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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 7 of 7 Research Studies DisplayedTheiss LM, Wood L, Shao C
Disparities in perioperative use of patient engagement technologies - not all use is equal.
The objective of this retrospective cohort study was to determine the association of patient-level characteristics and the use of a patient engagement technology during the perioperative period. Patients who had undergone elective colorectal surgery were enrolled in a patient engagement technology at a single institution and received educational content, healthcare reminders, patient reported outcome surveys, and health checks. Findings indicated that use of a patient engagement technology in the perioperative period differs significantly by sex, race/ethnicity, and insurance status. The authors concluded that this diverse usage should be considered during implementation of interventions to improve surgical outcomes.
AHRQ-funded; HS023009.
Citation: Theiss LM, Wood L, Shao C .
Disparities in perioperative use of patient engagement technologies - not all use is equal.
Ann Surg 2023 Jan;277(1):e218-e25. doi: 10.1097/sla.0000000000004970.
Keywords: Patient and Family Engagement, Disparities, Surgery, Hospital Discharge
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
De Roo AC, Vitous CA, Rivard SJ
High-risk surgery among older adults: not-quite shared decision-making.
This study explored surgeons’ approaches to decision-making for surgery among adults ≥65 years at high-risk of postoperative complications or death. The authors conducted semistructured in-depth interviews with 46 practicing surgeons across Michigan. They found that although shared decision-making is strongly recommended, surgeons who perform high-risk operations among older adults predominantly focused on assessing risk and setting expectations with patients and families rather than inviting them to actively participate in the decision-making process. Surgeons were also influenced by quality metrics, referrals, and personal experiences.
AHRQ-funded; HS026772; HS000053.
Citation: De Roo AC, Vitous CA, Rivard SJ .
High-risk surgery among older adults: not-quite shared decision-making.
Surgery 2021 Sep;170(3):756-63. doi: 10.1016/j.surg.2021.02.005..
Keywords: Elderly, Surgery, Decision Making, Patient and Family Engagement
Hurley VB, Rodriguez HP, Kearing S
The impact of decision aids on adults considering hip or knee surgery.
Investigators analyzed data for 2012-2015 about patients within the ten High Value Healthcare Collaborative member systems who were exposed to condition-specific decision aids in the context of consultations for hip and knee osteoarthritis, with the intention that the aids be used to support shared decision making. They found that, compared to matched patients not exposed to the decision aids, those exposed had two-and-a-half times the odds of undergoing hip replacement surgery and nearly twice the odds of undergoing knee replacement surgery within six months of the consultation. Their findings suggest that health care systems adopting decision aids developed for use in shared decisionmaking, and used in conjunction with hip and knee osteoarthritis consultations, should not expect reduced surgical utilization.
AHRQ-funded; HS024075.
Citation: Hurley VB, Rodriguez HP, Kearing S .
The impact of decision aids on adults considering hip or knee surgery.
Health Aff 2020 Jan;39(1):100-07. doi: 10.1377/hlthaff.2019.00100..
Keywords: Decision Making, Surgery, Orthopedics, Patient and Family Engagement
Garrity B, Berry Crofton, C
Parent-to-parent advice on considering spinal fusion in children with neuromuscular scoliosis.
The purpose of this study was to convey advice from families whose children recently underwent spinal fusion to families whose children are under consideration for initial spinal fusion for neuromuscular scoliosis and to providers who counsel families on this decision. Results showed that parents of children who had recently undergone spinal fusion had strong perceptions about what information to convey to families considering surgery, which may improve communication between future parents and physicians. Further investigation is needed to assess how best to incorporate the wisdom and experiences of parent peers into shared decisionmaking and preparation for spinal fusion in children with neuromuscular scoliosis.
AHRQ-funded; HS024453.
Citation: Garrity B, Berry Crofton, C .
Parent-to-parent advice on considering spinal fusion in children with neuromuscular scoliosis.
J Pediatr 2019 Oct;213:149-54. doi: 10.1016/j.jpeds.2019.05.055..
Keywords: Decision Making, Patient and Family Engagement, Caregiving, Children/Adolescents, Back Health and Pain, Surgery
Vemulakonda VM, Hamer MK, Kempe A
Surgical decision-making in infants with suspected UPJ obstruction: stakeholder perspectives.
Although there are significant demographic and clinical variations in treatment decisions for infants with high-grade hydronephrosis concerning for ureteropelvic junction obstruction (UPJO), there has been little research on the roles of parents and surgeons in the surgical decision-making (DM) process. The purpose of this study was to understand parents' and surgeons' perceived roles in the surgical DM process for infants with high-grade hydronephrosis.
AHRQ-funded; HS024597.
Citation: Vemulakonda VM, Hamer MK, Kempe A .
Surgical decision-making in infants with suspected UPJ obstruction: stakeholder perspectives.
J Pediatr Urol 2019 Oct;15(5):469.e1-69.e9. doi: 10.1016/j.jpurol.2019.05.027..
Keywords: Newborns/Infants, Decision Making, Surgery, Kidney Disease and Health, Caregiving, Provider: Physician, Provider, Patient and Family Engagement
Johnston FM, Beckman M
Navigating difficult conversations.
In this paper, the authors discussed breaking bad news and navigating difficult conversations in surgical oncology practice. They note that mounting evidence supports a patient-centered communication approach and models of shared decisionmaking. Physician training in patient-centered cancer communication also continues to evolve.
AHRQ-funded; HS024736.
Citation: Johnston FM, Beckman M .
Navigating difficult conversations.
J Surg Oncol 2019 Jul;120(1):23-29. doi: 10.1002/jso.25472..
Keywords: Cancer, Clinician-Patient Communication, Communication, Decision Making, Patient-Centered Healthcare, Patient and Family Engagement, Provider: Physician, Surgery