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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 31 Research Studies DisplayedFranklin PD, Bond CP, Rothrock NE
Strategies for effective implementation of patient-reported outcome measures in arthroplasty practice.
This study’s goal was to synthesize patient-reported outcome measure (PROM) implementation strategies that are successfully used by hundreds of arthroplasty surgeons and early PROM-adopter clinical systems. The authors developed guidelines to inform clinical care, drive quality-improvement activities, and support reporting for payer-sponsored incentives. They also outlined future research that is needed to define methods for optimal patient engagement, technology infrastructure, and operational systems to seamlessly integrate PROM collection in clinical care.
AHRQ-funded; HS018910.
Citation: Franklin PD, Bond CP, Rothrock NE .
Strategies for effective implementation of patient-reported outcome measures in arthroplasty practice.
J Bone Joint Surg Am 2021 Dec 15;103(24):e97. doi: 10.2106/jbjs.20.02072..
Keywords: Patient-Centered Outcomes Research, Orthopedics, Quality Improvement, Quality of Care, Evidence-Based Practice, Implementation, Outcomes
Kittelson AJ, Loyd BJ, Graber J
Examination of exclusion criteria in total knee arthroplasty rehabilitation trials: influence on the application of evidence in day-to-day practice.
This study investigated whether total knee arthroplasty (TKA) patients seen in routine practice who meet common exclusion criteria in clinical trials recover differently compared to research-eligible patients. Postoperative functional outcomes were compared using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Timed Up and Go (TUG). A total of 2,528 participants from 27 trials were compared to 474 patients from the clinical dataset. Research participants were older, with lower BMI than patients in the clinical dataset. There were no differences observed in functional recovery rate between groups, except for patients with diabetes whose TUG recovered more slowly than “eligible” patients.
AHRQ-funded; HS024316.
Citation: Kittelson AJ, Loyd BJ, Graber J .
Examination of exclusion criteria in total knee arthroplasty rehabilitation trials: influence on the application of evidence in day-to-day practice.
J Eval Clin Pract 2021 Dec;27(6):1335-42. doi: 10.1111/jep.13564..
Keywords: Orthopedics, Surgery, Rehabilitation, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Coley RY, Boggs JM, Beck A
Predicting outcomes of psychotherapy for depression with electronic health record data.
This study evaluated models for predicting outcomes of psychotherapy for depression in a clinical practice setting. Findings showed that prediction models did not accurately predict depression treatment outcomes despite using rich electronic health record data and advanced analytic techniques. Recommendations included caution when considering prediction models for psychiatric outcomes using baseline intake information and transparent research to evaluate performance of any model intended for clinical use.
AHRQ-funded; HS026369.
Citation: Coley RY, Boggs JM, Beck A .
Predicting outcomes of psychotherapy for depression with electronic health record data.
J Affect Disord Rep 2021 Dec;6:100198. doi: 10.1016/j.jadr.2021.100198..
Keywords: Depression, Behavioral Health, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient-Centered Outcomes Research, Outcomes
Jiang DH, Mundell BF, Shah ND
Impact of high deductible health plans on diabetes care quality and outcomes: systematic review.
The authors sought to provide a systematic literature review of the impact of high deductible health plans (HDHPs) on the utilizations of services required for optimal management of diabetes and subsequent health outcomes. They found that, although HDHPs reduce some health care utilization and costs, they appear to do so at the expense of limiting high-value care and medication adherence.
AHRQ-funded; HS025517; HS024075; HS025164; HS025402.
Citation: Jiang DH, Mundell BF, Shah ND .
Impact of high deductible health plans on diabetes care quality and outcomes: systematic review.
Endocr Pract 2021 Nov;27(11):1156-64. doi: 10.1016/j.eprac.2021.07.001..
Keywords: Health Insurance, Diabetes, Chronic Conditions, Outcomes, Quality of Care, Patient-Centered Outcomes Research
Austin EJ, LeRouge C, Lee JR
A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.
