National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (7)
- Ambulatory Care and Surgery (2)
- (-) Cancer (21)
- Cancer: Breast Cancer (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Children/Adolescents (2)
- Clostridium difficile Infections (1)
- Communication (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Delivery (2)
- Health Information Technology (HIT) (4)
- Hospitals (1)
- Imaging (1)
- Injuries and Wounds (1)
- Medical Errors (3)
- Medication (4)
- Medication: Safety (3)
- Mortality (2)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (3)
- Patient Experience (1)
- (-) Patient Safety (21)
- Provider (1)
- Provider: Clinician (1)
- Quality Improvement (1)
- Quality of Care (3)
- Risk (5)
- Surgery (5)
- Treatments (5)
- Women (1)
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 21 of 21 Research Studies DisplayedWong CI, Vannatta K, Gilleland Marchak J
Preventable harm because of outpatient medication errors among children with leukemia and lymphoma: a multisite longitudinal assessment.
The goal of this longitudinal study was to characterize rates and types of medication errors and harm to outpatient children with leukemia and lymphoma over seven months of treatment. The study included children taking medications at home for leukemia or lymphoma from three pediatric cancer centers. Ten percent experienced adverse drug events because of outpatient medication errors. Twenty-six percent of caregivers reported miscommunication leading to missed doses or overdoses. The authors concluded that improvements addressing communication with and among caregivers should be based on human-factors engineering and codeveloped with families.
AHRQ-funded; HS024390.
Citation: Wong CI, Vannatta K, Gilleland Marchak J .
Preventable harm because of outpatient medication errors among children with leukemia and lymphoma: a multisite longitudinal assessment.
Cancer 2023 Apr 1;129(7):1064-74. doi: 10.1002/cncr.34651.
Keywords: Children/Adolescents, Cancer, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Ambulatory Care and Surgery, Medication: Safety, Patient Safety
Lai LY, Oerline MK, Caram MEV
Risk of metabolic and cardiovascular adverse events with abiraterone or enzalutamide among men with advanced prostate cancer.
Investigators examined the association between the use of abiraterone or enzalutamide and the risk of metabolic or cardiovascular adverse events while on treatment for advanced prostate cancer. They found that, compared with men not receiving abiraterone, men receiving abiraterone were at increased risk of both a major composite adverse event and a minor composite adverse event. Compared with men not receiving enzalutamide, men receiving enzalutamide were at an increased risk of a major composite adverse event but not a minor composite adverse event. They recommended careful monitoring and management of men on abiraterone or enzalutamide through team-based approaches.
AHRQ-funded; HS027507.
Citation: Lai LY, Oerline MK, Caram MEV .
Risk of metabolic and cardiovascular adverse events with abiraterone or enzalutamide among men with advanced prostate cancer.
J Natl Cancer Inst 2022 Aug 8;114(8):1127-34. doi: 10.1093/jnci/djac081..
Keywords: Cardiovascular Conditions, Cancer: Prostate Cancer, Cancer, Risk, Adverse Events, Medication, Adverse Drug Events (ADE), Medication: Safety, Patient Safety
Fakhri B, Fiala MA, Shah N
Measuring cardiopulmonary complications of carfilzomib treatment and associated risk factors using the SEER-Medicare database.
This study’s goal was to measure rates of cardiopulmonary complications from carfilzomib treatment in patients with recurrent myeloma. Myeloma case data was extracted from the SEER-Medicare linked database from 2000 to 2013, and corresponding claims through 2014. There were 635 patients identified as being treated with carfilzomib. Of these, median age was 72 years, 55% were male, and 79% were white. Median duration of treatment was 58 days. Overall, 66% of patients had codes identifying cardiac or pulmonary adverse events. Cardiac adverse events included hypertension, peripheral edema and heart failure. Pulmonary adverse events included dyspnea, cough, and pneumonia.
AHRQ-funded; HS019455.
Citation: Fakhri B, Fiala MA, Shah N .
Measuring cardiopulmonary complications of carfilzomib treatment and associated risk factors using the SEER-Medicare database.
