National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (1)
- Antibiotics (3)
- Autism (1)
- Behavioral Health (1)
- Cancer (4)
- Cancer: Breast Cancer (2)
- Cancer: Lung Cancer (1)
- Care Management (2)
- Children/Adolescents (5)
- Chronic Conditions (3)
- Clinical Decision Support (CDS) (3)
- Communication (1)
- Data (2)
- Depression (1)
- Diabetes (3)
- Diagnostic Safety and Quality (1)
- Digestive Disease and Health (1)
- Disparities (1)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Emergency Medical Services (EMS) (1)
- Evidence-Based Practice (3)
- Genetics (2)
- Guidelines (4)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Healthcare Delivery (2)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (2)
- Health Services Research (HSR) (1)
- Health Systems (1)
- Heart Disease and Health (2)
- Hospitalization (1)
- Implementation (1)
- Infectious Diseases (1)
- Labor and Delivery (1)
- Long-Term Care (1)
- Medical Errors (1)
- Medicare (3)
- Medication (11)
- Medication: Safety (1)
- Nursing Homes (2)
- Pain (1)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (4)
- Patient and Family Engagement (1)
- Patient Safety (2)
- Pneumonia (1)
- (-) Practice Patterns (33)
- Primary Care (3)
- Primary Care: Models of Care (1)
- Provider (1)
- Provider: Physician (1)
- Quality Improvement (2)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (1)
- Rural Health (1)
- Shared Decision Making (5)
- Social Determinants of Health (1)
- Substance Abuse (1)
- Surgery (4)
- Telehealth (1)
- Tools & Toolkits (1)
- Training (1)
- Treatments (1)
- Women (3)
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 25 of 33 Research Studies DisplayedAhuja V, Sohn MW, Birge JR
Geographic variation in rosiglitazone use surrounding FDA warnings in the Department of Veterans Affairs.
The purpose of this study was to document variation in the use of rosiglitazone and other glucose- lowering drugs across 21 Veterans Integrated Service Networks. It found that aggregate rosiglitazone use increased monotonically from 7.7 percent, in the quarter it was added to the VA formulary, to a peak of 15.3 percent in the quarter when the FDA issued the safety alert.
AHRQ-funded; HS018542.
Citation: Ahuja V, Sohn MW, Birge JR .
Geographic variation in rosiglitazone use surrounding FDA warnings in the Department of Veterans Affairs.
J Manag Care Spec Pharm 2015 Dec;21(12):1214-34. doi: 10.18553/jmcp.2015.21.12.1214.
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Keywords: Adverse Drug Events (ADE), Medication: Safety, Medication, Practice Patterns
Furukawa MF, King J, Patel V
AHRQ Author: Furukawa MF
Physician attitudes on ease of use of EHR functionalities related to Meaningful Use.
The researchers assessed physician attitudes on ease of use of electronic health record (EHR) functionalities related to "Meaningful Use" (MU) and whether perceived ease of use was associated with EHR characteristics. Their study of a nationally representative survey of office-based physicians found that physicians' adoption and perceived ease of use of EHR functionalities related to MU was generally high.
AHRQ-authored.
Citation: Furukawa MF, King J, Patel V .
Physician attitudes on ease of use of EHR functionalities related to Meaningful Use.
Am J Manag Care 2015 Dec;21(12):e684-92.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Practice Patterns
Du XL, Parikh RC, Lairson DR
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
The authors examined racial/ethnic and geographical disparities in cancer care and costs during the last 6 months of life for lung cancer decedents after the FDA's approval of bevacizumab. They found that there were substantial racial/ethnic and geographic disparities in the types of cancer care and costs in the last 6 months of life among lung cancer decedents, regardless of the length of survival times and hospice care status.
AHRQ-funded; HS018956.
Citation: Du XL, Parikh RC, Lairson DR .
Racial and geographic disparities in the patterns of care and costs at the end of life for patients with lung cancer in 2007-2010 after the 2006 introduction of bevacizumab.
Lung Cancer 2015 Dec;90(3):442-50. doi: 10.1016/j.lungcan.2015.09.017.
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Keywords: Cancer, Cancer: Lung Cancer, Disparities, Healthcare Costs, Medication, Palliative Care, Patient-Centered Outcomes Research, Practice Patterns, Racial and Ethnic Minorities
Islam R, Weir CR, Jones M
Understanding complex clinical reasoning in infectious diseases for improving clinical decision support design.