The authors reported on their effort to develop generalizable learnings that can support the integration of electronic patient-reported outcome measures into clinical practice within a learning health system (LHS) framework. They concluded that the guidelines produced from this work highlighted the complex, multidisciplinary nature of implementing change within LHS contexts, as well as the value of action research approaches to enable rapid, iterative learning that leverages the knowledge and experience of communities of practice.
AHRQ-funded; HS023785.
Citation: Austin EJ, LeRouge C, Lee JR .
A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.
Learn Health Syst 2021 Oct;5(4):e10263. doi: 10.1002/lrh2.10263..
Keywords: Learning Health Systems, Health Information Technology (HIT), Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Kaufmann TL, Getz KD, Hsu JY
Identification of patient-reported outcome phenotypes among oncology patients with palliative care needs.
This retrospective study used patient-reported outcome (PRO) data to characterize oncology patients with palliative care needs. The objective was to determine if PRO data can identify latent phenotypes that characterize indications for specialty palliative care referral. Self-reported symptoms were collected on the Edmonton Symptom Assessment Symptom from solid tumor oncology patients (n = 745) referred to outpatient palliative care at eight community and academic sites from October 2012 to October 2018. The authors identified four PRO phenotypes: low symptoms (39.6%); moderate pain/fatigue + mood (24.2%); moderate pain/fatigue + appetite + dypsnea (27%); and high symptoms (9.3%). A secondary analysis of 421 patients found that two brief items assessing social and existential needs aligned with higher severity symptoms and psychological distress phenotypes.
AHRQ-funded; HS023681.
Citation: Kaufmann TL, Getz KD, Hsu JY .
Identification of patient-reported outcome phenotypes among oncology patients with palliative care needs.
JCO Oncol Pract 2021 Oct;17(10):e1473-e88. doi: 10.1200/op.20.00849..
Keywords: Cancer, Palliative Care, Patient-Centered Outcomes Research, Outcomes
Cardell CF, Knapp L, Cohen ME
Successful implementation of enhanced recovery in elective colorectal surgery is variable and dependent on the local environment.
This study looked at the results of a national colorectal enhanced recovery program (ERP) to improve patient outcomes. A total of 207 hospitals participated between 2017 and 2020. Quantitative (patient-level process and outcome) and qualitative (survey and structured interviews with hospital teams) data were collected and analyzed. Results shows that 62 hospitals were characterized as High Performance, and 52 as High Improvement. High Performance hospitals were larger with more annual colorectal surgeries. Fewer barriers to staff-buy-in and competing priorities, and more experience with standardized perioperative care were also characteristics of High Performance hospitals. High Improvement hospitals had lower baseline process measure (PM) adherence and less experience with perioperative care but had positive trends in annual patient outcomes such as annual morbidity, readmission, and prolonged length of stay compared to Low Improvement Hospitals.
AHRQ-funded; 233201500020I.
Citation: Cardell CF, Knapp L, Cohen ME .
Successful implementation of enhanced recovery in elective colorectal surgery is variable and dependent on the local environment.
Ann Surg 2021 Oct 1;274(4):605-12. doi: 10.1097/sla.0000000000005069..
Keywords: Surgery, Quality Improvement, Quality of Care, Outcomes, Patient-Centered Outcomes Research, Provider Performance
Kwee Wong, LL Sato, MM
Transarterial radioembolization for hepatocellular carcinoma with major vascular invasion: a nationwide propensity score-matched analysis with target trial emulation.
This study’s objective was to compare overall survival (OS) rates for hepatocellular carcinoma (HCC) with major vascular invasion (HCC-MVI) for patients undergoing either transarterial radioembolization (TARE) or systemic therapy. The National Cancer Database was used to identify 1,514 patients with HCC-MVI. TARE use had doubled between 2010 and 2015. OS was compared for the two treatments and TARE was found to be associated with significant survival benefits compared with systemic therapy.
