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
9151 to 9175 of 12139 Research Studies DisplayedBrodsky MB, Suiter DM, Gonzalez-Fernandez M
Screening accuracy for aspiration using bedside water swallow tests: a systematic review and meta-analysis.
This study evaluated screening accuracy of bedside water swallow tests used to identify patients at risk for dysphagia-associated aspiration, finding that currently-used tests offer sufficient screening.
AHRQ-funded; HS022331.
Citation: Brodsky MB, Suiter DM, Gonzalez-Fernandez M .
Screening accuracy for aspiration using bedside water swallow tests: a systematic review and meta-analysis.
Chest 2016 Jul;150(1):148-63. doi: 10.1016/j.chest.2016.03.059.
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Keywords: Respiratory Conditions, Diagnostic Safety and Quality, Pneumonia
Radovic A, Vona PL, Santostefano AM
Smartphone applications for mental health.
This study seeks to characterize apps readily available to smartphone users seeking mental health information and/or support. The most common purported purpose for the 208 apps studied was symptom relief (41 percent) and general mental health education (18 percent). The most frequently mentioned approaches to improving mental health were those that may benefit only milder symptoms such as relaxation (21 percent).
AHRQ-funded; HS022989.
Citation: Radovic A, Vona PL, Santostefano AM .
Smartphone applications for mental health.
Cyberpsychol Behav Soc Netw 2016 Jul;19(7):465-70. doi: 10.1089/cyber.2015.0619.
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Keywords: Behavioral Health, Telehealth, Education: Patient and Caregiver, Children/Adolescents, Health Information Technology (HIT)
Bishai D, Xu J, Sherry M
Strengthening the efferent arm in public health.
The purpose of the efferent arm in public health is to convene, coordinate, and shepherd the energy and resources of a community into collectively addressing shared health problems. The authors argue that the secret of an effective efferent arm is to focus on convening and communicating clearly the public health burdens and threats as widely as possible and to speak with authority about the evidence base of proven approaches.
AHRQ-funded; HS000029.
Citation: Bishai D, Xu J, Sherry M .
Strengthening the efferent arm in public health.
Am J Public Health 2016 Jul;106(7):1196-7. doi: 10.2105/ajph.2016.303216.
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Keywords: Evidence-Based Practice, Health Services Research (HSR), Public Health
Wisk LE, Weitzman ER
Substance use patterns through early adulthood: results for youth with and without chronic conditions.
As there have been no nationally representative studies of substance use during this period for these medically vulnerable youth, the authors examined onset and intensification of these behaviors for a national sample of youth with and without chronic conditions. Youth with chronic medical conditions (YCMC) were more likely to engage in any and heavier substance use; transition years and early adulthood were periods of peak risk for YCMC compared with their healthy peers.
AHRQ-funded; HS000063.
Citation: Wisk LE, Weitzman ER .
Substance use patterns through early adulthood: results for youth with and without chronic conditions.
Am J Prev Med 2016 Jul;51(1):33-45. doi: 10.1016/j.amepre.2016.01.029.
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Keywords: Children/Adolescents, Children/Adolescents, Chronic Conditions, Substance Abuse, Young Adults
Ishizuka M, Rangarajan V, Sawyer TL
The development of tracheal intubation proficiency outside the operating suite during pediatric critical care medicine fellowship training: a retrospective cohort study using cumulative sum analysis.
The researchers hypothesized that both overall and first-attempt tracheal intubation success rates by pediatric critical care medicine fellows would improve over the course of training. They found that all fellows who completed 3 years of training during the study period achieved an acceptable 90% overall tracheal intubation success rate. They concluded that further investigations on a larger scale across different training programs are necessary to clarify intensity and duration of the training to achieve tracheal intubation procedural competency.
AHRQ-funded; HS021583; HS022464.
Citation: Ishizuka M, Rangarajan V, Sawyer TL .
The development of tracheal intubation proficiency outside the operating suite during pediatric critical care medicine fellowship training: a retrospective cohort study using cumulative sum analysis.
Pediatr Crit Care Med 2016 Jul;17(7):e309-16. doi: 10.1097/pcc.0000000000000774.
