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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.

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1 to 6 of 6 Research Studies Displayed
Greenberg JK, Ahluwalia R, Hill M
Development and external validation of the KIIDS-TBI tool for managing children with mild traumatic brain injury and intracranial injuries.
This study's objectives were to develop a new risk model with improved sensitivity compared to the CHIIDA model for the post-neuroimaging management of children with mild traumatic brain injuries (mTBI) and intracranial injuries and further to validate externally the new model and CHIIDA model in a multicenter data set. Findings showed that the KIIDS-TBI model had high sensitivity and moderate specificity for risk stratifying children with mTBI and intracranial injuries. The researchers concluded that the use of their clinical decision support tool may help improve the safe, resource-efficient management of this important patient population.
AHRQ-funded; HS027075.
Citation: Greenberg JK, Ahluwalia R, Hill M . Development and external validation of the KIIDS-TBI tool for managing children with mild traumatic brain injury and intracranial injuries. Acad Emerg Med 2021 Dec;28(12):1409-20. doi: 10.1111/acem.14333..
View abstract on the National Library of Medicine site.
Keywords: Children/Adolescents, Brain Injury, Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT)
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..
View abstract on the National Library of Medicine site.
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT), Brain Injury, Guidelines, Evidence-Based Practice, Imaging
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.
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View abstract on the National Library of Medicine site.
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Brain Injury, Health Information Technology (HIT), Evidence-Based Practice, Decision Making
Simon KC, Reams N, Beltran E
Optimizing the electronic medical record to improve patient care and conduct quality improvement initiatives in a concussion specialty clinic.
The purpose of this study was to use the electronic medical record (EMR) to optimize patient care, facilitate documentation, and support quality improvement and practice-based research in a concussion (mild traumatic brain injury; mTBI) clinic. The investigators built a customized structured clinical documentation support (SCDS) toolkit for patients in a concussion specialty clinic. The toolkit collected hundreds of fields of discrete,
AHRQ-funded; HS024057.
Citation: Simon KC, Reams N, Beltran E . Optimizing the electronic medical record to improve patient care and conduct quality improvement initiatives in a concussion specialty clinic. Brain Inj 2020;34(1):62-67. doi: 10.1080/02699052.2019.1680867..
View abstract on the National Library of Medicine site.
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Brain Injury, Neurological Disorders
Melnick ER, Hess EP, Guo G
Patient-centered decision support: formative usability evaluation of integrated clinical decision support with a patient decision aid for minor head injury in the emergency department.
The study’s objective was to formatively evaluate an electronic tool that not only helps clinicians at the bedside to determine the need for CT use based on the Canadian CT Head Rule but also promotes evidence-based conversations between patients and clinicians regarding patient-specific risk and patients' specific concerns. It concluded that the Concussion or Brain Bleed app is a useful and usable final product integrating clinical decision support with a patient decision aid.
AHRQ-funded; HS021271.
Citation: Melnick ER, Hess EP, Guo G . Patient-centered decision support: formative usability evaluation of integrated clinical decision support with a patient decision aid for minor head injury in the emergency department. J Med Internet Res 2017 May 19;19(5):e174. doi: 10.2196/jmir.7846.
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View abstract on the National Library of Medicine site.
Keywords: Brain Injury, Decision Making, Emergency Department, Health Information Technology (HIT), Patient-Centered Healthcare
Chen W, Wheeler KK, Lin S
Computerized "Learn-As-You-Go" classification of traumatic brain injuries using NEISS narrative data.
This study evaluated a "Learn-As-You-Go" machine-learning program. When using this program, the user trains classification models and interactively checks on accuracy until a desired threshold is reached. It found that the time frame to classify tens of thousands of narratives was reduced from a few days to minutes after approximately sixty minutes of training.
AHRQ-funded; HS022277.
Citation: Chen W, Wheeler KK, Lin S . Computerized "Learn-As-You-Go" classification of traumatic brain injuries using NEISS narrative data. Accid Anal Prev 2016 Apr;89:111-7. doi: 10.1016/j.aap.2016.01.012.
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View abstract on the National Library of Medicine site.
Keywords: Brain Injury, Health Information Technology (HIT)

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