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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 20 of 20 Research Studies DisplayedMahmud A, Cushing-Haugen K, Wellman R
Understanding the relationship between social risk factors and COVID-19 contacts.
The purpose of this study was to facilitate researchers’ understanding of the prevalence of patients' social risk factors during the pandemic and recognize how social risks may intensify COVID-19. Between January and September 2020, the researchers conducted a national survey of Kaiser Permanente members and analyzed only the data from those who responded to a set of COVID-19 survey items. The survey included questions on their experiences with social risks, whether they knew of people with COVID-19, if COVID-19 affected their emotional and mental health, and their preferred type of assistance. The study found that 62% of respondents reported social risks, with 38% reporting having 2 or more social risks. The most common response was financial strain (45%). One third of respondents reported one or more contact types with COVID-19. respondents with 2 or more COVID-19 contact types reported higher rates of housing instability, financial strain, food insecurity, and social isolation than those with fewer contacts. Fifty percent of respondents reported that COVID-19 affected their emotional, mental health negatively, and 19% of respondents noted that it affected their ability to maintain a job.
AHRQ-funded; HS013853.
Citation: Mahmud A, Cushing-Haugen K, Wellman R .
Understanding the relationship between social risk factors and COVID-19 contacts.
Perm J 2023 Jun 15; 27(2):18-22. doi: 10.7812/tpp/22.146..
Keywords: COVID-19, Risk, Public Health, Infectious Diseases
Holmer HK, Mackey K, Fiordalisi CV
Major update 2: antibody response and risk for reinfection after SARS-CoV-2 infection-final update of a living, rapid review.
This paper is a final updated living rapid review to synthesize evidence on the SARS-CoV-2 antibody response and reinfection risk with a focus on gaps identified in the author’s prior reports. A literature review was done for English-language cohort studies evaluating IgG antibody duration at least 12 months after SARS-CoV-2 infection, the antibody response among immunocompromised adults, predictors of nonseroconversion, and reinfection risk. Study data was extracted and two investigators rated quality. Most adults had IgG antibodies after SARS-CoV-2 infection at time points greater than 12 months. Although most immunocompromised adults develop antibodies, the overall proportion with antibodies is lower compared with immunocompetent adults. Prior infection provided substantial, sustained protection against symptomatic reinfection with the Delta variant (high strength of evidence) and reduced the risk for severe disease due to Omicron variant (moderate strength of evidence). Prior infection was less protective against reinfection with Omicron overall (moderate strength of evidence), but protection from earlier variants waned rapidly (low strength of evidence).
AHRQ-funded; 290201700003C.
Citation: Holmer HK, Mackey K, Fiordalisi CV .
Major update 2: antibody response and risk for reinfection after SARS-CoV-2 infection-final update of a living, rapid review.
Ann Intern Med 2023 Jan; 176(1):85-91. doi: 10.7326/m22-1745..
Keywords: COVID-19, Evidence-Based Practice, Infectious Diseases, Risk
Miller AC, Koeneman SH, Arakkal AT
Incidence, duration, and risk factors associated with missed opportunities to diagnose herpes simplex encephalitis: a population-based longitudinal study.
This retrospective cohort study determined the frequency and duration of diagnostic delays for herpes simplex encephalitis (HSE) that are associated with increased morbidity and mortality. Data from the IBM Marketscan Databases from 2001-2017 was used. The authors estimated the number of visits with HSE-related symptoms before diagnosis that would be expected to occur in the absence of delays and compared this estimate to the observed pattern of visits. Then a simulation-based approach was used to compute the number of visits representing a delay. They identified 2667 patients diagnosed with HSE and estimated 45.9% of patients experienced at least 1 missed opportunity, with 21.9% of patients having delays lasting >7 days. Risk factors for delays included being seen only in the emergency department, age 65 or older, or a history of sinusitis or schizophrenia.
AHRQ-funded; HS027375.
Citation: Miller AC, Koeneman SH, Arakkal AT .
Incidence, duration, and risk factors associated with missed opportunities to diagnose herpes simplex encephalitis: a population-based longitudinal study.
