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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
76 to 100 of 2212 Research Studies DisplayedLi R, Wittmann D, Nelson CJ
Unmet sexual health needs of patients and female partners following diagnosis and treatment for prostate cancer.
This study’s objective was to perform a qualitative study to identify unmet sexual needs of patients and female partners after prostate cancer diagnosis. The authors conducted a qualitative study of posts to the Inspire Us TOO Prostate Cancer Online Support and Discussion Community. They identified 6,192 posts in the Sexual Health & Intimacy forum of the community, of which 661 posts were from female authors. A random sample of 10% of posts from female partners and an equal number of randomly selected posts from male patients were analyzed. Multiple themes emerged that were unique to female partners of prostate cancer survivors including included expanding the sexual repertoire, feeling invisible, contextualizing sexual intimacy within the broader picture of survival, and addressing relationship concerns. Patients and their partners had common concerns, including not receiving sufficient information from healthcare providers regarding sexual side effects from prostate cancer and its treatment. A limitation may be that members of the online community may not be representative of all couples facing prostate cancer. This study also does not examine sexual health needs among gay and bisexual couples.
AHRQ-funded; HS026120.
Citation: Li R, Wittmann D, Nelson CJ .
Unmet sexual health needs of patients and female partners following diagnosis and treatment for prostate cancer.
J Sex Med 2022 Dec; 19(12):1797-803. doi: 10.1016/j.jsxm.2022.08.195..
Keywords: Sexual Health, Cancer: Prostate Cancer, Cancer
Clements KM, Kunte PS, Clark MA
Uptake of hepatitis C virus treatment in a multi-state Medicaid population, 2013-2017.
The purpose of this study was to explore trends in the direct acting antiviral (DAA) uptake in a multi-state Medicaid population with hepatitis C virus (HCV) prior to and after ledipasvir/sofosbuvir (LDV/SOF) approval and changes in prior authorization (PA) requirements. The researchers analyzed annual enrollment, medical, and pharmacy claims for 38,302 to 45,005 people per year in four states, between December 2013 and December 2017. The study found that uptake increased from 0.34% per month in October 2014 to 0.70% per month after LDV/SOF approval and increased relative to the pre-LDV/SOV trend through June 2016. Uptake increased to 1.18% per month after PA change and remained static through 2017. In plans with few or no requirements through 2017, uptake increased to 1.19% per month after LDV/SOF approval and remained static through 2017, with 22.2% cumulatively treated. Among plans that lifted PA requirements from three to zero in mid-2016, uptake did not increase after LDV/SOF approval but did increase to 1.41% per month after PA change, with 18.1% cumulatively treated. The researchers concluded that LDV/SOF approval and lifting PA requirements led to an increase in uptake followed by static monthly utilization, and HCV treatment increased through 2017.
AHRQ-funded; HS025717.
Citation: Clements KM, Kunte PS, Clark MA .
Uptake of hepatitis C virus treatment in a multi-state Medicaid population, 2013-2017.
Health Serv Res 2022 Dec;57(6):1312-20. doi: 10.1111/1475-6773.13994..
Keywords: Hepatitis, Medicaid, Infectious Diseases, Healthcare Utilization
Yeung K, Bloudek L, Ding Y
AHRQ Author: Ding Y
Value-based pricing of US prescription drugs: estimated savings using reports from the Institute for Clinical and Economic Review.
The purpose of this cross-sectional study was to estimate how annual United States drug spending would change if prices for drugs were set to the Institute for Clinical and Economic Review- (ICER-) reported value-based prices (VBPs). The study included 73 unique drugs, the sum of which accounted for $110.4 billion in annual U.S. drug spending, approximately one-fifth of total U.S. drug spending in 2020. The researchers found that 11 unique drugs had multiple ICER-reported VBPs. 86.3% had observed net prices higher than the VBPs at $100,000 per quality-adjusted life-year (QALY) and and 72.6%, had $150,000 per QALY thresholds. Applying VBPs at $100,000 per QALY and $150,000 per QALY reduced the median spending per drug by $373 million. The researchers concluded that the reduction in median spending per drug reduction equated to an estimated total annual savings of $11.8 billion to $40.3 billion for the 73 drugs included in the study.
AHRQ-authored.
Citation: Yeung K, Bloudek L, Ding Y .
