National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 25 of 104 Research Studies DisplayedFeltner C, Wallace IF, Nowell SW
Screening for speech and language delay and disorders in children 5 years or younger: evidence report and systematic review for the US Preventive Services Task Force.
This evidence report and systematic review reviewed the evidence on screening for speech and language delay or disorders in children 5 years or younger to inform the US Preventive Services Task Force. This literature review looked at English-language studies of screening test accuracy, trials or cohort studies comparing screening vs no screening; randomized clinical trials (RCTs) of interventions. Main outcomes and measures were screening test accuracy, speech and language outcomes, school performance, function, quality of life, and harms. A total of 38 studies in 41 articles were included (N = 9006). There were 21 studies (n = 7489) that assessed the accuracy of 23 different screening tools that varied with regard to whether they were designed to be completed by parents vs trained examiners, and to screen for global (any) language problems vs specific skills (e.g., expressive language). Three studies assessing parent-reported tools for expressive language skills had consistently high sensitivity (range, 88%-93%) and specificity (range, 88%-85%). Other screening tools had widely varying accuracy. Seventeen RCTs (n = 1517) evaluated interventions for speech and language delay or disorders. There were no RCTs included on the harms of interventions.
AHRQ-funded; 75Q80120D00006.
Citation: Feltner C, Wallace IF, Nowell SW .
Screening for speech and language delay and disorders in children 5 years or younger: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2024 Jan 23; 331(4):335-51. doi: 10.1001/jama.2023.24647..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Screening, Prevention, Evidence-Based Practice
Peaker B, Dooley C B, Peaker B, Dooley C C
AHRQ Author: Peaker B
Screening for syphilis in nonpregnant adolescents and adults.
This case study described a 42-year-old male presenting at the clinic with low back pain that had been radiating down his right leg for one week. Case study questions related to the USPSTF recommendation on Screening for Syphilis in Nonpregnant Adolescents and Adults addressed why this patient was at increased risk, whether screening should take place, and why the USPSTF does not recommend screening for all people.
AHRQ-authored.
Citation: Peaker B, Dooley C B, Peaker B, Dooley C C .
Screening for syphilis in nonpregnant adolescents and adults.
Am Fam Physician 2024 Jan; 109(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Evidence-Based Practice, Sexual Health, Children/Adolescents
Bingham CA, Harris JG, Qui T
Pediatric Rheumatology Care and Outcomes Improvement Network's quality measure set to improve care of children with juvenile idiopathic arthritis.
The objective of this study was to describe the selection, development, and implementation of quality measures for juvenile idiopathic arthritis (JIA) by the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN), a multihospital learning health network. Clinicians in PR-COIN and parents of children with JIA collaboratively selected outcome quality measures and a committee of rheumatologists and data analysts developed operational definitions. Initial measures were clinical inactive disease, low pain score, and optimal physical functioning; the revised set included additional measures of disease activity, data quality, and a balancing measure. The authors concluded that PR-COIN's set of JIA quality measures is the first comprehensive set used at the point-of-care for a large cohort of JIA patients in a variety of pediatric rheumatology practice settings.
AHRQ-funded; HS021114.
Citation: Bingham CA, Harris JG, Qui T .
Pediatric Rheumatology Care and Outcomes Improvement Network's quality measure set to improve care of children with juvenile idiopathic arthritis.
Arthritis Care Res 2023 Dec; 75(12):2442-52. doi: 10.1002/acr.25168.
Keywords: Children/Adolescents, Arthritis, Quality Measures, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Chou R, Bougatsos C, Griffin J
Screening, referral, behavioral counseling, and preventive interventions for oral health in children and adolescents aged 5 to 17 years: a systematic review for the US Preventive Services Task Force.
