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
76 to 100 of 364 Research Studies DisplayedGold HT, Siman N, Cuthel AM
A practice facilitation-guided intervention in primary care settings to reduce cardiovascular disease risk: a cost analysis.
In this randomized controlled trial, researchers estimated the associated cost of practice facilitation (PF) for guideline adoption in small, private primary care practices. They found that the PF strategy cost approximately $10,000 per practice per quarter for program and practice costs, once implemented and running at highest efficiency. They indicated that whether or not this program is worthwhile to the decision-maker depends on the relative costs and effectiveness of their other options for improving cardiovascular risk reduction.
AHRQ-funded; HS023922.
Citation: Gold HT, Siman N, Cuthel AM .
A practice facilitation-guided intervention in primary care settings to reduce cardiovascular disease risk: a cost analysis.
Implement Sci Commun 2021 Feb 6;2(1):15. doi: 10.1186/s43058-021-00116-x..
Keywords: Primary Care, Cardiovascular Conditions, Guidelines, Prevention, Evidence-Based Practice, Primary Care: Models of Care, Healthcare Costs
Guirguis-Blake JM, Webber EM, Coppola EL
Screening for asymptomatic carotid artery stenosis in the general population: updated evidence report and systematic review for the US Preventive Services Task Force.
This evidence update aimed to identify studies published since the previous 2014 review to inform an updated USPSTF recommendation. The conclusions of this review are consistent with those of the previous review; there was no direct evidence examining the benefits or harms of screening. While there were few new trials examining the comparative effectiveness of revascularization compared with contemporary best medical treatment alone, the ongoing CREST-2, ECST-2, and ACTRIS trials will add to this treatment evidence base for asymptomatic carotid artery stenosis in the future.
AHRQ-funded; 290201500007I.
Citation: Guirguis-Blake JM, Webber EM, Coppola EL .
Screening for asymptomatic carotid artery stenosis in the general population: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Feb 2;325(5):487-89. doi: 10.1001/jama.2020.20364..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Screening, Guidelines, Evidence-Based Practice, Prevention
Dworsky JQ, Shenoy R, Childers CP
Older veterans undergoing inpatient surgery: what is the compliance with best practice guidelines?
This study’s objective was to determine the documented compliance with best practice guidelines for optimal perioperative care for the older adult surgical patient that were created by the American College of Surgeons Quality Improvement Program and the American Geriatrics Society. The guidelines include 38 measures. A retrospective chart review was conducted on 86 older adults undergoing elective inpatient coronary artery bypass graft, prostatectomy, or colectomy over a 2-year period at a single Veterans Affairs hospital. Mean reported compliance across measures was 41% ± 4%. Of the 38 analyzed measures, 10 measures were achieved for 0 patients, and only 1 patient for 7 measures. Future work is needed to understand barriers for implementation.
AHRQ-funded; HS000046.
Citation: Dworsky JQ, Shenoy R, Childers CP .
Older veterans undergoing inpatient surgery: what is the compliance with best practice guidelines?
Surgery 2021 Feb;169(2):356-61. doi: 10.1016/j.surg.2020.08.033..
Keywords: Elderly, Surgery, Guidelines, Evidence-Based Practice, Quality Improvement, Quality of Care, Quality Measures
Kemme S, Stahl M, Brigham D
Outcomes of severe seronegative hepatitis-associated aplastic anemia: a pediatric case series.
Hepatitis-associated aplastic anemia (HAAA) is a potentially life-threatening diagnosis without clear treatment guidelines. The goal of the study was to characterize the presentation, evaluation, histopathology, and outcomes of therapy in children with HAAA to guide future research and to develop standardized care guidelines for this rare disease. The investigators found that ATG-based IST induced remission of hepatitis in patients with steroid-refractory HAAA.
AHRQ-funded; HS026510.
Citation: Kemme S, Stahl M, Brigham D .
Outcomes of severe seronegative hepatitis-associated aplastic anemia: a pediatric case series.
J Pediatr Gastroenterol Nutr 2021 Feb;72(2):194-201. doi: 10.1097/mpg.0000000000002940..
