National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Ambulatory Care and Surgery (1)
- Anxiety (3)
- Asthma (1)
- Autism (2)
- Behavioral Health (10)
- Blood Pressure (4)
- Cancer (25)
- Cancer: Breast Cancer (17)
- Cancer: Cervical Cancer (2)
- Cancer: Colorectal Cancer (6)
- Care Management (1)
- Children/Adolescents (9)
- Chronic Conditions (3)
- Clinical Decision Support (CDS) (1)
- Colonoscopy (2)
- Communication (1)
- Comparative Effectiveness (2)
- Depression (10)
- Diabetes (5)
- (-) Diagnostic Safety and Quality (60)
- Digestive Disease and Health (2)
- Disparities (2)
- Education (1)
- Elderly (1)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (6)
- Eye Disease and Health (1)
- Family Health and History (1)
- Genetics (4)
- Guidelines (1)
- Healthcare Costs (4)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (1)
- Health Services Research (HSR) (1)
- Human Immunodeficiency Virus (HIV) (2)
- Imaging (15)
- Implementation (1)
- Infectious Diseases (1)
- Low-Income (2)
- Maternal Care (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (2)
- Neurological Disorders (1)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Practice Patterns (1)
- Pregnancy (2)
- Prevention (13)
- Primary Care (8)
- Primary Care: Models of Care (1)
- Provider Performance (3)
- Quality Improvement (2)
- Quality Measures (2)
- Quality of Care (3)
- Racial and Ethnic Minorities (3)
- Research Methodologies (1)
- Respiratory Conditions (1)
- Risk (4)
- (-) Screening (60)
- Sepsis (1)
- Sexual Health (1)
- Shared Decision Making (2)
- Social Determinants of Health (2)
- Substance Abuse (1)
- Surgery (1)
- U.S. Preventive Services Task Force (USPSTF) (3)
- Urban Health (2)
- Vulnerable Populations (1)
- Women (20)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 60 Research Studies DisplayedHo TH, Bissell MCS, Lee CI
Prioritizing screening mammograms for immediate interpretation and diagnostic evaluation on the basis of risk for recall.
The purpose of this study was to establish a prioritization method for immediate interpretation of screening mammograms and potential diagnostic assessment. A cohort based on the population, comprising screening mammograms conducted from 2012 to 2020 at 126 radiology centers from 7 Breast Cancer Surveillance Consortium registries, was examined. Classification trees were used to identify combinations of clinical history (age, BI-RADS density, time elapsed since the previous mammogram, history of false-positive recall or biopsy outcome), screening technique (digital mammography, digital breast tomosynthesis), and facility features (profit status, location, screening volume, practice type, academic affiliation) that grouped screening mammograms by recall rate, with ≥12/100 classified as high and ≥16/100 as very high. The efficiency ratio was calculated as the percentage of recalls divided by the percentage of mammograms. The research cohort consisted of 2,674,051 screening mammograms in 925,777 women, with 235,569 recalls. The study found that the primary predictor of recall was the time interval since the last mammogram, followed by age, history of false-positive recall, breast density, history of benign biopsy, and screening method. Recall rates were extremely high for baseline mammograms and high for women with ≥5 years since their previous mammogram. The 9.2% of mammograms in subgroups with very high and high recall rates represented 19.2% of recalls, yielding an efficiency ratio of 2.1 compared to a random strategy. Including women under 50 with dense breasts accounted for 20.3% of mammograms and 33.9% of recalls (efficiency ratio = 1.7). Findings incorporating facility-level characteristics were analogous.
AHRQ-funded; HS018366
Citation: Ho TH, Bissell MCS, Lee CI .
Prioritizing screening mammograms for immediate interpretation and diagnostic evaluation on the basis of risk for recall.
J Am Coll Radiol 2023 Mar;20(3):299-310. doi: 10.1016/j.jacr.2022.09.030.
Keywords: Cancer: Breast Cancer, Cancer, Screening, Imaging, Women, Prevention, Diagnostic Safety and Quality
Hickey EJ, Feinberg E, Kuhn J
Family impact during the time between autism screening and definitive diagnosis.
The purpose of this study was to explore parental perceptions of the impact their child’s behavior had on their family between the time risk of Autism Spectrum Disorder (ASD) was identified and before formal medical diagnosis, and then compare family impact among those whose child met diagnostic criteria for ASD and those who did not. The study found that the parents of children who received a non-ASD diagnosis reported a higher baseline level of family impact. Perception of difficult child behavior was a stronger predictor of family impact than later diagnostic group, and child functioning did not predict family impact. The researchers concluded that in this specific population, perceived difficult child behavior is a stronger predictor of family impact than later diagnostic category.
