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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
201 to 225 of 321 Research Studies DisplayedGartlehner G, Nussbaumer-Streit B, Wagner G
Increased risks for random errors are common in outcomes graded as high certainty of evidence.
The goal of this article was to assess the risk for random errors in outcomes graded as high certainty of evidence (CoE). Results showed that, overall, 38% of high CoE outcomes had increased risks for random errors. Outcomes assessing harms were more frequently affected than outcomes assessing benefits. Regrading of outcomes with increased random errors showed that 74% should have been downgraded based on current guidance. Recommendations included being aware that outcomes rated as high CoE often have increased risks for false-positive or false-negative findings.
AHRQ-funded; HS024749.
Citation: Gartlehner G, Nussbaumer-Streit B, Wagner G .
Increased risks for random errors are common in outcomes graded as high certainty of evidence.
J Clin Epidemiol 2019 Feb;106:50-59. doi: 10.1016/j.jclinepi.2018.10.009..
Keywords: Evidence-Based Practice, Health Services Research (HSR), Patient-Centered Outcomes Research, Research Methodologies
Cykert S, DeWalt DA, Weiner BJ
A population approach using cholesterol imputation to identify adults with high cardiovascular risk: a report from AHRQ's EvidenceNow initiative.
Investigators estimated cholesterol scores for patients between the ages of 40 and 79 in large practice electronic health networks who did not have that in their electronic health record (EHR). This data was used to calculate 10-year Assessment of Cardiovascular Disease Risk (ASCVD) risk scores for patients in 219 practices. They estimated the scores using both “good value’ estimation methodology and formal imputation. The “good value” estimation methodology resulted in less patients with risk scores than imputation but it had higher specificity and a lower false positive rate.
AHRQ-funded; HS023912.
Citation: Cykert S, DeWalt DA, Weiner BJ .
A population approach using cholesterol imputation to identify adults with high cardiovascular risk: a report from AHRQ's EvidenceNow initiative.
J Am Med Inform Assoc 2019 Feb;26(2):155-58. doi: 10.1093/jamia/ocy151..
Keywords: Cardiovascular Conditions, Electronic Health Records (EHRs), Heart Disease and Health, Evidence-Based Practice, Health Information Technology (HIT), Patient-Centered Outcomes Research, Quality Improvement
Yuo TH, Wallace JR, Fish L
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
This study compared outcomes of different revascularization surgeries among end stage renal disease (ESRD) patients with peripheral arterial disease (PAD). There is a high risk of complications for this surgery. Outcomes of endovascular revascularization (ER) and open surgical revascularisation (OSR) were compared. Outcomes measured included mortality and major amputation. There is a lower mortality risk for ER versus OSR. OSR has better 30-day limb salvage although there are similar long-term outcomes.
AHRQ-funded; HS019486.
Citation: Yuo TH, Wallace JR, Fish L .
Editor's choice - comparison of outcomes after open surgical and endovascular lower extremity revascularisation among end stage renal disease patients on dialysis.
Eur J Vasc Endovasc Surg 2019 Feb;57(2):248-57. doi: 10.1016/j.ejvs.2018.09.008..
Keywords: Adverse Events, Cardiovascular Conditions, Comparative Effectiveness, Dialysis, Evidence-Based Practice, Kidney Disease and Health, Mortality, Outcomes, Patient-Centered Outcomes Research, Risk, Surgery
Mathew SJ, Wilkinson ST, Altinay M
ELEctroconvulsive therapy (ECT) vs. Ketamine in patients with treatment-resistant depression: The ELEKT-D study protocol.
This article discusses the protocol that will be used for an ongoing study to compare electroconvulsive therapy (ECT) vs. ketamine for patients with treatment-resistant major depressive disorder (MDD). The study is being called ELEKT-D. Patients will be randomized between thrice-weekly ECT treatments or intravenous ketamine given twice weekly for 3-5 weeks. The objective of the study is to determine if ketamine will retain 90% of the ECT treatment effect. Additional outcomes to be measured include remission rates, depression severity, cognitive functioning, quality of live, adverse events, and tolerability.
AHRQ-funded; HS023000.
Citation: Mathew SJ, Wilkinson ST, Altinay M .
ELEctroconvulsive therapy (ECT) vs. Ketamine in patients with treatment-resistant depression: The ELEKT-D study protocol.
