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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
1 to 25 of 41 Research Studies DisplayedMelnick ER, Probst MA, Schoenfeld E
Development and testing of shared decision making interventions for use in emergency care: a research agenda.
This article provides background on decision aids and the conclusions of the 2016 Academic Emergency Medicine consensus conference SDM in practice work group regarding "Shared Decision Making in the Emergency Department: Development of a Policy-Relevant, Patient-Centered Research Agenda."
AHRQ-funded; HS021271; HS024311.
Citation: Melnick ER, Probst MA, Schoenfeld E .
Development and testing of shared decision making interventions for use in emergency care: a research agenda.
Acad Emerg Med 2016 Dec;23(12):1346-53. doi: 10.1111/acem.13045.
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Keywords: Shared Decision Making, Emergency Department, Emergency Medical Services (EMS), Patient-Centered Healthcare, Policy
Dodd KW, Berman A, Brown J
Funding research in emergency department shared decision making: a summary of the 2016 Academic Emergency Medicine Consensus Conference Panel Discussion.
This article summarizes a panel discussion of funding priorities and examples of successfully funded projects related to shared decision making in emergency medicine. The discussion was part of the 2016 Academic Emergency Medicine Consensus Conference, "Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda."
AHRQ-funded; HS024172.
Citation: Dodd KW, Berman A, Brown J .
Funding research in emergency department shared decision making: a summary of the 2016 Academic Emergency Medicine Consensus Conference Panel Discussion.
Acad Emerg Med 2016 Dec;23(12):1340-45. doi: 10.1111/acem.13063.
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Keywords: Emergency Department, Shared Decision Making, Emergency Medical Services (EMS), Health Services Research (HSR)
Castaneda-Guarderas A, Glassbereg J, Grudzen CR
Shared decision making with vulnerable populations in the emergency department.
The authors introduce a research agenda that includes community-engaged approaches, mixed-methods studies, and cost-effectiveness analyses to address questions of shared decision making (SDM) among vulnerable groups at a disadvantage in the healthcare system, as well as changes that are needed, and how to cultivate and teach these competencies.
AHRQ-funded; HS024172.
Citation: Castaneda-Guarderas A, Glassbereg J, Grudzen CR .
Shared decision making with vulnerable populations in the emergency department.
Acad Emerg Med 2016 Dec;23(12):1410-16. doi: 10.1111/acem.13134.
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Keywords: Cultural Competence, Shared Decision Making, Emergency Department, Patient and Family Engagement, Vulnerable Populations
Grudzen CR, Anderson JR, Carpenter CR
The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.
The authors described the current state of shared decision making in the emergency department context and provided an overview of the conference. They explained that the results of the conference published in the same journal issue provided an essential summary of the future research priorities for shared decision making to increase quality of care and patient-centered outcomes.
AHRQ-funded; HS024172.
Citation: Grudzen CR, Anderson JR, Carpenter CR .
The 2016 Academic Emergency Medicine Consensus Conference, Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda May 10, 2016, New Orleans, LA.
Acad Emerg Med 2016 Dec;23(12):1313-19. doi: 10.1111/acem.13047.
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Keywords: Shared Decision Making, Emergency Department, Emergency Medical Services (EMS), Patient-Centered Healthcare, Policy
Brody AM, Sharma VK, Singh A
Barriers to emergency physician diagnosis and treatment of uncontrolled chronic hypertension.
This study surveyed a national sample of emergency physicians on their perceived barriers in establishing an ED diagnosis of asymptomatic hypertension (HTN) and ED treatment of such patients. It found that the most common barriers to diagnosis of HTN were uncertainty regarding the validity of ED blood pressure measurements (92 percent)and reluctance to diagnose a condition which cannot be comprehensively managed in the ED setting (29 percent).
AHRQ-funded; HS000011.
Citation: Brody AM, Sharma VK, Singh A .
Barriers to emergency physician diagnosis and treatment of uncontrolled chronic hypertension.
Am J Emerg Med 2016 Nov;34(11):2241-42. doi: 10.1016/j.ajem.2016.08.050.
