Susanne Hempel

• PhD
• Southern California Evidence Review Center at University of Southern California

Background The coronavirus disease 2019 (COVID-19) pandemic era saw numerous treatments authorized for emergency use by the United States (US) Food and Drug Administration (FDA). The purpose of the review was to determine if convalescent plasma, antivirals, or monoclonal antibodies are associated with serious adverse events (SAEs) and, if so, which...

10.1542/6361089225112 Video Abstract PEDS-VA_2024-068270 6361089225112 CONTEXT Tethered cord syndrome is associated with motor and sensory deficits. OBJECTIVE Our objective was to summarize evidence regarding the diagnosis, prophylactic surgery, symptomatic treatment, and repeat surgery of tethered spinal cord in a systematic review (CRD420234612...

Clinician wellbeing is critical for effective patient care in healthcare organizations. Approaches to strengthen the key workforce are essential for alleviating burnout and reducing staff turnover. Some healthcare organizations have implemented chief wellness/wellbeing officers (CWOs) to oversee clinician wellbeing and first experiences have been...

CONTEXT Correct diagnosis is essential for the appropriate clinical management of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. OBJECTIVE This systematic review provides an overview of the available diagnostic tools. DATA SOURCES We identified diagnostic accuracy studies in 12 databases published from 1980 through J...

CONTEXT Effective treatment of attention-deficit/hyperactivity disorder (ADHD) is essential to improving youth outcomes. OBJECTIVES This systematic review provides an overview of the available treatment options. DATA SOURCES We identified controlled treatment evaluations in 12 databases published from 1980 to June 2023; treatments were not restri...

Multiple Chemical Sensitivity (MCS) is characterized by adverse responses to environmental exposures of multiple common chemical agents (e.g., perfumes, paint, cleaning products, and other inhaled or ingested agents) in low doses considered non-toxic for the general population. There is currently no consensus on defining, diagnosing or determining...

Objective We aimed to explore the construct of “high need” and identify common need domains among high-need patients, their care professionals, and healthcare organizations; and to describe the interventions that health care systems use to address these needs, including exploring the potential unintended consequences of interventions. Methods We c...

Introduction Multiple chemical sensitivity (MCS) has been characterised by reported adverse responses to environmental exposures of common chemical agents (eg, perfumes, paint, cleaning products and other inhaled or ingested agents) in low doses considered non-toxic for the general population. There is currently no consensus on whether MCS can be e...

Background Enhanced recovery after surgery (ERAS) interventions aim to improve patient outcomes. Vascular surgery patients have unique requirements and it is unclear which ERAS interventions are supported by an evidence base. Methods We conducted a scoping review to identify ERAS randomized controlled trials (RCTs) published in the biomedical or n...

Background: Childhood cancer survivors (CCS) experience many long-term health problems that can be mitigated with recommended survivorship care. However, many CCS do not have access to survivorship care nor receive recommended survivorship care. We reviewed the empirical evidence of disparities in survivorship care for CCS. Methods: This systema...

A strong global commitment exists to eliminate HIV-related stigma and discrimination, and multiple strategies to reduce or eliminate stigma and discrimination have been tried. Using a PICOTS framework and applying the GRADE criteria, we undertook a systematic review to determine the success of interventions aiming to address internalized stigma, st...

Objective For large, integrated healthcare delivery systems, coordinating patient care across delivery systems with providers external to the system presents challenges. We explored the domains and requirements for care coordination by professionals across healthcare systems and developed an agenda for research, practice and policy. Design The mod...

Following a suicide attempt, components of aftercare can include efforts to reduce suicidal behavior (i.e., suicide, attempt, or ideation) of a person who has attempted suicide and facilitate the psychosocial adjustment of the patient and their family members. The purpose of this systematic review and meta-analysis of key outcomes was to synthesize...

Chimeric Antigen Receptor (CAR) T cell therapy is an effective treatment approach for patients with relapsed or refractory acute lymphoblastic leukemia (R/R B-ALL). However, identifying the factors that influence long-term response to this therapy is necessary to optimize patient selection and treatment allocation. We conducted a literature review...

