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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.
Results
1 to 25 of 28 Research Studies DisplayedLuther M, Poppert Cordts KM, Williams CN
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
This is a systematic review to quantify sleep wake disturbances (SWD) after pediatric traumatic brain injury (TBI). These SWD can place children at risk for worse outcomes since sleep is needed for brain development and healing after injury. They also evaluated interventions for SWD and the association between SWD and other post-traumatic outcomes. Literature was searched from 1999-2019 evaluating sleep or fatigue in children hospitalized for TBI. Two independent reviewers assessed quality of the studies using the Newcastle-Ottowa Score for observational studies. Out of 966 identified articles, 126 full text articles were reviewed and 24 studies were included. Studies showed at least 20% of children with TBI had some degree of SWD including trouble falling or staying asleep, fatigue, daytime fatigue, and nightmares. SWD was negatively correlated with cognitive, behavioral, and quality of life outcomes. There was moderate-high risk of bias for all studies due to small sample size and lack of validated or objective SWD measures.
AHRQ-funded; HS022981.
Citation: Luther M, Poppert Cordts KM, Williams CN .
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
Sleep 2020 Oct;43(10):zsaa083. doi: 10.1093/sleep/zsaa083..
Keywords: Children/Adolescents, Sleep Problems, Brain Injury, Neurological Disorders, Trauma, Risk, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Evidence-Based Practice
Lindly O, Crossman M, Eaves M
Health literacy and health outcomes among children with developmental disabilities: a systematic review.
This systematic literature review focused on the impact of health literacy on health outcomes of children with developmental disabilities (DDs). A review of the literature of most of the major scientific databases was conducted. Out of 2,768 unique records identified, 53 full text articles were reviewed and four articles were included. The associations of family health literacy with health outcomes among children with DDs were mixed. Future research was recommended.
AHRQ-funded; HS000063.
Citation: Lindly O, Crossman M, Eaves M .
Health literacy and health outcomes among children with developmental disabilities: a systematic review.
Am J Intellect Dev Disabil 2020 Sep 1;125(5):389-407. doi: 10.1352/1944-7558-125.5.389..
Keywords: Children/Adolescents, Health Literacy, Disabilities, Evidence-Based Practice, Patient-Centered Outcomes Research, Outcomes
Mogul DB, Perito ER, Wood N
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
In December 2018, UNOS approved an allocation scheme based on recipients' geographic distance from a deceased donor ("acuity circles"). Previous analyses suggested acuity circles (AC) would reduce waitlist mortality overall, but their impact on pediatric subgroups was not considered. In this study, the investigators applied Scientific Registry of Transplant Recipients data from 2011-2016 towards the Liver Simulated Allocation Model (LSAM) to compare outcomes by age and illness severity for the UNOS-approved AC and the existing Donor Service Area (DSA)/Region-based allocation schemes.
AHRQ-funded; HS023876.
Citation: Mogul DB, Perito ER, Wood N .
Impact of acuity circles on outcomes for pediatric liver transplant candidates.
Transplantation 2020 Aug;104(8):1627-32. doi: 10.1097/tp.0000000000003079..
Keywords: Children/Adolescents, Transplantation, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice, Registries, Surgery, Access to Care
Kaiser SV, Johnson MD, Walls TA
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
This quality improvement study’s aim was to determine the effects of pediatric asthma pathway implementation in a diverse, national sample of emergency departments (EDs). Desired outcomes included systemic corticosteroid administration within 60 minutes (primary), assessment of severity at ED triage, chest radiograph use, hospital admission or transfer for higher level of care, and ED length of stay. Charts were reviewed each month by EDs for children ages 2-17 years with a primary diagnosis of asthma. A total of 83 EDs were enrolled, with 37 of them children’s hospitals, and 46 community hospitals. Seventy-three percent completed the study (n = 22,963). There was a significant increase in systematic corticosteroid administration within 60 minutes of arrival as well as increased odds of severity assessment at triage and decreased rate of change in odds of hospital admission/transfer. Chest radiograph or ED length of stay was not associated with pathway implementation.
AHRQ-funded; HS024592.
Citation: Kaiser SV, Johnson MD, Walls TA .
Pathways to improve pediatric asthma care: a multisite, national study of emergency department asthma pathway implementation.
J Pediatr 2020 Aug;223:100-07.e2. doi: 10.1016/j.jpeds.2020.02.080..
