National Healthcare Quality and Disparities Report
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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
51 to 75 of 366 Research Studies DisplayedChou R, Pappas M, Dana T
Screening and interventions to prevent dental caries in children younger than 5 years: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this evidence review was to update the 2014 review on dental caries screening and preventive interventions to inform the USPSTF. Findings showed no direct evidence on benefits and harms of primary care oral health screening or referral to dentist, while dietary fluoride supplementation and fluoride varnish were associated with improved caries outcomes in higher-risk children and settings.
AHRQ-funded; 290201500009I.
Citation: Chou R, Pappas M, Dana T .
Screening and interventions to prevent dental caries in children younger than 5 years: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Dec 7;326(21):2179-92. doi: 10.1001/jama.2021.15658..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Dental and Oral Health, Screening, Evidence-Based Practice, Guidelines, Prevention
Razon N, Hessler D, Bibbins-Domingo K
How hypertension guidelines address social determinants of health: a systematic scoping review.
Patient-level and community-level social and economic conditions impact hypertension risk and control. In this study, the investigators examined adult hypertension management guidelines to explore whether and how existing guidelines refer to social care activities. The investigators concluded that information about social determinants of health is included in many hypertension guidelines, but few guidelines provide clear guidance for clinicians or health systems on how to identify and address social risk factors in the context of care delivery.
AHRQ-funded; HS022241.
Citation: Razon N, Hessler D, Bibbins-Domingo K .
How hypertension guidelines address social determinants of health: a systematic scoping review.
Med Care 2021 Dec;59(12):1122-29. doi: 10.1097/mlr.0000000000001649..
Keywords: Social Determinants of Health, Guidelines, Evidence-Based Practice, Blood Pressure
Greenwald E, Olds E, Leonard J
Pediatric sepsis in community emergency care settings: guideline concordance and outcomes.
The authors sought to describe the rate of guideline-concordant care, and hypothesized that guideline-concordant care in community pediatric emergency care settings would be associated with decreased hospital length of stay (LOS). They found that guideline-concordant care was not associated with hospital LOS. The elements that drove overall concordance were timely recognition, vascular access, and timely antibiotics. Emergency care for pediatric sepsis in the community settings studied was concordant with guidelines in only 24% of the cases. They recommended future study to evaluate additional drivers of outcomes and ways to improve sepsis care in community emergency care settings.
AHRQ-funded; HS025696.
Citation: Greenwald E, Olds E, Leonard J .
Pediatric sepsis in community emergency care settings: guideline concordance and outcomes.
Pediatr Emerg Care 2021 Dec;37(12):e1571-e77. doi: 10.1097/pec.0000000000002120..
Keywords: Children/Adolescents, Sepsis, Emergency Department, Guidelines, Evidence-Based Practice
Mills J, Mohnot S
AHRQ Author: Mills J
Screening for gestational diabetes.
This “Putting Prevention into Practice: An Evidence Based Approach” paper is a case study with questions and answers related to a patient with gestational diabetes.
AHRQ-authored.
Citation: Mills J, Mohnot S .
Screening for gestational diabetes.
Am Fam Physician 2021 Dec 1;104(6):641-42..
Keywords: U.S. Preventive Services Task Force (USPSTF), Diabetes, Pregnancy, Screening, Prevention, Women, Evidence-Based Practice, Guidelines, Case Study
Caughey AB, Krist AH, Wolff TA
AHRQ Author: Wolff TA
USPSTF approach to addressing sex and gender when making recommendations for clinical preventive services.
The USPSTF reviewed its past recommendations that included the use of sex and gender terms, reviewed the approaches of other guideline-making bodies, and pilot-tested strategies to address sex and gender diversity. Based on the findings, the USPSTF intends to use an inclusive approach to identify issues related to sex and gender at the start of the guideline development process; assess the applicability, variability, and quality of evidence as a function of sex and gender; ensure clarity in the use of language regarding sex and gender; and identify evidence gaps related to sex and gender. The USPSTF recognizes limited evidence to inform the preventive care of populations based on gender identity.
AHRQ-authored.
Citation: Caughey AB, Krist AH, Wolff TA .
USPSTF approach to addressing sex and gender when making recommendations for clinical preventive services.
JAMA 2021 Nov 16;326(19):1953-61. doi: 10.1001/jama.2021.15731..