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Keywords: Children/Adolescents, Critical Care, Education: Continuing Medical Education, Children/Adolescents, Respiratory Conditions
John-Baptiste A, Schapira MM, Cravens C
AHRQ Author: John-Baptiste A, Cravens C, Siegel J, Lawrence W
The role of decision models in health care policy: a case study.
In 2009, the Centers for Medicare and Medicaid Services (CMS) underwent a National Coverage Determination on computed tomography colonography (CTC) to screen for colorectal cancer. The Cancer Intervention & Surveillance Network developed decision models to inform this decision. The purpose of this study was to investigate the role of models in this decision. It concluded that decision makers involved in the CTC decision believed in the adequacy of models to inform coverage decisions.
AHRQ-authored.
Citation: John-Baptiste A, Schapira MM, Cravens C .
The role of decision models in health care policy: a case study.
Med Decis Making 2016 Jul;36(5):666-79. doi: 10.1177/0272989x16646732.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Imaging, Policy
Kenzik KM, Kvale EA, Rocque GB
Treatment summaries and follow-up care instructions for cancer survivors: improving survivor self-efficacy and health care utilization.
The researchers examined the association of receiving summaries and care plans with cancer survivor self-efficacy for chronic illness management. They found that explanation of the follow-up care plan, beyond the written component, enhances survivor self-efficacy for managing cancer as a chronic condition-an important mediator for improving health care utilization outcomes.
AHRQ-funded; HS023009; HS013852.
Citation: Kenzik KM, Kvale EA, Rocque GB .
Treatment summaries and follow-up care instructions for cancer survivors: improving survivor self-efficacy and health care utilization.
Oncologist 2016 Jul;21(7):817-24. doi: 10.1634/theoncologist.2015-0517.
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Keywords: Cancer, Chronic Conditions, Education: Patient and Caregiver, Elderly, Patient Self-Management
Raval AD, Madhavan S, Mattes MD
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
The authors sought to examine the association between types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer. They found that a significant proportion of elderly men with chronic conditions have received aggressive initial cancer treatment, and they suggested a conservative approach for the initial prostate cancer treatment among elderly men with significant chronic conditions and localised prostate cancer.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
Int J Clin Pract 2016 Jul;70(7):606-18. doi: 10.1111/ijcp.12838.
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Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Chronic Conditions, Elderly, Men's Health
McCarthy ML, Shokoohi H
Ultrasonography versus landmark for peripheral intravenous cannulation: a randomized controlled trial.
Randomized controlled trials report inconsistent findings when comparing the initial success rate of peripheral intravenous cannulation using landmark versus ultrasonography for patients with difficult venous access. This study sought to determine which method was superior for patients with varying levels of intravenous access difficulty. The study concluded that ultrasonographic peripheral intravenous cannulation was advantageous among patients with difficult or moderately difficult intravenous access but was disadvantageous among patients anticipated to have easy access.
AHRQ-funded; HS017957.
Citation: McCarthy ML, Shokoohi H .
Ultrasonography versus landmark for peripheral intravenous cannulation: a randomized controlled trial.
Ann Emerg Med 2016 Jul;68(1):10-8. doi: 10.1016/j.annemergmed.2015.09.009..
Keywords: Emergency Department, Imaging
Healy MA, Yin H, Reddy RM
Use of positron emission tomography to detect recurrence and associations with survival in patients with lung and esophageal cancers.
The researchers sought to evaluate utilization of positron emission tomography (PET) to detect recurrence in asymptomatic patients and relationships with survival for patients with lung and esophageal cancers. Despite statistically significant variation in use of PET to detect tumor recurrence, there was no association with improved two-year survival.
AHRQ-funded; HS020937.
Citation: Healy MA, Yin H, Reddy RM .
Use of positron emission tomography to detect recurrence and associations with survival in patients with lung and esophageal cancers.
J Natl Cancer Inst 2016 Jul;108(7). doi: 10.1093/jnci/djv429.
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Keywords: Imaging, Cancer, Cancer: Lung Cancer, Healthcare Utilization
Grenda TR, Pradarelli JC, Dimick JB
Using surgical video to improve technique and skill.
