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
9526 to 9550 of 12139 Research Studies DisplayedStrom MA, Silverberg JI
Allergic disease is associated with childhood seizures: an analysis of the 1997-2013 National Health Interview Survey.
This study examined a number of bivariate associations with caregiver-reported seizures and allergic disease. The results confirm the results of previous studies that found a positive association between allergic disease and seizures. Hay fever, eczema, and food allergy, but not asthma, are associated with history of seizures in children. Risk of seizures was more strongly associated with increased number of comorbid allergic diseases.
AHRQ-funded; HS023011.
Citation: Strom MA, Silverberg JI .
Allergic disease is associated with childhood seizures: an analysis of the 1997-2013 National Health Interview Survey.
J Allergy Clin Immunol 2016 Mar;137(3):951-3.e2. doi: 10.1016/j.jaci.2015.09.021.
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Keywords: Children/Adolescents, Neurological Disorders
Wong AF, Pielmeier U, Haug PJ
An in silico method to identify computer-based protocols worthy of clinical study: an insulin infusion protocol use case.
In this paper, the authors compared two existing computer-based insulin infusion protocols: eProtocol-insulin from Utah, USA, and Glucosafe from Denmark. They concluded that preclinical in silico comparison analytical framework allows rapid and inexpensive identification of computer-based protocol care strategies that justify expensive and burdensome clinical trials.
AHRQ-funded; HS006594.
Citation: Wong AF, Pielmeier U, Haug PJ .
An in silico method to identify computer-based protocols worthy of clinical study: an insulin infusion protocol use case.
J Am Med Inform Assoc 2016 Mar;23(2):283-8. doi: 10.1093/jamia/ocv067.
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Keywords: Health Information Technology (HIT), Medication, Research Methodologies
Wilson KC, Gould MK, Krishnan JA
An official American Thoracic Society workshop report. A framework for addressing multimorbidity in clinical practice guidelines for pulmonary disease, critical illness, and sleep disorders.
The American Thoracic Society convened a workshop to establish a strategy to address multimorbidity within clinical practice guidelines. This report describes a framework that addresses multimorbidity in each of the key steps of guideline development: topic selection, panel composition, identifying clinical questions, searching for and synthesizing evidence, rating the quality of that evidence, summarizing benefits and harms, formulating recommendations, and rating the strength of the recommendations.
AHRQ-funded; HS020672.
Citation: Wilson KC, Gould MK, Krishnan JA .
An official American Thoracic Society workshop report. A framework for addressing multimorbidity in clinical practice guidelines for pulmonary disease, critical illness, and sleep disorders.
Ann Am Thorac Soc 2016 Mar;13(3):S12-21. doi: 10.1513/AnnalsATS.201601-007ST.
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Keywords: Sleep Problems, Guidelines, Evidence-Based Practice, Chronic Conditions, Respiratory Conditions
Sulzer SH, Feinstein NW, Wendland CL
Assessing empathy development in medical education: a systematic review.
The authors examined how researchers define the central construct of empathy and what they choose to measure. They found that the majority of studies were characterised by internal inconsistencies and vagueness in both the conceptualization and operationalization of empathy, constraining the validity and usefulness of the research. They suggested that future research follow the lead of basic scientific research that conceptualizes empathy as relational rather than as a personal quality that may be modified wholesale through appropriate training.
AHRQ-funded; HS000032.
Citation: Sulzer SH, Feinstein NW, Wendland CL .
Assessing empathy development in medical education: a systematic review.
Med Educ 2016 Mar;50(3):300-10. doi: 10.1111/medu.12806.
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Keywords: Education: Academic, Education: Continuing Medical Education, Patient-Centered Healthcare, Clinician-Patient Communication
Stevens VJ, Solberg LI, Bailey SR
Assessing trends in tobacco cessation in diverse patient populations.
This study examined change in tobacco use over 4 years among the general population of patients in six diverse health care organizations using electronic medical record data. It found that among smokers who regularly used these care systems, one in seven had achieved long-term cessation after 4 years. The study shows the practicality of using electronic medical records for monitoring patient smoking status over time.
AHRQ-funded; HS019828.
Citation: Stevens VJ, Solberg LI, Bailey SR .
Assessing trends in tobacco cessation in diverse patient populations.
Nicotine Tob Res 2016 Mar;18(3):275-80. doi: 10.1093/ntr/ntv092.