Value-based pricing of US prescription drugs: estimated savings using reports from the Institute for Clinical and Economic Review.
JAMA Health Forum 2022 Dec;3(12):e224631. doi: 10.1001/jamahealthforum.2022.4631..
Keywords: Healthcare Costs, Medication
Wurcel AG, Essien UR, Ortiz C
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
This cohort study examined antibiotics prescribed and variations by race among hospitalized patients with skin and soft tissue infections (SSTIs). A subanalysis of multisite, cross-sectional data collected through a national survey of acute care hospital groups within Vizient, Inc. considering adult inpatients treated for SSTIs was used. Of the 1242 adult inpatients included from 91 US hospitals, 45% were female, 18% were Black, and 69% were White with a mean age of 58 years. Penicillin allergy with hives was found in 23%, 19% with rash, and 18% with unknown effects, with allergy found more frequent in Black patients (23%) versus White (18%). Adjusting for multiple factors, White inpatients were at an increased risk of cefazolin use and decreased risk of clindamycin use compared with Black inpatients. Cefazolin use with less likely to be prescribed to Black inpatients than White inpatients and they were likely to be prescribed clindamycin. Cefazolin is considered a first-line SSTI treatment with clindamycin not recommended given frequent dosing and high potential for adverse effects including Clostridioides difficile infection (CDI). Although penicillin allergy is described as more prevalent among White patients, the authors observed an increased prevalence among Black inpatients compared with White inpatients treated for SSTI.
Citation: Wurcel AG, Essien UR, Ortiz C .
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
JAMA Netw Open 2021 Dec;4(12):e2140798. doi: 10.1001/jamanetworkopen.2021.40798..
Keywords: Antibiotics, Skin Conditions, Racial and Ethnic Minorities, Practice Patterns, Medication
Cardell CF, Yuce TK, Zhan T
What they are not telling us: analysis of nonresponders on a national survey of resident well-being.
The objective of this study was to characterize nonrespondents to a national survey about trainee well-being, and to examine patterns of responses to questions of a sensitive nature and assess how nonresponse biases estimates of mistreatment and well-being. The survey was administered with 2018 and 2019 American Board of Surgery In-Training Examinations and assessed demographics, dissatisfaction with education/career, mistreatment, burnout, thoughts of attrition, and suicidality. Overall response rates are high for this survey, but non-White or Hispanic residents were more likely to skip questions about racial/ethnic discrimination than White, non-Hispanic residents. Women were not more likely to omit questions regarding gender, gender identity, or sexual orientation discrimination. Prevalence estimates of burnout, suicidality, and gender discrimination were likely to be minimally impacted by nonresponse.
AHRQ-funded; HS025752.
Citation: Cardell CF, Yuce TK, Zhan T .
What they are not telling us: analysis of nonresponders on a national survey of resident well-being.
Ann Surg Open 2022 Dec; 3(4):e228. doi: 10.1097/as9.0000000000000228..
Keywords: Provider: Physician, Burnout
Wu A, Huang RJ, Colón GR
Low rates of structured advance care planning documentation in electronic health records: results of a single-center observational study.
This study’s objective was to determine rates of structured advanced care planning (S-ACP) documentation in electronic health records (EHRs) using a single, large university medical center in California. This retrospective cohort study used records from all patients 65 and older with at least one ambulatory encounter at Stanford Health Care between 2012 and 2020, and without concurrent hospice care. Analysis of 187,316 unique outpatient encounters between 2012 and 2020 showed only 7,902 (4.2%) contained S-ACP documentation in the EHR. The most common methods of S-ACP documentation were through problem list diagnoses (40.3%) and scanned documents (40.0%). Senior Care (46.6%) and Palliative Care (25%) demonstrated the highest rates at the clinical level.
AHRQ-funded; HS028747.
Citation: Wu A, Huang RJ, Colón GR .
Low rates of structured advance care planning documentation in electronic health records: results of a single-center observational study.
BMC Palliat Care 2022 Nov 22;21(1):203. doi: 10.1186/s12904-022-01099-9..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Juergens N, Huang J, Gopalan A
The association between video or telephone telemedicine visit type and orders in primary care.