The authors argue that video analysis affords the opportunity to study both surgical technique (i.e. the details of how an operation is conducted) and surgical skill (i.e. how well a surgeon performs a procedure). This strategy may be particularly applicable for technically complex procedures that already have the capability to capture video (e.g. advanced laparoscopy, robotic surgery, video-assisted thoracoscopic surgery). Furthermore, this work could also be extended to open procedures using other video-recording modalities.
AHRQ-funded; HS000053.
Citation: Grenda TR, Pradarelli JC, Dimick JB .
Using surgical video to improve technique and skill.
Ann Surg 2016 Jul;264(1):32-3. doi: 10.1097/sla.0000000000001592.
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Keywords: Patient Safety, Surgery, Training
Gavinski K, Carnahan R, Weckmann M
Validation of the delirium observation screening scale in a hospitalized older population.
The authors studied the accuracy of the Delirium Observation Screening Scale (DOS) as a screening tool in hospitalized patients over age 64. They also investigated the user-friendliness of the tool. They determined that DOS is an accurate and easy way to screen for delirium in older inpatients.
AHRQ-funded; HS022666.
Citation: Gavinski K, Carnahan R, Weckmann M .
Validation of the delirium observation screening scale in a hospitalized older population.
J Hosp Med 2016 Jul;11(7):494-7. doi: 10.1002/jhm.2580.
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Keywords: Elderly, Hospitalization, Neurological Disorders, Screening
Wilkes JJ, Hennessy S, Xiao R
Volume-outcome relationships in pediatric acute lymphoblastic leukemia: association between hospital pediatric and pediatric oncology volume with mortality and intensive care resources during initial therapy.
Researchers investigated if inpatient hospital volume influences outcomes. The objective of their study was to evaluate the relationship between inpatient pediatric and pediatric oncology volume and mortality and intensive care resources (ICU care). It concluded that induction mortality was low and that there was no inverse relationship between volume and mortality or ICU care.
AHRQ-funded; HS023419.
Citation: Wilkes JJ, Hennessy S, Xiao R .
Volume-outcome relationships in pediatric acute lymphoblastic leukemia: association between hospital pediatric and pediatric oncology volume with mortality and intensive care resources during initial therapy.
Clin Lymphoma Myeloma Leuk 2016 Jul;16(7):404-10.e1. doi: 10.1016/j.clml.2016.04.016.
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Keywords: Cancer, Children/Adolescents, Hospitalization, Mortality, Outcomes
Fiscella K, Fogarty C, Salas E
What can primary care learn from sports teams?
The authors used sports teams to illustrate key principles from team science and to extract practical lessons for primary care teams.
AHRQ-funded; HS022440.
Citation: Fiscella K, Fogarty C, Salas E .
What can primary care learn from sports teams?
J Ambul Care Manage 2016 Jul-Sep;39(3):279-85. doi: 10.1097/jac.0000000000000120.
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Keywords: Patient Safety, Primary Care, Quality Improvement, Teams
Saint S, Greene MT, Krein SL
AHRQ Author: Battles J
A program to prevent catheter-associated urinary tract infection in acute care.
The national Comprehensive Unit-based Safety Program, funded by AHRQ, aimed to reduce catheter-associated UTI in intensive care units (ICUs) and non-ICUs. The main program features were dissemination of information to sponsor organizations and hospitals, data collection, and guidance on key technical and socioadaptive factors in the prevention of catheter-associated UTI. Among the findings: in an adjusted analysis, catheter-associated UTI rates decreased from 2.40 to 2.05 infections per 1000 catheter-days.
AHRQ-authored; AHRQ-funded; 290201000025I; 29032001T.
Citation: Saint S, Greene MT, Krein SL .
A program to prevent catheter-associated urinary tract infection in acute care.
N Engl J Med 2016 Jun 2;374(22):2111-9. doi: 10.1056/NEJMoa1504906.
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Keywords: Comprehensive Unit-based Safety Program (CUSP), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Prevention, Urinary Tract Infection (UTI)
Augustine J, Warholak TL, Hines LE
Ability and use of comparative effectiveness research by P&T committee members and support staff: a 1-year follow-up.