Keywords: Children/Adolescents, Emergency Department, Asthma, Quality Improvement, Quality of Care, Care Management, Healthcare Delivery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Kaiser SV, Jennings B, Rodean J
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
This study examined whether implementation of a pathway strategy for inpatient pediatric asthma patients improve outcomes for these patients. Outcomes measured included length of stay (LOS), early administration of metered-dose inhalers, screening for secondhand tobacco exposure and referral to cessation resources, and 7-day hospital readmissions or emergency revisits. Eighty-five hospitals were enrolled and 68 completed the study with (n=12,013) admissions. Pathways were associated with increases in early administration of metered-dose inhalers, and referral to smoking cessation resources, but no statistically significant changes in the other outcomes were observed. Most hospitals did improve in at least one outcome.
AHRQ-funded; HS024592; HS024554.
Citation: Kaiser SV, Jennings B, Rodean J .
Pathways for improving inpatient pediatric asthma care (PIPA): a multicenter, national study.
Pediatrics 2020 Jun;145(6):e20193026. doi: 10.1542/peds.2019-3026..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Inpatient Care, Patient-Centered Outcomes Research, Outcomes, Hospitalization, Care Management
Heneghan MB, Hussain T, Barrera L
Applying the COM-B model to patient-reported barriers to medication adherence in pediatric acute lymphoblastic leukemia.
This study examined parent- and patient-reported barriers to oral chemotherapy adherence with children with pediatric acute lymphoblastic leukemia (ALL). The medicine most often used was 6-mercaptopurine (6-MP). Forty-nine parents and 15 patients were surveyed and most reported at least one adherence barrier. Most of the barriers were about meeting other patients with ALL or meeting other parents. Patients also reported difficulty in finding out what their medications are, and what 6-MP does. These barriers can lead to relapse if they are not addressed.
AHRQ-funded; HS023011.
Citation: Heneghan MB, Hussain T, Barrera L .
Applying the COM-B model to patient-reported barriers to medication adherence in pediatric acute lymphoblastic leukemia.
Pediatr Blood Cancer 2020 May;67(5):e28216. doi: 10.1002/pbc.28216..
Keywords: Children/Adolescents, Treatments, Cancer, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Whiteside SPH, Sim LA, Morrow AS
A meta-analysis to guide the enhancement of CBT for childhood anxiety: exposure over anxiety management.
Cognitive behavior therapy (CBT) is the most empirically supported therapy for childhood anxiety disorders (CADs) but has not reliably outperformed other credible interventions. The current study used meta-analysis to examine the frequency with which the most common treatment components are included in outcome studies and the relation of these components to symptom improvement.
AHRQ-funded; 290201500013I.
Citation: Whiteside SPH, Sim LA, Morrow AS .
A meta-analysis to guide the enhancement of CBT for childhood anxiety: exposure over anxiety management.
Clin Child Fam Psychol Rev 2020 Mar;23(1):102-21. doi: 10.1007/s10567-019-00303-2..
Keywords: Children/Adolescents, Anxiety, Behavioral Health, Treatments, Patient-Centered Outcomes Research, Evidence-Based Practice
Bowring MG, Massie AB, Chu NM
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
Researchers aimed to use national registry data and parametric models to project 20- and 30-year post-transplant outcomes for recently transplanted pediatric liver transplant (LT) recipients. Using Scientific Registry of Transplant Recipients data, they found that projected long-term outcomes for recently transplanted pediatric LT recipients are excellent, reflective of substantial improvements in medical care, and informative for physician-patient education and decision making in the current era.
AHRQ-funded; HS023876.
Citation: Bowring MG, Massie AB, Chu NM .
Projected 20- and 30-year outcomes for pediatric liver transplant recipients in the United States.
J Pediatr Gastroenterol Nutr 2020 Mar;70(3):356-63. doi: 10.1097/mpg.0000000000002592..
Keywords: Children/Adolescents, Transplantation, Patient-Centered Outcomes Research, Outcomes, Surgery, Registries, Evidence-Based Practice
Barry-Menkhaus SA, Wagner DV, Riley AR
Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes.
In this article, the authors review existing evidence for brief interventions, describe several untested clinical strategies, and make recommendations for accelerating the translational study of brief interventions among youth with type 1 diabetes.
AHRQ-funded; HS022981.
Citation: Barry-Menkhaus SA, Wagner DV, Riley AR .
Small interventions for big change: brief strategies for distress and self-management amongst youth with type 1 diabetes.
Curr Diab Rep 2020 Jan 30;20(1):3. doi: 10.1007/s11892-020-1290-7..