Contemp Clin Trials 2019 Feb;77:19-26. doi: 10.1016/j.cct.2018.12.009..
Keywords: Depression, Behavioral Health, Medication, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Lowenstern A, Al-Khatib SM, Sharan L
Interventions for preventing thromboembolic events in patients with atrial fibrillation: a systematic review.
The purpose of this review was to compare the effectiveness of therapies to prevent thromboembolic events and bleeding complications in adults with nonvalvular atrial fibrillation (AF). Two independent reviewers screened citations in order to identify comparative studies of treatments to prevent stroke in adults with nonvalvular AF who reported thromboembolic or bleeding complications, then abstracted data from 220 selected articles, assessed study quality and applicability, and rated the strength of evidence. The article concludes that available direct-acting oral anticoagulants (DOACs) are at least as effective and safe as warfarin for patients with nonvalvular AF and had similar benefits across several patient subgroups.
AHRQ-funded; 290201500004I.
Citation: Lowenstern A, Al-Khatib SM, Sharan L .
Interventions for preventing thromboembolic events in patients with atrial fibrillation: a systematic review.
Ann Intern Med 2018 Dec 4;169(11):774-87. doi: 10.7326/m18-1523..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Blood Thinners, Adverse Drug Events (ADE), Adverse Events, Medication, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Adelgais KM, Hansen M, Lerner EB
Establishing the key outcomes for pediatric emergency medical services research.
The evidence supporting best practices when treating children in the prehospital setting or even the effect emergency medical services (EMS) has on patient outcomes is limited. This article describes a consensus process among stakeholders in the pediatric emergency medicine and EMS community that identified the critical outcomes for EMS care in five clinical areas (traumatic brain injury, general injury, respiratory disease/failure, sepsis, and seizures).
AHRQ-funded; HS026101.
Citation: Adelgais KM, Hansen M, Lerner EB .
Establishing the key outcomes for pediatric emergency medical services research.
Acad Emerg Med 2018 Dec;25(12):1345-54. doi: 10.1111/acem.13637..
Keywords: Children/Adolescents, Emergency Medical Services (EMS), Evidence-Based Practice, Health Services Research (HSR), Outcomes, Patient-Centered Outcomes Research
Ishimine P, Adelgais K, Barata I
Executive summary: the 2018 Academic Emergency Medicine Consensus Conference: Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps.
Emergency care providers share a compelling interest in developing an effective patient-centered, outcomes-based research agenda that can decrease variability in pediatric outcomes. The 2018 Academic Emergency Medicine Consensus Conference "Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps (AEMCC)" aimed to fulfill this role. This paper discusses the conference which convened major thought leaders and stakeholders to introduce a research, scholarship, and innovation agenda for pediatric emergency care specifically to reduce health outcome gaps.
AHRQ-funded; HS026101.
Citation: Ishimine P, Adelgais K, Barata I .
Executive summary: the 2018 Academic Emergency Medicine Consensus Conference: Aligning the Pediatric Emergency Medicine Research Agenda to Reduce Health Outcome Gaps.
Acad Emerg Med 2018 Dec;25(12):1317-26. doi: 10.1111/acem.13667..
Keywords: Implementation, Evidence-Based Practice, Patient-Centered Outcomes Research, Children/Adolescents, Emergency Department, Outcomes, Research Methodologies
Hornor MA, Liu JY, Hu QL
Surgical technical evidence review for acute appendectomy conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery.
This evidence review uses enhanced recovery pathways (ERPs) protocols developed for the AHRQ-funded Safety Program for Improving Surgical Care and Recovery (ISCR Program) to develop ERPs for acute appendectomy surgery. The authors classified appendicitis into uncomplicated (nonperforated) and complicated (perforated or gangrenous) to help with risk stratification. They identified 13 components for appendectomy for review. The processes are organized by perioperative phase, and each phase includes the rationale, evidence review, summary of guidelines, and a recommendation summary of the evidence for or against inclusion in the ERP. Preoperative management components included: education and counseling; preoperative antibiotics; initial nonsurgical management for perforated appendicitis with abscess or phlegmon, venous thromboembolism prophylaxis, delay for operation for 12-24 hours for uncomplicated appendicitis. Intraoperative management components include: laparoscopic surgical technique, peritoneal drain placement, urinary catheter placement, and prophylactic nasogastric tube insertion. Postoperative management components include same-day surgery discharge for uncomplicated appendicitis, antibiotics, early oral alimentation, and early mobilization. Of the ERPs reviewed: there was no evidence to support the routine use of abdominal drainage in patients undergoing appendectomies, urinary catheter insertion for laparoscopic surgery, use of prophylactic nasogastric tube placement, postoperative antibiotic use for uncomplicated appendicitis, and early oral alimentation for uncomplicated appendicitis.
