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Search All Research Studies
Topics
- Adverse Events (3)
- Antibiotics (1)
- Cardiovascular Conditions (1)
- Caregiving (1)
- Children/Adolescents (7)
- Comparative Effectiveness (4)
- Critical Care (2)
- Evidence-Based Practice (6)
- Guidelines (4)
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- Labor and Delivery (1)
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- (-) Newborns/Infants (16)
- Nutrition (1)
- Outcomes (7)
- (-) Patient-Centered Outcomes Research (16)
- Patient Safety (1)
- Pregnancy (2)
- Prevention (2)
- Quality Improvement (1)
- Quality of Care (1)
- Respiratory Conditions (3)
- Risk (1)
- Screening (1)
- Sexual Health (1)
- Skin Conditions (1)
- Surgery (1)
- Teams (1)
- Urinary Tract Infection (UTI) (1)
- Vulnerable Populations (1)
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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 16 of 16 Research Studies DisplayedBossick AS, Painter I, Williams EC
Development of a composite risk index of reproductive autonomy using state laws: association with maternal and neonatal outcomes.
This study investigated whether greater reproductive autonomy would be associated with lower rates of severe maternal morbidity (SMM), pregnancy-related mortality (PRM), preterm birth (PTB), and low birthweight. It was hypothesized that greater reproductive autonomy would lower the risks of poor maternal and neonatal outcomes. The authors developed a composite index to quantify state legislation, which was used to examine the association with maternal and neonatal outcomes. A Delphi panel was used to inform index development, and restrictive policies were assigned values of -1 and enabling policies +1. Publicly available data was used to conduct a cross-sectional study of all live births in the 50 US states for people ages 15 to 44 from 2016 to 2018 to examine the association between the risk index and PRM, SMM, PTB, and low birthweight. There were 11,530,785 births, 2,846 pregnancy-related deaths, and 154,384 cases of SMM from 2016 to 2018. The Delphi panel found a summed state measure of 106 laws in 8 categories that could affect reproductive anatomy. In adjusted analyses, states in the most enabling reproductive autonomy quartile had a 44.7 per 10,000 higher rate of SMM compared with the most restrictive quartile. However, the most enabling quartile was associated with a 9.87 per 100,000 lower rate of PRM and 0.67 per 100 lower rate of PTB compared with the most restrictive quartile.
AHRQ-funded; HS013853.
Citation: Bossick AS, Painter I, Williams EC .
Development of a composite risk index of reproductive autonomy using state laws: association with maternal and neonatal outcomes.
Womens Health Issues 2023 Jul-Aug; 33(4):359-66. doi: 10.1016/j.whi.2023.03.008..
Keywords: Maternal Care, Sexual Health, Women, Newborns/Infants, Outcomes, Patient-Centered Outcomes Research
Balk EM, Danilack VA, Bhuma MR
Reduced compared with traditional schedules for routine antenatal visits: a systematic review.
This systematic review’s objective was to assess differences in maternal and child outcomes in studies comparing reduced routine antenatal visit schedules with traditional schedules. The search was conducted in multiple databases searching for antenatal (prenatal) care, pregnancy, obstetrics, telemedicine, remote care, smartphones, telemonitoring, and related terms. Abstrackr was used for double independent screening for studies comparing televisits and in person routine antenatal care visits for maternal, child, health care utilization, and harm outcomes. The authors found five randomized controlled trials and five nonrandomized comparative studies that compared reduced routine antenatal visit schedules with traditional schedules. The studies did not find differences between schedules in gestational age at birth, likelihood of being small for gestational age, likelihood of a low Apgar score, likelihood of neonatal intensive care unit admission, maternal anxiety, likelihood of preterm birth, and likelihood of low birth weight. There was also insufficient evidence for numerous prioritized outcomes of interest, including completion of the American College of Obstetricians and Gynecologists-recommended services and patient experience measures.
AHRQ-funded; 75Q80120D00001.
