National Healthcare Quality and Disparities Report
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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
26 to 40 of 40 Research Studies DisplayedKhorfan R, Schlick CJR, Yang AD
Utilization of minimally invasive surgery and its association with chemotherapy for locally advanced gastric cancer.
This study compared outcomes of patients with T3 or greater and/or N+ gastric carcinoma who had minimally invasive surgery (MIS) or traditional open surgery. Patients who received MIS had a greater likelihood of receiving postoperative chemotherapy. Patients from the National Cancer Database (21,872) from 2010 to 2015 were identified. The majority (72.2%) received open surgery although MIS rates went up during that time period. Predictors of MIS were Asian race, any insurance coverage and treatment at high-volume centers. Survival rates were higher for MIS patients although that could be explained by their increased likelihood of receiving adjuvant chemotherapy.
AHRQ-funded; HS026385.
Citation: Khorfan R, Schlick CJR, Yang AD .
Utilization of minimally invasive surgery and its association with chemotherapy for locally advanced gastric cancer.
J Gastrointest Surg 2020 Feb;24(2):243-52. doi: 10.1007/s11605-019-04410-x.
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Keywords: Surgery, Treatments, Cancer, Digestive Disease and Health, Healthcare Utilization, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Hoffman KE, Penson DF, Zhao Z
Patient-reported outcomes through 5 years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer.
This study compared different treatment of men with favorable-risk prostate cancer and those with unfavorable-risk disease and their functional outcomes 5 years post-treatment. Treatment options for favorable-risk disease include active surveillance, nerve-sparing prostatectomy, external beam radiation therapy (EBRT), or low-dose-rate brachytherapy with prostatectomy being the most common. Treatment options for men with unfavorable-risk disease is prostatectomy or EBRT with androgen deprivation therapy (ADT). The cohort analyzed included men diagnosed with prostate cancer in 2011 through 2012, accrued from 5 Surveillance, Epidemiology and End Results Program sites and a US prostate cancer registry, using surveys through September 2017. A total of 2005 men met inclusion criteria. For men with favorable-risk disease low-dose-rate brachytherapy was associated with worse urinary irritative, and sexual and bowel function at 1 year compared with active surveillance. Nerve-sparing prostatectomy was associated with worse urinary incontinence at 5 years and sexual function at 3 years compared with active surveillance. EBRT was not associated with clinically different function changes from active surveillance at any point during the 5 years. For men with unfavorable-risk disease, EBRT with ADT was associated with lower hormonal function at 6 months, bowel function at 1 year, but better sexual function and incontinence than prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Hoffman KE, Penson DF, Zhao Z .
Patient-reported outcomes through 5 years for active surveillance, surgery, brachytherapy, or external beam radiation with or without androgen deprivation therapy for localized prostate cancer.
JAMA 2020 Jan 14;323(2):149-63. doi: 10.1001/jama.2019.20675..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Treatments, Men's Health, Adverse Events, Surgery
Parsons HM, Forte ML, Abdi HI
Nutrition as prevention for improved cancer health outcomes: a systematic literature review.
This systematic review examined evidence for the effectiveness of providing nutritional interventions before or during cancer therapy to improve cancer treatment outcomes. The studies examined focused primarily on non-vitamin/mineral dietary supplements, nutrition support, and route or timing of inpatient nutrition interventions for patients with gastrointestinal or head and neck cancer; most of the studies evaluated changes in body weight, adverse events from cancer treatment, length of hospital stay, or quality of life. While studies with low- or medium risk-of-bias reported mixed results on the effect of nutritional interventions, the authors concluded that the methodological limitations impair the translation of study findings into clinical practice or guidelines.
AHRQ-funded; 75Q80120D00008.
Citation: Parsons HM, Forte ML, Abdi HI .
Nutrition as prevention for improved cancer health outcomes: a systematic literature review.
JNCI Cancer Spectr 2023 May 2; 7(3):pkad035. doi: 10.1093/jncics/pkad035..