Cancer 2020 Feb 15;128(4):808-13. doi: 10.1002/cncr.32601..
Keywords: Adverse Events, Medication, Cardiovascular Conditions, Risk, Cancer, Patient Safety
Sheetz KH, Chhabra KR, Smith ME
Association of discretionary hospital volume standards for high-risk cancer surgery with patient outcomes and access, 2005-2016.
Various clinical societies and patient advocacy organizations continue to encourage minimum volume standards at hospitals that perform certain high-risk operations. Although many clinicians and quality and safety experts believe this can improve outcomes, the extent to which hospitals have responded to these discretionary standards remains unclear. The purpose of this study was to evaluate the association between short-term clinical outcomes and hospitals' adherence to the Leapfrog Group's minimum volume standards for high-risk cancer surgery.
AHRQ-funded; HS000053; HS023597; HS024763.
Citation: Sheetz KH, Chhabra KR, Smith ME .
Association of discretionary hospital volume standards for high-risk cancer surgery with patient outcomes and access, 2005-2016.
JAMA Surg 2019 Nov;154(11):1005-12. doi: 10.1001/jamasurg.2019.3017..
Keywords: Patient Safety, Hospitals, Outcomes, Surgery, Cancer
Chang X, Li HH, Kalet AM
Development and validation of a bayesian network method to detect external beam radiation therapy physician order errors.
This study investigated using a Bayesian network (BN)-based method to detect physician order errors in external beam radiation therapy. The authors extracted data from 4331 total external beam radiation orders written from 2008 to 2017 at their institution of origin. The cohort was divided into 3 groups: single prescription, concurrent boost, and sequential boost. True-positive (TPR) and false-positive (FPR) rates were determined. The investigators saw good results using the BN method.
AHRQ-funded; HS022888.
Citation: Chang X, Li HH, Kalet AM .
Development and validation of a bayesian network method to detect external beam radiation therapy physician order errors.
Int J Radiat Oncol Biol Phys 2019 Oct 1;105(2):423-31. doi: 10.1016/j.ijrobp.2019.05.034..
Keywords: Medical Errors, Patient Safety, Cancer, Treatments
Patel MR, Friese CR, Mendelsohn-Victor K
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
This study examined the effects of electronic health records (EHRs) on communication and patient safety in oncology practices. The authors conducted a survey of 297 oncology nurses and prescribers in a statewide collaborative. They found there was an inverse relationship between reliance on EHRs and safety.
AHRQ-funded; HS024914.
Citation: Patel MR, Friese CR, Mendelsohn-Victor K .
Clinician perspectives on electronic health records, communication, and patient safety across diverse medical oncology practices.
J Oncol Pract 2019 Jun;15(6):e529-e36. doi: 10.1200/jop.18.00507..
Keywords: Cancer, Communication, Electronic Health Records (EHRs), Health Information Technology (HIT), Patient Safety, Provider, Provider: Clinician
Nonzee NJ, Luu TH
The drug shortage crisis in the United States: impact on cancer pharmaceutical safety.
This study examined the drug short crisis in the United States and its impact on cancer pharmaceutical safety. These shortages present safety risk for patients and adversely affect patient outcomes. There are multiple drivers of this problem including manufacturing disruptions, raw material shortages, regulatory issues, market dynamics and limited financial incentives for off-patent drugs.
AHRQ-funded; HS000046.
Citation: Nonzee NJ, Luu TH .
The drug shortage crisis in the United States: impact on cancer pharmaceutical safety.
Cancer Treat Res 2019;171:75-92. doi: 10.1007/978-3-319-43896-2_6..
Keywords: Cancer, Medication, Medication: Safety, Patient Safety
Ancker JS, Stabile C, Carter J
Informing, reassuring, or alarming? Balancing patient needs in the development of a postsurgical symptom reporting system in cancer.
After ambulatory surgeries, patients who recover at home have multiple questions about wound healing, symptoms and medication side effects, and recovery expectations. In this study, the investigators conducted user testing and rapid application development of a symptom reporting system that supports home-based recovery by inviting patients to self-report symptoms in the days after surgery and receive an immediate feedback report giving context for their reported symptoms.
