National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Blood Pressure (1)
- (-) Cardiovascular Conditions (7)
- (-) Clinical Decision Support (CDS) (7)
- Decision Making (3)
- Diagnostic Safety and Quality (2)
- Emergency Department (1)
- Evidence-Based Practice (1)
- Health Information Technology (HIT) (5)
- Heart Disease and Health (5)
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- Medication: Safety (1)
- Patient Safety (1)
- Prevention (1)
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- Provider: Clinician (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 7 of 7 Research Studies DisplayedRoberts MM, Marino M, Wells R
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
The objective of this cross-sectional study was to evaluate the association between population-based clinical decision support (CDS) tools and racial and sex disparities in the aspirin use, blood pressure control, cholesterol management, and smoking cessation (ABCS) care quality metrics among smaller primary care practices. Researchers used practice-level data from the EvidenceNOW initiative, from practices that submitted both survey data and electronic health record (EHR)-derived ABCS data stratified by race and sex. Their findings suggested that practices using CDS tools had small disparities but were not statistically significant; however, CDS tools were not associated with reductions in disparities. They concluded that more research was needed on effective practice-level interventions to mitigate disparities.
AHRQ-funded; HS023940.
Citation: Roberts MM, Marino M, Wells R .
Differences in use of clinical decision support tools and implementation of aspirin, blood pressure control, cholesterol management, and smoking cessation quality metrics in small practices by race and sex.
JAMA Netw Open 2023 Aug; 6(8):e2326905. doi: 10.1001/jamanetworkopen.2023.26905..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Cardiovascular Conditions, Tobacco Use, Tobacco Use: Smoking Cessation, Primary Care, Evidence-Based Practice, Prevention
Blecker S, Gannon M, De Leon S
Practice facilitation for scale up of clinical decision support for hypertension management: study protocol for a cluster randomized control trial.
This paper describes a protocol for a study that will be conducted to compare the effect of hypertension-focused clinical decision support (CDS) plus practice facilitation on blood pressure (BP) control, as compared to CDS alone. The investigators will conduct a cluster randomized control trial that will include initial training on the CDS and a review of current guidelines along with follow-up for coaching and integration support. They will randomize 46 small primary care practices in New York City who use the same electronic health record vendor to intervention or control. They will also assess implementation of CDS in all practices and practice facilitation in the intervention group.
AHRQ-funded; HS027120.
Citation: Blecker S, Gannon M, De Leon S .
Practice facilitation for scale up of clinical decision support for hypertension management: study protocol for a cluster randomized control trial.
Contemp Clin Trials 2023 Jun; 129:107177. doi: 10.1016/j.cct.2023.107177..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Blood Pressure, Cardiovascular Conditions
Gallo T, Heise CW, Woosley RL
Clinician satisfaction with advanced clinical decision support to reduce the risk of torsades de pointes.
The purpose of this study was to create an advanced torsades de pointes (TdP) clinical decision support (CDS) advisory that provides relevant, patient-specific information, including 1-click management options, and to evaluate clinician satisfaction with the CDS. The researchers implemented the advanced TdP CDS across a health system comprising 29 hospitals. A brief electronic survey was developed to collect clinician feedback on the advisory and was emailed to 442 clinicians who received the advisory. Feedback was generally positive across the 38 responding providers, with 79% of respondents reporting that the advisory assisted with their care for their patients and 87% responding that the alerts clearly specified alternative actions. The researchers concluded that providers who receive an advanced TdP risk CDS alert generally view the alert favorably.
AHRQ-funded; HS026662.
Citation: Gallo T, Heise CW, Woosley RL .
Clinician satisfaction with advanced clinical decision support to reduce the risk of torsades de pointes.
J Patient Saf 2022 Sep 1;18(6):e1010-e13. doi: 10.1097/pts.0000000000000996..
Keywords: Clinical Decision Support (CDS), Decision Making, Risk, Provider: Clinician, Heart Disease and Health, Cardiovascular Conditions
Gallo T, Heise CW, Woosley RL
Clinician responses to a clinical decision support advisory for high risk of Torsades de pointes.
