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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 971 Research Studies Displayed
Mao J, Sedrakyan A, Sun T
Assessing adverse event reports of hysteroscopic sterilization device removal using natural language processing.
This study’s objective was to develop an annotation model to develop natural language processing (NLP) to device adverse event reports and to implement the model to evaluate the most frequently experienced events among women reporting a sterilization device removal. Adverse event reports from the Manufacturer and User Facility Device Experience database from January 2005 to June 2018 were included. The authors used an iterative process to develop an annotation model that extracts six categories of desired information and applied the annotation model to train an NLP algorithm. A total of 16,535 reports of device removal were analyzed with the most frequently reported patient and device events being abdominal/pelvic/genital pain (79.6%) and device dislocation/migration (19.2%), respectively. A total of 7,932 patients reported an additional sterilization procedure of a hysterectomy or salpingectomy. One-fifth of the cases that had device removal timing specified reported a removal 7 years after original insertion.
AHRQ-funded; HS026291.
Citation:
Mao J, Sedrakyan A, Sun T .
Assessing adverse event reports of hysteroscopic sterilization device removal using natural language processing.
Pharmacoepidemiol Drug Saf 2022 Apr;31(4):442-51. doi: 10.1002/pds.5402..
Keywords:
Adverse Events, Surgery, Medical Devices, Patient Safety
Eisenberg MT, Block AM, Vopat ML
Rates of infection after ACL reconstruction in pediatric and adolescent patients: a MarketScan database study of 44,501 patients.
This study’s objective was to describe and analyze the rates of surgical site infections after anterior cruciate ligament (ACL) surgery in pediatric patients. The Truven Health Analytics MarketScan Commercial Claims and Encounters database was used to access data for privately insured individuals aged 5 to 30 years old. ACL reconstruction operation records were accessed for operations performed from 2006 to 2018. The database identified 44,501 individuals up to 18 years old, and 63,495 individuals aged 18 to 30 years old that underwent arthroscopic ACL reconstruction. No differences in infection rates were found between the two groups. However, among patients younger than 18 years, patients below 15 years old had a significantly lower infection rate at 0.37% compared with adolescents 15 to 17 years old at 0.55%. Among young adults, males had a higher infection rate than females, while no differences were observed in the pediatric and adolescent population.
AHRQ-funded; HS019455.
Citation:
Eisenberg MT, Block AM, Vopat ML .
Rates of infection after ACL reconstruction in pediatric and adolescent patients: a MarketScan database study of 44,501 patients.
J Pediatr Orthop 2022 Apr;42(4):e362-e66. doi: 10.1097/bpo.0000000000002080..
Keywords:
Children/Adolescents, Surgery, Orthopedics, Healthcare-Associated Infections (HAIs), Adverse Events, Injuries and Wounds
Kanters AE, Evilsizer SK, Regenbogen SE
Correlation of colorectal surgical skill with patient outcomes: a cautionary tale.
Some have proposed that video-based skill assessments be used as a way to measure technical skills, quality improvement, and credentialing in colorectal surgeons and other practitioners. However, it must first be determined whether video-based assessments can accurately predict patient outcomes. The researchers assembled a panel of 10 peer surgeons to evaluate videos of minimally invasive colectomy procedures submitted by 21 surgeons. Each surgeon submitted one video, and the videos were edited to highlight key steps in the procedure. The panel and the surgeon participants were all associated with the Michigan Surgical Quality Collaborative. The panel used a validated American Society of Colon and Rectal Surgeons assessment instrument to rate the surgeon’s skills. The surgeon’s ratings were then linked to a validated registry of surgical outcomes, and the researchers assessed the relationship between skill level and risk-adjusted complication rates. The researchers found that after risk-adjustment there was no statistically significant difference in complication rates between the bottom (17.5%) and top (16.8%) quartile surgeons (p=0.41). The study concluded that there was no correlation between video-based peer rating of minimally invasive colectomy and postoperative complications among specialty surgeons, and that caution should be used when utilizing video review in credentialing.
