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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
26 to 48 of 48 Research Studies DisplayedTyson MD, Koyama T, Lee D
Effect of prostate cancer severity on functional outcomes after localized treatment: comparative effectiveness analysis of surgery and radiation study results.
The purpose of this study was to determine whether differences in predicted function over time between radical prostatectomy (RP) or external beam radiotherapy (EBRT) for localized cancer varied by risk group. Patient-reported, disease-specific function was measured using the Expanded Prostate Index Composite and predicted function was estimated using regression models, compared by disease risk. The study found that sexual function was similar between surgery and radiation for patients with high-risk disease, and the authors conclude that high-risk patients undergoing radiation therapy should be counseled that their sexual function may not be as good as low-risk patients also undergoing radiation.
AHRQ-funded; HS019356; HS022640.
Citation: Tyson MD, Koyama T, Lee D .
Effect of prostate cancer severity on functional outcomes after localized treatment: comparative effectiveness analysis of surgery and radiation study results.
Eur Urol 2018 Jul;74(1):26-33. doi: 10.1016/j.eururo.2018.02.012..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Treatments, Surgery, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Semenkovich TR, Panni RZ, Hudson JL
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
This study examined comparative effectiveness and survival rates for upfront esophagectomy versus induction chemoradiation in patients with clinical stage T2N20 esophageal cancer. A decision analysis model was created for the two treatment strategies. Results showed comparable median survival rates for both strategies. The optimal treatment strategy depended on the accuracy of endoscopic ultrasound staging.
AHRQ-funded; HS022330.
Citation: Semenkovich TR, Panni RZ, Hudson JL .
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
J Thorac Cardiovasc Surg 2018 May;155(5):2221-30.e1. doi: 10.1016/j.jtcvs.2018.01.006..
Keywords: Treatments, Cancer, Surgery, Comparative Effectiveness, Decision Making, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes, Medication
Khan SA, Pruitt SL, Xuan L
How does autoimmune disease impact treatment and outcomes among patients with lung cancer? A national SEER-Medicare analysis.
The advent of cancer immunotherapy has made autoimmune disease in oncology populations clinically important. The researchers analyzed the association of autoimmune disease with treatment and outcomes among lung cancer patients. They found that lung cancer treatment patterns were similar among patients with and without autoimmune disease and there was no significant association with mortality.
AHRQ-funded; HS022418.
Citation: Khan SA, Pruitt SL, Xuan L .
How does autoimmune disease impact treatment and outcomes among patients with lung cancer? A national SEER-Medicare analysis.
Lung Cancer 2018 Jan;115:97-102. doi: 10.1016/j.lungcan.2017.11.024.
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Keywords: Cancer: Lung Cancer, Patient-Centered Outcomes Research, Treatments
Herbert MS, Goodin BR, Bulls HW
Ethnicity, cortisol, and experimental pain responses among persons with symptomatic knee osteoarthritis.
This study aimed to examine the relationship between cortisol and pain responses during a cold-pressor task (CPT) among African American (AA) and non-Hispanic White (NHW) adults with knee osteoarthritis (OA). Consistent with previous findings in young healthy adults, cold-pressor pain responses are related to pre-CPT cortisol concentrations in NHW persons with knee OA but not in their AA counterparts.
AHRQ-funded; HS013852.
Citation: Herbert MS, Goodin BR, Bulls HW .
Ethnicity, cortisol, and experimental pain responses among persons with symptomatic knee osteoarthritis.
Clin J Pain 2017 Sep;33(9):820-26. doi: 10.1097/ajp.0000000000000462.
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Keywords: Arthritis, Pain, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Treatments
Liotta EM, Prabhakaran S, Sangha RS
Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.
The researchers tested the hypothesis that admission serum magnesium levels are associated with hematoma volume, hematoma growth, and functional outcomes in patients with intracerebral hemorrhage (ICH). Their findings support the hypothesis that magnesium exerts a clinically meaningful influence on hemostasis in patients with ICH.