AHRQ-funded; HS021531.
Citation: Ancker JS, Stabile C, Carter J .
Informing, reassuring, or alarming? Balancing patient needs in the development of a postsurgical symptom reporting system in cancer.
AMIA Annu Symp Proc 2018 Dec 5;2018:166-74..
Keywords: Adverse Events, Ambulatory Care and Surgery, Cancer, Education: Patient and Caregiver, Health Information Technology (HIT), Patient Safety, Surgery
Bateni SB, Bold RJ, Meyers FJ
Comparison of common risk stratification indices to predict outcomes among stage IV cancer patients with bowel obstruction undergoing surgery.
Since preoperative risk stratification is critical, researchers sought to compare three standard risk indices, the American Society of Anesthesiology (ASA) classification, Charlson comorbidity index (CCI), and modified frailty index (mFI). Serious morbidity and mortality rates were 20.4 percent and 14.8 percent. ASA and CCI did not predict serious morbidity or prolonged length of stay, but were predictors of mortality.
AHRQ-funded; HS022236.
Citation: Bateni SB, Bold RJ, Meyers FJ .
Comparison of common risk stratification indices to predict outcomes among stage IV cancer patients with bowel obstruction undergoing surgery.
J Surg Oncol 2018 Mar;117(3):479-87. doi: 10.1002/jso.24866.
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Keywords: Adverse Events, Cancer, Patient Safety, Risk, Surgery
Gingrich AA, Bateni SB, Monjazeb AM
Neoadjuvant radiotherapy is associated with R0 resection and improved survival for patients with extremity soft tissue sarcoma undergoing surgery: a national cancer database analysis.
Neoadjuvant radiotherapy (RT) is increasingly advocated for the management of soft tissue sarcoma (STS). This study sought to characterize the impact of neoadjuvant RT on rates of R0 resection and overall survival (OS) in extremity STS patients undergoing surgery. The authors concluded that preoperative RT independently predicts higher rates of R0 resection for patients with extremity STS undergoing surgical resection. Negative surgical margins and pre- or postoperative RT are associated with improved OS.
AHRQ-funded; HS022236.
Citation: Gingrich AA, Bateni SB, Monjazeb AM .
Neoadjuvant radiotherapy is associated with R0 resection and improved survival for patients with extremity soft tissue sarcoma undergoing surgery: a national cancer database analysis.
Ann Surg Oncol 2017 Oct;24(11):3252-63. doi: 10.1245/s10434-017-6019-8..
Keywords: Adverse Events, Cancer, Mortality, Patient-Centered Outcomes Research, Patient Safety
Fisher KA, Mazor KM
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
This paper comments on the Mack et al. article “Evaluation of Patient and Family Outpatient Complaints as a Strategy to Prioritize Efforts to Improve Cancer Care Delivery”, published in 2017 in The Joint Commission Journal on Quality and Patient Safety, in which Mack et al. categorized all complaints filed at a large outpatient cancer center during a two-year period, put forth a preliminary rating system for assessing complaint severity, and catalogued the actions taken in response to the complaints.
AHRQ-funded; HS024596; HS022757.
Citation: Fisher KA, Mazor KM .
Patient and family complaints in cancer care: what can we learn from the tip of the iceberg?
Jt Comm J Qual Patient Saf 2017 Oct;43(10):495-97. doi: 10.1016/j.jcjq.2017.07.003..
Keywords: Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Patient Experience, Patient Safety, Quality of Care, Quality Improvement
Maitree R, Perez-Carrillo GJG, Shimony JS
Adaptive anatomical preservation optimal denoising for radiation therapy daily MRI.
An innovative method, adaptive anatomical preservation optimal denoising (AAPOD), was developed for optimal image denoising, i.e., to maximally reduce noise while preserving the tissue boundaries. The experimental results demonstrated that AAPOD was capable of reducing noise adaptively and optimally while avoiding tissue boundary losses.
AHRQ-funded; HS022888.
Citation: Maitree R, Perez-Carrillo GJG, Shimony JS .