The purpose of the study was to examine the constituents of decision complexity and explore the cognitive strategies clinicians use to control and adapt to their information environment. The following three themes emerged as the constituents of decision complexity experienced by the Infectious Diseases experts: 1) the overall clinical picture does not match the pattern, 2) a lack of comprehension of the situation and 3) dealing with social and emotional pressures such as fear and anxiety.
AHRQ-funded; HS023349.
Citation: Islam R, Weir CR, Jones M .
Understanding complex clinical reasoning in infectious diseases for improving clinical decision support design.
BMC Med Inform Decis Mak 2015 Nov 30;15:101. doi: 10.1186/s12911-015-0221-z.
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Keywords: Clinical Decision Support (CDS), Health Services Research (HSR), Practice Patterns
Potosky AL, O'Neill SC, Isaacs C
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
The authors evaluated the relation between gene expression profiling (GEP) testing and the use of adjuvant chemotherapy by women treated in a general oncology practice. They found that adjuvant chemotherapy use after GEP testing is generally consistent with the recommended test interpretation for women with a high or low predicted risk of recurrence. Chemotherapy use in the intermediate-risk group increased with Recurrence Score values, and evidence from ongoing randomized trials may help to clarify whether this finding reflects optimal interpretation of GEP test results.
AHRQ-funded; HS022915.
Citation: Potosky AL, O'Neill SC, Isaacs C .
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
Cancer 2015 Nov 15;121(22):4062-70. doi: 10.1002/cncr.29621.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Shared Decision Making, Genetics, Practice Patterns, Women
Kuo YF, Goodwin JS, Chen NW
Diabetes mellitus care provided by nurse practitioners vs primary care physicians.
The study objective was to compare processes and cost of care of older adults with diabetes mellitus cared for by nurse practitioners (NPs) with processes and cost of those cared for by primary care physicians (PCPs). It concluded that nurse practitioners were similar to PCPs or slightly lower in their rates of diabetes mellitus guideline–concordant care.
AHRQ-funded; HS020642; HS022134.
Citation: Kuo YF, Goodwin JS, Chen NW .
Diabetes mellitus care provided by nurse practitioners vs primary care physicians.
J Am Geriatr Soc 2015 Oct;63(10):1980-8. doi: 10.1111/jgs.13662..
Keywords: Chronic Conditions, Diabetes, Elderly, Primary Care, Practice Patterns
Siegel CA, Lofland JH, Naim A
Gastroenterologists' views of shared decision making for patients with inflammatory bowel disease.
The researchers examined gastroenterologists' perspectives about shared decision making (SDM) with patients with inflammatory bowel disease (IBD). They found three key barriers to practicing SDM were lack of time, reimbursement, and tools. They concluded that gastroenterologists lack the systematic approaches and tools for implementing SDM within their IBD practices.
AHRQ-funded; HS021747.
Citation: Siegel CA, Lofland JH, Naim A .
Gastroenterologists' views of shared decision making for patients with inflammatory bowel disease.
Dig Dis Sci 2015 Sep;60(9):2636-45. doi: 10.1007/s10620-015-3675-z.
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Keywords: Shared Decision Making, Digestive Disease and Health, Patient and Family Engagement, Practice Patterns
Mody L, Crnich C
Effects of excessive antibiotic use in nursing homes.
This research commentary discussed effects of excessive antibiotic use in nursing homes (NH), including Clostridium difficile infection, adverse drug reactions, and an increased risk of colonization and infection with multidrug-resistant organisms. The authors recommended that antibiotic improvement teams tailor their improvement efforts based on a locally generated needs assessment.
AHRQ-funded; HS022465.
Citation: Mody L, Crnich C .
Effects of excessive antibiotic use in nursing homes.
JAMA Intern Med 2015 Aug;175(8):1339-41. doi: 10.1001/jamainternmed.2015.2774.
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Keywords: Adverse Drug Events (ADE), Antibiotics, Practice Patterns, Nursing Homes, Healthcare-Associated Infections (HAIs)
Reschovsky JD, Rich EC, Lake TK
Factors contributing to variations in physicians' use of evidence at the point of care: a conceptual model.
The purpose of this article is to help identify modifiable factors that can influence clinical decisions at the point of care. It presents a conceptual model and literature review of physician decisionmaking. The authors describe the multitude of factors—drawn from different disciplines—that have been shown to influence physician point-of-care decisions. They also present a conceptual framework for organizing these factors.
AHRQ-funded; 23320095642; 23337033T.
Citation: Reschovsky JD, Rich EC, Lake TK .
Factors contributing to variations in physicians' use of evidence at the point of care: a conceptual model.
J Gen Intern Med 2015 Aug;30 Suppl 3:S555-61. doi: 10.1007/s11606-015-3366-7..