Purpose This scoping review describes existing care models that integrate primary care and childhood cancer survivorship care, examines the effectiveness of these models, and characterizes barriers and facilitators to their integration. Methods A systematic search (PubMed®, CINAHL®, Embase®) was conducted to identify citations which were evaluated...

Objectives: To evaluate alternative formats of summary of findings (SoF) tables for single comparison with multiple outcomes. Study design and setting: We conducted a three-arm randomized controlled non-inferiority trial (RCT) in the following systematic review (SR) users: researchers, clinical practice guideline developers, healthcare providers...

Although transitions between health care systems are common when patients move between jobs or insurers, they are especially difficult to navigate when patients with mental health conditions leave an integrated system, such as the Military Health System (MHS). The authors synthesize evidence from studies of interventions that facilitate transitions...

Background Quality improvement (QI) initiatives often reflect approaches based on anecdotal evidence, but it is unclear how initiatives can best incorporate scientific literature and methods into the QI process. Review of studies of QI initiatives that aim to systematically incorporate evidence review (termed evidence-based quality improvement (EBQ...

Objective: One potential barrier to optimal healthcare may be provider burnout or occupational-related stress in the workplace. The objective of this study is to conduct a systematic review to identify the predictors of burnout among US. healthcare providers. Design: Systematic review using in-depth critical appraisal to assess risk of bias and...

There is strong commitment to eliminate HIV-related stigma and discrimination, starting with global political commitments and reflected in global and national strategies as well as in the work of the many organizations and collaborations working to address them.

HIV-related stigma and discrimination constitute significant barriers to HIV responses around the world and can occur at many levels. Frameworks and measures are needed to address stigma and discrimination to advance research.

Introduction: There is strong global commitment to eliminate HIV-related stigma, and work in this area continues to evolve. Wide variation exists in frameworks and measures used. Methods: Building on the existing knowledge syntheses, we carried out a systematic review to identify frameworks and measures aiming to understand or assess internalize...

Introduction: There is strong global commitment to eliminate HIV-related stigma, and work in this area continues to evolve. Wide variation exists in frameworks and measures used. Methods: Building on the existing knowledge syntheses, we carried out a systematic review to identify frameworks and measures aiming to understand or assess internalized s...

Well-defined, systematic, and transparent processes to identify health research gaps, needs, and priorities are vital to ensuring that available funds target areas with the greatest potential for impact. This study documents a scoping review of published methods used for identifying health research gaps, establishing research needs, and determining...

Posttraumatic stress disorder (PTSD) is a condition that can emerge after exposure to a traumatic event. It involves several symptoms, including distressing memories or dreams and/or dissociative reactions; psychological distress at exposure to trauma cues; physiologic reactions to cues; avoidance of stimuli associated with the event; negative alte...

PurposeMany childhood cancer survivors experience disparities due to barriers to recommended survivorship care. With an aim to demonstrate evidence-based approaches to alleviate barriers and decrease disparities, we conducted a scoping review of (1) proposed strategies and (2) evaluated interventions for improving pediatric cancer survivorship care...

Transitions between health care systems are difficult to navigate when patients with mental health conditions leave an integrated system. The authors synthesize evidence from studies of interventions that facilitate transitions between mental health care systems, such as the transition from the Military Health System to the Veterans Health Administ...

Background: Healthcare systems are increasingly implementing programs for high-need patients, who often have multiple chronic conditions and complex social situations. Little, however, is known about quality indicators that might guide healthcare organizations and providers in improving care for high-need patients. We sought to conduct a systemati...

BMJ Open

This systematic review synthesizes the evidence on pretreatment patient characteristics and program features associated with treatment retention, response, and remission in military populations with posttraumatic stress disorder (PTSD).

Introduction There is strong global commitment to eliminate HIV-related stigma. Wide variation exists in frameworks and measures, and many strategies to prevent, reduce or mitigate stigma have been proposed but critical factors determining success or failure remain elusive. Methods and analysis Building on existing knowledge syntheses, we designed...

This Agency for Healthcare Research and Quality (AHRQ) Technical Brief was commissioned by the National Cancer Institute (NCI) to support the development of a research agenda associated with the Childhood Cancer Survivorship, Treatment, Access, and Research (STAR) Act. The Technical Brief provides an overview of the existing evidence and forthcomi...