AHRQ-funded.
Citation: Hornor MA, Liu JY, Hu QL .
Surgical technical evidence review for acute appendectomy conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2018 Dec;227(6):605-17.e2. doi: 10.1016/j.jamcollsurg.2018.09.024..
Keywords: Surgery, Quality Improvement, Quality of Care, Patient Safety, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Morrow AS, Whiteside SP, Sim LA
Developing tools to enhance the use of systematic reviews for clinical care in health systems.
The researchers’ goal was to develop tools to facilitate the uptake of evidence as summarized in systematic reviews by clinical decisionmakers in health systems. After they conducted a systematic review on the management of anxiety in children, the researchers interviewed health system representatives, clinicians and patients to gain additional information about decisionmaking. Two decision-aid tools - one for the health system and the other for the clinical encounter - were then developed using stakeholders' feedback and literature searches. The health system decision aid provided information on patients who were candidates for treatment, values and preferences, costs and resources, acceptability, impact on health equity, feasibility, drug dosing, alternative therapies, remission rates, and prognosis. The encounter decision aid was produced as a set of cards that contained information on the issues that drive treatment decisions. Health system stakeholders found the first decision aid useful, and patients, parents, and clinicians found the second to be helpful.
AHRQ-funded; 290201500013I; 29032001T.
Citation: Morrow AS, Whiteside SP, Sim LA .
Developing tools to enhance the use of systematic reviews for clinical care in health systems.
BMJ Evid Based Med 2018 Dec;23(6):206-09. doi: 10.1136/bmjebm-2018-110995..
Keywords: Children/Adolescents, Decision Making, Evidence-Based Practice, Patient-Centered Outcomes Research, Implementation
Borre ED, Goode A, Raitz G
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
This systematic review compared the strength of tools to predict stroke and bleeding risk in patients with atrial fibrillation (AF) taking blood thinners. Sixty-one studies were found to predict thromboembolic risk and 38 to predict bleeding risk.
AHRQ-funded; 290201500004I.
Citation: Borre ED, Goode A, Raitz G .
Predicting thromboembolic and bleeding event risk in patients with non-valvular atrial fibrillation: a systematic review.
Thromb Haemost 2018 Dec;118(12):2171-87. doi: 10.1055/s-0038-1675400..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Stroke, Blood Clots, Blood Thinners, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient-Centered Outcomes Research, Evidence-Based Practice
Magrath M, Yang E, Ahn C
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
The goal of this study was to characterize guideline adherence of surveillance recommendations after implementation of an electronic medical record (EMR)-based Colonoscopy Pathology Reporting and Clinical Decision Support System (CoRS). Results showed that an EMR-based CoRS was widely used and significantly improved guideline adherence of surveillance recommendations.
AHRQ-funded; HS022418.
Citation: Magrath M, Yang E, Ahn C .
Impact of a clinical decision support system on guideline adherence of surveillance recommendations for colonoscopy after polypectomy.
J Natl Compr Canc Netw 2018 Nov;16(11):1321-28. doi: 10.6004/jnccn.2018.7050..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Colonoscopy, Cancer: Colorectal Cancer, Screening, Cancer, Guidelines, Evidence-Based Practice, Patient-Centered Outcomes Research, Prevention
Desai AD, Simon TD, Leyenaar JK
Utilizing family-centered process and outcome measures to assess hospital-to-home transition quality.
This commentary describes the success of using 8 new caregiver-reported measures to assess the quality of hospital- and emergency department (ED)-to-home transitions in pediatric patients. This measures were originally created by the national Pediatric Quality Measures Program mandated by the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). An original article describing these measures was published 2016 and there have been several follow-up studies. These measures are undergoing further testing.
AHRQ-funded; HS024133; HS024299; HS020506.
Citation: Desai AD, Simon TD, Leyenaar JK .
Utilizing family-centered process and outcome measures to assess hospital-to-home transition quality.
Acad Pediatr 2018 Nov - Dec;18(8):843-46. doi: 10.1016/j.acap.2018.07.013..