AHRQ-funded; HS023437.
Citation: Liotta EM, Prabhakaran S, Sangha RS .
Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.
Neurology 2017 Aug 22;89(8):813-19. doi: 10.1212/wnl.0000000000004249..
Keywords: Patient-Centered Outcomes Research, Treatments, Outcomes, Brain Injury
Mehta HB, Vargas GM, Adhikari D
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
The objectives were to determine trends in the use of chemotherapy as the initial treatment and to evaluate the comparative effectiveness of initial chemotherapy vs resection of the primary tumor on survival (intention-to-treat analysis) in Stage IV colorectal cancer (CRC). Instrumental variable analysis found that, compared with resection, chemotherapy as the initial treatment offers similar or better 2-year survival in patients with Stage IV CRC.
AHRQ-funded; HS022134.
Citation: Mehta HB, Vargas GM, Adhikari D .
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
Colorectal Dis 2017 Jun;19(6):O210-o18. doi: 10.1111/codi.13659.
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Keywords: Cancer: Colorectal Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Surgery
Roth JA, Goulart BH, Ravelo A
Survival gains from first-line systemic therapy in metastatic non-small cell lung cancer in the U.S., 1990-2015: progress and opportunities.
The objectives of this study were to quantify survival gains from 1990, when best supportive care only was standard, to 2015 and to estimate the impact of expanded use of new systemic therapies in clinically appropriate patients. By using simulation modeling to quantify metastatic non-small cell lung cancer survival gains from 1990-2015, the researchers estimated that the one-year survival proportion and mean per-patient survival increased by 14.1 percent and 4.2 months, respectively.
AHRQ-funded; HS022982.
Citation: Roth JA, Goulart BH, Ravelo A .
Survival gains from first-line systemic therapy in metastatic non-small cell lung cancer in the U.S., 1990-2015: progress and opportunities.
Oncologist 2017 Mar;22(3):304-10. doi: 10.1634/theoncologist.2016-0253.
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Keywords: Treatments, Health Status, Cancer: Lung Cancer, Mortality, Patient-Centered Outcomes Research
Lidder AK, Detwiller KY, Price CP
Evaluating metrics of responsiveness using patient-reported outcome measures in chronic rhinosinusitis.
This study compares responsiveness of patient-reported outcome measures (PROMs) used in chronic rhinosinusitis (CRS) to inform the future development of a highly responsive instrument that accurately portrays CRS patients' symptom experiences. For both medical therapy (MT) patients and those undergoing endoscopic sinus surgery after failing MT, CRS-specific PROMs are more responsive to posttreatment clinical changes than general health measures.
AHRQ-funded; HS023011.
Citation: Lidder AK, Detwiller KY, Price CP .
Evaluating metrics of responsiveness using patient-reported outcome measures in chronic rhinosinusitis.
Int Forum Allergy Rhinol 2017 Feb;7(2):128-34. doi: 10.1002/alr.21866.
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Keywords: Chronic Conditions, Medication, Patient-Centered Outcomes Research, Treatments
Devine EB, Alfonso-Cristancho R, Yanez ND
Effectiveness of a medical vs revascularization intervention for intermittent leg claudication based on patient-reported outcomes.
This study compared the effectiveness of a medical (walking program, smoking cessation counseling, and medications) vs revascularization (endovascular or surgical) intervention for intermittent claudication (IC) in the community, focusing on outcomes of greatest importance to patients. Among patients with IC, those in the revascularization cohort had significantly improved function (Walking Impairment Questionnaire), better health-related quality of life , and fewer symptoms at 12 months compared with those in the medical cohort.
AHRQ-funded; HS020025.
Citation: Devine EB, Alfonso-Cristancho R, Yanez ND .
Effectiveness of a medical vs revascularization intervention for intermittent leg claudication based on patient-reported outcomes.
JAMA Surg 2016 Oct 19;151(10):e162024. doi: 10.1001/jamasurg.2016.2024.
