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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
6776 to 6800 of 12139 Research Studies DisplayedCollins DM, Downer B, Kumar A
Impact of multiple chronic conditions on activity limitations among older Mexican-American care recipients.
The authors examined the impact of multiple chronic conditions on basic activities of daily living (ADL) and instrumental activities of daily living (IADL) limitations. They found that care recipients with three or more chronic conditions had higher odds of having mobility limitations, self-care limitations, more than three ADL limitations, and more than three IADL limitations.
AHRQ-funded; HS022134.
Citation: Collins DM, Downer B, Kumar A .
Impact of multiple chronic conditions on activity limitations among older Mexican-American care recipients.
Prev Chronic Dis 2018 May 3;15:E51. doi: 10.5888/pcd15.170358.
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Keywords: Chronic Conditions, Elderly, Lifestyle Changes, Racial and Ethnic Minorities
Marconi VC, Duncan MS, So-Armah K
Bilirubin is inversely associated with cardiovascular disease among HIV-positive and HIV-negative individuals in VACS (Veterans Aging Cohort Study).
In this prospective cohort study, the investigators assessed whether bilirubin independently predicted the risk of CVD events among HIV(+) and uninfected participants in VACS (Veterans Aging Cohort Study. The investigators found that VACS participants (regardless of HIV status) with elevated bilirubin levels had a lower risk of incident total CVD, acute myocardial infarction, heart failure, and ischemic stroke events after adjusting for known risk factors.
AHRQ-funded; HS018372.
Citation: Marconi VC, Duncan MS, So-Armah K .
Bilirubin is inversely associated with cardiovascular disease among HIV-positive and HIV-negative individuals in VACS (Veterans Aging Cohort Study).
J Am Heart Assoc 2018 May 2;7(10). doi: 10.1161/jaha.117.007792..
Keywords: Human Immunodeficiency Virus (HIV), Cardiovascular Conditions, Risk
Parikh ND, Scaglione S, Li Y
A comparison of staging systems for hepatocellular carcinoma in a multicenter US cohort.
This study compared different staging systems for hepatocellular carcinoma at 4 US health systems between June 2012 and May 2013. The most commonly used staging system is the Barcelona Clinic Liver Cancer (BCLC) system. A total of 320 patients were included in the study. The cohort were predominantly male (75.3%), white (48.8%), and had a mean age of 61.0 years. Prognostic performance was compared with BCLC, as well as the Italian Liver Cancer, Hong Kong Liver Cancer (HKLC), the Cancer of the Liver Italian Program, and the model to estimate survival in ambulatory patients with hepatocellular carcinoma (MESIAH) systems. They concluded that the HKLC and MESIAH systems were superior to BCLC in the multicenter cohort.
AHRQ-funded; HS022418.
Citation: Parikh ND, Scaglione S, Li Y .
A comparison of staging systems for hepatocellular carcinoma in a multicenter US cohort.
Clin Gastroenterol Hepatol 2018 May;16(5):781-82. doi: 10.1016/j.cgh.2017.10.001..
Keywords: Cancer, Diagnostic Safety and Quality
Rosas LG, Lv N, Lewis MA
A Latino patient-centered, evidence-based approach to diabetes prevention.
Cultural tailoring of evidence-based diabetes prevention program (DPP) interventions is needed to effectively address obesity and its related chronic diseases among Latinos in primary care. This article described the patient-centered process used to adapt the DPP and reported cultural adaptations. The investigators concluded that the 2-stage approach actively engaging patients, family members, providers, and health care system leaders reinforced the cultural congruence of the existing intervention while further strengthening it with adaptations promoting Latino family and community support.
AHRQ-funded; HS022702.
Citation: Rosas LG, Lv N, Lewis MA .
A Latino patient-centered, evidence-based approach to diabetes prevention.
J Am Board Fam Med 2018 May-Jun;31(3):364-74. doi: 10.3122/jabfm.2018.03.170280..
Keywords: Cultural Competence, Diabetes, Evidence-Based Practice, Patient and Family Engagement, Patient-Centered Healthcare, Racial and Ethnic Minorities
Uno H, Claggett B, Tian L
Adding a new analytical procedure with clinical interpretation in the tool box of survival analysis.
The authors discuss the measures that are routinely used to quantify survival time in long-term comparative oncology trials. They discuss progression-free survival or overall survival time which is often the study endpoint, as well as the hazard ratio (HR) which has been utilized to quantify the between-group difference in survival analysis.
AHRQ-funded; HS022193.
Citation: Uno H, Claggett B, Tian L .