AHRQ-funded; HS022242.
Citation: Hickey EJ, Feinberg E, Kuhn J .
Family impact during the time between autism screening and definitive diagnosis.
J Autism Dev Disord 2022 Nov;52(11):4908-20. doi: 10.1007/s10803-021-05354-5..
Keywords: Autism, Screening, Diagnostic Safety and Quality
Tice JA, Gard CC, Miglioretti DL
Comparing mammographic density assessed by digital breast tomosynthesis or digital mammography: the Breast Cancer Surveillance Consortium.
This study’s purpose was to assess the consistency of Breast Imaging Reporting and Data System (BI-RADS) breast density reporting comparing digital breast tomosynthesis (DBT) with digital mammography (DM) and to evaluate density as a breast cancer risk factor when assessed using DM versus DBT. A secondary analysis of data from the Breast Cancer Surveillance Consortium was used from 342,149 women aged 40-79 years who underwent at least two screening mammography examinations less than 36 months apart. There were no significant differences in breast density assessment in pairs consisting of one DM and one DBT examination (57,516 of 74,729 [77%]), two DM examinations (238,678 of 301,743 [79%]), and two DBT examinations (20,763 of 26,854). Results were similar when pair analysis was restricted to readings by the same radiologist. The breast cancer hazard ratios (HRs) for breast density were similar for DM and DBT. The HRs for density acquired using DM and DBT, respectively, were 0.55 and 0.37 for almost entirely fat, 1.47 and 1.36 for heterogeneously dense, and 1.72 and 2.05 for extremely dense breasts.
AHRQ-funded; HS018366.
Citation: Tice JA, Gard CC, Miglioretti DL .
Comparing mammographic density assessed by digital breast tomosynthesis or digital mammography: the Breast Cancer Surveillance Consortium.
Radiology 2022 Feb; 302(2):286-92. doi: 10.1148/radiol.2021204579..
Keywords: Cancer: Breast Cancer, Cancer, Women, Imaging, Screening, Diagnostic Safety and Quality
Kuhn J, Levinson Udhnani, MD
What happens after a positive primary care autism screen among historically underserved families? Predictors of evaluation and autism diagnosis.
This study examined predictors of receiving a recommended diagnostic evaluation after a recommended primary care-administered autism screen, and of those who screen positive, who is most likely to be diagnosed with autism. Participants were 309 predominantly low-income, racial/ethnic minority parents and their child aged 15-27 months who screened positive with the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F). Significant predictors of diagnostic evaluation included older parental age, being non-Hispanic and the child having private insurance, lower child communication functioning, or receiving Early Intervention services. Significant predictors of an autism diagnosis included being male, having lower child communication functioning, screening directly in the parent’s preferred language, White/non-Hispanic parent, and no parent history of mood disorder.
AHRQ-funded; HS022242.
Citation: Kuhn J, Levinson Udhnani, MD .
What happens after a positive primary care autism screen among historically underserved families? Predictors of evaluation and autism diagnosis.
J Dev Behav Pediatr 2021 Sep;42(7):515-23. doi: 10.1097/dbp.0000000000000928..
Keywords: Children/Adolescents, Autism, Screening, Vulnerable Populations, Diagnostic Safety and Quality
Thomas TW, Golin C, Samuel-Hodge CD
Race and gender differences in abnormal blood glucose screening and clinician response to prediabetes: a mixed-methods assessment.
The projected three-fold increase in diabetes burden by 2060 in the United States will affect certain race and gender groups disproportionately. The objective of this mixed-methods study was to assess differences in prediabetes screening and clinician response to prediabetes by patient race and gender. The investigators found that qualitatively, physicians reported a non-systematic approach to prediabetes screening and follow-up care related to: 1) System-level barriers to screening and treatment; 2) Implicit bias; 3) Patient factors; and 4) Physician preferences for prediabetes treatment.
AHRQ-funded; HS025561; HS000032.
Citation: Thomas TW, Golin C, Samuel-Hodge CD .
Race and gender differences in abnormal blood glucose screening and clinician response to prediabetes: a mixed-methods assessment.
Prev Med 2021 Jul;148:106587. doi: 10.1016/j.ypmed.2021.106587..
