiratory motions.
AHRQ-funded; HS023506.
Citation: Rossol SL, Yang JK, Toney-Noland C .
Non-contact video-based neonatal respiratory monitoring.
Children 2020 Oct 6;7(10). doi: 10.3390/children7100171..
Keywords: Newborns/Infants, Health Information Technology (HIT), Respiratory Conditions, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU)
Lara OD, O'Cearbhaill RE, Smith MJ
COVID-19 outcomes of patients with gynecologic cancer in New York City.
Researchers studied clinical characteristics and outcomes of vulnerable populations with gynecologic cancer who developed COVID-19 infections. Among patients from six New York City area hospital systems with known gynecologic cancer and a COVID-19 diagnosis, the researchers found a case fatality rate of 14 percent, with no association between cytotoxic chemotherapy and cancer-directed surgery and COVID-19 severity or death. They recommended that patients be counseled regarding the safety of continued anticancer treatments during the pandemic, as the ability to continue cancer therapies for cancer control and cure is critical.
AHRQ-funded; HS026120.
Citation: Lara OD, O'Cearbhaill RE, Smith MJ .
COVID-19 outcomes of patients with gynecologic cancer in New York City.
Cancer 2020 Oct 1;126(19):4294-303. doi: 10.1002/cncr.33084..
Keywords: COVID-19, Respiratory Conditions, Cancer, Women, Vulnerable Populations, Outcomes, Urban Health
Miller Miller AG, Napolitano N, Turner DA, Miller AG, Napolitano N, Turner DA Miller AG, Napolitano N, Turner DA, Miller AG, Napolitano N, Turner DA
Respiratory therapist intubation practice in pediatric ICUs: a multicenter registry study.
Tracheal intubation by respiratory therapists (RTs) is a well-established practice that has been described primarily in adult and neonatal patients. However, minimal data exist regarding RTs' intubation performance in pediatric ICUs. The purpose of this study was to describe the current landscape of intubations performed by RTs in pediatric ICUs. The investigators found that RTs infrequently intubated in pediatric ICUs, with success rates similar to other providers but higher adverse event rates. RTs were more likely to use video laryngoscopy than other providers.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Miller Miller AG, Napolitano N, Turner DA, Miller AG, Napolitano N, Turner DA Miller AG, Napolitano N, Turner DA, Miller AG, Napolitano N, Turner DA .
Respiratory therapist intubation practice in pediatric ICUs: a multicenter registry study.
Respir Care 2020 Oct;65(10):1534-40. doi: 10.4187/respcare.07667..
Keywords: Children/Adolescents, Respiratory Conditions, Intensive Care Unit (ICU), Registries, Critical Care
Steuart R, Tan R, Melink K
Discharge before return to respiratory baseline in children with neurologic impairment.
Children with neurologic impairment (NI) are commonly hospitalized with acute respiratory infections (ARI). These children frequently require respiratory support at baseline and are often discharged before return to respiratory baseline. The purpose of this study was to determine if discharge before return to respiratory baseline was associated with reutilization among children with NI hospitalized with ARI.
AHRQ-funded; HS025138.
Citation: Steuart R, Tan R, Melink K .
Discharge before return to respiratory baseline in children with neurologic impairment.
J Hosp Med 2020 Sep;15(9):531-37. doi: 10.12788/jhm.3394..
Keywords: Children/Adolescents, Neurological Disorders, Respiratory Conditions, Hospital Readmissions, Hospital Discharge, Hospitals
Cotter JM, Tyler A, Reese J
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
This study looked at pediatric emergency department (ED) inpatient use of dexamethasone versus prednisone by providers for asthma treatment. A survey was distributed to providers who care for inpatient asthmatics. Ninety-two providers completed the survey. When patients received dexamethasone in the ED, 44% continued dexamethasone, 14% switched to prednisone, 2% stopped steroid use, and 40% said it depended on the circumstances. Hospitalists were significantly more likely to continue dexamethasone than pulmonologists (61% versus 15%). Switching to prednisone included factors such as severity of exacerbation (73%) and asthma history (47%). Just over half of providers (5f1%) felt uncomfortable using dexamethasone because of “minimal data to support [its] use inpatient.”
AHRQ-funded; HS026512.
Citation: Cotter JM, Tyler A, Reese J .
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
J Asthma 2020 Sep;57(9):942-48. doi: 10.1080/02770903.2019.1622713..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Medication, Inpatient Care, Care Management, Hospitalization, Emergency Department, Practice Patterns, Provider: Physician, Provider
Oates GR, Baker E, Rowe SM
Tobacco smoke exposure and socioeconomic factors are independent predictors of pulmonary decline in pediatric cystic fibrosis.
