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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 9 of 9 Research Studies Displayed
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..
View abstract on the National Library of Medicine site.
Keywords: Respiratory Conditions, Evidence-Based Practice, Diagnostic Safety and Quality, Imaging, Decision Making, Clinical Decision Support (CDS), Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Kotok D, Yang L, Evankovich JW
The evolution of radiographic edema in ARDS and its association with clinical outcomes: a prospective cohort study in adult patients.
The authors assessed the longitudinal evolution of radiographic edema using chest X-rays in patients with Acute Respiratory Distress Syndrome (ARDS) and examined its association with prognostic biomarkers, ARDS sub-phenotypes, and outcomes. They found that the Radiographic Assessment of Lung Edema (RALE) score was easily implementable with high inter-rater reliability. They concluded that the longitudinal RALE scoring appeared to be a reproducible approach to track the evolution of radiographic edema in patients with ARDS and could potentially predict prolonged need for mechanical ventilation.
AHRQ-funded; HS025455.
Citation: Kotok D, Yang L, Evankovich JW . The evolution of radiographic edema in ARDS and its association with clinical outcomes: a prospective cohort study in adult patients. J Crit Care 2020 Apr;56:222-28. doi: 10.1016/j.jcrc.2020.01.012..
View abstract on the National Library of Medicine site.
Keywords: Respiratory Conditions, Imaging, Diagnostic Safety and Quality
Russell FM, Ehman RR, Ferre R
Design and rationale of the B-lines lung ultrasound guided emergency department management of acute heart failure (BLUSHED-AHF) pilot trial.
Medical treatment for acute heart failure (AHF) has not changed substantially over the last four decades. Emergency department (ED)-based evidence for treatment is limited. The investigators discuss BLUSHED-AHF, a multicenter, randomized, pilot trial designed to test whether a strategy of care that utilizes a LUS-driven treatment protocol outperforms usual care for reducing pulmonary congestion in the ED.
AHRQ-funded; HS025411.
Citation: Russell FM, Ehman RR, Ferre R . Design and rationale of the B-lines lung ultrasound guided emergency department management of acute heart failure (BLUSHED-AHF) pilot trial. Heart Lung 2019 May - Jun;48(3):186-92. doi: 10.1016/j.hrtlng.2018.10.027..
View abstract on the National Library of Medicine site.
Keywords: Emergency Department, Heart Disease and Health, Cardiovascular Conditions, Imaging, Respiratory Conditions
Koziatek CA, Simon E, Horwitz LI
Automated pulmonary embolism risk classification and guideline adherence for computed tomography pulmonary angiography ordering.
The objective of this study was to measure the performance of automated, structured data-only versions of the Wells and revised Geneva risk scores in emergency department encounters during which a computed tomography pulmonary angiography was ordered. The hypothesis was that such an automated method would classify a patient's pulmonary embolism risk with high accuracy compared to manual chart review.
AHRQ-funded; HS024376.
Citation: Koziatek CA, Simon E, Horwitz LI . Automated pulmonary embolism risk classification and guideline adherence for computed tomography pulmonary angiography ordering. Acad Emerg Med 2018 Sep;25(9):1053-61. doi: 10.1111/acem.13442..
View abstract on the National Library of Medicine site.
Keywords: Respiratory Conditions, Risk, Diagnostic Safety and Quality, Emergency Department, Imaging, Guidelines
Morabito J, Bell MT, Montenij LJ
Perioperative considerations for chylothorax.
This paper presents the case report of a 73 year old man with recurrent right pleural effusions, and a mediastinal mass of indeterminate etiology after a computer tomography-guided biopsy and thoracentesis. It discusses the perioperative considerations for chylothorax.
AHRQ-funded; HS024124.
Citation: Morabito J, Bell MT, Montenij LJ . Perioperative considerations for chylothorax. J Cardiothorac Vasc Anesth 2017 Dec;31(6):2277-81. doi: 10.1053/j.jvca.2017.06.001..
