Evolution of Pediatric Outcomes
Improving Children's Health
Through Health Services Research was a special 1-day meeting held June 26, 1999, in Chicago. The state of the science in children's health services research
was explored, including public and private funding opportunities, networks for
conducting research, and uses of research in policy and practice. The meeting
was co-sponsored by the National Association of Children's Hospitals and Related
Institutions (NACHRI), with the Agency for Health Care Policy and Research (AHCPR),
the American Academy of Pediatrics (AAP), the David and Lucille Packard Foundation, the
Association for Health Services Research (AHSR), the Robert Wood Johnson Foundation, and Data
Dr. Clancy focused on lessons from
the world of adults for pediatric outcomes research, building upon the recent
report, The Outcomes of Outcomes Research
One lesson to be learned is the reason
for doing outcomes and effectiveness research: not just to build knowledge,
but to translate that knowledge into practice. She cautioned participants that
translating knowledge into practice is itself a science, that "not all
paths to outcomes improvement directly traverse the clinician's cerebral cortex."
Dr. Clancy pointed out that not every dependent variable is an "outcome"
of care or policy variations.
Turning to pediatric outcomes research,
Dr. Clancy noted that the early generation of large outcomes studies in children's
health were conducted as contracts rather than grants, because researchers did
not submit grant applications. Today, there are still many opportunities to
conduct research in pediatric outcomes.
- A paucity of measures and lack
of clarity about which measures are valid (e.g., proxy versus direct patient
reports of processes or outcomes).
- Short-term versus long-term outcomes
(e.g., asthma emergency department visits versus long term improvements in
social and educational functioning).
- The link between the child and
the family (e.g., parental productivity as an outcome related to the child's
reduced school absenteeism for asthma).
Clancy C. Evolution of
Pediatric Outcomes Research. Presentation Summary, Improving Children's
Health Through Health Services Research, Chicago, June 26, 1999. http://www.ahrq.gov/research/outresch.htm