Keywords: Nutrition, Cancer, Prevention, Quality of Life, Evidence-Based Practice, Patient-Centered Outcomes Research
Mullins BT, Basak R, Broughman JR
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
This study compares the effects of different types of radical prostatectomy and radiotherapy on sexual function. A population-based cohort of 835 men with newly diagnosed prostate cancer from 2011 through 2013 was recruited in collaboration with the Rapid Case Ascertainment system of the North Carolina Central Cancer Registry. They were enrolled prior to treatment and followed retrospectively using the validated Prostate Cancer Symptom Indices (PCSI) instrument. The sexual function scores were compared among patients who received the following treatment types: external-beam RT (EBRT), EBRT with androgen deprivation therapy (ADT), brachytherapy, nerve-sparing radical prostatectomy (RP), and non-nerve-sparing RP. The cohort was surveyed at 24 months post-therapy, and RT alone was found to result in the best preservation of sexual function with brachytherapy, RT with ADT, and nerve-sparing RP yielding similar outcomes. Patients treated with non-nerve-sparing RP experienced the worst sexual function outcome.
AHRQ-funded.
Citation: Mullins BT, Basak R, Broughman JR .
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
Cancer 2019 Oct 15;125(20):3657-65. doi: 10.1002/cncr.32288..
Keywords: Quality of Life, Sexual Health, Surgery, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Cancer: Prostate Cancer, Cancer, Evidence-Based Practice
Niu X, Amendola LM, Hart R
Clinical exome sequencing vs. usual care for hereditary colorectal cancer diagnosis: a pilot comparative effectiveness study.
The purpose of this study was to evaluate clinical exome sequencing (CES) compared to usual care (UC) in the diagnostic work-up of inherited colorectal cancer/polyposis (CRCP) in a randomized controlled trial (RCT). The investigators indicate that their results suggest that CES provides similar clinical benefits to multi-gene panels in the diagnosis of hereditary CRCP.
AHRQ-funded; HS021686.
Citation: Niu X, Amendola LM, Hart R .
Clinical exome sequencing vs. usual care for hereditary colorectal cancer diagnosis: a pilot comparative effectiveness study.
Contemp Clin Trials 2019 Sep;84:105820. doi: 10.1016/j.cct.2019.105820..
Keywords: Cancer: Colorectal Cancer, Cancer, Diagnostic Safety and Quality, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Yanez B, Bouchard LC, Cella D
Patient-centered engagement and symptom/toxicity monitoring in the new era of tumor next-generation sequencing and immunotherapy: the OncoTool and OncoPRO platforms.
This paper describes the development of the OncoTool and OncoPRO platforms to help patients with late-stage cancer (stages III-IV) and their providers in providing patient-centered education and remote and routine monitoring of symptoms and toxicities after tumor next-generation sequencing testing and treatment. The OncoTool is a web-based educational resource tailored for people with advanced cancer. It aims to provide patients with easy-to-understand treatment options and associated toxicities as well as evidence-based strategies for managing symptoms and improving stress management. It is fully integrated with OncoPRO which provides feedback on patient-reported outcomes (PROs) to clinicians. The data from the platform can be integrated with the patient’s electronic health record (HER) and can provide an alert message. These systems are currently being tested with 4 trials – 1 for OncoTool and the other 3 for OncoPRO.
AHRQ-funded; HS023011.
Citation: Yanez B, Bouchard LC, Cella D .
Patient-centered engagement and symptom/toxicity monitoring in the new era of tumor next-generation sequencing and immunotherapy: the OncoTool and OncoPRO platforms.
Cancer 2019 Jul 15;125(14):2338-44. doi: 10.1002/cncr.32030..
Keywords: Cancer, Education: Patient and Caregiver, Electronic Health Records (EHRs), Evidence-Based Practice, Health Information Technology (HIT), Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient and Family Engagement
Millar MM, Kinney AY, Camp NJ
Predictors of response outcomes for research recruitment through a central cancer registry: evidence from 17 recruitment efforts for population-based studies.
The authors conducted multivariable mixed-effects logistic regression to identify case and study characteristics associated with making contact with and obtaining cooperation of Utah cancer cases. They found that characteristics associated with lower odds of contact included Hispanic ethnicity, nonwhite race, and younger age at contact. Years since diagnosis was inversely associated with making contact. Increased odds of cooperation were associated with including a questionnaire, postage stamps, and incentives. They concluded that obtaining high response is challenging, but study features identified in this analysis support better results when recruiting through central cancer registries.
