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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
11276 to 11300 of 12139 Research Studies DisplayedTurner A, Osterhage K, Joe J
Use of patient portals: personal health information management in older adults.
This paper described initial results from the SOARING (Studying Older Adults & Researching Information Needs and Goals) study at the University of Washington, a participatory design investigation of personal health information management (PHIM) in older adults. Its findings indicate that patient portals designed to target the specific needs for older adults can support PHIM.
AHRQ-funded; HS022106.
Citation: Turner A, Osterhage K, Joe J .
Use of patient portals: personal health information management in older adults.
Stud Health Technol Inform 2015;216:978..
Keywords: Elderly, Electronic Health Records (EHRs), Health Information Technology (HIT), Web-Based
Kozlowski SWJ, Chao GT, Chang C-H
https://www.routledge.com/Big-Data-at-Work-The-Data-Science-Revolution-and-Organizational-Psychology/Tonidandel-King-Cortina/p/book/9781848725829
Using big data to advance the science of team effectiveness.
The authors discuss the longstanding treatment of team processes as static constructs rather than as dynamic processes per se. They then highlight research design issues that need to be considered in any effort to directly observe, assess, and capture teamwork process dynamics. Finally, they explain how researchers can directly assess and capture team process dynamics using illustrations from three ongoing projects.
AHRQ-funded; HS020295; HS022458.
Citation: Kozlowski SWJ, Chao GT, Chang C-H .
Using big data to advance the science of team effectiveness.
In: Tonidandel S, King E, Cortina J, editors. Big Data at Work: The Data Science Revolution and Organizational Psychology. New York: Routledge; 2015. p. 272-309, chapter 10..
Keywords: Teams, Research Methodologies, Data
Panahiazar M, Taslimitehrani V, Pereira N
Using EHRs and machine learning for heart failure survival analysis.
This study assessed the performance of the Seattle Heart Failure Model using EHRs at Mayo Clinic, and sought to develop a risk prediction model using machine learning techniques that applied routine clinical care data. Its results showed the models which were built using EHR data are more accurate (11 percent improvement in AUC) with the convenience of being more readily applicable in routine clinical care.
AHRQ-funded; HS023077.
Citation: Panahiazar M, Taslimitehrani V, Pereira N .
Using EHRs and machine learning for heart failure survival analysis.
Stud Health Technol Inform 2015;216:40-4..
Keywords: Electronic Health Records (EHRs), Heart Disease and Health, Risk, Data
Atkins EV, Sambamoorthi U, Bhattacharya R
Variations of depression treatment among women with hypertension.
This study examined depression treatment patterns among women with hypertension utilizing the Medical Expenditures Panel Survey (MEPS), a nationally representative survey of families and individuals, their medical providers, and employers across the United States. It found that 23.9 percent had no depression treatment, 56.8 percent had antidepressant use only, and 19.3 percent had psychotherapy with or without antidepressants.
AHRQ-funded; HS018622.
Citation: Atkins EV, Sambamoorthi U, Bhattacharya R .
Variations of depression treatment among women with hypertension.
Health Care Women Int 2015;36(6):730-50. doi: 10.1080/07399332.2015.1005303..
Keywords: Medical Expenditure Panel Survey (MEPS), Depression, Blood Pressure, Women, Behavioral Health
Casper GR, Flatley Brennan P, Perreault JO
vizHOME--a context-based home assessment: preliminary implications for informatics.
The focus of this paper is on the first phase of the vizHOME study, specifically on the exploration and documentation of the individual’s performance of self-management tasks including such things as medication management and use of a monitoring device. The researchers learned from the participants that while the tools may perform satisfactorily in usability assessment, they may not meet the needs of many users.
AHRQ-funded; HS022548.
Citation: Casper GR, Flatley Brennan P, Perreault JO .
vizHOME--a context-based home assessment: preliminary implications for informatics.
Stud Health Technol Inform 2015;216:842-6..
Keywords: Diabetes, Patient Self-Management, Home Healthcare, Health Information Technology (HIT), Medication
Baird J, Davies B, Hinds PS
What impact do hospital and unit-based rules have upon patient and family-centered care in the pediatric intensive care unit?
This qualitative, grounded theory study identified the existence of explicit and implicit rules in a pediatric intensive care unit, all of which negatively affected the family's ability to receive care that was attentive to their needs. The rules also placed the registered nurse in the challenging position of serving as rule enforcer and facilitator of patient and family-centered care.