The purpose of this study was to conduct a systematic evidence review on the effectiveness of primary care screening and prevention of dental caries in children and adolescents aged 5 to 17 years to inform the US Preventive Services Task Force. The main outcomes were dental caries, morbidity, functional status, quality of life, harms; and diagnostic test accuracy. Three systematic reviews with a total of 20,684 participants were included along with 19 randomized clinical trials, 3 nonrandomized trials, and 1 observational study with a total of 15,026 participants. When administered by dental professionals or in school settings, fluoride supplements compared with placebo or no intervention were associated with decreased change from baseline in the number of decayed, missing, or filled permanent teeth (DMFT index) or decayed or filled permanent teeth (DFT index) at 1.5 to 3 years (6 trials; n = 1395). Fluoride gels were associated with a DMFT- or DFT-prevented fraction of 0.18 at outcomes closest to 3 years (4 trials; n = 1525); fluoride varnish was associated with a DMFT- or DFT-prevented fraction of 0.44 at 1 to 4.5 years (5 trials; n = 3902); and resin-based sealants were associated with decreased risk of carious first molars at 48 to 54 months (4 trials; n = 440). There were no trials that evaluated primary care counseling or dental referral. There was very limited evidence on screening accuracy, silver diamine fluoride, xylitol; and harms were very limited, although serious harms were not reported.
AHRQ-funded; 75Q80120D00006.
Citation: Chou R, Bougatsos C, Griffin J .
Screening, referral, behavioral counseling, and preventive interventions for oral health in children and adolescents aged 5 to 17 years: a systematic review for the US Preventive Services Task Force.
JAMA 2023 Nov 7; 330(17):1674-86. doi: 10.1001/jama.2023.20435..
Keywords: Children/Adolescents, Dental and Oral Health, Screening, Prevention, Evidence-Based Practice, U.S. Preventive Services Task Force (USPSTF), Guidelines
Krishnan JA, Margellos-Anast H, Kumar R
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
The purpose of this clinical trial was to compare an emergency-department- (ED) only intervention and home visits by community health workers for 6 months (ED-plus-home) and enhanced usual care (UC). The study enrolled children aged 5 to 11 years with uncontrolled asthma. The primary outcomes were change over 6 months in the Patient-Reported Outcomes Measurement Information System Asthma Impact Scale score in children and Satisfaction with Participation in Social Roles score in caregivers. The secondary outcomes included guideline-recommended ED discharge care and self-management. The study found that of the 373 children recruited, only 63% completed the 6-month follow-up visit. Differences in Asthma Impact Scores or caregivers' Satisfaction with Participation in Social Roles scores were not significant. However, in the intervention groups guideline-recommended ED discharge care improved significantly versus in the UC group, and self-management behaviors were significantly improved in the ED-plus-home group versus in the ED-only and UC groups.
AHRQ-funded; HS027804.
Citation: Krishnan JA, Margellos-Anast H, Kumar R .
Coordinated Health Care Interventions for Childhood Asthma Gaps in Outcomes (CHICAGO) plan.
J Allergy Clin Immunol Glob 2023 Aug; 2(3). doi: 10.1016/j.jacig.2023.100100..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Emergency Department, Clinical Decision Support (CDS), Health Information Technology (HIT), Racial and Ethnic Minorities
Guirguis-Blake JM, Evans CV, Coppola EL
Screening for lipid disorders in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to examine benefits and harms of screening and treatment of pediatric dyslipidemia due to familial hypercholesterolemia (FH) and multifactorial dyslipidemia. Forty-three studies were included (n = 491,516). The study found that No RCTs directly addressed screening effectiveness and harms. Three US studies (n = 395,465) reported prevalence of phenotypically defined FH of 0.2% to 0.4% (1:250 to 1:500). Five studies (n = 142,257) reported multifactorial dyslipidemia prevalence; the prevalence of elevated total cholesterol level was 7.1% to 9.4% and of any lipid abnormality was 19.2%. Ten RCTs in children and adolescents with FH (n = 1,230) demonstrated that statins were related with an 81- to 82-mg/dL higher mean reduction in levels of total cholesterol and LDL-C compared with placebo at up to 2 years. Nonstatin-drug trials showed statistically significant lowering of lipid levels in FH populations, but few studies were available for any single drug. Observational studies indicate that starting statin treatment for FH in childhood or adolescence decreases long-term cardiovascular disease risk. Two multifactorial dyslipidemia behavioral counseling trials (n = 934) showed 3- to 6-mg/dL greater reductions in total cholesterol levels compared with the control group, but findings did not continue at longest follow-up. Harms reported in the short-term drug trials were similar in the intervention and control groups.