AHRQ-funded; HS019356; HS022640.
Citation: Millar MM, Kinney AY, Camp NJ .
Predictors of response outcomes for research recruitment through a central cancer registry: evidence from 17 recruitment efforts for population-based studies.
Am J Epidemiol 2019 May;188(5):928-39. doi: 10.1093/aje/kwz011..
Keywords: Cancer, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Outcomes, Research Methodologies
Schmidt B, Eapen RS, Cowan JE
Practice patterns of primary EBRT with and without ADT in prostate cancer treatment.
This study investigated usage of external-beam radiation therapy (EBRT), with or without neoadjuvant androgen deprivation therapy (ADT), using data from a community-based prospective disease registry (CaPSURE). Data on 1337 men diagnosed between 1990 and 2014 with localized disease who received EBRT as primary treatment was compared. The authors conclude that use of ADT in conjunction with primary EBRT has increased in frequency and duration since 1990, and that men who received ADT have higher risk characteristics than those who receive EBRT alone.
AHRQ-funded; HS019356.
Citation: Schmidt B, Eapen RS, Cowan JE .
Practice patterns of primary EBRT with and without ADT in prostate cancer treatment.
Prostate Cancer Prostatic Dis 2019 Mar;22(1):117-24. doi: 10.1038/s41391-018-0084-3..
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research, Practice Patterns, Evidence-Based Practice, Comparative Effectiveness, Outcomes, Treatments
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
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
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
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
Semenkovich TR, Panni RZ, Hudson JL
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
This study examined comparative effectiveness and survival rates for upfront esophagectomy versus induction chemoradiation in patients with clinical stage T2N20 esophageal cancer. A decision analysis model was created for the two treatment strategies. Results showed comparable median survival rates for both strategies. The optimal treatment strategy depended on the accuracy of endoscopic ultrasound staging.
AHRQ-funded; HS022330.
Citation: Semenkovich TR, Panni RZ, Hudson JL .
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
J Thorac Cardiovasc Surg 2018 May;155(5):2221-30.e1. doi: 10.1016/j.jtcvs.2018.01.006..
Keywords: Treatments, Cancer, Surgery, Comparative Effectiveness, Decision Making, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes, Medication
Patel HD, Iyoha E, Pierorazio PM
A systematic review of research gaps in the evaluation and management of localized renal masses.
The authors conducted a systematic review to summarize research gaps for the evaluation of composite models for predicting malignancy; use of percutaneous renal sampling for diagnosis; and comparative effectiveness of surgery, thermal ablation, and active surveillance. They recommended incorporation of emerging biomarkers into validated composite models, standardization of biopsy protocols, standard reporting of clinical stage, and performance of prospective studies with objective selection criteria.
AHRQ-funded; 290201200007I.
Citation: Patel HD, Iyoha E, Pierorazio PM .
A systematic review of research gaps in the evaluation and management of localized renal masses.
Urology 2016 Dec;98:14-20. doi: 10.1016/j.urology.2016.08.013.
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Keywords: Cancer, Evidence-Based Practice, Patient-Centered Outcomes Research, Quality Indicators (QIs), Research Methodologies
Gerber DE, Pruitt SL, Halm EA
Should criteria for inclusion in cancer clinical trials be expanded?
The authors argue that the time is right to take a more evidence-based approach to assessing the validity of many traditional exclusion criteria for cancer clinical trials. Furthermore, for investigators, it is critically important that their selection of inclusion and exclusion criteria be thoughtful, deliberate and justified. To accomplish this, they will need to use an array of methodological approaches to assess their validity and impact.
AHRQ-funded; HS022418.
Citation: Gerber DE, Pruitt SL, Halm EA .
Should criteria for inclusion in cancer clinical trials be expanded?
J Comp Eff Res 2015;4(4):289-91. doi: 10.2217/cer.15.27..
Keywords: Evidence-Based Practice, Research Methodologies, Cancer, Comparative Effectiveness, Patient-Centered Outcomes Research