National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Anxiety (2)
- Behavioral Health (2)
- Cancer (2)
- Case Study (1)
- Children/Adolescents (4)
- (-) Chronic Conditions (16)
- Depression (2)
- Diabetes (5)
- Diagnostic Safety and Quality (3)
- Disparities (1)
- Elderly (1)
- Evidence-Based Practice (4)
- Eye Disease and Health (1)
- Guidelines (1)
- Healthcare Costs (1)
- Health Services Research (HSR) (1)
- Health Systems (1)
- Hepatitis (2)
- Human Immunodeficiency Virus (HIV) (1)
- Implementation (1)
- Kidney Disease and Health (1)
- Low-Income (1)
- Neurological Disorders (1)
- Pain (1)
- Prevention (7)
- Primary Care (3)
- Quality Improvement (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (1)
- Research Methodologies (1)
- Respiratory Conditions (2)
- Risk (1)
- Rural Health (1)
- (-) Screening (16)
- Shared Decision Making (1)
- Social Determinants of Health (1)
- U.S. Preventive Services Task Force (USPSTF) (5)
- Urban Health (3)
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 16 of 16 Research Studies DisplayedCusick MM, Tisdale RL, Chertow GM
Population-wide screening for chronic kidney disease : a cost-effectiveness analysis.
The purpose of this study was to assess the cost-effectiveness of adding population-wide screening for chronic kidney disease (CKD), specifically; screening for albuminuria with and without adding Sodium-glucose cotransporter-2 (SGLT2) inhibitors to the current standard of care for CKD. The study found that one-time CKD screening at the age 55 years had an ICER of $86,300 per QALY gained by increasing costs from $249,800 to $259,000 and increasing QALYs from 12.61 to 12.72; this result was accompanied by a decrease in the incidence of kidney failure requiring dialysis or kidney transplant of 0.29 percentage points and an increase in life expectancy from 17.29 to 17.45 years. In the group aged 35 to 75 years, screening one time prevented dialysis or transplant in 398, 000 people and screening every 10 years until age the age of 75 years cost less than $100,000 per QALY gained. The study’s sensitivity analysis found that when SGLT2 inhibitors were 30% less effective, screening every 10 years during ages 35 to 75 years cost between $145,400 and $182,600 per QALY gained, and decreases in the price would be necessary for screening to be cost-effective.
AHRQ-funded; HS026128.
Citation: Cusick MM, Tisdale RL, Chertow GM .
Population-wide screening for chronic kidney disease : a cost-effectiveness analysis.
Ann Intern Med 2023 Jun; 176(6):788-97. doi: 10.7326/m22-3228..
Keywords: Kidney Disease and Health, Screening, Healthcare Costs, Chronic Conditions
Mills J, Barnhart H
AHRQ Author: Mills J
Screening for prediabetes and type 2 diabetes in children and adolescents.
This Putting Prevention into Practice case study is used to increase understanding of the USPSTF final recommendation on screening for prediabetes and type 2 diabetes in children and adolescents. A case study was presented using a 12-year-old-patient with no specific concerns but had gained 18 pounds since their last wellness visit and lives a sedentary lifestyle. The patient’s family history of type 2 diabetes mellitus in maternal and paternal grandparents is described. Three multiple-choice questions are presented regarding harms and benefits of screening for prediabetes and type 2 diabetes for that patient.
AHRQ-authored.
Citation: Mills J, Barnhart H .
Screening for prediabetes and type 2 diabetes in children and adolescents.
Am Fam Physician 2023 Jan; 107(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Evidence-Based Practice, Guidelines, Prevention, Chronic Conditions, Case Study
Lock LJ, Channa R, Brennan MB
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
The goal of this retrospective cohort study was to determine the role of level of disadvantage in diabetic eye screening to explain the effect of health systems on rural and urban disparities. Researchers used an all-payer, statewide claims database to include adult Wisconsin residents with diabetes who had claims billed throughout the baseline and measurement years. Results indicated that patients from urban underserved clinics were more likely to receive screening than those from rural underserved clinics; similar findings emerged for both Medicare and non-Medicare subgroups. The researchers concluded that health systems, especially those that serve urban underserved populations, have an opportunity to increase screening rates by leveraging health system-level interventions and supporting patients in overcoming barriers.
