Center for Outcomes and Evidence
The Outcome of Outcomes Research at AHCPR: Final Report
Outcomes Research Fact Sheet
Research Initiative in Clinical Economics
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CERTs Research: Child Health
CERTs Research: Nonsteroidal Antiinflammatory Drugs (NSAIDs)
CERTs Research: Women's Health
Medicaid Uses of Research from CERTs
Medicare Uses of Research from CERTs
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Evidence Reports
Evidence Report/Technology Assessment, No. 87:
Literacy and Health Outcomes
Evidence Report/Technology Assessment, No. 110:
End-of-Life Care and Outcomes
Evidence Report/Technology Assessment, No. 126:
Effects of Soy on Health Outcomes
Evidence Report/Technology Assessment, No. 160:
Impact of Gene Expression Profiling Tests on Breast Cancer Outcomes
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Patient Outcomes Research Team (PORT) Reports
Findings from the 1992-98
PORT on Low Birthweight: Clinical Highlights
Low Birthweight in Minority and
High-Risk Women
Pneumonia: More Patients
May Be Treated at Home
Pneumonia: New Prediction Model
Proves Promising
Routine Preoperative Testing Before Cataract Surgery
Patterns of Usual Care for Schizophrenia
Schizophrenia PORT Results
Provide Evidence-based Treatment Information
Schizophrenia PORT Treatment Recommendations
Stroke Prevention: Recommendations
What You Should Know About Stroke Prevention
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Research Findings
Agency Press Releases
Research Activities, August 2008:
Studies elaborate on the potential use of health information technology to improve care delivery
Research Activities, July 2008:
Physician experience may influence outcomes of hospitalized patients with HIV disease more than hospital HIV experience
Research Activities, June 2008:
Patient factors, not physician or clinic factors, account for most of the variance in blood sugar levels among adults with diabetes
Chest pain 6 months after a heart attack is linked to patient dissatisfaction
Minor complications, common after carotid endarterectomy, are associated with higher postoperative risk of death and stroke
Antidepressants and therapy may be cost-effective for patients with medically unexplained symptoms
More studies need to be done on potential risk of incident heart failure among certain patients taking TNF-alpha antagonists
Research Activities, May 2008:
Medication monitoring advice and feedback to physicians modestly improves outpatient medication safety
Use of a visual medication schedule and brief physician counseling can reduce time to anticoagulation control
Antidepressant use during pregnancy is linked to increases in preterm birth and potentially serious infant perinatal problems
Staff education and performance feedback only slightly improve fracture prevention among nursing home residents
Surgery patients have better outcomes when their surgical team communicates and collaborates
Delaying repair of an asymptomatic hernia does not adversely affect the patient
Hospitalists shorten stays but don't save much money or more lives
Coxibs and NSAIDs with gastroprotective agents offer better protection from ulcers than NSAIDs alone
Research Activities, April 2008:
More work is needed to determine the impact of hospital information technology applications on patient outcomes
Cost-effectiveness of primary care treatment of sinusitis depends on individual, societal, and payer's perspectives
Patients with unstable angina do not have better 1-year health status or rehospitalization outcomes than heart attack patients, despite better 2-year survival
Patients with heart problems fare better at cardiac hospitals than general hospitals
Life challenges, not discharge problems, cause repeat hospitalizations
Research Activities, March 2008:
Outcomes vary for prostate cancer patients choosing surgery, and no treatment was proven superior overall
Simulation improves caregivers' performance but whether it improves patient outcomes is still uncertain
Crash site data along with pelvic x-rays may aid triage of motor vehicle crash victims with pelvic fractures
Research Activities, February 2008:
Studies examine the impact of nurse staffing on complications, mortality, and length of hospital stay
A combination of maternal, baby, and episiotomy factors contribute to high rates of maternal birth trauma in Iowa
Doctors should remind patients about warfarin compliance, even those who claim to be taking the drug as directed
Research Activities, January 2008:
Antibiotics to prevent children's recurrent urinary tract infections have unclear benefits and potential risks
Regulatory warnings led to decreased use of antidepressants in children and adolescents in 2004 and 2005
Intervention programs that focus on already violent youth are more effective than other programs for reducing violent behavior
Some women with breast cancer do not receive adjuvant treatments recommended by guidelines
Disadvantaged newly immigrant Hispanic women have much better birth outcomes than disadvantaged U.S. black women