AHRQ-funded; 75Q80120D00004.
Citation: Guirguis-Blake JM, Evans CV, Coppola EL .
Screening for lipid disorders in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Jul 18; 330(3):261-74. doi: 10.1001/jama.2023.8867..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Prevention, Evidence-Based Practice, Guidelines, Children/Adolescents
Darling KE, Hayes JF, Evans EW
Engaging stakeholders to adapt an evidence-based family healthy weight program.
The purpose of this study was to describe the procedure of utilizing qualitative data from community and intervention stakeholders, children with overweight or obesity from low-income backgrounds, and caregivers to inform adaptations to the JOIN for ME pediatric weight management intervention. The researchers conducted qualitative interviews with 21 key community and intervention stakeholders, and conducted focus groups in both Spanish and English with 35 children with overweight or obesity from low-income backgrounds and 71 caregivers of children with overweight or obesity from low-income backgrounds. The results of the qualitative data analysis guided intervention modifications including content revisions to simplify and tailor materials, contextual revisions to improve intervention engagement and framing, resource awareness, and modality of delivery, training adaptations, and implementation/scale-up activities to improve community partner connections.
AHRQ-funded; HS02707.
Citation: Darling KE, Hayes JF, Evans EW .
Engaging stakeholders to adapt an evidence-based family healthy weight program.
Transl Behav Med 2023 Jul; 13(7):423-31. doi: 10.1093/tbm/ibac113..
Keywords: Obesity, Family Health and History, Evidence-Based Practice, Children/Adolescents
Reeves SL, Peng HK, Wing JJJ
Changes in hydroxyurea use among youths enrolled in Medicaid with sickle cell anemia after 2014 revision of clinical guidelines.
The objective of this cross-sectional study was to describe changes in hydroxyurea use among youths with sickle cell anemia (SCA) before and after the release of the 2014 National Heart, Lung, and Blood Institute guidelines. Data was taken from Michigan and New York State Medicaid programs, 2010-18, and the study population included youths aged 1 to 17 with SCA. The findings suggest that hydroxyurea was substantially underused in spite of its establishment as the primary disease-modifying therapy for SCA, and that there was incomplete clinician or patient uptake of the new guidelines. The authors conclude that increased use of hydroxyurea may require a multifaceted approach that includes addressing multiple system- and patient-level barriers.
AHRQ-funded; HS027785.
Citation: Reeves SL, Peng HK, Wing JJJ .
Changes in hydroxyurea use among youths enrolled in Medicaid with sickle cell anemia after 2014 revision of clinical guidelines.
JAMA Netw Open 2023 Mar;6(3):e234584. doi: 10.1001/jamanetworkopen.2023.4584.
Keywords: Children/Adolescents, Sickle Cell Disease, Chronic Conditions, Evidence-Based Practice
Fishbein AB, Lor J, Penedo FJ
Patient-reported outcomes for measuring sleep disturbance in pediatric atopic dermatitis: cross-sectional study of the patient reported outcomes measurement information system pediatric sleep measures and actigraphy.
The purposes of this cross-sectional study were to test the Patient-Reported Outcomes Measurement Information System (PROMIS) sleep measures in pediatric atopic dermatitis (AD) and to develop an algorithm to screen, evaluate, and intervene to reduce sleep disturbances. Participants were children with AD aged 5 to 17 and one parent who completed sleep, itch, and AD-specific questionnaires. Clinicians assessed disease severity. PROMIS sleep disturbance parent proxy reliability was high and was differentiated among Patient-Oriented Eczema Measure (POEM)-determined disease severity groups. The authors concluded that sleep disturbance in pediatric AD should be screened using the POEM sleep question, and further assessment using the PROMIS sleep disturbance measure or objective sleep monitoring if it is needed.