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Keywords: Blood Pressure, Emergency Department, Diagnostic Safety and Quality, Chronic Conditions
O'Malley JP, O'Keeffe-Rosetti M, Lowe RA
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
The authors sought to assess changes in emergency department, primary care, mental and behavioral health care, and specialist care visit rates among individuals gaining Medicaid over 24 months postinsurance gain and also to evaluate the association of previous insurance with utilization. They found that primary care visit rates in both newly and returning insured individuals significantly exceeded those of the continuously insured in months 4 through 12, but were not significantly elevated in the second year. In contrast, emergency department utilization rates were significantly higher in returning insured compared with newly or continuously insured individuals and remained elevated over time. New visits to primary and specialist care were higher among those who gained Medicaid compared with the continuously insured throughout the study period. They concluded that expansion evaluations should allow for rate stabilization.
AHRQ-funded; HS021522.
Citation: O'Malley JP, O'Keeffe-Rosetti M, Lowe RA .
Health care utilization rates after Oregon's 2008 Medicaid expansion: within-group and between-group differences over time among new, returning, and continuously insured enrollees.
Med Care 2016 Nov;54(11):984-91. doi: 10.1097/mlr.0000000000000600.
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Keywords: Medicaid, Healthcare Delivery, Healthcare Utilization, Emergency Department, Emergency Medical Services (EMS)
Gernant SA, Snyder ME, Jaynes H
The effectiveness of pharmacist-provided telephonic medication therapy management on emergency department utilization in home health patients.
This article's objective is to evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing emergency department utilization within a Medicare-insured home health population. The authors found that this pharmacist-delivered telephonic medication therapy management program did not decrease emergency department utilization overall but may further reduce the such risk among patients who are at lower risk of utilization.
AHRQ-funded; HS022119.
Citation: Gernant SA, Snyder ME, Jaynes H .
The effectiveness of pharmacist-provided telephonic medication therapy management on emergency department utilization in home health patients.
J Pharm Technol 2016 Oct 1;32(5):179-84. doi: 10.1177/8755122516660376.
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Keywords: Care Management, Emergency Department, Medication, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Provider: Pharmacist, Provider
Moore CL, Daniels B, Singh D
Ureteral stones: implementation of a reduced-dose CT protocol in patients in the emergency department with moderate to high likelihood of calculi on the basis of STONE score.
The purpose of this paper was to determine if a reduced-dose computed tomography (CT) protocol could effectively help to identify patients in the emergency department (ED) with moderate to high likelihood of calculi who would require urologic intervention within 90 days. The authors found that a CT protocol with over 85% dose reduction can be used in patients with moderate to high likelihood of ureteral stone to safely and effectively identify patients in the ED who will require urologic intervention.
AHRQ-funded; HS018322.
Citation: Moore CL, Daniels B, Singh D .
Ureteral stones: implementation of a reduced-dose CT protocol in patients in the emergency department with moderate to high likelihood of calculi on the basis of STONE score.
Radiology 2016 Sep;280(3):743-51. doi: 10.1148/radiol.2016151691.
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Keywords: Clinical Decision Support (CDS), Emergency Department, Imaging, Patient Safety
Rosenthal MB, Landrum MB, Robbins JA
Pay for performance in Medicaid: evidence from three natural experiments.
This study examined the impact of pay for performance in Medicaid on the quality and utilization of care. Primary outcomes of interest were Healthcare Effectiveness Data and Information Set (HEDIS)-like process measures of quality, utilization by service category, and ambulatory care-sensitive admissions and emergency department visits. Its findings were mixed, with no measurable quality improvements across the three states (Pennsylvania, Minnesota, Alabama), but reductions in hospital admissions in two programs.
AHRQ-funded.
Citation: Rosenthal MB, Landrum MB, Robbins JA .
Pay for performance in Medicaid: evidence from three natural experiments.
Health Serv Res 2016 Aug;51(4):1444-66. doi: 10.1111/1475-6773.12426.
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Keywords: Medicaid, Payment, Provider Performance, Healthcare Utilization, Quality of Care, Hospitalization, Emergency Department
Lima FO, Silva GS, Furie KL
Field assessment stroke triage for emergency destination: a simple and accurate prehospital scale to detect large vessel occlusion strokes.
