National Healthcare Quality and Disparities Report
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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
51 to 75 of 121 Research Studies DisplayedKirby JS, Butt M, King T
Severity and Area Score for Hidradenitis (SASH): a novel outcome measurement for hidradenitis suppurativa.
Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease with a large impact on patients' health-related quality of life. However, reliable and consistent outcome measures to assess body surface area (BSA) of HS have not been established. The objectives of this study were to develop and assess the reliability and validity of a novel outcome instrument for assessment of HS BSA in a clinical trial setting.
AHRQ-funded; HS024585.
Citation: Kirby JS, Butt M, King T .
Severity and Area Score for Hidradenitis (SASH): a novel outcome measurement for hidradenitis suppurativa.
Br J Dermatol 2020 Apr;182(4):940-48. doi: 10.1111/bjd.18244..
Keywords: Skin Conditions, Chronic Conditions, Patient-Centered Outcomes Research, Outcomes
Herb JN, Dunham LN, Ollila DW
Use of completion lymph node dissection for sentinel lymph node-positive melanoma.
This study examined the use and time trends of completion lymph node dissection (CLND) for sentinel lymph node-positive melanoma (SNPM). There has been found to be no benefit for CLND in SNPM patients. The National Cancer Database was used to find patients 18 years and older from 2012 to 2016 with SNPM. During that time period, 7,146 patients were identified with SNPM. From 2012 to 2014 the proportion of patients undergoing CLND was steady (61-63%) but decreased to 57% in 2015 and 50% in 2016. Use was less likely for women and increasing age. Higher use was more likely at high-volume centers, and associated with increased Breslow depth and ulceration.
Citation: Herb JN, Dunham LN, Ollila DW .
Use of completion lymph node dissection for sentinel lymph node-positive melanoma.
J Am Coll Surg 2020 Apr;230(4):515-24. doi: 10.1016/j.jamcollsurg.2019.12.010..
Keywords: Cancer: Skin Cancer, Cancer, Skin Conditions, Treatments
Lei D, Yousaf M, Janmohamed SR
Validation of four single-item patient-reported assessments of sleep in adult atopic dermatitis patients.
The purpose of this study was to assess the measurement properties of sleep-related items from the Patient-Oriented Eczema Measure (POEM), SCORing AD (SCORAD), 5-dimensions of itch (5D), and Itch-Related Quality of Life (ItchyQOL) in adults with atopic dermatitis (AD). Results showed modest overlap and weak to moderate concordance of responses to the different assessments. The researchers conclude that sleep-related items from POEM, SCORAD, 5D, and ItchyQOL showed good validity and responsiveness to monitor sleep disturbances in adult AD patients.
AHRQ-funded; HS023011.
Citation: Lei D, Yousaf M, Janmohamed SR .
Validation of four single-item patient-reported assessments of sleep in adult atopic dermatitis patients.
Ann Allergy Asthma Immunol 2020 Mar;124(3):261-66. doi: 10.1016/j.anai.2019.12.002..
Keywords: Sleep Problems, Skin Conditions, Quality of Life, Patient-Centered Outcomes Research
McKenzie C, Paller AS, Fishbein A
Association between the longitudinal course of AD, sleep disturbance, and overall health in US children.
Atopic dermatitis (AD) is a chronic inflammatory skin disease impacting 13% of children in the United States. It is associated with sleep disturbances. In this paper the investigators sought to examine the associations of AD onset, AD persistence, and comorbid atopic conditions with sleep disturbance and overall health in childhood. This study added to previous studies by demonstrating that comorbid atopy and AD course, particularly early-onset and more persistent AD, were associated with sleep disturbance.
AHRQ-funded; HS023011.
Citation: McKenzie C, Paller AS, Fishbein A .
Association between the longitudinal course of AD, sleep disturbance, and overall health in US children.
J Allergy Clin Immunol Pract 2020 Feb;8(2):812-14.e1. doi: 10.1016/j.jaip.2019.08.027..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions
Lee HH, Patel KR, Singam V
Associations of cutaneous and extracutaneous infections with hidradenitis suppurativa in U.S. children and adults.