AHRQ-funded; HS023011.
Citation: Fishbein AB, Lor J, Penedo FJ .
Patient-reported outcomes for measuring sleep disturbance in pediatric atopic dermatitis: cross-sectional study of the patient reported outcomes measurement information system pediatric sleep measures and actigraphy.
J Am Acad Dermatol 2023 Feb; 88(2):348-56. doi: 10.1016/j.jaad.2020.05.138..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice
Treadwell JR, Kessler SK, Wu M
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this systematic review study was to assess the effectiveness and harms of pharmacologic and dietary treatments for epilepsy in children aged 1-36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 to identify studies reporting data on children aged 1-36 months receiving pharmacologic or dietary treatments for epilepsy. Twenty-three studies met the inclusion criteria. The study found that Levetiracetam leads to seizure freedom in some infants but the data on 6 other medications (lamotrigine, phenytoin, rufinamide, stiripentol, topiramate, and vigabatrin) were too limited to allow conclusions about their effectiveness. Three medications (lamotrigine, levetiracetam, and topiramate) were rarely discontinued due to adverse effects, and severe events were also rare. In the category of diets, the ketogenic diet lead to seizure freedom in some infants and both the ketogenic diet and modified Atkins diet reduced average seizure frequency.
AHRQ-funded; 75Q80120D00002.
Citation: Treadwell JR, Kessler SK, Wu M .
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
Neurology 2023 Jan 3;100(1):e16-e27. doi: 10.1212/wnl.0000000000201026..
Keywords: Children/Adolescents, Neurological Disorders, Newborns/Infants, Medication, Nutrition, Treatments, Evidence-Based Practice
Tsou AY, Kessler SK, Wu M
Surgical treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this article was to summarize the findings of a systematic review commissioned by the American Epilepsy Society to evaluate evidence and describe evidence gaps for surgical treatments for epilepsy in children aged 1 to 36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 and included studies reporting data on children aged 1 month to 36 months or less enrolled in surgical interventions or neurostimulation for epilepsy. Eighteen studies met inclusion criteria. The review found that seizure freedom for infants undergoing hemispherectomy/hemispherotomy ranged from 7% to 76% at 1 year after surgery. For non-hemispheric surgeries seizure freedom ranged from 40% to 70%. Over half of infants undergoing hemispherectomy/hemispherotomy achieved a favorable outcome (Engel I or II, ILAE I to IV, or >50% seizure reduction) at follow-up of over 1 year. The researchers note that the studies had important limitations. The researchers concluded that while evidence remains sparse and low quality, some infants achieve seizure freedom after surgery and 50% or greater achieve favorable outcomes.
AHRQ-funded; 75Q80120D00002.
Citation: Tsou AY, Kessler SK, Wu M .
Surgical treatments for epilepsies in children aged 1-36 months: a systematic review.
Neurology 2023 Jan 3;100(1):e1-e15. doi: 10.1212/wnl.0000000000201012..
Keywords: Children/Adolescents, Newborns/Infants, Surgery, Treatments, Evidence-Based Practice
Rizk S, Kaelin VC, Sim JGC
Implementing an electronic patient-reported outcome and decision support tool in early intervention.
The study’s aim was to identify and prioritize early intervention (EI) stakeholders' perspectives of supports and barriers to implementing the Young Children's Participation and Environment Measure (YC-PEM), an electronic patient-reported outcome (e-PRO) tool, for scaling its implementation across multiple local and state EI programs. A mixed-methods study was conducted with EI families (n = 6), service coordinators (n = 9), and program leadership (n = 7). Semi-structured interviews and focus groups were conducted and used to share quantitative trial results. All three stakeholder groups identified thematic supports and barriers across multiple constructs within each of four Consolidated Framework for Implementation Research (CFIR) domains: (1) Six themes for "intervention characteristics," (2) Six themes for "process," (3) Three themes for "inner setting," and (4) Four themes for "outer setting." Priorities from stakeholders included prioritized reaching families with diverse linguistic preferences and user navigation needs, further tailoring its interface with automated data capture and exchange processes ("process"); and fostering a positive implementation climate ("inner setting"). Improving EI access (“outer setting”) using YC-PEM e-PRO results was also articulated by service coordinators and program leadership.