Use of antidepressants by low-income pregnant women has jumped more than twofold, raising questions about fetal risks
A computer-based intravenous protocol can improve glycemic control in surgical ICU patients
Successful epilepsy surgery reduces health care costs
Following recommended guidelines to manage cardiovascular disease improves patient outcomes
Journal supplement explores alternative research approaches to test drug safety and effectiveness
Nonsteroidal anti-inflammatory drugs do not appear to protect against development of lung cancer
New studies reveal the impact of drug copayment and coinsurance policies on statin and beta-blocker therapy after heart attack
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Research Activities, December 2007:
Parents and children are mostly passive during pediatric visits
Use of simple clinical information systems can improve outcomes of patients with diabetes
Adults with food allergies tend to have more severe asthma
Both invasive and noninvasive strategies can reduce the cardiac risks of noncardiac surgery
Patients with HIV who share treatment decisions with their doctor have better outcomes
Studies explore the challenges and complexities faced by paramedics performing out-of-hospital endotracheal intubation
Research Activities, November 2007:
Death and complications after breast cancer surgery are rare, with wound infection the most common problem
Women suffer fewer postoperative problems after vascular surgery at Veterans Administration than at private hospitals
Premature infants with chronic lung disease can be safely cared for by community-based providers coordinating with a nurse specialist
Postdischarge care management that integrates medical and social care can improve outcomes of the low-income elderly
Men with localized prostate cancer who undergo surgery may live longer than those who undergo radiation or observation
Low income middle-aged Americans have higher 10-year death rates even after controlling for their worse health at baseline
Complications following heart valve replacements are prevalent and worsen patient outcomes
Evidence of benefit is lacking for many common ways of treating osteoarthritis of the knee
Diagnosing coronary heart disease prior to a heart attack improves the chance of lowering the risk of future coronary events
Surgery is more likely than angioplasty to relieve pain for patients with coronary artery disease
Study confirms link between intravenous bisphosphonates and jaw infection or surgery
Research Activities, October 2007:
AHRQ and FDA to collaborate in the largest study ever of possible heart risks with ADHA medications
Studies examine dispensing of sample medications and preventing medication errors in primary care practices
Health literacy is not associated with how minorities perceive their physical or mental health status
Studies show lower colorectal cancer screening rates and access to surgery among the poor, minority, and uninsured
Asian Pacific American ethnic groups vary in their adherence to antihypertensive drug therapy
Elderly women in the early stages of lung cancer live longer than elderly men, regardless of the type of treatment they receive
One-third of patients with acute coronary syndrome and diabetes do not have their blood sugar assessed before hospital discharge
Studies show shorter hospital stays for coronary bypass surgery reduce costs without harm to patients
Research Activities, September 2007:
Parents of children with cancer are overly optimistic about a cure, but not about other outcomes of cancer therapy
Women with coronary heart disease are less likely than men to use aspirin to prevent further problems
A multipronged quality improvement strategy can markedly improve the quality of diabetes care and patient outcomes
Outpatient medication errors are common among patients who have received liver, kidney, and/or pancreas transplants
Three clinical characteristics double the likelihood of hysterectomy for women with common noncancerous pelvic conditions
Research Activities, August 2007:
Certain pelvic fracture patterns are more likely to cause urethral injury in men who suffer blunt trauma
Early detection and aggressive treatment for prostate cancer is linked to more use of androgen-deprivation therapy for older men
Over half of missed diagnoses in the emergency department alleged in malpractice claims resulted in harm to patients
Rates of inappropriate carotid endarterectomy surgery decreased after publication of the results from clinical trials
Acute respiratory distress syndrome leads to poor outcomes and high care costs, even after treatment with inhaled nitric oxide
Attaining clinical targets among hemodialysis patients is linked to better outcomes
How well dialysis patients view their current health at the start of hemodialysis is related to subsequent outcomes and utilization
Research Activities, July 2007:
While most diabetes drugs provide similar glucose control, some offer important advantages
Total, partial, and revision hip replacement are associated with different rates of postoperative complications and readmissions
