National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Access to Care (1)
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Antibiotics (2)
- Blood Thinners (1)
- Cancer (2)
- Cancer: Breast Cancer (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (2)
- Chronic Conditions (1)
- Critical Care (1)
- Decision Making (3)
- Diagnostic Safety and Quality (1)
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- (-) Healthcare Utilization (16)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (2)
- Hospitals (1)
- Imaging (3)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (1)
- Medicare (2)
- Medication (5)
- Neurological Disorders (1)
- Opioids (2)
- Pain (3)
- Patient-Centered Outcomes Research (1)
- (-) Practice Patterns (16)
- Registries (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 DisplayedWang T, Baskin A, Miller J
Trends in breast cancer treatment de-implementation in older patients with hormone receptor-positive breast cancer: a mixed methods study.
Guidelines allow for the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women >/= 70 years of age with hormone receptor-positive (HR +) breast cancer. Despite this, national data suggest these procedures have not been widely de-implemented. The objectives of this study were to evaluate trends in SLNB and post-lumpectomy radiotherapy utilization in patients who were eligible for omission and evaluate patient preferences as a target for de-implementation of low-value care.
AHRQ-funded; HS026030.
Citation: Wang T, Baskin A, Miller J .
Trends in breast cancer treatment de-implementation in older patients with hormone receptor-positive breast cancer: a mixed methods study.
Ann Surg Oncol 2021 Feb;28(2):902-13. doi: 10.1245/s10434-020-08823-w..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Healthcare Utilization, Practice Patterns, Women
Newberry CI, Casazza GC, Pruitt LC
Prescription patterns and opioid usage in sinonasal surgery.
The goal of this study was to identify factors associated with variable opioid usage and to delineate optimal prescription patterns for sinonasal surgery. The researchers found that patients used 9.3% of their full prescription and only 2.6% required a refill. The amount used was not associated with complexity of endoscopic sinus surgery, type of opiate prescribed, gender, distance living from hospital, or current opioid usage before surgery. They concluded that opioids are overprescribed after sinonasal surgery and that the amount of postoperative opiate prescribed should be greatly reduced and may be based on the specific procedures performed.
AHRQ-funded; HS024638.
Citation: Newberry CI, Casazza GC, Pruitt LC .
Prescription patterns and opioid usage in sinonasal surgery.
Int Forum Allergy Rhinol 2020 Mar;10(3):381-87. doi: 10.1002/alr.22478..
Keywords: Opioids, Medication, Pain, Surgery, Respiratory Conditions, Healthcare Utilization, Practice Patterns, Substance Abuse
Ellis RJ, Schlick CJR, Yang AD
Utilization and treatment patterns of cytoreduction surgery and intraperitoneal chemotherapy in the United States.
This paper discusses utilization and treatment patterns of cytoreduction surgery and intraperitoneal chemotherapy (CRS/IPC) treatment for patients with peritoneal metastases (PM) in the United States. This treatment is becoming more popular in the US. The authors used the National Inpatient Sample to identify patients from 2006 to 2015 who underwent CRS/IPC. The number of CRS/IPC treatments increased from 189 to 1540. The most common indication was for appendiceal cancer, followed by ovarian and colorectal cancers. The procedure was performed the most in large teaching hospitals. The authors recommend the creation of a national registry dedicated to cases of IPC to help evaluate further use and outcomes.
AHRQ-funded; HS000078; HS026385.
Citation: Ellis RJ, Schlick CJR, Yang AD .
Utilization and treatment patterns of cytoreduction surgery and intraperitoneal chemotherapy in the United States.
Ann Surg Oncol 2020 Jan;27(1):214-21. doi: 10.1245/s10434-019-07492-8..
Keywords: Healthcare Cost and Utilization Project (HCUP), Treatments, Cancer, Practice Patterns, Healthcare Utilization, Surgery
Yarrington ME, Anderson DJ, Dodds Ashley E
Impact of FDA black box warning on fluoroquinolone and alternative antibiotic use in southeastern US hospitals.
