Research Policies
- Funding Opportunities Announcement Guidance
- AHRQ Grants Policy Notices
- AHRQ Informed Consent & Authorization Toolkit for Minimal Risk Research
- HHS Grants Policy Statement
- Federal Regulations & Authorities
- Federal Register Notices
- Public Access to Federally Funded Research
- Protection of Human Subjects
Search All Research Studies
AHRQ Research Studies Date
Topics
- Access to Care (247)
- Adverse Drug Events (ADE) (225)
- Adverse Events (517)
- Aging (20)
- Alcohol Consumption (46)
- Ambulatory Care and Surgery (66)
- Antibiotics (121)
- Antidepressant (35)
- Antimicrobial Stewardship (79)
- Antiretroviral Therapy (43)
- Anxiety (32)
- Arthritis (108)
- Asthma (82)
- Atrial Fibrillation (37)
- Attention Deficit Hyperactivity Disorder (ADHD) (14)
- Autism (17)
- Back Health and Pain (43)
- Blood Clots (45)
- Blood Pressure (43)
- Blood Thinners (47)
- Brain Injury (45)
- Breast Feeding (16)
- Burnout (22)
- Cancer (453)
- Cancer: Breast Cancer (133)
- Cancer: Cervical Cancer (13)
- Cancer: Colorectal Cancer (88)
- Cancer: Lung Cancer (49)
- Cancer: Ovarian Cancer (7)
- Cancer: Prostate Cancer (72)
- Cancer: Renal Cancer (3)
- Cancer: Skin Cancer (10)
- Cardiovascular Conditions (409)
- Care Coordination (74)
- Caregiver (144)
- Care Management (186)
- Case Study (69)
- Catheter-Associated Urinary Tract Infection (CAUTI) (44)
- Centers for Education and Research on Therapeutics (CERTs) (11)
- Central Line-Associated Bloodstream Infections (CLABSI) (40)
- Chemotherapy (40)
- Children's Health Insurance Program (CHIP) (32)
- Children/Adolescents (960)
- Cholesterol (23)
- Chronic Conditions (377)
- Clinical Decision Support (CDS) (118)
- Clinician-Patient Communication (203)
- Clostridium difficile Infections (40)
- Colonoscopy (28)
- Communications (270)
- Community-Acquired Infections (38)
- Community-Based Practice (127)
- Community Partnerships (8)
- Comparative Effectiveness (429)
- Complementary and Alternative Medicine (19)
- Comprehensive Unit-based Safety Program (CUSP) (9)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) (55)
- Contraception (21)
- Critical Care (131)
- Cultural Competence (37)
- Data (175)
- Decision Making (429)
- Dementia (65)
- Dental Health (38)
- Depression (171)
- Diabetes (280)
- Diagnosis (255)
- Diagnostic Safety and Quality (113)
- Dialysis (35)
- Digestive Disease and Health (69)
- Disabilities (42)
- Disparities (302)
- Domestic Violence (17)
- Ear Infections (3)
- Education (28)
- Education: Academic (15)
- Education: Continuing Medical Education (128)
- Education: Curriculum (8)
- Education: Patient and Caregiver (188)
- Elderly (667)
- Electrocardiogram (ECG) (7)
- Electronic Health Records (EHRs) (511)
- Electronic Prescribing (E-Prescribing) (13)
- Emergency Department (329)
- Emergency Medical Services (EMS) (156)
- Emergency Preparedness (15)
- Evidence-based Practice (569)
- Eye Disease and Health (23)
- Falls (63)
- Family Health and History (54)
- Fractures (57)
- Genetics (71)
- Geriatrics (18)
- Guidelines (252)
- Healthcare-Associated Infections (HAIs) (316)
- Healthcare Cost and Utilization Project (HCUP) (280)
- Healthcare Costs (559)
- Healthcare Delivery (368)
- Healthcare Systems (47)
- Healthcare Utilization (290)
- Health Information Exchange (HIE) (37)
- Health Information Technology (HIT) (826)
- Health Insurance (268)
- Health Literacy (84)
- Health Promotion (56)
- Health Services Research (HSR) (298)
- Health Status (114)
- Heart Disease and Health (287)
- Hepatitis (27)
- Home Healthcare (89)
- Hospital Discharge (146)
- Hospitalization (408)