AHRQ-funded; HS000063.
Citation: Baird J, Davies B, Hinds PS .
What impact do hospital and unit-based rules have upon patient and family-centered care in the pediatric intensive care unit?
J Pediatr Nurs 2015 Jan-Feb;30(1):133-42. doi: 10.1016/j.pedn.2014.10.001.
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Keywords: Children/Adolescents, Intensive Care Unit (ICU), Patient and Family Engagement, Patient-Centered Healthcare, Children/Adolescents
Shetgiri R, Lee SC, Tillitski J
Why adolescents fight: a qualitative study of youth perspectives on fighting and its prevention.
The aim of this study was to examine fighters’ and non-fighters’ perspectives on fighting and strategies to prevent fighting, by use of focus groups. It found that non-fighters use various strategies to avoid fighting, whereas fighters are aware of few alternatives to fighting. Conflicting parental messages about fighting may enhance the likelihood of fighting.
AHRQ-funded; HS022418.
Citation: Shetgiri R, Lee SC, Tillitski J .
Why adolescents fight: a qualitative study of youth perspectives on fighting and its prevention.
Acad Pediatr. 2015 Jan-Feb;15(1):103-10. doi: 10.1016/j.acap.2014.06.020..
Keywords: Children/Adolescents, Prevention, Risk
Collinsworth AW, Masica AL, Priest EL
Modifying the electronic health record to facilitate the implementation and evaluation of a bundled care program for intensive care unit delirium.
This case study describes how an integrated health care delivery system modified its inpatient electronic health record to accelerate the implementation and evaluation of ABCDE bundle deployment as a safety and quality initiative for the prevention of delirium in intensive care unit patients.
AHRQ-funded; HS021459
Citation: Collinsworth AW, Masica AL, Priest EL .
Modifying the electronic health record to facilitate the implementation and evaluation of a bundled care program for intensive care unit delirium.
eGEMS. 2014;2(1):1121. doi: 10.13063/2327-9214.1121..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Intensive Care Unit (ICU), Patient Safety, Quality of Care
Holcomb CN, Graham LA, Richman JS
The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting.
The investigators sought to determine the incremental risk of noncardiac surgery on myocardial infarction (MI) and coronary revascularization following coronary stenting. They found that the incremental risk of noncardiac surgery on adverse cardiac events among post-stent patients is highest in the initial 6 months following stent implantation and stabilizes at 1.0% after 6 months.
AHRQ-funded; HS013852.
Citation: Holcomb CN, Graham LA, Richman JS .
The incremental risk of noncardiac surgery on adverse cardiac events following coronary stenting.
J Am Coll Cardiol 2014 Dec 30;64(25):2730-9. doi: 10.1016/j.jacc.2014.09.072.
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Keywords: Adverse Events, Cardiovascular Conditions, Patient-Centered Healthcare, Risk, Surgery
Bobb JF, Obermeyer Z, Wang Y
Cause-specific risk of hospital admission related to extreme heat in older adults.
The purpose of this study was to identify possible causes of hospital admissions during extreme heat events and to estimate their risks using historical data. The investigators found that among older adults, periods of extreme heat were associated with increased risk of hospitalization for fluid and electrolyte disorders, renal failure, urinary tract infection, septicemia, and heat stroke. They noted however, that the absolute risk increase was small and of uncertain clinical importance.
AHRQ-funded; HS021991.
Citation: Bobb JF, Obermeyer Z, Wang Y .
Cause-specific risk of hospital admission related to extreme heat in older adults.
JAMA 2014 Dec 24-31;312(24):2659-67. doi: 10.1001/jama.2014.15715..
Keywords: Elderly, Hospitalization, Risk
Singh JA, Lewallen DG
Are outcomes after total knee arthroplasty worsening over time? A time-trends study of activity limitation and pain outcomes.
The authors examined whether function and pain outcomes of patients undergoing primary total knee arthroplasty (TKA) are changing over time. Using Mayo Clinic Total Joint Registry data, they found that patient-reported function and pain outcomes after primary TKA have worsened over the study period 1993-95 to 2002-05; this time-trend is independent of changes in preoperative pain/limitation and certain patient characteristics.
AHRQ-funded; HS021110.
