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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.
Results
1 to 25 of 29 Research Studies Displayed
Feltner C, Wallace IF, Kistler CE
Screening for hearing loss in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to update the evidence review on screening for hearing loss in adults 50 years or older to inform the US Preventive Services Task Force. Findings showed that several screening tests can adequately detect hearing loss in older adults, while no studies reported on the harms of screening or treatment. Further, evidence showing benefit from hearing aids on hearing-related function among adults with screen-detected or newly detected hearing loss is limited to studies enrolling veterans.
AHRQ-funded; 290201500011I.
Citation:
Feltner C, Wallace IF, Kistler CE .
Screening for hearing loss in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Mar 23;325(12):1202-15. doi: 10.1001/jama.2020.24855..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Elderly, Screening, Guidelines, Evidence-Based Practice, Prevention
Serina P, Lo AX, Kocherginsky M
The clinical frailty scale and health services use for older adults in the emergency department.
The 2013 consensus geriatric emergency department (GED) guidelines, endorsed by the American Geriatrics Society and other professional societies, recommend “routine screening for all older adult patients at higher risk for adverse outcomes.” However, current screening tools are not predictive of health services use. In this study, the investigators evaluated whether CFS may be a useful ED screening tool by examining its association with health services use for older adults.
AHRQ-funded; HS026489.
Citation:
Serina P, Lo AX, Kocherginsky M .
The clinical frailty scale and health services use for older adults in the emergency department.
J Am Geriatr Soc 2021 Mar;69(3):837-39. doi: 10.1111/jgs.16937..
Keywords:
Elderly, Emergency Department, Screening, Prevention
Earl TR, Katapodis ND, Schneiderman SR
Using deprescribing practices and the screening tool of older persons' potentially inappropriate prescriptions criteria to reduce harm and preventable adverse drug events in older adults.
This paper is a systematic review of the literature published between 2008 to 2018 that studies the effect of interventions to reduce preventable adverse drug effects (ADEs) for adults who are prescribed multiple medications. Two safety practices were examined: 1) deprescribing interventions to reduce polypharmacy; and 2) use of the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) to reduce potentially inappropriate medications (PIMS). A total of 26 studies and 1 systematic review were included (14 for deprescribing and 12 for STOPP). Deprescribing interventions included decision support tools, educational interventions, and medication reviews. The STOPP tool most reported changes in PIMS, as well as some economic outcomes. Both methods were found to be effective.
AHRQ-funded; HHSP233201500013I.
Citation:
Earl TR, Katapodis ND, Schneiderman SR .
Using deprescribing practices and the screening tool of older persons' potentially inappropriate prescriptions criteria to reduce harm and preventable adverse drug events in older adults.
J Patient Saf 2020 Sep;16(3S Suppl 1):S23-s35. doi: 10.1097/pts.0000000000000747..
Keywords:
Elderly, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Screening, Prevention
H H, Caton Gilstrap L
Screening for cognitive impairment in older adults.
This evidence-based approach paper focuses on putting prevention into action. It discusses screening for cognitive impairment in older adults. It provides case study, case study questions and a discussion.
AHRQ-authored.
Citation:
H H, Caton Gilstrap L .
Screening for cognitive impairment in older adults.
Am Fam Physician 2020 Jun 15;101(12):753-54..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Dementia, Neurological Disorders, Elderly, Screening, Prevention, Case Study, Evidence-Based Practice, Guidelines
Garcia-Albeniz X, Hernan MA, Logan RW
Continuation of annual screening mammography and breast cancer mortality in women older than 70 years.
This study examined whether discontinuing annual screening mammographies in women older than 70 years results in an increased 8-year breast cancer mortality. The researchers used data from the Medicare program and looked at over 1 million beneficiaries aged 70 to 84 who had no previous breast cancer diagnosis, and who underwent screening mammography from 2000 to 20008. The 8-year risk difference for women aged 70 to 74 years was -1.0 death per 1000 women and for women aged 75 to 84 years it was 0.07. Neither of these show substantial reductions in 8-year breast cancer mortality compared with stopping screening.
AHRQ-funded; HS023128.
Citation:
Garcia-Albeniz X, Hernan MA, Logan RW .
Continuation of annual screening mammography and breast cancer mortality in women older than 70 years.
Ann Intern Med 2020 Mar 17;172(6):381-89. doi: 10.7326/m18-1199..