Keywords: Healthcare Delivery, Shared Decision Making, Evidence-Based Practice, Primary Care: Models of Care, Practice Patterns
DesRoches CM, Wong HS, Rich EC
AHRQ Author: Wong HS
Making the case for a new national data collection effort on physicians and their practices.
The pace of change in the U.S. health care system and the integral role played by physicians indicate a clear need for an ongoing, regular physician survey. The authors argue that the survey be designed to monitor over time the characteristics of all physicians in all specialties and the clinical, organizational, and financial contexts in which they operate.
AHRQ-authored
Citation: DesRoches CM, Wong HS, Rich EC .
Making the case for a new national data collection effort on physicians and their practices.
J Gen Intern Med 2015 Aug;30 Suppl 3:S553-4. doi: 10.1007/s11606-015-3386-3..
Keywords: Data, Practice Patterns, Provider, Provider: Physician
Fleming C, Rich E, DesRoches C
Measuring changes in the economics of medical practice.
This paper explores current issues relevant to defining and measuring the inputs and outputs of physician practice. It reviews practice inputs and outputs as typically described in the literature on the economics of medical practice, and identifies the conceptual challenges for defining these inputs and outputs in a complex and evolving health care system.
AHRQ-funded; 23320095642WC; 23337033T.
Citation: Fleming C, Rich E, DesRoches C .
Measuring changes in the economics of medical practice.
J Gen Intern Med 2015 Aug;30 Suppl 3:S562-7. doi: 10.1007/s11606-015-3368-5..
Keywords: Healthcare Delivery, Health Systems, Practice Patterns, Data
Converse L, Barrett K, Rich E
Methods of observing variations in physicians' decisions: the opportunities of clinical vignettes.
This review described various methods for measuring variations in physicians’ decisions and highlight a range of design features researchers should consider when developing a clinical vignette survey. It concluded by identifying areas for future research.
AHRQ-funded; 23320095642WC; 23337033T.
Citation: Converse L, Barrett K, Rich E .
Methods of observing variations in physicians' decisions: the opportunities of clinical vignettes.
J Gen Intern Med 2015 Aug;30 Suppl 3:S586-94. doi: 10.1007/s11606-015-3365-8..
Keywords: Shared Decision Making, Evidence-Based Practice, Practice Patterns
Ray KN, Demirci JR, Bogen DL
Optimizing telehealth strategies for subspecialty care: recommendations from rural pediatricians.
The authors elicited rural pediatrician experiences and preferences regarding different pediatric subspecialty telehealth strategies. Rural pediatricians from 17 states described complementary roles for different subspecialty care telehealth strategies. Additionally, rural pediatricians, through semistructured telephone interviews, provided recommendations for optimizing individual telehealth strategies.
AHRQ-funded; HS022989.
Citation: Ray KN, Demirci JR, Bogen DL .
Optimizing telehealth strategies for subspecialty care: recommendations from rural pediatricians.
Telemed J E Health 2015 Aug;21(8):622-9. doi: 10.1089/tmj.2014.0186.
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Keywords: Children/Adolescents, Children/Adolescents, Practice Patterns, Rural Health, Telehealth
Bauer NS, Carroll AE, Saha C
Computer decision support changes physician practice but not knowledge regarding autism spectrum disorders.
This study examined whether adding an autism module promoting adherence to clinical guidelines to an existing computer decision support system (CDSS) changed physician knowledge and self-reported clinical practice. It found that a CDSS module to improve primary care management of ASD in pediatric practice led to significant improvements in physician-reported use of validated screening tools to screen for ASDs.
AHRQ-funded; HS018453.
Citation: Bauer NS, Carroll AE, Saha C .
Computer decision support changes physician practice but not knowledge regarding autism spectrum disorders.
Appl Clin Inform 2015;6(3):454-65. doi: 10.4338/aci-2014-09-ra-0084.
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Keywords: Health Information Technology (HIT), Practice Patterns, Clinical Decision Support (CDS), Children/Adolescents, Autism
Williams DJ, Edwards KM, Self WH
Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines.
The 2011 national guidelines for the management of childhood community-acquired pneumonia (CAP) recommended narrow-spectrum antibiotics (e.g., ampicillin) for most children hospitalized with CAP. The researchers assessed the impact of these guidelines on antibiotic prescribing at 3 children’s hospitals. They found that, after publication of national guidelines, third-generation cephalosporin use declined and penicillin/ampicillin use increased among children hospitalized with CAP.
AHRQ-authored; HS022342.
Citation: Williams DJ, Edwards KM, Self WH .