AHRQ-funded; HS026279.
Citation: Lock LJ, Channa R, Brennan MB .
Effect of health system on the association of rurality and level of disadvantage with receipt of diabetic eye screening.
BMJ Open Diabetes Res Care 2022 Dec;10(6):e003174. doi: 10.1136/bmjdrc-2022-003174..
Keywords: Rural Health, Access to Care, Screening, Diabetes, Eye Disease and Health, Disparities, Chronic Conditions, Health Systems
Singal AG, Chen Y, Sridhar S
Novel application of predictive modeling: a tailored approach to promoting hcc surveillance in patients with cirrhosis.
Researchers conducted a secondary analysis of a randomized clinical trial evaluating a mailed outreach strategy to promote hepatocellular carcinoma (HCC) surveillance among cirrhosis patients at a safety-net health system. They found that predictive models can help stratify patients' likelihood to respond to surveillance outreach invitations, facilitating tailored strategies to maximize effectiveness and cost-effectiveness of HCC surveillance population health programs.
AHRQ-funded; HS022418.
Citation: Singal AG, Chen Y, Sridhar S .
Novel application of predictive modeling: a tailored approach to promoting hcc surveillance in patients with cirrhosis.
Clin Gastroenterol Hepatol 2022 Aug;20(8):1795-802.e2. doi: 10.1016/j.cgh.2021.02.038..
Keywords: Cancer, Chronic Conditions, Screening
Heller CG, Rehm CD, Parsons AH
The association between social needs and chronic conditions in a large, urban primary care population.
This study sought to understand the association between social needs and chronic health conditions using a screening tool and clinical data from Electronic Health Records. From April 2018 to December 2019, 33,550 adult patients completed a 10-item social needs screening tool during primary visits in Bronx and Westchester Counties, NY. A positive, cumulative association between social needs and each of the eight outcomes asked about was found. The relationship was strongest for elevated PHQ-2 (depression screening), alcohol/drug use disorder, and smoking. Those with 3 or greater social needs were 3.9 times more likely to have an elevated PHQ-2 than those without needs. Healthcare transportation challenges was associated with each condition and was the most strongly associated need with half of conditions in the fully-adjusted models. Examples included those with an alcohol/drug use disorder (84% more likely), and smokers (41% more likely).
AHRQ-funded; HS026396.
Citation: Heller CG, Rehm CD, Parsons AH .
The association between social needs and chronic conditions in a large, urban primary care population.
Prev Med 2021 Dec;153:106752. doi: 10.1016/j.ypmed.2021.106752..
Keywords: Chronic Conditions, Urban Health, Primary Care, Low-Income, Social Determinants of Health, Screening
Bifulco L, Anderson DR, Blankson ML
Evaluation of a chronic pain screening program implemented in primary care.
The purpose of this study was to evaluate a 2-step process for chronic pain screening and follow-up in primary care. Participants included primary care practitioners and medical assistants from 13 sites who implemented the screening process in primary care, and over 38,000 patients aged 18 or older with a primary care visit during the study’s July 2018-June 2019 time period. Findings showed that a systematic, 2-step process for chronic pain screening and functional assessment in primary care appeared to identify patients with previously undocumented chronic pain and that this process was feasible to implement.
AHRQ-funded; HS025354.
Citation: Bifulco L, Anderson DR, Blankson ML .
Evaluation of a chronic pain screening program implemented in primary care.
JAMA Netw Open 2021 Jul;4(7):e2118495. doi: 10.1001/jamanetworkopen.2021.18495..
Keywords: Pain, Chronic Conditions, Primary Care, Screening
Chou R, Blazina I, Bougatsos C
Screening for hepatitis B virus infection in nonpregnant adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors updated the 2014 hepatitis B virus (HBV) screening review in nonpregnant adolescents and adults to inform the USPSTF. They found no direct evidence for the clinical benefits and harms of HBV screening vs no screening. Antiviral therapy for HBV infection was associated with improved intermediate outcomes and may improve clinical outcomes.
