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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results
1 to 25 of 313 Research Studies Displayed
Berger AC, Simchoni N, Auerbach A
Implementation of clinical practice guidelines for hospitalized patients with COVID-19 in academic medical centers.
This study was a survey of members of the Hospital Medicine Reengineering Network to determine the rate at which US academic medical centers have adopted evidence-based practice guidelines for COVID-19. Of 83 hospitals contacted, 53 responded. Fifty-one sites issued internal COVID-19 management guidance. Guidance types included for infectious disease (98%), infection control (90%), hospital medicine (88%) and critical care (83%). Of the 51 sites with internal COVID-19 management guidance, recommendations were most commonly disseminated through email, institutional websites, and integration into electronic health records as COVID-19-specific order sets and note templates. Three themes emerged from the researcher’s analysis. First, translation from evidence to practice guidelines was remarkably complete for interventions supported by aligned national guidelines and high-quality studies. Second, institutions favored treatment over not treatment, particularly when guidelines diverged from each other. Lastly, academic medical centers demonstrated a willingness to innovate across a range of interventions.
AHRQ-funded; HS027369.
Citation:
Berger AC, Simchoni N, Auerbach A .
Implementation of clinical practice guidelines for hospitalized patients with COVID-19 in academic medical centers.
JAMA Netw Open 2022 Apr;5(4):e225657. doi: 10.1001/jamanetworkopen.2022.5657..
Keywords:
COVID-19, Guidelines, Inpatient Care
Brajcich BC, Benson AB, Gantt G
Management of colorectal cancer during the COVID-19 pandemic: recommendations from a statewide multidisciplinary cancer collaborative.
J Surg Oncol 2022 Mar;125(4):560-63. doi: 10.1002/jso.26758.
AHRQ-funded; HS026385.
Citation:
Brajcich BC, Benson AB, Gantt G .
Management of colorectal cancer during the COVID-19 pandemic: recommendations from a statewide multidisciplinary cancer collaborative.
J Surg Oncol 2022 Mar;125(4):560-63. doi: 10.1002/jso.26758..
Keywords:
COVID-19, Cancer: Colorectal Cancer, Cancer, Guidelines, Evidence-Based Practice, Healthcare Delivery
Harris S, Farah W, Snitchler C. S, Farah W, Snitchler C
Screening and interventions to prevent dental caries in children younger than five years.
This case study concerns Hispanic parents new to a practice who bring in their two children, two years of age and four months of age, for routine wellness visits. The parents have questions about dental care for their children. Three case study questions are provided along with answers. Bonus digital content provides an information sheet with a Clinical Summary of the USPSTF Recommendation.
AHRQ-authored.
Citation:
Harris S, Farah W, Snitchler C. S, Farah W, Snitchler C .
Screening and interventions to prevent dental caries in children younger than five years.
Am Fam Physician 2022 Mar;105(3):299-300..
Keywords:
Children/Adolescents, Dental and Oral Health, Screening, Guidelines, Evidence-Based Practice, Case Study
Penfold RB, Thompson EE, Hilt RJ
Development of a symptom-focused model to guide the prescribing of antipsychotics in children and adolescents: results of the first phase of the Safer Use of Antipsychotics in Youth (SUAY) Clinical Trial.
The purpose of this study was to develop a new approach to prescribing guidelines as part of a pragmatic trial, Safer Use of Antipsychotics in Youth (SUAY; ClinicalTrials.gov Identifier: NCT03448575), which supports prescribers in delivering high-quality mental health care to youths. Prescribing guidelines are often ignored because they do not incorporate the real-world availability of first-line psychosocial treatments, comorbid conditions, and clinical complexity. The investigators indicated that their approach addressed some of these concerns.
AHRQ-funded; HS026001; HS023258.
Citation:
Penfold RB, Thompson EE, Hilt RJ .
Development of a symptom-focused model to guide the prescribing of antipsychotics in children and adolescents: results of the first phase of the Safer Use of Antipsychotics in Youth (SUAY) Clinical Trial.
J Am Acad Child Adolesc Psychiatry 2022 Jan;61(1):93-102. doi: 10.1016/j.jaac.2021.04.010..
Keywords:
Children/Adolescents, Medication, Behavioral Health, Patient Safety, Guidelines, Evidence-Based Practice
Thomas TW, Golin CE, Kinlaw AC
Did the 2015 USPSTF abnormal blood glucose recommendations change clinician attitudes or behaviors? A mixed-method assessment.