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Keywords: Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research, Quality of Life, Treatments
Fitzgerald GK, Fritz JM, Childs JD
Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial.
The purposes of this paper are to determine if (1) treatment effects differ between participants receiving manual therapy (MT) with exercise compared to subjects who don't, and if (2) treatment effects are better sustained when participants receive booster sessions compared to those who don't over a one year period in subjects with knee osteoarthritis. The researchers found that MT or use of boosters with exercise did not result in additive improvement in the primary outcome at 1 year. Also, secondary outcomes suggest MT may have some short term benefit, and booster sessions may improve responder status and knee pain at 1 year.
AHRQ-funded; HS019624.
Citation: Fitzgerald GK, Fritz JM, Childs JD .
Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial.
Osteoarthritis Cartilage 2016 Aug;24(8):1340-9. doi: 10.1016/j.joca.2016.03.001.
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Keywords: Arthritis, Comparative Effectiveness, Patient-Centered Outcomes Research, Treatments
Farias AJ, Du XL
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
The aim of this study was to determine whether there are racial/ethnic differences in initiation and timing of adjuvant endocrine therapy (AET) after Medicare Part D drug coverage. After controlling for all variables, only Asian women were found to have a greater odds of initiation of overall AET compared to non-Hispanic white women. Hispanic Mexicans and non-Hispanic black patients had a significantly lower odds of tamoxifen initiation.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
Med Oncol 2016 Feb;33(2):19. doi: 10.1007/s12032-016-0732-1.
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Keywords: Cancer: Breast Cancer, Treatments, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Poonawalla IB, Piller LB, Lairson DR
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
The researchers sought to determine the effectiveness of erythropoietin-stimulating agent (ESA) and granulocyte colony-stimulating factor (CSF) in reducing blood transfusion needs and neutropenia incidence in community-dwelling elderly ovarian cancer patients. They found that erythropoietin-stimulating agents were effective in reducing blood transfusion need. Granulocyte colony-stimulating factors were effective in lowering neutropenia incidence and also were associated with improved survival in elderly ovarian cancer patients.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Piller LB, Lairson DR .
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
Int J Gynecol Cancer 2016 Jan;26(1):95-103. doi: 10.1097/igc.0000000000000564.
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Keywords: Cancer, Treatments, Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research
Du XL, Zhang Y, Parikh RC
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
The purpose of this study was to compare the effectiveness of chemotherapy in prolonging survival according to age in breast and colon cancer. It found that the effectiveness of chemotherapy decreased with age in participants with breast cancer, in whom chemotherapy appears to be effective until age 79 except for the doxorubicin-cyclophosphamide combination, which was effective in participants aged 80 to 84.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Parikh RC .
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
J Am Geriatr Soc 2015 Aug;63(8):1570-82. doi: 10.1111/jgs.13523..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research
Poonawalla IB, Lairson DR, Chan W
Cost-effectiveness of neoadjuvant chemotherapy versus primary surgery in elderly patients with advanced ovarian cancer.
This study investigated the cost-effectiveness of neoadjuvant chemotherapy (NAC) compared with that of standard primary debulking surgery. It concluded that NAC use before surgery has a favorable cost-effectiveness profile in the high-risk group alone at classic willingness-to-pay thresholds. Its use as a general first-line treatment in all patients is not supported.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Lairson DR, Chan W .
Cost-effectiveness of neoadjuvant chemotherapy versus primary surgery in elderly patients with advanced ovarian cancer.
Value Health 2015 Jun;18(4):387-95. doi: 10.1016/j.jval.2015.01.005..
Keywords: Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Surgery
Huo J, Du XL, Lairson DR
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
The authors examined the patterns of utilization of radiation therapy, chemotherapy, surgery, and hospice at the end-of-life care for patients diagnosed with metastatic melanoma. They found that surgery and hospice care use increased over the 8 years of this study, whereas the use of chemotherapy and radiation therapy remained consistent for patients diagnosed with metastatic melanoma.