AHRQ-funded; HS023185.
Citation: Kwee Wong, LL Sato, MM .
Transarterial radioembolization for hepatocellular carcinoma with major vascular invasion: a nationwide propensity score-matched analysis with target trial emulation.
J Vasc Interv Radiol 2021 Sep;32(9):1258-66.e6. doi: 10.1016/j.jvir.2021.07.001..
Keywords: Cancer, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Fredericksen RJ, Harding BN, Ruderman SA
Patient acceptability and usability of a self-administered electronic patient-reported outcome assessment in HIV care: relationship with health behaviors and outcomes.
The authors assessed acceptability/usability of tablet-based patient-reported outcome (PRO) assessments among patients in HIV care and relationships with health outcomes using a modified Acceptability E-Scale (AES) within a self-administered PRO assessment. They found that higher acceptability was associated with better quality of life and adherence while lower acceptability was associated with higher depression symptoms, recent illicit opioid use, and multiple recent sex partners. While patients endorsing depression symptoms, recent opioid use, sex without condoms, or multiple sex partners found PROs less acceptable, overall, patients found the assessments highly acceptable and easy to use.
AHRQ-funded; HS026154.
Citation: Fredericksen RJ, Harding BN, Ruderman SA .
Patient acceptability and usability of a self-administered electronic patient-reported outcome assessment in HIV care: relationship with health behaviors and outcomes.
AIDS Care 2021 Sep;33(9):1167-77. doi: 10.1080/09540121.2020.1845288..
Keywords: Human Immunodeficiency Virus (HIV), Quality of Life, Patient-Centered Outcomes Research, Outcomes, Chronic Conditions
Howard R, Johnson E, Berlin NL
Hospital and surgeon variation in 30-day complication rates after ventral hernia repair.
Researchers analyzed variability in 30-day complication rates and identified specific complications that contributed to this variability after ventral hernia repair. They found that, after adjusting for a number of patient-specific clinical variables, there was significant variation in 30-day complication rates after ventral hernia repair, representing a significant opportunity to improve patient outcomes.
AHRQ-funded; HS025778.
Citation: Howard R, Johnson E, Berlin NL .
Hospital and surgeon variation in 30-day complication rates after ventral hernia repair.
Am J Surg 2021 Aug;222(2):417-23. doi: 10.1016/j.amjsurg.2020.12.021..
Keywords: Surgery, Adverse Events, Outcomes, Patient-Centered Outcomes Research
Silverberg JI, Lai Cella, D D
Reliability and meaningful change of the Patient-Reported Outcomes Measurement Information System(®) Itch Questionnaire (PIQ) item banks in adults with atopic dermatitis.
The Patient-Reported Outcomes Measurement Information System Itch Questionnaire (PIQ), includes a suite of patient-reported outcome measures to assess the burden of itch in adults. In this study, the investigators sought to determine the smallest detectable change (SDC), threshold for meaningful improvement and test–retest reliability of PIQ item banks for assessing the burden of itch in adult AD.
AHRQ-funded; HS023011.
Citation: Silverberg JI, Lai Cella, D D .
Reliability and meaningful change of the Patient-Reported Outcomes Measurement Information System(®) Itch Questionnaire (PIQ) item banks in adults with atopic dermatitis.
Br J Dermatol 2021 Aug;185(2):438-39. doi: 10.1111/bjd.20066..
Keywords: Skin Conditions, Patient-Centered Outcomes Research, Outcomes, Diagnostic Safety and Quality
Richardson DR, Oakes AH, Crossnohere NL
Prioritizing the worries of AML patients: Quantifying patient experience using best-worst scaling.