AHRQ-funded; HS025365.
Citation:
Kanters AE, Evilsizer SK, Regenbogen SE .
Correlation of colorectal surgical skill with patient outcomes: a cautionary tale.
Dis Colon Rectum 2022 Mar;65(3):444-51. doi: 10.1097/dcr.0000000000002124..
Keywords:
Surgery, Provider: Physician, Provider Performance, Digestive Disease and Health, Outcomes
Fitzgerald DC, Simpson AN, Baker RA DC, Simpson AN, Baker RA
Determinants of hospital variability in perioperative red blood cell transfusions during coronary artery bypass graft surgery.
This observational cohort study’s objective was to identify to what extent distinguishing patient and procedural characteristics can explain center-level transfusion variation during coronary artery bypass grafting (CABG) surgery. The study used patients from the Perfusion Measures and Outcomes Registry from 43 adult cardiac surgical programs from July 2011 through June 2017. Of the 22,272 adult patients undergoing isolate CABG surgery using cardiopulmonary bypass, 7241 (32.5%) received at least 1 U allogeneic red blood cells. Patients who received transfusions were older (68 vs 64 years), were women (41.5% vs 15.9%), and had a lower body surface area, respectively. The majority of center-level transfusion variations could not be explained through models containing both patient and intraoperative factors.
AHRQ-funded; HS026003.
Citation:
Fitzgerald DC, Simpson AN, Baker RA DC, Simpson AN, Baker RA .
Determinants of hospital variability in perioperative red blood cell transfusions during coronary artery bypass graft surgery.
J Thorac Cardiovasc Surg 2022 Mar;163(3):1015-24.e1. doi: 10.1016/j.jtcvs.2020.04.141..
Keywords:
Surgery, Heart Disease and Health, Cardiovascular Conditions, Hospitals, Practice Patterns, Disparities
Shao CC, McLeod MC, Gleason L
Effect of COVID-19 pandemic restructuring on surgical volume and outcomes of non-COVID patients undergoing surgery.
The authors sought to assess changes in surgical case mix and outcomes due to restructuring during the pandemic. Institutional ACS-NSQIP data was used to identify patients undergoing surgery at a single tertiary care institution in the Deep South. They found that surgeries during the COVID-19 pandemic were more often outpatient without differences in post-operative outcomes. They recommended additional analysis to determine the impact of duration of operative delay on surgical outcomes with restructuring focusing more on outpatient surgeries.
AHRQ-funded; HS013852.
Citation:
Shao CC, McLeod MC, Gleason L .
Effect of COVID-19 pandemic restructuring on surgical volume and outcomes of non-COVID patients undergoing surgery.
Am Surg 2022 Mar;88(3):489-97. doi: 10.1177/00031348211054528..
Keywords:
COVID-19, Surgery, Public Health, Outcomes
Olsen MA, Greenberg JK, Peacock K
Lack of association of post-discharge prophylactic antibiotics with decreased risk of surgical site infection following spinal fusion.
This study’s objective was to determine the prevalence and factors associated with post-discharge prophylactic antibiotic use after spinal fusion and whether use was associated with decreased risk of surgical site infection (SSI). The study cohort included persons aged 10-64 years undergoing 156,446 spinal fusion procedures between January 2010 and July 2015. Excluded patients included complicated cases and those coded for infection from 30 days before to 2 days after surgical admission. Outpatient oral antibiotic prescriptions were identified within 2 days of surgical discharge. ICD-9-CM diagnosis codes were used to identify SSI within 90 days of surgery. Post-discharge prophylactic antibiotics were used in 9223 surgeries. SSIs occurred after 2557 procedures (1.6%). Factors significantly associated with post-discharge antibiotic use included history of lymphoma, diabetes, 3-7 versus 1-2 vertebral levels fused, and non-infectious postoperative complications. Analysis showed antibiotic use was not associated with decreased SSI risk after spinal fusion.
