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
10576 to 10600 of 12139 Research Studies DisplayedKenzik K, Pisu M, Johns SA
Unresolved pain interference among colorectal cancer survivors: Implications for patient care and outcomes.
This study describes pain interference (PI) prevalence across the cancer continuum; 2) identifies demographic and clinical factors associated with PI and changes in PI; and 3) examines PI’s relationship with survivors’ job changes. It concluded that almost half of survivors with PI during the initial phase of care had continued PI into posttreatment. Comorbidities, especially cardiovascular and pulmonary conditions, contributed to continued PI.
AHRQ-funded; HS013852.
Citation: Kenzik K, Pisu M, Johns SA .
Unresolved pain interference among colorectal cancer survivors: Implications for patient care and outcomes.
Pain Med 2015 Jul;16(7):1410-25. doi: 10.1111/pme.12727..
Keywords: Cancer, Cancer: Colorectal Cancer, Quality of Life, Pain, Patient-Centered Outcomes Research
Sage WM, Jablonski JS, Thomas EJ
Use of nondisclosure agreements in medical malpractice settlements by a large academic health care system.
The researchers sought to determine the frequency of nondisclosure agreements in medical malpractice settlements and the extent to which the restrictions in these agreements seem incompatible with good patient care. They found that an academic health system with a declared commitment to patient safety and transparency used nondisclosure clauses in most malpractice settlement agreements but with little standardization or consistency.
AHRQ-funded; HS019561.
Citation: Sage WM, Jablonski JS, Thomas EJ .
Use of nondisclosure agreements in medical malpractice settlements by a large academic health care system.
JAMA Intern Med 2015 Jul;175(7):1130-5. doi: 10.1001/jamainternmed.2015.1035..
Keywords: Adverse Events, Medical Errors, Medical Liability, Patient Safety
Gittner LS, Husaini BA, Hull PC
Use of Six Sigma for eliminating missed opportunities for prevention services.
Delivery of primary care preventative services can be significantly increased utilizing Six Sigma methods. This study compare missed preventative service opportunities in the study clinic with the community clinic in the same practice. The study clinic had 100% preventative services, compared with only 16.3 percent in the community clinic.
AHRQ-funded; HS011131.
Citation: Gittner LS, Husaini BA, Hull PC .
Use of Six Sigma for eliminating missed opportunities for prevention services.
J Nurs Care Qual 2015 Jul-Sep;30(3):254-60. doi: 10.1097/ncq.0000000000000113..
Keywords: Community-Based Practice, Prevention, Primary Care, Quality Improvement
Carter EJ, Cohen B, Murray MT
Using workflow diagrams to address hand hygiene in pediatric long-term care facilities.
The aim of the study was to engage staff in the development of workflow diagrams, which highlighted hand hygiene (HH) practices during commonly performed patient-care activities. Facility teams developed six workflow diagrams that underwent 22 validation observations. Four main themes emerged: 1) diagram specificity, 2) wording and layout, 3) timing of HH indications, and 4) environmental hygiene.
AHRQ-funded; HS021470.
Citation: Carter EJ, Cohen B, Murray MT .
Using workflow diagrams to address hand hygiene in pediatric long-term care facilities.
J Pediatr Nurs 2015 Jul-Aug;30(4):e17-21. doi: 10.1016/j.pedn.2014.12.002..
Keywords: Patient Safety, Quality of Care, Children/Adolescents, Long-Term Care
Lo Re V, Carbonari DM, Forde KA
Validity of diagnostic codes and laboratory tests of liver dysfunction to identify acute liver failure events.
The researchers examined positive predictive values (PPVs) of hospital ICD-9 diagnoses and laboratory tests of liver dysfunction for identifying acute liver failure (ALF) within a large, community-based integrated care organization. They found that algorithms comprising relevant hospital diagnoses, laboratory evidence of liver dysfunction, and prescriptions for hepatic encephalopathy treatment had low PPVs for confirmed (ALF) events. Studies of ALF will need to rely on medical records to confirm this outcome.
AHRQ-funded; HS018372.
Citation: Lo Re V, Carbonari DM, Forde KA .