Keywords: U.S. Preventive Services Task Force (USPSTF), Guidelines, Evidence-Based Practice, Prevention, Research Methodologies
Yao L, Ahmed MM, Guyatt GH
Discordant and inappropriate discordant recommendations in consensus and evidence based guidelines: empirical analysis.
The purpose of this study was to investigate whether alignment of strength of recommendations with quality of evidence differs in consensus based versus evidence based guidelines. The investigators concluded that consensus based guidelines produced more recommendations violating the evidence based medicine principles than evidence based guidelines. They suggested that ensuring appropriate alignment of quality of evidence with the strength of recommendations is key to the development of "trustworthy" guidelines.
AHRQ-funded; HS024917.
Citation: Yao L, Ahmed MM, Guyatt GH .
Discordant and inappropriate discordant recommendations in consensus and evidence based guidelines: empirical analysis.
BMJ 2021 Nov 25;375:e066045. doi: 10.1136/bmj-2021-066045..
Keywords: Guidelines, Evidence-Based Practice, Research Methodologies
Tracer H, West R
AHRQ Author: Tracer H
Screening for vitamin D deficiency in adults.
This case study in the “Putting Prevention into Practice: An Evidence Based Approach” series focuses on screening for vitamin D deficiency in adults. It includes a case study, questions, and answers.
AHRQ-authored.
Citation: Tracer H, West R .
Screening for vitamin D deficiency in adults.
Am Fam Physician 2021 Nov 1;104(5):515-16..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Prevention, Guidelines, Evidence-Based Practice, Case Study
Davidson KW, Krist AH, Tseng CW
AHRQ Author: Mills J, Borsky A
Incorporation of social risk in US Preventive Services Task Force Recommendations and identification of key challenges for primary care.
The authors assessed how social risks have been considered in USPSTF recommendation statements and identified current gaps in evidence needed to expand the systematic inclusion of social risks in future recommendations. They concluded that their report serves as a benchmark and foundation for ongoing work to advance the goal of ensuring that health equity and social risks are incorporated into USPSTF methods and recommendations.
AHRQ-authored.
Citation: Davidson KW, Krist AH, Tseng CW .
Incorporation of social risk in US Preventive Services Task Force Recommendations and identification of key challenges for primary care.
JAMA 2021 Oct 12;326(14):1410-15. doi: 10.1001/jama.2021.12833..
Keywords: U.S. Preventive Services Task Force (USPSTF), Primary Care, Social Determinants of Health, Risk, Evidence-Based Practice, Research Methodologies, Guidelines
Mills J, O'Dowd N
AHRQ Author: Mills J
Healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
This “Putting Prevention into Practice: An Evidence Based Approach” paper is a case study with questions and answers related to healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
AHRQ-authored.
Citation: Mills J, O'Dowd N .
Healthy diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors.
Am Fam Physician 2021 Oct 1;104(4):411-12..
Keywords: U.S. Preventive Services Task Force (USPSTF), Heart Disease and Health, Cardiovascular Conditions, Prevention, Lifestyle Changes, Risk, Evidence-Based Practice, Guidelines, Case Study
Bierman AS, Wang J, O'Malley PG
AHRQ Author: Bierman AS, Wang J, O'Malley PG, Moss DK
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
This article describes issues addressing the needs of those with multiple chronic conditions and discusses the AHRQ research agenda.
AHRQ-authored.
Citation: Bierman AS, Wang J, O'Malley PG .
Transforming care for people with multiple chronic conditions: Agency for Healthcare Research and Quality's research agenda.
Health Serv Res 2021 Oct;56(Suppl 1):973-79. doi: 10.1111/1475-6773.13863..
Keywords: Chronic Conditions, Health Services Research (HSR), Healthcare Delivery, Quality of Care, Primary Care, Guidelines, Evidence-Based Practice
Cantor A, Dana T, Griffin JC
Screening for chlamydial and gonococcal infections: updated evidence report and systematic review for the US Preventive Services Task Force.
This is the evidence summary and updated review for the September 2021 U.S. Preventive Services Task Force final recommendation on screening for chlamydial and gonococcal infections among sexually active women 25 years or older and sexually active men. The Task Force concluded that for women screening is recommended, but for men the current evidence is insufficient to assess the balance of benefits and harms. This systematic review screened over 2200 articles and included 20 articles. The articles included helped to answer the 4 key questions that were included in the research plan.
