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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
76 to 100 of 106 Research Studies DisplayedGandek B, Roos EM, Franklin PD
Item selection for 12-item short forms of the Knee injury and Osteoarthritis Outcome Score (KOOS-12) and Hip disability and Osteoarthritis Outcome Score (HOOS-12).
The goal of this study was to develop 12-item versions of the 42-item Knee injury and Osteoarthritis Outcome Score (KOOS) and 40-item Hip disability and Osteoarthritis Outcome Score (HOOS) surveys that measure joint-specific pain, function and quality of life (QOL) for patients. The shorter forms were given to 1,395 knee osteoarthritis (OA) and 1,281 hip OA patients from the FORCE-TJR cohort who had previously completed the KOOS and HOOS surveys before and after total joint replacement surgery. The KOOS-12 and HOOS-12 surveys were found to successfully measure pain and function items of the patients as well as the 42-item versions.
AHRQ-funded; HS024632; HS018910.
Citation: Gandek B, Roos EM, Franklin PD .
Item selection for 12-item short forms of the Knee injury and Osteoarthritis Outcome Score (KOOS-12) and Hip disability and Osteoarthritis Outcome Score (HOOS-12).
Osteoarthritis Cartilage 2019 May;27(5):746-53. doi: 10.1016/j.joca.2018.11.011..
Keywords: Patient-Centered Outcomes Research, Registries, Arthritis, Orthopedics
Perez FA, Quinet S, Jarvik JG
Lumbar spinal stenosis severity by CT or MRI does not predict response to epidural corticosteroid versus lidocaine injections.
This study compared the results of patients with lumbar spinal stenosis injected epidurally with corticosteroids and lidocaine, or lidocaine alone. A prospective, double-blind study was conducted on 350 patients who were then evaluated for qualitative or quantitative MR imaging or CT measures of lumbar spinal stenosis. There were no differences in improvement of disability or leg pain scores at 3 weeks between the two subgroups.
AHRQ-funded; HS019222; HS022972.
Citation: Perez FA, Quinet S, Jarvik JG .
Lumbar spinal stenosis severity by CT or MRI does not predict response to epidural corticosteroid versus lidocaine injections.
AJNR Am J Neuroradiol 2019 May;40(5):908-15. doi: 10.3174/ajnr.A6050..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Imaging, Medication, Orthopedics, Outcomes, Patient-Centered Outcomes Research
Hoffman SA, Ledford G, Cameron KA
A qualitative exploration of social and environmental factors affecting diet and activity in knee replacement patients.
This study examined perceived social and environmental barriers and encouragers for patients undergoing knee replacement surgery who are overweight or obese. Twenty patients were surveyed about factors that helped or hindered healthy behaviors. Many mentioned availability of healthy food, attending social gatherings, social support, and the weather.
AHRQ-funded; HS023011.
Citation: Hoffman SA, Ledford G, Cameron KA .
A qualitative exploration of social and environmental factors affecting diet and activity in knee replacement patients.
J Clin Nurs 2019 Apr;28(7-8):1156-63. doi: 10.1111/jocn.14719..
Keywords: Lifestyle Changes, Nutrition, Orthopedics, Surgery
Dy CJ, Brown DS, Maryam H
Two-state comparison of total joint arthroplasty utilization following Medicaid expansion.
The aim of this study was to determine whether Medicaid expansion was associated with increased utilization rates of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in Illinois (which expanded Medicaid) relative to Missouri (which did not expand Medicaid). The investigators concluded that their study demonstrated that Medicaid expansion in Illinois was associated with increased utilization of THA and TKA. They suggested that further study is needed to understand the impact of Medicaid expansion in other states and for other procedures.
AHRQ-funded; HS019455.
Citation: Dy CJ, Brown DS, Maryam H .
Two-state comparison of total joint arthroplasty utilization following Medicaid expansion.
J Arthroplasty 2019 Apr;34(4):619-25.e1. doi: 10.1016/j.arth.2018.12.019..
Keywords: Healthcare Utilization, Medicaid, Orthopedics, Surgery
Bell KM, Onyeukwu C, McClincy MP
Verification of a portable motion tracking system for remote management of physical rehabilitation of the knee.
The authors of this paper developed a remote rehabilitation management system combining two wireless inertial measurement units (IMUs) with an interactive mobile application and a web-based clinician portal (interACTION). The aim of their study was to verify the accuracy of the IMU-based knee angle measurement system during three common physical therapy exercises, quantify the effect of visual feedback on exercise performance, and understand the qualitative experience of the user interface through survey data.