Although patients with acute myeloid leukemia (AML) experience significant toxicities and poor outcomes, few studies have quantified patients' experience. In this study, a community-centered approach was used to develop an AML-specific best-worst scaling (BWS) instrument involving 13 items in four domains (psychological, physical, decision-making, treatment delivery) to quantify patient worry. A survey of patients and caregivers was conducted using the instrument. Data were analyzed using conditional logistic regression.
AHRQ-funded; HS000032.
Citation: Richardson DR, Oakes AH, Crossnohere NL .
Prioritizing the worries of AML patients: Quantifying patient experience using best-worst scaling.
Psychooncology 2021 Jul;30(7):1104-11. doi: 10.1002/pon.5652..
Keywords: Cancer, Patient Experience, Caregiving, Outcomes, Patient-Centered Outcomes Research
Amin AP, Rao SV, Seto AH
Transradial access for high-risk percutaneous coronary intervention: implications of the risk-treatment paradox.
The study’s objective was to examine whether the association between transradial percutaneous coronary intervention (PCI; TRI) use versus transfemoral PCI (TFI) and in-hospital outcomes is influenced by baseline risk. TRI was found to reduce adverse outcomes when compared with TFI. The authors analyzed 28,005 PCIs performed in a 7-hospital system between July 2009 and April 2018. TRI use increased over time. However a risk-treatment paradox for TRI use was observed not only for bleeding risk, but for acute kidney injury (AKI) and death. The absolute risk difference between TRI and TFI increased with increasing baseline risk.
AHRQ-funded; HS022481.
Citation: Amin AP, Rao SV, Seto AH .
Transradial access for high-risk percutaneous coronary intervention: implications of the risk-treatment paradox.
Circ Cardiovasc Interv 2021 Jul;14(7):e009328. doi: 10.1161/circinterventions.120.009328..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Adverse Events, Outcomes, Patient-Centered Outcomes Research
Pasalic D, Barocas DA, Huang LC
Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer.
This retrospective cohort study’s objective was to determine if there were differences in treatment-related regret or survival between prostate cancer patients who received external-beam radiation therapy (EBRT) with or without a brachytherapy boost (EBRT-LDR), over a 5-year period. The cohort included 695 men who met inclusion criteria and received either EBRT (n=583) or EBRT-LDR (n=112). Men who received either treatment reported clinically worse urinary irritation and bowel function through 3 years but resolved after 5 years. Men who received EBRT-LDR continued to report moderate- to-big problems with urinary function bother and frequent urination at 5 years. There was no difference in treatment-related regret or survival between patients who received either treatment.
AHRQ-funded; HS019356; HS022640.
Citation: Pasalic D, Barocas DA, Huang LC .
Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer.
Cancer 2021 Jun 1;127(11):1912-25. doi: 10.1002/cncr.33388..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research, Treatments
Aiyegbusi OL, Nair D, Peipert JD
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
This review discusses and summarizes evidence of the impact of electronic patient-reported outcomes measures (ePROMs) on clinical parameters and outcomes relevant to chronic diseases. Various studies have demonstrated the feasibility of ePROMs in routine clinical practice with patients increasing expressing a preference for an electronic mode of administration. These ePROMs could have significant impacts on outcomes valued by patients, healthcare providers, and researchers. Recently published literature.
AHRQ-funded; HS026395.
Citation: Aiyegbusi OL, Nair D, Peipert JD .
A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases.
Ther Adv Chronic Dis 2021 May 24;12:20406223211015958. doi: 10.1177/20406223211015958..