Keywords:
Cancer: Breast Cancer, Cancer, Screening, Mammogram, Prevention, Women, Elderly, Mortality
Patnode CD, Perdue LA, Rossom RC
Screening for cognitive impairment in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to systematically review the test accuracy of cognitive screening instruments and benefits and harms of interventions to treat cognitive impairment in older adults (>/=65 years) to inform the US Preventive Services Task Force. The investigators concluded that screening instruments could adequately detect cognitive impairment. They indicated that there was no empirical evidence, however, that screening for cognitive impairment improved patient or caregiver outcomes or causes harm.
AHRQ-funded; 290201500007I.
Citation:
Patnode CD, Perdue LA, Rossom RC .
Screening for cognitive impairment in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Feb 25;323(8):764-85. doi: 10.1001/jama.2019.22258..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Dementia, Neurological Disorders, Elderly, Guidelines, Screening, Prevention, Evidence-Based Practice
Davis SN, Wischhusen JW, Sutton SK
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
This study examined the frequency of limited health literacy and demographic and psychosocial factors associated with limited health literacy in a sample of older black Americans. The participants enrolled in a community-based intervention to promote colorectal cancer screening and completed baseline surveys that assessed their health literacy using the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test, CRC awareness, cancer fatalism, Preventive Health Model (PHM) constructs, and demographics. Findings showed that limited health literacy was associated with multiple complex factors. Recommendations include interventions to incorporate patient health literacy and low-literacy materials that can be delivered through multiple channels.
AHRQ-funded; HS026120.
Citation:
Davis SN, Wischhusen JW, Sutton SK .
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
Patient Educ Couns 2020 Feb;103(2):385-91. doi: 10.1016/j.pec.2019.08.026..
Keywords:
Health Literacy, Racial / Ethnic Minorities, Elderly, Screening, Cancer: Colorectal Cancer, Cancer, Prevention
Bravo RI, Kietzman KG, Toy P
Linking primary care and community organizations to increase colorectal cancer screening rates: the HAPPI project.
This paper describes the Healthy Aging Partnerships in Prevention Initiative (HAPPI) which aims to increase colorectal cancer screening and other preventive services among underserved Latinos and African-Americans in South Los Angeles who are 50 years and older. It uses an evidence-based model (SPARC) to leverage existing resources and has multi-sectoral partnerships among different agencies, community health centers (CHCs), and a university. The authors engaged five CHCs in quality improvement activities and eight non-governmental organizations in networking and programming to increase awareness of these preventive services.
AHRQ-funded; HS010858.
Citation:
Bravo RI, Kietzman KG, Toy P .
Linking primary care and community organizations to increase colorectal cancer screening rates: the HAPPI project.
Salud Publica Mex 2019 Jul-Aug;61(4):427-35. doi: 10.21149/9450..
Keywords:
Cancer: Colorectal Cancer, Cancer, Screening, Prevention, Primary Care: Models of Care, Primary Care, Elderly, Racial / Ethnic Minorities, Vulnerable Populations, Patient-Centered Healthcare
Hoover DS, Pappadis MR, Housten AJ
Preferences for communicating about breast cancer screening among racially/ethnically diverse older women.
The purpose of this study was to examine preferences for communicating about screening mammography among racially/ethnically diverse older women. Through in-depth interviews, findings revealed that older women desire information about the benefits and harms of screening mammography and would prefer to learn this information through discussions with healthcare providers and multiple other formats. Results were consistent regardless of participants' age, race/ethnicity, or education.
AHRQ-funded; HS022134.
Citation:
Hoover DS, Pappadis MR, Housten AJ .
Preferences for communicating about breast cancer screening among racially/ethnically diverse older women.
Health Commun 2019 Jun;34(7):702-06. doi: 10.1080/10410236.2018.1431026..
Keywords:
Cancer, Cancer: Breast Cancer, Clinician-Patient Communication, Communication, Elderly, Mammogram, Prevention, Racial / Ethnic Minorities, Screening, Women
Borsky AE, Zhang E
Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults.
This Putting Prevention into Practice case study demonstrates how a U.S. Preventive Services Task Force (USPSTF) recommendation can used by clinicians. This case study uses the Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults recommendation as an example. Three quiz questions are given which directly link to the recommendations. The questions involve screening guidelines, screening instruments, and follow-up if there is a positive screening and detailed answers are provided.
AHRQ-authored.