AHRQ-funded; 290201500009I.
Citation: Chou R, Blazina I, Bougatsos C .
Screening for hepatitis B virus infection in nonpregnant adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Dec 15;324(23):2423-36. doi: 10.1001/jama.2020.19750..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Hepatitis, Chronic Conditions, Screening, Evidence-Based Practice, Prevention
Liu FF, Lew A, Andes E
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
The objective of this study was to share key strategies that led to successful mental health screening (MHS) implementation in one pediatric cystic fibrosis center and to report implementation and screening outcomes. Results showed that leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
AHRQ-funded; HS026393.
Citation: Liu FF, Lew A, Andes E .
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
Pediatr Pulmonol 2020 Dec;55(12):3328-36. doi: 10.1002/ppul.24951..
Keywords: Children/Adolescents, Respiratory Conditions, Chronic Conditions, Depression, Anxiety, Behavioral Health, Screening, Implementation, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Koller KR, Day GE, Hiratsuka VY
Increase in diabetes among urban Alaska Native people in the Alaska EARTH follow-up study: a call for prediabetes screening, diagnosis, and referral for intervention.
This study estimated incidence of diabetes (DM) and pre-DM relative to DM risk factors among relatively healthy Alaska Native and American Indian (AN) adults living in urban south-central Alaska. Results showed that, controlling for age and sex, obesity, abdominal adiposity, pre-DM, and metabolic syndrome independently increased DM risk. Recommendations included advising health care providers of AN populations to seize the opportunity to screen, refer, and treat individuals with pre-DM and other modifiable DM risk factors prior to DM diagnosis in order to alter the epidemiologic course of disease progression in this urban AN population.
AHRQ-funded; HS000084.
Citation: Koller KR, Day GE, Hiratsuka VY .
Increase in diabetes among urban Alaska Native people in the Alaska EARTH follow-up study: a call for prediabetes screening, diagnosis, and referral for intervention.
Diabetes Res Clin Pract 2020 Sep;167:108357. doi: 10.1016/j.diabres.2020.108357..
Keywords: Diabetes, Racial and Ethnic Minorities, Urban Health, Risk, Prevention, Screening, Diagnostic Safety and Quality, Chronic Conditions
Obinwa U, Pérez A, Lingvay I
Multilevel variation in diabetes screening within an integrated health system.
Variation in diabetes screening in clinical practice is poorly described. In this study, the investigators examined the interplay of patient, provider, and clinic factors explaining variation in diabetes screening within an integrated health care system in the U.S. They concluded that screening practices varied widely and were only partially explained by patient, provider, and clinic factors available in the EHR.
AHRQ-funded; HS022418.
Citation: Obinwa U, Pérez A, Lingvay I .
Multilevel variation in diabetes screening within an integrated health system.
Diabetes Care 2020 May;43(5):1016-24. doi: 10.2337/dc19-1622..
Keywords: U.S. Preventive Services Task Force (USPSTF), Diabetes, Screening, Primary Care, Prevention, Evidence-Based Practice, Chronic Conditions
Munger Clary HM, Croxton RD, Allan J
Who is willing to participate in research? A screening model for an anxiety and depression trial in the epilepsy clinic.
This study assessed the willingness of epilepsy patients positively screened for anxiety and/or depression to participate in a research study. A total of 199 patients screened positively during a routine epilepsy screening visit and 154 (77.4%) opted-in for further research assessment. Nearly half of those 199 individuals were already being treated for anxiety and/or depression, with 46.7% receiving neither antidepressants or therapy. Higher depression scores and current treatment were independently associated with opting in. One-quarter reported a past psychiatric hospitalization, but only half of those individuals were currently receiving mental health specialty care.
AHRQ-funded; HS025723.
Citation: Munger Clary HM, Croxton RD, Allan J .
Who is willing to participate in research? A screening model for an anxiety and depression trial in the epilepsy clinic.