The purpose of this study was to examine the impact of telemedicine visit type on clinical ordering behavior. The researchers compared proportions of patient-scheduled video versus telephone visits for each of eight diagnosis groups and compared physician orders for medications, antibiotics, lab, and imaging studies by visit type within each diagnosis group. They observed statistically significant differences in clinician orders by visit type during telemedicine encounters for common primary care conditions. Their findings suggested that, for certain conditions, visual information conveyed during video visits may promote clinical work-up and treatment.
AHRQ-funded; HS025189.
Citation: Juergens N, Huang J, Gopalan A .
The association between video or telephone telemedicine visit type and orders in primary care.
BMC Med Inform Decis Mak 2022 Nov 19;22(1):302. doi: 10.1186/s12911-022-02040-z..
Keywords: Telehealth, Health Information Technology (HIT), Primary Care
Hashemi-Arend A, Vasquez KS, Guishard D
Implementing DASH-aligned meals and Self-Measured Blood Pressure to reduce hypertension at senior centers: a RE-AIM analysis.
Investigators implemented two evidence-based interventions not previously tested in senior centers, DASH-aligned congregate meals and Self-Measured Blood Pressure (SMBP), to lower blood pressure (BP) at two senior centers serving low-income, racially diverse communities. Using the RE-AIM framework to analyze implementation, they found that change in systolic BP at Month 1 trended towards significance and change in SMBP reached significance at Month 6; food costs increased by 10%. They concluded that this RE-AIM analysis highlighted the acceptability, feasibility, and fidelity of this DASH/SMBP health intervention to lower BP at senior centers.
AHRQ-funded; HS021667.
Citation: Hashemi-Arend A, Vasquez KS, Guishard D .
Implementing DASH-aligned meals and Self-Measured Blood Pressure to reduce hypertension at senior centers: a RE-AIM analysis.
Nutrients 2022 Nov 18;14(22):4890. doi: 10.3390/nu14224890..
Keywords: Blood Pressure, Patient Self-Management, Elderly, Nutrition, Lifestyle Changes
Burgermaster M, Rodriguez VA
Psychosocial-behavioral phenotyping: a novel precision health approach to modeling behavioral, psychological, and social determinants of health using machine learning.
The purpose of this study was to demonstrate a novel application of machine learning for psychosocial-behavioral phenotyping, which includes the identification of subgroups with similar combinations of psychosocial characteristics. The researchers conducted a secondary analysis of psychosocial and behavioral data from a community cohort (n = 5,883). The study found 20 psychosocial-behavioral phenotypes. Each phenotype suggested different contextual considerations for intervention design. The researchers concluded that psychosocial-behavioral phenotypes can identify possible targets of intervention.
AHRQ-funded; HS019853.
Citation: Burgermaster M, Rodriguez VA .
Psychosocial-behavioral phenotyping: a novel precision health approach to modeling behavioral, psychological, and social determinants of health using machine learning.
Ann Behav Med 2022 Nov 18;56(12):1258-71. doi: 10.1093/abm/kaac012..
Keywords: Social Determinants of Health, Health Information Technology (HIT), Research Methodologies
Schumacher JR, Zahrieh D, Chow S
Increasing socioeconomically disadvantaged patients' engagement in breast cancer surgery decision-making through a shared decision-making intervention (A231701CD): protocol for a cluster randomised clinical trial.
This paper describes the protocol for a multisite randomized trial to test the impact of a newly developed decision aid to increase socioeconomically disadvantaged patients' engagement in breast cancer surgery decision-making. The study will be conducted through 10 surgical clinics within the National Cancer Institute Community Oncology Research Program (NCORP). A stepped-wedge design with clinics will be randomized to the time of transition from usual care to the decision aid arm. Study participants will be female, aged ≥18 years, with newly diagnosed stage 0-III breast cancer who are planning breast surgery. Data collection will include a baseline surgeon survey, baseline patient survey, audio-recording of the surgeon-patient consultation, a follow-up patient survey and medical record data review. A subset of patients, surgeons, and clinic stakeholders will participate in interviews and focus groups.
AHRQ-funded; HS025194.
Citation: Schumacher JR, Zahrieh D, Chow S .
Increasing socioeconomically disadvantaged patients' engagement in breast cancer surgery decision-making through a shared decision-making intervention (A231701CD): protocol for a cluster randomised clinical trial.
