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
7976 to 8000 of 12139 Research Studies DisplayedDharmarajan K, Qin L, Bierlein M
Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study.
This study characterized rates and trends over time of emergency department treatment-and-discharge stays, repeat observation stays, inpatient stays, any hospital revisit, and death within 30 days of discharge from observation stays. Hospital revisits are common after discharge from observation stays, frequently result in inpatient hospitalizations, and have increased over time among Medicare beneficiaries.
AHRQ-funded; HS023000.
Citation: Dharmarajan K, Qin L, Bierlein M .
Outcomes after observation stays among older adult Medicare beneficiaries in the USA: retrospective cohort study.
BMJ 2017 Jun 20;357:j2616. doi: 10.1136/bmj.j2616.
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Keywords: Elderly, Emergency Department, Hospital Discharge, Hospital Readmissions, Medicare
O'Connor EA, Evans CV, Burda BU
Screening for obesity and intervention for weight management in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The researchers conducted a systematic review of the benefits and harms of screening and treatment for obesity and overweight in children and adolescents to inform the US Preventive Services Task Force. They concluded that lifestyle-based weight loss interventions with 26 or more hours of intervention contact are likely to help reduce excess weight in children and adolescents. The clinical significance of the small benefit of medication use is unclear.
AHRQ-funded; 290201200015IEPC4.
Citation: O'Connor EA, Evans CV, Burda BU .
Screening for obesity and intervention for weight management in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Jun 20;317(23):2427-44. doi: 10.1001/jama.2017.0332.
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Keywords: Children/Adolescents, Obesity, Screening, U.S. Preventive Services Task Force (USPSTF)
Rickard CM, Marsh NM, Webster J
Peripherally InSerted CEntral catheter dressing and securement in patients with cancer: the PISCES trial. protocol for a 2x2 factorial, superiority randomised controlled trial.
The researchers designed this trial to assess the clinical and cost-effectiveness of dressing and securements to prevent peripherally inserted central catheters (PICCs) failure. For the dressing hypothesis, they hypothesize (chlorhexidine gluconate (CHG) discs will reduce catheter-associated bloodstream infection (CABSI) compared with no CHG disc. For the securement hypothesis, they hypothesize that integrated securement dressing will reduce composite PICC failure (infection (CABSI/local infection), occlusion, dislodgement or thrombosis), compared with securement device.
AHRQ-funded; HS022835.
Citation: Rickard CM, Marsh NM, Webster J .
Peripherally InSerted CEntral catheter dressing and securement in patients with cancer: the PISCES trial. protocol for a 2x2 factorial, superiority randomised controlled trial.
BMJ Open 2017 Jun 15;7(6):e015291. doi: 10.1136/bmjopen-2016-015291.
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Keywords: Cancer, Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Patient Safety
Meyers D, Duncan J
AHRQ Author: Meyers D
Serologic screening for genital herpes infection.
This case study involves a 23-year-old woman who presents to your office for her first prenatal visit. She is in the eighth week of her first pregnancy. The study poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Meyers D, Duncan J .
Serologic screening for genital herpes infection.
Am Fam Physician 2017 Jun 15;95(12):801-02.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Sexual Health, Case Study
Ong T, Pradhananga R, Holve E
A framework for classification of electronic health data extraction-transformation-loading challenges in data network participation.
The researchers conducted key-informant interviews with data partner representatives to survey the Extract, Transform, Load (ETL) process challenges faced in clinical data research networks (CDRNs) and registries. The paper concluded that overcoming ETL technical challenges requires significant investments in a broad array of information technologies and human resources. Identifying these technical obstacles can inform optimal resource allocation to minimize the barriers and cost of entry for new data partners into extant networks, which in turn can expand data networks' inclusiveness and diversity.
AHRQ-funded; HS019564.
Citation: Ong T, Pradhananga R, Holve E .
A framework for classification of electronic health data extraction-transformation-loading challenges in data network participation.
eGEMS 2017 Jun 13;5(1):10. doi: 10.5334/egems.222..
Keywords: Comparative Effectiveness, Data, Health Information Technology (HIT), Patient-Centered Outcomes Research, Registries
Chang SH, Liu X, Carlsson NP
Reexamining the association of body mass index with overall survival outcomes after liver transplantation.