- Hospital Readmissions (248)
- Hospitals (471)
- Human Immunodeficiency Virus (HIV) (198)
- Hypertension (70)
- Imaging (169)
- Implementation (21)
- Infectious Diseases (155)
- Influenza (30)
- Injuries and Wounds (124)
- Innovations and Emerging Issues (61)
- Inpatient Care (148)
- Intensive Care Unit (ICU) (163)
- Kidney Disease and Health (115)
- Labor and Delivery (80)
- Learning Health Systems (16)
- Lifestyle Changes (112)
- Long-Term Care (141)
- Low-Income (121)
- Mammogram (29)
- Managed Care (25)
- Maternal Care (76)
- Medicaid (232)
- Medical Devices (45)
- Medical Errors (140)
- Medical Expenditure Panel Survey (MEPS) (142)
- Medical Liability (24)
- Medicare (385)
- Medication (1087)
- Medication: Safety (122)
- Men's Health (37)
- Mental Health (409)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (56)
- Mortality (304)
- Neonatal Intensive Care Unit (NICU) (26)
- Neurological Disorders (117)
- Newborns (153)
- Nursing (83)
- Nursing Homes (219)
- Nutrition (101)
- Obesity (193)
- Obesity: Weight Management (71)
- Opioids (136)
- Organization and Administration (172)
- Orthopedics (54)
- Osteoporosis (29)
- Outcomes (588)
- Outpatient Care (96)
- Pain (130)
- Palliative Care (111)
- Patient-Centered Healthcare (365)
- Patient-Centered Outcomes Research (916)
- Patient Adherence/Compliance (185)
- Patient and Family Engagement (207)
- Patient Experience (168)
- Patient Safety (1012)
- Patient Safety Organizations (1)
- Patient Self-Management (105)
- Payment (146)
- Pneumonia (56)
- Policy (327)
- Practice-Based Research Network (PBRN) (15)
- Practice Patterns (209)
- Pregnancy (205)
- Pressure Ulcers (25)
- Prevention (547)
- Primary Care (472)
- Primary Care: Models of Care (58)
- Provider (216)
- Provider: Clinician (37)
- Provider: Health Personnel (71)
- Provider: Nurse (40)
- Provider: Pharmacist (55)
- Provider: Physician (105)
- Provider Performance (127)
- Public Health (70)
- Public Reporting (41)
- Quality Improvement (374)
- Quality Indicators (QIs) (97)
- Quality Measures (157)
- Quality of Care (646)
- Quality of Life (139)
- Racial / Ethnic Minorities (501)
- Registries (127)
- Rehabilitation (56)
- Research Methodologies (327)
- Respiratory Conditions (207)
- Risk (543)
- Rural Health (67)
- Safety Net (60)
- Screening (283)
- Sepsis (71)
- Sex Factors (52)
- Sexual Health (52)
- Sickle Cell Disease (32)
- Simulation (25)
- Skin Conditions (65)
- Sleep (36)
- Sleep Apnea (20)
- Social Determinants of Health (32)
- Social Media (41)
- Social Stigma (42)
- Socioeconomic Factors (223)
- Spinal Cord Injury (9)
- Stress (51)
- Stroke (114)
- Substance Abuse (165)
- Surgery (764)
- Surveys on Patient Safety Culture (7)
- System Design (13)
- Teams (93)
- TeamSTEPPS (14)
- Technology Assessments (1)
- Telehealth (103)
- Tobacco Use (61)
- Tobacco Use: Smoking Cessation (9)
- Tools & Toolkits (41)
- Training (100)
- Transitions of Care (114)
- Translating Research Into Practice (TRIP) (55)
- Transplantation (97)
- Trauma (74)
- Treatments (100)
- U.S. Preventive Services Task Force (USPSTF) (148)
- Uninsured (61)
- Urban Health (64)
- Urinary Tract Infection (UTI) (46)
- Vaccination (111)
- Value (192)
- Veterans (79)
- Vitamins and Supplements (23)
- Vulnerable Populations (125)
- Web-Based (84)
- Women (288)
- Workflow (36)
- Workforce (54)
- Young Adults (67)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results
1 to 25 of 8240 Research Studies DisplayedIribarren S, Lentz C, Sheinfil AZ
Using an HIV self-test kit to test a partner: attitudes and preferences among high-risk populations.