Keywords: Diabetes, Racial and Ethnic Minorities, Screening, Diagnostic Safety and Quality
Asti L, Hopley C, Avelis C
The potential clinical and economic value of a human papillomavirus primary screening test that additionally identifies genotypes 31, 45, 51, and 52 individually.
This study looked at the potential clinical and economic value of a human papillomavirus (HPV) primary screening test that additionally identified genotypes 31,45,51, and 52 along with genotypes 16 and 18. The authors developed a Markov model of the HPV disease course and evaluated the clinical and economic value of HPV primary screening with Onclarity. Currently HPV primary screening results in 25,194 invasive procedures and 48 invasive cervical cancer (ICC) cases per 100,000 women. Screening with extended genotyping and later screening women with certain genotypes averted 903 to 3163 invasive procedures and results in 0 to 3 more ICC cases compared with current primary screening tests. Extended genotyping was cost effective when costing $75 and cost saving when costing $43. When the probabilities of disease progression increased 2-4 times, it was not cost-effective because it resulted in more ICC cases and accrued fewer quality-adjusted life-years.
AHRQ-funded; HS023317.
Citation: Asti L, Hopley C, Avelis C .
The potential clinical and economic value of a human papillomavirus primary screening test that additionally identifies genotypes 31, 45, 51, and 52 individually.
Sex Transm Dis 2021 May;48(5):370-80. doi: 10.1097/olq.0000000000001327.
.
.
Keywords: Sexual Health, Infectious Diseases, Screening, Diagnostic Safety and Quality, Genetics, Cancer: Cervical Cancer, Cancer, Women
Rauscher GH, Murphy AM, Qiu Q
The "sweet spot" revisited: optimal recall rates for cancer detection with 2D and 3D digital screening mammography in the Metro Chicago Breast Cancer Registry.
The authors examined the trade-offs for higher recall rates in terms of biopsy recommendations and cancer detection in mammography in a single large health care organization. 2D analog, 2D digital, and 3D digital mammography screenings among women 40-79 years old with cancer follow-up were examined. They found that the results of their investigation were in contrast to those of a recent study suggesting appropriateness of higher recall rates. They concluded that optimal cancer detection appeared to be in the recall rate range of 7-9% for both 2D digital mammography and 3D tomosynthesis.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Murphy AM, Qiu Q .
The "sweet spot" revisited: optimal recall rates for cancer detection with 2D and 3D digital screening mammography in the Metro Chicago Breast Cancer Registry.
AJR Am J Roentgenol 2021 Apr;216(4):894-902. doi: 10.2214/ajr.19.22429.
.
.
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Diagnostic Safety and Quality, Women, Prevention
Fraiman YS, Wojcik MH
The influence of social determinants of health on the genetic diagnostic odyssey: who remains undiagnosed, why, and to what effect?
This review article synthesizes the available evidence regarding population disparities in genetic testing for pediatric rare disease diagnosis and identifies gaps in care. The influence of social determinants of health is known, but this study’s goal is to examine the prevalence and nature of disparities in diagnostic testing. It synthesizes the available evidence regarding disparities, defining the need for further, prospective studies.
AHRQ-funded; HS000063.
Citation: Fraiman YS, Wojcik MH .
The influence of social determinants of health on the genetic diagnostic odyssey: who remains undiagnosed, why, and to what effect?
Pediatr Res 2021 Jan;89(2):295-300. doi: 10.1038/s41390-020-01151-5..
Keywords: Children/Adolescents, Social Determinants of Health, Genetics, Diagnostic Safety and Quality, Screening, Disparities
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
Rauscher GH, Tossas-Milligan K, Macarol T
Trends in attaining mammography quality benchmarks with repeated participation in a quality measurement program: going beyond the mammography quality standards act to address breast cancer disparities.
The Mammography Quality Standards Act requires that mammography facilities conduct audits, but there are no specifications on the metrics to be measured. In this study, the authors present trends from the first 5 years of data collection to examine whether continued participation in this quality improvement program was associated with an increase in the number of benchmarks met for breast cancer screening.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Tossas-Milligan K, Macarol T .
Trends in attaining mammography quality benchmarks with repeated participation in a quality measurement program: going beyond the mammography quality standards act to address breast cancer disparities.
J Am Coll Radiol 2020 Nov;17(11):1420-28. doi: 10.1016/j.jacr.2020.07.019..
Keywords: Cancer: Breast Cancer, Cancer, Women, Screening, Quality Measures, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Shah SC, Itzkowitz SH
Reappraising risk factors for inflammatory bowel disease-associated neoplasia: implications for colonoscopic surveillance in IBD.