This study’s objective was the quantify the effect of the 2016 FDA “black box” update on the use of fluoroquinolone antibiotics among a cohort of southeastern US hospitals. Fluoroquinolone was given a black box warning after many serious adverse events were reported. Antibiotic use data from 29 southeastern US hospitals over a 5-year period was analyzed. Fluoroquinolone use declined both and before after the FDA advisory update in 2016.
AHRQ-funded; HS023866.
Citation: Yarrington ME, Anderson DJ, Dodds Ashley E .
Impact of FDA black box warning on fluoroquinolone and alternative antibiotic use in southeastern US hospitals.
Infect Control Hosp Epidemiol 2019 Nov;40(11):1297-300. doi: 10.1017/ice.2019.247..
Keywords: Antibiotics, Medication, Practice Patterns, Healthcare Utilization, Hospitals, Adverse Drug Events (ADE), Adverse Events
Wang SV, Rogers JR, Jin Y
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
Clinical guidelines recommend anticoagulation for patients with atrial fibrillation (AF) at high risk of stroke; however, studies report 40% of this population is not anticoagulated. The purpose of this study was to evaluate a population health intervention to increase anticoagulation use in high-risk patients with AF. The investigators concluded that algorithms to identify underuse of anticoagulation among patients with AF in healthcare databases may not capture clinical subtleties or patient preferences and may overestimate the extent of undertreatment.
AHRQ-funded; HS022193.
Citation: Wang SV, Rogers JR, Jin Y .
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation.
BMJ Qual Saf 2019 Oct;28(10):835-42. doi: 10.1136/bmjqs-2019-009367..
Keywords: Blood Thinners, Heart Disease and Health, Cardiovascular Conditions, Medication, Health Information Technology (HIT), Decision Making, Electronic Health Records (EHRs), Practice Patterns, Healthcare Utilization
Shah NR, Ahmed ST, Winchester DE
Facility-level variation in stress test utilization in veterans with ischemic heart disease.
The aim of this study was to quantify variation in cardiac stress test utilization across the Veterans Health Administration (VA) in patients with established ischemic heart disease (IHD). The investigators used VA datasets to identify adults with IHD (myocardial infarction, percutaneous coronary intervention, and/or coronary artery bypass grafting) with a primary care clinic visit at the VA in fiscal year 2014.
AHRQ-funded; HS022998.
Citation: Shah NR, Ahmed ST, Winchester DE .
Facility-level variation in stress test utilization in veterans with ischemic heart disease.
JACC Cardiovasc Imaging 2019 Jul;12(7 Pt 1):1292-93. doi: 10.1016/j.jcmg.2019.02.020..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Diagnostic Safety and Quality, Healthcare Utilization, Practice Patterns, Imaging
Callaghan BC, Reynolds E, Banerjee M
Longitudinal pattern of pain medication utilization in peripheral neuropathy patients.
The authors of this article investigated the pattern and utilization of neuropathic pain medications in peripheral neuropathy patients. They found that opioid initiation and transition to chronic opioid therapy were frequent in the studied population despite few patients receiving more than one guideline-recommended medication. They concluded that efforts are needed to decrease opioid utilization and to increase guideline-recommended medication use in order to improve current neuropathic pain treatment.
AHRQ-funded; HS017690.
Citation: Callaghan BC, Reynolds E, Banerjee M .
Longitudinal pattern of pain medication utilization in peripheral neuropathy patients.
Pain 2019 Mar;160(3):592-99. doi: 10.1097/j.pain.0000000000001439..
Keywords: Chronic Conditions, Guidelines, Healthcare Utilization, Medication, Neurological Disorders, Opioids, Pain, Practice Patterns
Mundkur ML, Franklin J, Huybrechts KF
Changes in outpatient use of antibiotics by adults in the United States, 2006-2015.