Adding a new analytical procedure with clinical interpretation in the tool box of survival analysis.
Ann Oncol 2018 May;29(5):1092-94. doi: 10.1093/annonc/mdy109..
Keywords: Research Methodologies, Cancer
Eaton EF, Tamhane A, Davy-Mendez T
Brief report: kidney dysfunction does not contribute significantly to antiretroviral therapy modification in treatment-naive PLWH receiving initial ART.
Antiretroviral therapy (ART) durability, time to modification or cessation, has declined. The objective of this retrospective follow up study was to determine whether kidney dysfunction was contributing to reduced durability. The investigator found that for patients in their study initiated on ART, including TDF-based ART, in the last decade, kidney dysfunction was not a major factor leading to regimen modification.
AHRQ-funded; HS023009.
Citation: Eaton EF, Tamhane A, Davy-Mendez T .
Brief report: kidney dysfunction does not contribute significantly to antiretroviral therapy modification in treatment-naive PLWH receiving initial ART.
J Acquir Immune Defic Syndr 2019 May 1;81(1):e6-e9. doi: 10.1097/qai.0000000000001999..
Keywords: Patient-Centered Outcomes Research, Kidney Disease and Health, Evidence-Based Practice, Outcomes
Sterling MR, Jannat-Khah D, Vitale S
Can your patients with heart failure see? The prevalence of visual impairment among adults with heart failure.
This study used data from the 2005-2008 National Health and Nutrition Examination Survey to determine the prevalence of visual impairment among adults with heart failure. There is a higher prevalence of visual impairment with that cohort, even with wearing glasses. This finding warrants more collaboration between general internists, cardiologists, ophthalmologists, and other caregivers.
AHRQ-funded; HS000066.
Citation: Sterling MR, Jannat-Khah D, Vitale S .
Can your patients with heart failure see? The prevalence of visual impairment among adults with heart failure.
J Gen Intern Med 2018 May;33(5):605-07. doi: 10.1007/s11606-018-4366-1..
Keywords: Eye Disease and Health, Heart Disease and Health, Cardiovascular Conditions
Semenkovich TR, Panni RZ, Hudson JL
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
This study examined comparative effectiveness and survival rates for upfront esophagectomy versus induction chemoradiation in patients with clinical stage T2N20 esophageal cancer. A decision analysis model was created for the two treatment strategies. Results showed comparable median survival rates for both strategies. The optimal treatment strategy depended on the accuracy of endoscopic ultrasound staging.
AHRQ-funded; HS022330.
Citation: Semenkovich TR, Panni RZ, Hudson JL .
Comparative effectiveness of upfront esophagectomy versus induction chemoradiation in clinical stage T2N0 esophageal cancer: a decision analysis.
J Thorac Cardiovasc Surg 2018 May;155(5):2221-30.e1. doi: 10.1016/j.jtcvs.2018.01.006..
Keywords: Treatments, Cancer, Surgery, Comparative Effectiveness, Decision Making, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes, Medication
McBride S, Thurm C, Gouripeddi R
Comparison of empiric antibiotics for acute osteomyelitis in children.
Broad-spectrum antibiotics are commonly used for the empiric treatment of acute hematogenous osteomyelitis and often target methicillin-resistant Staphylococcus aureus (MRSA) with medication-associated risk and unknown treatment benefit. In this study, the investigators aimed to compare clinical outcomes among patients with osteomyelitis who did and did not receive initial antibiotics used to target MRSA. The investigators found that, early antibiotic treatment used to target MRSA was associated with a higher rate of repeat MRI.
AHRQ-funded; HS019862.
Citation: McBride S, Thurm C, Gouripeddi R .
Comparison of empiric antibiotics for acute osteomyelitis in children.
Hosp Pediatr 2018 May;8(5):280-87. doi: 10.1542/hpeds.2017-0079..
Keywords: Children/Adolescents, Antibiotics, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Medication, Imaging, Patient Safety
DuGoff EH
Continuity of care in older adults with multiple chronic conditions: how well do administrative measures correspond with patient experiences?
The objective of this study was to assess the concordance of administrative continuity indices and patient reports of continuity among older adults with multiple chronic conditions (MCCs). The investigators concluded that among older adults with two or more conditions, the Usual Provider of Care Index was not associated with any patient experience measure; Continuity of Care Index was associated with informational and management continuity items.
AHRQ-funded; HS000029.
Citation: DuGoff EH .
Continuity of care in older adults with multiple chronic conditions: how well do administrative measures correspond with patient experiences?
J Healthc Qual 2018 May/Jun;40(3):120-28. doi: 10.1097/jhq.0000000000000051..