Keywords: Children/Adolescents, Hepatitis, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Guidelines
Fleischer DM, Chan ES, Venter C
A consensus approach to the primary prevention of food allergy through nutrition: guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical
This paper provides a consensus approach to the primary prevention of pediatric food allergy through nutrition using data from a number of high-impact randomized controlled trials. Recommendations from the American Academy of Allergy, Asthma, and Immunology, American College of Allergy, Asthma, and Immunology, and the Canadian Society for Allergy and Clinical Immunology are to introduce peanut and egg around age 6 months, but not before 4 months as well as introducing other allergens. Maternal exclusion of allergens during pregnancy and/or breastfeeding to prevent food allergy is not recommended. No association was found between exclusive breast-feeding and the primary prevention of any specific food allergy.
AHRQ-funded; HS024599.
Citation: Fleischer DM, Chan ES, Venter C .
A consensus approach to the primary prevention of food allergy through nutrition: guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical
J Allergy Clin Immunol Pract 2021 Jan;9(1):22-43.e4. doi: 10.1016/j.jaip.2020.11.002..
Keywords: Asthma, Respiratory Conditions, Prevention, Guidelines, Evidence-Based Practice
Wolk CB, Schondelmeyer AC, Barg FK
Barriers and facilitators to guideline-adherent pulse oximetry use in bronchiolitis.
Continuous pulse oximetry monitoring (cSpO(2)) in children with bronchiolitis does not improve clinical outcomes and has been associated with increased resource use and alarm fatigue. It is critical to understand the factors that contribute to cSpO(2) overuse in order to reduce overuse and its associated harms. In this paper, the authors discuss the barriers and facilitators to guideline-adherent pulse oximetry use in bronchiolitis.
AHRQ-funded; HS023827; HS026763.
Citation: Wolk CB, Schondelmeyer AC, Barg FK .
Barriers and facilitators to guideline-adherent pulse oximetry use in bronchiolitis.
J Hosp Med 2021 Jan;16(1):23-30. doi: 10.12788/jhm.3535..
Keywords: Children/Adolescents, Respiratory Conditions, Guidelines
Reese TJ, Schlechter CR, Potter LN
Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations.
The purpose of this study was to determine the changes associated with the revised USPSTF guideline for lung cancer screening eligibility among female, Black, and Hispanic populations using a large nationwide survey. The investigators concluded that the revised USPSTF guideline may likely increase lung cancer screening rates for female, Black, and Hispanic populations. However, despite these potential improvements, lung cancer screening inequities may persist without tailored eligibility criteria.
AHRQ-funded; HS026198.
Citation: Reese TJ, Schlechter CR, Potter LN .
Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations.
JAMA Netw Open 2021 Jan;4(1):e2033769. doi: 10.1001/jamanetworkopen.2020.33769..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Screening, Racial and Ethnic Minorities, Women, Guidelines, Evidence-Based Practice
Navis A, George MC, Nmashie A
Validation of the Safer Opioid Prescribing Evaluation Tool (SOPET) for assessing adherence to the Centers for Disease Control opioid prescribing guidelines.
This study assessed the use of the Safer Opioid Prescribing Evaluation Tool (SOPET) which was designed to improve the implementation of the 2016 Centers for Disease Control Guidelines on the prescription of opioids for chronic pain. Four raters with varying levels of clinical experience were trained to use the SOPET and then used it to evaluate 21 baseline patient scenarios. Inter-rater reliability was measured using intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals for the total SOPET score based on a mean-rating absolute-agreement, two-way random-effects model. Inter-rater reliability was found to be good for the three physician raters (0.92, 0.97, and 0.99). However, inter-rater reliability for the non-physician rater was lower (0.67).
AHRQ-funded; HS025641.
Citation: Navis A, George MC, Nmashie A .
Validation of the Safer Opioid Prescribing Evaluation Tool (SOPET) for assessing adherence to the Centers for Disease Control opioid prescribing guidelines.
Pain Med 2020 Dec 25;21(12):3655-59. doi: 10.1093/pm/pnaa138..