Researchers explored attitudes and preferences among HIV-negative men who have sex with men and HIV-negative transgender women using an HIV self-testing (HIVST) kit to test partners. They found that most preferred gum swab over fingerprick tests, but would prefer a blood test if it gave results for other sexually transmitted infections (STIs). They concluded that efforts to improve HIVST uptake should focus on incorporating testing for other STIs, reducing test kit size, and reducing cost.
AHRQ-funded; HS026383.
Citation: Iribarren S, Lentz C, Sheinfil AZ .
Using an HIV self-test kit to test a partner: attitudes and preferences among high-risk populations.
AIDS Behav 2020 Nov;24(11):3232-43. doi: 10.1007/s10461-020-02885-3..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Infectious Diseases, Prevention
Joyce NR, Pfeiffer MR, Zullo AR
Individual and geographic variation in driver's license suspensions: evidence of disparities by race, ethnicity and income.
Using data from the New Jersey Safety Health Outcomes data warehouse 2004-2018, the authors compared characteristics of suspended drivers, their residential census tract, as well as access to public transportation and jobs, by reason for the suspension. They found that 91% of license suspensions were for non-driving-related events, with the most common reason for a suspension being failure to pay a fine. Non-driving-related suspended drivers lived in census tracts with a lower household median income, higher proportion of black and Hispanic residents and higher unemployment rates, but also better walkability scores and better access to public transportation and jobs. They recommended additional work to determine what effect this has for the social and economic well-being of suspended drivers.
AHRQ-funded; HS022998.
Citation: Joyce NR, Pfeiffer MR, Zullo AR .
Individual and geographic variation in driver's license suspensions: evidence of disparities by race, ethnicity and income.
J Transp Health 2020 Dec;19. doi: 10.1016/j.jth.2020.100933..
Keywords: Racial / Ethnic Minorities, Disparities, Low-Income, Vulnerable Populations, Socioeconomic Factors, Social Determinants of Health
Kemme S, Sundaram SS, Curtis DJ
A community divided: post-transplant live vaccine practices among Society of Pediatric Liver Transplantation (SPLIT) centers.
The goal of this study was to assess current post-transplant live vaccine practices at individual pediatric liver transplant centers following the updated AST guidelines. Using email surveys with a 93% response rate, findings showed that only 29% of centers offered live vaccines post-transplant, with each center using different eligibility criteria for live vaccines. The main reasons for a center not offering post-transplant live vaccines were safety concerns and inability to reach group consensus.
AHRQ-funded; HS026510.
Citation: Kemme S, Sundaram SS, Curtis DJ .
A community divided: post-transplant live vaccine practices among Society of Pediatric Liver Transplantation (SPLIT) centers.
Pediatr Transplant 2020 Aug 26:e13804. doi: 10.1111/petr.13804..
Keywords: Children/Adolescents, Transplantation, Surgery, Vaccination, Practice Patterns
Nicholas LH, Wu S
Do Medicare advantage rebates reduce enrollees' out-of-pocket spending?
Researchers used survey data on Medicare Advantage (MA) beneficiaries' actual out-of-pocket spending linked to MA payment information to test whether higher plan payments and rebates lowered enrollee out-of-pocket spending. They found that beneficiaries recovered only $0.65 of every $1.00 in payments exceeding fee-for-service spending through lower out-of-pocket spending but more than fully recovered the value of the rebates supporting supplemental benefits.
AHRQ-funded; HS000029.
Citation: Nicholas LH, Wu S .
Do Medicare advantage rebates reduce enrollees' out-of-pocket spending?
Med Care Res Rev 2020 Oct;77(5):474-82. doi: 10.1177/1077558718807847..
Keywords: Healthcare Costs, Medicare, Health Insurance, Managed Care
Montoya-Williams D, Passarella M, Lorch SA
The impact of paid family leave in the United States on birth outcomes and mortality in the first year of life.