Mandatory limits on medical resident work hours may constrain hospital house staff and affect patient outcomes and resource use
Research Activities, June 2007:
AHRQ publishes landmark Federal handbook on the use of patient registries
Parents prefer as much information as possible about the prognosis of their child's cancer
Research Activities, May 2007:
More intensive treatment contributes to better hypertension control in the United States compared with western Europe
Hip fracture patients with osteoarthritis have longer hospital stays, but similar functional gain as those without the condition
Research Activities, April 2007:
Use of asthma care guidelines reduces emergency visits and improves asthma care in children
Pulse oximetry and hospital observation can detect failure of amoxicillin treatment earlier in children with severe pneumonia
Pneumonia-vaccinated children with ear infections may acquire more strains of bacteria that could affect antibiotic treatment
Diabetes increases the risk of dying for patents with suspected acute coronary syndrome
Individuals who reside in areas with higher median household income have better rates of melanoma survival
Urologists' varied use of androgen deprivation therapy for prostate cancer raises concerns about its appropriate use
Prior use of fluoroquinolone antibiotics boosts the risk of fluoroquinolone-resistant infections
Research Activities, March 2007:
Efforts to improve chronic disease management quality yield better care delivery but not better intermediate outcomes
Reliability model improves hospital safety and eliminates bloodstream infections in the ICU
Some pediatric offices may not be prepared to handle emergencies such as seizures or severe asthmatic episodes
Stimulation of the subthalamic nucleus of the brain improves quality of life for patients with advanced Parkinson's disease
Higher-than-recommended doses of antipsychotic medications may not benefit people with schizophrenia and may increase side effects
Use of needle biopsy to diagnose lung nodules does not increase the risk of dying from localized nonsmall cell lung cancer
Some patients on mechanical ventilation fare worse at low-volume hospitals
Research Activities, February 2007:
Mitral valve repair, when compared with replacement, leads to better quality of life
Racial disparities in care vary widely among Medicare health plans and are only weakly correlated with overall quality of care
Evidence is lacking to support many off-label uses of atypical antipsychotic drugs
Followup care after total hip replacement could be improved
Inpatient lumbar surgery rates remained stable from 1994 to 2000, but outpatient surgery increased
Research Activities, January 2007:
Depression worsens the health and quality of life of people with diabetes
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Research Activities, December 2006:
Functional outcomes may be good markers of quality of care for hip fracture surgery patients
Studies examine factors influencing postoperative complications and functioning among patients undergoing hip fracture repair
Research Activities, November 2006:
New patient safety team training toolkit available for health care settings
Fungal infections in immunocompromised children dramatically increase mortality rate, length of hospital stay, and costs
Patient and hospital factors may contribute to worse outcomes for patients who suffer heart attacks
"Off-pump" bypass surgery is associated with reduced occurrence of stroke and other complications
Oncology nurses tend to follow guidelines to alleviate post-prostatectomy symptoms
Risk models can help predict medical and surgical complications of carotid endarterectomy
Research Activities, October 2006:
Perceptions of teamwork in hospital labor and delivery units
depend on caregiver role and the unit environment
Prescription drug benefits limits for Medicare beneficiaries are associated with less use of prescription drugs, worse clinical outcomes, and higher hospitalization costs
Studies examine the effectiveness, safety, and feasibility of out-of-hospital endotracheal intubation
Talc should be the agent of choice when treating fluid buildup
around the lungs from advanced cancer
Research Activities, September 2006:
Anthrax in children is difficult to detect and treat
Children receiving surgery for hypoplastic left heart syndrome have better outcomes at hospitals that perform more such surgeries
Nurse-led care improves functioning for patients with heart failure in minority communities
Research Activities, August 2006:
Obesity surgery complication rates are higher over time
Complications from chemotherapy in women with breast cancer are greater than previously estimated
Minority women are nearly twice as likely as white women to not receive needed postoperative treatments for early-stage breast cancer
Elderly women are more likely than men to die after coronary bypass surgery
Moderately premature infants born at 30 to 34 weeks gestation tend to suffer substantial health problems
Modifying unhealthy habits in middle age may reduce the likelihood of nursing home admissions later in life
