National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Arthritis (1)
- Brain Injury (2)
- Cancer (2)
- Cancer: Breast Cancer (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (1)
- Care Management (1)
- Children/Adolescents (4)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (9)
- Clinician-Patient Communication (2)
- Communication (1)
- Comparative Effectiveness (6)
- Data (2)
- (-) Decision Making (58)
- Dementia (1)
- Diabetes (2)
- Diagnostic Safety and Quality (3)
- Domestic Violence (1)
- Education: Patient and Caregiver (1)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (2)
- Emergency Medical Services (EMS) (1)
- (-) Evidence-Based Practice (58)
- Falls (1)
- Guidelines (19)
- Healthcare Costs (1)
- Healthcare Delivery (6)
- Health Information Technology (HIT) (7)
- Health Literacy (1)
- Health Systems (2)
- Heart Disease and Health (1)
- Hospitals (1)
- Imaging (4)
- Implementation (4)
- Influenza (1)
- Injuries and Wounds (2)
- Inpatient Care (1)
- Learning Health Systems (2)
- Medication (2)
- Neurological Disorders (2)
- Newborns/Infants (1)
- Orthopedics (1)
- Outcomes (2)
- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (15)
- Patient and Family Engagement (4)
- Patient Safety (1)
- Policy (2)
- Practice Patterns (4)
- Pregnancy (1)
- Prevention (3)
- Primary Care (2)
- Primary Care: Models of Care (1)
- Provider (4)
- Provider: Clinician (2)
- Provider: Physician (4)
- Quality Improvement (1)
- Quality of Care (1)
- Registries (2)
- Research Methodologies (9)
- Respiratory Conditions (3)
- Risk (2)
- Screening (1)
- Sickle Cell Disease (1)
- Surgery (6)
- Tools & Toolkits (1)
- Transplantation (2)
- Trauma (1)
- Treatments (1)
- Women (2)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 58 Research Studies DisplayedDjulbegovic B, Hozo I, Lizarraga D
Decomposing clinical practice guidelines panels' deliberation into decision theoretical constructs.
The creation of clinical practice guidelines (CPG) is hindered by the absence of a clear and transparent structure for integrating key components needed to develop practice recommendations. The purpose of the study was to compare the American Society of Hematology (ASH) CPG panel's deliberations for managing pulmonary embolism (PE) to relevant decision-theoretic constructs to evaluate the concordance between panel recommendations and explicit decision modeling. Five constructs were identified, with three employed to rephrase the panel's recommendations: 1) a standard, expected utility threshold (EUT) decision model; 2) an acceptable regret threshold model (ARg) for determining the acceptable frequency of false negative (FN) or false positive (FP) recommendations, and 3) fast-and-frugal tree (FFT) decision trees for devising a comprehensive strategy for PE management. The researchers compared four management approaches: withholding testing versus D-dimer → computerized pulmonary angiography (CTPA) ('ASH-Low') versus CTPA → D-dimer ('ASH-High') versus treatment without testing. The study found that various models yielded diverse recommendations. For instance, EUT suggested that testing should be withheld for prior PE probability <0.13%, a clinically implausible threshold up to 15 times (2/0.13) lower than the ASH guidelines threshold for excluding PE (at post probability of PE ≤2%). Only three models concurred that the 'ASH low' strategy should be applied to pretest PE probabilities between 0.13% and 13.27% and that the 'ASH high' approach should be utilized in a narrow range of prior PE probabilities between 90.85% and 93.07%. For all other prior PE probabilities, selecting one model did not guarantee consistency with other models
AHRQ-funded; HS024917
Citation: Djulbegovic B, Hozo I, Lizarraga D .
Decomposing clinical practice guidelines panels' deliberation into decision theoretical constructs.
J Eval Clin Pract 2023 Apr;29(3):459-71. doi: 10.1111/jep.13809.
Keywords: Guidelines, Evidence-Based Practice, Decision Making
Tyler A, Dempsey A, Spencer S
Do the guidelines apply?-A multisite, combined stakeholder qualitative case study to understand care decisions in bronchiolitis.