Background Well-defined, systematic, and transparent processes to identify health research gaps, needs, and priorities are vital to ensuring that available funds target areas with the greatest potential for impact.Objective The purpose of this review is to characterize methods conducted or supported by research funding organizations to identify hea...

This is a scoping review of methods used for identifying health research gaps, needs, and priorities. The review will be of interest to health policymakers and practitioners.

To identify baseline patient characteristics (i.e., demographic and psychological factors, military background) associated with better posttraumatic stress disorder (PTSD) treatment retention among veterans, we conducted a systematic review. After an electronic database search for studies of PTSD treatment in veterans, two reviewers independently s...

Genetic therapies replace or inactivate disease causing genes or introduce new or modified genes. These therapies have the potential to cure disease in a single application. This evidence map provides overview of randomized controlled trials (RCTs) and efficacy and safety of genetic therapies.

Background Uncertainty remains regarding the effectiveness of treatments for patients diagnosed with both an alcohol use disorder (AUD) and depressive disorder. This study aimed to compare the effectiveness of clinical interventions for improving symptoms of adults with co-occurring AUDs and depressive disorders. Methods and findings We searched C...

Objective(s) Provide a critical analysis of measurement properties of mHealth technologies (wearable sensors and smartphone applications) currently used to capture the amount and intensity of functional skills (locomotion and object-interaction) in stroke survivors. Data Sources The search was performed in four databases from inception to January...

Scoping reviews are an increasingly common approach to evidence synthesis with a growing suite of methodological guidance and resources to assist review authors with their planning, conduct and reporting. The latest guidance for scoping reviews includes the JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses—E...

Epilepsy prevalence is high among infants, but treatment guidelines are not clear. We conducted a scoping review of interventions to manage epilepsy in infants, and identified 37 studies. Most studies reported that interventions were effective (22 studies; 76%), but randomized controlled trials were uncommon (7 studies; 19%) and sample sizes were s...

Over the past two decades, the U.S. Department of Defense has made significant investments in developing effective treatments for military-related psychological health conditions. A survey of the military health system has shown that military personnel frequently seek complementary and alternative medicine (CAM) therapies. Researchers found that, i...

Military personnel, police officers, firefighters, and other first responders must prepare for and respond to life-threatening crises on a daily basis. This lifestyle places stress on personnel, and particularly so on military personnel who may be isolated from support systems and other resources. The authors conducted a systematic review of studie...

Military personnel, police officers, firefighters, and other first responders must prepare for and respond to life-threatening crises on a daily basis. This lifestyle places stress on personnel, and particularly so on military personnel who may be isolated from support systems and other resources. The authors conducted a systematic review of studie...

Objective Post-traumatic stress disorder (PTSD) can lead to many negative secondary outcomes for patients, including sleep disturbances. The objective of this meta-analysis is (1) to evaluate the effect of interventions for adults with PTSD on sleep outcomes, PTSD outcomes, and adverse events, and (2) to evaluate the differential effectiveness of i...

Introduction: Military personnel must prepare for and respond to life-threatening crises on a daily basis. This lifestyle places stress on personnel, and particularly so on deployed service members who are isolated from support systems and other resources. As part of a larger systematic review on the acceptability, efficacy, and comparative effect...

PURPOSE We aimed to provide a critical review of measurement properties of mHealth technologies used for stroke survivors to measure the amount and intensity of functional skills, and to identify facilitators and barriers toward adoption in research and clinical practice. MATERIALS AND METHODS Using Arksey and O’Malley’s framework, two independent...

Purpose This evidence report synthesizes the available evidence on radiation therapy for brain metastases. Methods and Materials The literature search included PubMed, EMBASE, Web of Science, Scopus, CINAHL, clinicaltrials.gov, and published guidelines in July 2020; independently submitted data, expert consultation, and contacting authors. Include...

This systematic review of the literature searched PubMed, CINAHL, EMBASE; Guideline clearing houses ECRI and GIN; and Google scholar. We conducted a targeted Google search, additional indicator sets were identified through reference mining, and contacting experts. We included publications suggesting quality indicators, evaluating quality indicators...