Studies examine use of computed tomography and risk of rupture in acute appendicitis
Research Activities, June 2006:
Clinical criteria can identify children with blunt head trauma who are unlikely to need CT scans
Interventions for primary care providers improve management of diabetes
Interventions that improve asthma outcomes in clinical trials may not translate to the practice level
Even modest rates of physical activity can improve the functioning of middle-age adults with arthritis
Delaying surgery and watchful waiting for inguinal hernias is safe in men with minimal symptoms
Research Activities, May 2006
Computerized prescribing alerts can be designed to be widely accepted by primary care clinicians
Studies connect patient satisfaction with back pain outcomes
Preoperative risk factors and surgical complexity are more predictive of hospital costs than postoperative complications
Research Activities, April 2006
Certain clinical features are associated with seizure frequency after epilepsy surgery
Clinical factors can identify blunt head injury patients at low risk for intracranial injuries
More intense guideline implementation results in more patients treated appropriately for pneumonia
Clinician recommendations for pneumonia vaccination play a key role in vaccination rates
Research Activities, March 2006
Stroke rehabilitation outcomes differ for blacks, whites, and Asian Americans
Ventilator-associated pneumonia is a serious and costly side effect of mechanical ventilation
Research Activities, February 2006:
Excessive nurse workload is a key factor affecting the safety of patients in intensive care units
Studies suggest that ethnic differences in use of knee replacement surgery are linked to patient expectations and preferences
Both aspirin and extended release dipyridamole/aspirin are cost-effective anticoagulant agents to prevent second strokes
Surgeon experience with on-pump coronary bypass surgery affects outcome of patients undergoing off-pump surgery
Variants in certain receptor genes affect the survival of patients with acute coronary syndrome who are prescribed beta-blocker therapy
Urethral catheterization to diagnose urinary tract infections in feverish infants is questioned
Delaying treatment may increase the need for bowel resection in patients surgically treated for complete small bowel obstruction
Concern about bleeding problems should not delay giving clot-busting drugs to heart attack patients with kidney disease
Research Activities, January 2006:
Women with mild-to-moderate pelvic inflammatory disease have similar reproductive outcomes from inpatient and outpatient care
Certain clinical and surgical factors affect a patient's risk of death or stroke following carotid endarterectomy
Improved survival rate after prostate cancer treatment may reflect a statistical artifact
Watchful waiting is an option for men with minimally symptomatic inguinal hernias
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Research Activities, December 2005:
Regional availability of specialists affects outcomes for patients with peripheral arterial disease
Research Activities, November 2005:
More high-quality studies are needed to gauge the safety of induced labor in women who have had prior cesarean deliveries
Research Activities, October 2005:
Computerized guidelines for reactive airway disease do not affect care delivery or outcomes
Studies examine diabetes hospitalizations and death, diabetes self-management outcomes, and undiagnosed diabetes
Telephone advice on how to manage eating behavior can improve adherence to a cholesterol-lowering diet
Keeping more medical appointments and taking medication as directed helps patients with diabetes control blood sugar levels
The type of dialysis used by patients with end-stage renal disease may affect their survival
Research Activities, September 2005:
Black and low-income workers have worse outcomes than other workers after filing compensation claims for low back injuries
Use of nurse case managers and physician peer leaders can reduce children's asthma symptoms but at a price
Delayed sternal closure increases the risk of mid-sternum infections in children following cardiac surgery
Patients in intensive care units are at significant risk for adverse events and serious errors
Increased use of ACE inhibitors for elderly people with diabetes could improve outcomes and save money
Patients with sciatica and lumbar disc herniation or spinal stenosis treated surgically or medically have similar 10-year outcomes
Training clinicians to support the autonomy of patients with diabetes may help improve outcomes
Distinct differences found in transient ischemic attacks with and without infarction
Study reveals a lower prevalence of a rare vasculitis syndrome among asthma drug users than previously reported
Research Activities, August 2005:
Routine pertussis vaccination of adolescents would be beneficial and reasonably cost effective
Elderly individuals with financial problems face more disability and risk of death after hospital discharge
