Equity Focus Recommended in Development and Use of Algorithms in Healthcare

AHRQ Stats: Heart Disease Treatment by Annual Income

In 2020, 10.3 percent of adults who were classified as poor (with annual family incomes 125 percent below the federal poverty level [FPL] or lower) and 9.7 percent of those in low-income families (125 to 200 percent below FPL) received treatment for heart disease. These percentages were higher than the 8.2 percent of adults in middle-income families (200 percent below to 400 percent above FPL) and the 7.1 percent of those in high-income families (400 percent or more above FPL) receiving heart disease treatment. (Source: AHRQ Medical Expenditure Panel Survey Statistical Brief #550, Healthcare Expenditures for Heart Disease among Adults Aged 18 and Older in the U.S. Civilian Noninstitutionalized Population, 2020.)

Today's Headlines:

• Equity Focus Recommended in Development and Use of Algorithms in Healthcare.
• Family-Observed Quality and Safety Concerns Can Improve Hospital Care for Children With Medical Complexity.
• During National Primary Care Week, AHRQ Highlights Resources To Address Unhealthy Alcohol Use.
• Highlights From AHRQ’s Patient Safety Network.
• Deadline Extended to Oct. 27 for Entries to Patient Safety Tools Challenge Competition.
• Explore Careers at AHRQ.
• New Research and Evidence From AHRQ.
• AHRQ in the Professional Literature.

Equity Focus Recommended in Development and Use of Algorithms in Healthcare

A new commentary published in Health Affairs recommends adopting a “race-aware,” as opposed to the current “race-based,” approach to the development and use of algorithms in healthcare to reduce disparities and advance a more equitable health system. The authors, including Arlene Bierman, M.D., M.S., AHRQ’s chief strategy officer, and Tina Hernandez-Boussard, Ph.D., M.P.H., M.S., a former member of AHRQ’s National Advisory Council, describe concerns about racial and ethnic biases built into algorithms that guide clinical decision-making. Algorithms that use race as a proxy for biological differences can lead to treatment patterns that are inappropriate, unjust and harmful, they assert. The authors conclude that increasing the diversity of clinical trial populations, broadening the focus of precision medicine, improving education about the complex factors shaping health outcomes, and developing new guidelines and policies to enable culturally responsive care are important next steps. Access the commentary, which is part of a special Health Affairs issue, Tackling Structural Racism In Health.

Family-Observed Quality and Safety Concerns Can Improve Hospital Care for Children With Medical Complexity

Hospitals can improve the quality and safety of care for children with medical complexity by actively seeking family input, according to a study published in the Journal of Hospital Medicine and co-authored by an AHRQ-supported scholar. Children with complex medical conditions account for only 1 percent of the pediatric patient population but 30 percent of readmissions and 55 percent of inpatient costs. Researchers analyzed safety reporting surveys among families of children with complex medical needs to identify what their families saw as priorities for improving the safety and quality of care. Five themes emerged from the survey responses: unmet expectations of hospital care/environment, lack of consistency, provider-patient communication lapses, families’ expertise about care, and the value of transparency. Researchers concluded that soliciting and listening to patient/family expertise can improve the patient/family care experience and increase trust in providers and hospital systems. Access the abstract.

During National Primary Care Week, AHRQ Highlights Resources To Address Unhealthy Alcohol Use

As part of AHRQ’s EvidenceNOW: Managing Unhealthy Alcohol Use (UAU) Initiative, the agency has developed a searchable database of nearly 600 resources—including trainings, toolkits and publications—for use by providers, organizational leadership and patients. These resources aim to improve skills in the use of screening for UAU, brief intervention for those at risk, and medication therapy for alcohol use disorder. A final report (PDF, 10.8 MB) explains the process for identifying these resources and the issues primary care providers face when implementing screening, brief interventions, and/or referral to treatment. During National Primary Care Week, access the National Center for Excellence in Primary Care Research to learn more about AHRQ’s support for primary care.

Highlights From AHRQ’s Patient Safety Network

AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:

• Scaling up a diagnostic pause at the ICU-to-ward transition: an exploration of barriers and facilitators to implementation of the ICU-PAUSE handoff tool.
• The influence of hospital leadership support on burnout, psychological safety, and safety climate for US infection preventionists during the coronavirus disease 2019 (COVID-19) pandemic.
• Making a move: using simulation to identify latent safety threats before the care of injured patients in a new physical space.

Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).

Deadline Extended to Oct. 27 for Entries to Patient Safety Tools Challenge Competition

The deadline for entries into AHRQ’s challenge competition on effective use of the agency’s patient safety tools has been extended to Oct. 27. Up to 10 winners who describe how the use of patient safety resources resulted in measurable improvement will receive $10,000 each. The challenge is designed to provide AHRQ with a deeper understanding about how its tools are being used and to inform future efforts to advance safety improvement efforts. Access more details about the challenge.

Explore Careers at AHRQ

Join the team that strives to improve healthcare for all Americans by investing in health systems research, creating strategies to support practice improvement and providing data and analytics to identify opportunities for improvement. Current vacancies include:

• Supervisory Physician/Director, Division of Evidence-Based Practice Centers / Center for Evidence and Practice Improvement. Application deadline: Oct. 18.
• Health Scientist Administrator, Division of Digital Healthcare Research / Center for Evidence and Practice Improvement. Application deadline: Oct. 16.

New Research and Evidence From AHRQ

• Technical Brief (draft open for comment): Measuring Primary Healthcare Spending.
• Comparative Effectiveness Review (draft open for comment): Strategies for Integrating Behavioral Health and Primary Care.

AHRQ in the Professional Literature

Proof-of-concept study of artificial intelligence-assisted review of CBCT image guidance. Neylon J, Luximon DC, Ritter T, et al. J Appl Clin Med Phys 2023 Sep;24(9):e14016. Epub 2023 May 10. Access the abstract on PubMed®.

Five new ways to advance diagnostic safety in your clinical practice. Bradford A, Goeschel C, Shofer M, et al. Am Fam Physician 2023 Jul;108(1):14-16. Access the abstract on PubMed®.

Is more better? The impact of implementing more interventions for hypertension control in a practice facilitation study for small- and medium-sized practices. Ross SM, Wang A, Anthony L, et al. J Hum Hypertens 2023 Mar 22. [Epub ahead of print.] Access the abstract on PubMed®.

Effects of the physical environment on children and families in hospital-based emergency departments: a systematic literature review. Gripko M, Joseph A, Mohammadigorji S. J Environ Psychol 2023 Mar;86. Access the abstract on PubMed®.

Shared decision making for elective surgical procedures in older adults with and without cognitive insufficiencies. Valentine KD, Vo H, Mancini B, et al. Med Decis Making 2023 Aug;43(6):656-66. Epub 2023 Jul 10. Access the abstract on PubMed®.

Validation of the Clinicians' Cultural Sensitivity Survey for use in pediatric primary care settings. Loo S, Brady KJS, Ragavan MI, et al. J Immigr Minor Health 2023 Aug;25(4):790-802. Epub 2023 Mar 26. Access the abstract on PubMed®.

Changes in out-of-pocket costs for US hospital admissions between December and January every year. Kannan S, Song Z. JAMA Health Forum 2023 May 5;4(5):e230784. Access the abstract on PubMed®.

Continuity of care and advanced prostate cancer. Jayadevappa R, Guzzo T, Vapiwala N, et al. Cancer Med 2023 May;12(10):11795-805. Epub 2023 Mar 23. Access the abstract on PubMed®.