Keywords: Diabetes, Patient-Centered Healthcare, Patient Self-Management, Patient Adherence/Compliance, Care Management, Patient-Centered Outcomes Research, Healthcare Delivery, Children/Adolescents
Stockmann C, Ampofo K, Pavia AT
Comparative effectiveness of oral versus outpatient parenteral antibiotic therapy for empyema.
This study compared outcomes between oral therapy and (outpatient parenteral antibiotic therapy (OPAT) for pediatric parapneumonic empyema (PPE) . The frequency of complications was similar with oral therapy and OPAT for children with PPE. Oral antibiotics may be considered safe and effective for children with PPE who will be discharged to complete therapy in the outpatient setting.
AHRQ-funded; HS023320.
Citation: Stockmann C, Ampofo K, Pavia AT .
Comparative effectiveness of oral versus outpatient parenteral antibiotic therapy for empyema.
Hosp Pediatr 2015 Dec;5(12):605-12. doi: 10.1542/hpeds.2015-0100.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Medication, Hospitalization, Children/Adolescents
Nkoy F, Fassl B, Stone B
Improving pediatric asthma care and outcomes across multiple hospitals.
This study aimed to assess the impact of an evidence-based care process model 5 years after implementation at Primary Children's Hospital, a tertiary care facility, and after its dissemination to 7 community hospitals. The intervention resulted in sustained, long-term improvement in asthma care and outcomes at the tertiary care hospital and successful dissemination to community hospitals.
AHRQ-funded; HS018166; HS018678.
Citation: Nkoy F, Fassl B, Stone B .
Improving pediatric asthma care and outcomes across multiple hospitals.
Pediatrics 2015 Dec;136(6):e1602-10. doi: 10.1542/peds.2015-0285..
Keywords: Children/Adolescents, Asthma, Hospitalization, Evidence-Based Practice, Patient-Centered Outcomes Research
Smith MJ, Gerber JS, Hersh AL
Inpatient antimicrobial stewardship in pediatrics: a systematic review.
The purpose of this paper was to describe the clinical and economic outcomes associated with pediatric antimicrobial stewardship programs and other supplemental antimicrobial stewardship interventions. The authors concluded that the studies researched demonstrated reductions in antimicrobial utilization, cost, and prescribing errors with no apparent negative impact on patient safety.
AHRQ-funded; HS023320.
Citation: Smith MJ, Gerber JS, Hersh AL .
Inpatient antimicrobial stewardship in pediatrics: a systematic review.
J Pediatric Infect Dis Soc 2015 Dec;4(4):e127-35. doi: 10.1093/jpids/piu141.
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Keywords: Antimicrobial Stewardship, Children/Adolescents, Healthcare Costs, Patient-Centered Outcomes Research, Children/Adolescents
Storch EA, Salloum A, King MA
A randomized controlled trial in community mental health centers of computer-assisted cognitive behavioral therapy versus treatment as usual for children with anxiety.
This study aimed to examine the real-world effectiveness of a computer-assisted cognitive behavioral therapy (CBT) protocol relative to treatment as usual (TAU) among anxious children presenting at community mental health centers. It found that relative to TAU, computer-assisted CBT was associated with greater reductions in parent-rated child impairment and internalizing symptoms, but not child-rated impairment and anxiety and depressive symptoms.
AHRQ-funded; HS018665.
Citation: Storch EA, Salloum A, King MA .
A randomized controlled trial in community mental health centers of computer-assisted cognitive behavioral therapy versus treatment as usual for children with anxiety.
Depress Anxiety 2015 Nov;32(11):843-52. doi: 10.1002/da.22399.
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Keywords: Anxiety, Children/Adolescents, Health Information Technology (HIT), Community-Based Practice, Patient-Centered Outcomes Research
Taveras EM, Marshall R, Sharifi M
Connect for Health: Design of a clinical-community childhood obesity intervention testing best practices of positive outliers.
The Connect for Health study is designed to assess whether a novel approach to care delivery that leverages clinical and community resources and addresses socio-contextual factors will improve body mass index and family-centered, obesity-related outcomes of interest to parents and children. The intervention is informed by clinical, community, parent, and youth stakeholders and incorporates successful strategies and best practices learned from 'positive outlier' families.
AHRQ-funded; HS022986.
Citation: Taveras EM, Marshall R, Sharifi M .
Connect for Health: Design of a clinical-community childhood obesity intervention testing best practices of positive outliers.
Contemp Clin Trials 2015 Nov;45(Pt B):287-95. doi: 10.1016/j.cct.2015.09.022.
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Keywords: Children/Adolescents, Obesity, Health Information Technology (HIT), Community-Based Practice, Patient-Centered Outcomes Research
Brent DA, