martes, 15 de marzo de 2016

AHRQ Research Studies | Agency for Healthcare Research & Quality

AHRQ Research Studies | Agency for Healthcare Research & Quality

AHRQ--Agency for Healthcare Research and Quality: Advancing Excellence in Health Care

To enrich the information provided to Articles of Interest (AI) subscribers, AHRQ has created anAHRQ Research Studies Web page that includes all categories and information you are used to seeing in AI, along with an expanded first section on AHRQ-funded and AHRQ-authored articles. This section now includes a 50-word summary of each article, and is searchable by key word and the first three authors. The main page also links to all of the other AI sections such as Evidence-based Practice Center-Related Articles and AHRQ-Related Articles, which retain their original format and brief annotations. The Web page is updated monthly.

Wittie M, Ngo-Metzger Q, Lebrun-Harris L
Enabling quality: electronic health record adoption and meaningful use readiness in federally funded health centers.
This study, the first to examine the adoption and use of electronic health records (EHRs) among all 1,128 federally funded health centers, found that, as of 2011, 80 percent of health centers reported using an EHR, and high proportions reported using many advanced EHR functionalities. There were no indications of disparities in EHR adoption by census region, urban/rural location, patient sociodemographic compositions, physician staffing or health center funding.
J Healthc Qual. 2016 Jan-Feb;38(1):42-51. doi: 10.1111/jhq.12067. 
View abstract on the National Library of Medicine site. 
Health IT, Electronic Health Records (EHRs), Disparities, Socioeconomic Factors
AHRQ Author: Ngo-Metzger Q
Risko R, Merdan S, Womble PR
Clinical predictors and recommendations for staging computed tomography scan among men with prostate cancer.
This study identified clinical variables associated with a positive computed tomography (CT) scan and estimated the performance of imaging recommendations in patients with newly diagnosed prostate cancer. It found that implementation of criterion for CT imaging that includes PSA levels greater than 20, a Gleason score of 8 or higher, or locally advanced disease (interpreted as cT3/4) would ensure that CT scans are performed for almost all men who would test positive for metastases.
Urology. 2014 Dec;84(6):1329-34. doi: 10.1016/j.urology.2014.07.051.
AHRQ-funded; HS018346 
View abstract on the National Library of Medicine site. 
Computed Tomography (CT) Scan, Cancer: Prostate Cancer, Screening, Diagnosis, Diagnostics
Berkman ND, Lohr KN, Ansari MT, Chang S
Grading the strength of a body of evidence when assessing health care interventions: an EPC update.
The purpose of this article is to revise the 2010 guidance on grading the strength of evidence (SOE) of the effectiveness of drugs, devices, and other preventive and therapeutic interventions produced by AHRQ’s Evidence-based Practice Center program. It concluded that no single approach for grading SOE suits all reviews, but a more consistent and transparent approach to reporting summary information will make reviews more useful.
J Clin Epidemiol. 2015 Nov;68(11):1312-24. doi: 10.1016/j.jclinepi.2014.11.023. 
AHRQ authored; AHRQ-funded 290200710056I 
View abstract on the National Library of Medicine site.
Comparative Effectiveness, Evidence-based Medicine, Evidence-based Practice Centers (EPCs), Research Methodologies
AHRQ Author: Chang S
Murphy DR, Thomas EJ, Meyer AN
Development and validation of electronic health record-based triggers to detect delays in follow-up of abnormal lung imaging findings.
In this study, the researchers developed an electronic health record (EHR)-based trigger algorithm to identify delays in follow-up evaluation of patients with imaging findings suggestive of lung cancer. After validating the trigger with retrospective data, they concluded that EHR-based triggers can be used to identify patients with suspicious imaging findings in whom follow-up diagnostic evaluation was delayed.
Radiology 2015 Oct;277(1):81-7. doi: 10.1148/radiol.2015142530. 
AHRQ-funded; HS017820. 
View abstract on the National Library of Medicine site.