Keywords: Chronic Conditions, Patient Experience, Health Information Technology (HIT), Outcomes, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Evidence-Based Practice
Cohen DJ, Sweeney SM, Miller WL
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
This study identified conditions and operational changes linked to improvements in smoking and blood pressure (BP) outcomes in primary care using samples and interviews from a subset of 104 practices participating in EvidenceNOW, a multisite cardiovascular disease prevention initiative. The authors calculated Clinical Quality Measure improvements, with targets of 10-point or greater absolute improvements in the proportion of patients with smoking screening, and if relevant, counseling and the proportion of hypertensive patients with adequately controlled BP. Primary care staff were surveyed and interviewed. In clinician-owned practices, implementing a workflow to routinely screen and counsel patients on smoking cessation resources, or implementing a documentation change or a referral to a resource alone led to an improvement of at least 10 points in the smoking outcome. These improvements did not occur though in health- or hospital system-owned practices or in Federally Qualified Health Centers. BP outcome improved by at least 10 points among solo practices after medical assistants learned how to take an accurate BP. Among larger, clinician-owned practices, BP outcomes improvement took place when staff took a second BP measurement after the first measurement was elevated and when staff learned where to document this information in the electronic health record. For larger and health- and hospital system-owned practices, 50 or more hours of facilitation was needed to improve BP outcomes.
AHRQ-funded; HS023940.
Citation: Cohen DJ, Sweeney SM, Miller WL .
Improving smoking and blood pressure outcomes: the interplay between operational changes and local context.
Ann Fam Med 2021 May-Jun;19(3):240-48. doi: 10.1370/afm.2668..
Keywords: Blood Pressure, Tobacco Use, Primary Care, Quality Improvement, Cardiovascular Conditions, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention, Outcomes
Paul R, Niedner M, Brilli R
Metric development for the multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative.
A 56 US hospital collaborative, Improving Pediatric Sepsis Outcomes (IPSO), has developed variables, metrics and a data analysis plan to track quality improvement (QI)-based patient outcomes over time. Improving Pediatric Sepsis Outcomes expands on previous pediatric sepsis QI efforts by improving electronic data capture and uniformity across sites. This paper describes the metric development for the multicenter IPSO Collaborative.
AHRQ-funded; HS025696.
Citation: Paul R, Niedner M, Brilli R .
Metric development for the multicenter Improving Pediatric Sepsis Outcomes (IPSO) Collaborative.
Pediatrics 2021 May;147(5):e2020017889. doi: 10.1542/peds.2020-017889..
Keywords: Children/Adolescents, Sepsis, Quality Improvement, Quality of Care, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Chan H, Zhang L, Choti MA
Recurrence patterns after surgical resection of gastroenteropancreatic neuroendocrine tumors: analysis from the national comprehensive cancer network oncology outcomes database.
Current National Comprehensive Cancer Network guidelines for gastroenteropancreatic neuroendocrine tumors (GEPNETs) recommend complete (R0) surgical resection of the primary tumor and metastases, if feasible. This study conducted large multicenter studies of recurrence patterns of GEPNETs after resection. Findings showed that R0 resection was associated with variable risk of recurrence across subtypes. Recommendations included further research to inform refinement of guidelines for the appropriate duration of surveillance after R0 resection.
AHRQ-funded; HS021700.
Citation: Chan H, Zhang L, Choti MA .
Recurrence patterns after surgical resection of gastroenteropancreatic neuroendocrine tumors: analysis from the national comprehensive cancer network oncology outcomes database.
Pancreas 2021 Apr;50(4):506-12. doi: 10.1097/mpa.0000000000001791..
Keywords: Cancer, Surgery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Brown CS, Osborne NH, Kim GY
Effect of concomitant deep venous reflux on truncal endovenous ablation outcomes in the Vascular Quality Initiative.
This study looked at outcomes for patients with varicose veins (C2 disease) undergoing truncal endovenous ablation with and without deep venous reflux. Data from the Vascular Quality Initiative was analyzed from 2015 to 2019. A total of 4881 patients were included, with 46.2% having combined deep and superficial reflux. Follow-up around a year later (median 336.5 days) was conducted after. Patients with deep reflux were less likely to be female, more likely to be Caucasian, and had no difference in BMI. Additionally, there were no differences in rates of prior varicose vein treatments, number of pregnancies, or history of deep venous thrombosis. However, patients without deep reflux were more likely to use anticoagulants at the time of the procedure. Patients without deep reflux had slightly higher median preprocedural Venous Clinician Severity Score (VCSS) scores as well as postprocedural VCSS scores. Total symptom score was higher for patients without deep reflux before and after the procedure, but there was no change in symptom score after the procedure. Patients with deep reflux had substantially higher rates of complications with a particular increase in proximal thrombus extension.