Researchers sought an improved understanding of factors that influence care decisions across multiple stakeholders and diverse settings in order to develop effective strategies to de-implement unnecessary testing and treatment for bronchiolitis. A qualitative case study was conducted across two geographically distinct university affiliated children's hospitals, including semistructured interviews and focus groups with patient participants. The researchers found that, incongruent with provider and care team perceptions, parents reported that they desire an evidence-based, less-is-more approach to bronchiolitis care.
AHRQ-funded; HS026512.
Citation: Tyler A, Dempsey A, Spencer S .
Do the guidelines apply?-A multisite, combined stakeholder qualitative case study to understand care decisions in bronchiolitis.
Acad Pediatr 2022 Jul;22(5):806-17. doi: 10.1016/j.acap.2021.08.003..
Keywords: Children/Adolescents, Respiratory Conditions, Decision Making, Guidelines, Evidence-Based Practice
Dullabh P, Sandberg SF, Heaney-Huls K
AHRQ Author: Berliner E, Dymek C, Harrison MI, Swiger J
Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan.
This AHRQ-authored horizon scan identified challenges and opportunities for advancing patient-centered clinical decision support (PC CDS) and future directions for PC CDS. The authors engaged a technical expert panel, conducted a scoping literature review, and interviewed key informants. They quantitatively analyzed literature and interview transcripts and mapped the findings to the 4 phases translating evidence into PC CDS interventions (Prioritizing, Authoring, Implementing, and Measuring) and to external factors. Twelve challenges were identified for PC CDS development with lack of patient input identified as a critical challenge. Lack of patient-centered terminology standards was viewed as a challenge in authoring PC CDS. They also found a dearth of CDS studies that measured clinical outcomes, creating significant gaps in the understanding of PC CDS’ impact.
AHRQ-authored; AHRQ-funded; 233201500023I.
Citation: Dullabh P, Sandberg SF, Heaney-Huls K .
Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan.
J Am Med Inform Assoc 2022 Jun 14;29(7):1233-43. doi: 10.1093/jamia/ocac059.
.
.
Keywords: Clinical Decision Support (CDS), Patient-Centered Healthcare, Health Information Technology (HIT), Decision Making, Patient-Centered Outcomes Research, Evidence-Based Practice
Lin E, Uhler LM, Finley EP
Incorporating patient-reported outcomes into shared decision-making in the management of patients with osteoarthritis of the knee: a hybrid effectiveness-implementation study protocol.
This article describes a US-based 2-year, two-site hybrid type 1 study to assess clinical effectiveness and implementation of a machine learning-based patient decision aid integrating patient-reported outcomes and clinical variables to support shared decision-making for patients with knee osteoarthritis considering total knee replacement. Study results will be disseminated through conference presentations, publications and professional societies.
AHRQ-funded; HS027037.
Citation: Lin E, Uhler LM, Finley EP .
Incorporating patient-reported outcomes into shared decision-making in the management of patients with osteoarthritis of the knee: a hybrid effectiveness-implementation study protocol.
BMJ Open 2022 Feb 21;12(2):e055933. doi: 10.1136/bmjopen-2021-055933..
Keywords: Clinical Decision Support (CDS), Decision Making, Arthritis, Patient-Centered Outcomes Research, Orthopedics, Health Information Technology (HIT), Evidence-Based Practice
Ibemere SO, Tanabe P, Bonnabeau E
Awareness and use of the sickle cell disease toolbox by primary care providers in North Carolina.
The authors developed a decision support tool for sickle cell disease (SCD) for SCD management (SCD Toolbox) based on the National Heart, Lung, and Blood Institute's SCD guidelines. Using data from primary care providers (PCPs) in North Carolina, they found that PCPs rarely co-managed with a specialist, had low awareness and use of the SCD Toolbox, and requested multiple formats for the toolbox.
AHRQ-funded; HS024501.
Citation: Ibemere SO, Tanabe P, Bonnabeau E .
Awareness and use of the sickle cell disease toolbox by primary care providers in North Carolina.