The purpose of this study is to identify the range of body mass index (BMI) at liver transplantation (LT) associated with the lowest risks of posttransplant mortality by Model of End Stage Liver Disease (MELD) category. It concluded that obesity in LT patients is not necessarily associated with higher posttransplantation mortality and highlighted the importance of the interaction between BMI and MELD category to determine their survival likelihood.
AHRQ-funded; HS022330.
Citation: Chang SH, Liu X, Carlsson NP .
Reexamining the association of body mass index with overall survival outcomes after liver transplantation.
Transplant Direct 2017 Jun 12;3(7):e172. doi: 10.1097/txd.0000000000000681.
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Keywords: Obesity, Transplantation, Mortality, Patient-Centered Outcomes Research, Outcomes
Wessell A, Kole MJ, Badjatia N
High compliance with scheduled nimodipine is associated with better outcome in aneurysmal subarachnoid hemorrhage patients cotreated with heparin infusion.
The researchers sought to determine whether compliance with scheduled nimodipine in subarachnoid hemorrhage patients impacted patient outcomes, with the intent of guiding future nimodipine management in patients who experience nimodipine-induced hypotension. They found that in those patients with modified Fisher scores 2 through 4 who are cotreated with a low-dose heparin infusion, full compliance with nimodipine dosing was associated with increased odds of discharge to home.
AHRQ-funded; HS024560.
Citation: Wessell A, Kole MJ, Badjatia N .
High compliance with scheduled nimodipine is associated with better outcome in aneurysmal subarachnoid hemorrhage patients cotreated with heparin infusion.
Front Neurol 2017 Jun 9;8:268. doi: 10.3389/fneur.2017.00268.
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Keywords: Patient-Centered Outcomes Research, Medication, Cardiovascular Conditions, Outcomes
Weitlauf AS, Sathe N, McPheeters ML
Interventions targeting sensory challenges in autism spectrum disorder: a systematic review.
This review evaluated the effectiveness and safety of interventions targeting sensory challenges in ASD. It concluded that some interventions may yield modest short-term (<6 months) improvements in sensory- and ASD symptom severity-related outcomes; the evidence base is small, and the durability of the effects is unclear. Although some therapies may hold promise, substantial needs exist for continuing improvements in methodologic rigor.
AHRQ-funded; 290201500003I.
Citation: Weitlauf AS, Sathe N, McPheeters ML .
Interventions targeting sensory challenges in autism spectrum disorder: a systematic review.
Pediatrics 2017 Jun;139(6):e20170347. doi: 10.1542/peds.2017-0347.
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Keywords: Patient-Centered Outcomes Research, Evidence-Based Practice, Comparative Effectiveness, Children/Adolescents, Autism
Bello JK, Mohanty N, Bauer V
Pediatric hypertension: provider perspectives.
The researchers aimed to gain insights into reasons for low rates of diagnosis and treatment from primary care providers. In interviews, providers reflected on numerous barriers to diagnosis, management, and follow-up; recommendations for educational content; and how community health center systems can be improved. Findings informed development of a multifaceted intervention.
AHRQ-funded; HS024100.
Citation: Bello JK, Mohanty N, Bauer V .
Pediatric hypertension: provider perspectives.
Glob Pediatr Health 2017 Jun 6;4:2333794x17712637. doi: 10.1177/2333794x17712637.
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Keywords: Children/Adolescents, Diagnostic Safety and Quality, Healthcare Delivery, Blood Pressure, Obesity, Primary Care
Goldmann E, Roberts ET, Parikh NS
Chronic physical illness burden and suicidal ideation among Dominicans in New York City.
This study used data from a community survey of 2753 Dominican adults in New York City to investigate the association between chronic illness and suicidal ideation. The investigators concluded that the association of interest did not differ significantly between younger and older adults. They suggest that screening for SI in health care practice, particularly among Dominican men with multiple chronic health conditions, may be warranted.
AHRQ-funded; HS022961.
Citation: Goldmann E, Roberts ET, Parikh NS .
Chronic physical illness burden and suicidal ideation among Dominicans in New York City.
J Immigr Minor Health 2017 Jun;19(3):616-22. doi: 10.1007/s10903-016-0477-0..
