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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 8 of 8 Research Studies DisplayedSchoenfeld EM, Poronsky KE, Westafer LM
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Both ultrasound and CT scan can be used for diagnosis of ureterolithiasis (or renal colic, the pain from an obstructing kidney stone), but the majority of patients receive a CT scan. Diagnostic pathways utilizing ultrasound have been shown to decrease radiation exposure to patients but are potentially less accurate. The investigators developed a decision aid to facilitate SDM in this scenario. The objective of this study was to determine the effects of this decision aid, as compared to usual care, on patient knowledge, radiation exposure, engagement, safety, and healthcare utilization.
AHRQ-funded; HS025701.
Citation: Schoenfeld EM, Poronsky KE, Westafer LM .
Feasibility and efficacy of a decision aid for emergency department patients with suspected ureterolithiasis: protocol for an adaptive randomized controlled trial.
Trials 2021 Mar 10;22(1):201. doi: 10.1186/s13063-021-05140-9..
Keywords: Emergency Department, Shared Decision Making, Kidney Disease and Health, Imaging, Diagnostic Safety and Quality
Shah PK, Yan PL, Dauw CA
Emergency department switching and duplicate computed tomography scans in patients with kidney stones.
The researchers measured the association between emergency department (ED) switching during a kidney stone episode and receipt of a repeat computed tomography (CT) scan. They found that 12% of patients who received a CT scan at their initial ED encounter had a revisit within 30 days of discharge. One-third of their revisits were made to a different ED than the iniital one. Duplicate CT scans were obtained at nearly 40% of all revisits. The risk of receiving a repeat CT was 12% higher if this revisit was made to a different ED. They concluded that their findings support the role of better health information exchange among providers to help reduce waste in the health-care system.
AHRQ-funded; HS024525; HS024728.
Citation: Shah PK, Yan PL, Dauw CA .
Emergency department switching and duplicate computed tomography scans in patients with kidney stones.
Urology 2018 Apr;114:41-44. doi: 10.1016/j.urology.2018.01.013.
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Keywords: Emergency Department, Imaging, Kidney Disease and Health
Weisenthal K, Karthik P, Shaw M
Evaluation of kidney stones with reduced-radiation dose CT: progress from 2011-2012 to 2015-2016-not there yet.
Researchers determined if the use of reduced-dose computed tomography (CT) for evaluation of kidney stones increased in 2015-2016 compared with that in 2011-2012. Use of reduced-radiation dose CT for evaluation of kidney stones has increased, but remains low; variability of radiation dose according to facility continues to be wide. National mean CT radiation exposure for evaluation of renal colic during 2015-2016 decreased relative to 2011-2012 values.
AHRQ-funded; HS023778.
Citation: Weisenthal K, Karthik P, Shaw M .
Evaluation of kidney stones with reduced-radiation dose CT: progress from 2011-2012 to 2015-2016-not there yet.
Radiology 2018 Feb;286(2):581-89. doi: 10.1148/radiol.2017170285.
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Keywords: Imaging, Kidney Disease and Health
Wang RC, Rodriguez RM, Moghadassi M
External validation of the STONE score, a clinical prediction rule for ureteral stone: an observational multi-institutional study.
The STONE score is a clinical decision rule that classifies patients with suspected nephrolithiasis into low-, moderate-, and high-score groups, with corresponding probabilities of ureteral stone. The researchers evaluated the STONE score compared with physician gestalt. They concluded that in its present form, the STONE score lacks sufficient accuracy to allow clinicians to defer CT scan for suspected ureteral stone.
AHRQ-funded; HS021281; HS019312.
Citation: Wang RC, Rodriguez RM, Moghadassi M .
External validation of the STONE score, a clinical prediction rule for ureteral stone: an observational multi-institutional study.
Ann Emerg Med 2016 Apr;67(4):423-32.e2. doi: 10.1016/j.annemergmed.2015.08.019.