The two goals of this observational study were to describe general trends in outpatient antibiotic use among adults from 2006 to 2015, and to identify rapid shifts in use during this time period as potential indicators for key events. Patients aged 18 years and older were selected from the Optum Clinformatics Datamart, a commercial insurance claims database; linear regression was used to identify trends in use over multiple years, and change-point regression was used to identify rapid shifts in use within individual years. Outpatient use of antibiotics from 2006 to 2015 decreased substantially among adults. Rapid shifts in use occurring in 2008 and 2013 may reflect the presence of key drivers of change.
AHRQ-funded; HS024930; 233201500020I.
Citation: Mundkur ML, Franklin J, Huybrechts KF .
Changes in outpatient use of antibiotics by adults in the United States, 2006-2015.
Drug Saf 2018 Dec;41(12):1333-42. doi: 10.1007/s40264-018-0697-4..
Keywords: Antibiotics, Healthcare Utilization, Medication, Practice Patterns
Zhou M, Oakes AH, Bridges JFP
Regional supply of medical resources and systemic overuse of health care among Medicare beneficiaries.
The goal of this study was to explore health care system factors associated with regional variation in overuse of resources, as measured by the Johns Hopkins Overuse Index (JHOI). Medicare fee-for-service claims data from beneficiaries age 65 was used to calculate the JHOI for 306 hospital referral regions in the U.S. Regions with a higher density of primary care physicians had a lower JHOI, which indicates less systemic overuse. Regional characteristics associated with higher JHOI included the number of acute care hospital beds per 1000 residents and number of hospital-based anesthesiologists, pathologists, and radiologists. The authors conclude that regional variations in health care resources are associated with the level of systemic overuse of health care, and that the role of primary care doctors in reducing overuse deserves further attention.
AHRQ-funded; T32 HS000029.
Citation: Zhou M, Oakes AH, Bridges JFP .
Regional supply of medical resources and systemic overuse of health care among Medicare beneficiaries.
J Gen Intern Med 2018 Dec;33(12):2127-31. doi: 10.1007/s11606-018-4638-9..
Keywords: Access to Care, Elderly, Healthcare Delivery, Healthcare Utilization, Medicare, Practice Patterns
Yun BJ, Borczuk P, Zachrison KS
Utilization of head CT during injury visits to United States emergency departments: 2012-2015.
This study examined national trends in utilization of head computed tomography (CT) imaging in emergency department (ED) patients presenting with an injury-related visit. Data from the US National Hospital Ambulatory Medical Care Survey from 2012 to 2015 was used to find ED patients who had at least one head CT. Overall there was an increase (11.7-13.23%) but it was not statistically significant.
AHRQ-funded; HS024561.
Citation: Yun BJ, Borczuk P, Zachrison KS .
Utilization of head CT during injury visits to United States emergency departments: 2012-2015.
Am J Emerg Med 2018 Aug;36(8):1463-66. doi: 10.1016/j.ajem.2018.05.018..
Keywords: Healthcare Utilization, Emergency Department, Imaging, Injuries and Wounds, Practice Patterns
Ross WT, Meister MR, Shepherd JP
Utilization of apical vaginal support procedures at time of inpatient hysterectomy performed for benign conditions: a national estimate.
The researchers sought to estimate trends and factors associated with use of apical support procedures at time of inpatient hysterectomy for benign indications in a large national database. Their study demonstrated that apical support procedures are not routinely performed at time of inpatient hysterectomy regardless of presence of prolapse diagnosis.
AHRQ-funded; HS019455.
Citation: Ross WT, Meister MR, Shepherd JP .
Utilization of apical vaginal support procedures at time of inpatient hysterectomy performed for benign conditions: a national estimate.
Am J Obstet Gynecol 2017 Oct;217(4):436.e1-36.e8. doi: 10.1016/j.ajog.2017.07.010.
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Keywords: Healthcare Utilization, Practice Patterns, Surgery, Women
Tsai HT, Philips G, Taylor KL
Utilization and predictors of expectant management among elderly men with low-and intermediate-risk localized prostate cancer in U.S. urological practice.