Keywords: Patient Experience, Chronic Conditions, Elderly
Klara K, Kim J, Ross JS
Direct-to-consumer broadcast advertisements for pharmaceuticals: off-label promotion and adherence to FDA guidelines.
Direct-to-consumer (DTC) advertisements for prescription drugs in the United States are regulated by the Food and Drug Administration (FDA). Off-label promotion, or the advertisement of a drug for an indication not approved by the FDA, is prohibited. The objective of this study was to examine the presence of off-label promotion in broadcast DTC ads and to assess their adherence to FDA guidelines mandating fair balance in presentation of risks and benefits and prohibiting misleading advertisement claims.
AHRQ-funded; HS022882.
Citation: Klara K, Kim J, Ross JS .
Direct-to-consumer broadcast advertisements for pharmaceuticals: off-label promotion and adherence to FDA guidelines.
J Gen Intern Med 2018 May;33(5):651-58. doi: 10.1007/s11606-017-4274-9..
Keywords: Medication, Guidelines, Policy, Communication
Ashlagi I, Bingaman A, Burq M
Effect of match-run frequencies on the number of transplants and waiting times in kidney exchange.
Many U.S. kidney paired donation (KPD) registries have gradually shifted to high-frequency match-runs, raising the question of whether this harms the number of transplants. The authors conducted simulations and found that longer intervals between match-runs do not increase the total number of transplants, and that prioritizing highly sensitized patients is more effective than waiting longer between match-runs for transplanting these patients. Further, increasing arrival rates of new pairs improves both the fraction of transplanted pairs and waiting times.
AHRQ-funded; HS020610.
Citation: Ashlagi I, Bingaman A, Burq M .
Effect of match-run frequencies on the number of transplants and waiting times in kidney exchange.
Am J Transplant 2018 May;18(5):1177-86. doi: 10.1111/ajt.14566..
Keywords: Transplantation, Kidney Disease and Health, Health Services Research (HSR), Policy, Registries
Danila MI, Outman RC, Rahn EJ
Evaluation of a multimodal, direct-to-patient educational intervention targeting barriers to osteoporosis care: a randomized clinical trial.
Osteoporosis treatment rates are declining, even among those with past fractures. Novel, low-cost approaches are needed to improve osteoporosis care. In this study, the investigators conducted a parallel group, controlled, randomized clinical trial evaluating a behavioral intervention for improving osteoporosis medication use. They found that the primary study outcome was self-report of osteoporosis medication use at 6 months. Other outcomes included calcium and vitamin D supplementation, bone mineral density (BMD) testing, readiness for behavioral change, and barriers to treatment.
AHRQ-funded; HS023009.
Citation: Danila MI, Outman RC, Rahn EJ .
Evaluation of a multimodal, direct-to-patient educational intervention targeting barriers to osteoporosis care: a randomized clinical trial.
J Bone Miner Res 2018 May;33(5):763-72. doi: 10.1002/jbmr.3395..
Keywords: Care Management, Education: Patient and Caregiver, Elderly, Healthcare Delivery, Osteoporosis
Gray SW, Gagan J, cerami E
Interactive or static reports to guide clinical interpretation of cancer genomics.
Misinterpretation of complex genomic data presents a major challenge in the implementation of precision oncology. In this randomized, vignette-based survey study, the investigators sought to determine whether interactive genomic reports with embedded clinician education and optimized data visualization improved genomic data interpretation. The investigators concluded that interactive genomic reports may improve physicians' ability to accurately assess genomic data and increase report-related satisfaction.
AHRQ-funded; HS024984.
Citation: Gray SW, Gagan J, cerami E .
Interactive or static reports to guide clinical interpretation of cancer genomics.
J Am Med Inform Assoc 2018 May;25(5):458-64. doi: 10.1093/jamia/ocx150..
Keywords: Genetics, Cancer, Diagnostic Safety and Quality
Richardson DB, Kinlaw AC, Keil AP
Inverse probability weights for the analysis of polytomous outcomes.
In this research letter, the authors proposed an inverse-probability-of-exposure weighted multinomial model for analysis of polytomous outcomes, described its implementation, and illustrated it. In investigators suggest that there are other approaches to handling multinomial model fitting with many parameters (such as shrinkage estimation approaches). However, they indicate that the proposed form of weighting may be attractive to some investigators because it is simpler to implement in many settings than shrinkage estimation.
AHRQ-funded; HS000032.
Citation: Richardson DB, Kinlaw AC, Keil AP .
Inverse probability weights for the analysis of polytomous outcomes.