The purpose of this study was to assess provider actions taken in response to a Clinical decision support (CDS) advisory for Torsade de pointes (TdP) that uses a modified Tisdale QT risk score and presents single click management options. The researchers implemented an inpatient TdP risk advisory across a large, 30 hospital health care system. The CDS advisory was programmed to appear when prescribers attempted to order medications with a known risk of TdP in a patient. The CDS advisory displayed patient-specific information and offered related management options including canceling the requested medication and ordering relevant protocols. The study found that 7794 TdP risk advisories were issued during an 8-month period. The most frequent advisory trigger was antibiotics (33.1%.) The most frequent action taken as a result of the advisory was ordering an ECG (20.3%). Incoming medication orders were canceled in 10.2% of the advisories. The researchers concluded that a single-click, modified Tisdale QT risk score-based CDS resulted in a high action/response rate.
AHRQ-funded; HS026662.
Citation: Gallo T, Heise CW, Woosley RL .
Clinician responses to a clinical decision support advisory for high risk of Torsades de pointes.
J Am Heart Assoc 2022 Jun 7;11(11):e024338. doi: 10.1161/jaha.122.024338..
Keywords: Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT), Heart Disease and Health, Cardiovascular Conditions
Soares WE, Knee A, Gemme SR
SC, et al. A prospective evaluation of Clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients.
The HEART score is a risk stratification aid that may safely reduce chest pain admissions for emergency department patients. However, differences in interpretation of subjective components potentially alters the performance of the score. In this study, the investigators compared agreement between HEART scores determined during clinical practice with research-generated scores and estimated their accuracy in predicting 30-day major adverse cardiac events.
AHRQ-funded; HS024815.
Citation: Soares WE, Knee A, Gemme SR .
SC, et al. A prospective evaluation of Clinical HEART score agreement, accuracy, and adherence in emergency department chest pain patients.
Ann Emerg Med 2021 Aug;78(2):231-41. doi: 10.1016/j.annemergmed.2021.03.024..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Emergency Department, Diagnostic Safety and Quality, Clinical Decision Support (CDS), Health Information Technology (HIT)
Levy AE, Shah NR, Matheny ME
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
The authors investigated whether Natural Language Processing (NLP) tools could potentially help estimate myocardial perfusion imaging (MPI) risk. Subjects were VA patients who underwent stress MPI and coronary angiography 2009-11; stress test reports were randomly selected for analysis. The authors found that post-test ischemic risk was determinable but rarely reported in this sample of stress MPI reports. They conclude that this supports the potential use of NLP to help clarify risk and recommend further study of NLP in this context.
AHRQ-funded; HS022998.
Citation: Levy AE, Shah NR, Matheny ME .
Determining post-test risk in a national sample of stress nuclear myocardial perfusion imaging reports: implications for natural language processing tools.
J Nucl Cardiol 2019 Dec;26(6):1878-85. doi: 10.1007/s12350-018-1275-y..
Keywords: Imaging, Risk, Clinical Decision Support (CDS), Health Information Technology (HIT), Diagnostic Safety and Quality, Cardiovascular Conditions, Heart Disease and Health
Blecker S, Austrian JS, Horwitz LI
Interrupting providers with clinical decision support to improve care for heart failure.
The goal of this study was to develop a clinical decision support (CDS) system to recommend an angiotenson converting enzyme (ACE) inhibitor during hospitalization so it could be promoted for continuation at discharge. Patients who were hospitalized with reduced ejection fraction were pseudo-randomized to deliver interruptive or non-interruptive CDS alerts to providers based on the patients’ even or odd medical record number. The utilization rate was higher for interruptive alert versus non-interruptive alert hospitalizations for a sample of 958. This resulted in improved quality of care for heart failure patients.
AHRQ-funded; HS023683.
Citation: Blecker S, Austrian JS, Horwitz LI .
Interrupting providers with clinical decision support to improve care for heart failure.
Int J Med Inform 2019 Nov;131:103956. doi: 10.1016/j.ijmedinf.2019.103956..
Keywords: Clinical Decision Support (CDS), Decision Making, Heart Disease and Health, Cardiovascular Conditions, Medication, Medication: Safety, Patient Safety, Quality Improvement, Quality of Care