Validity of diagnostic codes and laboratory tests of liver dysfunction to identify acute liver failure events.
Pharmacoepidemiol Drug Saf 2015 Jul;24(7):676-83. doi: 10.1002/pds.3774..
Keywords: Diagnostic Safety and Quality, Digestive Disease and Health
Chenoweth CE, Hines SC, Hall KK
Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.
The purpose of this study was to observe patient care across hemodialysis facilities enrolled in the National Opportunity to Improve Infection Control in ESRD (end-stage renal disease) (NOTICE) project in order to evaluate adherence to evidence-based practices aimed at prevention of infection. The researchers found considerable variation in infection control practices across enrolled facilities. Overall adherence to recommended practices was 68 percent (range, 45 percent–92 percent) across all facilities.
AHRQ-authored; AHRQ-funded; 290200600022I.
Citation: Chenoweth CE, Hines SC, Hall KK .
Variation in infection prevention practices in dialysis facilities: results from the national opportunity to improve infection control in ESRD (End-Stage Renal Disease) project.
Infect Control Hosp Epidemiol 2015 Jul;36(7):802-6. doi: 10.1017/ice.2015.55..
Keywords: Kidney Disease and Health, Evidence-Based Practice, Guidelines, Healthcare-Associated Infections (HAIs), Prevention
Abdelsattar ZM, Hendren S, Wong SL
Variation in transfusion practices and the effect on outcomes after noncardiac surgery.
The researchers assessed the hospital-level variation in transfusion practices for packed red blood cells and the patient-level effects on outcomes after noncardiac general or vascular surgery, using population-based prospectively collected data. They found that postoperative transfusions after noncardiac surgery are associated with increased adverse postoperative outcomes, with the exception of postoperative myocardial infarction.
AHRQ-funded; HS000053.
Citation: Abdelsattar ZM, Hendren S, Wong SL .
Variation in transfusion practices and the effect on outcomes after noncardiac surgery.
Ann Surg 2015 Jul;262(1):1-6. doi: 10.1097/sla.0000000000001264..
Keywords: Patient Safety, Surgery, Outcomes, Adverse Events
Wang Y, Cai L, Wu Y
What childhood obesity prevention programmes work? A systematic review and meta-analysis.
The researchers systematically evaluated the effectiveness of childhood obesity prevention programs conducted in high-income countries and implemented in various settings. Their review found at least moderately strong evidence supporting the effectiveness of school-based interventions involving physical activity, diet or combined diet and physical activity for preventing childhood obesity.
AHRQ-funded; 290200710061I.
Citation: Wang Y, Cai L, Wu Y .
What childhood obesity prevention programmes work? A systematic review and meta-analysis.
Obes Rev 2015 Jul;16(7):547-65. doi: 10.1111/obr.12277..
Keywords: Children/Adolescents, Comparative Effectiveness, Obesity, Prevention
Allen LA, Fonarow GC, Simon DN
Digoxin use and subsequent outcomes among patients in a contemporary atrial fibrillation cohort.
This study sought to describe digoxin use over time in patients with AF who were stratified by the presence or absence of heart failure (HF), to characterize the predictors of digoxin use and initiation, and to correlate digoxin use with outcomes. It found that, after adjustment for detailed clinical factors, digoxin use in registry patients with AF had a neutral association with outcomes under most circumstances.
AHRQ-funded; HS021092.
Citation: Allen LA, Fonarow GC, Simon DN .
Digoxin use and subsequent outcomes among patients in a contemporary atrial fibrillation cohort.
J Am Coll Cardiol 2015 Jun 30;65(25):2691-8. doi: 10.1016/j.jacc.2015.04.045..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Medication
Lewis ZH, Lyons EJ, Jarvis JM
Using an electronic activity monitor system as an intervention modality: a systematic review.
The authors aimed to synthesize the efficacy and feasibility results of electronic activity monitor systems (EAMSs) within published physical activity interventions. They found preliminary evidence suggesting that EAMS can increase physical activity and decrease weight significantly, but their efficacy compared to other interventions has not yet been demonstrated.
AHRQ-funded; HS022134.