BMJ Open 2022 Nov 17;12(11):e063895. doi: 10.1136/bmjopen-2022-063895..
Keywords: Cancer: Breast Cancer, Cancer, Patient and Family Engagement, Decision Making, Patient-Centered Healthcare, Surgery, Women
Morrow EL, Duff MC, Mayberry LS
Mediators, moderators, and covariates: matching analysis approach for improved precision in cognitive-communication rehabilitation research.
This tutorial’s goals were to (a) increase awareness and use of mediation and moderation models in cognitive-communication rehabilitation research by describing options, benefits, and attainable analytic approaches for researchers with limited resources and sample sizes and (b) describe how these findings may be interpreted for clinicians consuming research to inform clinical care. The authors discuss the potential of mediation and moderation analyses to reduce the research-to-practice gap and describe how researchers may begin to implement these models, even in smaller sample sizes. They describe how researchers may begin to implement these models, even in smaller sample sizes. They believe it is critical to harness new approaches to advance clinical-translational research results for complex, heterogeneous groups with cognitive-communication disorders.
AHRQ-funded; HS026122.
Citation: Morrow EL, Duff MC, Mayberry LS .
Mediators, moderators, and covariates: matching analysis approach for improved precision in cognitive-communication rehabilitation research.
J Speech Lang Hear Res 2022 Nov 17;65(11):4159-71. doi: 10.1044/2022_jslhr-21-00551..
Keywords: Communication, Rehabilitation, Research Methodologies
MacEwan SR, Sieck CJ, McAlearney AS
Geographic location impacts patient portal use via desktop and mobile devices.
The purpose of this study was to assess patient portal use by geographic location according to: proximity to the medical center offering the portal, urban/rural classification, and degree of digital distress. The study found that patients living further from the medical center, in rural areas, or in areas of higher digital distress were less likely to be active portal users. Patients living in areas of higher digital distress were more likely to use the mobile portal application instead of the desktop portal website. Users of the mobile portal application used portal functions more frequently, and being a mobile user had a greater impact on the use of some portal functions by patients residing in areas of higher digital distress. The researchers concluded that mobile patient portal applications have the potential to increase the use of patient portals.
AHRQ-funded; HS024091; HS024379.
Citation: MacEwan SR, Sieck CJ, McAlearney AS .
Geographic location impacts patient portal use via desktop and mobile devices.
J Med Syst 2022 Nov 16;46(12):97. doi: 10.1007/s10916-022-01881-5..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Schuttner L, Lee JR, Hockett Sherlock S
Primary care physician perspectives on the influence of patient values, health priorities, and preferences on clinical decision-making for complex patients with multimorbidity: a qualitative study.
The purpose of this study was to explore primary care physician (PCP) perspectives on the influence of patients' values, health priorities and goals, and preferences on clinical decisions for patients with multimorbidity and higher psychosocial complexity. Between May and July 2020 the researchers utilized semi-structured telephone interviews with 23 PCPs in patient-centered medical home teams in a nationally integrated health system in the United States. The study found three major themes: (1) The personal values of patients were rarely directly discussed in routine clinical encounters but informed more typically discussed constructs of patient preferences, goals, and priorities; (2) Patient preferences, goals, and priorities were sources of conflicting perspectives about care plans between healthcare teams, patients, and families; (3) Physicians used direct strategies to communicate and negotiate about patient preferences, goals, and priorities when developing care plans. The researchers concluded that during clinical decision-making for complex patients with multimorbidity, primary care physicians perceive patient values, preferences, health priorities and goals as influential.
AHRQ-funded; HS026369.
Citation: Schuttner L, Lee JR, Hockett Sherlock S .
Primary care physician perspectives on the influence of patient values, health priorities, and preferences on clinical decision-making for complex patients with multimorbidity: a qualitative study.
Risk Manag Healthc Policy 2022 Nov 16; 15:2135-46. doi: 10.2147/rmhp.S380021..