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Keywords: Tobacco Use, Electronic Health Records (EHRs), Patient-Centered Outcomes Research, Healthcare Delivery, Lifestyle Changes
Fonarow GG, Liang L, Thomas L
Assessment of home-time after acute ischemic stroke in Medicare beneficiaries.
The researchers evaluated home-time as a patient-centered outcome in Medicare beneficiaries with ischemic stroke in comparison with modified Rankin Scale (mRS) score at 90 days and at 1 year post event. They concluded that in a population of older patients with ischemic stroke, home-time was readily available from administrative data and associated with mRS at 90 days and 1 year.
AHRQ-funded; HS019479; HS016964.
Citation: Fonarow GG, Liang L, Thomas L .
Assessment of home-time after acute ischemic stroke in Medicare beneficiaries.
Stroke 2016 Mar;47(3):836-42. doi: 10.1161/strokeaha.115.011599.
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Keywords: Medicare, Stroke, Elderly, Home Healthcare, Patient-Centered Outcomes Research
Chrischilles EA, Schneider KM, Schroeder MC
Association between preadmission functional status and use and effectiveness of secondary prevention medications in elderly survivors of acute myocardial infarction.
The researchers sought to determine whether function-related indicators, derived from preadmission claims data, help explain the frequent practice of forgoing secondary prevention medications observed in Medicare. They found that greater impairment in preadmission functional status, using a measure derived from claims data, was associated with less use of secondary prevention medications after acute myocardial infarction.
AHRQ-funded; HS018381; HS019440.
Citation: Chrischilles EA, Schneider KM, Schroeder MC .
Association between preadmission functional status and use and effectiveness of secondary prevention medications in elderly survivors of acute myocardial infarction.
J Am Geriatr Soc 2016 Mar;64(3):526-35. doi: 10.1111/jgs.13953.
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Keywords: Elderly, Prevention, Medication, Heart Disease and Health
Charles-Schoeman C, Wang X, Lee YY
Association of triple therapy with improvement in cholesterol profiles over two-year followup in the treatment of early aggressive rheumatoid arthritis trial.
The researchers evaluated long-term changes in cholesterol levels in patients with early rheumatoid arthritis (RA) who were randomized to begin treatment with methotrexate (MTX) monotherapy, MTX plus etanercept, or triple therapy (MTX plus sulfasalazine plus hydroxychloroquine) . Triple therapy was strongly associated with higher levels of HDL cholesterol, lower levels of LDL cholesterol, and higher ratios of total cholesterol.
AHRQ-funded; HS018517.
Citation: Charles-Schoeman C, Wang X, Lee YY .
Association of triple therapy with improvement in cholesterol profiles over two-year followup in the treatment of early aggressive rheumatoid arthritis trial.
Arthritis Rheumatol 2016 Mar;68(3):577-86. doi: 10.1002/art.39502.
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Keywords: Arthritis, Heart Disease and Health, Medication
Silverberg JI
Atopic disease and cardiovascular risk factors in US children.
The researcher examined the impact of atopic disease on cardiovascular risk in children. He found that in multivariable models, pediatric asthma and hay fever were associated with higher odds of overweight and obesity, hypertension, and hyperlipidemia, but not diabetes. However, eczema was associated with higher odds of overweight and obesity, but not hypertension, hyperlipidemia, or diabetes.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Atopic disease and cardiovascular risk factors in US children.
J Allergy Clin Immunol 2016 Mar;137(3):938-40.e1. doi: 10.1016/j.jaci.2015.09.012.
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Keywords: Cardiovascular Conditions, Risk, Children/Adolescents, Children/Adolescents, Children/Adolescents
Jafarzadeh SR, Warren DK, Nickel KB
Bayesian estimation of the accuracy of ICD-9-CM- and CPT-4-based algorithms to identify cholecystectomy procedures in administrative data without a reference standard.
The researchers sought to estimate the accuracy of two algorithms to identify cholecystectomy procedures using ICD-9-CM and CPT-4 codes in administrative data. They found that both ICD-9-CM- and CPT-4-based algorithms had high sensitivity to identify cholecystectomy procedures in administrative data when used individually and especially in a parallel-joint approach.
AHRQ-funded; HS019713.
Citation: Jafarzadeh SR, Warren DK, Nickel KB .
Bayesian estimation of the accuracy of ICD-9-CM- and CPT-4-based algorithms to identify cholecystectomy procedures in administrative data without a reference standard.
Pharmacoepidemiol Drug Saf 2016 Mar;25(3):263-8. doi: 10.1002/pds.3870.