The study’s objective was to provide a follow-up assessment of the use of comparative effectiveness research (CER) in the pharmacy and therapeutics (P&T) committee decision-making process, using information collected from participants 1 year after attending a live continuing education program. It concluded that health professionals attending a continuing education CER program reported higher use of CER materials compared with nonattendees.
AHRQ-funded; HS019220.
Citation: Augustine J, Warholak TL, Hines LE .
Ability and use of comparative effectiveness research by P&T committee members and support staff: a 1-year follow-up.
J Manag Care Spec Pharm 2016 Jun;22(6):618-25. doi: 10.18553/jmcp.2016.22.6.618.
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Keywords: Comparative Effectiveness, Education: Continuing Medical Education, Provider: Health Personnel, Provider: Pharmacist
Coulam R, Kralewski J, Dowd B
The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.
The purpose of this study was to gain insights into the role these administrators play in quality assurance programs. It found that administrators conducted due diligence on Medicare's physician quality reporting system, influenced how the issue was presented to physicians for adoption, and managed implementation thereafter. Administrators' recommendations were heavily influenced by practice characteristics, financial incentives, and practice commitments to early adoption of quality improvement innovations.
AHRQ-funded; HS019964.
Citation: Coulam R, Kralewski J, Dowd B .
The role of medical group practice administrators in the adoption and implementation of Medicare's physician quality reporting system.
Health Care Manage Rev 2016 Apr-Jun;41(2):145-54. doi: 10.1097/hmr.0000000000000061.
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Keywords: Medicare, Provider Performance, Quality Improvement, Quality of Care, Public Reporting
Cohen DJ, Balasubramanian BA, Gordon L
A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.
This paper describes the study protocol for the EvidenceNOW national evaluation, which is called Evaluating System Change to Advance Learning and Take Evidence to Scale (ESCALATES). Quantitative, qualitative, and mixed methods analyses will be conducted to examine how Cooperatives organize to provide external support to practices, to compare effectiveness of the dissemination and implementation approaches they implement, and to examine how regional variations and other organization and contextual factors influence implementation and effectiveness.
AHRQ-funded; HS022981; HS023940.
Citation: Cohen DJ, Balasubramanian BA, Gordon L .
A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol.
Implement Sci 2016 Jun 29;11(1):86. doi: 10.1186/s13012-016-0449-8.
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Keywords: Cardiovascular Conditions, Evidence-Based Practice, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Primary Care, Research Methodologies
Fiks AG, DuRivage N, Mayne SL
Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study.
The researchers evaluated the feasibility of using a patient portal for pediatric asthma in primary care. Fewer than three percent of those families invited to enroll used the portal. The authors found that although use of the portal was associated with higher treatment engagement, their results suggested that achieving widespread portal adoption is unlikely in the short term.
AHRQ-funded; HS021645; HS022689.
Citation: Fiks AG, DuRivage N, Mayne SL .
Adoption of a portal for the primary care management of pediatric asthma: a mixed-methods implementation study.
J Med Internet Res 2016 Jun 29;18(6):e172. doi: 10.2196/jmir.5610.
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Keywords: Web-Based, Primary Care, Children/Adolescents, Patient-Centered Healthcare, Asthma
Roosan D, Del Fiol G, Butler J
Feasibility of population health analytics and data visualization for decision support in the infectious diseases domain: a pilot study.
The objectives of this study were: 1) to explore the feasibility of extracting and displaying population-based information from an actual clinical population's database records, 2) to explore specific design features for improving population display, 3) to explore perceptions of population information displays, and 4) to explore the impact of population information display on cognitive outcomes. It concluded that a population database has great potential for reducing complexity and uncertainty in medicine to improve clinical care.
AHRQ-funded; HS023349.
Citation: Roosan D, Del Fiol G, Butler J .
Feasibility of population health analytics and data visualization for decision support in the infectious diseases domain: a pilot study.
Appl Clin Inform 2016 Jun 29;7(2):604-23. doi: 10.4338/aci-2015-12-ra-0182.