We updated a systematic review commissioned by the Agency for Healthcare Research and Quality (AHRQ) on evidence-based approaches and searched research databases for evaluation of strategies for policymakers.

Aim Adverse childhood experiences (ACEs) are associated with numerous adverse mental and physical health outcomes. While interest in routine screening for ACEs is growing, there is still significant opposition to universal screening. This review explores the feasibility of implementing routine screening for ACEs in primary care settings. Subject a...

Chimeric antigen receptor (CAR)-T cell therapies appear to be promising treatments for non-Hodgkin’s and B-cell lymphoma. However, several CAR-T therapies approved by the US Food and Drug Administration have only been tested for efficacy in relatively few single-arm clinical trials with small sample sizes. We sought to examine the differences betwe...

Background Understanding the safety of vaccines is critical to inform decisions about vaccination. Our objective was to conduct a systematic review of the safety of vaccines recommended for children, adults, and pregnant women in the United States. Methods We searched the literature in November 2020 to update a 2014 Agency for Healthcare Research...

Objective: In pandemics like COVID-19, the need for medical resources quickly outpaces available supply. Policymakers need strategies to inform decisions about allocating scarce resources. Study design and setting: We updated a systematic review on evidence-based approaches and searched databases through May 2020 for evaluation of strategies for po...

Managing patient access to care in health care delivery organizations is instrumental in shaping patient experiences. We convened an inclusive stakeholder panel, informed by evidence, to understand the dimensions and establish definitions of access and access management. The literature varies in access definitions, but the temporal measure "time to...

This Agency for Healthcare Research and Quality (AHRQ) Technical Brief was commissioned by the National Cancer Institute (NCI) to support the development of a research agenda associated with the Childhood Cancer Survivorship, Treatment, Access, and Research (STAR) Act. This Technical Brief provides an overview of the existing evidence and forthcomi...

This report aims to inform health care organizations by reviewing the recent research and bringing together diverse stakeholder perspectives on primary care productivity. The report addresses the current lack of consensus on what constitutes primary care productivity and on what inputs and outputs are important for assessing it. The objectives were...

Objective: Cost, distance, and stigma may present barriers to face-to-face treatment for anxiety disorders. Technology can help overcome these barriers. The evidence map presented here provides an overview of technology use in clinical care for anxiety. Methods: Searches in three databases from their inception dates to June 2019 identified publi...

Objectives Genetic therapies replace or inactivate disease-causing genes or introduce new or modified genes. These therapies have the potential to cure in a single application rather than treating symptoms through repeated administrations. This evidence map provides a broad overview of the genetic therapies that have been evaluated in randomised co...

• When decision makers need to make difficult choices regarding the allocation of scarce resources and pandemic response, potential strategies include: o Reduction of demand for healthcare services through medical countermeasures (e.g., mass vaccination) or nonpharmaceutical interventions (e.g., social distancing); o Optimization of existing reso...

The objective of this systematic review was to synthesize the effectiveness of health care provider interventions that aim to increase the uptake of evidence-based treatment of depression in routine clinical practice. This study summarizes results of comprehensive searches in the quality improvement, implementation science, and behavior change lite...

Managing patient access to care in healthcare delivery organizations is critical for shaping patient healthcare experiences. Conceptual work to understand the components of access and access management is necessary for improvement initiatives. The work aims to advance primary care access management practice and research to support healthcare delive...

Evidence reviews should inform organizational guidelines. Learning in organizations requires innovative methods to engage practitioners. The Clinical Operations Evidence Review Cyber-Seminar process focused on promoting stakeholder-informed evidence-based decision-making. We evaluated the use of an interactive cyber-seminar linking evidence review...

Epilepsy is more common in children than in adults, with several unique childhood-onset epilepsy syndromes. Despite its significant prevalence, limited research exists on infantile epilepsy. The objective of the topic brief is to identify and categorize the existing literature on management strategies for infantile epilepsy to help the Patient-Cent...