Citation:
Borsky AE, Zhang E .
Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults.
Am Fam Physician 2019 May 15;99(10):649-50..
Keywords:
Case Study, Domestic Violence, Elderly, Evidence-Based Practice, Screening, U.S. Preventive Services Task Force (USPSTF), Vulnerable Populations
Lewis CL, Kistler CE, Dalton AF
A decision aid to promote appropriate colorectal cancer screening among older adults: a randomized controlled trial.
The purpose of this study was to test a patient decision aid (PtDA) to promote CRC screening in older adults. The PtDA was designed to facilitate individual decision-making to help patients understand the potential risks and benefit of CRC screening. 424 patients aged 70 – 84 who were not up to date with CRC screening participated in a double-blinded randomized controlled trial, using the PtDA or an attention control. Two outcomes - appropriate CRC screening behavior at 6 months following the initial visit or appropriate screening intent immediately after the visit - were defined as completed screening or intent for patients in good health, discussion about screening with their provider for patients in intermediate health, or no screening or intent for patients in poor health. Appropriate screening behavior at 6 months was higher in the intervention group; appropriate screening intent following the provider visit was also higher. The authors conclude that the PtDA for older adults promoted appropriate CRC screening behavior.
AHRQ-funded; HS021133.
Citation:
Lewis CL, Kistler CE, Dalton AF .
A decision aid to promote appropriate colorectal cancer screening among older adults: a randomized controlled trial.
Med Decis Making 2018 Jul;38(5):614-24. doi: 10.1177/0272989x18773713..
Keywords:
Cancer, Cancer: Colorectal Cancer, Decision Making, Education: Patient and Caregiver, Elderly, Prevention, Screening
Pappadis MR, Volk RJ, Krishnan S
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
The authors explored older women's perceptions about the concept of overdetection of breast cancer and its influence on future screening intentions. Semistructured interviews were conducted with 59 English-speaking women aged 70 years or older with no prior history of breast cancer. The authors found that many older women did not understand the concept of overdetection, in addition to being suspicious of or resistant to the concept. Providing older women with descriptions of overdetection may not be sufficient to influence screening intentions.
AHRQ-funded; HS022134.
Citation:
Pappadis MR, Volk RJ, Krishnan S .
Perceptions of overdetection of breast cancer among women 70 years of age and older in the USA: a mixed-methods analysis.
BMJ Open 2018 Jun 14;8(6):e022138. doi: 10.1136/bmjopen-2018-022138..
Keywords:
Cancer: Breast Cancer, Cancer, Women, Elderly, Decision Making, Mammogram, Diagnostic Safety and Quality, Imaging, Screening, Prevention
Housten AJ, Pappadis MR, Krishnan S
Resistance to discontinuing breast cancer screening in older women: a qualitative study.
Screening mammography is associated with reduced breast cancer-specific mortality; however, among older women, evidence suggests that the potential harms of screening may outweigh the benefits. This study used a qualitative approach to examine the willingness of older women from different racial/ethnic groups to discontinue breast cancer screening. The authors found that among older women who planned to continue screening, intentions to continue breast cancer screening appear to be highly resilient and resistant to recommendations from physicians or expert/government panels.
AHRQ-funded; HS022134.
Citation:
Housten AJ, Pappadis MR, Krishnan S .
Resistance to discontinuing breast cancer screening in older women: a qualitative study.
Psychooncology 2018 Jun;27(6):1635-41. doi: 10.1002/pon.4708..
Keywords:
Cancer: Breast Cancer, Elderly, Screening, Prevention, Women
Kistler CE, Golin C, Sundaram A
Individualized colorectal cancer screening discussions between older adults and their primary care providers: a cross-sectional study.
The aim of this study was to describe colorectal cancer (CRC) screening discussions and explore their associations with patient characteristics and screening intentions. The investigators found that CRC screening discussions varied by type of participant and content. They assert that future work is needed to determine if interventions focused on specific domains alters the appropriateness of participants' colorectal cancer screening intentions.
AHRQ-funded; HS021133.
Citation:
Kistler CE, Golin C, Sundaram A .
Individualized colorectal cancer screening discussions between older adults and their primary care providers: a cross-sectional study.
MDM Policy Pract 2018 Jan-Jun;3(1):2381468318765172. doi: 10.1177/2381468318765172..
Keywords:
Cancer: Colorectal Cancer, Decision Making, Elderly, Primary Care, Screening
Kistler CE, Golin C, Morris C
Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults.