Keywords: Opioids, Medication, Medication: Safety, Patient Safety, Guidelines, Practice Patterns, Pain, Chronic Conditions, Evidence-Based Practice
Nguyen AM, Cuthel AM, Rogers ES
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
This study called HealthyHearts NYC was a stepped wedge randomized control trial that tested the effectiveness of practice facilitation in small primary care practices in adopting cardiovascular disease guidelines. The practice-level benchmark desired was having 70% or greater of hypertensive patients having controlled blood pressure. A mixed methods multiple-case study design was used and implemented at 6 small practices. The investigator’s first key finding was that the high-performing and improved practices in their study looked and acted similarly during the intervention implementation. Three key attributes of these practices were found to be: 1) advanced use of electronic health records; 2) dedicated resources and commitment to quality improvement; and 3) an actively engaged lead clinician and office manager.
AHRQ-funded; HS023922.
Citation: Nguyen AM, Cuthel AM, Rogers ES .
Attributes of high-performing small practices in a guideline implementation: a multiple-case study.
J Prim Care Community Health 2020 Jan-Dec;11. doi: 10.1177/2150132720984411..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Primary Care, Evidence-Based Practice, Guidelines, Implementation
Gelfand JM, Armstrong AW, Bell S
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
This article describes the process that was used to create the first version of a guidance document for management of psoriatic disease during the COVID-19 pandemic developed by the National Psoriasis Foundation. A task force of 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care was created with supplementation by nonvoting members. A Delphi process was created, out of which 22 guidance statements were approved. All guidance statements were recommended, with 9 of them high consensus, and the remaining 13 were moderate consensus. Topics covered included how COVID-19 can impact patients, how medical care can be optimized during the pandemic, and what patients can do to lower their risk of getting infected with COVID-19. This guidance will be updated by the TF as new data emerges.
AHRQ-funded; HS026372.
Citation: Gelfand JM, Armstrong AW, Bell S .
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
J Am Acad Dermatol 2020 Dec;83(6):1704-16. doi: 10.1016/j.jaad.2020.09.001..
Keywords: Skin Conditions, Chronic Conditions, Care Management, Evidence-Based Practice, Guidelines, COVID-19
Harder VS, Shaw JS, McCulloch CE
Statewide asthma learning collaborative participation and asthma-related emergency department use.
This study looked at outcomes from participation of pediatric practices in a quality improvement (QI) collaborative to decrease asthma-related emergency department (ED) visits. A statewide network of practices participated in the collaborative from 2015 to 2016. Asthma-related ED visit rates per 100 child-years for children ages 3 to 21 was evaluated using the state’s all-payer claims databases. The authors found that in the postintervention year (2017) participating practices’ ED visit rate decreased by 5.8 per 100 child-years, compared to an increase of 1.8 per 100 child-years in non-participating practices. There were no statistically significant differences in asthma-related ED visit rates during 2016, which indicated that it took some time for QI elements to be successfully implemented in pediatric practices.
AHRQ-funded; HS025297.
Citation: Harder VS, Shaw JS, McCulloch CE .
Statewide asthma learning collaborative participation and asthma-related emergency department use.
Pediatrics 2020 Dec;146(6):e20200213. doi: 10.1542/peds.2020-0213..
Keywords: Children/Adolescents, Asthma, Emergency Department, Quality Improvement, Quality of Care, Primary Care, Guidelines
O'Connor EA, Evans CV, Rushkin MC
Behavioral counseling to pomote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: updated evidence report and systematic review for the US Preventive Services Task Force.
Researchers reviewed the benefits and harms of behavioral counseling interventions to improve diet and physical activity in adults with cardiovascular risk factors. They found that medium- and high-contact multisession behavioral counseling interventions to improve diet and increase physical activity for people with elevated blood pressure and lipid levels were effective in reducing cardiovascular events, blood pressure, low-density lipoproteins, and adiposity-related outcomes, with little to no risk of serious harm.
AHRQ-funded; 290201200015I.
Citation: O'Connor EA, Evans CV, Rushkin MC .
Behavioral counseling to pomote a healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Nov 24;324(20):2076-94. doi: 10.1001/jama.2020.17108..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Nutrition, Lifestyle Changes, Risk, Prevention, Evidence-Based Practice, Guidelines
Fan T, Palma M
AHRQ Author: Fan T
Behavioral counseling interventions to prevent sexually transmitted infections.
This case study of a 24-year-old cisgender woman presents three questions with answers concerning USPSTF recommendations about sexually transmitted infections and counseling.