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Keywords: Data, Surgery
Fakih MG, Gould CV, Trautner BW
Beyond infection: device utilization ratio as a performance measure for urinary catheter harm.
As multiple definitions for measuring catheter-associated urinary tract infections exist, the authors advocate use of the device utilization ratio (DUR) as an additional performance measure for potential urinary catheter harm. The DUR is currently captured as part of National Healthcare Safety Network reporting, and the data are readily obtainable from electronic medical records. This method also provides a more direct reflection of improvement efforts focused on reducing inappropriate urinary catheter use.
AHRQ-funded; 290201000025I.
Citation: Fakih MG, Gould CV, Trautner BW .
Beyond infection: device utilization ratio as a performance measure for urinary catheter harm.
Infect Control Hosp Epidemiol 2016 Mar;37(3):327-33. doi: 10.1017/ice.2015.287.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Prevention, Patient-Centered Outcomes Research
Lee S, Teschemaker AR, Daniel M
Calcium and vitamin D use among older adults in U.S.: results from national survey.
The investigators conducted this study to describe a 10-year trend of calcium and vitamin D use from 2000 to 2009 and to evaluate age, gender, and racial disparities using national level health data. They found variability in the access to the medications, despite the observed increases associated with calcium and vitamin D supplements.
AHRQ-funded; HS011673.
Citation: Lee S, Teschemaker AR, Daniel M .
Calcium and vitamin D use among older adults in U.S.: results from national survey.
J Nutr Health Aging 2016 Mar;20(3):300-5. doi: 10.1007/s12603-015-0614-9.
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Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors
Howard HA, Malouin R, Callow-Rucker M
Care managers and knowledge shift in primary care patient-centered medical home transformation.
Based on a health insurance company-sponsored primary care transformation project, this study explores the perceptions of care management from the perspective of providers and practice staff to examine shifts in knowledge and their broader implications for primary care. It demonstrates how the diffusion of clinical power and knowledge production redefine primary care relationships to patients, as traditional hierarchies shift to team-based care.
AHRQ-funded; HS020046; HS01795.
Citation: Howard HA, Malouin R, Callow-Rucker M .
Care managers and knowledge shift in primary care patient-centered medical home transformation.
Hum Organ 2016 Spring;75(1):10-20..
Keywords: Care Management, Patient-Centered Healthcare, Primary Care, Practice Patterns, Teams
Vora AN, Peterson ED, Hellkamp AS
Care transitions after acute myocardial infarction for transferred-in versus direct-arrival patients.
Many patients in the United States require transfer from one hospital to another for acute myocardial infarction (MI) care. How well these transferred-in patients are transitioned back to their local community is unknown. This study found that transferred-in patients with acute MI are less likely to have outpatient clinic follow-up within 30 days and more likely to be readmitted within the first 30 days post discharge compared with direct-arrival patients.
AHRQ-funded; HS021092.
Citation: Vora AN, Peterson ED, Hellkamp AS .
Care transitions after acute myocardial infarction for transferred-in versus direct-arrival patients.
Circ Cardiovasc Qual Outcomes 2016 Mar;9(2):109-16. doi: 10.1161/circoutcomes.115.002108.
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Keywords: Transitions of Care, Hospital Readmissions, Cardiovascular Conditions, Patient-Centered Outcomes Research, Hospital Discharge
Topaz M, Lai K, Dhopeshwarkar N
Clinicians' reports in electronic health records versus patients' concerns in social media: A pilot study of adverse drug reactions of aspirin and atorvastatin.
The study’s objective was to compare electronic health record data and social media data to better understand differences and similarities between clinician-reported adverse drug reactions (ADRs) and patients' concerns regarding aspirin and atorvastatin. It found that the most frequently reported ADRs matched the most frequent patients' concerns. However, several less frequently reported reactions were more prevalent on social media (i.e., aspirin-induced hypoglycemia was discussed only on social media).
AHRQ-funded; HS022728.
Citation: Topaz M, Lai K, Dhopeshwarkar N .
Clinicians' reports in electronic health records versus patients' concerns in social media: A pilot study of adverse drug reactions of aspirin and atorvastatin.
Drug Saf 2016 Mar;39(3):241-50. doi: 10.1007/s40264-015-0381-x..
Keywords: Electronic Health Records (EHRs), Social Media, Health Information Technology (HIT), Adverse Drug Events (ADE), Patient Safety
Chung S, Johns N, Zhao B
Clocks moving at different speeds: cultural variation in the satisfaction with wait time for outpatient care.