Citation: Lewis ZH, Lyons EJ, Jarvis JM .
Using an electronic activity monitor system as an intervention modality: a systematic review.
BMC Public Health 2015 Jun 24;15:585. doi: 10.1186/s12889-015-1947-3.
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Keywords: Diabetes, Health Promotion, Lifestyle Changes, Obesity
Pokorney SD, Miller AL, Chen AY
Implantable cardioverter-defibrillator use among Medicare patients with low ejection fraction after acute myocardial infarction.
This study examined Implantable Cardioverter-Defibrillator (ICD) implantation rates and associated mortality among older MI patients with low ejection fraction (EF). It found that fewer than 1 in 10 eligible patients with low EF received an ICD within 1 year after MI, although ICD implantation was associated with lower risk-adjusted mortality at 2 years.
AHRQ-funded; HS021092.
Citation: Pokorney SD, Miller AL, Chen AY .
Implantable cardioverter-defibrillator use among Medicare patients with low ejection fraction after acute myocardial infarction.
JAMA 2015 Jun 23-30;313(24):2433-40. doi: 10.1001/jama.2015.6409..
Keywords: Medical Devices, Heart Disease and Health, Medicare
Haidari LA, Wahl B, Brown ST
One size does not fit all: the impact of primary vaccine container size on vaccine distribution and delivery.
The researchers examined the questions of how the design of the primary container may affect the distribution of the vaccine, its resulting cost, and whether the vial is ultimately opened. Using a simulation model, they determined that when choosing a primary vaccine container, the choice depends on characteristics of the vaccine, the vaccine supply chain, immunization session size, and goals of decision makers. In fact, the optimal vial size may vary among locations within a country.
AHRQ-funded; HS023317.
Citation: Haidari LA, Wahl B, Brown ST .
One size does not fit all: the impact of primary vaccine container size on vaccine distribution and delivery.
Vaccine 2015 Jun 22;33(28):3242-7. doi: 10.1016/j.vaccine.2015.04.018..
Keywords: Healthcare Costs, Vaccination
Gallego CJ, Shirts BH, Bennette CS
Next-generation sequencing panels for the diagnosis of colorectal cancer and polyposis syndromes: a cost-effectiveness analysis.
The researchers evaluated the cost effectiveness of next-generation sequencing (NGS) panels for the diagnosis of colorectal cancer and polyposis (CRCP) syndromes in patients referred to cancer genetics clinics. They concluded that the use of an NGS panel that includes genes associated with highly penetrant CRCP syndromes in addition to Lynch syndrome genes as a first-line test is likely to provide meaningful clinical benefits in a cost-effective manner.
AHRQ-funded; HS021686.
Citation: Gallego CJ, Shirts BH, Bennette CS .
Next-generation sequencing panels for the diagnosis of colorectal cancer and polyposis syndromes: a cost-effectiveness analysis.
J Clin Oncol 2015 Jun 20;33(18):2084-91. doi: 10.1200/jco.2014.59.3665..
Keywords: Cancer, Cancer: Colorectal Cancer, Decision Making, Diagnostic Safety and Quality, Genetics, Healthcare Costs, Screening
Yehia BR, Stephens-Shields AJ, Fleishman JA
AHRQ Author: Fleishman JA
The HIV care continuum: changes over time in retention in care and viral suppression.
The researchers followed individual patients over a three-year period to determine how retention in care and viral suppression statuses interact and change over time. Overall, 65.8 percent of patients were retained/suppressed, 17.4 percent retained/not-suppressed, 10.0 percent not-retained/suppressed, and 6.8 percent not-retained/not-suppressed in 2010. 59.5 percent of patients maintained the same status in 2011 and 53.3 percent maintained the same status in 2012.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Yehia BR, Stephens-Shields AJ, Fleishman JA .
The HIV care continuum: changes over time in retention in care and viral suppression.
PLoS One 2015 Jun 18;10(6):e0129376. doi: 10.1371/journal.pone.0129376..
Keywords: Human Immunodeficiency Virus (HIV), Outcomes
Norman BA, Rajgopal J, Lim J
Modular vaccine packaging increases packing efficiency.