AHRQ-funded; HS027583.
Citation: Rizk S, Kaelin VC, Sim JGC .
Implementing an electronic patient-reported outcome and decision support tool in early intervention.
Appl Clin Inform 2023 Jan; 14(1):91-107. doi: 10.1055/s-0042-1760631..
Keywords: Clinical Decision Support (CDS), Health Information Technology (HIT), Children/Adolescents, Evidence-Based Practice, Patient-Centered Outcomes Research, Implementation
Mills J, Barnhart H
AHRQ Author: Mills J
Screening for prediabetes and type 2 diabetes in children and adolescents.
This Putting Prevention into Practice case study is used to increase understanding of the USPSTF final recommendation on screening for prediabetes and type 2 diabetes in children and adolescents. A case study was presented using a 12-year-old-patient with no specific concerns but had gained 18 pounds since their last wellness visit and lives a sedentary lifestyle. The patient’s family history of type 2 diabetes mellitus in maternal and paternal grandparents is described. Three multiple-choice questions are presented regarding harms and benefits of screening for prediabetes and type 2 diabetes for that patient.
AHRQ-authored.
Citation: Mills J, Barnhart H .
Screening for prediabetes and type 2 diabetes in children and adolescents.
Am Fam Physician 2023 Jan; 107(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Evidence-Based Practice, Guidelines, Prevention, Chronic Conditions, Case Study
Viswanathan M, Wallace IF, Cook Middleton J
Screening for depression and suicide risk in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
The authors sought to review the evidence on screening for depression or suicide risk in children and adolescents to inform the US Preventive Services Task Force. They found indirect evidence that suggested some screening instruments were reasonably accurate for detecting depression. Further, psychotherapy and pharmacotherapy were associated with some benefits and no statistically significant harms for depression, but the evidence was limited for suicide risk screening instruments and interventions.
AHRQ-funded; 290201500011I.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for depression and suicide risk in children and adolescents: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 18;328(15):1543-56. doi: 10.1001/jama.2022.16310..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Depression, Behavioral Health, Screening, Primary Care, Guidelines, Evidence-Based Practice, Prevention
Viswanathan M, Wallace IF, Cook Middleton J
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this paper was to review the evidence on screening for anxiety in children and adolescents to inform the US Preventive Services Task Force. Indirect evidence of findings suggested that some screening instruments were reasonably accurate. Cognitive behavioral therapy and pharmacotherapy were associated with benefits; no statistically significant association with harms was reported.
AHRQ-funded; 290201500011I, 75Q80120D00007.
Citation: Viswanathan M, Wallace IF, Cook Middleton J .
Screening for anxiety in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Oct 11;328(14):1445-55. doi: 10.1001/jama.2022.16303..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Anxiety, Behavioral Health, Primary Care, Screening, Guidelines, Evidence-Based Practice, Prevention
Scott Scott, Kempe A, Bajaj L
"These are our kids": qualitative interviews with clinical leaders in general emergency departments on motivations, processes, and guidelines in pediatric sepsis care.
Researchers sought to identify barriers and facilitators to pediatric sepsis care in general emergency departments (EDs), including care processes, the role of guidelines, and incentivized metrics. They interviewed medical directors, nurse managers, and quality coordinators. They found that leaders in general EDs were motivated to provide high-quality pediatric sepsis care but disagreed on whether reportable metrics would drive improvements. Leaders universally sought direct support from their nearest children's hospitals and actionable guidelines.
AHRQ-funded; HS025696.
Citation: Scott Scott, Kempe A, Bajaj L .
