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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 25 of 58 Research Studies Displayed
McCoy RG, Van Houten HK, Dunlay SM
Race and sex differences in the initiation of diabetes drugs by privately insured US adults.
The authors examined the differences in the use of three glucose-lowering medications as a function of both sex and race. They found that, compared to white men, GLP-1RA were 43% more likely to be started by White women, 12% more likely to be started by non-White men, and 21% less likely to be started by non-White women. SGLT2i were at least 10% less likely to be started by all groups compared to White men, and DPP4i were used more often by non-White than White patients of both sexes.
AHRQ-funded; HS024075.
Citation:
McCoy RG, Van Houten HK, Dunlay SM .
Race and sex differences in the initiation of diabetes drugs by privately insured US adults.
Race and sex differences in the initiation of diabetes drugs by privately insured US adults..
Keywords:
Diabetes, Chronic Conditions, Medication, Sex Factors, Racial / Ethnic Minorities
Mody P, Pandey A, Slutsky AS
Gender-based differences in outcomes among resuscitated patients with out-of-hospital cardiac arrest.
In this study, the investigators examined gender based differences in outcomes among resuscitated patients with out-of-hospital cardiac arrest. Studies examining gender-based differences in outcomes of out-of-hospital cardiac arrest patients have demonstrated that despite a higher likelihood of return of spontaneous circulation, women do not have higher survival. The investigators concluded that among resuscitated out-of-hospital cardiac arrest patients, discharge to survival was significantly lower in women compared with men especially among patients considered to have a favorable prognosis.
AHRQ-authored.
Citation:
Mody P, Pandey A, Slutsky AS .
Gender-based differences in outcomes among resuscitated patients with out-of-hospital cardiac arrest.
Circulation 2021 Feb 16;143(7):641-49. doi: 10.1161/circulationaha.120.050427..
Keywords:
Sex Factors, Heart Disease and Health, Cardiovascular Conditions, Outcomes
Thompson HM
Stakeholder experiences with gender identity data capture in electronic health records: implementation effectiveness and a visibility paradox.
Advocates have endorsed transgender visibility via gender identity (GI) data capture with the advent of the Affordable Care Act and electronic health record (EHR) requirements. Visibility in data in order to enumerate a population contrasts with ways in which other LGBT and public health scholars have deployed these concepts. This article aims to assess the effectiveness of GI data capture in EHRs and implications for trans health care quality improvements and research.
AHRQ-funded; HS026385.
Citation:
Thompson HM .
Stakeholder experiences with gender identity data capture in electronic health records: implementation effectiveness and a visibility paradox.
Health Educ Behav 2021 Feb;48(1):93-101. doi: 10.1177/1090198120963102.
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Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Health Services Research (HSR), Vulnerable Populations, Sex Factors
Khodneva Y, Richman J, Kertesz S
Gender differences in association of prescription opioid use and mortality: a propensity-matched analysis from the REasons for Geographic And Racial Differences in Stroke (REGARDS) prospective cohort.
Prescription opioids (PO) have been widely used for chronic non-cancer pain, with commensurate concerns for overdose. The long-term effect of these medications on non-overdose mortality in the general population remains poorly understood. This study's objective was to examine the association of prescription opioid use and mortality in a large cohort, accounting for gender differences and concurrent benzodiazepine use, and using propensity score matching.
AHRQ-funded; HS013852.
Citation:
Khodneva Y, Richman J, Kertesz S .
Gender differences in association of prescription opioid use and mortality: a propensity-matched analysis from the REasons for Geographic And Racial Differences in Stroke (REGARDS) prospective cohort.
Subst Abus 2021;42(1):94-103. doi: 10.1080/08897077.2019.1702609..
Keywords:
Stroke, Cardiovascular Conditions, Sex Factors, Opioids, Medication, Mortality
Baik D, Liu J, Cho H
Factors related to biological sex differences in engagement with healthcare providers in persons living with HIV.