In 2015, the US Preventive Services Task Force (USPSTF) revised clinical recommendations to more broadly recommend abnormal blood glucose screening and more clearly recommend referral to behavioral interventions for adults with prediabetes. The objective of this study was to assess the effects of the 2015 USPSTF recommendation changes on abnormal blood glucose screening and referral to behavioral interventions, and to examine physicians' perceptions of the revised recommendation.
AHRQ-funded; HS025561; HS000032.
Citation:
Thomas TW, Golin CE, Kinlaw AC .
Did the 2015 USPSTF abnormal blood glucose recommendations change clinician attitudes or behaviors? A mixed-method assessment.
J Gen Intern Med 2022 Jan;37(1):15-22. doi: 10.1007/s11606-021-06749-x..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Diabetes, Screening, Guidelines, Prevention
Tracer H, Mohnot S
Screening for prediabetes and type 2 diabetes mellitus.
In this “Putting Prevention Into Practice An Evidence-Based Approach”, the authors provide a case study with questions and answers related to Screening for Prediabetes and Type 2 Diabetes Mellitus.
AHRQ-authored.
Citation:
Tracer H, Mohnot S .
Screening for prediabetes and type 2 diabetes mellitus.
Screening for prediabetes and type 2 diabetes mellitus.
Am Fam Physician 2022 Jan 1;105(1):73-74..
Am Fam Physician 2022 Jan 1;105(1):73-74..
Keywords:
Diabetes, Screening, Prevention, Evidence-Based Practice, Guidelines, Case Study
Chou R, Pappas M, Dana T
Screening and interventions to prevent dental caries in children younger than 5 years: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this evidence review was to update the 2014 review on dental caries screening and preventive interventions to inform the USPSTF. Findings showed no direct evidence on benefits and harms of primary care oral health screening or referral to dentist, while dietary fluoride supplementation and fluoride varnish were associated with improved caries outcomes in higher-risk children and settings.
AHRQ-funded; 290201500009I.
Citation:
Chou R, Pappas M, Dana T .
Screening and interventions to prevent dental caries in children younger than 5 years: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Dec 7;326(21):2179-92. doi: 10.1001/jama.2021.15658..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Dental and Oral Health, Screening, Evidence-Based Practice, Guidelines, Prevention
Razon N, Hessler D, Bibbins-Domingo K
How hypertension guidelines address social determinants of health: a systematic scoping review.
Patient-level and community-level social and economic conditions impact hypertension risk and control. In this study, the investigators examined adult hypertension management guidelines to explore whether and how existing guidelines refer to social care activities. The investigators concluded that information about social determinants of health is included in many hypertension guidelines, but few guidelines provide clear guidance for clinicians or health systems on how to identify and address social risk factors in the context of care delivery.
AHRQ-funded; HS022241.
Citation:
Razon N, Hessler D, Bibbins-Domingo K .
How hypertension guidelines address social determinants of health: a systematic scoping review.
Med Care 2021 Dec;59(12):1122-29. doi: 10.1097/mlr.0000000000001649..
Keywords:
Hypertension, Social Determinants of Health, Guidelines, Evidence-Based Practice
Greenwald E, Olds E, Leonard J
Pediatric sepsis in community emergency care settings: guideline concordance and outcomes.
The authors sought to describe the rate of guideline-concordant care, and hypothesized that guideline-concordant care in community pediatric emergency care settings would be associated with decreased hospital length of stay (LOS). They found that guideline-concordant care was not associated with hospital LOS. The elements that drove overall concordance were timely recognition, vascular access, and timely antibiotics. Emergency care for pediatric sepsis in the community settings studied was concordant with guidelines in only 24% of the cases. They recommended future study to evaluate additional drivers of outcomes and ways to improve sepsis care in community emergency care settings.
AHRQ-funded; HS025696.
Citation:
Greenwald E, Olds E, Leonard J .
Pediatric sepsis in community emergency care settings: guideline concordance and outcomes.
Pediatr Emerg Care 2021 Dec;37(12):e1571-e77. doi: 10.1097/pec.0000000000002120..
Keywords:
Children/Adolescents, Sepsis, Emergency Department, Guidelines, Evidence-Based Practice
Mills J, Mohnot S
Screening for gestational diabetes.