Epilepsy Behav 2020 Mar;104(Pt A):106907. doi: 10.1016/j.yebeh.2020.106907..
Keywords: Anxiety, Depression, Behavioral Health, Neurological Disorders, Chronic Conditions, Screening, Diagnostic Safety and Quality, Health Services Research (HSR), Research Methodologies
Chou R, Dana T, Fu R
Screening for hepatitis C virus infection in adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
AHRQ-funded; 290201500009I.
Citation: Chou R, Dana T, Fu R .
Screening for hepatitis C virus infection in adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Mar 10;323(10):970-75. doi: 10.1001/jama.2019.20788..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Hepatitis, Chronic Conditions, Screening, Evidence-Based Practice, Prevention
Shirley DK, Kaner RJ, Glesby MJ
Screening for chronic obstructive pulmonary disease (COPD) in an urban HIV clinic: a pilot study.
This study aimed to determine the predictive value of a COPD screening strategy validated in the general population and to identify HIV-related factors associated with decreased lung function. It found that questionnaire and peak flow together had low sensitivity, but abnormal peak flow shows potential as a screening tool for COPD in HIV/AIDS. These data suggest that lung function may be influenced by HIV-related factors.
AHRQ-funded; HS000066.
Citation: Shirley DK, Kaner RJ, Glesby MJ .
Screening for chronic obstructive pulmonary disease (COPD) in an urban HIV clinic: a pilot study.
AIDS Patient Care STDS 2015 May;29(5):232-9. doi: 10.1089/apc.2014.0265..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Chronic Conditions, Respiratory Conditions, Urban Health
Gross CP, Fried TR, Tinetti ME
Decision-making and cancer screening: a qualitative study of older adults with multiple chronic conditions.
The researchers sought to understand how older persons with multiple chronic conditions (MCC) approach decisions about cancer screenings. They found that some older persons with MCC employ heuristics which circumvent the traditional quantitative comparison of risks and benefits, providing an important challenge to informed decision making.
AHRQ-funded; HS018598.
Citation: Gross CP, Fried TR, Tinetti ME .
Decision-making and cancer screening: a qualitative study of older adults with multiple chronic conditions.
J Geriatr Oncol 2015 Mar;6(2):93-100. doi: 10.1016/j.jgo.2014.12.001..
Keywords: Cancer, Chronic Conditions, Shared Decision Making, Elderly, Screening
Rugge JB, Bougatsos C, Chou R
Screening and treatment of thyroid dysfunction: an evidence review for the U.S. Preventive Services Task Force.
This review is an update of a 2004 USPSTF review on the benefits and harms of screening and treatment of subclinical and undiagnosed overt hypothyroidism and hyperthyroidism in adults without goiter or thyroid nodules. It concluded that no study evaluated treatment versus no treatment of screen-detected, undiagnosed overt thyroid dysfunction.
AHRQ-funded; 290200710057I
Citation: Rugge JB, Bougatsos C, Chou R .
Screening and treatment of thyroid dysfunction: an evidence review for the U.S. Preventive Services Task Force.
Ann Intern Med. 2015 Jan 6;162(1):35-45. doi: 10.7326/M14-1456..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Prevention, Chronic Conditions
Chung S, Azar KM, Baek M
Reconsidering the age thresholds for type II diabetes screening in the U.S.
In order to examine the optimal age cut-point for opportunistic universal screening (as opposed to targeted screening), the researchers used a nationally representative sample from the National Health and Nutrition Examination Survey (2007-2010) and other resources. They found that opportunistic screening among individuals 35 years of age and older could greatly reduce the prevalence of undiagnosed diabetes or pre-diabetes.
AHRQ-funded; HS019815; HS019815.
Citation: Chung S, Azar KM, Baek M .
Reconsidering the age thresholds for type II diabetes screening in the U.S.
Am J Prev Med. 2014 Oct;47(4):375-81. doi: 10.1016/j.amepre.2014.05.012..
Keywords: Diabetes, Screening, Prevention, Chronic Conditions