Keywords: Primary Care, Provider: Physician, Decision Making, Chronic Conditions
Feltnerl. C, Wallace IF, Aymes S
Screening for obstructive sleep apnea in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to examine the evidence on screening for obstructive sleep apnea (OSA) in asymptomatic adults or those with unrecognized OSA symptoms to inform the U.S. Preventive Services Task Force. The researchers utilized data from PubMed/MEDLINE, Cochrane Library, Embase, and trial registries through August 23, 2021 and surveillance data through September 23, 2022. The main outcomes were accuracy, excessive daytime sleepiness, sleep-related and general health-related quality of life (QOL), and harms. Eighty-six studies were included (N = 11,051), researchers finding that no study directly compared screening with no screening. Five studies evaluating the accuracy of other screening tools provided inconsistent results. When compared with inactive control, positive airway pressure was associated with a significant improvement in ESS score from baseline, sleep-related QOL, and general health-related QOL measured by the 36-Item Short Form Health Survey (SF-36) mental health component summary score change, and SF-36 physical health component summary score change. When compared with controls, utilization of mandibular advancement devices was also related with a significantly larger ESS score change. Reporting of other health outcomes was scarce; no trial included in the study found significant benefit related with treatment on mortality, cardiovascular events, or motor vehicle crashes. In 3 systematic reviews, positive airway pressure was significantly associated with reduced blood pressure; but the difference was relatively small. The researchers concluded that the accuracy and clinical usefulness of OSA screening tools was unclear.
Citation: Feltnerl. C, Wallace IF, Aymes S .
Screening for obstructive sleep apnea in adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Nov 15;328(19):1951-71. doi: 10.1001/jama.2022.18357..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sleep Problems, Screening, Evidence-Based Practice, Prevention
Govindan S, O'Malley ME, Flanders SA
The MI-PICC Score: a risk-Prediction Model for PICC-associated Complications in the ICU.
The authors examined predictive factors for adverse events in critically ill patients with peripherally inserted central catheters (PICCs). They found that PICC-related complications in the ICU were significantly associated with history of deep vein thrombosis, active diagnosis of cancer, presence of a second central venous catheter, blood transfusion through the PICC, and PICC dwell time.
AHRQ-funded; HS025891.
Citation: Govindan S, O'Malley ME, Flanders SA .
The MI-PICC Score: a risk-Prediction Model for PICC-associated Complications in the ICU.
Am J Respir Crit Care Med 2022 Nov 15;206(10):1286-89. doi: 10.1164/rccm.202204-0760LE..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Critical Care, Intensive Care Unit (ICU), Risk, Adverse Events
Gupta AK, Kasthurirathne SN, Xu H
A framework for a consistent and reproducible evaluation of manual review for patient matching algorithms.
The authors proposed a robust framework for creating and evaluating manually reviewed gold standard data sets for measuring the performance of patient matching algorithms. They indicated that their framework can help record linkage method developers provide necessary transparency when creating and validating gold standard reference matching data sets. They concluded that this transparency will support both the internal and external validity of recording linkage studies and improve the robustness of new record linkage strategies.
AHRQ-funded; HS023808.
Citation: Gupta AK, Kasthurirathne SN, Xu H .
A framework for a consistent and reproducible evaluation of manual review for patient matching algorithms.
J Am Med Inform Assoc 2022 Nov 14;29(12):2105-09. doi: 10.1093/jamia/ocac175..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Pitts SI, Yang Y, Thomas B
Discontinuation of outpatient medications: implications for electronic messaging to pharmacies using CancelRx.
This study aimed to describe the proportion of discontinued outpatient medications that would result in a prescription discontinuation, or CancelRx message to understand its impact on medication safety. The authors used a data report to identify all outpatient medications discontinued in the electronic health record (EHR) of an academic health system in 1 month (October 2018). A total of 63,485 medications were discontinued, with 36.4% e-prescribed, 40.9% patient-reported or reconciled, and the remainder prescribed nonelectronically. Discontinued high-risk medications were more likely to be e-prescribed (47%). A discontinuation reason was specified in 58.9% of all discontinued medications. Approximately one-third to one-half of discontinued medications were e-prescribed within the same EHR that would result in a CancelRx message to the pharmacy. Extension of this functionality to reconciled medications in the EHR could significantly expand the impact of CancelRx on medication safety.
AHRQ-funded.
Citation: Pitts SI, Yang Y, Thomas B .
Discontinuation of outpatient medications: implications for electronic messaging to pharmacies using CancelRx.
J Am Med Inform Assoc 2022 Nov 14;29(12):2101-04. doi: 10.1093/jamia/ocac181..