Investigators conducted a secondary analysis of data collected from four projects focused on improving health outcomes in persons living with HIV (PLWH). They found that male patients displayed negative association between depression and engagement with healthcare providers and positive association between engagement with healthcare providers and medication adherence, while female patients showed no association between any of these factors. Anxiety and stigma were not significantly associated with medication adherence. They concluded that adherence interventions for PLWH should be tailored by biological sex.
AHRQ-funded; HS025071.
Citation:
Baik D, Liu J, Cho H .
Factors related to biological sex differences in engagement with healthcare providers in persons living with HIV.
AIDS Behav 2020 Sep;24(9):2656-65. doi: 10.1007/s10461-020-02823-3..
Keywords:
Human Immunodeficiency Virus (HIV), Sex Factors, Patient and Family Engagement, Patient Adherence/Compliance, Depression, Behavioral Health, Medication
Aronson BD, Sittner KJ, Walls ML
The mediating role of diabetes distress and depressive symptoms in type 2 diabetes medication adherence gender differences.
Medication adherence is negatively related to both diabetes distress (DD) and depressive symptoms (DS). Past research suggests gender differences in adherence, DD, and DS. A gap exists in determining if gender differences in adherence are mediated by DD and DS, or if gender moderates differences in adherence by DD/DS. Aims. This study investigated the relationship between gender, DD, DS, and medication adherence and tested for mediating and moderating effects on medication adherence among American Indian adults with type 2 diabetes.
AHRQ-funded; HS024180.
Citation:
Aronson BD, Sittner KJ, Walls ML .
The mediating role of diabetes distress and depressive symptoms in type 2 diabetes medication adherence gender differences.
Health Educ Behav 2020 Jun;47(3):474-82. doi: 10.1177/1090198119885416..
Keywords:
Medication, Diabetes, Patient Adherence/Compliance, Chronic Conditions, Sex Factors
Hay CC, Graham JE, Pappadis MR
The impact of one's sex and social living situation on rehabilitation outcomes after a stroke.
The goal of this retrospective observational study was to investigate sex differences and the impact of social living situation on individual functional independence measure outcomes after stroke rehabilitation. Subjects were Medicare fee-for-service beneficiaries discharged from inpatient rehabilitation facilities after a stroke. Results showed that when sociodemographic and clinical factors were controlled, females were more likely to discharge from inpatient rehabilitation at a supervision level or better for most functional independence measure items. Individuals who lived alone before their stroke had higher odds of discharging at a supervision level or better.
AHRQ-funded; HS022134.
Citation:
Hay CC, Graham JE, Pappadis MR .
The impact of one's sex and social living situation on rehabilitation outcomes after a stroke.
Am J Phys Med Rehabil 2020 Jan;99(1):48-55. doi: 10.1097/phm.0000000000001276..
Keywords:
Stroke, Rehabilitation, Elderly, Patient-Centered Outcomes Research, Sex Factors, Cardiovascular Conditions, Outcomes
Adediran T, Drumheller BC, McCunn M
Sex differences in in-hospital complications among older adults after traumatic brain injury.
This study examined sex differences in in-hospital complications among older adults after traumatic brain injury (TBI). Previous evidence has suggested that women have better outcomes than men after TBI. A retrospective cohort study was conducted of adults aged 65 years and older treated for moderate to severe TBI at R. Adams Cowley Shock Trauma Center from 1996 to 2012. The investigators identified TBI using ICD-9 CM codes and inclusion in the study required an abbreviated injury scale head score of 3 or greater, abbreviated injury scale scores for other body regions of 2 or greater, and a blunt injury mechanism. Out of 2511 patients, 51.1% were men, and 25.1% developed an in-hospital complication. Men had a complication rate of 28.1% versus 22.0% for women.
AHRQ-funded; HS024560.
Citation:
Adediran T, Drumheller BC, McCunn M .
Sex differences in in-hospital complications among older adults after traumatic brain injury.
J Surg Res 2019 Nov;243:427-33. doi: 10.1016/j.jss.2019.05.053..
Keywords:
Elderly, Sex Factors, Adverse Events, Hospitalization, Brain Injury
Hansen M, Schoonover A, Skarica B
Implicit gender bias among US resident physicians.