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Keywords: Clinical Decision Support (CDS), Data, Decision Making, Infectious Diseases, Public Health
Chen J, Hsieh AF, Dharmarajan K
National trends in heart failure hospitalization after acute myocardial infarction for Medicare beneficiaries: 1998-2010.
This study used a complete national sample of 2 789 943 AMI hospitalizations of Medicare fee-for-service beneficiaries from 1998 through 2010, we evaluated annual changes in the incidence of subsequent heart failure (HF) hospitalization and mortality using Poisson and survival analysis models. It found that HF hospitalization after AMI decreased from 1998 to 2010, which may indicate improvements in the management of AMI.
AHRQ-funded; HS018781.
Citation: Chen J, Hsieh AF, Dharmarajan K .
National trends in heart failure hospitalization after acute myocardial infarction for Medicare beneficiaries: 1998-2010.
Circulation 2013 Dec 17;128(24):2577-84. doi: 10.1161/circulationaha.113.003668..
Keywords: Hospitalization, Medicare, Heart Disease and Health, Mortality
Menon S, Murphy DR, SIngh H
Workarounds and test results follow-up in electronic health record-based primary care.
This study sought to understand why primary care practitioners use workarounds to manage test results by analyzing data from a previously conducted national cross-sectional survey on test result management. It concluded that workarounds to manage EHR-based test results are common, and their use results from unmet provider information management needs.
AHRQ-funded; HS022901; HS022087.
Citation: Menon S, Murphy DR, SIngh H .
Workarounds and test results follow-up in electronic health record-based primary care.
Appl Clin Inform 2016 Jun 22;7(2):543-59. doi: 10.4338/aci-2015-10-ra-0135.
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Keywords: Communication, Electronic Health Records (EHRs), Primary Care, Workflow
Guirguis-Blake JM, Evans CV, Senger CA
Aspirin for the primary prevention of cardiovascular events: a systematic evidence review for the U.S. Preventive Services Task Force.
This is an update of a systematic review about the benefits of aspirin for the primary prevention of cardiovascular events in adults aged 40 years or older and to evaluate effect modification in subpopulations. It concluded that the beneficial effect of aspirin for the primary prevention of CVD is modest and also occurs at doses of 100 mg or less per day. Older adults seem to achieve a greater relative MI benefit.
AHRQ-funded; 290201200015.
Citation: Guirguis-Blake JM, Evans CV, Senger CA .
Aspirin for the primary prevention of cardiovascular events: a systematic evidence review for the U.S. Preventive Services Task Force.
Ann Intern Med 2016 Jun 21;164(12):804-13. doi: 10.7326/m15-2113.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Medication, Risk, Prevention
Huang ES
Management of diabetes mellitus in older people with comorbidities.
Guidelines recommend that physicians individualize the intensity of glucose control and treatments on the basis of the prognosis (for example, three tiers based on comorbidities and functional impairments). Very few studies have attempted to study these concepts in clinical practice. To better meet the treatment needs of older patients with diabetes and comorbidities, more research is needed to determine the risks and benefits of intensifying, maintaining, or de-intensifying treatments in this population.
AHRQ-funded; HS018542.
Citation: Huang ES .
Management of diabetes mellitus in older people with comorbidities.
BMJ 2016 Jun 15;353:i2200. doi: 10.1136/bmj.i2200.
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Keywords: Diabetes, Elderly, Patient-Centered Outcomes Research, Chronic Conditions
Ngo-Metzger Q, Owings J
AHRQ Author: Ngo-Metzger Q
Screening for abnormal blood glucose and type 2 diabetes mellitus.
This case study involves a 43-year-old woman with a seven pack-year smoking history. She has no health concerns and has not visited a physician in four years. Her blood pressure and pulse are normal, and her body mass index (BMI) is 27 kg per m2. She does not have a family history of diabetes mellitus. The case study poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Ngo-Metzger Q, Owings J .
Screening for abnormal blood glucose and type 2 diabetes mellitus.
Am Fam Physician 2016 Jun 15;93(12):1025-6.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Diabetes, Screening, Tobacco Use, Guidelines