The purpose of this study was to evaluate the effect of paid family leave in California on statewide rates of preterm birth, low birthweight, post-neonatal mortality, and overall infant mortality. Probabilistic methods were used to match records of live birth with maternal and newborn hospital records; only singleton births were included in the study. Rates of infant health outcomes before and after implementation of the 2004 policy in California were compared with rates in two states that had no paid family leave policy. Findings showed that implementation of paid family leave policies in California was associated with a 12-percent reduction in post-neonatal mortality after adjusting for maternal and neonatal factors.
AHRQ-funded; HS018661.
Citation: Montoya-Williams D, Passarella M, Lorch SA .
The impact of paid family leave in the United States on birth outcomes and mortality in the first year of life.
Health Serv Res 2020 Oct;55(Suppl 2):807-14. doi: 10.1111/1475-6773.13288..
Keywords: Newborns, Pregnancy, Mortality, Policy, Outcomes, Labor and Delivery
Merkow RP, Shan Y, Gupta AR
A comprehensive estimation of the costs of 30-day postoperative complications using actual costs from multiple, diverse hospitals.
The objective of this study was to define the cost of individual, 30-day postoperative complications using robust cost data from a diverse group of hospitals. Findings showed that the three complications associated with the highest independent adjusted cost per event were prolonged ventilation, unplanned intubation, and renal failure, while the three complications associated with the lowest independent adjusted cost per event were urinary tract infection, superficial surgical site infection and venous thromboembolism. The authors indicated that the actual hospital costs of complications were estimated using cost data from four diverse hospitals, and that these data can be used by hospitals to estimate the financial benefit of reducing surgical complications.
AHRQ-funded; HS024516; HS026385.
Citation: Merkow RP, Shan Y, Gupta AR .
A comprehensive estimation of the costs of 30-day postoperative complications using actual costs from multiple, diverse hospitals.
The objective of this study was to define the cost of individual, 30-day postoperative .
Keywords: Surgery, Healthcare Costs, Adverse Events, Quality Improvement, Quality of Care
Lake ET, Staiger DO, Cramer E
Association of patient acuity and missed nursing care in U.S. neonatal intensive care units.
The health outcomes of infants in neonatal intensive care units (NICUs) may be jeopardized when required nursing care is missed. The authors conducted a correlational study of using 2016 NICU registered nurse survey responses from the National Database of Nursing Quality Indicators. They found that 36% of nurses missed one or more care activities on their past shift. The most common activities missed involved patient comfort and counseling and parent education. They recommended that nurses' assignments account for patient acuity. NICU nurse staffing and work environments warrant attention to reduce missed care and promote optimal infant and family outcomes.
AHRQ-funded; HS024918.
Citation: Lake ET, Staiger DO, Cramer E .
Association of patient acuity and missed nursing care in U.S. neonatal intensive care units.
Med Care Res Rev 2020 Oct;77(5):451-60. doi: 10.1177/1077558718806743..
Keywords: Newborns, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Nursing, Quality Indicators (QIs), Quality of Care
Khouja T, Burgette JM, Donohue JM
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Researchers examined whether low-income children's use of preventive dental services is linked to variation in state Medicaid policies that affect parents' access to dental care in Medicaid. Using MEPS data along with Area Health Resources File and Medicaid adult dental coverage policies, they found no change in children's receipt of preventive dental care associated with Medicaid expansions in states that covered vs did not cover preventive dental services for adults. They concluded that factors other than parental access to dental benefits through Medicaid may be more salient determinants of preventive dental care use among low-income children.
AHRQ-funded; HS026727.
Citation: Khouja T, Burgette JM, Donohue JM .
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Health Serv Res 2020 Oct;55(5):642-50. doi: 10.1111/1475-6773.13324..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Dental Health, Medicaid, Health Insurance, Low-Income, Access to Care, Policy
Henry SG, White AEC, Magnan EM
Making the most of video recorded clinical encounters: optimizing impact and productivity through interdisciplinary teamwork.
The authors provided concrete advice in this paper based on their experience collecting and analyzing a single set of video-recorded clinical encounters and non-video data. They presented the research process, timeline, and advice based upon their experience with interdisciplinary collaboration. They found that integrating disciplines and traditions required patience, compromise, and mutual respect, and that learning from one other enhanced their enjoyment of the process, their productivity, and the clinical relevance of their research.
AHRQ-funded; HS022236.
Citation: Henry SG, White AEC, Magnan EM .