Citation: Balk EM, Danilack VA, Bhuma MR .
Reduced compared with traditional schedules for routine antenatal visits: a systematic review.
Obstet Gynecol 2023 Jul 1; 142(1):8-18. doi: 10.1097/aog.0000000000005193..
Keywords: Maternal Care, Newborns/Infants, Women, Patient-Centered Outcomes Research, Outcomes, Comparative Effectiveness, Evidence-Based Practice
Aronson PL, Fleischer E, Schaeffer P
Development of a parent-reported outcome measure for febrile infants ≤60 days old.
This study’s aim was to develop a patient-reported outcome measure for febrile infants 60 days or younger evaluated in the emergency department. This 3-part study included: 1) individual, semistructured interviews with parents of febrile infants 60 days or younger to generate potential items for the measure; 2) expert review with pediatric emergency medicine physicians and member checking with parents, and 3) cognitive interviews with a new sample of parents who gave feedback and rated the measure’s ease of use on a 4-point scale. In part 1 24 parents of 21 infants were interviewed. The interviews revealed several themes: parents' experiences with medical care, communication, and decision making; parents' emotions, particularly worry, fear, and stress; the infant's outcomes valued by parents; and the impact of the infant's illness on the family, from which 22 potential items for inclusion were identified. In part 2, 10 items were revised for clarity based on feedback from physicians and parents. In part 3, the authors further revised the measure for clarity and added an item. The final measure included 23 items.
AHRQ-funded; HS026006.
Citation: Aronson PL, Fleischer E, Schaeffer P .
Development of a parent-reported outcome measure for febrile infants ≤60 days old.
Pediatr Emerg Care 2022 Feb;38(2):e821-e27. doi: 10.1097/pec.0000000000002378.
Keywords: Newborns/Infants, Patient-Centered Outcomes Research, Outcomes
Greenhawt M, Shaker M
Determining levers of cost-effectiveness for screening infants at high risk for peanut sensitization before early peanut introduction.
The authors sought to identify scenarios in which current early peanut introduction guidelines would be cost-effective. They found that the current screening approach to early peanut introduction could be cost-effective at a particular health utility for an in-clinic reaction, skin prick test sensitivity and specificity, and high baseline peanut allergy prevalence among high-risk infants. However, such conditions are unlikely to be plausible to achieve realistically. They recommend further research to define the health state utility associated with reaction location.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Shaker M .
Determining levers of cost-effectiveness for screening infants at high risk for peanut sensitization before early peanut introduction.
JAMA Netw Open 2019 Dec 2;2(12):e1918041. doi: 10.1001/jamanetworkopen.2019.18041..
Keywords: Patient-Centered Outcomes Research, Newborns/Infants, Children/Adolescents, Respiratory Conditions, Skin Conditions, Screening, Healthcare Costs, Evidence-Based Practice, Guidelines
Williams CN, Eriksson CO, Kirby A
Hospital mortality and functional outcomes in pediatric neurocritical care.
Pediatric neurocritical care (PNCC) outcomes research is scarce. In this study, the investigators aimed to expand knowledge about outcomes in PNCC by evaluating death and changes in Functional Status Scale (FSS) from baseline among PNCC diagnoses. The investigators concluded that PNCC patients had high rates of death and new disability at discharge, varying significantly between PNCC diagnoses. Multiple domains of disability were affected, underscoring the ongoing multidisciplinary health care needs of survivors.
AHRQ-funded; HS022981.
Citation: Williams CN, Eriksson CO, Kirby A .
Hospital mortality and functional outcomes in pediatric neurocritical care.
Hosp Pediatr 2019 Dec;9(12):958-66. doi: 10.1542/hpeds.2019-0173..
Keywords: Children/Adolescents, Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Neurological Disorders, Mortality, Hospitals, Inpatient Care, Outcomes, Patient-Centered Outcomes Research
Desai S, Aronson PL, Shabanova V
Parenteral antibiotic therapy duration in young infants with bacteremic urinary tract infections.