Keywords: Chronic Conditions, Depression, Behavioral Health, Racial and Ethnic Minorities, Risk
Miller GE, Vistnes J, Buettgens M
AHRQ Author: Miller GE, Vistnes J
The availability and marginal costs of dependent employer-sponsored health insurance.
In this study, the investigators examined differences by firm size in the availability of dependent coverage and the incremental cost of such coverage. They indicate that their results suggest that firm size may be an important factor in policy assessments, such as analyses of the financial implications for families excluded from subsidized Marketplace coverage due to affordable offers of single coverage or of potential rollbacks to public coverage for children.
AHRQ-authored.
Citation: Miller GE, Vistnes J, Buettgens M .
The availability and marginal costs of dependent employer-sponsored health insurance.
Int J Health Econ Manag 2017 Jun;17(2):251-60. doi: 10.1007/s10754-016-9210-8..
Keywords: Medical Expenditure Panel Survey (MEPS), Health Insurance, Healthcare Costs
Boltey E, Yakusheva O, Costa DK
5 nursing strategies to prevent ventilator-associated pneumonia.
This article reviews the top five evidence-based nursing practices for reducing ventilator-associated pneumonia (VAP) risk in critically ill adults.
AHRQ-funded; HS024552.
Citation: Boltey E, Yakusheva O, Costa DK .
5 nursing strategies to prevent ventilator-associated pneumonia.
Am Nurse Today 2017 Jun;12(6):42-43..
Keywords: Critical Care, Healthcare-Associated Infections (HAIs), Nursing, Prevention, Pneumonia
Halbert CH, Bellamy S, Briggs V
A comparative effectiveness education trial for lifestyle health behavior change in African Americans.
The authors of this study compared the effects of alternate behavioral interventions on obesity-related health behaviors by conducting a comparative effectiveness education trial in a community-based sample of 530 adult African Americans. The investigators suggest that education about risk factors for chronic disease and evidence-based strategies for health behavior change may be useful for addressing obesity-related behaviors among African Americans.
AHRQ-funded; HS019339.
Citation: Halbert CH, Bellamy S, Briggs V .
A comparative effectiveness education trial for lifestyle health behavior change in African Americans.
Health Educ Res 2017 Jun 1;32(3):207-18. doi: 10.1093/her/cyx039..
Keywords: Comparative Effectiveness, Education: Patient and Caregiver, Lifestyle Changes, Lifestyle Changes, Obesity, Racial and Ethnic Minorities
Pisu M, Demark-Wahnefried W, Kenzik KM
A dance intervention for cancer survivors and their partners (RHYTHM).
The purpose of this study was to assess the feasibility, acceptability, and impact of a ballroom dance intervention on improving quality of life (QOL) and relationship outcomes in cancer survivors and their partners. It found that survivors saw this light-intensity physical activity as easing them into becoming more physically active. Light intensity ballroom dancing has the potential to improve cancer survivors' QOL.
AHRQ-funded; HS023009.
Citation: Pisu M, Demark-Wahnefried W, Kenzik KM .
A dance intervention for cancer survivors and their partners (RHYTHM).
J Cancer Surviv 2017 Jun;11(3):350-59. doi: 10.1007/s11764-016-0593-9.
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Keywords: Cancer, Health Promotion, Quality of Life
Le P, Martinez KA, Pappas MA
A decision model to estimate a risk threshold for venous thromboembolism prophylaxis in hospitalized medical patients.
To determine a threshold for prophylaxis based on risk of venous thromboembolism, the researchers constructed a decision model with a decision-tree following patients for 3 months after hospitalization, and a lifetime Markov model with 3-month cycles. They found that the prophylaxis threshold was relatively insensitive to low-molecular-weight heparin cost and bleeding risk, but very sensitive to patient age and life expectancy.
AHRQ-funded; HS022883.
Citation: Le P, Martinez KA, Pappas MA .
A decision model to estimate a risk threshold for venous thromboembolism prophylaxis in hospitalized medical patients.
J Thromb Haemost 2017 Jun;15(6):1132-41. doi: 10.1111/jth.13687.
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Keywords: Adverse Events, Clinical Decision Support (CDS), Inpatient Care, Patient Safety, Risk
Shortell SM, Poon BY, Ramsay PP
A multilevel analysis of patient engagement and patient-reported outcomes in primary care practices of accountable care organizations.