Making the most of video recorded clinical encounters: optimizing impact and productivity through interdisciplinary teamwork.
Patient Educ Couns 2020 Oct;103(10):2178-84. doi: 10.1016/j.pec.2020.06.005..
Keywords: Healthcare Delivery, Clinician-Patient Communication, Communications
Glass M, Rana S, Coghlan R
Global palliative care education in the time of COVID-19.
This paper describes the Global Palliative Education Collaborative (GPEC), which is a training partnership between Harvard, University of California San Francisco, and Tulane medical schools in the U.S., and international palliative care (PC) programs in Uganda and India. U.S.-based fellowships are offered by GPEC to learn about resource-limited PC provision, gain perspectives on global challenges to caring for patients at the end of life, and cultivate resiliency. They also offer a novel educational project that the GPEC faculty and fellows are participating in called the Resilient Inspirational Storytelling Empathy Project. Palliative care has become even more important during the COVID-19 pandemic.
AHRQ-funded; HS026383.
Citation: Glass M, Rana S, Coghlan R .
Global palliative care education in the time of COVID-19.
J Pain Symptom Manage 2020 Oct;60(4):e14-e19. doi: 10.1016/j.jpainsymman.2020.07.018..
Keywords: Palliative Care, Infectious Diseases, Education: Continuing Medical Education, Training
Ganguli I, Lupo C, Mainor AJ
Association between specialist compensation and Accountable Care Organization performance.
This study’s objective was to determine whether Medicare Shared Savings Program Accountable Care Organizations (ACOs) using cost reduction measures in specialist compensation demonstrated better performance. National cross-sectional survey data on ACOs from 2013-2015 was linked to public-use data on ACO performance from 2014-2016. Out of 160 ACOs surveys, 26% reported using cost reduction measures to help determine specialist compensation. However, these ACOs did not have savings in the short term.
AHRQ-funded; HS023812.
Citation: Ganguli I, Lupo C, Mainor AJ .
Association between specialist compensation and Accountable Care Organization performance.
Health Serv Res 2020 Oct;55(5):722-28. doi: 10.1111/1475-6773.13323..
Keywords: Provider Performance, Healthcare Costs, Value, Payment, Medicare
Ferguson MC, O'Shea KJ, Hammer LD
Can following formula-feeding recommendations still result in infants who are overweight or have obesity?
This study compares guidelines for formula feeding and whether current recommendations still result in infants who are overweight or have obesity. The researchers used their “Virtual Infant” agent-based model representing infant-caregiver pairs that allowed caregivers to feed infants each day according to guidelines from Johns Hopkins Medicine (JHM), Children’s Hospital of Philadelphia (CHOP), Children’s Hospital of the King’s Daughters (CHKD), and Women, Infants, and Children (WIC). The WIC guidelines were found to be the best as opposed to JHM/CHOP/CHKD where infants still became overweight/obese by 6 months. The study recommended the minimum recommended amount of daily formula feeding should be made lower for JHM/CHOP/CHKD guidelines and that WIC guidelines may be a good starting point for caregivers.
AHRQ-funded; HS023317.
Citation: Ferguson MC, O'Shea KJ, Hammer LD .
Can following formula-feeding recommendations still result in infants who are overweight or have obesity?
Pediatr Res 2020 Oct;88(4):661-67. doi: 10.1038/s41390-020-0844-3..
Keywords: Newborns, Obesity: Weight Management, Obesity, Guidelines, Caregiver, Evidence-based Practice
Ellis RJ, Yuce TK, Hewitt DB
National evaluation of patient preferences in selecting hospitals and health care providers.
This study examined patient views of public databases for hospital quality. Interviews and focus groups were conducted at local outpatient clinics as well as a national administered survey on an anonymous digital platform. A 42% response rate was received (4672 responses). Measures patients considered most important were hospital reputation, physician experience, and primary care recommendations. Unimportant factors included guideline adherence, hospital academic affiliation, and morbidity and mortality outcome measures. This was true irrespective of age, sex, education status, or income of the respondent.
AHRQ-funded; HS023011; HS026385; HS021857; HS000078.
Citation: Ellis RJ, Yuce TK, Hewitt DB .
National evaluation of patient preferences in selecting hospitals and health care providers.
