APPENDIX I. SEARCH STRATEGY 

Search terms and MeSH headings: 

((VA [tw] OR veteran* [tw]) OR (United States Department of Veterans Affairs [mh] OR 

veterans [mh] OR veterans hospitals [mh])) AND ((ethnic* [tw] OR race [tw] OR racial [tw] OR 

disparity [tw] OR disparities [tw] OR blacks [tw] OR black [tw] OR Hispanic* [tw]) OR 

(population groups [mh] OR race relations [mh])) 

Databases searched: Medline via PubMed, HealthSTAR, and Health Services Research Projects 

(HSRProj). The HSRProj database identified ongoing and completed VA research projects, and 

indicated whether these studies had been published. 

Dates searched: 1966-October 9, 2006. 

Automatic updates: The search strategy is saved in the PubMed database to provide weekly 

updates on new publications. 

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APPENDIX II. INCLUSION / EXCLUSION CRITERIA 

Inclusion / Exclusion Codes for abstracts and full-text articles 

Code Include / 

Exclude 

Reason 

I1 Include Published studies that: 

a. Are conducted within VHA or with VA beneficiaries AND 

b. Report data by patient race and/or ethnicity AND 

c. Report data on 

i. Utilization of health care services 

ii. Quality of health care services 

1. Process-of-care measures (e.g., use of 

appropriate screening tests) 

2. Outcome measures used by VHA as quality 

metrics (e.g., blood pressure control) 

3. Patient evaluations of care (e.g., patient 

satisfaction) 

4. Direct observations of care (e.g., 

communication patterns) 

iii. Potential mediators of racial/ethnic disparities in 

utilization or quality 

1. System level mediators (e.g., distribution of 

services) 

2. Provider level mediators (e.g., racial bias) 

3. Patient level mediators (e.g., trust) 

4. Patient-provider level mediators (e.g., 

communication) 

I2 Include Systematic review or meta-analysis of studies meeting I1 

I3 Include Unpublished research meeting I1 

I4 Include Background or review articles relevant to racial disparities in VHA (for 

review of reference lists) 

I5 Include Other (specify) 

X1 Exclude Outcomes that are not clear indicators of utilization or quality of care or 

potential mediators of disparities in utilization/quality (e.g., reports on health 

outcomes that are not clearly markers of health care quality) 

X2 Exclude Non-U.S.VHA setting and non-VA population 

X3 Exclude Data not stratified by patient race and/or ethnicity 

X4 Exclude No original data 

X5 Exclude Non-English language, no abstract 

X6 Exclude Non-human, animal 

X7 Exclude Other (specify) e.g. NRF 
HSR&D Evidence Synthesis Pilot

Racial Dispar

1098 abstracts imported from Medline via 

PubMed, HealthSTAR 

(1966-October 9, 2006) 

+ 7 from manual and automatic updates 

934 abstracts ex

171 full-text articles pulled and reviewed 

with inclusion/exclusion criteria, sorted by 

clinical content area 

Arthritis/pain 

management 

Diabetes Heart/CVD HIV/HCV Rehab/ 

palliative 

care 

Mental 

Health 

Preventive/

ambulatory 

care 

Cancer 

17 incl 8 incl 

4 excl 

7 incl 

7 excl 

35 incl 

6 excl 

8 incl 

1 excl 

29 incl 

7 excl 

14 incl 

6 excl 

5 incl 

1 excl 

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APPENDIX III. SEARCH AND SELECTION OF LITERATURE 
APPENDIX IV. EVIDENCE TABLES 

Please see MS Excel spreadsheets available for download from the HSR&D website: 

www.hsrd.research.va.gov/publications/esp/AppendixIV-EvidenceTables.xls 

This MS Excel file contains all ten Evidence Tables as well as the List of Abbreviations. 

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