For adult primary care practices seeing patients with diabetes and/or cardiovascular disease, researchers examined the relationship between selected practice characteristics, patient engagement, and patient-reported outcomes of care. They found that having a patient-centered culture was positively associated with fewer depression symptoms and better physical function scores. Patient activation was positively associated with fewer depression symptoms.
AHRQ-funded; HS024075.
Citation: Shortell SM, Poon BY, Ramsay PP .
A multilevel analysis of patient engagement and patient-reported outcomes in primary care practices of accountable care organizations.
J Gen Intern Med 2017 Jun;32(6):640-47. doi: 10.1007/s11606-016-3980-z.
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Keywords: Patient and Family Engagement, Patient-Centered Outcomes Research, Primary Care, Chronic Conditions, Diabetes, Cardiovascular Conditions
Harrison KL, Dzeng E, Ritchie CS
Addressing palliative care clinician burnout in organizations: a workforce necessity, an ethical imperative.
Clinician burnout reduces the capacity for providers and health systems to deliver timely, high quality, patient-centered care and increases the risk that clinicians will leave practice. Efforts to mitigate and prevent burnout currently focus on individual clinicians. However, analysis of the problem of burnout should be expanded to include both individual- and systems-level factors as well as solutions; comprehensive interventions must address both.
AHRQ-funded; HS023681.
Citation: Harrison KL, Dzeng E, Ritchie CS .
Addressing palliative care clinician burnout in organizations: a workforce necessity, an ethical imperative.
J Pain Symptom Manage 2017 Jun;53(6):1091-96. doi: 10.1016/j.jpainsymman.2017.01.007.
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Keywords: Burnout, Palliative Care, Patient-Centered Healthcare, Provider: Clinician, Provider: Physician, Provider
Donnelly JP, Safford MM, Shapiro NI
Application of the Third International Consensus Definitions for Sepsis (Sepsis-3) Classification: a retrospective population-based cohort study.
The Consensus Definitions present clinical criteria for the classification of patients with sepsis. Researchers investigated incidence and long-term outcomes of patients diagnosed with these classifications, which are currently unknown. Their findings support the use of the elevated sepsis-related organ failure assessment (SOFA) score from Sepsis-3, and elevated quick SOFA (qSOFA) score from Sepsis-3 classifications to identify patients with infection who are at elevated risk of poor outcomes.
AHRQ-funded; HS013852.
Citation: Donnelly JP, Safford MM, Shapiro NI .
Application of the Third International Consensus Definitions for Sepsis (Sepsis-3) Classification: a retrospective population-based cohort study.
Lancet Infect Dis 2017 Jun;17(6):661-70. doi: 10.1016/s1473-3099(17)30117-2.
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Keywords: Sepsis, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Outcomes
McGrath SP, Pyke J, Taenzer AH
Assessment of continuous acoustic respiratory rate monitoring as an addition to a pulse oximetry-based patient surveillance system.
This study explored the technical and logistical aspects of augmenting pulse oximetry-based patient surveillance systems with continuous respiratory rate monitoring and offers some insight into the impact on patient deterioration detection that may result.
AHRQ-funded; HS024403.
Citation: McGrath SP, Pyke J, Taenzer AH .
Assessment of continuous acoustic respiratory rate monitoring as an addition to a pulse oximetry-based patient surveillance system.
J Clin Monit Comput 2017 Jun;31(3):561-69. doi: 10.1007/s10877-016-9884-y..
Keywords: Diagnostic Safety and Quality, Respiratory Conditions
Meyer AND, Singh H
Calibrating how doctors think and seek information to minimise errors in diagnosis.
This editorial discusses a study by Sheringham et al., published in 2017 in BMJ Quality and Safety, and entitled “Variations in GPs’ decisions to investigate suspected lung cancer: a factorial experiment using multimedia vignettes” in which they used simulated patient vignettes to understand the role that patient characteristics (including demographics and symptomatology) play in physicians’ decisions to investigate for possible diagnosis of lung cancer.
AHRQ-funded; HS022087; HS023602.
Citation: Meyer AND, Singh H .
Calibrating how doctors think and seek information to minimise errors in diagnosis.
BMJ Qual Saf 2017 Jun;26(6):436-38. doi: 10.1136/bmjqs-2016-006071..