Keywords: Medication, Provider: Pharmacist, Electronic Prescribing (E-Prescribing), Health Information Technology (HIT)
Sittig DF, Sherman JD, Eckelman MJ
i-CLIMATE: a "clinical climate informatics" action framework to reduce environmental pollution from healthcare.
This article describes an action framework called “Information technology-enabled Clinical cLimate InforMAtics acTions for the Environment” (i-CLIMATE) to reduce environmental pollution from healthcare. The framework has 5 actionable components: (1) create a circular economy for health IT, (2) reduce energy consumption through smarter use of health IT, (3) support more environmentally friendly decision-making by clinicians and health administrators, (4) mobilize healthcare workforce environmental stewardship through informatics, and (5) inform policies and regulations for change.
AHRQ-funded; HS027363.
Citation: Sittig DF, Sherman JD, Eckelman MJ .
i-CLIMATE: a "clinical climate informatics" action framework to reduce environmental pollution from healthcare.
J Am Med Inform Assoc 2022 Nov 14;29(12):2153-60. doi: 10.1093/jamia/ocac137..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT)
Ganeshan S, Pierce L, Mourad M
Impact of patient portal-based self-scheduling of diagnostic imaging studies on health disparities.
The purpose of this study was to explore the impact of self-scheduling on equitable access to care. The researchers utilized an electronic health record patient portal at the University of California San Francisco which deployed a self-scheduling tool allowing patients to self-schedule diagnostic imaging studies. The study found that among all patient portal users, Latinx, Black/African American, and non-English speaking patients, as well as patients with Medi-Cal, California's Medicaid program, and Medicare insurance were less likely to self-schedule studies. were all less likely to self-schedule when compared with commercially insured patients.
AHRQ-funded; HS026383.
Citation: Ganeshan S, Pierce L, Mourad M .
Impact of patient portal-based self-scheduling of diagnostic imaging studies on health disparities.
J Am Med Inform Assoc 2022 Nov 14;29(12):2096-100. doi: 10.1093/jamia/ocac152..
Keywords: Disparities, Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Information Technology (HIT)
Kang D, Charlton P, Applebury DE
Utilizing eye tracking to assess electronic health record use by pharmacists in the intensive care unit.
The authors conducted a study using high-fidelity electronic health record (EHR)-based simulations with incorporated eye tracking to understand the workflow of critical care pharmacists within the EHR, with specific attention to the data elements most frequently viewed. They found that, in addition to medication information, laboratory data and clinical notes are key focuses of intensive care unit pharmacist review of patient records and that navigation to multiple screens is required in order to view these data with the EHR.
AHRQ-funded; HS023793.
Citation: Kang D, Charlton P, Applebury DE .
Utilizing eye tracking to assess electronic health record use by pharmacists in the intensive care unit.
Am J Health Syst Pharm 2022 Nov 7;79(22):2018-25. doi: 10.1093/ajhp/zxac158..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Intensive Care Unit (ICU), Critical Care, Provider: Pharmacist
Guzman A, Brown T, Lee JY
Look-back and look-forward durations and the apparent appropriateness of ambulatory antibiotic prescribing.
Researchers assessed how the apparent appropriateness of antibiotic prescribing changes when using different look-back and look-forward periods. Classifying all ambulatory antibiotic prescriptions in the electronic health record of an integrated health care system as chronic, appropriate, potentially appropriate, inappropriate, or not associated with any diagnosis, they concluded that ambulatory programs and studies focused on appropriate or inappropriate antibiotic prescribing can reasonably use a short duration of association between an antibiotic prescription and diagnosis codes. They further indicated that programs and studies focused on potentially appropriate antibiotic prescribing might consider examining longer durations.
AHRQ-funded; HS024930.
Citation: Guzman A, Brown T, Lee JY .
Look-back and look-forward durations and the apparent appropriateness of ambulatory antibiotic prescribing.
Antibiotics 2022 Nov 4;11(11). doi: 10.3390/antibiotics11111554..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Ambulatory Care and Surgery, Practice Patterns
Schroeder MC, Chapman CG, Chrischilles EA
Generating practice-based evidence in the use of guideline-recommended combination therapy for secondary prevention of acute myocardial infarction.