One of the most feared complications of inflammatory bowel disease [IBD]-associated colitis is colorectal cancer. An opportunity for early detection is being missed in a group that is overlooked as high-risk, as a substantial proportion of colorectal cancers are being diagnosed in individuals with colonic IBD who have disease duration shorter than when guidelines recommend surveillance initiation. In this study, the investigators discuss a viewpoint that supports a paradigm shift that will ideally result in a more effective and higher-value colorectal cancer prevention approach in IBD.
AHRQ-funded; HS026395.
Citation: Shah SC, Itzkowitz SH .
Reappraising risk factors for inflammatory bowel disease-associated neoplasia: implications for colonoscopic surveillance in IBD.
J Crohns Colitis 2020 Sep 7;14(8):1172-77. doi: 10.1093/ecco-jcc/jjaa040..
Keywords: Digestive Disease and Health, Risk, Cancer: Colorectal Cancer, Cancer, Colonoscopy, Prevention, Diagnostic Safety and Quality, Screening
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
Gale BM, Hall KK
The use of patient monitoring systems to improve sepsis recognition and outcomes: a systematic review.
This systematic review’s aim was to determine the impact of automated patient monitoring systems (PMSs) on sepsis recognition and outcomes. The review was conducted using articles published from 2008 through 2018. Nineteen articles were identified for inclusion with 4 systematic reviews and 15 individual studies. Study results for outcome measures were mixed, with more than half the studies showing a significant improvement in at least one outcome measure (eg mortality, intensive care unit length of stay, ICU transfer). Evidence for process measure improvement was of moderate strength across multiple hospital units.
AHRQ-funded; 233201500013I.
Citation: Gale BM, Hall KK .
The use of patient monitoring systems to improve sepsis recognition and outcomes: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S8-s11. doi: 10.1097/pts.0000000000000750..
Keywords: Clinical Decision Support (CDS), Sepsis, Diagnostic Safety and Quality, Screening, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Sprague BL, Miglioretti DL, Lee CI
New mammography screening performance metrics based on the entire screening episode.
Established mammography screening performance metrics use the initial screening mammography assessment because they were developed for radiologist performance auditing, yet these metrics are frequently used to inform health policy and screening decision making. The authors developed new performance metrics based on the final assessment that consider the entire screening episode, including diagnostic workup. They concluded that established screening performance metrics underestimated the interval cancer rate of a mammography screening episode, particularly for women with dense breasts or an elevated breast cancer risk.
AHRQ-funded; HS018366.
Citation: Sprague BL, Miglioretti DL, Lee CI .
New mammography screening performance metrics based on the entire screening episode.
Cancer 2020 Jul 15;126(14):3289-96. doi: 10.1002/cncr.32939..
Keywords: Screening, Diagnostic Safety and Quality, Cancer: Breast Cancer, Cancer, Prevention, Women, Provider Performance, Imaging
Pollack LM, Ekwueme DU, Hung MC Pollack LM, Ekwueme DU, Hung MC, Pollack LM, Ekwueme DU, Hung MC Pollack LM, Ekwueme DU, Hung MC, Hung MC
Estimating the impact of increasing cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program among low-income women in the USA.
The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides free cervical cancer screening to low-income women. This study estimated the health benefits gained in terms of life years (LYs) saved and quality-adjusted life years (QALYs) gained if cervical cancer screening by the NBCCEDP increased to reach more eligible women. The investigators found that the reported estimates emphasized the value of cervical cancer screening program by extending LE in low-income women.
Citation: Pollack LM, Ekwueme DU, Hung MC Pollack LM, Ekwueme DU, Hung MC, Pollack LM, Ekwueme DU, Hung MC Pollack LM, Ekwueme DU, Hung MC, Hung MC .
Estimating the impact of increasing cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program among low-income women in the USA.
Cancer Causes Control 2020 Jul;31(7):691-702. doi: 10.1007/s10552-020-01314-z..
Keywords: Medical Expenditure Panel Survey (MEPS), Cancer: Cervical Cancer, Cancer: Breast Cancer, Cancer, Screening, Women, Diagnostic Safety and Quality, Low-Income
Lowry KP, Coley RY, Miglioretti DL
Screening performance of digital breast tomosynthesis vs digital mammography in community practice by patient age, screening round, and breast density.