AHRQ-authored.
Citation: Fan T, Palma M .
Behavioral counseling interventions to prevent sexually transmitted infections.
Am Fam Physician 2020 Nov 15;102(10):623-24..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sexual Health, Infectious Diseases, Public Health, Prevention, Case Study, Guidelines
Ehlers AP, Vitous CA, Sales A
Exploration of factors associated with surgeon deviation from practice guidelines for management of inguinal hernias.
Investigators explored factors associated with surgeon choice of approach (minimally invasive vs open) in inguinal hernia repair as a tool to gain an understanding of guideline-discordant care. They found that decision-making for the approach to inguinal hernia repair was largely influenced by surgeon preference and access to resources rather than patient factors. Although a one-size-fits-all approach is not recommended, the operative approach should ideally be informed by patient factors, including hernia characteristics. They recommended addressing surgeon preference and available resources with a clinician-facing decision aid to provide an opportunity to optimize care for patients undergoing inguinal hernia repair.
AHRQ-funded; HS025778.
Citation: Ehlers AP, Vitous CA, Sales A .
Exploration of factors associated with surgeon deviation from practice guidelines for management of inguinal hernias.
JAMA Netw Open 2020 Nov 2;3(11):e2023684. doi: 10.1001/jamanetworkopen.2020.23684..
Keywords: Surgery, Guidelines, Provider: Physician, Provider, Decision Making, Evidence-Based Practice
Kapoor N, Lacson R, Hammer M
Physician agreement with recommendations contained in a national guideline for the management of incidental pulmonary nodules: a case study.
This survey of physicians was used to determine agreement with recommendations in the national guideline for the management of incidental pulmonary nodules from the 2017 Fleischner Society Guidelines for Management of Incident Pulmonary Nodules (FSG). The FSG contains 18 unique recommendations which were codified into a clinical evidence logic statement (CELS) for this study. The FSG also included ratings for strength of evidence based on the American Society of Chest Physicians grading system. In order to internally grade the strength of evidence behind each recommendation, two medical librarians from the Harvard Library of Evidence analyzed each CELS independently and graded the recommendations based on the supporting clinical studies using the Oxford Centre for Evidence-Based levels of evidence and the US Preventive Service Task Force I-scores. Nine physicians from a single large academic institution were then surveyed via SurveyMonkey to assess agreement with each of the 18 CELS. Agreement on each recommendation ranged from 0 to 100%. This study was meant to be exploratory and to test the hypothesis that guideline nonadherence may be partly affected by lack of physician agreement with guideline component recommendations.
AHRQ-funded; HS024722.
Citation: Kapoor N, Lacson R, Hammer M .
Physician agreement with recommendations contained in a national guideline for the management of incidental pulmonary nodules: a case study.
J Am Coll Radiol 2020 Nov;17(11):1437-42. doi: 10.1016/j.jacr.2020.07.020..
Keywords: U.S. Preventive Services Task Force (USPSTF), Guidelines, Evidence-Based Practice, Respiratory Conditions, Practice Patterns, Provider: Physician, Provider
Brown W, Santhosh L, Brady AK
A call for collaboration and consensus on training for endotracheal intubation in the medical intensive care unit.
This article presents a review of endotracheal intubation (EI) training for healthcare professionals in pulmonary and critical care medicine (PCCM). Although the ACGME mandates that trainees in PCCM achieve competence, only 60% of US PCCM trainees feel they are proficient in EI upon graduation. This article includes a review of EI training literature; the recommendations of a national group of PCCM, anesthesiology, emergency medicine, and pediatric experts; and a call for further research, collaboration, and consensus guidelines.
Citation: Brown W, Santhosh L, Brady AK .
A call for collaboration and consensus on training for endotracheal intubation in the medical intensive care unit.
Crit Care 2020 Oct 22;24(1):621. doi: 10.1186/s13054-020-03317-3..
Keywords: Training, Education: Continuing Medical Education, Critical Care, Intensive Care Unit (ICU), Guidelines
Mills J, Wonoprabowo L
AHRQ Author: Mills J
Primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults.