Study explores physician job satisfaction and quality of care and outcomes for managed care patients with pain and depression
Laboratory drug monitoring of outpatients taking long-term medications could be improved
Research Activities, July 2005:
Stem cell transplant centers that have greater physician involvement in patient care have better patient outcomes
Participation in a physically active lifestyle during mid-life helps to maintain high physical function in later years
Research Activities, June 2005:
Absence of chest pain in patients with suspected heart attack or angina does not signal a less severe condition
Three clinical factors can determine the likelihood of cervical spine fractures in elderly victims of blunt trauma
Photodynamic therapy is a cost-effective treatment option for patients with high-grade dysplasia in Barrett's esophagus
More frequent sit-down rounds in dialysis units are associated with better patient outcomes
Limiting residents' work hours may have unintended consequences on continuity of care
Research Activities, May 2005:
Long-term outcomes data do not support aggressive treatment of localized low-grade prostate cancer
A delay of 2 or more days in surgical repair of hip fracture substantially increases mortality rates
Prolonging clopidogrel therapy from 1 month to 1 year after coronary angioplasty with stent placement is cost effective
Low literacy is associated with several adverse health outcomes
Rates of coronary angiography are inappropriately low in older cardiac patients who have chronic kidney disease
Even seemingly mild complications after surgery may radically alter an elderly person's risk of dying
Researchers examine effects of antiretroviral therapy on increases in serum liver enzymes in HIV-infected patients
Research Activities, April 2005:
Patients who have preprocedural angina appear to derive the most benefit from coronary angioplasty
SPECT imaging with Tc-99m sestamibi can improve ED triage of diabetes patients with suspected cardiac ischemia
Postoperative functioning, age, obesity, and social support influence where patients go after total hip replacement
Pulmonary arterial hypertension markedly worsens a person's quality of life, but medication may help
Whooping cough can produce symptoms that are severe and prolonged
Patients of thoracic surgeons are less likely to die after lung cancer surgery than those of general surgeons, but volume counts
Study finds no evidence that antiretroviral therapy causes serious liver disease in HIV patients coinfected with hepatitis C
HIV-infected patients with severe depression or bipolar disorder often do not adhere to their medication regimens
Research Activities, March 2005:
Health plans take action to improve services for members with limited English proficiency
Increased use of early revascularization in heart attack patients with cardiogenic shock will save lives
Enhanced CT performs better than unenhanced CT in predicting extent of damaged brain tissue in acute stroke patients
Androgen-deprivation therapy for prostate cancer increases the risk of fracture among elderly men
Late bottle-weaning is associated with an increased risk of overweight
Research Activities, February 2005:
Computed tomography may be more accurate than ultrasound for diagnosing appendicitis in adults and adolescents
Physicians often change their clinical decisions about management of cancer patients based on results of PET scans
Following protocols for managing hypertension and metabolic syndrome can reduce cardiovascular risk factors
Out-of-hospital endotracheal intubation found to be associated with adverse outcomes for traumatic brain injury patients
Research Activities, January 2005:
Improving access to coronary angioplasty in hospitals without CABG surgery programs is risky
Use of multidisciplinary team can reduce hospital stays and costs without adverse effects on readmissions or outcomes
Use of comprehensive QI program in primary care can improve delivery of preventive services for heart disease and stroke
Researchers find potentially inappropriate drug use in nursing homes associated with deaths of elderly residents
Voluntary primary care safety reporting system includes errors due to communication, diagnostic tests, and medication
Involving all staff members in guideline-recommended care can improve oversight and coordination of patient care
Marketing and prescribing of hormone replacement therapy declined substantially following reports of harm
Study suggests that use of lifesaving beta-blockers for heart attack patients is increasing at community hospitals
Women who have given birth only via cesarean are less likely than those with vaginal deliveries to report stress incontinence
Disparities in heart disease among British civil servants are not due to cardiac care differences
Appropriately targeting thrombolytic therapy for heart attack patients has the potential to save both lives and money
Early referral of patients with chronic kidney disease reduces complications and mortality
Controlling diet and physical activity can help obese and overweight children lose weight