Adaptive anatomical preservation optimal denoising for radiation therapy daily MRI.
J Med Imaging 2017 Jul;4(3):034004. doi: 10.1117/1.jmi.4.3.034004.
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Keywords: Imaging, Treatments, Cancer, Patient Safety
Rickard CM, Marsh NM, Webster J
Peripherally InSerted CEntral catheter dressing and securement in patients with cancer: the PISCES trial. protocol for a 2x2 factorial, superiority randomised controlled trial.
The researchers designed this trial to assess the clinical and cost-effectiveness of dressing and securements to prevent peripherally inserted central catheters (PICCs) failure. For the dressing hypothesis, they hypothesize (chlorhexidine gluconate (CHG) discs will reduce catheter-associated bloodstream infection (CABSI) compared with no CHG disc. For the securement hypothesis, they hypothesize that integrated securement dressing will reduce composite PICC failure (infection (CABSI/local infection), occlusion, dislodgement or thrombosis), compared with securement device.
AHRQ-funded; HS022835.
Citation: Rickard CM, Marsh NM, Webster J .
Peripherally InSerted CEntral catheter dressing and securement in patients with cancer: the PISCES trial. protocol for a 2x2 factorial, superiority randomised controlled trial.
BMJ Open 2017 Jun 15;7(6):e015291. doi: 10.1136/bmjopen-2016-015291.
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Keywords: Cancer, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety
Cannon CM, Musuuza JS, Barker AK
Risk of Clostridium difficile infection in hematology-oncology patients colonized with toxigenic C. difficile.
This study determined that the prevalence of colonization with toxigenic Clostridium difficile among patients with hematological malignancies and/or bone marrow transplant at admission to a 566-bed academic medical care center was 9.3 percent. Thirteen percent of colonized patients developed symptomatic disease during hospitalization. This population may benefit from targeted C. difficile infection control interventions.
AHRQ-funded; HS024039; HS023791.
Citation: Cannon CM, Musuuza JS, Barker AK .
Risk of Clostridium difficile infection in hematology-oncology patients colonized with toxigenic C. difficile.
Infect Control Hosp Epidemiol 2017 Jun;38(6):718-20. doi: 10.1017/ice.2017.48.
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Keywords: Cancer, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Risk
Dorris K, Liu C, Li D
A comparison of safety and efficacy of cytotoxic versus molecularly targeted drugs in pediatric phase I solid tumor oncology trials.
A systematic review of pediatric phase I solid tumor trials published in 1990-2013 was performed. The published reports were evaluated for patient characteristics, toxicity information, and response numbers. The review concluded that in phase I pediatric solid tumor trials, objective response rates were significantly higher for cytotoxic versus targeted agents. Stable disease rates were similar in targeted and cytotoxic drug trials.
AHRQ-funded; HS022437.
Citation: Dorris K, Liu C, Li D .
A comparison of safety and efficacy of cytotoxic versus molecularly targeted drugs in pediatric phase I solid tumor oncology trials.
Pediatr Blood Cancer 2017 Mar;64(3). doi: 10.1002/pbc.26258.
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Keywords: Patient Safety, Patient-Centered Outcomes Research, Children/Adolescents, Cancer, Medication
Wong SL, Revels SL, Yin H
Variation in hospital mortality rates with inpatient cancer surgery.
The purpose of this national study was to elucidate clinical mechanisms underlying variation in hospital mortality with major cancer surgery. It found that case-fatality rates among patients with complications at high-mortality hospitals were approximately twice as high as at low-mortality hospitals. This study implicates failure to rescue as the major reason for differences in hospital mortality rates with major cancer surgery.
AHRQ-funded; HS020937.
Citation: Wong SL, Revels SL, Yin H .
Variation in hospital mortality rates with inpatient cancer surgery.
Ann Surg 2015 Apr;261(4):632-6. doi: 10.1097/sla.0000000000000690..
Keywords: Mortality, Surgery, Cancer, Patient Safety, Quality of Care
Liu S, Mazur T, Li H
SU-F-T-275: A correlation study on 3D fluence-based QA and 2D dose measurement-based QA.