"These are our kids": qualitative interviews with clinical leaders in general emergency departments on motivations, processes, and guidelines in pediatric sepsis care.
Ann Emerg Med 2022 Oct;80(4):347-57. doi: 10.1016/j.annemergmed.2022.05.030..
Keywords: Children/Adolescents, Emergency Department, Sepsis, Guidelines, Evidence-Based Practice
Jonas DE, Vander Schaaf EB, Riley S
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to explore the evidence on the benefits and harms of screening children and adolescents for prediabetes and type 2 diabetes to inform the US Preventive Services Task Force (USPSTF). The researchers utilized references; experts; literature surveillance, and PubMed/MEDLINE, Cochrane Library, and trial registries. The final review included 8 publications with 856 participants with a mean age of 14 years. The researchers found that none of the eligible studies directly assessed the benefits or harms of preventive screening. The limited eligible clinical trials reported few health outcomes and found no difference between groups.
AHRQ-funded; 290201500007I.
Citation: Jonas DE, Vander Schaaf EB, Riley S .
Screening for prediabetes and type 2 diabetes in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Sep 13;328(10):968-79. doi: 10.1001/jama.2022.7957..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Diabetes, Screening, Prevention, Evidence-Based Practice, Guidelines
Tyler A, Dempsey A, Spencer S
Do the guidelines apply?-A multisite, combined stakeholder qualitative case study to understand care decisions in bronchiolitis.
Researchers sought an improved understanding of factors that influence care decisions across multiple stakeholders and diverse settings in order to develop effective strategies to de-implement unnecessary testing and treatment for bronchiolitis. A qualitative case study was conducted across two geographically distinct university affiliated children's hospitals, including semistructured interviews and focus groups with patient participants. The researchers found that, incongruent with provider and care team perceptions, parents reported that they desire an evidence-based, less-is-more approach to bronchiolitis care.
AHRQ-funded; HS026512.
Citation: Tyler A, Dempsey A, Spencer S .
Do the guidelines apply?-A multisite, combined stakeholder qualitative case study to understand care decisions in bronchiolitis.
Acad Pediatr 2022 Jul;22(5):806-17. doi: 10.1016/j.acap.2021.08.003..
Keywords: Children/Adolescents, Respiratory Conditions, Shared Decision Making, Guidelines, Evidence-Based Practice
Ivlev I, Beil TL, Haynes JS
Rapid evidence review of digital cognitive-behavioral therapy for adolescents with depression.
This rapid evidence review was conducted to explore the benefits and harms of digital cognitive-behavioral therapy (dCBT) and the barriers to and facilitators of implementing dCBT for adolescents. An extensive literature review was done through December 6, 2021 for controlled trials conducted in settings highly applicable to the US. Additionally, the authors searched relevant systematic reviews for eligible studies. They identified 12 trials that examined the effects of nine dCBT programs. Overall, dCBT was slightly superior to other therapies in improving depression symptoms immediately, but not at a longer follow-up. There did not appear to be an increased risk for suicidal attempts or ideation with dCBT, however the number of events was very small. Potential barriers to implementing and maintaining dCBT included challenges engaging/retaining patients, developing infrastructure, and training therapists to facilitate dCBT. No data on harms or unintended negative consequences were reported in the included studies.
AHRQ-funded; HS026370.
Citation: Ivlev I, Beil TL, Haynes JS .
Rapid evidence review of digital cognitive-behavioral therapy for adolescents with depression.
J Adolesc Health 2022 Jul;71(1):14-19. doi: 10.1016/j.jadohealth.2022.01.220..
Keywords: Children/Adolescents, Depression, Behavioral Health, Evidence-Based Practice, Patient-Centered Outcomes Research
Eiraldi R, McCurdy BL, Khanna MS
Development and evaluation of a remote training strategy for the implementation of mental health evidence-based practices in rural schools: pilot study protocol.