The purpose of this study was to determine whether Hidradenitis suppurativa (HS) is associated with cutaneous and extracutaneous infections and related outcomes. Using data from the Nationwide Inpatient Sample, results showed that adults and children with HS had increased acute and chronic, cutaneous, extracutaneous, and systemic infections, which were associated with increased mortality and cost.
AHRQ-funded; HS023011.
Citation: Lee HH, Patel KR, Singam V .
Associations of cutaneous and extracutaneous infections with hidradenitis suppurativa in U.S. children and adults.
Br J Dermatol 2020 Feb;182(2):327-34. doi: 10.1111/bjd.18093..
Keywords: Healthcare Cost and Utilization Project (HCUP), Skin Conditions, Children/Adolescents
Baxa J, McCreary E, Schulz L
Finding the niche: an interprofessional approach to defining oritavancin use criteria in the emergency department.
This study’s purpose was to identify a population of emergency department (ED) patients with cellulitis who would be the most appropriate to receive oritavancin which is a novel, broad-spectrum antibiotic. This antibiotic is given in one dose for the entire treatment course. A retrospective cohort study of cellulitis patients was conducted at a Midwest healthcare system with 2 EDs. All adult patients admitted from the ED to an inpatient ward were reviewed over a 1-year period. Potentially avoidable admissions (PAAs) were identified and characterized. Out of 86 patients, nine were deemed a PAA. The majority had at last one risk factor for treatment failure (55% with diabetes mellitus) and they were significantly younger than the non-PAA group. In other respects there was no difference between the two groups for non-age demographics and other risk factors or length of stay.
AHRQ-funded; HS024342.
Citation: Baxa J, McCreary E, Schulz L .
Finding the niche: an interprofessional approach to defining oritavancin use criteria in the emergency department.
Am J Emerg Med 2020 Feb;38(2):321-24. doi: 10.1016/j.ajem.2019.158442..
Keywords: Emergency Department, Skin Conditions, Antibiotics, Medication
Pembroke M, Nemeth LS
Instruments to evaluate self-management of radiation dermatitis in patients with breast cancer.
Radiation dermatitis (RD) is a side effect of radiation to the breast and chest wall. Healthcare providers routinely grade the severity of RD without assessing its impact on quality of life. This study investigates instruments to identify a patient's ability and confidence to self-manage RD. Findings showed that using a validated instrument to assess patients' needs and ability to self-manage RD will promote personalized care plans tailored to each patient. These findings can be used to implement a patient-reported outcome measure into clinical practice, to develop educational programs for RD management, and to create personalized care plans.
AHRQ-funded.
Citation: Pembroke M, Nemeth LS .
Instruments to evaluate self-management of radiation dermatitis in patients with breast cancer.
Oncol Nurs Forum 2020 Jan;47(1):101-11. doi: 10.1188/20.Onf.101-111..
Keywords: Patient Self-Management, Cancer: Breast Cancer, Cancer, Skin Conditions
Sarfo A, Butt M, Kirby JS
Periodic worsening, or flare, in hidradenitis suppurativa: the perspective of people with hidradenitis.
Hidradenitis suppurativa (HS) is an inflammatory skin disease described as chronic and recurrent, with intermittent periods of worsening, also described as ‘flares’. The aim of this qualitative study was to explore the patient perspective of HS flare. The investigators indicated that the findings from this study illuminate the impact of HS flares on patients’ lives and may help to inform the development of a precise and measurable definition of HS for use in clinical studies and practice.
AHRQ-funded; HS024585.
Citation: Sarfo A, Butt M, Kirby JS .
Periodic worsening, or flare, in hidradenitis suppurativa: the perspective of people with hidradenitis.
Br J Dermatol 2020 Jan;182(1):218-19. doi: 10.1111/bjd.18210..
Keywords: Skin Conditions
Greenhawt M, Shaker M
Determining levers of cost-effectiveness for screening infants at high risk for peanut sensitization before early peanut introduction.
The authors sought to identify scenarios in which current early peanut introduction guidelines would be cost-effective. They found that the current screening approach to early peanut introduction could be cost-effective at a particular health utility for an in-clinic reaction, skin prick test sensitivity and specificity, and high baseline peanut allergy prevalence among high-risk infants. However, such conditions are unlikely to be plausible to achieve realistically. They recommend further research to define the health state utility associated with reaction location.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Shaker M .