The purpose of this study was to compare digital mammography (DM) vs digital breast tomosynthesis (DBT) performance by age, baseline vs subsequent screening round, and breast density category. Information was taken from screening examinations at participating Breast Cancer Surveillance Consortium facilities of 1.5 million women aged 40 to 79 with no prior history of breast cancer. Findings showed that improvements in recall and cancer detection rates with DBT were greatest on baseline mammograms. On subsequent screening mammograms, the benefits of DBT varied by age and breast density, and women with extremely dense breasts did not benefit from improved recall or cancer detection with DBT on subsequent screening rounds.
AHRQ-funded; HS018366.
Citation: Lowry KP, Coley RY, Miglioretti DL .
Screening performance of digital breast tomosynthesis vs digital mammography in community practice by patient age, screening round, and breast density.
JAMA Netw Open 2020 Jul;3(7):e2011792. doi: 10.1001/jamanetworkopen.2020.11792..
Keywords: Imaging, Screening, Cancer: Breast Cancer, Cancer, Women, Evidence-Based Practice, Comparative Effectiveness, Diagnostic Safety and Quality
DiPiro PJ, Alper DP, Giess CS
Comparing breast and abdominal subspecialists' follow-up recommendations for incidental liver lesions on breast MRI.
This study compared breast and abdominal subspecialists’ follow-up recommendations following discovery of incidental liver lesions (ILLs) after breast MRI. When breast subspecialists recommended no follow-up abdominal subspecialists agreed with them in 29 out of 30 cases examined, but disagreed with 28 or 30 breast subspecialists’ follow-up recommendations. When breast imagers reported no ILLs, there was 93% agreement with abdominal subspecialists.
AHRQ-funded; HS024722.
Citation: DiPiro PJ, Alper DP, Giess CS .
Comparing breast and abdominal subspecialists' follow-up recommendations for incidental liver lesions on breast MRI.
J Am Coll Radiol 2020 Jun;17(6):773-78. doi: 10.1016/j.jacr.2019.12.024..
Keywords: Imaging, Diagnostic Safety and Quality, Screening, Cancer: Breast Cancer, Cancer, Women
Wu Y, Levis B, Riehm KE
Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. In this study the investigators assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
AHRQ-funded; HS018246.
Citation: Wu Y, Levis B, Riehm KE .
Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis.
Psychol Med 2020 Jun;50(8):1368-80. doi: 10.1017/s0033291719001314..
Keywords: Diagnostic Safety and Quality, Depression, Behavioral Health, Screening
Lacson R, Wang A, Cochon L
Factors associated with optimal follow-up in women with BI-RADS 3 breast findings.
Investigators assessed the rate of and the factors associated with optimal follow-up in patients with BI-RADS 3 breast findings. They found that follow-up of BI-RADS 3 breast imaging findings is optimal in only 74% of women. They recommended further interventions to promote follow-up targeting younger, unmarried women, those with Hispanic ethnicity, and women without history of breast cancer and without insurance coverage.
AHRQ-funded; HS024722.
Citation: Lacson R, Wang A, Cochon L .
Factors associated with optimal follow-up in women with BI-RADS 3 breast findings.
J Am Coll Radiol 2020 Apr;17(4):469-74. doi: 10.1016/j.jacr.2019.10.003..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Screening, Women, Diagnostic Safety and Quality
Sprague BL, Coley RY, Kerlikowske K
Assessment of radiologist performance in breast cancer screening using digital breast tomosynthesis vs digital mammography.
Many US radiologists have screening mammography recall rates above the expert-recommended threshold of 12%. The influence of digital breast tomosynthesis (DBT) on the distribution of radiologist recall rates is uncertain. The objective of this study was to evaluate radiologists' recall and cancer detection rates before and after beginning interpretation of DBT examinations.
AHRQ-funded; HS018366.
Citation: Sprague BL, Coley RY, Kerlikowske K .
Assessment of radiologist performance in breast cancer screening using digital breast tomosynthesis vs digital mammography.
JAMA Netw Open 2020 Mar 2;3(3):e201759. doi: 10.1001/jamanetworkopen.2020.1759..
Keywords: Cancer: Breast Cancer, Cancer, Diagnostic Safety and Quality, Imaging, Screening, Women, Prevention, Provider Performance
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
Murphy CC, Sen A, Watson B
A systematic review of repeat fecal occult blood tests for colorectal cancer screening.