J Prim Care Community Health 2021 Jan-Dec;12:21501327211049050. doi: 10.1177/21501327211049050..
Keywords: Sickle Cell Disease, Primary Care, Chronic Conditions, Decision Making, Evidence-Based Practice
Samal L, Fu HN, Camara DS
AHRQ Author: Camara DS, Wang J, Bierman AS
Health information technology to improve care for people with multiple chronic conditions.
The objective of this study was to review evidence regarding the use of Health Information Technology (health IT) interventions aimed at improving care for people living with multiple chronic conditions (PLWMCC) in order to identify critical knowledge gaps. The investigators concluded that the body of literature included in this review provides critical information on the state of the science as well as the many gaps that need to be filled for digital health to fulfill its promise in supporting care delivery that meets the needs of PLWMCC.
AHRQ-authored; AHRQ-funded; HS026849; 290201600001B.
Citation: Samal L, Fu HN, Camara DS .
Health information technology to improve care for people with multiple chronic conditions.
Health Serv Res 2021 Oct;56(Suppl 1):1006-36. doi: 10.1111/1475-6773.13860..
Keywords: Chronic Conditions, Health Information Technology (HIT), Evidence-Based Practice, Decision Making, Healthcare Delivery
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
Murad MH, Chang SM, Fiordalisi CV
AHRQ Author: Chang SM
Improving the utility of evidence synthesis for decision makers in the face of insufficient evidence.
The authors identified and suggested strategies to make insufficient evidence ratings in systematic reviews more actionable. A workgroup comprising members from AHRQ’s Evidence-Based Practice Program convened throughout 2020. They identified five strategies for supplementing systematic review findings when evidence on benefits or harms is expected to be, or found to be, insufficient: 1) reconsider eligible study designs, 2) summarize indirect evidence, 3) summarize contextual and implementation evidence, 4) consider modelling, and 5) incorporate unpublished health system data in the evidence synthesis. While these strategies may not increase the strength of evidence, they may improve the utility of reports for decision makers.
AHRQ-authored; AHRQ-funded; 290201700003C; 290201500013I; 290201500008I; 290201500007I; 290201500011I; 290201500010I; 290201500002I; 290201500005I; 290201500012I; 290201500006I.
Citation: Murad MH, Chang SM, Fiordalisi CV .
Improving the utility of evidence synthesis for decision makers in the face of insufficient evidence.
J Clin Epidemiol 2021 Jul;135:170-75. doi: 10.1016/j.jclinepi.2021.02.028..
Keywords: Evidence-Based Practice, Decision Making, Patient-Centered Outcomes Research
Greenberg JK, Otun A, Nasraddin A
Electronic clinical decision support for children with minor head trauma and intracranial injuries: a sociotechnical analysis.
This paper discusses the development of an evidence-based clinical decision support (CDS) for management of children with minor head trauma (MHT) and evaluates the sociotechnical environment impacting the implementation of electronic CDS, including workflow and communication, institutional culture, and hardware and software infrastructure. Semi-structured qualitative focus group interviews were conducted with 28 physicians and four information technology specialists between March and May 2020. Five primary themes were identified through inductive thematic analysis: 1) clinical impact; 2) stakeholders and users; 3) tool content; 4) clinical practice integration; and 5) post-implementation evaluation measures. Participants generally supported CDS use to determine an appropriate level-of-care. However, some had mixed feelings regarding how the tool could best be used by neurosurgeons versus non-neurosurgeons. Feedback helped refine the tool content and highlighted potential technical and workflow barriers to address prior to implementation.
AHRQ-funded; HS027075.
Citation: Greenberg JK, Otun A, Nasraddin A .
Electronic clinical decision support for children with minor head trauma and intracranial injuries: a sociotechnical analysis.
BMC Med Inform Decis Mak 2021 May 19;21(1):161. doi: 10.1186/s12911-021-01522-w.
.
.