AHRQ-funded; HS022989.
Citation: Bell KM, Onyeukwu C, McClincy MP .
Verification of a portable motion tracking system for remote management of physical rehabilitation of the knee.
Sensors 2019 Feb 28;19(5). doi: 10.3390/s19051021..
Keywords: Care Management, Health Information Technology (HIT), Orthopedics, Rehabilitation, Telehealth
Lamplot JD, Bansal A, Nguyen JT
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
The purpose of this study using HCUP data was to determine how demographic and other patient-specific factors are associated with the risk of subsequent joint replacement in the contralateral or a different joint following an index joint replacement for osteoarthritis. Results showed a relatively high risk of subsequent replacement of the contralateral joint and a relatively low risk of subsequent replacement of a different joint within 5 to 8 years after an index total hip arthroplasty, total knee arthroplasty, or total shoulder arthroplasty. Obesity was associated with a higher risk of subsequent replacement of the contralateral joint or a different joint.
AHRQ-funded; HS019455.
Citation: Lamplot JD, Bansal A, Nguyen JT .
Risk of subsequent joint arthroplasty in contralateral or different joint after index shoulder, hip, or knee arthroplasty: association with index joint, demographics, and patient-specific factors.
J Bone Joint Surg Am 2018 Oct 17;100(20):1750-56. doi: 10.2106/jbjs.17.00948..
Keywords: Arthritis, Healthcare Cost and Utilization Project (HCUP), Risk, Surgery, Orthopedics, Healthcare Utilization
Hilliard PE, Waljee J, Moser S
Prevalence of preoperative opioid use and characteristics associated with opioid use among patients presenting for surgery.
Researchers assessed the prevalence of preoperative opioid use and the characteristics of patients in a broadly representative surgical cohort. They found that patients undergoing lower extremity procedures were most likely to report preoperative opioid use, with 1 in 4 of all patients presenting for surgery reporting such use. They concluded that the data provided important insights into this population and would appear to help guide future preoperative optimization and perioperative opioid-weaning interventions.
AHRQ-funded; HS023313.
Citation: Hilliard PE, Waljee J, Moser S .
Prevalence of preoperative opioid use and characteristics associated with opioid use among patients presenting for surgery.
JAMA Surg 2018 Oct;153(10):929-37. doi: 10.1001/jamasurg.2018.2102..
Keywords: Opioids, Surgery, Pain, Medication, Healthcare Utilization, Orthopedics
Mittal M, Wang CE, Goben AH
Proprietary management and higher readmission rates: a correlation.
This study examined readmission rates of patients for six diseases including acute myocardial infarction, heart failure, coronary artery bypass graft, pneumonia, COPD, and total hip or total knee arthroplasty from the Center for Medicare and Medicaid Readmissions Reduction Production (HRRP) for 2012 to 2015. The type of hospital ownership was the variable that was being studied. There were statistically higher readmission rates in proprietary (for profit) hospitals compared to government and non-profit hospitals. This was true regardless of their location.
AHRQ-funded; HS024679.
Citation: Mittal M, Wang CE, Goben AH .
Proprietary management and higher readmission rates: a correlation.
PLoS One 2018 Sep 18;13(9):e0204272. doi: 10.1371/journal.pone.0204272..
Keywords: Cardiovascular Conditions, Hospital Readmissions, Hospitals, Orthopedics, Respiratory Conditions
Pellegrini CA, Chang RW, Dunlop DD
Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: a pilot study.
This article reports the results of a randomized pilot study that assessed changes in weight during a Patient Centered Weight Loss Program (PACE) initiated either before or after knee replacement. The feasibility of recruiting and retaining participants over 26 weeks was also examined. Recruitment outreach was extended to patients scheduled for knee replacement. Sixteen participants were randomly assigned to a 14-session weight loss program that started either at least 6 weeks before surgery or at 12 weeks following surgery. The authors conclude that behavioral intervention is challenging but feasible in a knee replacement population. Preliminary evidence suggests that initiating a program 12 weeks after surgery produces greater weight losses at 26 weeks when compared to a program that begins before knee replacement.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Chang RW, Dunlop DD .
Comparison of a Patient-Centered Weight Loss Program starting before versus after knee replacement: a pilot study.
