Health Services and Outcomes Research Methodology Health Services and Outcomes Research Methodology RSS feedThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Development, methodology, and adaptation of the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS ®) patient experience survey, 2007–2019
AbstractThe Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys collect standardized information about patient experiences of care from nationally representative samples of people with Medicare to support consumers ’ enrollment choices and enable the Centers for Medicare& Medicaid Services to monitor care quality and incentivize high quality patient-centered care. Since 2007, protocols for data collection, analysis, and reporting have evolved to address expanded Medicare coverage options and a shift from a single survey vendor to a model in which health plans hire approved vendors to ad...
Source: Health Services and Outcomes Research Methodology - July 29, 2022 Category: Statistics Source Type: research

Health status balancing weights for estimation of health care disparities
This article presents the balancing weights based on the health status PS applied to the IOM definition of racial disparity. Particularly, we propose using the absolute standardized difference to assess the degree to which specific balancing weights satisfy the IOM definition. We consider hybrid health status balancing weights, which are equivalent to the inverse probability weights and overlap weights as special cases. We propose a data-adaptive selection of the tuning parameter for the hybrid weights to minimize the bias of disparity estimates due to the alterations of the distributions of socioeconomic status variables ...
Source: Health Services and Outcomes Research Methodology - July 28, 2022 Category: Statistics Source Type: research

Extending computations for disparity testing when data sources are uncertain
AbstractThe topic of this article is one-sided hypothesis testing on the means of two populations when there is uncertainty as to which population a datum is drawn. Along with each datum, a probability is given as to which of the populations the datum emanated. Such situations arise, for example, in the use of Bayesian imputation methods to assess racial and ethnic disparities with certain survey, health, and financial data. By use of a Bayesian framework and Markov Chain Monte Carlo sampling from the joint posterior distribution of the population means, the probability of a disparity hypothesis is estimated. This approach...
Source: Health Services and Outcomes Research Methodology - July 18, 2022 Category: Statistics Source Type: research

Methodological considerations for estimating policy effects in the context of co-occurring policies
In this study, we utilized Monte Carlo simulations to assess the impact of co-occurring policies on the performance of commonly-used statistical models in state policy evaluations. Simulation conditions varied effect sizes of the co-occurring policies and length of time between policy enactment dates, among other factors. Outcome data (annual state-specific opioid mortality rate per 100,000) were obtained from 1999 to 2016 National Vital Statistics System (NVSS) Multiple Cause of Death mortality files, thus yielding longitudinal annual state-level data over 18  years from 50 states. When co-occurring policies are ignored ...
Source: Health Services and Outcomes Research Methodology - July 9, 2022 Category: Statistics Source Type: research

Adjustment for biased sampling using NHANES derived propensity weights
AbstractThe Consent-to-Contact (C2C) registry at the University of California, Irvine collects data from community participants to aid in the recruitment to clinical research studies. Self-selection into the C2C likely leads to bias due in part to enrollees having more years of education relative to the US general population. Salazar et al. (Alzheimer ’s Dementia Transl Res Clin Interv 6(1):e120023, 2020,https://doi.org/10.1002/trc2.12023) recently used the C2C to examine associations of race/ethnicity with participant willingness to be contacted about research studies. To obtain representative estimates from C2C we use ...
Source: Health Services and Outcomes Research Methodology - July 8, 2022 Category: Statistics Source Type: research

Test-specific funnel plots for healthcare provider profiling leveraging individual- and summary-level information
AbstractIn addition to applications in meta-analysis, funnel plots have emerged as an effective graphical tool for visualizing the detection of health care providers with unusual performance. Although there already exist a variety of approaches to producing funnel plots in the literature of provider profiling, limited attention has been paid to elucidating the critical relationship between funnel plots and hypothesis testing. Within the framework of generalized linear models, here we establish methodological guidelines for creating funnel plots specific to the statistical tests of interest. Moreover, we show that the test-...
Source: Health Services and Outcomes Research Methodology - July 6, 2022 Category: Statistics Source Type: research