This paper reports on the design of a randomized clinical trial to understand the effects of a patient decision aid on appropriate colorectal cancer screening. The study aims to determine the ability of a patient decision aid to increase individualized and appropriate colorectal cancer screening.
AHRQ-funded; HS021133.
Citation:
Kistler CE, Golin C, Morris C .
Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults.
Clin Trials 2017 Dec;14(6):648-58. doi: 10.1177/1740774517725289..
Keywords:
Cancer, Cancer: Colorectal Cancer, Decision Making, Elderly, Prevention, Screening
Garcia-Albeniz X, Hsu J, Bretthauer M
Effectiveness of screening colonoscopy to prevent colorectal cancer among Medicare beneficiaries aged 70 to 79 years: a prospective observational study.
The researchers evaluated the effectiveness and safety of screening colonoscopy to prevent colorectal cancer (CRC) in persons aged 70 to 74 and those aged 75 to 79 years. They concluded that screening colonoscopy may have had a modest benefit in preventing CRC in beneficiaries aged 70 to 74 years and a smaller benefit in older beneficiaries.
AHRQ-funded; HS023128.
Citation:
Garcia-Albeniz X, Hsu J, Bretthauer M .
Effectiveness of screening colonoscopy to prevent colorectal cancer among Medicare beneficiaries aged 70 to 79 years: a prospective observational study.
Ann Intern Med 2017 Jan 3;166(1):18-26. doi: 10.7326/m16-0758.
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.
Keywords:
Cancer: Colorectal Cancer, Colonoscopy, Elderly, Prevention, Screening
Goodwin JS, Sheffield K, Li S
Receipt of cancer screening is a predictor of life expectancy.
The researchers sought to determine the association between receipt of screening mammography or PSA and overall survival. They found that the subjects with prior cancer screening had actual median survivals higher than those who were not screened, with differences ranging from 1.7 to 2.1 years for women and 0.9 to 1.1 years for men.
AHRQ-funded; HS022134.
Citation:
Goodwin JS, Sheffield K, Li S .
Receipt of cancer screening is a predictor of life expectancy.
J Gen Intern Med 2016 Nov;31(11):1308-14. doi: 10.1007/s11606-016-3787-y.
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Keywords:
Cancer, Cancer: Breast Cancer, Cancer: Prostate Cancer, Elderly, Mammogram, Men's Health, Screening, Women
Gavinski K, Carnahan R, Weckmann M
Validation of the delirium observation screening scale in a hospitalized older population.
The authors studied the accuracy of the Delirium Observation Screening Scale (DOS) as a screening tool in hospitalized patients over age 64. They also investigated the user-friendliness of the tool. They determined that DOS is an accurate and easy way to screen for delirium in older inpatients.
AHRQ-funded; HS022666.
Citation:
Gavinski K, Carnahan R, Weckmann M .
Validation of the delirium observation screening scale in a hospitalized older population.
J Hosp Med 2016 Jul;11(7):494-7. doi: 10.1002/jhm.2580.
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Keywords:
Elderly, Hospitalization, Neurological Disorders, Screening
Pollack CE, Blackford AL, Schoenborn NL
Comparing prognostic tools for cancer screening: considerations for clinical practice and performance assessment.
The researchers compared the agreement and rates of cancer screening using four prognostic tools that require different types of clinical information. They found high agreement among the four prognostic tools. They concluded that the high rates of cancer screening of individuals with limited life expectancy suggest the importance of incorporating tools into clinical decision-making.
AHRQ-funded; HS000029.
Citation:
Pollack CE, Blackford AL, Schoenborn NL .
Comparing prognostic tools for cancer screening: considerations for clinical practice and performance assessment.
J Am Geriatr Soc 2016 May;64(5):1032-8. doi: 10.1111/jgs.14089.
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Keywords:
Elderly, Cancer, Screening, Decision Making
Zanwar P, Lin YL, Kuo YF
Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S. Medicare public insurance claims data: a retrospective cohort
The investigators assessed the tests, treatments, and payments for prostate cancer care in men aged 75 or older who have primary care physicians (PCPs) with high or low prostate specific antigen (PSA) testing rates. They found that older men seeing PCPs with high rates of PSA testing undergo more testing and treatments for prostate cancer, with higher Medicare insurance payments.
AHRQ-funded; HS022134.