The aim of this paper was to demonstrate the feasibility and creditability of computing and verifying 3D fluencies to assure IMRT and VMAT treatment deliveries, by correlating the passing rates of the 3D fluence-based QA (P(alpha)) to the passing rates of 2D dose measurement based QA (P(Dm)). It concluded that the demonstrated correlations improve the creditability of using 3D fluence-based QA for assuring treatment deliveries for IMRT/VMAT plans.
AHRQ-funded; HS022888.
Citation: Liu S, Mazur T, Li H .
SU-F-T-275: A correlation study on 3D fluence-based QA and 2D dose measurement-based QA.
Med Phys 2016 Jun;43(6 Part 17):3525-26. doi: 10.1118/1.4956415.
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Keywords: Cancer, Healthcare Delivery, Treatments, Patient Safety, Health Information Technology (HIT)
Liu S, Wu Y, Chang X
TU-FG-201-03: Automatic pre-delivery verification using statistical analysis of consistencies in treatment plan parameters by the treatment site and modality.
A novel computer software system, namely APDV (Automatic Pre-Delivery Verification), was developed for verifying patient treatment plan parameters right prior to treatment deliveries in order to automatically detect and prevent catastrophic errors. This study implemented APDV as a stand-alone program to ensure required real time performance. It concluded that APDV could be useful in detecting and preventing catastrophic errors immediately before treatment deliveries.
AHRQ-funded; HS022888.
Citation: Liu S, Wu Y, Chang X .
TU-FG-201-03: Automatic pre-delivery verification using statistical analysis of consistencies in treatment plan parameters by the treatment site and modality.
Med Phys 2016 Jun;43(6 Part 35):3753. doi: 10.1118/1.4957526.
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Keywords: Cancer, Healthcare Delivery, Treatments, Patient Safety, Health Information Technology (HIT)
Yang D, Wooten HO, Green O
A software tool to automatically assure and report daily treatment deliveries by a Cobalt-60 radiation therapy device.
The researchers developed a method for verification of treatment delivery after each treatment fraction in order to detect and correct errors, and they developed a comprehensive daily report. The end result has been integrated into a commercial version of the treatment delivery system, and it has been in clinical use for over one year.
AHRQ-funded; HS022888.
Citation: Yang D, Wooten HO, Green O .
A software tool to automatically assure and report daily treatment deliveries by a Cobalt-60 radiation therapy device.
J Appl Clin Med Phys 2016 May 8;17(3):6001.
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Keywords: Treatments, Cancer, Quality of Care, Patient Safety
Singh H, Allen JI
Patient safety counterpoint: systems approaches and multidisciplinary strategies at the centerpiece of error prevention.
The understanding and awareness of patient safety issues has led to many calls for systems improvement, transparency, and accountability for more than a decade. The authors encourage all of those interested in this topic to critically examine the recent literature in relevant topics related to patient safety, systems thinking, and preventable delays in cancer diagnosis from across the globe.
AHRQ-funded; HS022087.
Citation: Singh H, Allen JI .
Patient safety counterpoint: systems approaches and multidisciplinary strategies at the centerpiece of error prevention.
Clin Gastroenterol Hepatol 2015 May;13(5):824-6. doi: 10.1016/j.cgh.2015.01.005..
Keywords: Patient Safety, Medical Errors, Cancer
Olsen MA, Nickel KB, Margenthaler JA
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
The aim of this study was to determine the risk of surgical site infection (SSI) after primary breast-conserving surgery (BCS) versus re-excision among women with carcinoma in situ or invasive breast cancer. It found that the risk of SSI after re-excision remained significantly higher after accounting for multiple procedures within a woman.
AHRQ-funded; HS019713.
Citation: Olsen MA, Nickel KB, Margenthaler JA .
Increased risk of surgical site infection among breast-conserving surgery re-excisions.
Ann Surg Oncol 2015;22(6):2003-9. doi: 10.1245/s10434-014-4200-x..
Keywords: Surgery, Risk, Cancer: Breast Cancer, Cancer, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Adverse Events, Patient Safety, Women