Health Information Technology (HIT), Electronic Health Records (EHRs), Cancer: Lung Cancer, Diagnostics
Grundmeier RW, Song L, Ramos MJ
Imputing missing race/ethnicity in pediatric electronic health records: Reducing bias with use of U.S. census location and surname data.
The researchers assessed the utility of imputing race/ethnicity using U.S. Census race/ethnicity, residential address, and surname information compared to standard missing data methods in a pediatric cohort. In a simulation experiment, they constructed dichotomous and continuous outcomes with pre-specified associations with known race/ethnicity. They found that imputation using U.S. Census information reduced bias for both continuous and dichotomous outcomes.
Health Serv Res 2015 Aug;50(4):946-60. doi: 10.1111/1475-6773.12295.
AHRQ-funded; HS021645. 
View abstract on the National Library of Medicine site. 
Health Information Technology (HIT), Electronic Health Records (EHRs), Pediatrics, Racial and Ethnic Minority Groups
DeVoe JE, Crawford C, Angier H
The association between Medicaid coverage for children and parents persists: 2002-2010.
The researchers assessed the likelihood of children’s having public health insurance coverage and their parents’ maintenance, gain, or loss of public coverage. The study found that, despite differing eligibility requirements, strong associations persisted between coverage continuity for parents and children in Oregon’s public health insurance program.
Matern Child Health J. 2015 Aug;19(8):1766-74. doi: 10.1007/s10995-015-1690-5. 
AHRQ-funded; HS018569 
View abstract on the National Library of Medicine site. 
Medicaid, Children, Health Insurance
Schroeder EB, Powers JD, O'Connor PJ
Prevalence of chronic kidney disease among individuals with diabetes in the SUPREME-DM Project, 2005-2011.
The researchers used a database including over 1 million individuals with diabetes to examine the prevalence of chronic kidney disease (CKD) and trends from 2005 to 2011. They found that CKD prevalence was 20.0 percent using diagnostic codes, 17.7 percent using impaired estimated glomerular filtration rate alone, 11.9 percent using albuminuria, and 32.7 percent when one or more methods suggested CKD.
J Diabetes Complications. 2015 Jul;29(5):637-43. doi: 10.1016/j.jdiacomp.2015.04.007. 
AHRQ-funded; HS019859 
View abstracton the National Library of Medicine site. 
Kidney Disease, Diabetes, Chronic Conditions
Zuvekas SH
The take-up of employer-sponsored insurance among Americans with mental disorders: Implications for health care reform.
This study used data from the 2004-2008 Medical Expenditure Panel Survey to examine differences in offers and take-up of employer-sponsored health insurance (ESI) coverage among adults aged 27-54 by mental health status. It found little difference in the take-up of offers of ESI coverage between those with and without mental disorders.
J of Behav Health Serv and Res. 2015 Jul;42(3):279-91. doi: 10.1007/s11414-015-9459-6. 
View abstract on the National Library of Medicine site. 
Mental Health, Medical Expenditure Panel Survey (MEPS), Employer-Sponsored Health Insurance
AHRQ Author: Zuvekas SH
Sittig DF, Murphy DR, Smith MW
Graphical display of diagnostic test results in electronic health records: a comparison of 8 systems.
In an attempt to understand how well current electronic health records (EHRs) facilitate accurate display and interpretation of clinical laboratory test results, the researchers evaluated the graphical displays of laboratory test results in 8 EHRs using objective criteria for optimal graphs. None of the EHRs met all 11 criteria.
J Am Med Inform Assoc. 2015 Jul;22(4):900-4. doi: 10.1093/jamia/ocv013.
AHRQ-funded; HS022087 
View abstract on the National Library of Medicine site. 
Electronic Health Records (EHRs), Health IT, Comparative Effectiveness
Smith ME, Haney E, McDonagh M
Treatment of myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
This review evaluates and summarizes research on the benefits and harms of medical and nonmedical treatments for myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) based on trials enrolling patients meeting criteria for ME, CFS, or both. It concluded that trials of rintatolimod, counseling therapies, and graded exercise therapy suggest benefit for some patients meeting case definitions for CFS, whereas evidence for other treatments and harms is insufficient.