Open Forum Infect Dis 2021 Sep;8(9):ofab400. doi: 10.1093/ofid/ofab400..
Keywords: Infectious Diseases, Neurological Disorders, Diagnostic Safety and Quality, Risk
Michelson KA, Neuman MI, Pruitt CM
Height of fever and invasive bacterial infection.
This study evaluated the association of higher fevers with invasive bacterial infection (IBI) among febrile infants ≤60 days of age. Maximum temperatures of febrile infants with IBI were compared to infants without IBI. The median temperature was higher for infants with IBI (38.8°C) compared to those without IBI (38.4°C). Temperatures ranges of 39°C-39.4°C and 39.5°C-39.9°C were associated with a higher likelihood of IBI, although 30.4% of febrile infants with IBI had maximum temperatures <38.5°C.
AHRQ-funded; HS026006; HS026503.
Citation: Michelson KA, Neuman MI, Pruitt CM .
Height of fever and invasive bacterial infection.
Arch Dis Child 2021 Jun;106(6):594-96. doi: 10.1136/archdischild-2019-318548..
Keywords: Newborns/Infants, Infectious Diseases, Diagnostic Safety and Quality, Risk
Lin CY, Xie J, Freedman SB
Predicting adverse outcomes for Shiga toxin-producing Escherichia coli infections in emergency departments.
Investigators assessed the performance of a hemolytic uremic syndrome (HUS) severity score among children with Shiga toxin-producing Escherichia coli (STEC) infections and HUS by stratifying them according to their risk of adverse events. They found that the HUS severity score was able to discriminate between high- and low-risk children less than 5 years old with STEC-associated HUS at a statistically acceptable level; however, it did not appear to provide clinical benefit at a meaningful risk threshold.
AHRQ-funded; HS026503.
Citation: Lin CY, Xie J, Freedman SB .
Predicting adverse outcomes for Shiga toxin-producing Escherichia coli infections in emergency departments.
J Pediatr 2021 May;232:200-06.e4. doi: 10.1016/j.jpeds.2020.12.077..
Keywords: Children/Adolescents, Infectious Diseases, Emergency Department, Risk
Bramante CT, Ingraham NE, Murray TA
Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis.
This study examined whether metformin use by patients with diagnosed with type 2 diabetes had reduced mortality when hospitalized for COVID-19. Pharmacy claims data from UnitedHealth Group’s Clinical Discovery Claims Database was used. Patient data were included if they were aged 18 years or older; had type 2 diabetes or obesity (defined based on claims); at least 6 months of continuous enrolment in 2019; and admission to hospital for COVID-19 confirmed by PCR; manual chart review by UHG; or reported from the hospital to UHG. Metformin was not associated with significant reduction in mortality among men, but there was an association with decreased mortality in women.
AHRQ-funded; HS026379.
Citation: Bramante CT, Ingraham NE, Murray TA .
Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis.
Lancet Healthy Longev 2021 Jan;2(1):e34-e41. doi: 10.1016/s2666-7568(20)30033-7..
Keywords: COVID-19, Hospitalization, Medication, Mortality, Risk, Diabetes, Chronic Conditions, Public Health, Infectious Diseases
Selden TM, Berdahl TA
AHRQ Author: Selden TM, Berdahl TA
Risk of severe COVID-19 among workers and their household members.
Using prepandemic MEPS data, the investigators examined the prevalence of Centers for Disease Control and Prevention (CDC) risk factors for severe coronavirus disease 2019 (COVID-19). They then estimated how many adults at increased risk of severe COVID-19 held essential jobs and could not work at home (WAH) or who lived in households with such workers.
AHRQ-authored.
Citation: Selden TM, Berdahl TA .
Risk of severe COVID-19 among workers and their household members.
JAMA Intern Med 2021 Jan;181(1):120-22. doi: 10.1001/jamainternmed.2020.6249..
Keywords: Medical Expenditure Panel Survey (MEPS), COVID-19, Risk, Public Health, Infectious Diseases
Selden TM, Berdahl TA, Fang Z
AHRQ Author: Selden TM, Berdahl TA, Fang Z
The risk of severe COVID-19 within households of school employees and school-age children.