Obes Res Clin Pract 2018 Sep - Oct;12(5):472-78. doi: 10.1016/j.orcp.2018.06.009..
Keywords: Orthopedics, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Obesity: Weight Management, Surgery, Obesity, Outcomes
Urish KL, Qin Y, Li BY
Predictors and cost of readmission in total knee arthroplasty.
The Comprehensive Care for Joint Replacement bundle was created to decrease total knee arthroplasty (TKA) cost. To help accomplish this, there is a focus on reducing TKA readmissions. The study’s authors used the Nationwide Readmission Database to examine national readmission rates, predictors of readmission, and associated readmission costs for elective TKA procedures.
AHRQ-funded; HS018726.
Citation: Urish KL, Qin Y, Li BY .
Predictors and cost of readmission in total knee arthroplasty.
J Arthroplasty 2018 Sep;33(9):2759-63. doi: 10.1016/j.arth.2018.04.008..
Keywords: Arthritis, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Orthopedics
Rosenberg RE, Abzug JM, Rappaport DI
Collaborations with pediatric hospitalists: national surveys of pediatric surgeons and orthopedic surgeons.
In this study, to understand characteristics of pediatric hospitalist (PH) involvement in the care of children admitted to surgical services and explore surgeons' perspectives of PH effectiveness, the investigators conducted a cross-sectional, web-based survey of pediatric surgical (PS) and pediatric orthopedic subspecialists (OS) from professional organizations.
AHRQ-funded; HS022198.
Citation: Rosenberg RE, Abzug JM, Rappaport DI .
Collaborations with pediatric hospitalists: national surveys of pediatric surgeons and orthopedic surgeons.
J Hosp Med 2018 Aug;13(8):566-69. doi: 10.12788/jhm.2921..
Keywords: Children/Adolescents, Orthopedics, Surgery, Hospitals, Inpatient Care
Pellegrini CA, Ledford G, Chang RW
Understanding barriers and facilitators to healthy eating and physical activity from patients either before and after knee arthroplasty.
The researchers sought to identify patient-reported barriers and facilitators to healthy eating and physical activity among patients before or after knee arthroplasty. They found that identifying specific eating and activity barriers and facilitators provides critical insight from the patient perspective, which will aid in developing weight management programs during rehabilitation for knee arthroplasty patients.
AHRQ-funded; HS023011.
Citation: Pellegrini CA, Ledford G, Chang RW .
Understanding barriers and facilitators to healthy eating and physical activity from patients either before and after knee arthroplasty.
Disabil Rehabil 2018 Aug;40(17):2004-10. doi: 10.1080/09638288.2017.1323026.
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Keywords: Nutrition, Obesity, Orthopedics, Surgery
Goodman SM, Mandi LA, Mehta B
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
The authors assessed the interaction between education and poverty on 2-year Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function. They found that having no college was associated with worse pain and function at baseline and 2 years and that living in a poor neighborhood was associated with worse 2-year pain and function. There was a strong interaction between individual education and community poverty with WOMAC scores at 2 years. Patients without college living in poor communities had pain scores that were ~10 points worse than those with some college; in wealthy communities, college was associated with a 1-point difference in pain. Function was similar. The authors recommended further study on how education protects those in impoverished communities.
AHRQ-funded; HS016075.
Citation: Goodman SM, Mandi LA, Mehta B .
Does education level mitigate the effect of poverty on total knee arthroplasty outcomes?
Arthritis Care Res 2018 Jun;70(6):884-91. doi: 10.1002/acr.23442..
Keywords: Arthritis, Education, Low-Income, Orthopedics, Outcomes, Patient-Centered Outcomes Research, Social Determinants of Health
Childers CP, Siletz AE, Singer ES
Surgical technical evidence review for elective total joint replacement conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
AHRQ, the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery - a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty and total hip arthroplasty.
AHRQ-funded; 233201500020I.
Citation: Childers CP, Siletz AE, Singer ES .
Surgical technical evidence review for elective total joint replacement conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
Geriatr Orthop Surg Rehabil 2018 Feb 12;9:2151458518754451. doi: 10.1177/2151458518754451.
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Keywords: Evidence-Based Practice, Orthopedics, Patient Safety, Surgery, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research
Pitta M, Esposito CI, Li Z
Failure after modern total knee arthroplasty: a prospective study of 18,065 knees.