This case study concerns a 14-year-old patient who presents for a well-child visit. The patient eats a healthy diet, is part of a local soccer league, is an overall good student, and just started high school in the fall. The patient denies trying any illicit substances but reports trying to “get high” from cough syrup. Three questions are presented, and answers provided.
AHRQ-authored.
Citation: Mills J, Wonoprabowo L .
Primary care-based interventions to prevent illicit drug use in children, adolescents, and young adults.
Am Fam Physician 2020 Oct 15;102(8):493-94..
Keywords: Children/Adolescents, Young Adults, Substance Abuse, Primary Care, Prevention, U.S. Preventive Services Task Force (USPSTF), Case Study, Guidelines, Evidence-Based Practice
Ferguson MC, O'Shea KJ, Hammer LD
Can following formula-feeding recommendations still result in infants who are overweight or have obesity?
This study compares guidelines for formula feeding and whether current recommendations still result in infants who are overweight or have obesity. The researchers used their “Virtual Infant” agent-based model representing infant-caregiver pairs that allowed caregivers to feed infants each day according to guidelines from Johns Hopkins Medicine (JHM), Children’s Hospital of Philadelphia (CHOP), Children’s Hospital of the King’s Daughters (CHKD), and Women, Infants, and Children (WIC). The WIC guidelines were found to be the best as opposed to JHM/CHOP/CHKD where infants still became overweight/obese by 6 months. The study recommended the minimum recommended amount of daily formula feeding should be made lower for JHM/CHOP/CHKD guidelines and that WIC guidelines may be a good starting point for caregivers.
AHRQ-funded; HS023317.
Citation: Ferguson MC, O'Shea KJ, Hammer LD .
Can following formula-feeding recommendations still result in infants who are overweight or have obesity?
Pediatr Res 2020 Oct;88(4):661-67. doi: 10.1038/s41390-020-0844-3..
Keywords: Newborns/Infants, Obesity: Weight Management, Obesity, Guidelines, Caregiving, Evidence-Based Practice
Knerr S, West KM, Angelo FA
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
Programs conducting population-based screening and genetic service delivery for hereditary cancer prevention and control are rare in practice. The authors interviewed individuals instrumental in implementing seven unique clinical programs conducting either universal tumor screening for Lynch Syndrome or routine family history screening and provision of genetic services for hereditary breast and ovarian cancer in the United States. Their findings suggest that developing interventions targeting change efficacy and cultivating practice change champions may be two promising ways to increase uptake of population-based hereditary cancer screening and genetic service delivery in clinical practice.
AHRQ-funded; HS022982.
Citation: Knerr S, West KM, Angelo FA .
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
J Genet Couns 2020 Oct;29(5):867-76. doi: 10.1002/jgc4.1216.
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Keywords: Cancer, Screening, Genetics, Prevention, Guidelines, Healthcare Delivery, Organizational Change, Implementation
Chen DW, Reyes-Gastelum D, Radhakrishnan A
Physician-reported misuse of thyroid ultrasonography.
The authors explored physician-reported use of thyroid ultrasonography. They found that a substantial number of physicians endorsed the use of ultrasonography for reasons not supported by clinical guidelines and in conflict with the Choosing Wisely recommendations. They concluded that their study highlights the need for focused physician education on clinically supported and unsupported indications for use of thyroid ultrasonography, with potential roles for future clinical practice guidelines, patient decision-making aids, and clinical decision-making support tools.
AHRQ-funded; HS024512.
Citation: Chen DW, Reyes-Gastelum D, Radhakrishnan A .
Physician-reported misuse of thyroid ultrasonography.
JAMA Surg 2020 Oct;155(10):984-86. doi: 10.1001/jamasurg.2020.2507..
Keywords: Imaging, Decision Making, Guidelines, Evidence-Based Practice
Davidson KW, Kemper AR, Doubeni CA
AHRQ Author: Mills J, Borsky A
Developing primary care-based recommendations for social determinants of health: methods of the U.S. Preventive Services Task Force.
This article highlights social determinants already included in USPSTF recommendations and proposes a process by which others may be considered for primary care preventive recommendations. By reviewing the evidence on the effects of screening and interventions on social determinants relevant to primary care, the USPSTF will continue to be able to provide recommendations on clinical preventive services to improve the health of all Americans.