This longitudinal study evaluates the effects of tobacco smoke exposure and socioeconomic factors on pulmonary decline in pediatric cystic fibrosis (CF). Data from the CF Foundation Patient Registration was obtained for patients who were 6-18 years old at the end of 2016. Lung function measures (ppFEV(1)) for 10,895 individuals was calculated at each attained age. At age 6, lung function was 4.7% lower among smoke-exposed children than among unexposed with this deficit continuing through age 18. Smoke exposure and socioeconomic factors had independent, additive associations with lung function. Factors that declined ppFEV(1) include smoke exposure (2.4%), lower paternal education (4.9%), public insurance (0.3%), and increased 0.2% with each $10,000 annual household income.
AHRQ-funded; HS023009.
Citation: Oates GR, Baker E, Rowe SM .
Tobacco smoke exposure and socioeconomic factors are independent predictors of pulmonary decline in pediatric cystic fibrosis.
J Cyst Fibros 2020 Sep;19(5):783-90. doi: 10.1016/j.jcf.2020.02.004..
Keywords: Children/Adolescents, Respiratory Conditions, Tobacco Use, Social Determinants of Health, Risk
Oates GR, Harris WT, Gutierrez HH
Tobacco smoke exposure in pediatric cystic fibrosis: a qualitative study of clinician and caregiver perspectives on smoking cessation.
This qualitative study identified barriers and facilitators of smoking cessation in caregivers to children with cystic fibrosis (CF) and outlined potential interventional approaches. Researchers conducted semi-structured interviews with CF familial caregivers who were current or former smokers, and with members of the CF care team, asking about experiences, practices, and prerequisites for a successful program. Findings revealed intrapersonal, interpersonal, and structural barriers to eliminating tobacco smoke exposure in children with CF, outlined opportunities to address these barriers, and made recommendations for a comprehensive tobacco cessation strategy.
AHRQ-funded; HS023009.
Citation: Oates GR, Harris WT, Gutierrez HH .
Tobacco smoke exposure in pediatric cystic fibrosis: a qualitative study of clinician and caregiver perspectives on smoking cessation.
Pediatr Pulmonol 2020 Sep;55(9):2330-40. doi: 10.1002/ppul.24879..
Keywords: Children/Adolescents, Tobacco Use, Tobacco Use: Smoking Cessation, Caregiving, Respiratory Conditions
Bartsch SM, Mitgang EA, Geller G
What if the influenza vaccine did not offer such variable protection?
This study looked at the impact of reducing the variability in responses to the influenza vaccine across the population. Protection from the vaccine can vary significantly from person to person due to differences in immune systems, body types, and other factors. The authors compared the projected cases, direct medical costs, and productivity losses at the 30%, 50%, and 70% efficacy rates.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Mitgang EA, Geller G .
What if the influenza vaccine did not offer such variable protection?
J Infect Dis 2020 Sep 1;222(7):1138-44. doi: 10.1093/infdis/jiaa240..
Keywords: Influenza, Vaccination, Respiratory Conditions, Public Health
Hernandez AV, Roman YM, Pasupuleti V
Hydroxychloroquine or chloroquine for treatment or prophylaxis of COVID-19: a living systematic review.
Investigators summarized evidence about the benefits and harms of hydroxychloroquine or chloroquine for the treatment or prophylaxis of coronavirus disease 2019 (COVID-19). They found that evidence on the benefits and harms of using hydroxychloroquine or chloroquine to treat COVID-19 was very weak and conflicting.
AHRQ-funded; 290201500012I.
Citation: Hernandez AV, Roman YM, Pasupuleti V .
Hydroxychloroquine or chloroquine for treatment or prophylaxis of COVID-19: a living systematic review.
Ann Intern Med 2020 Aug 18;173(4):287-96. doi: 10.7326/m20-2496..
Keywords: COVID-19, Respiratory Conditions, Medication, Evidence-Based Practice
Joshi RP, Pejaver V, Hammarlund NE
A predictive tool for identification of SARS-CoV-2 PCR-negative emergency department patients using routine test results.
This retrospective case-control study investigated whether the use of a prediction tool based on complete blood count results and patient sex can better allocate testing for SARS-CoV-2 PCR testing in hospital emergency departments. Participants were emergency department patients who had concurrent complete blood counts and SARS-CoV-2 PCR testing in Northern California, Seattle, Washington, Chicago Illinois, and South Korea. A hypothetical scenario of 1000 patients requiring testing was developed, but in this scenario testing resources are limited to 60% of patients. This tool would allow a 33% increase in properly allocated resources.
AHRQ-funded; HS026385.
Citation: Joshi RP, Pejaver V, Hammarlund NE .
A predictive tool for identification of SARS-CoV-2 PCR-negative emergency department patients using routine test results.
J Clin Virol 2020 Aug;129:104502. doi: 10.1016/j.jcv.2020.104502..
Keywords: Emergency Department, COVID-19, Pneumonia, Respiratory Conditions, Diagnostic Safety and Quality, Clinical Decision Support (CDS)
Schondelmeyer AC, Dewan ML, Brady PW
Cardiorespiratory and pulse oximetry monitoring in hospitalized children: a Delphi process.