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Keywords: Shared Decision Making, Diagnostic Safety and Quality, Imaging, Kidney Disease and Health, Practice Patterns
Daniels B, Gross CP, Molinaro A
STONE PLUS: evaluation of emergency department patients with suspected renal colic, using a clinical prediction tool combined with point-of-care limited ultrasonography.
This study sought to determine whether renal point-of-care limited ultrasonography (PLUS) used in conjunction with the Sex, Timing, Origin, Nausea, Erythrocytes (STONE) clinical prediction score can aid identification of emergency department (ED) patients with uncomplicated ureteral stone or need for urologic intervention. It concluded that hydronephrosis on renal PLUS modestly improved risk stratification in low- and moderate-risk STONE score patients.
AHRQ-funded; HS018322.
Citation: Daniels B, Gross CP, Molinaro A .
STONE PLUS: evaluation of emergency department patients with suspected renal colic, using a clinical prediction tool combined with point-of-care limited ultrasonography.
Ann Emerg Med 2016 Apr;67(4):439-48. doi: 10.1016/j.annemergmed.2015.10.020.
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Keywords: Shared Decision Making, Emergency Department, Imaging, Kidney Disease and Health
Eng J, Wilson RF, Subramaniam RM
Comparative effect of contrast media type on the incidence of contrast-induced nephropathy: a systematic review and meta-analysis.
This review compared contrast-induced nephropathy (CIN) risk for contrast media within and between osmolality classes in patients receiving diagnostic or therapeutic imaging procedures. No differences were found in CIN risk among types of low-osmolar contrast media (LOCM). Iodixanol had a slightly lower risk for CIN than LOCM, but the lower risk did not exceed a criterion for clinical importance.
AHRQ-funded; 290201200007I.
Citation: Eng J, Wilson RF, Subramaniam RM .
Comparative effect of contrast media type on the incidence of contrast-induced nephropathy: a systematic review and meta-analysis.
Ann Intern Med 2016 Mar 15;164(6):417-24. doi: 10.7326/m15-1402.
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Keywords: Comparative Effectiveness, Imaging, Risk, Kidney Disease and Health, Adverse Events
Moore CL, Daniels B, Ghita M
Accuracy of reduced-dose computed tomography for ureteral stones in emergency department patients.
The researchers compared the sensitivity and specificity of reduced-dose computed tomography (CT) for diagnosis of clinically important urologic causes of kidney stones likely to require intervention within a 90-day follow-up period. In 201 patients with a range of body mass indexes who received both regular and reduced dose scans contemporaneously, reduced-dose CT were 96% sensitive for stones requiring intervention.
AHRQ-funded; HS018322.
Citation: Moore CL, Daniels B, Ghita M .
Accuracy of reduced-dose computed tomography for ureteral stones in emergency department patients.
Ann Emerg Med 2015 Feb;65(2):189-98.e2. doi: 10.1016/j.annemergmed.2014.09.008..
Keywords: Emergency Medical Services (EMS), Emergency Department, Kidney Disease and Health, Imaging
Valencia V, Moghadassi M, Kriesel DR
Study of Tomography Of Nephrolithiasis Evaluation (STONE): methodology, approach and rationale.
This paper describes the rationale and methods of STONE (Study of Tomography Of Nephrolithiasis Evaluation), a pragmatic randomized comparative effectiveness trial comparing different imaging strategies for patients with suspected urolithiasis. It concluded that the detailed methodology of STONE will provide a roadmap for comparative effectiveness studies of diagnostic imaging conducted in an ED setting.
AHRQ-funded; HS019312.
Citation: Valencia V, Moghadassi M, Kriesel DR .
Study of Tomography Of Nephrolithiasis Evaluation (STONE): methodology, approach and rationale.
Contemp Clin Trials 2014 May;38(1):92-101. doi: 10.1016/j.cct.2014.03.006..
Keywords: Comparative Effectiveness, Imaging, Kidney Disease and Health, Research Methodologies