AHRQ-funded; HS019455; HS027075.
Citation:
Olsen MA, Greenberg JK, Peacock K .
Lack of association of post-discharge prophylactic antibiotics with decreased risk of surgical site infection following spinal fusion.
J Antimicrob Chemother 2022 Mar 31;77(4):1178-84. doi: 10.1093/jac/dkab475..
Keywords:
Antibiotics, Medication, Surgery, Antimicrobial Stewardship, Practice Patterns
Schreyer J, Koch A, Herlemann A
RAS-NOTECHS: validity and reliability of a tool for measuring non-technical skills in robotic-assisted surgery settings.
This study’s objective was to develop and consent-validate a tool to assess multidisciplinary non-technical skills (NTS) in robotic-assisted surgery (RAS). The authors conducted a scoping literature review first to compile a set of RAS-specific teamwork behaviors. They then merged these behaviors with a well-established assessment tool on operating room (OR) teamwork called NOTECHS II. Finally, the new tool RAS-NOTECHS was applied in standardized observations of real-world procedures to test its reliability. The scoping review found 5242 articles, of which 21 were included based on pre-established inclusion criteria. The authors elicited 16 RAS-specific behaviors from the literature base. They were synthesized further with 18 behavioral markers into a list of 26 behavioral markers. The list was reviewed by 7 RAS experts and condensed to 15 expert-validated RAS-specific behavioral markers. For five observations of urologic RAS procedures, inter-rater agreement for identification of behavioral markers was strong. Agreement of RAS-NOTECHS scores ranged from moderate to strong agreement.
AHRQ-funded; HS026491.
Citation:
Schreyer J, Koch A, Herlemann A .
RAS-NOTECHS: validity and reliability of a tool for measuring non-technical skills in robotic-assisted surgery settings.
Surg Endosc 2022 Mar;36(3):1916-26. doi: 10.1007/s00464-021-08474-2..
Keywords:
Surgery
Graber J, Lockhart S, Matlock DD
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
In this qualitative study, researchers sought to understand patients' and physical therapists' perspectives related to decision making during outpatient rehabilitation after total knee arthroplasty (TKA) and further to describe potential barriers and opportunities for shared decision making (SDM) in this setting. They found that physical therapists described using decision-making strategies with varying levels of patient involvement, while both patients and physical therapists described barriers to routine use of SDM in the outpatient setting. They also presented actionable strategies for overcoming these barriers for providers and organizations seeking consistently to use SDM in outpatient TKA rehabilitation.
AHRQ-funded; HS025692.
Citation:
Graber J, Lockhart S, Matlock DD .
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
J Eval Clin Pract 2022 Feb;28(1):99-107. doi: 10.1111/jep.13591..
Keywords:
Decision Making, Rehabilitation, Orthopedics, Surgery, Patient-Centered Healthcare
Joseph JM, Gori D, Curtin C
Gaps in standardized postoperative pain management quality measures: a systematic review.
Poor pain control in patients can lead to chronic pain, chronic opiate use or addiction, and patient suffering, making postoperative pain an important clinical issue. The researchers state that it is unclear whether measures for managing pain after surgery exist, warranting the study goal of assessment of the availability of postoperative pain management quality measures, including National Quality Forum-endorsed measures. In November 2019, the researchers conducted a systematic literature review using the National Quality Forum Quality Positioning System, the Agency for Healthcare Research and Quality Indicators, and the Centers for Medicare and Medicaid Services Measures Inventory Tool databases, to identify quality measures for the period between March 11, 2015, and March 11, 2020. The review identified 19 pain management quality measures, 5 of which were endorsed by the National Quality Forum. Three of the non-endorsed measures were specific to postoperative pain, with none of the endorsed measures specific to post-operative pain. The study concluded that there is a need for published, endorsed, rigorous postoperative pain quality measures.