Cardiorespiratory and pulse oximetry monitoring in children who are hospitalized should balance benefits of detecting deterioration with potential harms of alarm fatigue. The authors of this paper developed recommendations for monitoring outside the ICU on the basis of available evidence and expert opinion. They conducted a comprehensive literature search for studies addressing the utility of cardiorespiratory and pulse oximetry monitoring in common pediatric conditions and drafted candidate monitoring recommendations based on their findings.
AHRQ-funded; HS026620; HS026763; HS023827.
Citation: Schondelmeyer AC, Dewan ML, Brady PW .
Cardiorespiratory and pulse oximetry monitoring in hospitalized children: a Delphi process.
Pediatrics 2020 Aug;146(2). doi: 10.1542/peds.2019-3336..
Keywords: Children/Adolescents, Respiratory Conditions, Guidelines, Evidence-Based Practice
Beltran Ale G, Benscoter D, Hossain MM
Impact of respiratory viral polymerase chain reaction testing on de-escalation of antibiotic therapy in children who require chronic positive pressure ventilation.
This study examined whether positive viral infection results stops antibiotic use in children who require chronic positive pressure ventilation (CPPV) who are frequently hospitalized with acute respiratory infections. A retrospective cohort study was conducted with 118 children on CPPV who had respiratory viral polymerase chain reaction (RVP) testing on admission. A viral pathogen was identified in 46.5% of the cases, with rhinovirus the most frequently identified. Antibiotic de-escalation occurred in only 33% of admissions and did not seem to impact antibiotic prescribing for hospitalized children on CPPV.
AHRQ-funded; HS012538.
Citation: Beltran Ale G, Benscoter D, Hossain MM .
Impact of respiratory viral polymerase chain reaction testing on de-escalation of antibiotic therapy in children who require chronic positive pressure ventilation.
Pediatr Pulmonol 2020 Aug;55(8):2150-55. doi: 10.1002/ppul.24884..
Keywords: Children/Adolescents, Respiratory Conditions, Antibiotics, Medication, Chronic Conditions
Daly Guris RJ, Doshi A, Boyer DL
Just-in-time simulation to guide workflow design for coronavirus disease 2019 difficult airway management.
This paper describes the development and enactment of a number of simulation exercises, increasing in complexity for clinicians to practice intubation of critically ill children while wearing personal protective equipment due to coronavirus disease. The simulations ended up aiding in a real-life situation that then occurred less than 12 hours later that validated potential failure points and effectiveness of rapidly generated guidance. From this simulation a COVID-19 airway bundle template was created.
AHRQ-funded; HS026939; HS024511.
Citation: Daly Guris RJ, Doshi A, Boyer DL .
Just-in-time simulation to guide workflow design for coronavirus disease 2019 difficult airway management.
Pediatr Crit Care Med 2020 Aug;21(8):e485-e90. doi: 10.1097/pcc.0000000000002435..
Keywords: Children/Adolescents, COVID-19, Respiratory Conditions, Workflow, Simulation, Training
Greenhawt M, Shaker M
Keeping risk in context while rethinking the setting of asthma biologics in patient-centered care.
This perspective article discusses the benefits and risks of patients with severe asthma self-administering asthma biologics at home instead of at a physician’s office. While most biologics are now FDA-approved to be administered at home, many of them are also recommended by the FDA to be administered by a health care professional with post-injection monitoring due to the possibility of post-injection anaphylaxis. The authors argue that there can be more risk associated with getting into an automobile accident on the way to or from the clinic or office. Given the current circumstances with limited patient visit hours due to COVID-19 it is even more important that patients can administer the biologic themselves.
AHRQ-funded; K08 HS024599.
Citation: Greenhawt M, Shaker M .
Keeping risk in context while rethinking the setting of asthma biologics in patient-centered care.
Ann Allergy Asthma Immunol 2020 Aug;125(2):124-25. doi: 10.1016/j.anai.2020.05.029..
Keywords: Asthma, Respiratory Conditions, Home Healthcare, Medication, Patient-Centered Healthcare
Thomson J, Hall M, Ambroggio L
Antibiotics for aspiration pneumonia in neurologically impaired children.
The objective of the study was to compare hospital outcomes associated with commonly used antibiotic therapies for aspiration pneumonia in children with neurologic impairment (NI). The investigators concluded that anaerobic therapy appeared to be important in the treatment of aspiration pneumonia in children with NI. They suggested that while Gram-negative coverage alone was associated with worse outcomes, its addition to anaerobic therapy may not yield improved outcomes.
AHRQ-funded; HS025138.
Citation: Thomson J, Hall M, Ambroggio L .
Antibiotics for aspiration pneumonia in neurologically impaired children.
J Hosp Med 2020 Jul;15(7):395-402. doi: 10.12788/jhm.3338..
Keywords: Children/Adolescents, Pneumonia, Respiratory Conditions, Neurological Disorders, Antibiotics, Medication, Outcomes