AHRQ-funded; HS000053.
Citation: Brown CS, Osborne NH, Kim GY .
Effect of concomitant deep venous reflux on truncal endovenous ablation outcomes in the Vascular Quality Initiative.
J Vasc Surg Venous Lymphat Disord 2021 Mar;9(2):361-68.e3. doi: 10.1016/j.jvsv.2020.04.031..
Keywords: Cardiovascular Conditions, Chronic Conditions, Surgery, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Brown CS, Obi AT, Cronenwett JL
Outcomes after truncal ablation with or without concomitant phlebectomy for isolated symptomatic varicose veins (C2 disease).
This study looked outcomes of patients with varicose veins (C2 disease) who were treated with venous ablation alone or ablation plus phlebectomy using the Vascular Quality Initiative Varicose Vein Registry. Data between January 2015 and March 2015 was used to investigate postoperative as well as long-term clinical and patient-reported outcomes among patients with documented symptomatic C2 disease undergoing truncal endovenous ablations alone and combined ablation and phlebectomy. Out of 3375 patients, 40.1% underwent isolated truncal ablation and the rest had the combined procedure of ablation and phlebectomy. Complications were low for both procedures (8.4% and 8.7%). Overall, improvement in symptoms was experienced by 94.4% of patients with more increases in patients undergoing ablation and phlebectomy than ablation alone. Both procedures are recommended by the authors to be covered by insurance.
AHRQ-funded; HS000053.
Citation: Brown CS, Obi AT, Cronenwett JL .
Outcomes after truncal ablation with or without concomitant phlebectomy for isolated symptomatic varicose veins (C2 disease).
J Vasc Surg Venous Lymphat Disord 2021 Mar;9(2):369-76. doi: 10.1016/j.jvsv.2020.05.016..
Keywords: Cardiovascular Conditions, Chronic Conditions, Surgery, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Pennington KM, Dykhoff HJ, Yao X
The impact of antifungal prophylaxis in lung transplant recipients.
This study evaluated the effect of antifungal prophylaxis on all-cause mortality and invasive fungal infections (IFI) on lung transplant recipients. Administrative claims data was used to identify adult patients who underwent lung transplantation between 2005 and 2018. The authors identified 662 lung transplant recipients. All-cause mortality was found to be significantly lower in those receiving antifungal prophylaxis compared to those who did not. Patients receiving antifungal prophylaxis also had a lower rate of IFI, but it was not statistically significant.
AHRQ-funded; HS025164; HS025402; HS025517; HS024075.
Citation: Pennington KM, Dykhoff HJ, Yao X .
The impact of antifungal prophylaxis in lung transplant recipients.
Ann Am Thorac Soc 2021 Mar;18(3):468-76. doi: 10.1513/AnnalsATS.202003-267OC..
Keywords: Transplantation, Surgery, Medication, Prevention, Respiratory Conditions, Mortality, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Thompson MP, Yaser JM, Hou H
Determinants of hospital variation in cardiac rehabilitation enrollment during coronary artery disease episodes of care.
Cardiac rehabilitation (CR) is associated with improved outcomes for patients with coronary artery disease (CAD). However, CR enrollment remains low and there is a dearth of real-world data on hospital-level variation in CR enrollment. In this study, the investigators sought to explore determinants of hospital variability in CR enrollment during CAD episodes of care: medical management of acute myocardial infarction (AMI-MM), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG).
AHRQ-funded; HS026003.
Citation: Thompson MP, Yaser JM, Hou H .
