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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 11 of 11 Research Studies DisplayedStarnes LS, Starnes JR, Stopczynski T
Clinical prediction model: multisystem inflammatory syndrome in children versus Kawasaki disease.
This study aimed to develop a prediction model to differentiate between multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD). Using retrospective and prospective cohort data, a logistic regression model was developed, incorporating factors such as age, laboratory values, and clinical indicators. The model showed excellent discrimination (AUC 0.96) and calibration. It offers potential usefulness in aiding the diagnosis of MIS-C but requires further validation.
AHRQ-funded; HS026122.
Citation: Starnes LS, Starnes JR, Stopczynski T .
Clinical prediction model: multisystem inflammatory syndrome in children versus Kawasaki disease.
J Hosp Med 2024 Mar; 19(3):175-84. doi: 10.1002/jhm.13290.
Keywords: Children/Adolescents, Respiratory Conditions, COVID-19, Chronic Conditions
Cuca YP, Horvat C, Corless IB IB
The social, mental, and physical health impacts of the COVID-19 pandemic on people with HIV: protocol of an observational international multisite study.
The authors described the protocol for an international multisite observational study based on the SPIRIT guidelines to examine impact on the health and HIV outcomes for immunocompromised individuals such as people with HIV (PWH) from COVID-19 and from the strategies enacted to contain it. Investigators will recruit PWH to complete the study online or in-person. Study questions will address demographics, HIV continuum of care indicators, mental and social health, COVID-19 and vaccination knowledge, attitudes, behaviors, and fears; and overall outcomes. Results of this study can inform responses to future public health crises to minimize impacts on vulnerable populations such as PWH.
AHRQ-funded; HS028523.
Citation: Cuca YP, Horvat C, Corless IB IB .
The social, mental, and physical health impacts of the COVID-19 pandemic on people with HIV: protocol of an observational international multisite study.
J Assoc Nurses AIDS Care 2024 Jan-Feb; 35(1):60-74. doi: 10.1097/jnc.0000000000000444..
Keywords: COVID-19, Human Immunodeficiency Virus (HIV), Chronic Conditions
Reeves SL, Patel PN, Madden B
Telehealth use before and during the COVID-19 pandemic among children with sickle cell anemia.
This study’s goal was to determine telehealth use before and during the COVID pandemic for children ages 1-17 years old with sickle cell anemia (SCA). The authors identified children with SCA continuously enrolled in Michigan Medicaid from January 2019 to December 2020. The study population consisted of 493 children with SCA with a mean age of 8.7 years at study entry. Pre-pandemic there were 4,367 outpatient visits, with all but 19 in-person. Telehealth visits peaked in April 2020 and then began declining. The majority of telehealth visits were with hematologists, followed up adult subspecialists (27%) and pediatrics/family medicine.
AHRQ-funded; HS027632.
Citation: Reeves SL, Patel PN, Madden B .
Telehealth use before and during the COVID-19 pandemic among children with sickle cell anemia.
Telemed J E Health 2022 Aug;28(8):1166-71. doi: 10.1089/tmj.2021.0132..
Keywords: Children/Adolescents, COVID-19, Telehealth, Health Information Technology (HIT), Sickle Cell Disease, Chronic Conditions, Access to Care
Semere W, Makaroun LK, Beach S
Family caregivers navigating the health care system: evolving roles during the COVID-19 pandemic.
The purpose of this study was to explore changes in the ways family caregivers assisted family members with chronic illness and disability in addressing their health care needs during the COVID-19 pandemic. The researchers administered telephone and online surveys to family caregivers who were listed in a regional research registry, asking them what level of helping they provided during the pandemic compared to the level they were providing prior to the pandemic. The study found that of the 561caregivers that responded to the survey, 59% reported an increase in providing help with 1 or more heath care activities. The researchers advise that for caregivers assisting vulnerable patients to access care, support strategies should be considered by the health system and health care providers.
AHRQ-funded; HS027844.
Citation: Semere W, Makaroun LK, Beach S .
Family caregivers navigating the health care system: evolving roles during the COVID-19 pandemic.
Fam Syst Health 2022 Jun;40(2):268-73. doi: 10.1037/fsh0000688..
Keywords: Caregiving, COVID-19, Chronic Conditions
Roberts JE, Campbell JI, Gauvreau K
Differentiating multisystem inflammatory syndrome in children: a single-centre retrospective cohort study.