Researchers assessed the use and predictors of expectant management (EM) to understand its uptake in U.S. practice. In U.S. practice, the utilization of EM steadily increased in low-risk prostate cancer and remained low in the intermediate-risk group over time. While patients with advanced age or comorbidities were more likely to receive EM, its use varied substantially by geographic region.
AHRQ-funded; HS022915.
Citation: Tsai HT, Philips G, Taylor KL .
Utilization and predictors of expectant management among elderly men with low-and intermediate-risk localized prostate cancer in U.S. urological practice.
Urol Pract 2017 Mar;4(2):132-39. doi: 10.1016/j.urpr.2016.05.005.
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Keywords: Decision Making, Elderly, Healthcare Utilization, Cancer: Prostate Cancer, Practice Patterns
Melnick ER, O'Brien EG, Kovalerchik O
The association between physician empathy and variation in imaging use.
This paper's objective was to describe empathy in a cohort of emergency physicians and evaluate its association with CT utilization. The authors found that, on the four psychometric scales used, performance was not predictive of risk-adjusted CT utilization in the emergency department. They concluded that the underlying physician-based factors that mediate interphysician variation remain to be clearly identified.
AHRQ-funded; HS021271.
Citation: Melnick ER, O'Brien EG, Kovalerchik O .
The association between physician empathy and variation in imaging use.
Acad Emerg Med 2016 Aug;23(8):895-904. doi: 10.1111/acem.13017.
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Keywords: Decision Making, Emergency Medical Services (EMS), Healthcare Utilization, Imaging, Practice Patterns
Lyu PF, Hockenberry JM, Gaydos LM
Impact of a sequential intervention on albumin utilization in critical care.
The authors evaluated the effect of a sequential multifaceted intervention on decreasing albumin use in the intensive care unit. They found that a sequential intervention achieved significant reductions in albumin use and cost savings without changes in patient outcomes, supporting the combination of financial and nonfinancial strategies to align providers with evidence-based practices.
AHRQ-funded; HS000055.
Citation: Lyu PF, Hockenberry JM, Gaydos LM .
Impact of a sequential intervention on albumin utilization in critical care.
Crit Care Med 2016 Jul;44(7):1307-13. doi: 10.1097/ccm.0000000000001638.
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Keywords: Critical Care, Healthcare Utilization, Intensive Care Unit (ICU), Patient-Centered Outcomes Research, Practice Patterns
Ayers DC, Li W, Harrold L
Preoperative pain and function profiles reflect consistent TKA patient selection among US surgeons.
This study compared early data from a recently established US national total knee arthroplasty (TKA) cohort including patients from 123 surgeons in 22 states to evaluate preoperative variability in patient selection across surgeons. Their findings suggest that no clinical difference could be detected in the median (typical) patient across all sites.
AHRQ-funded; HS018910.
Citation: Ayers DC, Li W, Harrold L .
Preoperative pain and function profiles reflect consistent TKA patient selection among US surgeons.
Clin Orthop Relat Res 2015 Jan;473(1):76-81. doi: 10.1007/s11999-014-3716-5..
Keywords: Surgery, Pain, Healthcare Utilization, Practice Patterns
Davidoff AJ, Weiss SR, Baer MR
AHRQ Author: Davidoff AJ
Patterns of erythropoiesis-stimulating agent use among Medicare beneficiaries with myelodysplastic syndromes and consistency with clinical guidelines.
The researchers used SEER registries data to assess population-based patterns of erythropoiesis-stimulating agents (ESA) use relative to treatment guidelines. They found widespread use of ESA in Medicare beneficiaries with myelodysplastic syndromes.
AHRQ-authored.
Citation: Davidoff AJ, Weiss SR, Baer MR .
Patterns of erythropoiesis-stimulating agent use among Medicare beneficiaries with myelodysplastic syndromes and consistency with clinical guidelines.
Leuk Res 2013 Jun;37(6):675-80. doi: 10.1016/j.leukres.2013.02.021.
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Keywords: Guidelines, Healthcare Utilization, Medicare, Practice Patterns, Registries