View abstract on the National Library of Medicine site.
Keywords: Case Study, Imaging, Respiratory Conditions, Surgery
Wang RC, Bent S, Weber E
The impact of clinical decision rules on computed tomography use and yield for pulmonary embolism: a systematic review and meta-analysis.
The researchers performed a systematic review of impact analyses on clinical decision rules for pulmonary embolism. They found that among participants with suspected pulmonary embolism, implementation of the Wells criteria was associated with a modest increase in CT angiography yield. They concluded that there is a lack of cluster-randomized trials to confirm the efficacy of clinical decision rules for the diagnosis of pulmonary embolism.
AHRQ-funded; HS021281.
Citation: Wang RC, Bent S, Weber E . The impact of clinical decision rules on computed tomography use and yield for pulmonary embolism: a systematic review and meta-analysis. Ann Emerg Med 2016 Jun;67(6):693-701.e3. doi: 10.1016/j.annemergmed.2015.11.005.
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View abstract on the National Library of Medicine site.
Keywords: Clinical Decision Support (CDS), Decision Making, Imaging, Respiratory Conditions
Gullett J, Donnelly JP, Sinert R
Interobserver agreement in the evaluation of B-lines using bedside ultrasound.
The researchers evaluated agreement among trained emergency physicians assessing the degree of B-line presence on bedside ultrasound in patients presenting to the emergency department (ED) with acute undifferentiated dyspnea. They concluded that interrater agreement was best in the anterior/superior thoracic zones followed by the lateral/superior zones for both expert/expert and expert/novice pairs.
AHRQ-funded; HS013852.
Citation: Gullett J, Donnelly JP, Sinert R . Interobserver agreement in the evaluation of B-lines using bedside ultrasound. J Crit Care 2015 Dec;30(6):1395-9. doi: 10.1016/j.jcrc.2015.08.021.
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View abstract on the National Library of Medicine site.
Keywords: Emergency Department, Imaging, Respiratory Conditions
Smith SS, Ference EH, Evans CT
The prevalence of bacterial infection in acute rhinosinusitis: a systematic review and meta-analysis.
The primary objective of this systematic review of 29 studies was to assess the prevalence of bacterial infection in adults with clinically diagnosed acute rhinosinusitis (ARS) who undergo culture from antral puncture or endoscopically directed middle meatus culture. The review provides evidence that the prevalence of bacterial infection in patients with clinically diagnosed ARS remains poorly defined, but is likely greater than the 0.5% to 2% figure previously widely quoted.
AHRQ-funded; HS000078.
Citation: Smith SS, Ference EH, Evans CT . The prevalence of bacterial infection in acute rhinosinusitis: a systematic review and meta-analysis. Laryngoscope 2015 Jan;125(1):57-69. doi: 10.1002/lary.24709..
View abstract on the National Library of Medicine site.
Keywords: Diagnostic Safety and Quality, Imaging, Respiratory Conditions
Deppen SA, Blume JD, Kensinger CD
Accuracy of FDG-PET to diagnose lung cancer in areas with infectious lung disease: a meta-analysis.
The purpose of this study was to estimate the diagnostic accuracy of positron emission tomography (PET) combined with fludeoxyglucose F18 (FDG) for pulmonary modules suspicious for lung cancer in regions where infectious lung disease is endemic and compare the accuracy in regions where such disease is rare. It found that the accuracy of FDG-PET was extremely heterogeneous.
AHRQ-funded; HS021554.
Citation: Deppen SA, Blume JD, Kensinger CD . Accuracy of FDG-PET to diagnose lung cancer in areas with infectious lung disease: a meta-analysis. JAMA 2014 Sep 24;312(12):1227-36. doi: 10.1001/jama.2014.11488..
View abstract on the National Library of Medicine site.
Keywords: Cancer, Cancer: Lung Cancer, Diagnostic Safety and Quality, Respiratory Conditions, Imaging

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