Citation: Singh JA, Lewallen DG .
Are outcomes after total knee arthroplasty worsening over time? A time-trends study of activity limitation and pain outcomes.
BMC Musculoskelet Disord 2014 Dec 17;15:440. doi: 10.1186/1471-2474-15-440.
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Keywords: Centers for Education and Research on Therapeutics (CERTs), Orthopedics, Pain, Patient-Centered Outcomes Research, Surgery
Franklin PD, Lewallen D, Bozic K
Implementation of patient-reported outcome measures in U.S. total joint replacement registries: rationale, status, and plans.
The authors report on the status of patient-reported outcomes (PRO) implementation as well as perceived barriers and facilitators of PRO use among five U.S. total joint replacement registries. They find that the current stage of implementation of patient-reported outcomes measures varies widely among U.S. registries.
AHRQ-funded; HS018910.
Citation: Franklin PD, Lewallen D, Bozic K .
Implementation of patient-reported outcome measures in U.S. total joint replacement registries: rationale, status, and plans.
J Bone Joint Surg Am 2014 Dec 17;96 Suppl 1:104-9. doi: 10.2106/jbjs.n.00328..
Keywords: Registries, Surgery, Comparative Effectiveness, Patient-Centered Outcomes Research
Singh JA, Lewallen DG
Increasing obesity and comorbidity in patients undergoing primary total hip arthroplasty in the U.S.: a 13-year study of time trends.
The researchers examined the time-trends in key demographic and clinical characteristics of patients undergoing primary total hip arthroplasty (THA). They found that obesity, medical and psychological comorbidity increased and the underlying diagnosis of RA/inflammatory arthritis decreased rapidly in primary THA patients over 13-years.
AHRQ-funded; HS021110.
Citation: Singh JA, Lewallen DG .
Increasing obesity and comorbidity in patients undergoing primary total hip arthroplasty in the U.S.: a 13-year study of time trends.
BMC Musculoskelet Disord 2014 Dec 17;15:441. doi: 10.1186/1471-2474-15-441..
Keywords: Surgery, Obesity, Risk, Registries, Arthritis
McCullagh LJ, Sofianou A, Kannry J
User centered clinical decision support tools: adoption across clinician training level.
This study examined the differences in adoption of CDS tools across providers’ training level. It found that the completion rates of the CDS calculator and medication order sets were higher among first year residents compared to all other training levels. Attending physicians were the less likely to accept the initial step of the CDS tool (29.3 percent) or complete the medication order sets (22.4 percent) that guided their prescription decisions.
AHRQ-funded; HS018491.
Citation: McCullagh LJ, Sofianou A, Kannry J .
User centered clinical decision support tools: adoption across clinician training level.
Appl Clin Inform 2014 Dec 17;5(4):1015-25. doi: 10.4338/aci-2014-05-ra-0048.
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Keywords: Clinical Decision Support (CDS), Decision Making, Practice Patterns
Van der Wees PJ, Friedberg MW, Guzman EA
Comparing the implementation of team approaches for improving diabetes care in community health centers.
The researchers sought to clarify implementation processes and experiences of integrating office-based medical assistant (MA) panel management and community health worker (CHW) community-based management into routine care for diabetic patients. They found that CHW and MA responsibilities converged over time to focus on health coaching of diabetic patients, with the MA health coaches experiencing difficulty in allocating dedicated time due to other responsibilities. Time constraints also limited the personal introduction of patients to health coaches by clinicians. Participants highlighted the importance of a supportive team climate and proactive leadership as important enablers for MAs and CHWs to implement their health coaching responsibilities. This study suggests that a flexible approach to implementing health coaching is more important than fidelity to rigid models that do not allow for variable allocation of responsibilities across team members.
AHRQ-funded; HS020120.
Citation: Van der Wees PJ, Friedberg MW, Guzman EA .
Comparing the implementation of team approaches for improving diabetes care in community health centers.
BMC Health Serv Res 2014 Dec 3;14:608. doi: 10.1186/s12913-014-0608-z.
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Keywords: Community-Based Practice, Diabetes, Patient-Centered Healthcare, Quality Improvement, Teams
Turan B, Stringer KL, Onono M
Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study.