The authors aimed to develop a simple field scale to identify large vessel occlusion strokes (LVOS). They found that Field Assessment Stroke Triage for Emergency Destination (FAST-ED) is a simple scale that, if successfully validated in the field, may be used by medical emergency professionals to identify LVOS in the prehospital setting enabling rapid triage of patients.
AHRQ-funded; HS011392.
Citation: Lima FO, Silva GS, Furie KL .
Field assessment stroke triage for emergency destination: a simple and accurate prehospital scale to detect large vessel occlusion strokes.
Stroke 2016 Aug;47(8):1997-2002. doi: 10.1161/strokeaha.116.013301.
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Keywords: Care Management, Elderly, Emergency Department, Stroke
Kim HS, Monte AA
Colorado cannabis legalization and its effect on emergency care.
The authors noted that increased marijuana use after legalization has been accompanied by increases in emergency department visits and hospitalizations due to marijuana intoxication. They recommended that providers in states with impending legalization measures should become familiar with the symptoms and management of acute marijuana intoxication, as well as understand the effects on chronic diseases frequently observed in the emergency department. Further, they suggested that residency program directors should make an effort to integrate this topic into their residency curricula.
AHRQ-funded; HS000078.
Citation: Kim HS, Monte AA .
Colorado cannabis legalization and its effect on emergency care.
Ann Emerg Med 2016 Jul;68(1):71-5. doi: 10.1016/j.annemergmed.2016.01.004.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Hospitalization, Policy, Substance Abuse
Melvin CL, Saef SH, Pierce HO
Health information exchange in the ED: what do ED clinicians think?
The researchers investigated reasons for low Carolina eHealth Alliance health information exchange (CeHA-HIE)utilization. They found that most emergency department clinicians believed the system added value to their work but preferred better integration with their electronic medical records systems.
AHRQ-funded; HS019339; HS023047.
Citation: Melvin CL, Saef SH, Pierce HO .
Health information exchange in the ED: what do ED clinicians think?
South Med J 2016 Jul;109(7):419-26. doi: 10.14423/smj.0000000000000466.
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Keywords: Health Information Exchange (HIE), Emergency Department, Electronic Health Records (EHRs), Emergency Medical Services (EMS)
McCarthy ML, Shokoohi H
Ultrasonography versus landmark for peripheral intravenous cannulation: a randomized controlled trial.
Randomized controlled trials report inconsistent findings when comparing the initial success rate of peripheral intravenous cannulation using landmark versus ultrasonography for patients with difficult venous access. This study sought to determine which method was superior for patients with varying levels of intravenous access difficulty. The study concluded that ultrasonographic peripheral intravenous cannulation was advantageous among patients with difficult or moderately difficult intravenous access but was disadvantageous among patients anticipated to have easy access.
AHRQ-funded; HS017957.
Citation: McCarthy ML, Shokoohi H .
Ultrasonography versus landmark for peripheral intravenous cannulation: a randomized controlled trial.
Ann Emerg Med 2016 Jul;68(1):10-8. doi: 10.1016/j.annemergmed.2015.09.009..
Keywords: Emergency Department, Imaging
Dugas AF, Kirsch TD, Toerper M
An electronic emergency triage system to improve patient distribution by critical outcomes.
This study derives and validates a computer-based electronic triage system (ETS) to improve patient acuity distribution based on serious patient outcomes. The authors found improved differentiation of patients compared to the current standard Emergency Severity Index.
AHRQ-funded; HS023641.
Citation: Dugas AF, Kirsch TD, Toerper M .
An electronic emergency triage system to improve patient distribution by critical outcomes.
J Emerg Med 2016 Jun;50(6):910-8. doi: 10.1016/j.jemermed.2016.02.026.
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Keywords: Care Management, Electronic Health Records (EHRs), Emergency Department, Health Information Technology (HIT), Healthcare Delivery
Blecker S, Gavin NP, Park H
Observation units as substitutes for hospitalization or home discharge.
The purpose of this study is to determine the effect of the availability of observation units on hospitalizations and discharges to home for emergency department (ED) patients. The authors concluded that half of ED visits for chest pain that resulted in an observation unit admission were made by patients who may have been discharged home had the observation unit not been available.