Med Care 2020 Oct;58(10):867-73. doi: 10.1097/mlr.0000000000001374..
Keywords: Hospitals, Quality of Care, Provider
de Cordova PB, Jones T, Riman KA
Staffing trends in magnet and non-magnet hospitals after state legislation.
This study examined whether there was a difference in staffing of registered nurses in Magnet and non-Magnet hospitals using unit-level, publicly available data in New Jersey. This secondary analysis of longitudinal RN staffing data was conducted using 64 hospitals representing 12 nursing specialties during the time span of 2008 to 2015. There was a slight increase in staffing at Magnet hospitals compared to non-Magnet hospitals, but RN staffing improved in all hospitals. No meaningful difference in staffing for all 12 specialties was found.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Jones T, Riman KA .
Staffing trends in magnet and non-magnet hospitals after state legislation.
J Nurs Care Qual 2020 Oct/Dec;35(4):323-28. doi: 10.1097/ncq.0000000000000479..
Keywords: Hospitals, Policy, Healthcare Delivery, Workforce
Bartsch SM, O'Shea KJ, Ferguson MC
Vaccine efficacy needed for a COVID-19 coronavirus vaccine to prevent or stop an epidemic as the sole intervention.
This study examined the needed efficacy and coverage of a COVID-19 vaccine to prevent or stop the pandemic. Simulation experiments were conducted at 60-80% efficacy rates. At 60% efficacy, vaccination coverage needs to be 100%. If the coverage rate is reduced to 75%, the efficacy needs to be 70% and up to 80% when coverage drops to 60%. These findings show that the vaccine needs to have at least an efficacy rate of 70% to prevent an epidemic and at least 80% to extinguish an epidemic without any other measures such as social distancing.
AHRQ-funded; HS023317.
Citation: Bartsch SM, O'Shea KJ, Ferguson MC .
Vaccine efficacy needed for a COVID-19 coronavirus vaccine to prevent or stop an epidemic as the sole intervention.
Am J Prev Med 2020 Oct;59(4):493-503. doi: 10.1016/j.amepre.2020.06.011..
Keywords: Vaccination, Infectious Diseases, Public Health, Prevention, Evidence-based Practice
Knerr S, West KM, Angelo FA
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
Programs conducting population-based screening and genetic service delivery for hereditary cancer prevention and control are rare in practice. The authors interviewed individuals instrumental in implementing seven unique clinical programs conducting either universal tumor screening for Lynch Syndrome or routine family history screening and provision of genetic services for hereditary breast and ovarian cancer in the United States. Their findings suggest that developing interventions targeting change efficacy and cultivating practice change champions may be two promising ways to increase uptake of population-based hereditary cancer screening and genetic service delivery in clinical practice.
AHRQ-funded; HS022982.
Citation: Knerr S, West KM, Angelo FA .
Organizational readiness to implement population-based screening and genetic service delivery for hereditary cancer prevention and control.
J Genet Couns 2020 Oct;29(5):867-76. doi: 10.1002/jgc4.1216.
.
.
Keywords: Cancer, Screening, Genetics, Prevention, Guidelines, Healthcare Delivery, Organization and Administration, Implementation
Barnes GD, Sippola E, Dorsch M
Applying population health approaches to improve safe anticoagulant use in the outpatient setting: the DOAC Dashboard multi-cohort implementation evaluation study protocol.
This paper discusses the study protocol that is being used in the ongoing multi-cohort implementation evaluation study on applying population health approaches to improve safe use of direct oral anticoagulants (DOAC) for treatment of atrial fibrillation and venous thromboembolism. It is hoped that these approaches will help prevent incorrect dosing which is common and puts patients at risk of adverse events. Population health tools, including interactive dashboards built into the electronic health record (EHR), are being evaluated as a way to improve safe prescribing. A three-phase project is being conducted at the Veterans Health Administration (VHA) using both quantitative and qualitative methods. The DOAC Dashboard will be implemented in four new health systems. Quantitative evaluation of the implementation will follow the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. Stakeholders will be interviewed as part of the qualitative evaluation using the Consolidated Framework for Implementation Research and Technology Acceptance Models. The goals of the study are to evaluate the implementation of the EHR-based population health tool, guide the adoption in four new health systems, and evaluate the multi-center implementation effort.