Am J Epidemiol 2018 May;187(5):1125-27. doi: 10.1093/aje/kwy020..
Keywords: Research Methodologies
Ogarek JA, McCreedy EM, Thomas KS
Minimum data set changes in health, end-stage disease and symptoms and signs scale: a revised measure to predict mortality in nursing home residents.
The purpose of this study was to revise the Minimum Data Set (MDS) Changes in Health, End-stage disease and Symptoms and Signs (CHESS) scale, an MDS 2.0-based measure widely used to predict mortality in institutional settings, in response to the release of MDS 3.0. The MDS-CHESS 3.0 predicts mortality in newly admitted and long-stay nursing home populations. The additional relationship to hospitalizations and successful discharges to community increases the utility of this scale as a potential risk adjustment tool.
AHRQ-funded; HS000011.
Citation: Ogarek JA, McCreedy EM, Thomas KS .
Minimum data set changes in health, end-stage disease and symptoms and signs scale: a revised measure to predict mortality in nursing home residents.
J Am Geriatr Soc 2018 May;66(5):976-81. doi: 10.1111/jgs.15305..
Keywords: Decision Making, Elderly, Health Status, Mortality, Nursing Homes
Singal AG, Corley DA, Kamineni A
Patterns and predictors of repeat fecal immunochemical and occult blood test screening in four large health care systems in the United States.
The objectives of this study were to characterize screening patterns and identify factors associated with repeat screening among patients who completed an index guaiac fecal occult blood test (gFOBT) or fecal immunochemical test (FIT). The investigators found that screening patterns varied substantially across healthcare systems, with consistent screening proportions ranging from 1 to 54.3% and no repeat screening proportions ranging from 6.9 to 42.8%. Consistent screening increased with older age but was less common among racial/ethnic minorities and patients with more comorbidities.
AHRQ-funded; HS022418.
Citation: Singal AG, Corley DA, Kamineni A .
Patterns and predictors of repeat fecal immunochemical and occult blood test screening in four large health care systems in the United States.
Am J Gastroenterol 2018 May;113(5):746-54. doi: 10.1038/s41395-018-0023-x..
Keywords: Screening, Cancer: Colorectal Cancer, Cancer, Practice Patterns, Diagnostic Safety and Quality
Hemler JR, Hall JD, Cholan RA
Practice facilitator strategies for addressing electronic health record data challenges for quality improvement: EvidenceNOW.
In this paper, the authors describe the strategies facilitators use to help practices perform quality improvement (QI) when complete or accurate performance data are not available. The investigators found facilitators faced practice-level EHR data challenges, such as a lack of clinical performance data, partial or incomplete clinical performance data, and inaccurate clinical performance data.
AHRQ-funded; HS023940.
Citation: Hemler JR, Hall JD, Cholan RA .
Practice facilitator strategies for addressing electronic health record data challenges for quality improvement: EvidenceNOW.
J Am Board Fam Med 2018 May-Jun;31(3):398-409. doi: 10.3122/jabfm.2018.03.170274..
Keywords: Electronic Health Records (EHRs), Quality Improvement, Evidence-Based Practice, Health Information Technology (HIT), Primary Care, Quality of Care
Viswanathan M, Patnode CD, Berkman ND
AHRQ Author: Chang S
Recommendations for assessing the risk of bias in systematic reviews of health-care interventions.
Risk-of-bias assessment is a central component of systematic reviews, but little conclusive empirical evidence exists on the validity of such assessments. In the context of such uncertainty, the investigators present pragmatic recommendations that promote transparency and reproducibility in processes, address methodological advances in the risk-of-bias assessment, and can be applied consistently across review topics.
AHRQ-authored; AHRQ-funded; 290201500011I; 290201500001I; 290201500005I; 290201500006I; 290201500013I; 290201500008I; 290201500009I.
Citation: Viswanathan M, Patnode CD, Berkman ND .
Recommendations for assessing the risk of bias in systematic reviews of health-care interventions.
J Clin Epidemiol 2018 May;97:26-34. doi: 10.1016/j.jclinepi.2017.12.004..
Keywords: Evidence-Based Practice, Research Methodologies
Bachmann JM, Mayberry LS, Wallston KA
Relation of perceived health competence to physical activity in patients with coronary heart disease.
The authors evaluated the effect of perceived health competence--a patient's belief in his or her ability to achieve health-related goals--on cumulative physical activity levels in the Mid-South Coronary Heart Disease Cohort Study. They found that low perceived health competence was strongly associated with less physical activity in patients with coronary heart disease. They suggested that this may represent a potential target for behavioral interventions.