Keywords: Cancer: Lung Cancer, Decision Making, Diagnostic Safety and Quality
Hanlon JT, Zhao X, Naples JG
Central nervous system medication burden and serious falls in older nursing home residents.
The researchers examined the association between CNS medication burden and serious falls in those with a recent fall history. They found that CNS medication burden, approximately 3 + standardized daily doses, was associated with an increased risk of serious falls in nursing home residents with recent fall.
AHRQ-funded; HS023779.
Citation: Hanlon JT, Zhao X, Naples JG .
Central nervous system medication burden and serious falls in older nursing home residents.
J Am Geriatr Soc 2017 Jun;65(6):1183-89. doi: 10.1111/jgs.14759.
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Keywords: Elderly, Falls, Medication, Nursing Homes, Patient Safety
Henriksen K, Dymek C, Harrison MI
AHRQ Author: Henriksen K, Dymek C, Harrison MI, Brady PJ, Arnold SB
Challenges and opportunities from the Agency for Healthcare Research and Quality (AHRQ) research summit on improving diagnosis: a proceedings review.
AHRQ held a research summit in the fall of 2016, inviting members from a diverse collection of organizations, both inside and outside of government, to share their suggestions regarding what is known about diagnosis and the challenges that need to be addressed. Among the goals of the summit were to learn from the insights of participants and examine issues associated with definitions of diagnostic error and gaps in the evidence base.
AHRQ-authored.
Citation: Henriksen K, Dymek C, Harrison MI .
Challenges and opportunities from the Agency for Healthcare Research and Quality (AHRQ) research summit on improving diagnosis: a proceedings review.
Diagnosis 2017 Jun;4(2):57-66.
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Keywords: Diagnostic Safety and Quality, Medical Errors, Evidence-Based Practice, Quality of Care
Mehta HB, Vargas GM, Adhikari D
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
The objectives were to determine trends in the use of chemotherapy as the initial treatment and to evaluate the comparative effectiveness of initial chemotherapy vs resection of the primary tumor on survival (intention-to-treat analysis) in Stage IV colorectal cancer (CRC). Instrumental variable analysis found that, compared with resection, chemotherapy as the initial treatment offers similar or better 2-year survival in patients with Stage IV CRC.
AHRQ-funded; HS022134.
Citation: Mehta HB, Vargas GM, Adhikari D .
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
Colorectal Dis 2017 Jun;19(6):O210-o18. doi: 10.1111/codi.13659.
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Keywords: Cancer: Colorectal Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Surgery
Aliu O, Zhong L, Chetta MD
Comparing health care resource use between implant and autologous reconstruction of the irradiated breast: a national claims-based assessment.
Nationwide data were used to examine health care resource use associated with implant and autologous reconstruction. Thirty-two percent of implant reconstructions failed, compared with 5 percent of autologous cases. In aggregate, failures constituted more than 20 percent of the cumulative costs of implant reconstruction compared with less than 5 percent for autologous reconstruction.
AHRQ-funded; HS023313.
Citation: Aliu O, Zhong L, Chetta MD .
Comparing health care resource use between implant and autologous reconstruction of the irradiated breast: a national claims-based assessment.
Plast Reconstr Surg 2017 Jun;139(6):1224e-31e. doi: 10.1097/prs.0000000000003336.
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Keywords: Cancer: Breast Cancer, Healthcare Costs, Surgery
Bostwick D, Wolf S, Samsa G
Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness.
Researchers compared functionality, advanced care planning, hospital admissions, prognosis, quality of life, pain, dyspnea, fatigue, and depression between patients with cancer and three non-cancer diagnoses-end-stage renal disease (ESRD), heart failure (HF), and chronic obstructive pulmonary disease (COPD). Patients with COPD, ESRD, and HF were less functional and more likely to be hospitalized at time of referral to palliative care than cancer patients.
AHRQ-funded; HS022763.
Citation: Bostwick D, Wolf S, Samsa G .
Comparing the palliative care needs of those with cancer to those with common non-cancer serious illness.
J Pain Symptom Manage 2017 Jun;53(6):1079-84.e1. doi: 10.1016/j.jpainsymman.2017.02.014.
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Keywords: Cancer, Respiratory Conditions, Kidney Disease and Health, Heart Disease and Health, Palliative Care