This “Putting Prevention into Practice: An Evidence Based Approach” paper is a case study with questions and answers related to a patient with gestational diabetes.
AHRQ-authored.
Citation:
Mills J, Mohnot S .
Screening for gestational diabetes.
Am Fam Physician 2021 Dec 1;104(6):641-42..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Diabetes, Pregnancy, Screening, Prevention, Women, Evidence-Based Practice, Guidelines, Case Study
Caughey AB, Krist AH, Wolff TA
USPSTF approach to addressing sex and gender when making recommendations for clinical preventive services.
The USPSTF reviewed its past recommendations that included the use of sex and gender terms, reviewed the approaches of other guideline-making bodies, and pilot-tested strategies to address sex and gender diversity. Based on the findings, the USPSTF intends to use an inclusive approach to identify issues related to sex and gender at the start of the guideline development process; assess the applicability, variability, and quality of evidence as a function of sex and gender; ensure clarity in the use of language regarding sex and gender; and identify evidence gaps related to sex and gender. The USPSTF recognizes limited evidence to inform the preventive care of populations based on gender identity.
AHRQ-authored.
Citation:
Caughey AB, Krist AH, Wolff TA .
USPSTF approach to addressing sex and gender when making recommendations for clinical preventive services.
JAMA 2021 Nov 16;326(19):1953-61. doi: 10.1001/jama.2021.15731..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Guidelines, Evidence-Based Practice, Prevention, Research Methodologies
Yao L, Ahmed MM, Guyatt GH
Discordant and inappropriate discordant recommendations in consensus and evidence based guidelines: empirical analysis.
The purpose of this study was to investigate whether alignment of strength of recommendations with quality of evidence differs in consensus based versus evidence based guidelines. The investigators concluded that consensus based guidelines produced more recommendations violating the evidence based medicine principles than evidence based guidelines. They suggested that ensuring appropriate alignment of quality of evidence with the strength of recommendations is key to the development of "trustworthy" guidelines.
AHRQ-funded; HS024917.
Citation:
Yao L, Ahmed MM, Guyatt GH .
Discordant and inappropriate discordant recommendations in consensus and evidence based guidelines: empirical analysis.
BMJ 2021 Nov 25;375:e066045. doi: 10.1136/bmj-2021-066045..
Keywords:
Guidelines, Evidence-Based Practice, Research Methodologies
Tracer H, West R
Screening for vitamin D deficiency in adults.
This case study in the “Putting Prevention into Practice: An Evidence Based Approach” series focuses on screening for vitamin D deficiency in adults. It includes a case study, questions, and answers.
AHRQ-authored.
Citation:
Tracer H, West R .
Screening for vitamin D deficiency in adults.
Am Fam Physician 2021 Nov 1;104(5):515-16..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Vitamins and Supplements, Screening, Prevention, Guidelines, Evidence-Based Practice, Case Study
Davidson KW, Krist AH, Tseng CW
Incorporation of social risk in US Preventive Services Task Force Recommendations and identification of key challenges for primary care.
The authors assessed how social risks have been considered in USPSTF recommendation statements and identified current gaps in evidence needed to expand the systematic inclusion of social risks in future recommendations. They concluded that their report serves as a benchmark and foundation for ongoing work to advance the goal of ensuring that health equity and social risks are incorporated into USPSTF methods and recommendations.
AHRQ-authored.
Citation:
Davidson KW, Krist AH, Tseng CW .
Incorporation of social risk in US Preventive Services Task Force Recommendations and identification of key challenges for primary care.
JAMA 2021 Oct 12;326(14):1410-15. doi: 10.1001/jama.2021.12833..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Primary Care, Social Determinants of Health, Risk, Evidence-Based Practice, Research Methodologies, Guidelines
Mills J, O'Dowd N
Healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
This “Putting Prevention into Practice: An Evidence Based Approach” paper is a case study with questions and answers related to healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
AHRQ-authored.
Citation:
Mills J, O'Dowd N .
Healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
Am Fam Physician 2021 Oct 1;104(4):411-12..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Cardiovascular Conditions, Prevention, Lifestyle Changes, Risk, Evidence-Based Practice, Guidelines, Case Study
Bierman AS, Wang J, O'Malley PG
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
This article describes issues addressing the needs of those with multiple chronic conditions and discusses the AHRQ research agenda.