Citation:
Zanwar P, Lin YL, Kuo YF .
Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S. Medicare public insurance claims data: a retrospective cohort
BMC Health Serv Res 2016 Jan 15;16:17. doi: 10.1186/s12913-016-1265-1.
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Keywords:
Elderly, Medicare, Primary Care, Cancer: Prostate Cancer, Screening
Rezaee ME, Ward CE, Odom BD
Prostate cancer screening practices and diagnoses in patients age 50 and older, Southeastern Michigan, pre/post 2012.
This study investigated the regional impact of the 2012 U.S. Preventive Services Task Force (USPSTF) recommendation against the use of prostate specific antigen (PSA) screening for prostate cancer. PSA utilization significantly increased during the pre-period, but significantly decreased in the post-period. Prostate biopsies decreased before the 2012 recommendation and did not change afterwards.
AHRQ-funded; HS000084.
Citation:
Rezaee ME, Ward CE, Odom BD .
Prostate cancer screening practices and diagnoses in patients age 50 and older, Southeastern Michigan, pre/post 2012.
Prev Med 2016 Jan;82:73-6. doi: 10.1016/j.ypmed.2015.11.017.
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Keywords:
U.S. Preventive Services Task Force (USPSTF), Cancer: Prostate Cancer, Screening, Elderly, Healthcare Utilization
Sutkowi-Hemstreet A, Vu M, Harris R
Adult patients' perspectives on the benefits and harms of overused screening tests: a qualitative study.
This study determined how patients think about the harms and benefits of overused screening tests and how they consider these and other factors when making decisions. It found that many patients could not name a harm of screening. When they did name harms, patients often focused on only the harms of the screening test itself and rarely mentioned harms further along the screening cascade.
AHRQ-funded; HS021133.
Citation:
Sutkowi-Hemstreet A, Vu M, Harris R .
Adult patients' perspectives on the benefits and harms of overused screening tests: a qualitative study.
J Gen Intern Med 2015 Nov;30(11):1618-26. doi: 10.1007/s11606-015-3283-9.
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Keywords:
Prevention, Screening, Patient Experience, Elderly, Education: Patient and Caregiver
Pfoh E, Mojtabai R, Bailey J
Impact of Medicare annual wellness visits on uptake of depression screening.
This study assessed whether patients with an initial annual wellness visit (AWV) were more likely to be screened for depression than those with a primary care visit. Fifteen percent of patients with non-AWVs and 10 percent of patients with AWVs received depression screening. After accounting for clustering, there was no statistically significant difference in depression screening by visit type.
AHRQ-funded; HS000029.
Citation:
Pfoh E, Mojtabai R, Bailey J .
Impact of Medicare annual wellness visits on uptake of depression screening.
Psychiatr Serv 2015 Nov;66(11):1207-12. doi: 10.1176/appi.ps.201400524.
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Keywords:
Depression, Screening, Medicare, Elderly, Primary Care
Cantor SB, Deshmukh AA, Krahn MD
Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model.
The researchers sought to determine whether the forecasted assessment of how someone would feel in a future health state can be predictive of utilities (e.g. as elicited by the time-trade-off method) and also predictive of optimal decisions as determined by a decision-analytic model. They concluded that anticipated difficulty adjusting to adverse health effects were highly related to preferences and could be used as a proxy measure of utility.
AHRQ-funded; HS08992.
Citation:
Cantor SB, Deshmukh AA, Krahn MD .
Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model.
Health Expect 2015 Oct;18(5):1610-20. doi: 10.1111/hex.12150.
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Keywords:
Decision Making, Cancer: Prostate Cancer, Elderly, Quality of Life, Screening
Fan T, Rossi C
Screening for cognitive impairment in older adults.
This case study describes a 72-year-old white man comes the physician’s office for a preventive visit. He does not have any symptoms of dementia but asks whether he should be screened. Based on the recommendations of the U.S. Preventive Services Task Force, the authors ask (and answer) three questions concerning approaches to screening for cognitive impairment, risk factors for cognitive impairment or dementia in older adults, and the epidemiology of cognitive impairment in the United States.
AHRQ-authored
Citation:
Fan T, Rossi C .
Screening for cognitive impairment in older adults.
Am Fam Physician 2015 Jul 15;92(2):125-6..
Keywords:
Case Study, Elderly, Neurological Disorders, Screening, U.S. Preventive Services Task Force (USPSTF)