Keywords: Hospital Discharge, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Transitions of Care, Quality of Care, Quality Measures, Quality Improvement, Children's Health Insurance Program (CHIP), Evidence-Based Practice
Ma X, Lin L, Qu Z
Performance of between-study heterogeneity measures in the Cochrane Library.
The growth in comparative effectiveness research and evidence-based medicine has increased attention to systematic reviews and meta-analyses. Assessing heterogeneity is critical for performing a meta-analysis and interpreting results. This article evaluates two heterogeneity measures. To evaluate these measures' performance empirically, the investigators applied them to 20,599 meta-analyses in the Cochrane Library.
AHRQ-funded; HS024743.
Citation: Ma X, Lin L, Qu Z .
Performance of between-study heterogeneity measures in the Cochrane Library.
Epidemiology 2018 Nov;29(6):821-24. doi: 10.1097/ede.0000000000000857..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies
Drucker AM, Adam GP, Rofeberg V
Treatments of primary basal cell carcinoma of the skin: a systematic review and network meta-analysis.
The purpose of the study was to evaluate the comparative effectiveness and safety of treatments of primary basal cell carcinoma (BCC) in adults. The investigators concluded that surgical treatments and external-beam radiation have low recurrence rates for the treatment of low-risk BCC, but substantial uncertainty exists about their comparative effectiveness versus other treatments. Gaps remain regarding high-risk BCC subtypes and important outcomes, including costs.
AHRQ-funded; 290201500002I.
Citation: Drucker AM, Adam GP, Rofeberg V .
Treatments of primary basal cell carcinoma of the skin: a systematic review and network meta-analysis.
Ann Intern Med 2018 Oct 2;169(7):456-66. doi: 10.7326/m18-0678.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Cancer: Skin Cancer, Treatments
Lee T, Qian J, Thamer M
Tradeoffs in vascular access selection in elderly patients initiating hemodialysis with a catheter.
In this study the investigators evaluated clinically relevant vascular access outcomes in elderly patients receiving an arteriovenous fistulas (AVF) or arteriovenous grafts AVG after hemodialysis therapy initiation. The investigators found that in elderly hemodialysis patients initiating hemodialysis therapy with a catheter, the optimal vascular access selection depended on tradeoffs between shorter catheter dependence and less frequent interventions to make the vascular access (AVG) functional versus longer access patency and fewer interventions after successful use of the vascular access (AVF).
AHRQ-funded; HS022931; HS021229.
Citation: Lee T, Qian J, Thamer M .
Tradeoffs in vascular access selection in elderly patients initiating hemodialysis with a catheter.
Am J Kidney Dis 2018 Oct;72(4):509-18. doi: 10.1053/j.ajkd.2018.03.023..
Keywords: Dialysis, Kidney Disease and Health, Elderly, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Baldwin LM, Fischer MA, Powell J
Virtual educational outreach intervention in primary care based on the principles of academic detailing.
This paper describes the efforts of the Healthy Hearts Northwest (H2N) EvidenceNOW cooperative in providing virtual outreach intervention in primary care based on the principles of academic detailing (AD). EvidenceNOW is AHRQ’s initiative to fund seven regional cooperatives to identify and implement effective strategies to improve the quality of cardiovascular care in communities across the United States. The H2N network covers three states: Oregon, Washington, and Idaho. For this initiative they recruited 259 primary care practices that had 10 full-time or fewer providers and met stage 1 electronic health record meaningful use criteria. The aim was to increase adoption of the four ABCS of heart disease prevention: Aspirin use by high-risk individuals, Blood pressure control, Cholesterol management, and Smoking cessation. Due to the long distances and staffing limitations H2N decided to develop an educational outreach program using virtual visits instead of the traditional AD program structure. The findings and outcomes of this program is described in detail in this paper.
AHRQ-funded; HS023236; HS023908.
Citation: Baldwin LM, Fischer MA, Powell J .
Virtual educational outreach intervention in primary care based on the principles of academic detailing.
J Contin Educ Health Prof 2018 Fall;38(4):269-75. doi: 10.1097/ceh.0000000000000224..
Keywords: Cardiovascular Conditions, Heart Disease and Health, Evidence-Based Practice, Primary Care, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research, Outcomes, Prevention
Mentias A, Shantha G, Chaudhury P
Assessment of outcomes of treatment with oral anticoagulants in patients with atrial fibrillation and multiple chronic conditions: a comparative effectiveness analysis.