The purpose of this study was to characterize implicit gender bias among residents in US Emergency Medicine and OB/GYN residencies. The investigators found that gender bias was present among US residents favoring men in leadership positions, this bias differed between male and female residents, and was associated with discipline. Implicit bias did not differ across training years, and was associated with explicit bias.
AHRQ-funded; HS023457.
Citation:
Hansen M, Schoonover A, Skarica B .
Implicit gender bias among US resident physicians.
BMC Med Educ 2019 Oct 29;19(1):396. doi: 10.1186/s12909-019-1818-1..
Keywords:
Provider, Provider: Physician, Sex Factors
Brescia AA, Wu X, Paone G
Effect of sex on nadir hematocrit and rates of acute kidney injury in coronary artery bypass.
Researchers explored whether there a sex-related difference on nadir hematocrit and rates of acute kidney injury in coronary artery bypass. A prospective, observational study was conducted of 17,363 patients not on dialysis undergoing the procedure between 2011 and 2016 across 41 institutions from the Perfusion Measure and Outcomes registry. There was no sex-related differences found for nadir hematocrit or rates of acute kidney injury.
AHRQ-funded; HS026003; HS022535.
Citation:
Brescia AA, Wu X, Paone G .
Effect of sex on nadir hematocrit and rates of acute kidney injury in coronary artery bypass.
J Thorac Cardiovasc Surg 2019 Oct;158(4):1073-80.e4. doi: 10.1016/j.jtcvs.2019.03.042..
Keywords:
Injuries and Wounds, Sex Factors, Kidney Disease and Health, Adverse Events, Surgery, Heart Disease and Health, Cardiovascular Conditions
Purnell TS, Luo X, Crews DC
Neighborhood poverty and sex differences in live donor kidney transplant outcomes in the United States.
Neighborhood poverty has been associated with worse outcomes after live donor kidney transplantation (LDKT), and prior work suggests that women with kidney disease may be more susceptible to the negative influence of poverty than men. As such, our goal was to examine whether poverty differentially affects women in influencing LDKT outcomes. The investigators concluded that given their findings that poverty was more strongly associated with graft loss in women, targeted efforts are needed to specifically address mechanisms driving these disparities in LDKT outcomes.
AHRQ-funded; HS024600.
Citation:
Purnell TS, Luo X, Crews DC .
Neighborhood poverty and sex differences in live donor kidney transplant outcomes in the United States.
Transplantation 2019 Oct;103(10):2183-89. doi: 10.1097/tp.0000000000002654.
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Keywords:
Transplantation, Kidney Disease and Health, Patient-Centered Outcomes Research, Disparities, Women, Sex Factors, Low-Income, Outcomes
Jarman MP, Pollack Porter K, Curriero FC
Factors mediating demographic determinants of injury mortality.
The authors investigated the role of injury characteristics and access to trauma care as mediators of the relationships between race, ethnicity, sex, and injury mortality. They found that distance, injury characteristics, and insurance mediate the effects of demographic characteristics on injury mortality and appear to contribute to disparities in injury mortality.
AHRQ-funded; HS000029.
Citation:
Jarman MP, Pollack Porter K, Curriero FC .
Factors mediating demographic determinants of injury mortality.
Ann Epidemiol 2019 Jun;34:58-64.e2. doi: 10.1016/j.annepidem.2019.03.013..
Keywords:
Access to Care, Disparities, Injuries and Wounds, Mortality, Racial / Ethnic Minorities, Sex Factors, Social Determinants of Health, Trauma
Knutsen J, Crossman M, Perrin J
Sex differences in restricted repetitive behaviors and interests in children with autism spectrum disorder: an Autism Treatment Network study.
Researchers examined sex differences in clinically identified (Autism Diagnostic Observation Schedule) restricted and repetitive behavior symptoms of age-matched and intelligence quotient-matched female and male children with autism spectrum disorder. Their findings identified key restricted and repetitive behavior similarities and differences among young females and males with autism spectrum disorder and emphasized the need for a deeper understanding of the female autism phenotype.