AHRQ-funded; HS024096; HS027434.
Citation:
Joseph JM, Gori D, Curtin C .
Gaps in standardized postoperative pain management quality measures: a systematic review.
Surgery 2022 Feb;171(2):453-58. doi: 10.1016/j.surg.2021.08.004..
Keywords:
Pain, Surgery, Quality Measures, Quality of Care, Practice Patterns
Lai LY, Kaufman SR, Modi PK
Impact of advanced practice provider integration into multispecialty group practices on outcomes following major surgery.
Researchers examined the impact of advanced practice provider (APP) integration into multispecialty group practices on outcomes after major surgery. Using Medicare data, they found that integration of APPs into multispecialty group practices was associated with improved postoperative outcomes after major surgery. They recommended that future research identify the mechanisms by which APPs improve outcomes to inform optimal utilization.
AHRQ-funded; HS025707.
Citation:
Lai LY, Kaufman SR, Modi PK .
Impact of advanced practice provider integration into multispecialty group practices on outcomes following major surgery.
Surg Innov 2022 Feb;29(1):111-17. doi: 10.1177/15533506211013150..
Keywords:
Surgery, Healthcare Delivery
Merkow RP, Massarweh NN
Looking beyond perioperative morbidity and mortality as measures of surgical quality.
The authors discussed the problems with a contemporaneous focus on morbidity and mortality as surgical quality measures and offered potential alternative options which could better refine and evolve surgical quality measurement, including process measures, value-based measures, patient-centered measures, and health equity.
AHRQ-funded; HS026385.
Citation:
Merkow RP, Massarweh NN .
Looking beyond perioperative morbidity and mortality as measures of surgical quality.
Ann Surg 2022 Feb;275(2):e281-e83. doi: 10.1097/sla.0000000000004966..
Keywords:
Surgery, Quality Measures, Quality of Care, Mortality
Ko H, Martin BI, Nelson RE
Patient selection in the Comprehensive Care for Joint Replacement model.
This study investigated whether the Comprehensive Care for Joint Replacement (CJR) program induced participating hospitals to 1) preferentially select lower risk patients, 2) reduce 90-day episode-of-care costs, 3) improve quality of care, and 4) achieve greater cost reduction during its second year. The authors identified Medicare beneficiaries age 65 years or older undergoing hip or knee joint replacement from fee-for-service inpatient (Part A) claims from January 2013 through August 2017. Cases were linked to subsequent outpatient, Part B, home health agency, and skilled nursing facility claims. The effect of CJR was estimated for 785 participating hospitals in 67 metropolitan statistical area (MSA) and compared to those in 104 non-CJR MSAs (962 hospitals total). They excluded 172 hospitals from their analysis due to their preexisting BPCI participation. Reductions in 90-day episode-of-care costs were greater among CJR hospitals, which was largely driven by a 16.8% decline in 90-day spending in skilled nursing homes. CJR hospitals also significantly reduced the 90-day readmission rate and preferentially avoided patients 85 years or older and Black patients.
AHRQ-funded; HS024714.
Citation:
Ko H, Martin BI, Nelson RE .
Patient selection in the Comprehensive Care for Joint Replacement model.
Health Serv Res 2022 Feb;57(1):72-90. doi: 10.1111/1475-6773.13880..
Keywords:
Orthopedics, Surgery
Chhabra KR, Ghaferi AA, Yang J
Relationship between health care spending and clinical outcomes in bariatric surgery: implications for Medicare bundled payments.
This study’s objective was to evaluate sources of 90-day episode spending variation in Medicare patients undergoing bariatric surgery and whether spending variation was related to quality of care. A retrospective analysis of fee-for-service Medicare claims data from 761 acute care hospitals providing inpatient bariatric surgery was conducted between January 1, 2011 and September 30, 2016. Of 64,537 bariatric patients, 46% went sleeve gastrectomy, 22% revisited the emergency department (ED) within 90 days, and 12.5% were readmitted. Average 90-day payments were $14,124, ranging from $12,220 to $16,887. The largest components of spending variation were readmissions (44% of variation), post-acute care (19%), and index professional fees (15%). The lowest spending hospitals had the lowest complication, ED visit, post-acute utilization, and readmission rates.