This study compared rates of recurring bacteremic urinary tract infections (UTIs) among hospitalized infants who received parenteral antibiotics 7 days or less compared with infants who received long-term treatment defined as greater than 7 days. Among 115 infants with bactermic UTI, half received short-course parenteral antibiotics and no difference in 30-day UTI recurrence was found.
AHRQ-funded; HS026006.
Citation: Desai S, Aronson PL, Shabanova V .
Parenteral antibiotic therapy duration in young infants with bacteremic urinary tract infections.
Pediatrics 2019 Sep;144(3). doi: 10.1542/peds.2018-3844..
Keywords: Newborns/Infants, Antibiotics, Urinary Tract Infection (UTI), Medication, Inpatient Care, Hospitalization, Outcomes, Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice
Hoch JM, Fatusin O, Yenokyan G
Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization.
The purpose of this paper was to identify types of feeding methods following stage 2 palliation and their influence on length of stay. Results showed that feeding methods established at admission for stage 2 palliation are not likely to change by discharge, and that length of stay is more likely to be impacted by tube feeding and intubation history than by age or weight-for-age z score at admission. Recommendations included a better understanding for selection of feeding methods and their impact on patient outcomes in order to develop evidence-based guidelines to decrease variability in clinical practice patterns and to provide appropriate counseling to caregivers.
AHRQ-funded; HS021114.
Citation: Hoch JM, Fatusin O, Yenokyan G .
Feeding methods for infants with single ventricle physiology are associated with length of stay during stage 2 surgery hospitalization.
Congenit Heart Dis 2019 May;14(3):438-45. doi: 10.1111/chd.12742.
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Keywords: Nutrition, Newborns/Infants, Children/Adolescents, Hospitalization, Surgery, Heart Disease and Health, Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research
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
Greenhawt M, Chan ES, Fleischer DM
Caregiver and expecting caregiver support for early peanut introduction guidelines.
This study investigates caregiver preferences for early peanut introduction (EPI) recommendations. The study concluded that among new and expecting caregivers, there is poor current willingness and questionable support for early allergenic solid food recommendations, including in-office allergy risk assessment before introduction. Willingness was better among expecting vs current caregivers.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Chan ES, Fleischer DM .
Caregiver and expecting caregiver support for early peanut introduction guidelines.
Ann Allergy Asthma Immunol 2018 Jun;120(6):620-25. doi: 10.1016/j.anai.2018.03.001..
Keywords: Caregiving, Children/Adolescents, Guidelines, Newborns/Infants, Patient-Centered Outcomes Research
Travers CP, Carlo WA, McDonald SA
Mortality and pulmonary outcomes of extremely preterm infants exposed to antenatal corticosteroids.
This study sought to determine if exposure to antenatal corticosteroids is associated with a lower rate of death and pulmonary morbidities by 36 weeks' postmenstrual age. It concluded that among infants 22-28 weeks' gestational age, any or partial antenatal exposure to corticosteroids compared to no exposure is associated with a lower rate of death while the rate of bronchopulmonary dysplasia in survivors did not differ.
AHRQ-funded; HS013852.
Citation: Travers CP, Carlo WA, McDonald SA .
Mortality and pulmonary outcomes of extremely preterm infants exposed to antenatal corticosteroids.
Am J Obstet Gynecol 2018 Jan;218(1):130.e1-30.e13. doi: 10.1016/j.ajog.2017.11.554.
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Keywords: Medication, Mortality, Newborns/Infants, Patient-Centered Outcomes Research, Respiratory Conditions
Burstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Sobotka SA, Msall ME
Supporting vulnerable children after life-threatening neonatal illness: opportunities for improving outcomes.
This article discusses two articles in the same issue, one involving kindergarten readiness after prematurity, and the other examining medical and surgical factors impacting children with congenital heart disease (CHD) and their later school age achievement test performance. The authors state that these two articles provide evidence for longitudinal support of infants who survive critical illness.