AHRQ-funded; 290201500009I.
Citation: Cantor A, Dana T, Griffin JC .
Screening for chlamydial and gonococcal infections: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Sep 14;326(10):957-66. doi: 10.1001/jama.2021.10577..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sexual Health, Infectious Diseases, Screening, Evidence-Based Practice, Guidelines, Prevention
Trent SA, George N, Havranek EP
Established evidence-based treatment guidelines help mitigate disparities in quality of emergency care.
Evidence-based guidelines are often cited as a means of ensuring high-quality care for all patients. The objective of this study was to assess whether emergency department (ED) adherence to core evidence-based guidelines differed by patient sex and race/ethnicity and to assess the effect of ED guideline adherence on patient outcomes by sex and race/ethnicity. The investigators concluded that longstanding, nationally reported evidence-based guidelines can help eliminate sex and race/ethnicity disparities in quality of care.
AHRQ-funded; HS022400.
Citation: Trent SA, George N, Havranek EP .
Established evidence-based treatment guidelines help mitigate disparities in quality of emergency care.
Acad Emerg Med 2021 Sep;28(9):1051-60. doi: 10.1111/acem.14235..
Keywords: Evidence-Based Practice, Guidelines, Emergency Department, Disparities, Quality of Care
Schondelmeyer AC, Bettencourt AP, Xiao R
Evaluation of an educational outreach and audit and feedback program to reduce continuous pulse oximetry use in hospitalized infants with stable bronchiolitis: a nonrandomized clinical trial.
National guidelines recommend against continuous pulse oximetry use for hospitalized children with bronchiolitis who are not receiving supplemental oxygen, yet guideline-discordant use remains high. The objective of this study was to evaluate deimplementation outcomes of educational outreach and audit and feedback strategies aiming to reduce guideline-discordant continuous pulse oximetry use in children hospitalized with bronchiolitis who are not receiving supplemental oxygen.
AHRQ-funded; HS026763.
Citation: Schondelmeyer AC, Bettencourt AP, Xiao R .
Evaluation of an educational outreach and audit and feedback program to reduce continuous pulse oximetry use in hospitalized infants with stable bronchiolitis: a nonrandomized clinical trial.
JAMA Netw Open 2021 Sep;4(9):e2122826. doi: 10.1001/jamanetworkopen.2021.22826..
Keywords: Newborns/Infants, Hospitalization, Guidelines, Practice Patterns, Training, Respiratory Conditions
Fan T, Stefanos R
AHRQ Author: Fan T
Screening for colorectal cancer.
This AHRQ-authored Putting Preventions in Practice quiz has three questions and answers on the US Preventive Services Task Force final recommendation on screening for colorectal cancer. A case study is presented with questions on the best behavioral interventions, the effect of a patient’s age on the counseling approach, and what is an appropriate test and interval for colorectal screening. References are also provided at the end of the answers.
AHRQ-authored.
Citation: Fan T, Stefanos R .
Screening for colorectal cancer.
Am Fam Physician 2021 Sep 1;104(3):295-96..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Colorectal Cancer, Cancer, Screening, Prevention, Guidelines, Evidence-Based Practice, Case Study
Pillay J, Donovan L, Guitard S
Screening for gestational diabetes: updated evidence report and systematic review for the US Preventive Services Task Force.
The objective of this study was to update the 2012 review on screening for gestational diabetes to inform the US Preventive Services Task Force. The investigators concluded that direct evidence on screening vs no screening remained limited. One- vs 2-step screening was not significantly associated with improved health outcomes. At or after 24 weeks of gestation, treatment of gestational diabetes was significantly associated with improved health outcomes.
Citation: Pillay J, Donovan L, Guitard S .
Screening for gestational diabetes: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Aug 10;326(6):539-62. doi: 10.1001/jama.2021.10404..
Keywords: U.S. Preventive Services Task Force (USPSTF), Diabetes, Pregnancy, Screening, Evidence-Based Practice, Women, Prevention, Guidelines
Marin JR, Rodean J, Mannix RC
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
The objective of this study was to examine whether the presence of clinical guidelines and clinical decision support (CDS) for mild traumatic brain injury (mTBI) were associated with lower head computed tomography (CT) use. The investigators concluded that clinical guidelines for mTBI, and particularly CDS, were associated with lower rates of head CT use without adverse clinical outcomes.