Objective: To identify priorities for improving healthcare organization management of patient access to primary care based on prior evidence and a stakeholder panel. Background: Studies on healthcare access show its importance for ensuring population health. Few studies show how healthcare organizations can improve access. Methods: We conducte...

Background: Managing patient access to care in healthcare delivery organizations is complex, yet instrumental in shaping patient healthcare experiences. Conceptual work to understand the dimensions of access and access management is critical for improvement initiatives. This work aims to advance primary care access management practice and research...

Given the documented gender differences in characteristics of alcohol use disorder, men and women might also respond differently to some treatments for this disorder. If so, this would be important for physicians to consider when selecting treatment. The purpose of this systematic review was to synthesize the evidence for gender differences in effe...

Enhanced Recovery After Surgery (ERAS) protocols are interventions that aim to improve recovery after surgical procedures. The objective of the topic brief is to identify and categorize the existing effectiveness and comparative effectiveness ERAS literature for vascular surgery to determine whether there is sufficient literature to warrant a syste...

Background: To promote evidence-based health care, clinical providers and decision makers rely on scientific evidence to inform best practices. Evidence synthesis (ES) is a key component of this process that serves to inform health care decisions by integrating and contextualizing research findings across studies. Objective: This paper describes th...

Background: Evidence synthesis is key in promoting evidence-based health care, but it is resource-intense. Methods are needed to identify and prioritize evidence synthesis needs within health care systems. We describe a collaboration between an agency charged with facilitating the implementation of evidence-based research and practices across the...

Background: Access to health care is a critical concept in the design, delivery, and evaluation of high quality care. Meaningful evaluation of access requires research evidence and the integration of perspectives of patients, providers, and administrators. Objective: Because of high-profile access challenges, the Department of Veterans Affairs (...

Objective: Ductal carcinoma in situ (DCIS) has the potential to progress to invasive carcinoma. The optimal management of DCIS and methods for individualizing treatment of DCIS are still being determined. This evidence map depicts the robustness and topical span of research on DCIS management choice on patient-centered and clinical outcomes. Meth...

This guide to conducting literature reviews includes strategies for defining the research question, using search tools and managing citations, and ensuring an unbiased summary of existing research.

Background: The objective was to conduct a systematic review of toolkit evaluations intended to spread interventions to improve healthcare quality. We aimed to determine the components, uptake, and effectiveness of publicly available toolkits. Methods: We searched PubMed, CINAHL, and the Web of Science from 2005 to May 2018 for evaluations of pu...

Objective: Obesity is preventable and yet continues to be a major risk factor for chronic disease. Multiple prevention approaches have been proposed across multiple settings where people live, work, learn, worship, and play. This review searched the vast literature on obesity prevention interventions to assess their effects on daily energy consume...

The objective of the evidence map is to provide an overview of the use of technology in the clinical care of depression. https://academyhealth.confex.com/academyhealth/2019arm/meetingapp.cgi/Paper/30452

Background: Mindfulness interventions aim to foster greater attention and awareness of present moment experiences. Uptake of mindfulness programs in the workplace has grown as organizations look to support employee health, wellbeing and performance. Objective: In support of evidence-based decision making in workplace contexts, we created an evid...

Objective Pain and opioid use are highly prevalent, leading for calls to include nonpharmacological options in pain management, including complementary and integrative health (CIH) therapies. More than 2,000 randomized controlled trials (RCTs) and many systematic reviews have been conducted on CIH therapies, making it difficult to easily understand...

Human gene therapy has evolved rapidly and may be poised to affect mainstream medicine. Gene therapy initially targeted incurable genetic diseases (eg, metabolic diseases) but is now most commonly used to treat certain cancers. In response to the increase in approved gene therapy approaches, the Patient-Centered Outcomes Research Institute (PCORI)...

A burgeoning number of toolkits dedicated to improving health care exist but development guidance is lacking. The authors convened a panel of health care stakeholders, including developers, purchasers, users, funders, and disseminators of toolkits. The panel was informed by a literature review that analyzed 44 publications and 27 toolkits. A modifi...

A ready-to-use checklist for quality improvement toolkits

Appendix to Quality Improvement Toolkits: Recommendations for Development https://journals.sagepub.com/doi/abs/10.1177/1062860618822102