AHRQ-funded; HS022986; HS000063.
Citation:
Knutsen J, Crossman M, Perrin J .
Sex differences in restricted repetitive behaviors and interests in children with autism spectrum disorder: an Autism Treatment Network study.
Autism 2019 May;23(4):858-68. doi: 10.1177/1362361318786490..
Keywords:
Autism, Behavioral Health, Children/Adolescents, Patient-Centered Outcomes Research, Sex Factors
Khan NNS, Kelly-Blake K, Luo Z
Sex differences in statin prescribing in diabetic and heart disease patients in FQHCs: a comparison of the ATPIII and 2013 ACC/AHA cholesterol guidelines.
The study’s purpose was to determine differences in the rate of statin prescribing by sex based on the Adult Treatment Panel (ATP) III and 2013 American College of Cardiology (ACC/American Heart Association) cholesterol guidelines in Federally Qualified Health Centers (FQHCs). The study also wanted to determine adherence to those guidelines based on the 2013 recommendations. Two FQHCs were used and patients with coronary heart disease and diabetes mellitus (DM) were recruited. There was no difference between men and women in statin prescribing under ATPIII; however there was underprescribing for both men and women with atherosclerotic cardiovascular disease (ASCVD).
AHRQ-funded; HS018104.
Citation:
Khan NNS, Kelly-Blake K, Luo Z .
Sex differences in statin prescribing in diabetic and heart disease patients in FQHCs: a comparison of the ATPIII and 2013 ACC/AHA cholesterol guidelines.
Health Serv Res Manag Epidemiol 2019 Mar 5;6:2333392818825414. doi: 10.1177/2333392818825414..
Keywords:
Cardiovascular Conditions, Diabetes, Medication, Practice Patterns, Sex Factors
Marcolini EG, Albrecht JS, Sethuraman KN
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
This study used US and European trauma database statistics, including the National Trauma Databank, to examine sex disparities in trauma care. Their findings indicate that sex differences in risk-taking behaviors that lead to traumatic injury have been associated with males, with female menstrual cycle timing, and with cortisol levels. Differences in access to services at trauma centers, including triage or transfer and level of medical attention are associated with sex as well race, rural or urban location, and insurance status. Outcomes, such as in-hospital mortality, multiple organ failure, pneumonia, and sepsis are associated with sex disparities in the general trauma patient; outcomes after general trauma and specifically traumatic brain injury show mixed results.
AHRQ-funded; HS024560.
Citation:
Marcolini EG, Albrecht JS, Sethuraman KN .
Gender disparities in trauma care: how sex determines treatment, behavior, and outcome.
Anesthesiol Clin 2019 Mar;37(1):107-17. doi: 10.1016/j.anclin.2018.09.007..
Keywords:
Access to Care, Disparities, Injuries and Wounds, Outcomes, Patient-Centered Outcomes Research, Risk, Sex Factors, Trauma
Lee T, Qian J, Thamer M
Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients.
In this study, the investigators assessed clinically relevant arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) surgical outcomes in elderly male and female patients initiating hemodialysis with a central venous catheter (CVC). The investigators concluded that while AVFs should be considered the preferred vascular access in most circumstances, clinical AVF surgical outcomes were uniformly worse in females. They suggest that clinicians should also consider AVGs as a viable alternative in elderly female patients initiating hemodialysis with a CVC to avoid extended CVC dependence.
AHRQ-funded; HS022931; HS021229.
Citation:
Lee T, Qian J, Thamer M .
Gender disparities in vascular access surgical outcomes in elderly hemodialysis patients.
Am J Nephrol 2019;49(1):11-19. doi: 10.1159/000495261..
Keywords:
Dialysis, Disparities, Elderly, Outcomes, Patient-Centered Outcomes Research, Sex Factors, Surgery
Sutherland S, Brunwasser SM
Sex differences in vulnerability to prenatal stress: a review of the recent literature.
This review evaluates the degree to which recent studies provide evidence that prenatal maternal stress (PNMS) has a varying effect on child health outcomes depending on the child's biological sex. “Stress” includes negative life events, psychological stress, and established stress biomarkers. A review of 50 peer-reviewed articles revealed that most found evidence of either sex-specific associations or significant PNMS (x) stress interactions for at least one outcome. Sex-dependent effects were strongest in the group of studies that evaluated child neural/nervous system development and temperament.
AHRQ-funded; HS022990.
Citation:
Sutherland S, Brunwasser SM .
Sex differences in vulnerability to prenatal stress: a review of the recent literature.
Sex differences in vulnerability to prenatal stress: a review of the recent literature.
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Keywords:
Children/Adolescents, Newborns/Infants, Outcomes, Pregnancy, Sex Factors, Stress
Donato KM, Leon-Perez G, Wallston KA
Something old, something new: when gender matters in the relationship between social support and health.
This paper investigated how social support differentially benefitted self-rated health among men and women hospitalized with heart disease. They found that gender differentiated the effect of nonmarital family contact on health but only when heart disease was newly diagnosed. When newly diagnosed, more frequent contact with family was associated with better self-rated health for women but not men.
AHRQ-funded; HS024898.
Citation:
Donato KM, Leon-Perez G, Wallston KA .
Something old, something new: when gender matters in the relationship between social support and health.
J Health Soc Behav 2018 Sep;59(3):352-70. doi: 10.1177/0022146518789362..
Keywords:
Cardiovascular Conditions, Hospitalization, Sex Factors
Angraal S, Khera R, Wang Y
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
The authors sought to evaluate how the use of coronary artery bypass grafting (CABG) and its outcomes have evolved in different sex and racial subgroups. Using Medicare data, they found that women and black patients had persistently higher CABG mortality than men and white patients, respectively, despite greater declines over the time period. The authors conclude that these findings indicate progress, but further progress is needed.
AHRQ-funded; HS023000.
Citation:
Angraal S, Khera R, Wang Y .
Sex and race differences in the utilization and outcomes of coronary artery bypass grafting among Medicare beneficiaries, 1999-2014.
J Am Heart Assoc 2018 Jul 12;7(14). doi: 10.1161/jaha.118.009014..
Keywords:
Cardiovascular Conditions, Elderly, Evidence-Based Practice, Heart Disease and Health, Healthcare Utilization, Medicare, Outcomes, Patient-Centered Outcomes Research, Racial / Ethnic Minorities, Sex Factors
Gilmore-Bykovskyi A, Johnson R, Walljasper L
Underreporting of gender and race/ethnicity differences in NIH-funded dementia caregiver support interventions.
The objective of this study was to determine the inclusion and reporting rates among NIH-funded dementia caregiver support interventions. Findings suggested limited NIH guideline compliance that may reflect a lack of awareness regarding potential gender disparities in caregiving roles. In order to ensure NIH guideline compliance, shared investments from researchers, editors, and reviewers to make certain that group differences are systematically identified and reported are recommended.
AHRQ-funded; HS022548.
Citation:
Gilmore-Bykovskyi A, Johnson R, Walljasper L .
Underreporting of gender and race/ethnicity differences in NIH-funded dementia caregiver support interventions.
Am J Alzheimers Dis Other Demen 2018 May;33(3):145-52. doi: 10.1177/1533317517749465..
Keywords:
Caregiving, Sex Factors, Racial / Ethnic Minorities, Guidelines, Dementia, Disparities
Marsh JC, Park K, Lin YA
Gender differences in trends for heroin use and nonmedical prescription opioid use, 2007-2014.
This study uses National Survey on Drug Use and Health (NSDUH) data to study gender differences in trends for heroin use and nonmedical prescription opioid use from 2007-2014. There has been a steady decline in nonmedical prescription heroin use but a notable increase in heroin use during this period for both men and women. However, women are increasing heroin use at a faster rate than men but their nonmedical prescription opioid use is not decreasing as fast as men. The researchers conclude that more study is needed on gender differences in use and treatment access.
AHRQ-funded; HS000084.
Citation:
Marsh JC, Park K, Lin YA .
Gender differences in trends for heroin use and nonmedical prescription opioid use, 2007-2014.
J Subst Abuse Treat 2018 Apr;87:79-85. doi: 10.1016/j.jsat.2018.01.001..
Keywords:
Medication, Opioids, Sex Factors, Substance Abuse
Lau KSL, Rosenman MB, Wiehe SE
Race/ethnicity, and behavioral health status: first arrest and outcomes in a large sample of juvenile offenders.
The objective of this study was to assess the simultaneous effects of gender, race/ethnicity, and pre-arrest behavioral health (BH) service-use on age at first arrest, and first arrest outcomes. It found that black youth were arrested at younger ages than white or Hispanic youth. Youth with psychiatric problems were arrested at younger ages than youth with substance-use, dual-diagnoses, or no BH problems.
AHRQ-funded; HS024296; HS023318.
Citation:
Lau KSL, Rosenman MB, Wiehe SE .
Race/ethnicity, and behavioral health status: first arrest and outcomes in a large sample of juvenile offenders.
J Behav Health Serv Res 2018 Apr;45(2):237-51. doi: 10.1007/s11414-017-9578-3.
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Keywords:
Behavioral Health, Outcomes, Racial / Ethnic Minorities, Sex Factors
Gupta A, Barrabes JA, Strait K
Sex differences in timeliness of reperfusion in young patients with ST-segment-elevation myocardial infarction by initial electrocardiographic characteristics.
Investigators aimed to determine the electrocardiographic correlates of delay in reperfusion in young patients with ST-segment-elevation myocardial infarction. They found that sex disparities in timeliness to reperfusion in young patients with ST-segment-elevation myocardial infarction persisted, despite adjusting for initial electrocardiographic characteristics. They concluded that left ventricular hypertrophy by voltage criteria and absence of prehospital ECG are strongly positively correlated and ST elevation in lateral leads is negatively correlated with reperfusion delay.
AHRQ-funded; HS023000.
Citation:
Gupta A, Barrabes JA, Strait K .
Sex differences in timeliness of reperfusion in young patients with ST-segment-elevation myocardial infarction by initial electrocardiographic characteristics.
J Am Heart Assoc 2018 Mar 7;7(6). doi: 10.1161/jaha.117.007021..
Keywords:
Sex Factors, Heart Disease and Health, Cardiovascular Conditions, Disparities
Kochkodan J, Telem DA, Ghaferi AA
Physiologic and psychological gender differences in bariatric surgery.
This paper aims to describe differences in bariatric surgery outcomes by gender and to understand the physiologic and psychological differences that may explain this gender gap. It concludes that, despite significantly lower weight loss and increased complication rates, males tend to have markedly higher satisfaction and psychological well-being scores than females.
AHRQ-funded; HS023621; HS024403.
Citation:
Kochkodan J, Telem DA, Ghaferi AA .
Physiologic and psychological gender differences in bariatric surgery.
Surg Endosc 2018 Mar;32(3):1382-88. doi: 10.1007/s00464-017-5819-z.
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Keywords:
Obesity, Outcomes, Sex Factors, Surgery, Obesity: Weight Management
Sun CJ, Seloilwe ES, Magowe M
Gender differences in sexual and reproductive health protective and risk factors of Batswana adolescents: implications for parent and adolescent interventions.
The HIV epidemic continues in sub-Saharan Africa and Botswana and adolescents there have borne the brunt. This analysis assessed gender differences in sexual and reproductive health protective and risk factors in 228 Batswana adolescents. Although three-quarters of adolescents prefer to have their parents teach them about sex, it is the fourth most common source of information.
AHRQ-funded; HS022981.
Citation:
Sun CJ, Seloilwe ES, Magowe M .
Gender differences in sexual and reproductive health protective and risk factors of Batswana adolescents: implications for parent and adolescent interventions.
AIDS Educ Prev 2018 Feb;30(1):35-46. doi: 10.1521/aeap.2018.30.1.35..
Keywords:
Caregiving, Children/Adolescents, Human Immunodeficiency Virus (HIV), Prevention, Risk, Sex Factors, Sexual Health