Authorization and privacy preservation in cloud-based distributed ehr system using blockchain technology and anonymous digital ring signature
AbstractElectronics-Health Care is one of the new ideas in the healthcare industry. For analyzing the patient's records, doctors need a centralized record of the patients, which gives useful and enormous information. There will be a threat of leaking of confidential e-health data, which will seriously endanger by modifying the health care data of medical and its individual entities. Protection of the confidential data of patients will be a primary constraint in the health care industry. There is a lot of progressiveness in the human services area as well as there is a lot of usage of the information gathered from various s...
Source: Health Services and Outcomes Research Methodology - June 27, 2022 Category: Statistics Source Type: research

Addressing unmeasured confounding bias with a prior knowledge guided approach: coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) in patients with stable ischemic heart disease
We present the “L-table”, a simulation-based, prior knowledge (e.g., RCTs) guided approach that estimates the true effect adjusting for the potential influence of unmeasured confounders w hen using observational data. Using electronic health record data from Kaiser Permanente Southern California, we compare the effectiveness of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) on endpoints at 1, 3, 5, and 10 years for patients with stable ischemic h eart disease. We applied the L-table approach to the propensity score adjusted cohort to derive the omitted-confounder-adjusted estimated...
Source: Health Services and Outcomes Research Methodology - June 21, 2022 Category: Statistics Source Type: research

Dealing with endogeneity in non-randomized medical studies: a study of acute kidney injury following cardiopulmonary bypass surgery
AbstractMany medical studies have used non-randomized sampling, which tends to be the case in research that involves a surgical procedure. Intra-operative procedures and actions conducted by the attending surgical team may be based on pre-operative conditions of the patient, which can introduce endogeneity. Using acute kidney injury (AKI) following cardiopulmonary bypass surgery as a research setting, the present study uses a control function approach to explain why two perfusionist-directed principle components of delivered oxygen (DO2) while the patient is on pump —hemoglobin and cardiac index—need to be treated as e...
Source: Health Services and Outcomes Research Methodology - June 10, 2022 Category: Statistics Source Type: research

PcBEHR: patient-controlled blockchain enabled electronic health records for healthcare 4.0
AbstractIndustry 4.0 has ushered in a new era in the manufacturing industry. Healthcare delivery, like manufacturing, is on the verge of a fundamental shift into the new era of smart and connected health care, termed Health Care 4.0. Sharing healthcare data is an important step in improving the healthcare system ’s intelligence and service quality. Healthcare data, which is a personal asset of the patient, should be owned and managed by the patient rather than being dispersed among several healthcare systems, preventing data exchange and jeopardizing patient privacy. Electronic Health Records (EHRs) assis t individuals b...
Source: Health Services and Outcomes Research Methodology - June 7, 2022 Category: Statistics Source Type: research

A two-stage super learner for healthcare expenditures
AbstractTo improve the estimation of healthcare expenditures by introducing a novel method that is well-suited to situations where data exhibit strong skewness and zero-inflation. Simulations, and two real-world datasets: the 2016 –2017 Medical Expenditure Panel Survey; the Back Pain Outcomes using Longitudinal Data. Super learner is an ensemble machine learning approach that can combine several algorithms to improve estimation. We propose a two-stage super learner that is well suited for healthcare expenditure data by sepa rately estimating the probability of any healthcare expenditure and the mean amount of healthcare ...
Source: Health Services and Outcomes Research Methodology - June 6, 2022 Category: Statistics Source Type: research

A tutorial comparing different covariate balancing methods with an application evaluating the causal effects of substance use treatment programs for adolescents
We present a step-by-step guide to the use of PSBW for estimation of causal treatment effects that includes steps on how to evaluate overlap before the analysis, obtain estimates of PSBW using multiple methods and select the optimal one, check for covariate balance on multiple metrics, and assess sensitivity of findings (both the estimated treatment effect and statistical significance) to unobserved confounding. We illustrate the key steps using a case study examining the relative effectiveness of substance use treatment programs and provide a user-friendly Shiny application that can implement the proposed steps for any ap...
Source: Health Services and Outcomes Research Methodology - May 27, 2022 Category: Statistics Source Type: research