Across the United States, school districts are grappling with questions of whether and how to reopen elementary and secondary schools in the 2020-21 academic year. Using pre-pandemic household data, the authors examined how often persons at risk of severe coronavirus disease 2019 (COVID-19) were connected to schools, either as employees or by living in the same households as school employees or school-age children.
AHRQ-authored.
Citation: Selden TM, Berdahl TA, Fang Z .
The risk of severe COVID-19 within households of school employees and school-age children.
Health Aff 2020 Nov;39(11):2002-09. doi: 10.1377/hlthaff.2020.01536..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, COVID-19, Public Health, Risk, Infectious Diseases
Misra-Hebert AD, Ji X, Nowacki AS
Impact of the COVID-19 pandemic on healthcare workers' risk of infection and outcomes in a large, integrated health system.
Researchers assessed healthcare workers (HCW) risk for COVID-19 infection, hospitalization, and intensive care unit (ICU) admission. Participants were individuals who had tested for SARS-CoV-2 infection in a large academic healthcare system. The study found that, in a large healthcare system, HCW had similar odds for testing positive, but lower odds of hospitalization, compared to non-HCW. Patient-facing HCW had higher odds of a positive test.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Ji X, Nowacki AS .
Impact of the COVID-19 pandemic on healthcare workers' risk of infection and outcomes in a large, integrated health system.
J Gen Intern Med 2020 Nov;35(11):3293-301. doi: 10.1007/s11606-020-06171-9..
Keywords: COVID-19, Risk, Provider: Health Personnel, Public Health, Healthcare Delivery, Infectious Diseases
Sheinfil AZ, Giguere R, Dolezal C
Information and motivation predict HIV-serostatus among a population of high-risk men and transgender women who have sex with men.
In this study, two constructs from the information-motivation-behavioral skills model were used to predict HIV-serostatus among a sample of men and transgender women who have sex with men. Hypotheses were that lower levels of HIV knowledge and lower levels of motivation to remain HIV-negative would be associated with an increased likelihood of receiving a positive HIV test result at a study eligibility-screening session.
AHRQ-funded; HS026383.
Citation: Sheinfil AZ, Giguere R, Dolezal C .
Information and motivation predict HIV-serostatus among a population of high-risk men and transgender women who have sex with men.
AIDS Behav 2020 Oct;24(10):2863-71. doi: 10.1007/s10461-020-02835-z..
Keywords: Human Immunodeficiency Virus (HIV), Sexual Health, Infectious Diseases, Risk
Shang J, Russell D, Dowding D
A predictive risk model for infection-related hospitalization among home healthcare patients.
Infection prevention is a high priority for home healthcare (HHC), but tools are lacking to identify patients at highest risk of developing infections. The purpose of this study was to develop and test a predictive risk model to identify HHC patients at risk of an infection-related hospitalization or emergency department visit. A nonexperimental study using secondary data was conducted.
AHRQ-funded; HS024723.
Citation: Shang J, Russell D, Dowding D .
A predictive risk model for infection-related hospitalization among home healthcare patients.
J Healthc Qual 2020 May/Jun;42(3):136-47. doi: 10.1097/jhq.0000000000000214..
Keywords: Elderly, Home Healthcare, Infectious Diseases, Community-Acquired Infections, Risk, Hospitalization, Emergency Department
Patel SA, Araujo T, Rodriguez LP
Long peripheral catheters: a retrospective review of major complications.
The risk of infectious and noninfectious complications associated with long peripheral catheters (LPCs) is unknown. In this retrospective study of 539 catheters, the investigators did a retrospective review of major complications. Among other discoveries, they found LPCs were often placed for the indications of difficult access and long-term antibiotics.
AHRQ-funded; HS025891.
Citation: Patel SA, Araujo T, Rodriguez LP .
Long peripheral catheters: a retrospective review of major complications.
J Hosp Med 2019 Dec;14(12):758-60. doi: 10.12788/jhm.3313..
Keywords: Healthcare-Associated Infections (HAIs), Adverse Events, Patient Safety, Central Line-Associated Bloodstream Infections (CLABSI), Blood Clots, Infectious Diseases, Risk
Cruz AT, Nigrovic LE, Xie J
Predictors of invasive herpes simplex virus infection in young infants.