Ann Intern Med 2015 Jun 16;162(12):841-50. doi: 10.7326/m15-0114.
AHRQ-funded; 290201200014I. 
View abstract on the National Library of Medicine site. 
Comparative Effectiveness, Comparative Effectiveness Review (CER), Evidence-based Medicine, Treatments
Haney E, Smith ME, McDonagh M
Diagnostic methods for myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
The purpose of this systematic review was to evaluate and compare studies of methods to diagnose myalgic encephalomyelitis /chronic fatigue syndrome (ME/CFS), identify limitations of current studies, and determine needs for future research. It found that 9 sets of clinical criteria are used to define ME/CFS, yet none of the current diagnostic methods have been adequately tested to identify patients with ME/CFS when diagnostic uncertainty exists.
Ann Intern Med 2015 Jun 16;162(12):834-40. doi: 10.7326/m15-0443.
AHRQ-funded; 290201200014I. 
View abstract on the National Library of Medicine site. 
Comparative Effectiveness, Evidence-based Medicine, Diagnostics, Comparative Effectiveness Review (CER)
Briesacher BA, Madden JM, Zhang F
Did Medicare Part D affect national trends in health outcomes or hospitalizations? A time-series analysis.
The researchers examined changes in health outcomes and medical services in the Medicare population after implementation of Medicare Part D. They found that 5 years after implementation, and contrary to previous reports, there was no evidence of Part D's effect on a range of population-level health indicators among Medicare enrollees. Further, there was no clear evidence of gains in medical care efficiencies.
Ann Intern Med. 2015 Jun 16;162(12):825-33. doi: 10.7326/m14-0726.
AHRQ-funded; HS018577 
View abstract on the National Library of Medicine site. 
Hospitalization, Outcomes, Medicare, Health Status, Elderly
Nuckols TK, Smith-Spangler C, Morton SC
The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis.
The primary objective of this systematic review and meta-analysis study was to quantitatively assess the effectiveness of computerized provider order entry (CPOE) at reducing preventable adverse drug events (pADE). It found that CPOE is associated with cutting in half the number of pADEs. Medication errors were also about half as common with CPOE.
Syst Rev. 2014 Jun 4;3:56. doi: 10.1186/2046-4053-3-56. 
AHRQ-funded; HS017954 
View abstract on the National Library of Medicine site.
Computer-Based Provider Order Entry (CPOE), Health Information Technology (HIT), Adverse Drug Events (ADE), Medications, Patient Safety
Duseja R, Bardach NS, Lin GA
Revisit rates and associated costs after an emergency department encounter: a multistate analysis.
This study describes revisit rates, variation in revisit rates by diagnosis and state, and associated costs. It found that revisits after an index ED encounter are more frequent than previously reported, in part because many occur outside the index institution. Among ED patients in Florida, more resources are spent on revisits than on index ED visits.
Ann Intern Med 2015 Jun 2;162(11):750-6. doi: 10.7326/m14-1616. 
AHRQ-funded; HS020667. 
View abstract on the National Library of Medicine site.
Healthcare Cost and Utilization Project (HCUP), Health Care Costs, Emergency Department, Hospitalization, Hospital Readmissions
Chinnadurai S, Francis DO, Epstein RA
Treatment of ankyloglossia for reasons other than breastfeeding: a systematic review.
The researchers systematically reviewed literature on feeding, speech, and social outcomes of treatments for infants and children with ankyloglossia. After analyzing two randomized controlled trials, 2 cohort studies, and 11 case series assessing the effects of frenotomy on feeding, speech, and social outcomes, they determined that data are currently insufficient for assessing the effects of frenotomy on nonbreastfeeding outcomes that may be associated with ankyloglossia.