AHRQ-funded; HS026006.
Citation: Marin JR, Rodean J, Mannix RC .
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
J Pediatr 2021 Aug;235:178-83.e1. doi: 10.1016/j.jpeds.2021.04.026..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Shared Decision Making, Health Information Technology (HIT), Brain Injury, Guidelines, Evidence-Based Practice, Imaging
Djulbegovic B, Hozo I, Li SA
Certainty of evidence and intervention's benefits and harms are key determinants of guidelines' recommendations.
This study’s goal was to identify the key determinants of clinical guideline development. This study used a web-based survey of 12 panels of 153 “voting” members who issued 2941 recommendations and a qualitative analysis of 13 panels of 311 attendees. When intervention’s benefits outweigh harms compared with no recommendations: the probability of issuing strong recommendations in favor of intervention was 0.22 when certainty of evidence (CoE) was very low; 0.5 when low; 0.74 when moderate, and 0.85 when high. No other factor significantly affected recommendations. Panelists spent over 50% of their time debating CoE with the chairs and co-chairs dominating discussion.
AHRQ-funded; HS024917.
Citation: Djulbegovic B, Hozo I, Li SA .
Certainty of evidence and intervention's benefits and harms are key determinants of guidelines' recommendations.
J Clin Epidemiol 2021 Aug;136:1-9. doi: 10.1016/j.jclinepi.2021.02.025..
Keywords: Evidence-Based Practice, Guidelines, Research Methodologies, Shared Decision Making
Darling KE, Warnick J, Hadley W
Reactions to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity: a multi-informant qualitative approach.
This study measured reactions by adolescents, parents, and physicians to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity. The guidelines recommended those identified should be referred to comprehensive weight management programs consisting of at least 26 contact hours and focus on multiple targets of behavior. In-depth interviews were conducted with 7 adolescents, 7 parents, and 4 physicians. In general, participants viewed the guidelines positively but identified changes that may be necessary to increase the feasibility of adolescents engaging in programs that meet these guidelines. Participants also noted the importance of flexibility within programs.
AHRQ-funded; HS02707.
Citation: Darling KE, Warnick J, Hadley W .
Reactions to the U.S. Preventive Services Task Force guidelines for the management of adolescent obesity: a multi-informant qualitative approach.
Clin Obes 2021 Aug;11(4):e12451. doi: 10.1111/cob.12451..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Obesity, Guidelines, Evidence-Based Practice
Fan T, Tan M
AHRQ Author: Fan T
Screening for hypertension in adults.
This Putting Prevention into Practice case study involves a 23-year-old patient presenting for a wellness visit with no concerns. The patient’s medical record shows a history of polycystic ovary syndrome, blood pressure of 110/70 mm Hg from a visit one year ago, and a body mass index of 28.2. Three questions are presented, along with answers.
AHRQ-authored.
Citation: Fan T, Tan M .
Screening for hypertension in adults.
Am Fam Physician 2021 Aug 1;104(2):193-94..
Keywords: U.S. Preventive Services Task Force (USPSTF), Blood Pressure, Screening, Evidence-Based Practice, Guidelines, Prevention, Case Study
Silverstein M, Kemper AR, Henderson JT
AHRQ Author: Mabry-Hernandez I
Importance of assessing wellbeing for United States Preventive Services Task Force recommendations.
The investigators discuss the importance of assessing wellbeing for United States Preventive Services Task Force recommendations despite the current data limitations. They discuss the pathway out of the current limitations of the data on meaningful health outcomes for child and adolescent preventive services. They assert that developing measures of subjective wellbeing for children and families and deploying them at appropriate time intervals in prevention trials offers a promising, although admittedly challenging, pathway out of the child health evidence void.
AHRQ-authored.
Citation: Silverstein M, Kemper AR, Henderson JT .
Importance of assessing wellbeing for United States Preventive Services Task Force recommendations.
Pediatrics 2021 Jul;148(Suppl 1):s37-s39. doi: 10.1542/peds.2021-050693H..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Evidence-Based Practice, Guidelines, Screening, Prevention
Hochheimer CJ, Sabo RT, Tong ST
Practice, clinician, and patient factors associated with the adoption of lung cancer screening.