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Brain Injury, Health Information Technology (HIT), Evidence-Based Practice, Decision Making
McKinney WT, Schaffhausen CR, Schladt D
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
The Scientific Registry of Transplant Recipients provides transplant program-specific information, but it is unclear what patients and stakeholders need to know. Acceptance criteria for the candidate waitlist and donor organs vary by program and region, but there is no means to search for programs by the clinical profiles of recipients and donors. The authors examined variability in program-specific characteristics that could influence access to transplantation.
AHRQ-funded; HS026379; HS024527.
Citation: McKinney WT, Schaffhausen CR, Schladt D .
Designing a patient-specific search of transplant program performance and outcomes: feedback from heart transplant candidates and recipients.
Clin Transplant 2021 Feb;35(2):e14183. doi: 10.1111/ctr.14183..
Keywords: Transplantation, Surgery, Heart Disease and Health, Cardiovascular Conditions, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice, Decision Making
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
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
Macheel C, Reicks P, Sybrant C
Clinical decision support intervention for rib fracture treatment.
The authors developed an evidence-based rib fracture protocol and clinical decision support intervention (CDSI) at their institution. The purpose of their study was to evaluate implementation and clinical outcomes using this CDSI. They found that the development and use of a CDSI resulted in improved provider delivery of evidence-based practice and was associated with reduced hospital length of stay.
AHRQ-funded; HS026379.
Citation: Macheel C, Reicks P, Sybrant C .
Clinical decision support intervention for rib fracture treatment.
J Am Coll Surg 2020 Aug;231(2):249-56.e2. doi: 10.1016/j.jamcollsurg.2020.04.023..
Keywords: Decision Making, Clinical Decision Support (CDS), Injuries and Wounds, Evidence-Based Practice
Wang T, Baskin AS, Dossett LA
Deimplementation of the choosing wisely recommendations for low-value breast cancer surgery: a systematic review.
Overtreatment of early-stage breast cancer results in increased morbidity and cost without improving survival. Major surgical organizations participating in the Choosing Wisely campaign identified 4 breast cancer operations as low value. The purpose of this study was to evaluate the extent to which these procedures have been deimplemented, determine the implications of decreased use, and recognize possible barriers and facilitators to deimplementation.
AHRQ-funded; HS026030.
Citation: Wang T, Baskin AS, Dossett LA .
Deimplementation of the choosing wisely recommendations for low-value breast cancer surgery: a systematic review.
JAMA Surg 2020 Aug;155(8):759-70. doi: 10.1001/jamasurg.2020.0322..
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Decision Making, Women, Evidence-Based Practice
Lin JS, Murad MH, Leas B
A narrative review and proposed framework for using health system data with systematic reviews to support decision-making.
This paper addresses when and how the use of health system data might make systematic reviews more useful to decisionmakers. The authors have developed a framework to guide the use of health system data alongside systematic reviews based on a narrative review of the literature and empirical experience. They recommend future methodological work on how best to handle internal and external validity concerns of health system data in the context of systematically reviewed data and work on developing infrastructure to do this type of work.
AHRQ-funded; 290201500007I; 29032001T05; 290201500005I; 290201500009I.
Citation: Lin JS, Murad MH, Leas B .
A narrative review and proposed framework for using health system data with systematic reviews to support decision-making.
J Gen Intern Med 2020 Jun;35(6):1830-35. doi: 10.1007/s11606-020-05783-5..
Keywords: Learning Health Systems, Health Systems, Evidence-Based Practice, Data, Decision Making
Westafer LM, Kunz A, Bugajska P
Provider perspectives on the use of evidence-based risk stratification tools in the evaluation of pulmonary embolism: a qualitative study.
Providers often pursue imaging in patients at low risk of pulmonary embolism (PE), resulting in imaging yields <10% and false-positive imaging rates of 10% to 25%. Attempts to curb overtesting have had only modest success and no interventions have used implementation science frameworks. The objective of this study was to identify barriers and facilitators to the adoption of evidence-based diagnostic testing for PE.
AHRQ-funded; HS025701.
Citation: Westafer LM, Kunz A, Bugajska P .
Provider perspectives on the use of evidence-based risk stratification tools in the evaluation of pulmonary embolism: a qualitative study.