The researchers developed a spreadsheet model that evaluated the impact of different packing schemes for the Benin routine regimen plus the introduction of the Rotarix vaccine. Their analysis suggests that modular packaging systems could offer significant advantages over conventional vaccine packaging systems with respect to space efficiency and potential numbers of fully-immunized children, when they are stored in standard vaccine carrying devices.
AHRQ-funded; HS023317.
Citation: Norman BA, Rajgopal J, Lim J .
Modular vaccine packaging increases packing efficiency.
Vaccine 2015 Jun 17;33(27):3135-41. doi: 10.1016/j.vaccine.2015.04.091..
Keywords: Vaccination, Medication, Children/Adolescents
Haney E, Smith ME, McDonagh M
Diagnostic methods for myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
The purpose of this systematic review was to evaluate and compare studies of methods to diagnose myalgic encephalomyelitis /chronic fatigue syndrome (ME/CFS), identify limitations of current studies, and determine needs for future research. It found that 9 sets of clinical criteria are used to define ME/CFS, yet none of the current diagnostic methods have been adequately tested to identify patients with ME/CFS when diagnostic uncertainty exists.
AHRQ-funded; 290201200014I.
Citation: Haney E, Smith ME, McDonagh M .
Diagnostic methods for myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
Ann Intern Med 2015 Jun 16;162(12):834-40. doi: 10.7326/m15-0443..
Keywords: Comparative Effectiveness, Diagnostic Safety and Quality, Evidence-Based Practice
Briesacher BA, Madden JM, Zhang F
Did Medicare Part D affect national trends in health outcomes or hospitalizations? A time-series analysis.
The researchers examined changes in health outcomes and medical services in the Medicare population after implementation of Medicare Part D. They found that 5 years after implementation, and contrary to previous reports, there was no evidence of Part D's effect on a range of population-level health indicators among Medicare enrollees. Further, there was no clear evidence of gains in medical care efficiencies.
AHRQ-funded; HS018577
Citation: Briesacher BA, Madden JM, Zhang F .
Did Medicare Part D affect national trends in health outcomes or hospitalizations? A time-series analysis.
Ann Intern Med. 2015 Jun 16;162(12):825-33. doi: 10.7326/m14-0726..
Keywords: Hospitalization, Outcomes, Medicare, Health Status, Elderly
Smith ME, Haney E, McDonagh M
Treatment of myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
This review evaluates and summarizes research on the benefits and harms of medical and nonmedical treatments for myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) based on trials enrolling patients meeting criteria for ME, CFS, or both. It concluded that trials of rintatolimod, counseling therapies, and graded exercise therapy suggest benefit for some patients meeting case definitions for CFS, whereas evidence for other treatments and harms is insufficient.
AHRQ-funded; 290201200014I.
Citation: Smith ME, Haney E, McDonagh M .
Treatment of myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
Ann Intern Med 2015 Jun 16;162(12):841-50. doi: 10.7326/m15-0114..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Treatments
Shih T, Chen LM, Nallamothu BK
Will bundled payments change health care? Examining the evidence thus far in cardiovascular care.
The authors explore bundled payment initiatives and their potential advantages and disadvantages, focusing their review on previous and current bundled payment programs for cardiovascular conditions. They conclude by discussing what implications these programs might have as healthcare reform takes further shape in the coming years.
AHRQ-funded; HS020671.
Citation: Shih T, Chen LM, Nallamothu BK .
Will bundled payments change health care? Examining the evidence thus far in cardiovascular care.
Circulation 2015 Jun 16;131(24):2151-8. doi: 10.1161/circulationaha.114.010393..
Keywords: Healthcare Costs, Evidence-Based Practice, Cardiovascular Conditions, Policy
Polgreen LA, Cook EA, Brooks JM
Increased statin prescribing does not lower pneumonia risk.
The objective of this study was to determine if the observed protective effects of statins against pneumonia are a result of nonrandom treatment assignment rather than a direct effect of the medication. It found that in at least 1 major population of statin users the protective effects of statins against pneumonia disappear once nonrandom treatment assignment is accounted for.
AHRQ-funded; HS018381.
Citation: Polgreen LA, Cook EA, Brooks JM .
Increased statin prescribing does not lower pneumonia risk.
Clin Infect Dis 2015 Jun 15;60(12):1760-6. doi: 10.1093/cid/civ190..
Keywords: Medication, Healthcare-Associated Infections (HAIs), Risk, Comparative Effectiveness
Fan T, Rossi C
AHRQ Author: Fan T
Primary care behavioral interventions to reduce illicit drug and nonmedical pharmaceutical use in children.
This case study involves a 16-year-old white female nonsmoker who presents for a sports clearance physical. It poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Fan T, Rossi C .
Primary care behavioral interventions to reduce illicit drug and nonmedical pharmaceutical use in children.
Am Fam Physician 2015 Jun 15;91(12):865-6.
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Keywords: Children/Adolescents, Primary Care, Behavioral Health, U.S. Preventive Services Task Force (USPSTF), Substance Abuse
Ross ME, Kreider AR, Huang YS
Propensity score methods for analyzing observational data like randomized experiments: challenges and solutions for rare outcomes and exposures.
The researchers expanded upon an approach to the analysis of observational data sets that mimics a sequence of randomized studies by implementing propensity score models within each trial to achieve covariate balance, using weighting and matching. Challenges included a rare outcome, a rare exposure, substantial and important differences between exposure groups, and a very large sample size.
AHRQ-funded; HS018550.
Citation: Ross ME, Kreider AR, Huang YS .
Propensity score methods for analyzing observational data like randomized experiments: challenges and solutions for rare outcomes and exposures.
Am J Epidemiol 2015 Jun 15;181(12):989-95. doi: 10.1093/aje/kwu469..
Keywords: Comparative Effectiveness, Data, Research Methodologies
Nace DA, Lin CJ, Ross TM
Randomized, controlled trial of high-dose influenza vaccine among frail residents of long-term care facilities.
The researchers compared high-dose to standard-dose inactivated influenza vaccine in residents of long-term-care facilities (LTCFs) during the 2011-2012 and 2012-2013 influenza seasons. They found that, among frail, elderly residents of LTCFs, high-dose influenza vaccine produced superior responses for all strains except influenza A(H1N1) in 2012-2013.
AHRQ-funded; HS023779.
Citation: Nace DA, Lin CJ, Ross TM .
Randomized, controlled trial of high-dose influenza vaccine among frail residents of long-term care facilities.
J Infect Dis 2015 Jun 15;211(12):1915-24. doi: 10.1093/infdis/jiu622.
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Keywords: Elderly, Influenza, Long-Term Care, Prevention, Vaccination
Crotty BH, Mostaghimi A, O'Brien J
Prevalence and risk profile of unread messages to patients in a patient web portal.
The researchers sought to assess the prevalence and risk profile of unread messages in a mature patient portal. They found that overall, secure messaging appears a safe form of communication, but systems to notify senders when messages are unread may have value. While most clinical messages were read, many outreach messages were not.
AHRQ-funded; HS021495.
Citation: Crotty BH, Mostaghimi A, O'Brien J .
Prevalence and risk profile of unread messages to patients in a patient web portal.
Appl Clin Inform 2015 Jun 12;6(2):375-82. doi: 10.4338/aci-2015-01-cr-0006..
Keywords: Communication, Health Information Technology (HIT), Web-Based, Patient Safety
Proctor E, Luke D, Calhoun A
Sustainability of evidence-based healthcare: research agenda, methodological advances, and infrastructure support.
This project identifies the challenges associated with sustainability research and generates recommendations for accelerating and strengthening this work. Its recommendations fell into three domains: (1) pursue high priority research questions as a unified agenda on sustainability; (2) advance methods for sustainability research; (3) advance infrastructure to support sustainability research.
AHRQ-funded; HS020775.
Citation: Proctor E, Luke D, Calhoun A .
Sustainability of evidence-based healthcare: research agenda, methodological advances, and infrastructure support.
Implement Sci 2015 Jun 11;10:88. doi: 10.1186/s13012-015-0274-5..
Keywords: Evidence-Based Practice, Healthcare Delivery, Implementation, Research Methodologies