The investigators examined associations between linkage to HIV care, postpartum depression, and internalized stigma in a population with a high risk of depression: newly diagnosed HIV-positive pregnant women. They found that, in this study group of women from rural Kenya, at 6 weeks postpartum, those who had not linked to HIV care after testing positive at their first antenatal visit had higher levels of depression and internalized stigma, compared to women who had linked to care. Internalized stigma mediated the effect of linkage to care on depression. Furthermore, participants who had both linked to HIV care and initiated antiretroviral therapy reported the lowest levels of depressive symptoms.
AHRQ-funded; HS013852.
Citation: Turan B, Stringer KL, Onono M .
Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study.
BMC Pregnancy Childbirth 2014 Dec 3;14:400. doi: 10.1186/s12884-014-0400-4.
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Keywords: Depression, Human Immunodeficiency Virus (HIV), Pregnancy, Social Stigma
Concannon TW, Fuster M, Saunders T
A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research.
This study reviewed 70 articles on methods of stakeholder engagement in comparative effectiveness research and patient-centered outcomes research. The authors found frequent engagement with patients, modestly frequent engagement with clinicians, and infrequent engagement with other stakeholders.The roles and activities of stakeholders were highly variable across research and program reports.
AHRQ-funded; HS017726
Citation: Concannon TW, Fuster M, Saunders T .
A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research.
J Gen Intern Med. 2014 Dec;29(12):1692-701. doi: 10.1007/s11606-014-2878-x..
Keywords: Comparative Effectiveness, Clinician-Patient Communication, Decision Making
Moyer VA, Papile LA, Eichenwald E
An intervention to improve transitions from NICU to ambulatory care: quasi-experimental study.
The authors tested whether a multifaceted intervention that included a health coach to assist families and an enhanced personal health record to improve the quality of information available to parents and community professionals would decrease adverse events and improve family assessment of the transition of infants born prematurely or with complex medical problems to home. They found that a multicomponent discharge intervention designed to address specific problems identified using Healthcare Failure Modes and Effects Analysis did not reduce certain adverse outcomes in the post-discharge period.
AHRQ-funded; HS017889.
Citation: Moyer VA, Papile LA, Eichenwald E .
An intervention to improve transitions from NICU to ambulatory care: quasi-experimental study.
BMJ Qual Saf 2014 Dec;23(12):e3. doi: 10.1136/bmjqs-2012-001726.
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Keywords: Neonatal Intensive Care Unit (NICU), Ambulatory Care and Surgery, Patient Safety, Quality Improvement, Transitions of Care
Vyas A, Madhavan S, Sambamoorthi U
Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.
The objective of this study is to determine the association between persistence with mammography screening and stage at breast cancer (BC) diagnosis among elderly women. It found that, as compared to women who were not persistent with mammography screening, women who were persistent with mammography screening were significantly more likely to be diagnosed at earlier stages of BC.
AHRQ-funded; HS018622.
Citation: Vyas A, Madhavan S, Sambamoorthi U .
Association between persistence with mammography screening and stage at diagnosis among elderly women diagnosed with breast cancer.
Breast Cancer Res Treat 2014 Dec;148(3):645-54. doi: 10.1007/s10549-014-3204-3..
Keywords: Cancer, Cancer: Breast Cancer, Diagnostic Safety and Quality, Elderly, Prevention, Screening, Women
Vaughan Sarrazin MS, Jones M, Mazur A
Bleeding rates in Veterans Affairs patients with atrial fibrillation who switch from warfarin to dabigatran.
This study evaluated the relative risks of any, gastrointestinal, intracranial, and other bleeding for Veterans Affairs patients who switched to dabigatran after at least 6 months on warfarin. It found that among veterans with atrial fibrillation who switched to dabigatran, dabigatran increased the risk of gastrointestinal hemorrhage by 54% and was not associated with rates of other bleeding or death.
AHRQ-funded; HS021992
Citation: Vaughan Sarrazin MS, Jones M, Mazur A .
Bleeding rates in Veterans Affairs patients with atrial fibrillation who switch from warfarin to dabigatran.
Am J Med. 2014 Dec;127(12):1179-85. doi: 10.1016/j.amjmed.2014.07.024..
Keywords: Blood Thinners, Adverse Events, Patient Safety
Prentice JC, Conlin PR, Gellad WF
Capitalizing on prescribing pattern variation to compare medications for type 2 diabetes.