The purpose of this retrospective comparative effectiveness analysis was to determine whether there are differences in efficacy and safety of dabigatran, rivaroxaban, and warfarin regarding stroke prevention and bleeding rates, respectively, in elderly patients with atrial fibrillation (AF) with multiple chronic conditions (MCC). The investigators concluded that oral anticoagulants were similarly effective in stroke prevention among patients with AF with MCC. However, the indicate that dabigatran and rivaroxaban use may be associated with lower rates of mortality in patients with MCC.
AHRQ-funded; HS023104.
Citation: Mentias A, Shantha G, Chaudhury P .
Assessment of outcomes of treatment with oral anticoagulants in patients with atrial fibrillation and multiple chronic conditions: a comparative effectiveness analysis.
JAMA Netw Open 2018 Sep 7;1(5):e182870. doi: 10.1001/jamanetworkopen.2018.2870..
Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Outcomes, Patient-Centered Outcomes Research, Medication, Evidence-Based Practice, Comparative Effectiveness, Chronic Conditions
Lee DJ, Barocas DA, Zhao Z
Contemporary prostate cancer radiation therapy in the United States: patterns of care and compliance with quality measures.
This study measured compliance with quality measures for radiation therapy treatment of prostate cancer. The Comparative Effectiveness Analysis of Surgery and Radiation Study enrolled men who were treated for localized prostate cancer from 2011 and 2012. Medical records were reviewed, and patients completed surveys. Researchers concluded that men who received external beam radiation therapy (EBRT) were treated more appropriately than those treated with brachytherapy (BT). White men were also more likely to receive appropriate treatment than African-American and other minorities.
AHRQ-funded; HS019356; HS022640.
Citation: Lee DJ, Barocas DA, Zhao Z .
Contemporary prostate cancer radiation therapy in the United States: patterns of care and compliance with quality measures.
Pract Radiat Oncol 2018 Sep-Oct;8(5):307-16. doi: 10.1016/j.prro.2018.04.009..
Keywords: Cancer, Cancer: Prostate Cancer, Comparative Effectiveness, Evidence-Based Practice, Guidelines, Patient-Centered Outcomes Research, Practice Patterns, Quality Measures
Lin SY, Azar A, Suarez-Cuervo C
Role of sublingual immunotherapy in the treatment of asthma: an updated systematic review.
This systematic review analyzed a number of studies on sublingual immunotherapy treatment (SLIT) for asthma caused by allergies. Fourteen randomized control trials (RCTs) studies were identified to analyze effective for allergies of house mites, birch, and grasses. However, a total of 20 RCTs and 10 observational studies were identified and used in this review. The review showed moderate-to-high strength evidence that SLIT is effective in improving allergic asthma symptoms. It also reduced long-term medication use and improved FEV1.
AHRQ-funded; 290201500006I.
Citation: Lin SY, Azar A, Suarez-Cuervo C .
Role of sublingual immunotherapy in the treatment of asthma: an updated systematic review.
Int Forum Allergy Rhinol 2018 Sep;8(9):982-92. doi: 10.1002/alr.22152..
Keywords: Asthma, Evidence-Based Practice, Patient-Centered Outcomes Research, Treatments
Glass JE, Bobb JF, Lee AL
Study protocol: a cluster-randomized trial implementing Sustained Patient-centered Alcohol-related Care (SPARC trial).
Implementation researchers and clinical leaders at Kaiser Permanente Washington (KPWA) partnered to design a high-quality program of evidence-based care for unhealthy alcohol use: the Sustained Patient-centered Alcohol-related Care (SPARC) program. This paper describes the cluster-randomized trial implementing SPARC.
AHRQ-funded; HS023173.
Citation: Glass JE, Bobb JF, Lee AL .
Study protocol: a cluster-randomized trial implementing Sustained Patient-centered Alcohol-related Care (SPARC trial).
Implement Sci 2018 Aug 6;13(1):108. doi: 10.1186/s13012-018-0795-9..
Keywords: Alcohol Use, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Primary Care
Beg MS, Gupta A, Sher D
Impact of concurrent medication use on pancreatic cancer survival-SEER-Medicare analysis.