Determining levers of cost-effectiveness for screening infants at high risk for peanut sensitization before early peanut introduction.
JAMA Netw Open 2019 Dec 2;2(12):e1918041. doi: 10.1001/jamanetworkopen.2019.18041..
Keywords: Patient-Centered Outcomes Research, Newborns/Infants, Children/Adolescents, Respiratory Conditions, Skin Conditions, Screening, Healthcare Costs, Evidence-Based Practice, Guidelines
Quan VL, Erickson T, Daftary K
Atopic dermatitis across shades of skin.
This narrative review discussed key terminology related to atopic dermatitis (AD) across shades of skin, including modern definitions of 'race', 'ethnicity', and 'skin of color (SOC)'. Current literature describing disparities in AD prevalence, disease recognition, and burden was synthesized alongside data regarding genetic and immunologic findings across SOC populations. The authors highlighted key concomitant social determinants of health, including environmental factors, socioeconomic status, and access to care, within the context of these findings. They also discussed future efforts to move toward a more inclusive understanding of AD that encompasses all shades of skin and ensures equitable representation of diverse populations in high impact research.
AHRQ-funded; HS026385.
Citation: Quan VL, Erickson T, Daftary K .
Atopic dermatitis across shades of skin.
Am J Clin Dermatol 2023 Sep; 24(5):731-51. doi: 10.1007/s40257-023-00797-1..
Keywords: Skin Conditions, Racial and Ethnic Minorities
Montgomery KB, Holder AM, Burgan CM
Is it time for synoptic reporting in melanoma nodal surveillance ultrasonography?
Previous qualitative research has identified a potential gap between surgeons’ and radiologists’ awareness of Second Multicenter Selective Lymphadenectomy Trial (MSLT-II) criteria. The purpose of this study was to explore how these criteria have been adopted and reported outside of clinical trial settings or utilized by surgical teams when interpreting ultrasound results. The study found that of the 269 nodal ultrasounds performed in 78 patients, 81.0% reported normal findings versus 19% abnormal findings. Researchers indicated that only 15% of normal ultrasounds had one or more MSLT-II criteria reported versus 88.9% abnormal ultrasounds. While 37% of abnormal ultrasounds had only one MSLT-II criterion reported, 27.8% had two criteria and 24.1% had three criteria. Of the eight abnormal ultrasounds with biopsy recommendation, 75% had two or more MSLT-II criteria reported. Clinically actionable recommendations were provided in 94.9% of normal ultrasounds compared with 64.8% of abnormal ultrasounds.
AHRQ-funded; HS013852.
Citation: Montgomery KB, Holder AM, Burgan CM .
Is it time for synoptic reporting in melanoma nodal surveillance ultrasonography?
Ann Surg Oncol 2023 Sep; 30(9):5327-28. doi: 10.1245/s10434-023-13749-0..
Keywords: Cancer: Skin Cancer, Cancer, Skin Conditions, Imaging
Singam V, Rastogi S, Patel KR
The mental health burden in acne vulgaris and rosacea: an analysis of the US National Inpatient Sample.
Little is known about the mental health (MH) hospitalization among patients with acne and rosacea. The purpose of this study was to determine the MH disorders and cost burden associated with acne and rosacea. The investigators concluded that inpatients with acne or rosacea had increased odds of comorbid MH disorders. In particular, there was an increased number of hospital admissions secondary to a primary MH disorder with coexistent acne/rosacea. MH comorbidities were associated with considerable excess costs among inpatients with acne or rosacea.
AHRQ-funded; HS023011.
Citation: Singam V, Rastogi S, Patel KR .
The mental health burden in acne vulgaris and rosacea: an analysis of the US National Inpatient Sample.
Clin Exp Dermatol 2019 Oct;44(7):766-22. doi: 10.1111/ced.13919..
Keywords: Healthcare Cost and Utilization Project (HCUP), Skin Conditions, Behavioral Health, Hospitalization
Mower WR, Crisp JG, Krishnadasan A
Effect of initial bedside ultrasonography on emergency department skin and soft tissue infection management.
Researchers examined the utility of emergency department (ED) ultrasonography in treatment of skin and soft tissue infections. Study participants were ED patients with skin and soft tissue infections; the study also surveyed clinicians with regard to their pre-ultrasonography certainty about the presence or absence of an abscess, their planned management, post-ultrasonography findings, and actual management. The researchers found that ultrasonography rarely changed management when clinicians were certain about the presence or absence of an abscess. When clinicians were uncertain, ultrasonography changed drainage decisions in approximately one quarter of cases, of which most were appropriate.
AHRQ-funded; HS009699.
Citation: Mower WR, Crisp JG, Krishnadasan A .
Effect of initial bedside ultrasonography on emergency department skin and soft tissue infection management.
Ann Emerg Med 2019 Sep;74(3):372-80. doi: 10.1016/j.annemergmed.2019.02.002..
Keywords: Emergency Department, Imaging, Skin Conditions
Treister AD, Stefek H, Grimaldi D
Sleep and limb movement characteristics of children with atopic dermatitis coincidentally undergoing clinical polysomnography.
Atopic dermatitis (AD) is a prevalent, chronic, itchy skin condition. Children undergoing polysomnography (PSG) may coincidentally have AD. Many children with AD have sleep disturbances. This study aimed to characterize limb movements in children with AD and their effect on sleep. The investigators found altered PSG parameters in children with AD, suggesting that clinicians should consider the diagnosis when affected children undergo PSG.
AHRQ-funded; HS023011.
Citation: Treister AD, Stefek H, Grimaldi D .
Sleep and limb movement characteristics of children with atopic dermatitis coincidentally undergoing clinical polysomnography.
J Clin Sleep Med 2019 Aug 15;15(8):1107-13. doi: 10.5664/jcsm.7800..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions
Kates AE, Zimbric ML, Mitchell K
The impact of chlorhexidine gluconate on the skin microbiota of children and adults: a pilot study.
The authors examined the effect of chlorhexidine gluconate bathing on the skin microbiota of adult and pediatric patients. They observed no differences in pediatric patients, but multiple genera of bacteria were observed to be significantly less abundant in adults. They recommended further research to determine long-term impact.
AHRQ-funded; HS024039.
Citation: Kates AE, Zimbric ML, Mitchell K .
The impact of chlorhexidine gluconate on the skin microbiota of children and adults: a pilot study.
Am J Infect Control 2019 Aug;47(8):1014-16. doi: 10.1016/j.ajic.2019.01.024..
Keywords: Children/Adolescents, Skin Conditions, Healthcare-Associated Infections (HAIs), Prevention, Patient Safety
Blumenthal KG, Topaz M, Zhou L
Mining social media data to assess the risk of skin and soft tissue infections from allergen immunotherapy.
This study examined large social media databases including Facebook, Twitter, and Reddit to identify postings of rare incidents of contamination or infection from extracts for allergen immunotherapy (AIT). They used natural language processing (NLP) related to AIT from 2012 to 2016. They compared posts on adverse events for AIT compared to influenza vaccinations. The results showed that both types of posts are rare events.
AHRQ-funded; HS025375.
Citation: Blumenthal KG, Topaz M, Zhou L .
Mining social media data to assess the risk of skin and soft tissue infections from allergen immunotherapy.
J Allergy Clin Immunol 2019 Jul;144(1):129-34. doi: 10.1016/j.jaci.2019.01.029..
Keywords: Social Media, Skin Conditions, Adverse Events, Patient Safety, Vaccination, Risk
Ren Z, Laumann AE, Silverberg JI
Association of dermatomyositis with systemic and opportunistic infections in the United States.
This study examined whether dermatomyositis is associated with opportunistic and antibiotic-resistant infections. Data was analyzed from the Nationwide Inpatient Sample from 2002 to 2012 with a cross-sectional representative 20% sample of all hospitalizations in the US. There was an association found with serious infections in adults and children, with more associated with adults. Infections were found in the skin, bone, joints, brain, heart, lungs, and gastrointestinal system. Predictors of infections included non-white race/ethnicity, insurance status, history of long-term corticosteroid usage, Cushing’s syndrome, diabetes and cancer. This in turn caused higher odds, costs, and inpatient mortality from these infections.
AHRQ-funded; HS023011.
Citation: Ren Z, Laumann AE, Silverberg JI .
Association of dermatomyositis with systemic and opportunistic infections in the United States.
Arch Dermatol Res 2019 Jul;311(5):377-87. doi: 10.1007/s00403-019-01913-0..
Keywords: Antibiotics, Healthcare Cost and Utilization Project (HCUP), Infectious Diseases, Risk, Skin Conditions
Briscoe CC, Reich P, Fritz S
Staphylococcus aureus antibiotic susceptibility patterns in pediatric atopic dermatitis.
Researchers characterized Staphylococcus aureus strains recovered from pediatric atopic dermatitis patients with clinically apparent bacterial skin infections treated in an academic medical center. They conducted a five-year retrospective study to characterize the S aureus strains; patient demographics and dilute bleach bath usage were assessed to determine whether these factors were correlated with methicillin resistance. Culture results from the cohort were compared to those from pediatric patients presenting to a children's hospital emergency department with S aureus skin abscesses. The researchers concluded that first-generation cephalosporins remains an appropriate empiric therapy for most pediatric atopic dermatitis patients.
AHRQ-funded; HS021736; HS024269.
Citation: Briscoe CC, Reich P, Fritz S .
Staphylococcus aureus antibiotic susceptibility patterns in pediatric atopic dermatitis.
Pediatr Dermatol 2019 Jul;36(4):482-85. doi: 10.1111/pde.13867..
Keywords: Antibiotics, Children/Adolescents, Medication, Skin Conditions
Lee HH, Patel KR, Singam V
A systematic review and meta-analysis of the prevalence and phenotype of adult-onset atopic dermatitis.
This study analyzed the differences between childhood and adult-onset atopic dermatitis (AD). A systematic review was conducted using a range of online databases to find observational studies. A review was done of study title, abstract review, and data extraction. A pooled meta-analysis of the adult-onset AD was performed. A total of 25 studies met inclusion criteria. There were phenotypic differences across studies for adult-onset versus child-onset AD. This included higher rates of foot dermatitis and a personal history of atopy. It was found that 1 in 4 adults with AD report that it adult-onset.
AHRQ-funded; HS023011.
Citation: Lee HH, Patel KR, Singam V .
A systematic review and meta-analysis of the prevalence and phenotype of adult-onset atopic dermatitis.
J Am Acad Dermatol 2019 Jun;80(6):1526-32.e7. doi: 10.1016/j.jaad.2018.05.1241..
Keywords: Skin Conditions
Patel KR, Singam V, Vakharia pp
Measurement properties of three assessments of burden used in atopic dermatitis in adults.
The objectives of this study were to determine the content validity, construct validity, internal consistency, differential reporting, responsiveness, floor or ceiling effects and feasibility of the Dermatology Life Quality Index (DLQI), Itchy Quality of Life (ItchyQoL) and 5-dimensions (5-D) itch scales for assessing burden of AD in adults and to compare their performance.
AHRQ-funded; HS023011.
Citation: Patel KR, Singam V, Vakharia pp .
Measurement properties of three assessments of burden used in atopic dermatitis in adults.
Br J Dermatol 2019 May;180(5):1083-89. doi: 10.1111/bjd.17243..
Keywords: Skin Conditions, Healthcare Costs, Quality of Life
Savage SA, Li SW, Utter GH
The EGS grading scale for skin and soft-tissue infections is predictive of poor outcomes: a multicenter validation study.
Using the hypothesis that the grading scale used for emergency general surgery (EGS) diseases would be predictive of complications, length of stay, and mortality in skin and soft-tissue infections (STIs), this multi-institutional study sought to validate the grading scale by applying it to a different disease process with a higher associated mortality. Data collected from 12 trauma centers included outcomes such as mortality, complications, and length of stay as well as demographic variables and disease characteristics. The EGS scale for STI was used to grade each infection; two surgeons graded each case to evaluate inter-rater reliability. The authors conclude that their validation effort demonstrates that grade IV and V STIs are significantly predictive of these outcomes.
AHRQ-funded; HS022236.
Citation: Savage SA, Li SW, Utter GH .
The EGS grading scale for skin and soft-tissue infections is predictive of poor outcomes: a multicenter validation study.
J Trauma Acute Care Surg 2019 Apr;86(4):601-08. doi: 10.1097/ta.0000000000002175..
Keywords: Diagnostic Safety and Quality, Skin Conditions
Ren Z, Hsu D, Brieva J
Association between climate, pollution and hospitalization for pemphigus in the USA.
The goal of this study was to determine whether the impact of ultraviolet exposure, climate factors and pollutants are associated with pemphigus exacerbation resulting in hospitalization. Data from the National Inpatient Sample was used. The findings indicate a significant statewide variation in the prevalence of hospitalization for pemphigus, with ‘hotspots’ in the southwest and northeast states. Higher rates of admission for pemphigus occurred during the summer and autumn months. All associations remained significant in multilevel regression models that controlled for age, sex and race/ethnicity, except for ultraviolet index, which was associated with pemphigus hospitalization only for Hispanic patients. The authors conclude that higher temperature, UV exposure. and small particle air pollution are associated with increased hospitalization for pemphigus, and that patients with pemphigus may benefit from avoidance of these potential environmental triggers.
AHRQ-funded; HS023011.
Citation: Ren Z, Hsu D, Brieva J .
Association between climate, pollution and hospitalization for pemphigus in the USA.
Clin Exp Dermatol 2019 Mar;44(2):135-43. doi: 10.1111/ced.13650..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Skin Conditions
Patel KR, Singam V, Rastogi S
Association of vitiligo with hospitalization for mental health disorders in US adults.
The goal of this study was to examine the relationship between vitiligo and mental-health hospitalizations in the US using data from the National Inpatient Sample. Prevalence of hospitalization for mental-health disorders, length of stay (LOS), and cost of care were examined for patients with vitiligo in comparison with those without vitiligo. Hospitalization for mental-health disorders occurred more commonly in those with vitiligo. Vitiligo patients who were hospitalized with any mental-health disorder had higher LOS as well as cost of inpatient care.
AHRQ-funded; HS023011.
Citation: Patel KR, Singam V, Rastogi S .
Association of vitiligo with hospitalization for mental health disorders in US adults.
J Eur Acad Dermatol Venereol 2019 Jan;33(1):191-97. doi: 10.1111/jdv.15255..
Keywords: Healthcare Cost and Utilization Project (HCUP), Healthcare Costs, Hospitalization, Behavioral Health, Skin Conditions
Hsu DY, Smith B, Silverberg JI
Atopic dermatitis and hospitalization for mental health disorders in the United States.
Investigators analyzed data from the Nationwide Inpatient Sample (NIS) from 2002 to 2012 to determine the incidence of mental health (MH) emergencies with atopic dermatitis (AD). Primary admission for MH disorders associated with AD is known for adults with mood disorders, schizophrenia and developmental disorders.
AHRQ-funded; HS023011.
Citation: Hsu DY, Smith B, Silverberg JI .
Atopic dermatitis and hospitalization for mental health disorders in the United States.
Dermatitis 2019 Jan/Feb;30(1):54-61. doi: 10.1097/der.0000000000000418.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Hospitalization, Behavioral Health, Skin Conditions
Vakharia PP, Chopra R, Silverberg NB
Efficacy and safety of topical cantharidin treatment for molluscum contagiosum and warts: a systematic review.
The objective of this systematic review was to assess the efficacy and safety of topical cantharidin treatment for molluscum contagiosum and warts. The investigators found that topical cantharidin demonstrated clearance of warts, particularly in combination with podophyllotixin and salicylic acid, and modest benefit for pediatric molluscum contagiosum with good tolerability and safety.
AHRQ-funded; HS023011.
Citation: Vakharia PP, Chopra R, Silverberg NB .
Efficacy and safety of topical cantharidin treatment for molluscum contagiosum and warts: a systematic review.
Am J Clin Dermatol 2018 Dec;19(6):791-803. doi: 10.1007/s40257-018-0375-4..
Keywords: Evidence-Based Practice, Skin Conditions, Treatments