AHRQ-funded; HS018956.
Citation: Huo J, Du XL, Lairson DR .
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
Am J Clin Oncol 2015 Jun;38(3):235-41. doi: 10.1097/COC.0b013e31829378f9.
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Keywords: Cancer, Cancer: Skin Cancer, Treatments, Elderly, Healthcare Utilization, Palliative Care, Patient-Centered Outcomes Research, Surgery
Singh JA, Akhras KS, Shiozawa A
Comparative effectiveness of urate lowering with febuxostat versus allopurinol in gout: analyses from large U.S. managed care cohort.
The researchers sought to assess the comparative effectiveness of febuxostat and allopurinol in reducing serum urate (sUA) levels in a real-world U.S. managed care setting. It concluded that febuxostat was more effective than allopurinol at the currently used doses in lowering sUA in gout patients as demonstrated by post-index mean sUA level, the likelihood of and the time to achieving sUA goals.
AHRQ-funded; HS021110.
Citation: Singh JA, Akhras KS, Shiozawa A .
Comparative effectiveness of urate lowering with febuxostat versus allopurinol in gout: analyses from large U.S. managed care cohort.
Arthritis Res Ther 2015 May 12;17(1):120. doi: 10.1186/s13075-015-0624-3..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Medication, Treatments
Zhang J, Xie F, Delzell E
Impact of biologic agents with and without concomitant methotrexate and at reduced doses in older rheumatoid arthritis patients.
The purpose of this study was to examine whether concomitant methotrexate (MTX) use is associated with better biologic persistence and whether self-administered anti–tumor necrosis factor (anti-TNF) therapies are used at reduced doses in real world clinical care settings, not just clinical trials. It found that use of concomitant MTX is associated with greater persistence to biologic therapy.
AHRQ-funded; HS018517.
Citation: Zhang J, Xie F, Delzell E .
Impact of biologic agents with and without concomitant methotrexate and at reduced doses in older rheumatoid arthritis patients.
Arthritis Care Res 2015 May;67(5):624-32. doi: 10.1002/acr.22510..
Keywords: Arthritis, Comparative Effectiveness, Patient-Centered Outcomes Research, Treatments
Hazelwood GS, Rezaie A, Borman M
Comparative effectiveness of immunosuppressants and biologics for inducing and maintaining remission in Crohn's disease: a network meta-analysis.
The authors compared therapies for induction and maintenance of remission in patients with Crohn's disease. They found that adalimumab and infliximab + azathioprine are the most effective therapies for induction and maintenance of remission of Crohn's disease.
AHRQ-funded; HS021747.
Citation: Hazelwood GS, Rezaie A, Borman M .
Comparative effectiveness of immunosuppressants and biologics for inducing and maintaining remission in Crohn's disease: a network meta-analysis.
Gastroenterology 2015 Feb;148(2):344-54.e5; quiz e14-5. doi: 10.1053/j.gastro.2014.10.011.
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Keywords: Comparative Effectiveness, Digestive Disease and Health, Medication, Patient-Centered Outcomes Research, Treatments
Rundell SD, Sherman KJ, Heagerty PJ
Patient-reported outcomes associated with use of physical therapist services by older adults with a new visit for back pain.
The researchers conducted an observational comparative effectiveness research study to investigate the association between types or amounts of physical therapist services and outcomes, such as disability and pain intensity, among older adults. Higher amounts of active physical therapy were associated with decreased back and leg pain and increased odds of clinically meaningful improvements in back and leg pain relative to results obtained with no active physical therapy.
AHRQ-funded; HS019222.
Citation: Rundell SD, Sherman KJ, Heagerty PJ .
Patient-reported outcomes associated with use of physical therapist services by older adults with a new visit for back pain.
Phys Ther 2015 Feb;95(2):190-201. doi: 10.2522/ptj.20140132..