The investigators sought to determine the mechanism of failure among primary total knee arthroplasties (TKAs) performed at a single high-volume institution. They found that the most common reasons for failure within 2 years after TKA were infection and stiffness. They suggested that the study identified preoperative risk factors for failure of primary TKAs, which may be useful information for developing strategies to improve outcomes following TKA.
AHRQ-funded; HS016075.
Citation: Pitta M, Esposito CI, Li Z .
Failure after modern total knee arthroplasty: a prospective study of 18,065 knees.
J Arthroplasty 2018 Feb;33(2):407-14. doi: 10.1016/j.arth.2017.09.041..
Keywords: Arthritis, Orthopedics
George MD, Baker JF, Hsu JY
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
The purpose of this retrospective cohort study was to evaluate the association between infliximab timing and serious infection after elective hip or knee arthroplasty. The investigators concluded that administering infliximab within 4 weeks of elective knee or hip arthroplasty was not associated with a higher risk of short- or long-term serious infection compared to withholding infliximab for longer time periods. They also concluded that glucocorticoid use, especially >10 mg/day, was associated with an increased infection risk.
AHRQ-funded; HS018517.
Citation: George MD, Baker JF, Hsu JY .
Perioperative timing of infliximab and the risk of serious infection after elective hip and knee arthroplasty.
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Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Orthopedics, Patient Safety, Surgery
Tedesco D, Gori D, Desai KR
Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
The authors systematically reviewed and meta-analyzed evidence of nonpharmacological interventions for postoperative pain management after total knee arthroplasty. The most commonly performed interventions included in the review were continuous passive motion, preoperative exercise, cryotherapy, electrotherapy, and acupuncture. In the meta-analysis, electrotherapy and acupuncture after total knee arthroplasty were associated with reduced and delayed opioid consumption.
AHRQ-funded; HS024096.
Citation: Tedesco D, Gori D, Desai KR .
Drug-free interventions to reduce pain or opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.
JAMA Surg 2017 Oct 18;152(10):e172872. doi: 10.1001/jamasurg.2017.2872.
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Keywords: Care Management, Medication, Opioids, Orthopedics, Pain, Surgery
Ehlers AP, Khor S, Cizik AM
Use of patient-reported outcomes and satisfaction for quality assessments.
This study investigated the relationship between PROs and satisfaction among spine surgery patients. The authors hypothesized that there would be significant disparities between patient satisfaction and PROs at the 1-year postoperative time point. The study found that overall, patients undergoing elective lumbar spine surgery reported being satisfied with outcomes, but the reported responses in PROs were much more variable.
AHRQ-funded; HS020025.
Citation: Ehlers AP, Khor S, Cizik AM .
Use of patient-reported outcomes and satisfaction for quality assessments.
Am J Manag Care 2017 Oct;23(10):618-22..
Keywords: Patient-Centered Outcomes Research, Patient Experience, Quality of Care, Surgery, Outcomes, Orthopedics
Cramer JD, Patel UA, Maas MB
Is neck dissection associated with an increased risk of postoperative stroke?
The researchers investigated whether neck dissection is an independent risk factor for postoperative stroke. They found that the rate of postoperative stroke was greater with neck dissection than without it and concluded that stroke is a rare but highly morbid complication after head and neck surgery. Compared with other head and neck surgery, neck dissection in patients at risk for carotid artery stenosis is associated with an increased risk of postoperative stroke.
AHRQ-funded; HS023011.
Citation: Cramer JD, Patel UA, Maas MB .
Is neck dissection associated with an increased risk of postoperative stroke?
Otolaryngol Head Neck Surg 2017 Aug;157(2):226-32. doi: 10.1177/0194599817698414.
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Keywords: Orthopedics, Quality Improvement, Risk, Stroke, Surgery
Lemay CA, Lewis CG, Singh JA
Receipt of pain management information preoperatively is associated with improved functional gain after elective total joint arthroplasty.
This study evaluated patient-reported receipt of preoperative pain management information in a national prospective cohort evaluating postoperative pain and function following elective TJA. It found that patients who received pain information reported less pain 2 weeks postoperatively, greater use of non-narcotic pain care strategies, and better physical function scores at 6 months postoperatively.
AHRQ-funded; HS018910; HS021110.
Citation: Lemay CA, Lewis CG, Singh JA .
Receipt of pain management information preoperatively is associated with improved functional gain after elective total joint arthroplasty.
J Arthroplasty 2017 Jun;32(6):1763-68. doi: 10.1016/j.arth.2017.01.028.