Researchers examined the association of several medication classes on pancreatic cancer survival, using data from the Surveillance, Epidemiology, and End Results-Medicare database. They found that the use of beta-blockers, heparin, insulin, and warfarin were associated with improved survival in patients with pancreatic cancer, whereas metformin, thiazolidinedione, statin, and combination therapies were not. The authors recommended additional studies to validate these findings in the clinical setting.
AHRQ-funded; HS022418.
Citation: Beg MS, Gupta A, Sher D .
Impact of concurrent medication use on pancreatic cancer survival-SEER-Medicare analysis.
Impact of concurrent medication use on pancreatic cancer survival-SEER-Medicare analysis..
Keywords: Cancer, Medication, Mortality, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Ciolino JD, Jackson KL, Liss DT
Design of Healthy Hearts in the Heartland (H3): a practice-randomized, comparative effectiveness study.
The Healthy Hearts in the Heartland (H3) study is part of a nationwide effort, EvidenceNOW, seeking to better understand the ability of small primary care practices to improve "ABCS" clinical quality measures: appropriate Aspirin therapy, Blood pressure control, Cholesterol management, and Smoking cessation. In this paper, the authors describe the design and randomization of the H3 study.
AHRQ-funded; HS023921.
Citation: Ciolino JD, Jackson KL, Liss DT .
Design of Healthy Hearts in the Heartland (H3): a practice-randomized, comparative effectiveness study.
Contemp Clin Trials 2018 Aug;71:47-54. doi: 10.1016/j.cct.2018.06.004..
Keywords: Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Heart Disease and Health, Prevention, Primary Care, Quality of Care, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Angraal S, Khera R, Wang Y
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
The authors sought to evaluate how the use of coronary artery bypass grafting (CABG) and its outcomes have evolved in different sex and racial subgroups. Using Medicare data, they found that women and black patients had persistently higher CABG mortality than men and white patients, respectively, despite greater declines over the time period. The authors conclude that these findings indicate progress, but further progress is needed.
AHRQ-funded; HS023000.
Citation: Angraal S, Khera R, Wang Y .
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
J Am Heart Assoc 2018 Jul 12;7(14). doi: 10.1161/jaha.118.009014..
Keywords: Cardiovascular Conditions, Elderly, Evidence-Based Practice, Heart Disease and Health, Healthcare Utilization, Medicare, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities, Sex Factors
Tyson MD, Koyama T, Lee D
Effect of prostate cancer severity on functional outcomes after localized treatment: comparative effectiveness analysis of surgery and radiation study results.
The purpose of this study was to determine whether differences in predicted function over time between radical prostatectomy (RP) or external beam radiotherapy (EBRT) for localized cancer varied by risk group. Patient-reported, disease-specific function was measured using the Expanded Prostate Index Composite and predicted function was estimated using regression models, compared by disease risk. The study found that sexual function was similar between surgery and radiation for patients with high-risk disease, and the authors conclude that high-risk patients undergoing radiation therapy should be counseled that their sexual function may not be as good as low-risk patients also undergoing radiation.
AHRQ-funded; HS019356; HS022640.
Citation: Tyson MD, Koyama T, Lee D .
Effect of prostate cancer severity on functional outcomes after localized treatment: comparative effectiveness analysis of surgery and radiation study results.
Eur Urol 2018 Jul;74(1):26-33. doi: 10.1016/j.eururo.2018.02.012..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Treatments, Surgery, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Wu P, Escobar GJ, Gebretsadik T
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
This retrospective cohort study examined the effectiveness of respiratory syncytial virus (RSV) prophylaxis for infants born between 1996 and 2008. The infants were enrolled in the Kaiser Permanente Northern California integrated health system. Infants who ever received RSV immunoprophylaxis had a 32% decreased risk of bronchiolitis hospitalization and finants with chronic lung disease (CLD) had a 52% decreased risk. The 2014 American Academy of Pediatrics (AAP) guidelines changed recommendations for RSV immunoprophylaxis which made 48% of infants no longer eligible but nearly all infants with CLD would remain eligible.
AHRQ-funded; HS018454.
Citation: Wu P, Escobar GJ, Gebretsadik T .
Effectiveness of respiratory syncytial virus immunoprophylaxis in reducing bronchiolitis hospitalizations among high-risk infants.
Am J Epidemiol 2018 Jul;187(7):1490-500. doi: 10.1093/aje/kwy008..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Hospitalization, Newborns/Infants, Outcomes, Patient-Centered Outcomes Research, Prevention, Respiratory Conditions, Risk