Acad Emerg Med 2020 Jun;27(6):447-56. doi: 10.1111/acem.13908..
Keywords: Respiratory Conditions, Evidence-Based Practice, Diagnostic Safety and Quality, Imaging, Decision Making, Clinical Decision Support (CDS), Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Guise JM, Reid E, Fiordalisi CV
AHRQ Author: Borsky A, Chang S
AHRQ series on improving translation of evidence: progress and promise in supporting learning health systems.
The authors discuss the articles in the AHRQ EPC series published in this journal over the past six months. They state that satisfaction, care, and costs would all improve if health care delivery were as efficient and effective as possible given current knowledge. They conclude that millions of health decisions must be made by clinicians, patients, and health care systems, and they believe better decisions will be made with evidence.
AHRQ-authored; AHRQ-funded; 290201700003C.
Citation: Guise JM, Reid E, Fiordalisi CV .
AHRQ series on improving translation of evidence: progress and promise in supporting learning health systems.
Jt Comm J Qual Patient Saf 2020 Jan;46(1):51-52. doi: 10.1016/j.jcjq.2019.10.008..
Keywords: Implementation, Evidence-Based Practice, Learning Health Systems, Health Systems, Healthcare Delivery, Decision Making
Schaffhausen CR, Bruin MJ, Chu S
Comparing pretransplant and posttransplant outcomes when choosing a transplant center: focus groups and a randomized survey.
In response to calls for an increased focus on pretransplant outcomes and other patient-centered metrics in public reports of center outcomes, this mixed methods study evaluated how the content and presentation style of new information influenced decision-making. This mixed methods design utilized qualitative and quantitative phases where the strengths of one method helped address limitations of the other, and multiple methods facilitated comparing results. The authors concluded that the presentation of public reports influenced decision-making behavior.
AHRQ-funded; HS026379; HS024527.
Citation: Schaffhausen CR, Bruin MJ, Chu S .
Comparing pretransplant and posttransplant outcomes when choosing a transplant center: focus groups and a randomized survey.
Transplantation 2020 Jan;104(1):201-10. doi: 10.1097/tp.0000000000002809..
Keywords: Transplantation, Decision Making, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Dugas AF, Hsieh YH, LoVecchio F
Derivation and validation of a clinical decision guideline for influenza testing in 4 US emergency departments.
This study looked at which patients should be tested for influenza among adult emergency department (ED) patients with fever or respiratory symptoms who met criteria for antiviral treatment per 2013 CDC guidelines. A prospective cohort study was conducted at 4 US EDs from November 2013 to April 2014. All 1941 enrolled participants were tested for influenza using polymerase chain reaction (PCR), and 183 patients (9.4%) had influenza. The CDC clinical decision guidelines (CDGs) for influenza testing includes new or increased cough (2 points), headache (1 point), subjective fever (1 point), and triage temperature >100.4F degrees. The CDG had a sensitivity and specificity of 94.1% and 36.6% respectively in the derivation set and the validation set.
AHRQ-funded; HS009699.
Citation: Dugas AF, Hsieh YH, LoVecchio F .
Derivation and validation of a clinical decision guideline for influenza testing in 4 US emergency departments.
Clin Infect Dis 2020 Jan;70(1):49-58. doi: 10.1093/cid/ciz171..
Keywords: Guidelines, Decision Making, Influenza, Respiratory Conditions, Emergency Department, Evidence-Based Practice, Diagnostic Safety and Quality
Lomotan EA, Meadows G, Michaels M
AHRQ Author: Lomotan EA
To share is human! Advancing evidence into practice through a national repository of interoperable clinical decision support.
The purpose of this study was to describe how a national repository of clinical decision support (CDS) can serve as a public resource for healthcare systems, academic researchers, and informaticists seeking to share and reuse CDS knowledge resources. AHRQ’s CDS Connect has provided a functional platform where CDS developers are actively sharing their work. CDS sharing may lead to improved implementation efficiency through numerous pathways, and further research is ongoing to quantify efficiencies gained.