This study’s objective was to identify independent predictors of invasive herpes simplex virus (HSV) infection in infants aged 60 days or less. This 23-center nested case-control study matched 149 infants with HSV to 1340 controls. All were 60 days or less old and had cerebrospinal fluid obtained within 24 hours of presentation or had HSV detected. Of the 149 infants with HSV, 90 had invasive and 59 had skin, eyes, and mouth disease. Predictors independently associated with invasive HSV included younger age (<28 days), prematurity, seizure at home, ill appearance, abnormal triage temperature, vesicular rash, thrombocytopenia, and cerebrospinal fluid pleocytosis. Infants with invasive HSV had a higher median risk score than those without invasive HSV.
AHRQ-funded; HS026006; HS025138.
Citation: Cruz AT, Nigrovic LE, Xie J .
Predictors of invasive herpes simplex virus infection in young infants.
Pediatrics 2021 Sep;148(3). doi: 10.1542/peds.2021-050052..
Keywords: Newborns/Infants, Infectious Diseases, Risk
Obodozie-Ofoegbu OO, Teng C, Mortensen EM
Antipseudomonal monotherapy or combination therapy for older adults with community-onset pneumonia and multidrug-resistant risk factors: a retrospective cohort study.
Infectious Diseases Society of America guidelines recommend empiric antipseudomonal combination therapy when Pseudomonas is suspected. However, combination antipseudomonal therapy is controversial. This population-based retrospective cohort study compared all-cause 30-day mortality in older patients who received antipseudomonal monotherapy (PMT) or antipseudomonal combination therapy (PCT) for the treatment of community-onset pneumonia. The investigators found that older adults who received combination antipseudomonal therapy for community-onset pneumonia fared worse than those who received monotherapy.
AHRQ-funded; HS022418.
Citation: Obodozie-Ofoegbu OO, Teng C, Mortensen EM .
Antipseudomonal monotherapy or combination therapy for older adults with community-onset pneumonia and multidrug-resistant risk factors: a retrospective cohort study.
Am J Infect Control 2019 Sep;47(9):1053-58. doi: 10.1016/j.ajic.2019.02.018..
Keywords: Antibiotics, Community-Acquired Infections, Elderly, Infectious Diseases, Medication, Pneumonia, Risk
Tourani R, Murphree DH, Melton-Meaux G
The value of aggregated high-resolution intraoperative data for predicting post-surgical infectious complications at two independent sites.
Surgical procedures carry the risk of postoperative infectious complications, which can be severe, expensive, and morbid. A growing body of evidence indicates that high-resolution intraoperative data can be predictive of these complications. However, these studies are often contradictory in their findings. In this work, data and models from two independent institutions, Mayo Clinic and University of Minnesota-affiliated Fairview Health Services, were directly compared using a common set of definitions for the variables and outcomes.
AHRQ-funded; HS024532.
Citation: Tourani R, Murphree DH, Melton-Meaux G .
The value of aggregated high-resolution intraoperative data for predicting post-surgical infectious complications at two independent sites.
Stud Health Technol Inform 2019 Aug 21;264:398-402. doi: 10.3233/shti190251..
Keywords: Surgery, Adverse Events, Risk, Infectious Diseases, Healthcare-Associated Infections (HAIs)
Ren Z, Laumann AE, Silverberg JI
Association of dermatomyositis with systemic and opportunistic infections in the United States.
This study examined whether dermatomyositis is associated with opportunistic and antibiotic-resistant infections. Data was analyzed from the Nationwide Inpatient Sample from 2002 to 2012 with a cross-sectional representative 20% sample of all hospitalizations in the US. There was an association found with serious infections in adults and children, with more associated with adults. Infections were found in the skin, bone, joints, brain, heart, lungs, and gastrointestinal system. Predictors of infections included non-white race/ethnicity, insurance status, history of long-term corticosteroid usage, Cushing’s syndrome, diabetes and cancer. This in turn caused higher odds, costs, and inpatient mortality from these infections.
AHRQ-funded; HS023011.