AHRQ-funded; HS024403; HS023597.
Citation:
Chhabra KR, Ghaferi AA, Yang J .
Relationship between health care spending and clinical outcomes in bariatric surgery: implications for Medicare bundled payments.
Ann Surg 2022 Feb;275(2):356-62. doi: 10.1097/sla.0000000000003979..
Keywords:
Healthcare Costs, Surgery, Obesity, Outcomes
Roberson ML, Nichols HB, Wheeler
Validity of breast cancer surgery treatment information in a state-based cancer registry.
Surgery is an important part of early stage breast cancer treatment that affects overall survival. Statewide cancer registries contain data on first course of cancer treatment for all patients diagnosed with cancer but the accuracy of these data are uncertain. In this study, the authors examined validity of breast cancer surgery treatment information in a state-based cancer registry.
AHRQ-funded; HS027299.
Citation:
Roberson ML, Nichols HB, Wheeler .
Validity of breast cancer surgery treatment information in a state-based cancer registry.
Cancer Causes Control 2022 Feb;33(2):261-69. doi: 10.1007/s10552-021-01520-3..
Keywords:
Cancer: Breast Cancer, Cancer, Surgery, Registries
Fatemi P, Zhang Y, Han SS
A, et al. External validation of a predictive model of adverse events following spine surgery.
The authors externally validated a previously developed predictive model for common 30-day adverse events after spine surgery, the Risk Assessment Tool for Adverse Events after Spine Surgery (RAT-Spine). Their results are presented as low-, moderate-, and high-risk designations.
AHRQ-funded; HS023800.
Citation:
Fatemi P, Zhang Y, Han SS .
A, et al. External validation of a predictive model of adverse events following spine surgery.
Spine J 2022 Jan;22(1):104-12. doi: 10.1016/j.spinee.2021.06.006..
Keywords:
Surgery, Adverse Events, Orthopedics, Risk
Cofran L, Cohen T, Alfred M
Barriers to safety and efficiency in robotic surgery docking.
The authors sought to explore operating room variation in robotic-assisted surgery across multiple clinical sites and procedures and further sought to examine the sources of those flow disruptions. They concluded that direct observation of surgical procedures can help to identify approaches to improve the design of technology and procedures, the training of staff, and the configuration of the operating room environment, with the eventual goal of improving safety, efficiency, and teamwork in high technology surgery.
AHRQ-funded; HS026491.
Citation:
Cofran L, Cohen T, Alfred M .
Barriers to safety and efficiency in robotic surgery docking.
Surg Endosc 2022 Jan;36(1):206-15. doi: 10.1007/s00464-020-08258-0..
Keywords:
Patient Safety, Surgery
Kho RM, Desai VB, Schwartz PE
Endometrial sampling for preoperative diagnosis of uterine leiomyosarcoma.
This retrospective cohort study examined the effectiveness of endometrial sampling for preoperative detection of uterine leiomyosarcoma in women undergoing hysterectomy, identified factors associated with missed diagnosis, and compared the outcomes of patients who had a preoperative diagnosis with those patients who had a missed diagnosis. A total of 79 patients with uterine leiomyosarcoma were included in the study. Of those patients, 46 (58.2%) were diagnosed preoperatively and 33 postoperatively. The groups were similar in age, race/ethnicity, bleeding symptoms, and comorbidities. Women who had endometrial sampling performed with hysteroscopy had a higher likelihood of preoperative diagnosis. Patients with localized stage (vs distant stage) or tumor size >11 cm were less likely to be diagnosed preoperatively.
AHRQ-funded; HS024702.
Citation:
Kho RM, Desai VB, Schwartz PE .