AHRQ-funded; HS026874.
Citation: Barnes GD, Sippola E, Dorsch M .
Applying population health approaches to improve safe anticoagulant use in the outpatient setting: the DOAC Dashboard multi-cohort implementation evaluation study protocol.
Implement Sci 2020 Sep 21;15(1):83. doi: 10.1186/s13012-020-01044-5.
.
.
Keywords: Blood Thinners, Medication, Patient Safety, Implementation, Adverse Drug Events (ADE), Adverse Events, Medical Errors
Nayfe R, Chansard M, Hynan LS
Comparison of patient-reported outcomes measurement information system and legacy instruments in multiple domains among older veterans with chronic back pain.
This study evaluated construct (convergent and discriminant) validity and time to complete NIH's Patient Reported Outcomes Measurement Information System (PROMIS) as compared to legacy instruments. Results showed that, given time efficiency of using PROMIS, along with strong construct validity, PROMIS instruments are a practical choice for measuring multidimensional patient-reported outcomes in older Veterans with chronic low back pain for both research and clinical purposes.
AHRQ-funded; HS022418.
Citation: Nayfe R, Chansard M, Hynan LS .
Comparison of patient-reported outcomes measurement information system and legacy instruments in multiple domains among older veterans with chronic back pain.
BMC Musculoskelet Disord 2020 Sep 8;21(1):598. doi: 10.1186/s12891-020-03587-6..
Keywords: Elderly, Veterans, Back Health and Pain, Pain, Chronic Conditions, Patient-Centered Outcomes Research, Research Methodologies
Li X, Lewis KH, Callaway K
Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?
The authors assessed the availability and validity of claims-based weight-related diagnosis codes among bariatric surgery patients who underwent adjusted gastric banding, Roux-en-Y gastric bypass, or sleeve gastrectomy. They found that claims-based weight-related diagnosis codes had excellent validity before and after bariatric surgical operation but suboptimal availability after operation. Claims databases can be used for bariatric surgery studies of non-weight-related effectiveness and safety outcomes that are well-captured.
AHRQ-funded; HS026214.
Citation: Li X, Lewis KH, Callaway K .
Suitability of administrative claims databases for bariatric surgery research - is the glass half-full or half-empty?
BMC Med Res Methodol 2020 Sep 7;20(1):225. doi: 10.1186/s12874-020-01106-8..
Keywords: Obesity: Weight Management, Obesity, Surgery, Health Services Research (HSR), Research Methodologies
Fischer SH, Rudin RS, Shi Y
Trends in the use of computerized physician order entry by health-system affiliated ambulatory clinics in the United States, 2014-2016.
This study examined trends in the use of computerized physical order entry (CPOE) by health-system affiliated ambulatory clinics from 2014-2016 in the United States. A total of 19,109 ambulatory clinics that participated in all 3 years of the Healthcare Information and Management Systems Society Analytics survey was analyzed. They calculated descriptive statistics to examine overall trends in use, location of order entry, and system-level use of CPOE. The use of CPOE increased from than 9 percentage points from 2015 to 2016, from 58% to 67%. Larger clinics and those affiliated with multi-health hospital systems were more likely to use CPOE.
AHRQ-funded; HS024067.
Citation: Fischer SH, Rudin RS, Shi Y .
Trends in the use of computerized physician order entry by health-system affiliated ambulatory clinics in the United States, 2014-2016.
BMC Health Serv Res 2020 Sep 7;20(1):836. doi: 10.1186/s12913-020-05679-4..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Ambulatory Care and Surgery, Healthcare Systems
Rundell SD, Resnik L, Heagerty PJ
Performance of the Functional Comorbidity Index (FCI) in prognostic models for risk adjustment in patients with back pain.
The Functional Comorbidity Index (FCI) is a comorbidity measure associated with physical function and may contribute to risk adjustment models in rehabilitation settings, but an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) of the FCI has not been tested in outpatient settings. The purpose of this cohort study was to examine the ability of an ICD-9-CM- based FCI to predict function, health-related quality of life, and overall health care use.
AHRQ-funded; HS01922201; HS022972.
Citation: Rundell SD, Resnik L, Heagerty PJ .
Performance of the Functional Comorbidity Index (FCI) in prognostic models for risk adjustment in patients with back pain.