This study sought to assess lung cancer screening uptake in three health systems. Findings showed that certain patients appeared more likely to be screened. Of the three systems studied, the only one with increased lung cancer screening explicitly promoted screening rather than relying on clinicians to implement the new 2013 USPSTF guideline.
AHRQ-funded; HS025032.
Citation: Hochheimer CJ, Sabo RT, Tong ST .
Practice, clinician, and patient factors associated with the adoption of lung cancer screening.
J Med Screen 2021 Jun;28(2):158-62. doi: 10.1177/0969141320937326..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Guidelines
McDonald MV, Brickner C, Russell D
Observation of hand hygiene practices in home health care.
The purpose of this observational study was to describe nurse hand hygiene practices in the home health care (HHC) setting, nurse adherence to hand hygiene guidelines, and factors associated with hand hygiene opportunities during home care visits. The investigators concluded that hand hygiene adherence in HHC was suboptimal, with rates mirroring those reported in hospital and outpatient settings.
AHRQ-funded; HS024723.
Citation: McDonald MV, Brickner C, Russell D .
Observation of hand hygiene practices in home health care.
J Am Med Dir Assoc 2021 May;22(5):1029-34. doi: 10.1016/j.jamda.2020.07.031..
Keywords: Home Healthcare, Nursing, Provider: Nurse, Provider, Prevention, Healthcare-Associated Infections (HAIs), Guidelines
Carey RM, Wright JT, Taler SJ
Guideline-driven management of hypertension: an evidence-based update.
This paper is an evidence-based update to the 2017 American College of Cardiology/American Heart Association Blood Pressure Guideline. The authors conducted a literature review of relevant observational studies, randomized clinical trials, and meta-analyses published between January 2018 and March 2021. Topics included blood pressure (BP) measurement, patient evaluation, patient evaluation for secondary hypertension, cardiovascular disease risk assessment and BP threshold for drug therapy, lifestyle and pharmacological management, treatment target BP goal, management of hypertension in older adults, diabetes, chronic kidney disease, resistant hypertension, and optimization of care using patient, provider, and health system approaches.
AHRQ-funded; HS027944.
Citation: Carey RM, Wright JT, Taler SJ .
Guideline-driven management of hypertension: an evidence-based update.
Circ Res 2021 Apr 2;128(7):827-46. doi: 10.1161/circresaha.121.318083..
Keywords: Blood Pressure, Guidelines, Evidence-Based Practice, Cardiovascular Conditions, Chronic Conditions
Tanabe P, Blewer AL, Bonnabeau E
Dissemination of evidence-based recommendations for sickle cell disease to primary care and emergency department providers in North Carolina: a cost benefit analysis.
Sickle cell disease (SCD) is a genetic condition affecting primarily individuals of African descent, who happen to be disproportionately impacted by poverty and who lack access to health care. Many providers do not feel prepared to care for individuals with SCD, despite the existence of evidence-based guidelines. The authors report the development of a SCD toolbox and the dissemination process to primary care and emergency department (ED) providers in North Carolina (NC). They report the effect of this dissemination on health-care utilization, cost of care, and overall cost-benefit.
AHRQ-funded; HS024501.
Citation: Tanabe P, Blewer AL, Bonnabeau E .
Dissemination of evidence-based recommendations for sickle cell disease to primary care and emergency department providers in North Carolina: a cost benefit analysis.
J Health Econ Outcomes Res 2021 Apr 1;8(1):18-28. doi: 10.36469/jheor.2021.21535..
Keywords: Sickle Cell Disease, Evidence-Based Practice, Guidelines, Primary Care, Emergency Department, Tools & Toolkits
Feltner C, Wallace IF, Kistler CE
Screening for hearing loss in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to update the evidence review on screening for hearing loss in adults 50 years or older to inform the US Preventive Services Task Force. Findings showed that several screening tests can adequately detect hearing loss in older adults, while no studies reported on the harms of screening or treatment. Further, evidence showing benefit from hearing aids on hearing-related function among adults with screen-detected or newly detected hearing loss is limited to studies enrolling veterans.
AHRQ-funded; 290201500011I.
Citation: Feltner C, Wallace IF, Kistler CE .
Screening for hearing loss in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2021 Mar 23;325(12):1202-15. doi: 10.1001/jama.2020.24855..
Keywords: U.S. Preventive Services Task Force (USPSTF), Elderly, Screening, Guidelines, Evidence-Based Practice, Prevention