This paper describes a pilot study protocol to develop and evaluate a remote training strategy for the implementation of mental health evidence-based practices (EBPs) in rural schools. Rural schools are increasingly implementing multi-tier positive behavioral interventions and supports (PBIS) to address school-climate problems. The study will use a mixed-methods approach for the development of the training platform, and a hybrid type 2, pilot randomized controlled trial to examine the implementation and student outcomes of two training strategies: Remote Video vs. Remote Video plus Coaching. The EPBs will be evaluated on appropriateness, feasibility, acceptability, usability, and preliminary student outcomes of the two online training strategies for the implementation of EPBs at PBIS Tier 2.
AHRQ-funded; HS027755.
Citation: Eiraldi R, McCurdy BL, Khanna MS .
Development and evaluation of a remote training strategy for the implementation of mental health evidence-based practices in rural schools: pilot study protocol.
Pilot Feasibility Stud 2022 Jun 17;8(1):128. doi: 10.1186/s40814-022-01082-4..
Keywords: Children/Adolescents, Behavioral Health, Evidence-Based Practice, Rural Health, Training
Capone CA, Emerson B, Sweberg T
Intubation practice and outcomes among pediatric emergency departments: a report from National Emergency Airway Registry for Children (NEAR4KIDS).
The purpose of this study was to describe Tracheal Intubation (TI) practice and outcomes in pediatric Emergency Departments as compared to those in intensive care units (ICUs) and use the resulting data to identify targets for quality improvement. The researchers analyzed consecutive TI encounters from pediatric EDs and ICUs in the National Emergency Airway Registry for Children (NEAR4KIDS) database from 2015 to 2018. The study found a total of 12,512 TIs in 51 pediatric/cardiac ICUs, and 756 TIs in 13 pediatric EDs and were reported. Proportion of TIs for shock (26% ED vs. 14% ICU), respiratory decompensation (52% vs. 64%), and neurologic deterioration (30% vs. 11%) also differed by location. Limited neck mobility was reported more often in the ED (16% vs. 6%). TIs in the ED were performed more often via video laryngoscopy (64% vs. 29%). Oxygen desaturation was less commonly reported in ED TIs (13.6%) than ICU TIs (17%). Among ED TIs, shock as an indication and limited mouth opening were independently associated with adverse TI-associated events (TIAEs). The study concluded that TI characteristics vary between pediatric EDs and ICUs, yet outcomes are similar.
AHRQ-funded; HS022464.
Citation: Capone CA, Emerson B, Sweberg T .
Intubation practice and outcomes among pediatric emergency departments: a report from National Emergency Airway Registry for Children (NEAR4KIDS).
Acad Emerg Med 2022 Apr;29(4):406-14. doi: 10.1111/acem.14431..
Keywords: Children/Adolescents, Emergency Department, Registries, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Critical Care, Intensive Care Unit (ICU)
Starnes LS, Krehnbrink M, Carroll AR
A pain in the neck: an adolescent with neck pain.
This case study involves a 15-year-old boy who presents with several years of intermittent neck pain, which has acutely worsened during the past 4 days. Patient history, diagnosis (Salmonella osteomyelitis.), and treatment are explored.
AHRQ-funded; HS026122.
Citation: Starnes LS, Krehnbrink M, Carroll AR .
A pain in the neck: an adolescent with neck pain.
Pediatr Rev 2022 Mar;43(3):174-77. doi: 10.1542/pir.2020-004168..
Keywords: Children/Adolescents, Infectious Diseases, Diagnostic Safety and Quality, Case Study, Evidence-Based Practice
Harris S, Farah W, Snitchler C. S, Farah W, Snitchler C
AHRQ Author: Harris S
Screening and interventions to prevent dental caries in children younger than five years.
This case study concerns Hispanic parents new to a practice who bring in their two children, two years of age and four months of age, for routine wellness visits. The parents have questions about dental care for their children. Three case study questions are provided along with answers. Bonus digital content provides an information sheet with a Clinical Summary of the USPSTF Recommendation.
AHRQ-authored.
Citation: Harris S, Farah W, Snitchler C. S, Farah W, Snitchler C .
Screening and interventions to prevent dental caries in children younger than five years.