First-week followup of newborns after hospital discharge is critical to prevent severe jaundice and other problems
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Research Activities, December 2004:
Patterns of care and outcomes of pneumonia in children vary substantially by ethnicity and race
Two approaches hold promise for lowering U.S. infant mortality rates, which are particularly high for minority infants
Risk of rupture from tubal pregnancy is highest within 48 hours after onset of symptoms
Outcomes of repeat coronary bypass surgery are comparable to outcomes of initial bypass surgery
Cardiac resynchronization improves functioning and reduces deaths for certain heart failure patients
Obesity contributes to early-onset heart problems and longer hospital stays
Exercise may not mitigate the weight gain of late middle age, but it can reduce the risk of health decline
Diabetes-specific knowledge is associated with performance of self-management activities but not with outpatient care
Research Activities, November 2004:
Cancer survivors often have long-term health limitations and lost productivity associated with their disease
Research Activities, October 2004:
Prolonged Candida infections in children with central venous catheters can lead to bloodstream and internal organ infections
Higher volume in trauma centers does not necessarily correlate with improved survival of trauma victims
Short-term symptoms of urinary or other dysfunction after brachytherapy for prostate cancer may indicate long-term outcomes
Doubling of PSA blood levels after prostate cancer treatment is linked with an increased risk of death from prostate cancer
Testing for hypercoagulable disorders in patients with deep vein thrombosis followed by 2 years of anticoagulation is cost effective
Research Activities, September 2004:
Certain biological factors that may represent insulin resistance are associated with a decline in physical functioning
Communication problems often contribute to untimely care of acute infections in nursing homes
Researchers compare treatment of U.S. and Dutch nursing home residents with dementia who develop lower respiratory infections
Only 9 percent of children with out-of-hospital cardiopulmonary arrest survive, despite prolonged CPR and epinephrine
Research Activities, August 2004:
A disproportionate increase in B-type natriuretic peptide after heart transplant in children may signal organ rejection
Researchers examine disparities in receipt of preventive care
Supplemental private insurance affects use of care and outcomes of Medicare patients who have heart attacks
Research Activities, July 2004:
Individuals who suffer from both major depression and diabetes function worse than those with either illness alone
Improved access to medication and therapy for depressed primary care patients improves 5-year outcomes
Research Activities, June 2004:
Regular use of inhaled antiinflammatory medication improves outcomes for children with persistent asthma
Shorter hospital length of stay not associated with worse outcomes for patients without DNR orders
Variation in outcomes is small for CABG surgery patients treated at high-volume vs. lower volume hospitals
Both the nature of physician contact and visit frequency are important factors in hemodialysis patient outcomes
Despite international treatment variations in cataract management, optimal vision is the usual patient outcome
Poorer outcomes from stroke are more common among minorities than whites
Research Activities, May 2004:
Early surgery reduces hip fracture pain
Study finds substantial mortality after a long-term followup period among patients with community-acquired pneumonia
Researchers find no adverse perinatal outcomes associated with respiratory hospitalizations of pregnant women during flu season
Even with advances in surgery, deaths among children with single ventricle congenital heart disease remain high
Studies examine hospital mortality rates and long-term outcomes of very low birthweight babies
Greater severity of peripheral arterial disease among blacks may account for their high rate of amputations
Research Activities, April 2004:
Hysterectomy results in better outcomes than medicine for patients with abnormal uterine bleeding
Hospitals with low mortality rates for coronary bypass surgery also perform well in valve replacement
Research Activities, March 2004:
Relying on clinical guidelines to treat young infants with fevers may not improve outcomes
Undiagnosed angina is common and is associated with a two-fold risk of death when ECGs are abnormal
Patients with cardiac complications following noncardiac surgery are more likely to have other complications as well
Research Activities, February 2004:
Some managed care strategies to improve drug use appear to be effective, but little is known about long term clinical outcomes
Research Activities, January 2004:
Researchers examine kidney disease progression and dialysis
Providing rehabilitation to newly admitted nursing home residents increases the likelihood of community discharge and lengthens survival
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