This study’s objective was to identify clinical and laboratory findings that distinguished multisystem inflammatory syndrome in children (MIS-C) from febrile illnesses in which MIS-C was considered but ultimately excluded, and to examine the diseases that most often mimicked MIS-C in a tertiary medical center. All children who were hospitalized at the author’s center with fever were evaluated for MIS-C and were compared for clinical signs and symptoms, SARS-CoV-2 status, and laboratory studies between those with and without MIS-C. The authors identified 50 confirmed MIS-C cases (MIS-C(+)) and 68 children evaluated for, but ultimately not diagnosed with, MIS-C (MIS-C(-)). Symptoms of conjunctivitis, abdominal pain, fatigue, hypoxaemia, tachypnoea and hypotension at presentation were significantly more common among MIS-C(+) patients, with MIS-C(+) and MIS-C(-) patients having similar elevations in C-reactive protein (CRP), but were differentiated by thrombocytopenia, lymphopenia, and elevated ferritin, neutrophil/lymphocyte ratio, BNP and troponin. Children hospitalized with MIS-C were older, more likely to present with conjunctivitis, oral mucosa changes, abdominal pain and hypotension, and had higher neutrophil/lymphocyte ratios and lower platelet counts.
AHRQ-funded; HS000063.
Citation: Roberts JE, Campbell JI, Gauvreau K .
Differentiating multisystem inflammatory syndrome in children: a single-centre retrospective cohort study.
Arch Dis Child 2022 Mar; 107(3):e3. doi: 10.1136/archdischild-2021-322290..
Keywords: Children/Adolescents, COVID-19, Chronic Conditions, Diagnostic Safety and Quality
Choi K, Becerra-Culqui T, Bhakta B
Parent intentions to vaccinate children with autism spectrum disorder against COVID-19.
This study’s purpose was to investigate associations between parent vaccine confidence and intentions to have their child with autism vaccinated with the COVID-19 vaccine. A cross-sectional, web-based survey of 332 parents of children with autism spectrum disorder who were members of an integrated healthcare system in Southern California was conducted from May to July 2021. Approximately 35% of parents were going to vaccinate their child against COVID-19. Positive vaccine beliefs, healthcare provider trust, or parent vaccination status were associated with intention to vaccinate.
AHRQ-funded; HS026407.
Citation: Choi K, Becerra-Culqui T, Bhakta B .
Parent intentions to vaccinate children with autism spectrum disorder against COVID-19.
J Pediatr Nurs 2022 Mar-Apr;63:108-10. doi: 10.1016/j.pedn.2021.11.019..
Keywords: Children/Adolescents, COVID-19, Vaccination, Autism, Chronic Conditions
Misra-Hebert AD, Hu B, Pantalone KM
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
This study sought to examine factors associated with total and virtual primary care use for patients with type 2 diabetes (T2D) during the COVID-19 pandemic. This study used electronic medical records in the Cleveland Clinic Health System comparing prepandemic use from August 2019 to March 2020 (baseline period 0) to two pandemic periods: March to June 2020 (period 1) when in-person visits were converted to virtual; and July to November 2020 when in-person visits resumed (period 2). Demographic characteristics were obtained including age, sex, race, insurance type, median income estimated by zip code and baseline HbA1C. The study included 76,015 patients with T2D who completed a primary care visit in baseline period 0. Cohort median age was 66.2 years, 50.7% women, 21.7% Black, 71.0% White and 7.4 Other. Insurance distribution was 43.2% private, 46.5% Medicare, and 9.5% Medicaid. Median income was estimated at $59,000 and baseline HbA1C was ≤ 7% for 59.6% of patients. There were higher odds of Black patients, those with uncontrolled T2D, and those with Medicare and Medicare using virtual visits during the 2 postpandemic periods suggesting that virtual visits may be a preference for those groups. Older and male patients had lower odds of visit completion.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Pantalone KM .
Primary care health care use for patients with type 2 diabetes during the COVID-19 pandemic.
Diabetes Care 2021 Sep;44(9):e173-e74. doi: 10.2337/dc21-0853..