This systematic review examined the prevalence of repeat fecal occult blood tests (FOBT) for colorectal cancer screening. MEDLINE, Embase, and the Cochrane Library were searched for studies published from 1997 to 2017 and reported repeat FOBT over 2 and more screening rounds. Thirty-five articles (n=27) were identified which measured repeat FOBT as 1) proportion of Round 1 participants completing repeat FOBT in Round 2; 2) proportion completing two, consecutive FOBTs; or 3) proportion completing 3 or more rounds. The number of participants completing Round 1 ranged from 24.6% to 89.6%. Those who completed Round 2 ranged from 16.4% to 80%; and completion of 3 or more rounds ranged from 0.8% to 64.1%. Repeat FOBT was higher in mailed outreach than opportunistic screening.
AHRQ-funded; HS022418.
Citation: Murphy CC, Sen A, Watson B .
A systematic review of repeat fecal occult blood tests for colorectal cancer screening.
Cancer Epidemiol Biomarkers Prev 2020 Feb;29(2):278-87. doi: 10.1158/1055-9965.Epi-19-0775..
Keywords: Cancer: Colorectal Cancer, Cancer, Screening, Diagnostic Safety and Quality, Prevention, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Evidence-Based Practice
Klawetter S, McNitt C, Hoffman JA
Perinatal depression in low-income women: a literature review and innovative screening approach.
This paper is a literature review of perinatal depression prevalence, consequences, and screening among low-income women and women of color. The Warm Connections program has an innovative perinatal depression screening protocol and was used with WIC participants. The literature showed mixed findings of perinatal prevalence among low-income women and women of color. There were lower perinatal depression rates in the Warm Connections program in studies using less specific perinatal depression screening instruments with similar samples.
AHRQ-funded; HS026370.
Citation: Klawetter S, McNitt C, Hoffman JA .
Perinatal depression in low-income women: a literature review and innovative screening approach.
Curr Psychiatry Rep 2020 Jan 7;22(1):1. doi: 10.1007/s11920-019-1126-9.
.
.
Keywords: Depression, Pregnancy, Women, Low-Income, Social Determinants of Health, Screening, Behavioral Health, Maternal Care, Disparities, Diagnostic Safety and Quality
Samples H, Stuart EA, Saloner B
The role of screening in depression diagnosis and treatment in a representative sample of US primary care visits.
This study aimed to examine depression screening patterns and the role of screening in depression diagnosis and treatment in the outpatient primary care setting. The investigators found that physicians appeared to use depression screening selectively based on patients' presenting symptoms. Higher screening rates were associated with higher odds of depression diagnosis and treatment. The investigators suggest that even modest increases in screening rates could meaningfully increase population-level rates of depression identification and treatment in primary care.
AHRQ-funded; HS000029.
Citation: Samples H, Stuart EA, Saloner B .
The role of screening in depression diagnosis and treatment in a representative sample of US primary care visits.
J Gen Intern Med 2020 Jan;35(1):12-20. doi: 10.1007/s11606-019-05192-3..
Keywords: Depression, Behavioral Health, Diagnostic Safety and Quality, Primary Care, Screening, Ambulatory Care and Surgery
Richards JE, Bobb JF, Lee AK
Integration of screening, assessment, and treatment for cannabis and other drug use disorders in primary care: an evaluation in three pilot sites.
This pilot study examined whether integrating evidence-based implementation strategies to implement Behavioral Health Integration (BHI) into primary care to increase diagnosis and treatment of substance use disorders (SUDs). Three pilot sites were used and patients were given annual screening for past-year cannabis and drug use, a Symptom Checklist for DSM-5 SUDs, and shared decision-making about different treatment options. Out of 39,599 eligible patients, almost 60% were screened for cannabis and other drug use. Daily cannabis use was reported with 2% of patients, and other drug use 1%. Of those patients, 51% and 37% completed an SUD Symptom Checklist. There was a higher proportion of patients diagnosed with cannabis use disorder (CUD) but not drug use disorder. However, the reverse was true for patients receiving treatment for drug-use disorders.
AHRQ-funded; HS023173.
Citation: Richards JE, Bobb JF, Lee AK .
Integration of screening, assessment, and treatment for cannabis and other drug use disorders in primary care: an evaluation in three pilot sites.
Drug Alcohol Depend 2019 Aug 1;201:134-41. doi: 10.1016/j.drugalcdep.2019.04.015..
Keywords: Substance Abuse, Behavioral Health, Evidence-Based Practice, Primary Care, Patient-Centered Healthcare, Screening, Diagnostic Safety and Quality