AHRQ-authored; AHRQ-funded; 290201600001U; 233201500022I.
Citation: Lomotan EA, Meadows G, Michaels M .
To share is human! Advancing evidence into practice through a national repository of interoperable clinical decision support.
Appl Clin Inform 2020 Jan;11(1):112-21. doi: 10.1055/s-0040-1701253..
Keywords: Clinical Decision Support (CDS), Decision Making, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Health Information Technology (HIT)
McGinn T, Cohen S, Khan S
The high cost of low value care.
The main focus of this study was bridging the "evidence gap" between frontline decision-making in health care and the actual evidence, with the hope of reducing unnecessary diagnostic testing and treatments. From their work in pulmonary embolism (PE) and over ordering of computed tomography pulmonary angiography, the investigators integrated the highly validated Wells' criteria into the electronic health record at two of their major academic tertiary hospitals.
AHRQ-funded; HS022061.
Citation: McGinn T, Cohen S, Khan S .
The high cost of low value care.
Trans Am Clin Climatol Assoc 2019;130:60-70..
Keywords: Healthcare Costs, Evidence-Based Practice, Patient-Centered Outcomes Research, Decision Making, Comparative Effectiveness
Gance-Cleveland B, Leiferman J, Aldrich H
Using the technology acceptance model to develop startsmart: mHealth for screening, brief intervention, and referral for risk and protective factors in pregnancy.
The purpose of this study was to develop StartSmart, a mobile health (mHealth) intervention to support evidence-based prenatal screening, brief intervention, and referral to treatment for risk and protective factors in pregnancy. Expert clinicians provided guidance on the screening instruments, resources, and practice guidelines. Clinicians suggested identifying specific prenatal visits for the screening. Patients reported that the tablet-based screening was useful to promote adherence to guidelines and provided suggestions for improvement.
AHRQ-funded; HS024738.
Citation: Gance-Cleveland B, Leiferman J, Aldrich H .
Using the technology acceptance model to develop startsmart: mHealth for screening, brief intervention, and referral for risk and protective factors in pregnancy.
J Midwifery Womens Health 2019 Sep;64(5):630-40. doi: 10.1111/jmwh.13009..
Keywords: Health Information Technology (HIT), Domestic Violence, Clinical Decision Support (CDS), Decision Making, Pregnancy, Women, Evidence-Based Practice, Screening, Prevention
Schroeder AD, Tubre DJ, Fitzgibbons RJ
Watchful waiting for inguinal hernia.
In this article, the authors examine the available evidence regarding nonoperative treatment or ‘‘watchful waiting’’ of inguinal hernias. The goal was to develop evidence-based recommendations to provide patients with inguinal hernia the treatment strategy that will maximize benefit while minimizing potential risks.
AHRQ-funded; HS009860.
Citation: Schroeder AD, Tubre DJ, Fitzgibbons RJ .
Watchful waiting for inguinal hernia.
Adv Surg 2019 Sep;53:293-303. doi: 10.1016/j.yasu.2019.04.014.
.
.
Keywords: Care Management, Evidence-Based Practice, Decision Making
Armstrong MJ, Gronseth GS, Day GS
Patient stakeholder versus physician preferences regarding amyloid PET testing.
Patient and caregiver perspectives on amyloid positron emission tomography (PET) use are largely unexplored, particularly as compared with clinician views. In this study, the investigators surveyed clinicians, patients, caregivers, and dementia advocates on topics relating to an evidence-based guideline on amyloid PET use. They found that patients and caregivers emphasized the importance of having a dementia diagnosis and placed more value on testing and outcomes for asymptomatic populations than clinicians.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Gronseth GS, Day GS .
Patient stakeholder versus physician preferences regarding amyloid PET testing.
Alzheimer Dis Assoc Disord 2019 Jul-Sep;33(3):246-53. doi: 10.1097/wad.0000000000000311..
Keywords: Decision Making, Dementia, Diagnostic Safety and Quality, Evidence-Based Practice, Guidelines, Imaging, Neurological Disorders, Patient-Centered Outcomes Research, Provider, Provider: Physician