AHRQ-authored.
Citation:
Bierman AS, Wang J, O'Malley PG .
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
Health Serv Res 2021 Oct;56(Suppl 1):973-79. doi: 10.1111/1475-6773.13863..
Keywords:
Chronic Conditions, Health Services Research (HSR), Healthcare Delivery, Quality of Care, Primary Care, Guidelines, Evidence-Based Practice
Cantor A, Dana T, Griffin JC
Screening for chlamydial and gonococcal infections: updated evidence report and systematic review for the US Preventive Services Task Force.
This is the evidence summary and updated review for the September 2021 U.S. Preventive Services Task Force final recommendation on screening for chlamydial and gonococcal infections among sexually active women 25 years or older and sexually active men. The Task Force concluded that for women screening is recommended, but for men the current evidence is insufficient to assess the balance of benefits and harms. This systematic review screened over 2200 articles and included 20 articles. The articles included helped to answer the 4 key questions that were included in the research plan.
AHRQ-funded; 290201500009I.
Citation:
Cantor A, Dana T, Griffin JC .
Screening for chlamydial and gonococcal infections: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Sep 14;326(10):957-66. doi: 10.1001/jama.2021.10577..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Sexual Health, Infectious Diseases, Screening, Evidence-Based Practice, Guidelines, Prevention
Trent SA, George N, Havranek EP
Established evidence-based treatment guidelines help mitigate disparities in quality of emergency care.
Evidence-based guidelines are often cited as a means of ensuring high-quality care for all patients. The objective of this study was to assess whether emergency department (ED) adherence to core evidence-based guidelines differed by patient sex and race/ethnicity and to assess the effect of ED guideline adherence on patient outcomes by sex and race/ethnicity. The investigators concluded that longstanding, nationally reported evidence-based guidelines can help eliminate sex and race/ethnicity disparities in quality of care.
AHRQ-funded; HS022400.
Citation:
Trent SA, George N, Havranek EP .
Established evidence-based treatment guidelines help mitigate disparities in quality of emergency care.
Acad Emerg Med 2021 Sep;28(9):1051-60. doi: 10.1111/acem.14235..
Keywords:
Evidence-Based Practice, Guidelines, Emergency Department, Disparities, Quality of Care
Schondelmeyer AC, Bettencourt AP, Xiao R
Evaluation of an educational outreach and audit and feedback program to reduce continuous pulse oximetry use in hospitalized infants with stable bronchiolitis: a nonrandomized clinical trial.
National guidelines recommend against continuous pulse oximetry use for hospitalized children with bronchiolitis who are not receiving supplemental oxygen, yet guideline-discordant use remains high. The objective of this study was to evaluate deimplementation outcomes of educational outreach and audit and feedback strategies aiming to reduce guideline-discordant continuous pulse oximetry use in children hospitalized with bronchiolitis who are not receiving supplemental oxygen.
AHRQ-funded; HS026763.
Citation:
Schondelmeyer AC, Bettencourt AP, Xiao R .
Evaluation of an educational outreach and audit and feedback program to reduce continuous pulse oximetry use in hospitalized infants with stable bronchiolitis: a nonrandomized clinical trial.
JAMA Netw Open 2021 Sep;4(9):e2122826. doi: 10.1001/jamanetworkopen.2021.22826..
Keywords:
Newborns/Infants, Hospitalization, Guidelines, Practice Patterns, Training, Respiratory Conditions
Fan T, Stefanos R
Screening for colorectal cancer.
This AHRQ-authored Putting Preventions in Practice quiz has three questions and answers on the US Preventive Services Task Force final recommendation on screening for colorectal cancer. A case study is presented with questions on the best behavioral interventions, the effect of a patient’s age on the counseling approach, and what is an appropriate test and interval for colorectal screening. References are also provided at the end of the answers.
AHRQ-authored.
Citation:
Fan T, Stefanos R .
Screening for colorectal cancer.
Am Fam Physician 2021 Sep 1;104(3):295-96..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Cancer: Colorectal Cancer, Cancer, Screening, Prevention, Guidelines, Evidence-Based Practice, Case Study
Pillay J, Donovan L, Guitard S
Screening for gestational diabetes: updated evidence report and systematic review for the US Preventive Services Task Force.
