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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.
Results1 to 6 of 6 Research Studies Displayed
Schuttner L, Haraldsson B, Maynard C
Factors associated with low-value cancer screenings in the Veterans Health Administration.
Most clinical practice guidelines recommend stopping cancer screenings when risks exceed benefits, yet low-value screenings persist. The Veterans Health Administration focuses on improving the value and quality of care, using a patient-centered medical home model that may affect cancer screening behavior. The objective of this study was to understand rates and factors associated with outpatient low-value cancer screenings.
Citation: Schuttner L, Haraldsson B, Maynard C . Factors associated with low-value cancer screenings in the Veterans Health Administration. JAMA Netw Open 2021 Oct;4(10):e2130581. doi: 10.1001/jamanetworkopen.2021.30581..
Keywords: Veterans, Screening, Value, Cancer
Spalluto LB, Lewis JA, Stolldorf D
Organizational readiness for lung cancer screening: a cross-sectional evaluation at a Veterans Affairs medical center.
Lung cancer has the highest cancer-related mortality in the United States and among Veterans. Screening of high-risk individuals with low-dose CT (LDCT) can improve survival through detection of early-stage lung cancer. Organizational factors that aid or impede implementation of this evidence-based practice in diverse populations are not well described. In this study, the investigators evaluated organizational readiness for change and change valence (belief that change is beneficial and valuable) for implementation of LDCT screening.
Citation: Spalluto LB, Lewis JA, Stolldorf D . Organizational readiness for lung cancer screening: a cross-sectional evaluation at a Veterans Affairs medical center. J Am Coll Radiol 2021 Jun;18(6):809-19. doi: 10.1016/j.jacr.2020.12.010..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Veterans, Implementation, Organizational Change
Danan ER, White KM, Wilt TJ
Reactions to recommendations and evidence about prostate cancer screening among White and Black male veterans.
This study looked at differences in attitudes about recommendations and evidence on prostate cancer screening among White and Black male veterans. The authors provided a draft educational pamphlet about the benefits and harms of Prostate Specific Antigen (PSA) screening to 44 men, ages 55-81 at a midwestern VA medical center in 2013 and 2015. The groups were divided into four White and two Black focus groups. Three universal themes were low baseline familiarity with prostate cancer, surprise and resistance to the guidelines not to test routinely, and negative emotions in response to ambiguity. Discussions in the White groups highlighted the potential benefits of screening, minimized the harms, and emphasized personal choice in screening decisions. Discussions in Black groups devoted almost no time to benefits, considered harms significant, and emphasized personal and collective responsibility for cancer prevention through diet, exercise, and alternative medicine. Discussion in Black groups also emphasized the history of racism and discrimination in healthcare and medical research.
Citation: Danan ER, White KM, Wilt TJ . Reactions to recommendations and evidence about prostate cancer screening among White and Black male veterans. Am J Mens Health 2021 May-Jun;15(3):15579883211022110. doi: 10.1177/15579883211022110..
Keywords: Veterans, Cancer: Prostate Cancer, Cancer, Screening, Prevention, Racial / Ethnic Minorities, Evidence-Based Practice, Health Promotion, Education: Patient and Caregiver
Clark BJ, Rubinsky AD, Ho PM
Alcohol screening scores and the risk of intensive care unit admission and hospital readmission.
This study sought to determine whether alcohol misuse was associated with admission to an intensive care unit (ICU) among patients receiving outpatient care. Among 486,115 veterans receiving outpatient care, the adjusted probability of ICU admission within 1 year was 2.0 percent for abstinent patients, 1.6 percent for patients with lower-risk alcohol use, 1.8 percent for patients with moderate alcohol misuse, and 2.5 percent for patients with severe alcohol misuse.
Citation: Clark BJ, Rubinsky AD, Ho PM . Alcohol screening scores and the risk of intensive care unit admission and hospital readmission. Subst Abus 2016 Jul-Sep;37(3):466-73. doi: 10.1080/08897077.2015.1137259.
Keywords: Alcohol Use, Hospital Readmissions, Intensive Care Unit (ICU), Ambulatory Care and Surgery, Screening, Substance Abuse, Veterans
Williams EC, Achtmeyer CE, Young JP
Local implementation of alcohol screening and brief intervention at five Veterans Health Administration primary care clinics: Perspectives of clinical and administrative staff.
The researchers conducted a qualitative key informant study to describe local implementation of alcohol screening and brief intervention from the perspectives of frontline adopters in VA primary care . Findings suggest that the local process of implementing alcohol screening and brief intervention may have inadequately addressed important adopter needs.
Citation: Williams EC, Achtmeyer CE, Young JP . Local implementation of alcohol screening and brief intervention at five Veterans Health Administration primary care clinics: Perspectives of clinical and administrative staff. J Subst Abuse Treat 2016 Jan;60:27-35. doi: 10.1016/j.jsat.2015.07.011.
Keywords: Alcohol Use, Screening, Veterans, Primary Care
Lapham GT, Rubinsky AD, Williams EC
Decreasing sensitivity of clinical alcohol screening with the AUDIT-C after repeated negative screens in VA clinics.
The purpose of this study was to evaluate the performance of repeat annual clinical alcohol screening in 4 samples of VA outpatients with 1–4 prior consecutive negative annual screens. It found that among patients with repeated negative clinical alcohol screens, the proportion who subsequently screened positive a year later was low and decreased as patients had more prior negative screens.
Citation: Lapham GT, Rubinsky AD, Williams EC . Decreasing sensitivity of clinical alcohol screening with the AUDIT-C after repeated negative screens in VA clinics. Drug Alcohol Depend 2014 Sep 1;142:209-15. doi: 10.1016/j.drugalcdep.2014.06.017..
Keywords: Screening, Alcohol Use, Substance Abuse, Veterans