AHRQ-funded; HS022990.
Citation: Bachmann JM, Mayberry LS, Wallston KA .
Relation of perceived health competence to physical activity in patients with coronary heart disease.
Am J Cardiol 2018 May 1;121(9):1032-38. doi: 10.1016/j.amjcard.2018.01.024..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Lifestyle Changes
McCreedy E, Loomer L, Palmer JA
Representation in the care planning process for nursing home residents with dementia.
This study examined the participation of residents, family members, or representatives in nursing home (NH) long-term care planning for residents with cognitive impairment. A large for-profit NH system was used to recruit study participants. A sample of 18,552 long-stay NH residents in 2016 were surveyed. Of residents with no cognitive impairment, 8% had family or representative participation in care planning, compared with 26% of residents with severe impairments. Family participation was greater in NHs with more social workers.
AHRQ-funded; HS000011.
Citation: McCreedy E, Loomer L, Palmer JA .
Representation in the care planning process for nursing home residents with dementia.
J Am Med Dir Assoc 2018 May;19(5):415-21. doi: 10.1016/j.jamda.2018.01.004..
Keywords: Dementia, Nursing Homes, Long-Term Care, Patient and Family Engagement, Neurological Disorders
Glazer KB, Eliot MN, Danilack VA
Residential green space and birth outcomes in a coastal setting.
The objective of this study was to evaluate associations between green and blue space and birth outcomes in a coastal area of the northeastern US. Findings from this study did not support the hypothesis that residential green space was associated with reduced risk of preterm birth or higher birthweight after adjustment for individual and contextual socioeconomic factors, but variation in results with incremental adjustment raised questions about the optimal degree of control for confounding by markers of SES. The investigators found that living near a freshwater body was associated with higher birthweight.
AHRQ-funded; HS025013.
Citation: Glazer KB, Eliot MN, Danilack VA .
Residential green space and birth outcomes in a coastal setting.
Environ Res 2018 May;163:97-107. doi: 10.1016/j.envres.2018.01.006..
Keywords: Pregnancy, Newborns/Infants, Outcomes, Adverse Events, Women
Westover AN, Nakonezny PA, Halm EA
Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.
This study's aims were to ascertain the demographics of stimulant medication users compared with non-users, examine temporal trends of stimulant medication use and estimate risk factors for development of amphetamine use disorder (AUD) and mortality among new users of stimulant medications. The investigators concluded that in their cohort comorbid substance use disorders were common and were risk factors for development of (AUD).
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Halm EA .
Risk of amphetamine use disorder and mortality among incident users of prescribed stimulant medications in the Veterans Administration.
Addiction 2018 May;113(5):857-67. doi: 10.1111/add.14122..
Keywords: Substance Abuse, Medication, Risk, Mortality, Patient-Centered Outcomes Research, Outcomes
Barsuk JH, Cohen ER, Williams MV
Simulation-based mastery learning for thoracentesis skills improves patient outcomes: a randomized trial.
Physicians-in-training often perform bedside thoracenteses in academic medical centers, and complications are more common among less experienced clinicians. Simulation-based mastery learning (SBML) is one potential solution to this problem. This study evaluated the effects of a randomized trial of thoracentesis SBML on patient complications: iatrogenic pneumothorax, hemothorax, and reexpansion pulmonary edema.
AHRQ-funded; HS021202.
Citation: Barsuk JH, Cohen ER, Williams MV .
Simulation-based mastery learning for thoracentesis skills improves patient outcomes: a randomized trial.
Acad Med 2018 May;93(5):729-35. doi: 10.1097/acm.0000000000001965..
Keywords: Education: Continuing Medical Education, Patient Safety, Provider, Provider: Physician, Simulation, Training
Stablein T, Loud KJ, DiCapua C
The catch to confidentiality: the use of electronic health records in adolescent health care.
This study examined the issues that the use of electronic health records (EHRs) have in pediatric practices in adolescent health care. Twenty-six pediatric health care providers were given in-depth interviews about their experiences using EHRs. Issues concerning privacy and confidentiality including longevity of EHRs were voiced. Some pediatric health care providers selectively omit or conceal information in order to protect adolescent confidentiality. These issues could impact having accurate documentation for a patient.
AHRQ-funded; HS021537.
Citation: Stablein T, Loud KJ, DiCapua C .
The catch to confidentiality: the use of electronic health records in adolescent health care.
J Adolesc Health 2018 May;62(5):577-82. doi: 10.1016/j.jadohealth.2017.11.296..
Keywords: Children/Adolescents, Electronic Health Records (EHRs), Health Information Technology (HIT)