Pm r 2020 Sep;12(9):891-98. doi: 10.1002/pmrj.12315..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Quality of Life, Rehabilitation
Rhee C, Baker M, Vaidya V
Incidence of nosocomial COVID-19 in patients hospitalized at a large US academic medical center.
Some patients are avoiding essential care for fear of contracting coronavirus disease 2019 (COVID-19) in hospitals. The purpose of this study was to assess the incidence of COVID-19 among patients hospitalized at a large US academic medical center in the 12 weeks after the first inpatient case was identified. The investigators concluded that in this cohort study of patients in a large academic medical center with rigorous infection control measures, nosocomial COVID-19 was rare during the height of the pandemic in the region.
AHRQ-funded; K08 HS025008.
Citation: Rhee C, Baker M, Vaidya V .
Incidence of nosocomial COVID-19 in patients hospitalized at a large US academic medical center.
JAMA Netw Open 2020 Sep;3(9):e2020498. doi: 10.1001/jamanetworkopen.2020.20498..
Keywords: Infectious Diseases, Hospitalization, Hospitals, Inpatient Care
Radhakrishnan A, Reyes-Gastelum D, Gay B
Primary care provider involvement in thyroid cancer survivorship care.
While prior research has examined how primary care providers (PCPs) can care for breast and colon cancer survivors, little is known about their role in thyroid cancer survivorship. The purpose of this study was to understand PCP involvement and confidence in thyroid cancer survivorship care. The investigators found that while PCPs reported being involved in long-term surveillance, gaps remained in their confidence in handling survivorship care. They indicated that thyroid cancer survivorship guidelines that delineate PCP roles present one opportunity to increase confidence about their participation.
AHRQ-funded; HS024512.
Citation: Radhakrishnan A, Reyes-Gastelum D, Gay B .
Primary care provider involvement in thyroid cancer survivorship care.
J Clin Endocrinol Metab 2020 Sep;105(9):e3300-6. doi: 10.1210/clinem/dgaa437..
Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer, Primary Care
Li J, Qi M, Werner RM
Assessment of receipt of the first home health care visit after hospital discharge among older adults.
Investigators examined how often patients referred to home health care at hospital discharge receive it and whether there is evidence of disparities. Their study used Medicare data regarding the postacute home health care setting; participants were Medicare fee-for-service and Medicare Advantage beneficiaries discharged from the hospital with a referral to home health care. They found that only 54% of patients discharged received home health care services within 14 days of discharge. Of the remaining 46% discharged, 37.7% never received any home health care, while 8.3% were institutionalized or died within 14 days without a preceding home health care visit. Patients who were Black or Hispanic received home health at lower rates than did patients who were White. They concluded that disparities in the use of home health care remain an issue in the US.
AHRQ-funded; HS024266; HS026836.
Citation: Li J, Qi M, Werner RM .
Assessment of receipt of the first home health care visit after hospital discharge among older adults.
JAMA Netw Open 2020 Sep;3(9):e2015470. doi: 10.1001/jamanetworkopen.2020.15470..
Keywords: Elderly, Hospital Discharge, Home Healthcare, Disparities, Access to Care, Racial / Ethnic Minorities
Hsieh CJ, DeJong G, Vita M
AHRQ Author: Hsieh CJ
Effect of outpatient rehabilitation on functional mobility after single total knee arthroplasty: a randomized clinical trial.
Researchers compared post-total knee arthroplasty (TKA) functional mobility outcomes among 3 newly-developed physical therapy protocols with a standard-of-care post-TKA rehabilitation protocol. They found no statistically or clinically significant differences in outcomes across the 4 study arms (control, treadmill, neuromuscular stimulation device, and combination intervention). As outcomes were similar among arms, they recommended that clinicians instead consider relative cost in tailoring TKA rehabilitation.
AHRQ-authored.
Citation: Hsieh CJ, DeJong G, Vita M .
Effect of outpatient rehabilitation on functional mobility after single total knee arthroplasty: a randomized clinical trial.
JAMA Netw Open 2020 Sep;3(9):e2016571. doi: 10.1001/jamanetworkopen.2020.16571..
Keywords: Rehabilitation, Orthopedics, Surgery, Outcomes, Evidence-based Practice