Keywords: Back Health and Pain, Patient-Centered Outcomes Research, Comparative Effectiveness, Treatments, Elderly
Dulai PS, Siegel CA, Colombel JF
Systematic review: monotherapy with antitumour necrosis factor alpha agents versus combination therapy with an immunosuppressive for IBD.
The authors discussed the efficacy and the risks of anti-TNF monotherapy versus combination therapy with an immunosuppressive in patients with IBD. They concluded that the addition of an immunosuppressive to anti-TNF therapy improves treatment efficacy for infliximab in ulcerative colitis and Crohn’s disease. Further, the use of combination therapy appears to add no significant incremental risk for serious infections above that seen with anti-TNF or immunosuppressive monotherapy in most patients.
AHRQ-funded; HS021747.
Citation: Dulai PS, Siegel CA, Colombel JF .
Systematic review: monotherapy with antitumour necrosis factor alpha agents versus combination therapy with an immunosuppressive for IBD.
Gut 2014 Dec;63(12):1843-53. doi: 10.1136/gutjnl-2014-307126.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Medication, Outcomes, Patient-Centered Outcomes Research, Treatments
Goode AP, Richardson WJ, Schectman RM
Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions.
The authors sought to determine the 1-year risk of complications, cervical revision fusions, hospital readmissions, and health care services utilization after bone morphogenetic protein (BMP) use with cervical spine fusions. They found that patients receiving BMP were 29% more likely to have a complication and a nervous system complication; cervical revision fusions were more likely among patients receiving BMP; the risk of 30-day readmission was greater with BMP use; and readmission occurred 27.4% sooner on an average. Additionally, patients receiving BMP were more likely to receive computed tomography scans and epidurals with anterior surgical approaches.
AHRQ-funded; HS019479.
Citation: Goode AP, Richardson WJ, Schectman RM .
Complications, revision fusions, readmissions, and utilization over a 1-year period after bone morphogenetic protein use during primary cervical spine fusions.
Spine J 2014 Sep;14(9):2051-9. doi: 10.1016/j.spinee.2013.11.042.
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Keywords: Adverse Events, Hospital Readmissions, Patient Safety, Outcomes, Patient-Centered Outcomes Research, Surgery, Treatments
Osterman MT, Haynes K, Delzell E
Comparative effectiveness of infliximab and adalimumab for Crohn's disease.
This study compared the effectiveness of infliximab and adalimumab, the two most commonly used anti-tumor necrosis factor agents in patients with Crohn’s disease (CD). It found that both drugs were of similar effectiveness with respect to surgical rates, hospitalization rates, and the percentage of patients remaining on the drugs after 26 weeks.
AHRQ-funded; HS018517
Citation: Osterman MT, Haynes K, Delzell E .
Comparative effectiveness of infliximab and adalimumab for Crohn's disease.
Clin Gastroenterol Hepatol. 2014 May;12(5):811-817.e3. doi: 10.1016/j.cgh.2013.06.010..
Keywords: Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research, Treatments
Neugebauer R, Fireman B, Roy JA
Impact of specific glucose-control strategies on microvascular and macrovascular outcomes in 58,000 adults with type 2 diabetes.
This study used comparative effectiveness research methods to compare the effect of four distinct glucose-control strategies on subsequent myocardial infarction and nephropathy in type 2 diabetes. It found that in a large group of adults with type 2 diabetes, more aggressive glucose-control strategies have mixed short-term effects on microvascular complications and do not reduce the myocardial infarction rate over 4 years of follow-up.
AHRQ-funded; 29020050033I.
Citation: Neugebauer R, Fireman B, Roy JA .
Impact of specific glucose-control strategies on microvascular and macrovascular outcomes in 58,000 adults with type 2 diabetes.
Diabetes Care 2013 Nov;36(11):3510-6. doi: 10.2337/dc12-2675..
Keywords: Comparative Effectiveness, Diabetes, Outcomes, Patient-Centered Outcomes Research, Treatments