AHRQ-authored.
Citation: Davidson KW, Kemper AR, Doubeni CA .
Developing primary care-based recommendations for social determinants of health: methods of the U.S. Preventive Services Task Force.
Ann Intern Med 2020 Sep 15;173(6):461-67. doi: 10.7326/m20-0730..
Keywords: U.S. Preventive Services Task Force (USPSTF), Primary Care, Social Determinants of Health, Evidence-Based Practice, Guidelines, Screening, Prevention
Strobel RJ, Harrington SD, Hill C
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Pneumonia is the most prevalent healthcare-associated infection after coronary artery bypass grafting (CABG), but the relative effectiveness of strategies to reduce its incidence remains unclear. In this study, the investigators evaluated the relationship between healthcare-associated infection recommendations and risk of pneumonia after CABG. These pneumonia prevention recommendations may serve as effective targets for avoiding postoperative healthcare-associated infections.
AHRQ-funded; HS022535; HS022909.
Citation: Strobel RJ, Harrington SD, Hill C .
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Ann Thorac Surg 2020 Sep;110(3):903-10. doi: 10.1016/j.athoracsur.2019.12.053..
Keywords: Pneumonia, Cardiovascular Conditions, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Prevention, Evidence-Based Practice, Guidelines, Risk
Gregory EF, Miller JM, Wasserman RC
Adherence to pediatric universal cholesterol testing guidelines across body mass index categories: A CER(2) cohort study.
This study asks whether, and to what extent, universal cholesterol testing has been adopted since the 2011 guideline. Findings showed that cholesterol testing by age 12 years increased between 2011 and 2016; children with elevated BMI were more likely to complete testing for all birth cohorts. However, testing among children with normal BMI has become increasingly prevalent, suggesting a shift toward universal cholesterol testing in pediatrics since the 2011 recommendation.
AHRQ-funded; HS021645.
Citation: Gregory EF, Miller JM, Wasserman RC .
Adherence to pediatric universal cholesterol testing guidelines across body mass index categories: A CER(2) cohort study.
Circ Cardiovasc Qual Outcomes 2020 Aug;13(8):e006519. doi: 10.1161/circoutcomes.119.006519..
Keywords: Children/Adolescents, Heart Disease and Health, Guidelines, Practice Patterns, Evidence-Based Practice
Smith ME, Vitous CA, Hughes TM
Barriers and facilitators to de-implementation of the Choosing Wisely((R)) guidelines for low-value breast cancer surgery.
The objective of this study was to understand why surgeons stop performing certain unnecessary cancer operations but not others and how best to de-implement entrenched and emerging unnecessary procedures. The investigators concluded that with a growing focus on the elimination of ineffective, unproven or low value practices, it is imperative that the behavioral determinants are understood and targeted with specific interventions to decrease utilization rapidly.
AHRQ-funded; HS026030.
Citation: Smith ME, Vitous CA, Hughes TM .
Barriers and facilitators to de-implementation of the Choosing Wisely((R)) guidelines for low-value breast cancer surgery.
Ann Surg Oncol 2020 Aug;27(8):2653-63. doi: 10.1245/s10434-020-08285-0..
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Decision Making, Guidelines, Women
Schondelmeyer AC, Dewan ML, Brady PW
Cardiorespiratory and pulse oximetry monitoring in hospitalized children: a Delphi process.
Cardiorespiratory and pulse oximetry monitoring in children who are hospitalized should balance benefits of detecting deterioration with potential harms of alarm fatigue. The authors of this paper developed recommendations for monitoring outside the ICU on the basis of available evidence and expert opinion. They conducted a comprehensive literature search for studies addressing the utility of cardiorespiratory and pulse oximetry monitoring in common pediatric conditions and drafted candidate monitoring recommendations based on their findings.
AHRQ-funded; HS026620; HS026763; HS023827.
Citation: Schondelmeyer AC, Dewan ML, Brady PW .
Cardiorespiratory and pulse oximetry monitoring in hospitalized children: a Delphi process.
Pediatrics 2020 Aug;146(2). doi: 10.1542/peds.2019-3336..
Keywords: Children/Adolescents, Respiratory Conditions, Guidelines, Evidence-Based Practice