This study explored racial/ethnic differences in satisfaction with wait time of scheduled office visits by comparing electronic health record -based, patient-reported, and patient satisfaction with wait time. It found that given actual wait times, Asians perceive longer wait time and were less satisfied with wait times. Asians may have different expectations about wait time at the clinic.
AHRQ-funded; HS019815.
Citation: Chung S, Johns N, Zhao B .
Clocks moving at different speeds: cultural variation in the satisfaction with wait time for outpatient care.
Med Care 2016 Mar;54(3):269-76. doi: 10.1097/mlr.0000000000000473.
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Keywords: Patient Experience, Racial and Ethnic Minorities, Electronic Health Records (EHRs), Ambulatory Care and Surgery
Gartlehner G, Gaynes BN, Amick HR
Comparative benefits and harms of antidepressant, psychological, complementary, and exercise treatments for major depression: An evidence report for a clinical practice guideline from the American College of Physicians.
This evidence report compared the benefits and harms of second-generation antidepressants and psychological, complementary and alternative medicine (CAM), and exercise treatments as first- and second-step interventions for adults with acute major depressive disorder (MDD). It concluded tht, given their similar efficacy, cognitive behavioral therapy and antidepressants are both viable choices for initial treatment of MDD.
AHRQ-funded.
Citation: Gartlehner G, Gaynes BN, Amick HR .
Comparative benefits and harms of antidepressant, psychological, complementary, and exercise treatments for major depression: An evidence report for a clinical practice guideline from the American College of Physicians.
Ann Intern Med 2016 Mar 1;164(5):331-41. doi: 10.7326/m15-1813.
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Keywords: Medication, Comparative Effectiveness, Complementary and Alternative Medicine, Depression, Behavioral Health
Chen LM, Norton EC, Birkmeyer JD
Comparing approaches to controlling Medicare spending.
For 3 common surgical procedures (coronary artery bypass grafting (CABG), prostatectomy, and hip replacement), the researchers compared the relative influence of procedure rates versus episode payments (among those with procedures) on total Medicare expenditures. Using complete Part A and B Medicare claims data, they found that reducing procedure rates lowers total Medicare spending substantially more than reducing episode payments.
AHRQ-funded; HS020671.
Citation: Chen LM, Norton EC, Birkmeyer JD .
Comparing approaches to controlling Medicare spending.
J Hosp Med 2016 Mar;11(3):215-6. doi: 10.1002/jhm.2527.
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Keywords: Medicare, Healthcare Costs, Surgery
Wancata LM, Banerjee M, Muenz DG
Conditional survival in advanced colorectal cancer and surgery.
The authors evaluated the impact of cancer-directed surgery on long-term survival in patients with advanced colorectal cancer (CRC). They found that five-year disease-specific conditional survival improves dramatically over time for selected patients with advanced CRC who undergo cancer-directed surgery.
AHRQ-funded; HS020937.
Citation: Wancata LM, Banerjee M, Muenz DG .
Conditional survival in advanced colorectal cancer and surgery.
J Surg Res 2016 Mar;201(1):196-201. doi: 10.1016/j.jss.2015.10.021.
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Keywords: Cancer: Colorectal Cancer, Mortality, Outcomes, Patient-Centered Outcomes Research, Surgery
Fritz JM, Rundell SD, Dougherty P
Deconstructing chronic low back pain in the older adult-step by step evidence and expert-based recommendations for evaluation and treatment. Part vi: Lumbar spinal stenosis.
This article is the sixth in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. It focuses on the evaluation and management of lumbar spinal stenosis (LSS), the most common condition for which older adults undergo spinal surgery. It concluded that lumbar spinal stenosis exists not uncommonly in older adults with CLBP and management often can be accomplished without surgery.
AHRQ-funded; HS022982.
Citation: Fritz JM, Rundell SD, Dougherty P .
Deconstructing chronic low back pain in the older adult-step by step evidence and expert-based recommendations for evaluation and treatment. Part vi: Lumbar spinal stenosis.
Pain Med 2016 Mar;17(3):501-10. doi: 10.1093/pm/pnw011..
Keywords: Back Health and Pain, Elderly, Chronic Conditions, Treatments, Surgery
Beck AF, Tschudy MM, Coker TR
AHRQ Author: Mistry KB
Determinants of health and pediatric primary care practices.