Am Fam Physician 2022 Mar;105(3):299-300..
Keywords: Children/Adolescents, Dental and Oral Health, Screening, Guidelines, Evidence-Based Practice, Case Study
Bhalala US, Gist KM, Tripathi S
Characterization and outcomes of hospitalized children with coronavirus disease 2019: a report from a multicenter, viral infection and respiratory illness universal study (Coronavirus Disease 2019) registry.
The purpose of this retrospective study was to examine data from the Society of Critical Care Medicine Viral Infection and Respiratory Illness Universal Study (Coronavirus Disease 2019) registry and describe the characteristics, ICU admissions, and outcomes in children hospitalized with COVID-19. The study included 874 children under the age of 18 hospitalized with coronavirus disease 2019 at 51 participating hospital centers from February 2020 to January 2021. The primary outcome was ICU admission. Secondary outcomes included hospital and ICU duration of stay and ICU, hospital, and 28-day mortality. The researchers found that the median age was 8 years, with 62.9% non-Hispanic and a boy to girl ratio of 1:2. A total of 28.2% of the children met the Centers for Disease Control and Prevention criteria for multisystem inflammatory syndrome in children, and 46.2% were admitted to the ICU. A child’s age, the presence of a fever, multisystem inflammatory syndrome, and pre-existing seizure disorder were independently associated with a greater odds of ICU admission. The rate of hospital mortality for this group was 1.8%. The median duration of ICU stay was 3.9 days and the median duration of hospital stay was 4 days. For those patients with 28-day data, the survival rate was 86.3%. The researchers concluded that in this study, older age, fever, multisystem inflammatory syndrome in children, and seizure disorder were independently related with ICU admission.
AHRQ-funded; HS026393; HS026485.
Citation: Bhalala US, Gist KM, Tripathi S .
Characterization and outcomes of hospitalized children with coronavirus disease 2019: a report from a multicenter, viral infection and respiratory illness universal study (Coronavirus Disease 2019) registry.
Crit Care Med 2022 Jan;50(1):e40-e51. doi: 10.1097/ccm.0000000000005232..
Keywords: COVID-19, Children/Adolescents, Registries, Patient-Centered Outcomes Research, Evidence-Based Practice, Inpatient Care
Menon K, Schlapbach LJ, Akech S
Criteria for pediatric sepsis-a systematic review and meta-analysis by the Pediatric Sepsis Definition Taskforce.
This meta-analysis conducted by the Pediatric Sepsis Definition Taskforce determined the associations of demographic, clinical, laboratory, organ dysfunction, and illness severity variable values with sepsis, severe sepsis, or septic shock in children with infection; and multiple organ dysfunction or death in children with sepsis, severe sepsis, or septic shock. Criteria for included studies were case-control studies, cohort studies, and randomized controlled trials in children greater than or equal to 37-week-old postconception to 18 years with suspected or confirmed infection, which included the terms "sepsis," "septicemia," or "septic shock" in the title or abstract. One hundred and six studies met eligibility criteria of which 81 were included. Sixteen studies provided data for the sepsis, severe sepsis, or septic shock outcome and 71 studies for the mortality outcome. Significant and consistent associations with mortality were demonstrated in children with sepsis/severe sepsis/septic shock, chronic conditions, oncologic diagnosis, use of vasoactive/inotropic agents, mechanical ventilation, serum lactate, platelet count, fibrinogen, procalcitonin, multi-organ dysfunction syndrome, Pediatric Logistic Organ Dysfunction score, Pediatric Index of Mortality-3, and Pediatric Risk of Mortality score.
AHRQ-funded; HS025696.
Citation: Menon K, Schlapbach LJ, Akech S .
Criteria for pediatric sepsis-a systematic review and meta-analysis by the Pediatric Sepsis Definition Taskforce.
Crit Care Med 2022 Jan;50(1):21-36. doi: 10.1097/ccm.0000000000005294..
Keywords: Children/Adolescents, Sepsis, Evidence-Based Practice