Antibiotic choice for children hospitalized with pneumonia and adherence to national guidelines.
Pediatrics 2015 Jul;136(1):44-52. doi: 10.1542/peds.2014-3047..
Keywords: Children/Adolescents, Hospitalization, Guidelines, Medication, Practice Patterns
Tjia J, Field T, Mazor K
Dissemination of evidence-based antipsychotic prescribing guidelines to nursing homes: a cluster randomized trial.
This study evaluated the effectiveness of efforts to translate and disseminate evidence-based guidelines about atypical antipsychotic use to nursing homes (NHs). It found that RE-AIM indicators suggest some success in disseminating the toolkit and differences in reach, adoption, and implementation according to dissemination strategy but no measurable effect on antipsychotic prescribing trends.
AHRQ-funded; HS019351.
Citation: Tjia J, Field T, Mazor K .
Dissemination of evidence-based antipsychotic prescribing guidelines to nursing homes: a cluster randomized trial.
J Am Geriatr Soc 2015 Jul;63(7):1289-98. doi: 10.1111/jgs.13488..
Keywords: Communication, Evidence-Based Practice, Guidelines, Long-Term Care, Medication, Nursing Homes, Practice Patterns, Tools & Toolkits, Implementation
Andrews SE, Alston MJ, Allshouse AA
Does the number of forceps deliveries performed in residency predict use in practice?
The researchers aimed to determine whether a threshold number of forceps deliveries in residency predicts use of forceps in independent practice. They concluded that, although exceeding 13 forceps deliveries made it highly likely that obstetricians would use them in practice, further study is necessary to set goals for a number of resident forceps deliveries that translate into use in practice.
AHRQ-funded; HS022143.
Citation: Andrews SE, Alston MJ, Allshouse AA .
Does the number of forceps deliveries performed in residency predict use in practice?
Am J Obstet Gynecol 2015 Jul;213(1):93.e1-4. doi: 10.1016/j.ajog.2015.03.025..
Keywords: Labor and Delivery, Patient-Centered Outcomes Research, Practice Patterns, Training, Women
Krell RW, Reames BN, Hendren S
Surgical referral for colorectal liver metastases: a population-based survey.
The researchers sought to understand medical oncologists’ perspectives on referral for colorectal liver metastases (CLM). They found wide variation in surgical referral patterns for CLM. Many felt that bilobar disease and tumor size were contraindications to liver-directed therapy despite a lack of supporting data.
AHRQ-funded; HS020937.
Citation: Krell RW, Reames BN, Hendren S .
Surgical referral for colorectal liver metastases: a population-based survey.
Ann Surg Oncol 2015 Jul;22(7):2179-94. doi: 10.1245/s10434-014-4318-x..
Keywords: Cancer, Surgery, Guidelines, Practice Patterns
Smith RJ, Kilaru AS, Perrone J
How, why, and for whom do emergency medicine providers use prescription drug monitoring programs?
The authors examined how emergency physicians use Prescription Drug Monitoring Programs (PDMPs), for which patients, and for what reasons. They found that providers use the information in PDMPs to alter clinical decisions and guide opioid prescribing patterns. Physicians used the databases additionally for improving their ability to facilitate discussions on addiction and for providing patient education. The authors recommended minimizing administrative barriers to PDMP access and suggested that alternative PDMP uses be further studied to determine their appropriateness and potentially expand their role in clinical practice.
AHRQ-funded; HS021956.
Citation: Smith RJ, Kilaru AS, Perrone J .
How, why, and for whom do emergency medicine providers use prescription drug monitoring programs?
Pain Med 2015 Jun;16(6):1122-31. doi: 10.1111/pme.12700.
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Keywords: Shared Decision Making, Emergency Medical Services (EMS), Medication, Practice Patterns, Substance Abuse
Sorkin DH, Billimek J, August KJ
AHRQ Author: Ngo-Metzger Q
Mental health symptoms and patient-reported diabetes symptom burden: implications for medication regimen changes.
The aim of this paper was to examine the relative contribution of glycaemic control (HbA1C) and depressive symptoms on diabetes-related symptom burden (hypoglycaemia and hyperglycaemia) in order to guide medication modification. The authors found that mental health symptoms are associated with higher levels of patient-reported diabetes-related symptoms, but the association between diabetes-related symptoms and subsequent regimen modifications is diminished in patients with greater depressive symptoms.
AHRQ-authored.
Citation: Sorkin DH, Billimek J, August KJ .
Mental health symptoms and patient-reported diabetes symptom burden: implications for medication regimen changes.