This article describes how care structures and processes can be altered in ways that align with the needs of families living in poverty. It also illustrate how such a roadmap can be adapted by practices depending on the degree of patient need and the availability of practice resources devoted to intervening on the social determinants of health.
AHRQ-authored.
Citation: Beck AF, Tschudy MM, Coker TR .
Determinants of health and pediatric primary care practices.
Pediatrics 2016 Mar;137(3):e20153673. doi: 10.1542/peds.2015-3673.
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Keywords: Primary Care, Low-Income, Children/Adolescents, Health Services Research (HSR), Policy
Kessler DO, Walsh B, Whitfill T
Disparities in adherence to pediatric sepsis guidelines across a spectrum of emergency departments: a multicenter, cross-sectional observational in situ simulation study.
The authors sought to measure and compare adherence to pediatric sepsis guidelines across a spectrum of emergency departments. They found that among 47 teams across 24 emergency departments, adherent teams had significantly higher Emergency Medical Services for Children readiness scores, MD composition of physicians to total team members, teamwork scores, provider perceptions of pediatric preparedness, and provider perceptions of sepsis preparedness. They concluded that only composite team experience level of the providers was associated with improved guideline adherence.
AHRQ-funded; HS020286.
Citation: Kessler DO, Walsh B, Whitfill T .
Disparities in adherence to pediatric sepsis guidelines across a spectrum of emergency departments: a multicenter, cross-sectional observational in situ simulation study.
J Emerg Med 2016 Mar;50(3):403-15.e1-3. doi: 10.1016/j.jemermed.2015.08.004.
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Keywords: Emergency Department, Disparities, Guidelines, Children/Adolescents, Sepsis
Fordis M, King JE, Bonaduce de Nigris F
Dissemination of evidence from systematic reviews through academic CME providers: a feasibility study.
This study explored the feasibility of working with continuing medical education (CME) directors and faculty to promote systematic review utilization. They found that potential barriers included faculty unfamiliarity with systematic reviews, challenges in maintaining review currency, and review scope. Systematic review evidence and summary products proved acceptable to CME directors, course faculty, and learners by multiple measures, demonstrating the feasibility of approaches to use AHRQ-SRs in CME courses and programming.
AHRQ-funded; 290200810015.
Citation: Fordis M, King JE, Bonaduce de Nigris F .
Dissemination of evidence from systematic reviews through academic CME providers: a feasibility study.
J Contin Educ Health Prof 2016 Spring;36(2):104-12. doi: 10.1097/ceh.0000000000000074.
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Keywords: Communication, Education: Continuing Medical Education, Evidence-Based Practice, Implementation
Domino ME, Jackson C, Beadles CA
Do primary care medical homes facilitate care transitions after psychiatric discharge for patients with multiple chronic conditions?
The purpose of this manuscript is to assess outpatient follow-up rates with primary care and mental health providers following psychiatric discharge by medical home enrollment and medical complexity. Hospitalized persons with multiple chronic conditions including serious mental illness enrolled in a medical home were more likely to receive timely outpatient follow-up with a primary care provider but not with a mental health specialist.
AHRQ-funded; HS000032; HS019659.
Citation: Domino ME, Jackson C, Beadles CA .
Do primary care medical homes facilitate care transitions after psychiatric discharge for patients with multiple chronic conditions?
Gen Hosp Psychiatry 2016 Mar-Apr;39:59-65. doi: 10.1016/j.genhosppsych.2015.11.002.
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Keywords: Primary Care, Patient-Centered Healthcare, Behavioral Health, Hospitalization, Chronic Conditions
Baird J, Rehm RS, Hinds PS
Do you know my child? Continuity of nursing care in the pediatric intensive care unit.
The objective of this analysis was to explore the delivery of continuity of nursing care in the pediatric intensive care unit (PICU), from the perspective of both parents and nurses. Parents repeatedly endorsed a desire for continuity of nursing care, wanting to ensure that the bedside nurse valued their child as an individual and understood the complexities of the child's care regimen.
AHRQ-funded; HS000063.
Citation: Baird J, Rehm RS, Hinds PS .
Do you know my child? Continuity of nursing care in the pediatric intensive care unit.
Nurs Res 2016 Mar-Apr;65(2):142-50. doi: 10.1097/nnr.0000000000000135.
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Keywords: Care Management, Children/Adolescents, Critical Care, Healthcare Delivery, Intensive Care Unit (ICU), Nursing