The objective of this study was to update the 2012 review on screening for gestational diabetes to inform the US Preventive Services Task Force. The investigators concluded that direct evidence on screening vs no screening remained limited. One- vs 2-step screening was not significantly associated with improved health outcomes. At or after 24 weeks of gestation, treatment of gestational diabetes was significantly associated with improved health outcomes.
Citation:
Pillay J, Donovan L, Guitard S .
Screening for gestational diabetes: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Aug 10;326(6):539-62. doi: 10.1001/jama.2021.10404..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Diabetes, Pregnancy, Screening, Evidence-Based Practice, Women, Prevention, Guidelines
Dorr DA, D'Autremont C, Pizzimenti C
Assessing data adequacy for high blood pressure clinical decision support: a quantitative analysis.
This study examined guideline-based high blood pressure (HBP) and hypertension recommendations and evaluated the suitability and adequacy of the data and logic required for a Fast Healthcare Interoperable Resources-based, patient-facing clinical decision support HBP application. Findings showed that data quality from the electronic health record required to implement recommendations for HBP was highly inconsistent, reflecting a fragmented health care system and incomplete implementation of standard terminologies and workflows. Although imperfect, data were deemed adequate for two test use cases.
AHRQ-funded; HS026849.
Citation:
Dorr DA, D'Autremont C, Pizzimenti C .
Assessing data adequacy for high blood pressure clinical decision support: a quantitative analysis.
Appl Clin Inform 2021 Aug;12(4):710-20. doi: 10.1055/s-0041-1732401..
Keywords:
Hypertension, Blood Pressure, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Guidelines
Marin JR, Rodean J, Mannix RC
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
The objective of this study was to examine whether the presence of clinical guidelines and clinical decision support (CDS) for mild traumatic brain injury (mTBI) were associated with lower head computed tomography (CT) use. The investigators concluded that clinical guidelines for mTBI, and particularly CDS, were associated with lower rates of head CT use without adverse clinical outcomes.
AHRQ-funded; HS026006.
Citation:
Marin JR, Rodean J, Mannix RC .
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
J Pediatr 2021 Aug;235:178-83.e1. doi: 10.1016/j.jpeds.2021.04.026..
Keywords:
Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT), Brain Injury, Guidelines, Evidence-Based Practice, Imaging
Djulbegovic B, Hozo I, Li SA
Certainty of evidence and intervention's benefits and harms are key determinants of guidelines' recommendations.
This study’s goal was to identify the key determinants of clinical guideline development. This study used a web-based survey of 12 panels of 153 “voting” members who issued 2941 recommendations and a qualitative analysis of 13 panels of 311 attendees. When intervention’s benefits outweigh harms compared with no recommendations: the probability of issuing strong recommendations in favor of intervention was 0.22 when certainty of evidence (CoE) was very low; 0.5 when low; 0.74 when moderate, and 0.85 when high. No other factor significantly affected recommendations. Panelists spent over 50% of their time debating CoE with the chairs and co-chairs dominating discussion.
AHRQ-funded; HS024917.
Citation:
Djulbegovic B, Hozo I, Li SA .
Certainty of evidence and intervention's benefits and harms are key determinants of guidelines' recommendations.
J Clin Epidemiol 2021 Aug;136:1-9. doi: 10.1016/j.jclinepi.2021.02.025..
Keywords:
Evidence-Based Practice, Guidelines, Research Methodologies, Decision Making
Darling KE, Warnick J, Hadley W
Reactions to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity: a multi-informant qualitative approach.
This study measured reactions by adolescents, parents, and physicians to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity. The guidelines recommended those identified should be referred to comprehensive weight management programs consisting of at least 26 contact hours and focus on multiple targets of behavior. In-depth interviews were conducted with 7 adolescents, 7 parents, and 4 physicians. In general, participants viewed the guidelines positively but identified changes that may be necessary to increase the feasibility of adolescents engaging in programs that meet these guidelines. Participants also noted the importance of flexibility within programs.
AHRQ-funded; HS02707.
Citation:
Darling KE, Warnick J, Hadley W .
Reactions to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity: a multi-informant qualitative approach.
Clin Obes 2021 Aug;11(4):e12451. doi: 10.1111/cob.12451..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Obesity, Guidelines, Evidence-Based Practice