Pediatrics 2015 Jun;135(6):e1467-74. doi: 10.1542/peds.2015-0660. 
AHRQ-funded; 290201200009I. 
View abstract on the National Library of Medicine site. 
Breast Feeding, Children, Outcomes, Comparative Effectiveness
Goldman LE, Chu PW, Bacchetti P
Effect of present-on-admission (POA) reporting accuracy on hospital performance assessments using risk-adjusted mortality.
This study evaluated how the accuracy of present-on-admission (POA) reporting affects hospital 30-day acute myocardial infarction (AMI) mortality assessments. It finds that the use of POA indicators in administrative data significantly alters risk-adjusted hospital assessments that do not incorporate a method for distinguishing between comorbidities and complications.
Health Serv Res 2015 Jun;50(3):922-38. doi: 10.1111/1475-6773.12239.
AHRQ-funded; HS018090. 
View abstract on the National Library of Medicine site. 
Myocardial Infarction, Hospital Admissions, Mortality, Quality Indicators
Goldberg DS, Forde KA, Carbonari DM
Population-representative incidence of drug-induced acute liver failure based on an analysis of an integrated health care system.
The researchers conducted an assessment of the incidence and outcomes of acute drug-induced liver failure within a large, integrated healthcare system that approximates a population-representative cohort. They found the incident of acute drug-induced liver failure to be 1.61 per million person years with the overwhelming majority being due to over-the-counter medications or products.
Gastroenterology 2015 Jun;148(7):1353-61.e3. doi: 10.1053/j.gastro.2015.02.050. 
AHRQ-funded; HS018372. 
View abstract on the National Library of Medicine site. 
Medications, Chronic Conditions, Patient Safety
Francis DO, Krishnaswami S, Mcpheeters M
Treatment of ankyloglossia and breastfeeding outcomes: a systematic review.
This systematic review of literature on surgical and nonsurgical treatments for infants with ankyloglossia, a condition restricting tongue mobility in infants, found that frenotomy may be associated with mother-reported improvements in breastfeeding, and potentially in nipple pain. Since the existing studies are small and short-term with inconsistent methodology, the strength of the evidence is low to insufficient.
Pediatrics 2015 Jun;135(6):e1458-66. doi: 10.1542/peds.2015-0658. 
AHRQ-funded; 290201200009I. 
View abstract on the National Library of Medicine site. 
Breast Feeding, Outcomes, Comparative Effectiveness, Evidence-based Medicine, Infant Health
Curtis JR, Xie F, Yun H
Risk of hospitalized infection among rheumatoid arthritis patients concurrently treated with a biologic agent and denosumab.
The researchers evaluated rates of hospitalized infection among patients treated with biologic agents for RA who subsequently initiated denosumab in order to assess whether rates of infection were increased with concurrent biologic agent use for RA. They found that the rate of hospitalized infection among RA patients receiving denosumab concurrently with biologic agents for RA was not increased compared to those receiving zoledronate.
Arthritis Rheumatol. 2015 Jun;67(6):1456-64. doi: 10.1002/art.39075.
AHRQ-funded; HS018517 
View abstract on the National Library of Medicine site. 
Rheumatoid Arthritis, Hospital-Acquired Infections, Risk, Patient Safety, Comparative Effectiveness
Atkins DN, Bradford WD
Association between increased emergency contraception availability and risky sexual practices.
The researchers use a national survey of youth to explore the relationship between increased emergency contraception (EC) availability and the probability of risky sexual practices for women over age 18. They found that FDA approval of behind the counter sales of an EC pill was associated with a reduction in the probability of sexual activity, and in the likelihood of reporting multiple partnerships; however, there was no relationship between the new policy and unprotected sexual activity.
Health Serv Res. 2015 Jun;50(3):809-29. doi: 10.1111/1475-6773.12251.
AHRQ-funded; HS011326 
View abstract on the National Library of Medicine site. 
Contraception, Sexual Health, Child/Adolescent Health


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