Endometrial sampling for preoperative diagnosis of uterine leiomyosarcoma.
J Minim Invasive Gynecol 2022 Jan;29(1):119-27. doi: 10.1016/j.jmig.2021.07.004.
.
.
Keywords:
Cancer, Diagnostic Safety and Quality, Surgery, Women
Heiderscheit EA, Schlick CJR, Ellis RJ
Experiences of LGBTQ+ residents in US general surgery training programs.
The purpose of this study was to determine the national prevalence of mistreatment and poor well-being for lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) surgery residents compared with their non-LGBTQ+ peers. A voluntary, anonymous survey was conducted for clinically active general surgery residents training in accredited general surgery programs following their American Board of Surgery In-Training Examination. Findings showed that mistreatment was a common experience for LGBTQ+ surgery residents, with attending surgeons being the most common overall source. Increased suicidality among LGBTQ+ surgery residents was associated with this mistreatment. Recommendations included multifaceted interventions to develop safer and more inclusive learning environments.
AHRQ-funded; HS000078.
Citation:
Heiderscheit EA, Schlick CJR, Ellis RJ .
Experiences of LGBTQ+ residents in US general surgery training programs.
JAMA Surg 2022 Jan;157(1):23-32. doi: 10.1001/jamasurg.2021.5246..
Keywords:
Provider: Physician, Surgery, Training, Education: Continuing Medical Education
Ingraham A, Schumacher J, Fernandes-Taylor S
General surgeon involvement in the care of patients designated with an American Association for the Surgery of Trauma-endorsed ICD-10-CM emergency general surgery diagnosis code in Wisconsin.
The authors sought to: (1) translate previously-developed ICD-9-CM diagnosis codes representing emergency general surgery (EGS) conditions to ICD-10-CM codes and (2) determine the national burden of and assess surgeon involvement across EGS conditions. They found that, of the seven most common EGS diagnoses, surgeon involvement was highest for appendicitis and biliary tract disease. For the other five most common conditions, surgeons were involved in roughly 20% of patient care episodes.
AHRQ-funded; HS025224.
Citation:
Ingraham A, Schumacher J, Fernandes-Taylor S .
General surgeon involvement in the care of patients designated with an American Association for the Surgery of Trauma-endorsed ICD-10-CM emergency general surgery diagnosis code in Wisconsin.
J Trauma Acute Care Surg 2022 Jan;92(1):117-25. doi: 10.1097/ta.0000000000003387..
Keywords:
Healthcare Cost and Utilization Project (HCUP), Surgery, Critical Care
Herb J, Williams B, Stitzenberg K
Hospital price transparency rules are inadequate to inform patients needing major gastrointestinal cancer operations.
This cross-sectional descriptive study evaluated the hospital price transparency web pages, machine-readable files, and online out-of-pocket cost estimators (OOPCEs) for all National Cancer Institute Designated Clinical Cancer Centers. Findings showed that hospital charges were readily available and the availability of consumer-friendly OOPCEs had improved with the updated price transparency policy. However, the utility of the available information for cancer patients who need a major gastrointestinal operation was limited. Although chargemasters were available for nearly all hospitals, using these to determine what a patient may pay would be very difficult, if not impossible.
AHRQ-funded; HS000032.
Citation:
Herb J, Williams B, Stitzenberg K .
Hospital price transparency rules are inadequate to inform patients needing major gastrointestinal cancer operations.
Ann Surg Oncol 2022 Jan;29(1):45-46. doi: 10.1245/s10434-021-10244-2..
Keywords:
Hospitals, Healthcare Costs, Surgery
Chrenka EA, Solberg LI, Asche SE
Is shared decision-making associated with better patient-reported outcomes? A longitudinal study of patients undergoing total joint arthroplasty.