Fam Pract 2015 Jun;32(3):317-22. doi: 10.1093/fampra/cmv014.
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Keywords: Depression, Diabetes, Medication, Practice Patterns, Social Determinants of Health
Dinan MA, Mi X, Reed SD
Initial trends in the use of the 21-gene recurrence score assay for patients with breast cancer in the Medicare population, 2005-2009.
The researchers examined trends in the use of the 21-gene recurrence score (RS) assay in routine clinical practice in a nationally representative sample of women with breast cancer. They found that the RS assay was adopted quickly in clinical practice after the Medicare coverage decision in 2006, and use appears to be consistent with guidelines and equitable across geographic and racial groups.
AHRQ-funded; HS022189.
Citation: Dinan MA, Mi X, Reed SD .
Initial trends in the use of the 21-gene recurrence score assay for patients with breast cancer in the Medicare population, 2005-2009.
JAMA Oncol 2015 May;1(2):158-66. doi: 10.1001/jamaoncol.2015.43..
Keywords: Cancer, Cancer: Breast Cancer, Genetics, Guidelines, Medicare, Practice Patterns, Women
De Martino RR, Hoel AW, Beck AW
Participation in the Vascular Quality Initiative is associated with improved perioperative medication use, which is associated with longer patient survival.
The researchers analyzed the effect of Vascular Quality Initiative (VQI) participation on perioperative (preoperative and postoperative) medical management (MM) use over time and the effect of discharge MM on patient survival. They demonstrated that MM is associated with improved survival after a number of vascular procedures, and that VQI participation improves the use of MM, demonstrating that involvement in an organized quality effort can affect patient outcomes.
AHRQ-funded; HS021581.
Citation: De Martino RR, Hoel AW, Beck AW .
Participation in the Vascular Quality Initiative is associated with improved perioperative medication use, which is associated with longer patient survival.
J Vasc Surg 2015 Apr;61(4):1010-9. doi: 10.1016/j.jvs.2014.11.073.
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Keywords: Medication, Quality Improvement, Patient-Centered Outcomes Research, Practice Patterns
Martin BI, Lurie JD, Tosteson AN
Use of bone morphogenetic protein among patients undergoing fusion for degenerative diagnoses in the United States, 2002 to 2012.
The authors examined whether published concerns about the safety of bone morphogenetic protein (BMP) altered clinical practice. They found that use of BMP in spinal fusion surgery declined subsequent to published safety concerns and revelations of financial conflicts of interest for investigators involved in the pivotal clinical trials.
AHRQ-funded; HS021695.
Citation: Martin BI, Lurie JD, Tosteson AN .
Use of bone morphogenetic protein among patients undergoing fusion for degenerative diagnoses in the United States, 2002 to 2012.
Spine J 2015 Apr;15(4):692-9. doi: 10.1016/j.spinee.2014.12.010.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Patient Safety, Patient-Centered Outcomes Research, Practice Patterns, Surgery
Magnan EM, Gittelson R, Bartels CM
Establishing chronic condition concordance and discordance with diabetes: a Delphi study.
This study aimed to provide more information for the future research and clinical use of the concordant/discordant framework by increasing the number of conditions that can be characterized as concordant or discordant with diabetes. By finding that 12 conditions were concordant with diabetes care and 50 were discordant, the study significantly adds to the number of conditions for which there is information on concordance and discordance for diabetes care.
AHRQ-funded; HS018368; HS007646; HS021899.
Citation: Magnan EM, Gittelson R, Bartels CM .
Establishing chronic condition concordance and discordance with diabetes: a Delphi study.
BMC Fam Pract 2015 Mar 28;16:42. doi: 10.1186/s12875-015-0253-6..
Keywords: Chronic Conditions, Diabetes, Primary Care, Practice Patterns
Hersh AL, Gerber JS, Hicks LA
Lessons learned in antibiotic stewardship: fluoroquinolone use in pediatrics.
For adults, fluoroquinolones are the leading class of antibiotics prescribed in ambulatory care visits, whereas, in children, they are the least frequently prescribed class. This paper highlights the impact of physicians' perception of direct patient harm in antibiotic decision making which has implications for antibiotic stewardship.
AHRQ-funded; HS020921.
Citation: Hersh AL, Gerber JS, Hicks LA .
Lessons learned in antibiotic stewardship: fluoroquinolone use in pediatrics.
J Pediatric Infect Dis Soc 2015 Mar;4(1):57-9. doi: 10.1093/jpids/piu044.
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Keywords: Antibiotics, Children/Adolescents, Medication, Children/Adolescents, Practice Patterns