This study used observational quasi-experimental methods using instrumental variables (IVs) to compare the effect of two hypoglycemic medications, sulfonylureas (SUs) and thiazolidinediones (TZDs), on long-term outcomes. It found that individuals who used an SU as a second-line agent experienced significantly more adverse long-term health outcomes than did individuals who started on a TZD.
AHRQ-funded; HS019708.
Citation: Prentice JC, Conlin PR, Gellad WF .
Capitalizing on prescribing pattern variation to compare medications for type 2 diabetes.
Value Health 2014 Dec;17(8):854-62. doi: 10.1016/j.jval.2014.08.2674..
Keywords: Diabetes, Medication, Outcomes, Comparative Effectiveness
Berry JG, Hall M, Neff J
Children with medical complexity and Medicaid: spending and cost savings.
The authors described the expenditures for children with medical complexity insured by Medicaid across the care continuum, reported the increasingly large amount of spending on hospital care for these children, and presented a business case that estimates how cost savings might be achieved from potential reductions in hospital and emergency department use and shows how the savings could underwrite investments in outpatient and community care. They concluded by discussing the importance of these findings in the context of Medicaid's quality of care and health care reform.
AHRQ-funded; HS023092.
Citation: Berry JG, Hall M, Neff J .
Children with medical complexity and Medicaid: spending and cost savings.
Health Aff 2014 Dec;33(12):2199-206. doi: 10.1377/hlthaff.2014.0828.
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Keywords: Children/Adolescents, Medicaid, Healthcare Costs, Inpatient Care, Quality of Care
Raebel MA, Newcomer SR, Bayliss EA
Chronic opioid use emerging after bariatric surgery.
The purpose of this study was to determine opioid use the year after bariatric surgery among patients who did not use opioids chronically pre-surgery and to identify pre-surgery characteristics associated with chronic opioid use after surgery. It found that patients dispensed 60 to 119 days’ supply during the pre-surgery year were 13.23 to 14.29 times more likely to use opioids chronically post-surgery than patients without opioid use pre-surgery.
AHRQ-funded; HS019912.
Citation: Raebel MA, Newcomer SR, Bayliss EA .
Chronic opioid use emerging after bariatric surgery.
Pharmacoepidemiol Drug Saf 2014 Dec;23(12):1247-57. doi: 10.1002/pds.3625..
Keywords: Medication, Obesity, Opioids, Pain, Substance Abuse, Surgery
Aterburn D, Powers JD, Toh S
Comparative effectiveness of laparoscopic adjustable gastric banding vs laparoscopic gastric bypass.
A retrospective study of 7,457 patients undergoing laparoscopic bariatric surgery found that patients receiving gastric bypass experienced much greater weight loss than those receiving gastric banding but they had a higher risk of short-term complications and long-term subsequent hospitalizations. However, gastric bypass patients had a lower risk of long-term subsequent intervention procedures than did gastric banding patients.
AHRQ-funded; HS019912
Citation: Aterburn D, Powers JD, Toh S .
Comparative effectiveness of laparoscopic adjustable gastric banding vs laparoscopic gastric bypass.
JAMA Surg. 2014 Dec;149(12):1279-87. doi: 10.1001/jamasurg.2014.1674..
Keywords: Obesity, Surgery, Adverse Events, Patient Safety, Hospitalization
Chin DL, Wilson MH, Bang H
Comparing patient outcomes of academician-preceptors, hospitalist-preceptors, and hospitalists on internal medicine services in an academic medical center.
The aim of this study was to compare patient outcomes between hospitalist-preceptors and hospitalists working alone, and between hospitalist-preceptors and academician-preceptors. The researchers found that preceptor-led medicine services were associated with more readmissions within 30 days, shorter lengths of stay, and lower index admission-associated costs. However, they also found that when considering cumulative hospitalization costs, patients discharged by academician-preceptors incurred the highest cost and hospitalist-preceptors incurred the lowest cost.
AHRQ-funded; HS022236.
Citation: Chin DL, Wilson MH, Bang H .
Comparing patient outcomes of academician-preceptors, hospitalist-preceptors, and hospitalists on internal medicine services in an academic medical center.
J Gen Intern Med 2014 Dec;29(12):1672-8. doi: 10.1007/s11606-014-2982-y.
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Keywords: Comparative Effectiveness, Hospital Readmissions, Patient-Centered Outcomes Research, Teams