This study examined whether shared decision making (SDM) provides better outcomes using patients undergoing total joint arthroplasty as a test case. This observational longitudinal survey-based study surveyed patients receiving an initial THA or TKA from a large, multispecialty medical group in the Midwestern United States after they were scheduled for surgery and again at 12 months after their procedure. The majority of included patients were white (1255 of 1344) with only 3% using Medicaid benefits at the time of surgery. The three-item collaboRATE measure of SDM was added to existing patient surveys of patient-reported outcome measures (PROMs). Patient responses were analyzed in regression models to estimate the association between preoperative collaborate scores and Oxford knee or hip scores at 12 months postoperatively. There was a moderate, positive association between preoperative collaborate scores and the Oxford scores at 12 months. The association suggests that SDM could be one tool to encourage better outcomes.
AHRQ-funded; HS025618.
Citation:
Chrenka EA, Solberg LI, Asche SE .
Is shared decision-making associated with better patient-reported outcomes? A longitudinal study of patients undergoing total joint arthroplasty.
Clin Orthop Relat Res 2022 Jan;480(1):82-91. doi: 10.1097/corr.0000000000001920..
Keywords:
Decision Making, Patient-Centered Outcomes Research, Orthopedics, Surgery
Shore S, Pienta MJ, Watt TMF
Non-patient factors associated with infections in LVAD recipients: a scoping review.
Infections are the most common complication in recipients of durable left ventricular assist devices (LVAD) and are associated with increased morbidity, mortality, and expenditures. The existing literature examining factors associated with infection in LVAD recipients is limited and principally comprises single-center studies. This scoping review synthesized all available evidence related to identifying modifiable, non-patient factors associated with infections among LVAD recipients.
AHRQ-funded; HS026003.
Citation:
Shore S, Pienta MJ, Watt TMF .
Non-patient factors associated with infections in LVAD recipients: a scoping review.
J Heart Lung Transplant 2022 Jan;41(1):1-16. doi: 10.1016/j.healun.2021.10.006..
Keywords:
Heart Disease and Health, Cardiovascular Conditions, Surgery, Medical Devices
Greenberg JK, Olsen MA, Dibble CF
Comparison of cost and complication rates for profiling hospital performance in lumbar fusion for spondylolisthesis.
Investigators sought to evaluate the reliability of 90-day inpatient hospital costs, overall complications, and rates of serious complications for profiling hospital performance in lumbar fusion surgery for spondylolisthesis. Using HCUP data, they found that 90-day inpatient costs were highly reliable for assessing variation across hospitals, whereas overall and serious complications were only moderately reliable for profiling performance. They concluded that their results support the viability of emerging bundled payment programs that assume true differences in costs of care exist across hospitals.
AHRQ-funded; HS027075; HS019455.
Citation:
Greenberg JK, Olsen MA, Dibble CF .
Comparison of cost and complication rates for profiling hospital performance in lumbar fusion for spondylolisthesis.
Spine J 2021 Dec;21(12):2026-34. doi: 10.1016/j.spinee.2021.06.014..
Keywords:
Healthcare Costs, Hospitals, Provider Performance, Surgery, Quality Measures, Quality of Care
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
Abraham J, Meng A, Holzer KJ
Exploring patient perspectives on telemedicine monitoring within the operating room.
The authors sought to identify participant-rated items contributing to patient attitudes, beliefs, and level of comfort with electronic OR (eOR) monitoring and to highlight barriers and facilitators to eOR use. They found that participants expressed significant support for intraoperative telemedicine use and greater comfort with local telemedicine systems instead of long-distance telemedicine systems. They further found that reservations centered on organizational policies, procedures, environment, culture; people; workflow and communication; and hardware and software.
Citation:
Abraham J, Meng A, Holzer KJ .
Exploring patient perspectives on telemedicine monitoring within the operating room.
Int J Med Inform 2021 Dec;156:104595. doi: 10.1016/j.ijmedinf.2021.104595..
Keywords:
Telehealth, Health Information Technology (HIT), Surgery, Patient Experience