This study’s goal was to determine if variation in real-world practice of guideline-recommended combination therapy for secondary prevention of acute myocardial infarction (AMI) reflects poor quality-of-care or a balance of outcome tradeoffs among patients. Medicare fee-for-service beneficiaries hospitalized 2007-2008 for AMI were included. Treatment within 30-days post-discharge was grouped into one of eight possible combinations for the three drug classes: beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers, and statins. Outcomes looked at included one-year overall survival, one-year cardiovascular-event-free survival, and 90-day adverse events. Results were found that each drug combination was observed in the final sample (N = 124,695), with 35.7% having all three, and 13.5% having none. There were both treatment benefits and harms in patients with AMIs with higher rates of guideline-recommended treatment.
AHRQ-funded; HS018381.
Citation: Schroeder MC, Chapman CG, Chrischilles EA .
Generating practice-based evidence in the use of guideline-recommended combination therapy for secondary prevention of acute myocardial infarction.
Pharmacy 2022 Nov 3;10(6). doi: 10.3390/pharmacy10060147..
Keywords: Evidence-Based Practice, Guidelines, Heart Disease and Health, Cardiovascular Conditions, Comparative Effectiveness, Patient-Centered Outcomes Research, Prevention
Wu A, Wu JY, Lim M
Updates in intraoperative strategies for enhancing intra-axial brain tumor control.
This review looked at recent advances in intraoperative strategies for enhancing intra-axial brain tumor control. The authors looked at published research centered on different innovative tools and techniques, including fluorescence-guided surgery, new methods of drug delivery, and minimally invasive procedural options.
AHRQ-funded; HS028747.
Citation: Wu A, Wu JY, Lim M .
Updates in intraoperative strategies for enhancing intra-axial brain tumor control.
Neuro Oncol 2022 Nov 2;24(suppl 6):S33-S41. doi: 10.1093/neuonc/noac170..
Keywords: Cancer, Surgery, Imaging
Klawetter S, Cetin N, Ilea P
"All these people saved her life, but she needs me too": understanding and responding to parental mental health in the NICU.
The purpose of this qualitative study was to examine the mental health needs of parents of infants in a neonatal intensive care unit (NICU), and the challenges and solutions to meeting those needs. Through interviews with 15 parents and staff at a level IV NICU in the United States, the study found: the relationship between staff and parents filter protect from trauma and distress; information needs and mental health needs change over time, a lack of continuity of care affects response to mental health concerns, and NICU plays a critical role in addressing the mental health of parents. The researchers concluded that mental health support should be integrated into and customized to the entire NICU trajectory, with emphasis on parents living in rural locations and non-English-speaking parents.
AHRQ-funded; HS026370.
Citation: Klawetter S, Cetin N, Ilea P .
"All these people saved her life, but she needs me too": understanding and responding to parental mental health in the NICU.
J Perinatol 2022 Nov;42(11):1496-503. doi: 10.1038/s41372-022-01426-1..
Keywords: Caregiving, Newborns/Infants, Critical Care, Intensive Care Unit (ICU), Behavioral Health
Malik MA, Motta-Calderon D, Piniella N
A structured approach to EHR surveillance of diagnostic error in acute care: an exploratory analysis of two institutionally-defined case cohorts.
The purpose of this study was to examine a structured electronic health record (EHR) case review process to identify diagnostic errors (DE) and diagnostic process failures (DPFs) in acute care. The researchers created two test cohorts of all preventable cases (n=28) and an equal number of randomly sampled non-preventable cases (n=28) from 365 adult general medicine patients who expired and were part of the mortality case review process at the research institution. Twenty-seven preventable and 24 non-preventable cases were included in the review process. The study found that the frequency of DE contributing to death was significantly higher for the preventable cohort compared to the non-preventable cohort. The researchers concluded that substantial agreement was observed among final consensus and expert panel reviews using their structured EHR case review process, and DEs contributing to death associated with DPFs were identified in institutionally designated preventable and non-preventable cases.
AHRQ-funded; HS026613.
Citation: Malik MA, Motta-Calderon D, Piniella N .
A structured approach to EHR surveillance of diagnostic error in acute care: an exploratory analysis of two institutionally-defined case cohorts.
Diagnosis 2022 Nov;9(4):446-57. doi: 10.1515/dx-2022-0032..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality, Medical Errors