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Keywords: Education: Patient and Caregiver, Orthopedics, Surgery, Pain
Taylor LK, Thomas GW, Karam MD
Assessing wire navigation performance in the operating room.
The researchers sought to develop meaningful, objective measures of wire navigation performance in the operating room. They concluded that several video-based metrics were consistent across the 4 video reviewers and are likely to be useful for performance assessment. The tip-apex distance (TAD) measurement was less reliable than previous reports have suggested, but remains a valuable metric of performance.
AHRQ-funded; HS022077.
Citation: Taylor LK, Thomas GW, Karam MD .
Assessing wire navigation performance in the operating room.
J Surg Educ 2016 Sep-Oct;73(5):780-7. doi: 10.1016/j.jsurg.2016.03.018.
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Keywords: Surgery, Provider Performance, Injuries and Wounds, Orthopedics
Tedesco D, Hernandez-Boussard T, Carretta E
Evaluating patient safety indicators in orthopedic surgery between Italy and the USA.
The authors compared patient safety in major orthopedic procedures between an orthopedic hospital in Italy and 26 Florida hospitals of similar size. AHRQ Patient Safety Indicators (PSIs) were used to identify inpatient adverse events (AEs). They found that US patients had lower adjusted odds of developing a PSI compared to Italy for pressure ulcers, hemorrhage or hematoma, and physiologic and metabolic derangement. while Italian patients had lower odds of pulmonary embolism/deep vein thrombosis compared to US patients.
AHRQ-funded; HS018558.
Citation: Tedesco D, Hernandez-Boussard T, Carretta E .
Evaluating patient safety indicators in orthopedic surgery between Italy and the USA.
Int J Qual Health Care 2016 Sep;28(4):486-91. doi: 10.1093/intqhc/mzw053.
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Keywords: Adverse Events, Orthopedics, Patient Safety, Quality Indicators (QIs), Surgery
Ellimoottil C, Ryan AM, Hou H
Medicare's new bundled payment for joint replacement may penalize hospitals that treat medically complex patients.
Using Medicare claims for patients in Michigan who underwent lower extremity joint replacement in the period 2011-13, the researchers applied payment methods analogous to those CMS intends to use in determining annual bonuses or penalties (reconciliation payments) to hospitals. Their findings suggest that CMS should include risk adjustment in the Comprehensive Care for Joint Replacement program and in future bundled payment programs.
AHRQ-funded; HS024193; HS018546.
Citation: Ellimoottil C, Ryan AM, Hou H .
Medicare's new bundled payment for joint replacement may penalize hospitals that treat medically complex patients.
Health Aff 2016 Sep;35(9):1651-7. doi: 10.1377/hlthaff.2016.0263.
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Keywords: Medicare, Payment, Healthcare Costs, Orthopedics, Provider Performance
Dicks KV, Baker AW, Durkin MJ
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
The purpose of this paper was to determine the association between shorter operative duration and surgical site infection (SSI) and also between surgeon median operative duration and SSI risk among first-time hip and knee arthroplasties. The researchers concluded that short operative durations were not associated with a higher SSI risk for knee or hip arthroplasty procedures in their analysis.
AHRQ-funded; HS023866.
Citation: Dicks KV, Baker AW, Durkin MJ .
Short operative duration and surgical site infection risk in hip and knee arthroplasty procedures.
Infect Control Hosp Epidemiol 2015 Dec;36(12):1431-6. doi: 10.1017/ice.2015.222.
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Keywords: Healthcare-Associated Infections (HAIs), Orthopedics, Patient Safety, Adverse Events, Surgery, Injuries and Wounds
Singh JA, Ramachandran R
Age-related differences in the use of total shoulder arthroplasty over time: use and outcomes.
The authors assessed the age-related differences in the use of total shoulder arthroplasty (TSA) and outcomes, and associated time-trends using the United States Nationwide Inpatient Sample (NIS) between 1998 and 2010. They noted a time-related increase in the use of TSA and increasing age-related differences in outcomes indicating a changing epidemiology of the use of TSA and concluded that age-related differences in outcomes suggest that attention should focus on groups with the worst outcomes.
AHRQ-funded; HS021110.
Citation: Singh JA, Ramachandran R .
Age-related differences in the use of total shoulder arthroplasty over time: use and outcomes.
Bone Joint J 2015 Oct;97-b(10):1385-9. doi: 10.1302/0301-620x.97b10.35696.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Elderly, Orthopedics, Surgery