AHRQ-funded; HS023683.
Citation: Blecker S, Gavin NP, Park H .
Observation units as substitutes for hospitalization or home discharge.
Ann Emerg Med 2016 Jun;67(6):706-13.e2. doi: 10.1016/j.annemergmed.2015.10.025.
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Keywords: Hospitalization, Hospital Discharge, Emergency Department, Emergency Medical Services (EMS)
Gillespie SM, Shah MN, Wasserman EB
Reducing emergency department utilization through engagement in telemedicine by senior living communities.
High-intensity telemedicine has been shown to reduce the need for emergency department (ED) care for older adult senior living community (SLC) residents with acute illnesses. In this study, the investigators evaluated the effect of SLC engagement in a telemedicine program on ED use rates. The investigators concluded that individuals residing in more engaged SLCs experienced a greater decrease in ED use compared with subjects residing in less engaged SLCs or those without access to high-intensity telemedicine for acute illnesses.
AHRQ-funded; HS018047.
Citation: Gillespie SM, Shah MN, Wasserman EB .
Reducing emergency department utilization through engagement in telemedicine by senior living communities.
Telemed J E Health 2016 Jun;22(6):489-96. doi: 10.1089/tmj.2015.0152..
Keywords: Elderly, Emergency Department, Health Information Technology (HIT), Healthcare Utilization, Patient and Family Engagement, Telehealth
Jonassaint CR, Beach MC, Haythornthwaite JA
The association between educational attainment and patterns of emergency department utilization among adults with sickle cell disease.
The authors aimed to determine what factors are related to emergency department visits in hopes of guiding treatments and early interventions. They concluded that early interventions addressing disparities in academic performance, especially for those children most at risk, may lead to improved long-term health outcomes in this population.
AHRQ-funded; HS022989.
Citation: Jonassaint CR, Beach MC, Haythornthwaite JA .
The association between educational attainment and patterns of emergency department utilization among adults with sickle cell disease.
Int J Behav Med 2016 Jun;23(3):300-09. doi: 10.1007/s12529-016-9538-y.
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Keywords: Education, Emergency Department, Healthcare Utilization, Pain, Sickle Cell Disease
Figueiredo R, Dempster L, Quinonez C
Emergency department use for dental problems among homeless individuals: a population-based cohort study.
The researchers evaluated emergency department (ED) visits for dental problems among Toronto's homeless population (Ontario, Canada). They found that over 80% of the ED visits by homeless people were for odontogenic infections, and 46% of homeless people had more than one such visit. They concluded that access to dental care is inadequate and that ED settings are ineffective for treatment of dental problems.
AHRQ-funded; HS014129.
Citation: Figueiredo R, Dempster L, Quinonez C .
Emergency department use for dental problems among homeless individuals: a population-based cohort study.
J Health Care Poor Underserved 2016;27(2):860-8. doi: 10.1353/hpu.2016.0081.
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Keywords: Access to Care, Dental and Oral Health, Emergency Department, Vulnerable Populations
Shy BD, Kim EY, Genes NG
Increased identification of emergency department 72-hour returns using multihospital health information exchange.
The authors tested the use of a health information exchange (HIE) to improve identification of 72-hour return visits compared to individual hospitals' site-specific data. They found that HIE increased the identification ability of 72-hour ED return analyses by a mean of 11.16% compared with site-specific (no HIE) analyses. They concluded that their analysis demonstrates incremental improvements in the ability to identify early ED returns using increasing levels of HIE data aggregation.
AHRQ-funded; HS021261.
Citation: Shy BD, Kim EY, Genes NG .
Increased identification of emergency department 72-hour returns using multihospital health information exchange.
Acad Emerg Med 2016 May;23(5):645-9. doi: 10.1111/acem.12954.
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Keywords: Emergency Department, Health Information Exchange (HIE), Hospital Discharge, Hospital Readmissions
Michelson KA, Monuteaux MC, Neuman MI
Variation and trends in anaphylaxis care in United States children's hospitals.
The authors sought to determine the extent of variation in treatment of children with anaphylaxis. They found that there is substantial variability in the use of common therapies and hospitalization rates for children cared for in U.S. children's hospitals, highlighting the need for research defining optimal care for anaphylaxis.