AHRQ-funded; HS023007.
Citation: Sobotka SA, Msall ME .
Supporting vulnerable children after life-threatening neonatal illness: opportunities for improving outcomes.
J Pediatr 2016 Nov;178:12-14. doi: 10.1016/j.jpeds.2016.07.037.
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Keywords: Children/Adolescents, Newborns/Infants, Patient-Centered Outcomes Research, Children/Adolescents, Vulnerable Populations
Sanders RC, Jr., Nett ST, Davis KF
Family presence during pediatric tracheal intubations.
The researchers described the current practice of family presence (FP) during tracheal intubation (TI) and evaluated the association with procedural and clinician (including physician, respiratory therapist, and nurse practitioner) outcomes across multiple pediatric intensive care units (PICUs). They found that FP was not associated with first attempt success, adverse TI-associated events, oxygen desaturation (<80%), or higher team stress level.
AHRQ-funded; HS022464; HS022469; HS021583.
Citation: Sanders RC, Jr., Nett ST, Davis KF .
Family presence during pediatric tracheal intubations.
JAMA Pediatr 2016 Mar 7;170(3):e154627. doi: 10.1001/jamapediatrics.2015.4627.
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Keywords: Newborns/Infants, Children/Adolescents, Critical Care, Adverse Events, Patient-Centered Outcomes Research
Chinnadurai S, Fonnesbeck C, Snyder KM
Pharmacologic interventions for infantile hemangioma: a meta-analysis.
The objective of this report was to meta-analyze studies of pharmacologic interventions for children with infantile hemangiomas (IH). It concluded that propranolol was effective at reducing IH size compared with placebo, observation, and other treatments including steroids in most studies. Corticosteroids demonstrated moderate effectiveness at reducing IH size/volume.
AHRQ-funded; 290201200009I.
Citation: Chinnadurai S, Fonnesbeck C, Snyder KM .
Pharmacologic interventions for infantile hemangioma: a meta-analysis.
Pediatrics 2016 Feb;137(2):e20153896. doi: 10.1542/peds.2015-3896.
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Keywords: Medication, Children/Adolescents, Newborns/Infants, Comparative Effectiveness, Patient-Centered Outcomes Research
Bateman BT, Huybrechts KF, Maeda A
Calcium channel blocker exposure in late pregnancy and the risk of neonatal seizures.
This study assessed whether maternal calcium channel blocker exposure during late pregnancy is independently associated with neonatal seizures after carefully controlling for confounding factors. It found no significant increase in the risk of neonatal seizures in neonates attributable to maternal calcium channel blocker exposure in late pregnancy.
AHRQ-funded; HS018533.
Citation: Bateman BT, Huybrechts KF, Maeda A .
Calcium channel blocker exposure in late pregnancy and the risk of neonatal seizures.
Obstet Gynecol 2015 Aug;126(2):271-8. doi: 10.1097/aog.0000000000000908..
Keywords: Pregnancy, Adverse Events, Medication, Patient-Centered Outcomes Research, Newborns/Infants
Ho T, Dukhovny D, Zupancic JA
Choosing Wisely in newborn medicine: five opportunities to increase value.
This report describes the identification of 5 tests and treatments in newborn medicine. The expert panel achieved consensus on the top 5 items. The first item was to avoid routine use of antireflux medications for treatment of symptomatic gastroesophageal reflux disease or for treatment of apnea and desaturation in preterm infants.
AHRQ-funded; HS000063.
Citation: Ho T, Dukhovny D, Zupancic JA .
Choosing Wisely in newborn medicine: five opportunities to increase value.
Pediatrics 2015 Aug;136(2):e482-9. doi: 10.1542/peds.2015-0737..
Keywords: Newborns/Infants, Prevention, Patient-Centered Outcomes Research, Guidelines