Citation: Ren Z, Laumann AE, Silverberg JI .
Association of dermatomyositis with systemic and opportunistic infections in the United States.
Arch Dermatol Res 2019 Jul;311(5):377-87. doi: 10.1007/s00403-019-01913-0..
Keywords: Antibiotics, Healthcare Cost and Utilization Project (HCUP), Infectious Diseases, Risk, Skin Conditions
Goodman KE, Lessler J, Harris AD
A methodological comparison of risk scores versus decision trees for predicting drug-resistant infections: a case study using extended-spectrum beta-lactamase (ESBL) bacteremia.
Timely identification of multidrug-resistant gram-negative infections remains an epidemiological challenge. Statistical models for predicting drug resistance can offer utility where rapid diagnostics are unavailable or resource-impractical. The investigators previously reported on a decision tree for predicting extended-spectrum beta-lactamase bloodstream (ESBL) infections. Their objective in the current study was to develop a risk score from the same ESBL dataset to compare these 2 methods and to offer general guiding principles for using each approach.
AHRQ-funded; HS025089.
Citation: Goodman KE, Lessler J, Harris AD .
A methodological comparison of risk scores versus decision trees for predicting drug-resistant infections: a case study using extended-spectrum beta-lactamase (ESBL) bacteremia.
Infect Control Hosp Epidemiol 2019 Apr;40(4):400-07. doi: 10.1017/ice.2019.17..
Keywords: Research Methodologies, Risk, Infectious Diseases
Goodman KE, Simner PJ, Klein EY
How frequently are hospitalized patients colonized with carbapenem-resistant
This study evaluated whether hospitalized patients who tested positive for carbapenem-resistant Enteriobacteriaceae (CRE) were on contact precautions so that staff and other patients would not risk transmission. Since CRE colonization at admission was infrequent, there is some risk of transmission.
AHRQ-funded; HS025089.
Citation: Goodman KE, Simner PJ, Klein EY .
How frequently are hospitalized patients colonized with carbapenem-resistant
Infect Control Hosp Epidemiol 2018 Dec;39(12):1491-93. doi: 10.1017/ice.2018.236..
Keywords: Hospitalization, Hospitals, Infectious Diseases, Prevention, Risk
Yun H, Yang S, Chen L
Risk of herpes zoster in autoimmune and inflammatory diseases: implications for vaccination.
This study was undertaken to evaluate the age-stratified incidence of herpes zoster (HZ) in patients with autoimmune or inflammatory (AI) diseases as compared to older adults for whom the HZ vaccine is currently recommended by the US Centers for Disease Control and Prevention. The researchers found that systemic lupus erythematosus, inflammatory bowel disease, and rheumatoid arthritis are AI diseases associated with a higher risk of HZ compared to that in older adults for whom vaccination is currently recommended, suggesting that individuals with these conditions who are as young as age 40 years could potentially benefit from the HZ vaccine.
AHRQ-funded; HS021694; HS018517.
Citation: Yun H, Yang S, Chen L .
Risk of herpes zoster in autoimmune and inflammatory diseases: implications for vaccination.
Arthritis Rheumatol 2016 Sep;68(9):2328-37. doi: 10.1002/art.39670.
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Keywords: Infectious Diseases, Prevention, Arthritis, Risk, Sexual Health, Vaccination
Muenks CE, Hogan PG, Wang JW
Diversity of Staphylococcus aureus strains colonizing various niches of the human body.
The objectives of this study were to determine whether S. aureus polyclonal colonization exists within one body niche and to determine the optimal sampling sites and culture methodology to capture the diversity of S. aureus strains in community-dwelling individuals. The researchers found S. aureus polyclonality within a single body niche and that culture methodology and sampling sites influenced the analytical sensitivity of S. aureus colonization detection and the robustness of phenotypic and genotypic strain recovery.
AHRQ-funded; HS021736; HS024269.
Citation: Muenks CE, Hogan PG, Wang JW .
Diversity of Staphylococcus aureus strains colonizing various niches of the human body.
J Infect 2016 Jun;72(6):698-705. doi: 10.1016/j.jinf.2016.03.015.
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Keywords: Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA), Risk