Determinants of hospital variation in cardiac rehabilitation enrollment during coronary artery disease episodes of care.
Circ Cardiovasc Qual Outcomes 2021 Feb;14(2):e007144. doi: 10.1161/circoutcomes.120.007144..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Rehabilitation, Outcomes, Patient-Centered Outcomes Research, Hospitals
Fischer CP, Knapp L, Cohen ME
Feasibility of enhanced recovery in emergency colorectal operation.
This study examines the feasibility of using enhanced recovery pathways (ERPs) in emergency colorectal operations. It has been successfully used with elective surgical care but has not been examined for emergency procedures. A total of 31,511 patients who underwent colorectal operations at 235 hospitals were identified from a national ERP collaborative. Most were elective surgeries (28,425), with 3,086 emergencies. For emergency cases, rates of early Foley removal and venous thromboembolism prophylaxis were highest. Rates of multimodal pain control, early mobilization, and early liquid intake were modest. Patients younger than age 65 years, those with independent functional status, American Society of Anesthesiologists Physical Status Classification 1 to 3, and without physiologic derangement had the most nonadherence. Lack of mobilization or liquid intake was independently associated with increased odds of ileus and prolonged length of stay.
AHRQ-funded; 233201500020I.
Citation: Fischer CP, Knapp L, Cohen ME .
Feasibility of enhanced recovery in emergency colorectal operation.
J Am Coll Surg 2021 Feb;232(2):178-85. doi: 10.1016/j.jamcollsurg.2020.10.004..
Keywords: Surgery, Digestive Disease and Health, Emergency Department, Patient-Centered Outcomes Research, Outcomes
Kohn R, Harhay MO, Bayes B
Influence of bedspacing on outcomes of hospitalised medicine service patients: a retrospective cohort study.
The objective of this cohort study was to assess the association of bedspacing with patient-centered outcomes among United States patients admitted to general medicine services. The study compared internal medicine, family medicine and geriatric service patients who were bedspaced versus cohorted for the entirety of their hospital stay within three large, urban hospitals. Findings showed that bedspacing was associated with adverse patient-centered outcomes. Recommendations for future work included a need to confirm these findings, to understand mechanisms contributing to adverse outcomes, and to identify factors that mitigate these adverse effects in order to provide high-value, patient-centered care to hospitalized patients.
AHRQ-funded; HS026372.
Citation: Kohn R, Harhay MO, Bayes B .
Influence of bedspacing on outcomes of hospitalised medicine service patients: a retrospective cohort study.
BMJ Qual Saf 2021 Feb;30(2):116-22. doi: 10.1136/bmjqs-2019-010675..
Keywords: Patient-Centered Outcomes Research, Outcomes, Inpatient Care, Hospitals, Healthcare Delivery, Care Management, Adverse Events
Gupta A, Sedhom R, Sharma R
Nonpharmacological interventions for managing breathlessness in patients with advanced cancer: a systematic review.
The purpose of this review was to evaluate the advantages and harms of nonpharmacological interventions for managing breathlessness in adults with advanced cancer. PubMed, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials databases were searched for English-language studies about randomized and nonrandomized clinical trials, controlled trials, and observational studies. Findings included the safety and association with improved breathlessness of several nonpharmacological interventions for adults with advanced cancer. Recommendations included incorporating nonpharmacological interventions as first-line treatment for adults with advanced cancer and breathlessness.
AHRQ-funded; 290201500006I.
Citation: Gupta A, Sedhom R, Sharma R .
Nonpharmacological interventions for managing breathlessness in patients with advanced cancer: a systematic review.
JAMA Oncol 2021 Feb;7(2):290-98. doi: 10.1001/jamaoncol.2020.5184..
Keywords: Cancer, Respiratory Conditions, Treatments, Evidence-Based Practice, Comparative Effectiveness, Quality of Life, Outcomes, Patient-Centered Outcomes Research