Keywords: COVID-19, Diabetes, Primary Care, Telehealth, Health Information Technology (HIT), Healthcare Delivery, Access to Care, Chronic Conditions
Kim D, Lee Y, Thorsness R
Racial and ethnic disparities in excess deaths among persons with kidney failure during the COVID-19 pandemic, March-July 2020.
This national study estimated excess deaths for the kidney failure population by race and ethnicity from March 1 through August 1, 2020. Findings showed that, among the US kidney failure population, the number of excess deaths was 16% higher than expected, similar to reports for the general population. However, results showed that the relative increase in deaths among Black and Hispanic patients was more than 4-fold higher than that observed among White patients. The magnitude of these disparities was larger than corresponding relative ratios reported among COVID-19–associated deaths in the general population.
AHRQ-funded; HS028285.
Citation: Kim D, Lee Y, Thorsness R .
Racial and ethnic disparities in excess deaths among persons with kidney failure during the COVID-19 pandemic, March-July 2020.
Am J Kidney Dis 2021 May;77(5):827-29. doi: 10.1053/j.ajkd.2021.02.003..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Mortality, Kidney Disease and Health, Chronic Conditions, Social Determinants of Health
Nair D, Malhotra S, Lupu D
Challenges in communication, prognostication and dialysis decision-making in the COVID-19 pandemic: implications for interdisciplinary care during crisis settings.
This paper uses case vignettes to highlight challenges in communication, prognostication, and medical decision-making that have been exacerbated by the COVD-19 pandemic for patients with kidney disease. The authors include best practice recommendations to mitigate those issues and conclude with implications for interdisciplinary models of care in crisis settings. Concerns about certain biomarkers, demographics, and medical comorbidities that can predict an increased risk for mortality among patients with COVID-19 and kidney disease are discussed, because there may be communication barriers related to physical exposure and conservation of personal protective equipment with those at-risk patients.
AHRQ-funded; HS026395.
Citation: Nair D, Malhotra S, Lupu D .
Challenges in communication, prognostication and dialysis decision-making in the COVID-19 pandemic: implications for interdisciplinary care during crisis settings.
Curr Opin Nephrol Hypertens 2021 Mar 1;30(2):190-97. doi: 10.1097/mnh.0000000000000689..
Keywords: COVID-19, Dialysis, Kidney Disease and Health, Shared Decision Making, Clinician-Patient Communication, Communication, Chronic Conditions
Bramante CT, Ingraham NE, Murray TA
Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis.
This study examined whether metformin use by patients with diagnosed with type 2 diabetes had reduced mortality when hospitalized for COVID-19. Pharmacy claims data from UnitedHealth Group’s Clinical Discovery Claims Database was used. Patient data were included if they were aged 18 years or older; had type 2 diabetes or obesity (defined based on claims); at least 6 months of continuous enrolment in 2019; and admission to hospital for COVID-19 confirmed by PCR; manual chart review by UHG; or reported from the hospital to UHG. Metformin was not associated with significant reduction in mortality among men, but there was an association with decreased mortality in women.
AHRQ-funded; HS026379.
Citation: Bramante CT, Ingraham NE, Murray TA .
Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis.
Lancet Healthy Longev 2021 Jan;2(1):e34-e41. doi: 10.1016/s2666-7568(20)30033-7..
Keywords: COVID-19, Hospitalization, Medication, Mortality, Risk, Diabetes, Chronic Conditions, Public Health, Infectious Diseases
Gelfand JM, Armstrong AW, Bell S
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
This article describes the process that was used to create the first version of a guidance document for management of psoriatic disease during the COVID-19 pandemic developed by the National Psoriasis Foundation. A task force of 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care was created with supplementation by nonvoting members. A Delphi process was created, out of which 22 guidance statements were approved. All guidance statements were recommended, with 9 of them high consensus, and the remaining 13 were moderate consensus. Topics covered included how COVID-19 can impact patients, how medical care can be optimized during the pandemic, and what patients can do to lower their risk of getting infected with COVID-19. This guidance will be updated by the TF as new data emerges.
AHRQ-funded; HS026372.
Citation: Gelfand JM, Armstrong AW, Bell S .
National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Vversion 1.
J Am Acad Dermatol 2020 Dec;83(6):1704-16. doi: 10.1016/j.jaad.2020.09.001..
Keywords: Skin Conditions, Chronic Conditions, Care Management, Evidence-Based Practice, Guidelines, COVID-19