AHRQ-funded; HS000063.
Citation: Michelson KA, Monuteaux MC, Neuman MI .
Variation and trends in anaphylaxis care in United States children's hospitals.
Acad Emerg Med 2016 May;23(5):623-7. doi: 10.1111/acem.12922.
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Keywords: Children/Adolescents, Emergency Department, Hospitals, Care Management, Hospitalization
Brach C
AHRQ Author: Brach C
Even in an emergency, doctors must make informed consent an informed choice.
When a stroke is suspected, a daughter is pressured to consent to her father's treatment without fully understanding the risks.
AHRQ-authored.
Citation: Brach C .
Even in an emergency, doctors must make informed consent an informed choice.
Health Aff 2016 Apr;35(4):739-43. doi: 10.1377/hlthaff.2015.1407.
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Keywords: Case Study, Shared Decision Making, Emergency Department, Health Literacy, Patient and Family Engagement, Stroke
Medford-Davis L, Park E, Shlamovitz G
Diagnostic errors related to acute abdominal pain in the emergency department.
This study reviewed a selected high-risk cohort of patients presenting to the ED with abdominal pain to evaluate for possible diagnostic errors and associated process breakdowns. Diagnostic errors occurred in 35 of 100 high-risk cases. Over two-thirds had breakdowns involving the patient-provider encounter (most commonly history-taking or ordering additional tests) and/or follow-up and tracking of diagnostic information (most commonly follow-up of abnormal test results).
AHRQ-funded; HS022087.
Citation: Medford-Davis L, Park E, Shlamovitz G .
Diagnostic errors related to acute abdominal pain in the emergency department.
Emerg Med J 2016 Apr;33(4):253-9. doi: 10.1136/emermed-2015-204754.
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Keywords: Pain, Emergency Department, Diagnostic Safety and Quality, Medical Errors, Clinician-Patient Communication
Leyenaar JK, Lagu T, Lindenauer PK
Direct admission to the hospital: an alternative approach to hospitalization.
The authors discussed the role of hospital medicine in the changing epidemiology of hospital admissions, the potential risks and benefits of direct admission to the hospital, and the need for research to evaluate the safety and effectiveness of this admission approach. They proposed that transitions of care research and quality improvement be expanded to address transitions into the hospital.
AHRQ-funded; HS024133.
Citation: Leyenaar JK, Lagu T, Lindenauer PK .
Direct admission to the hospital: an alternative approach to hospitalization.
J Hosp Med 2016 Apr;11(4):303-5. doi: 10.1002/jhm.2512.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Hospitalization, Transitions of Care
Kayle M, Brennan-Cook J, Carter BM
Evaluation of a sickle cell disease educational website for emergency providers.
Electronic surveys were used to conduct a formal evaluation of the accuracy and relevance of the website's content, as well as the effectiveness of the education modules in improving knowledge among health care providers. Both sickle cell disease experts and ED providers agreed that the module content was clear and easy to understand, accurate, comprehensive, relevant, and met module objectives.
AHRQ-funded; HS019646.
Citation: Kayle M, Brennan-Cook J, Carter BM .
Evaluation of a sickle cell disease educational website for emergency providers.
Adv Emerg Nurs J 2016 Apr-Jun;38(2):123-32. doi: 10.1097/tme.0000000000000099.
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Keywords: Education: Continuing Medical Education, Emergency Department, Health Information Technology (HIT), Provider, Sickle Cell Disease
Wang RC
Managing urolithiasis.
More than 1 million patients with suspected urolithiasis present to an emergency department (ED) each year in the United States. This review describes ED evaluation, therapies and the identification of patients who require urgent urologic intervention, with recommendations based on clinical trials; on guidelines from the American College of Emergency Physicians (ACEP), American College of Radiology, and American Urologic Association; and on anecdotal experience.
AHRQ-funded; HS021281.
Citation: Wang RC .
Managing urolithiasis.
Ann Emerg Med 2016 Apr;67(4):449-54. doi: 10.1016/j.annemergmed.2015.10.021.
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Keywords: Diagnostic Safety and Quality, Emergency Department, Guidelines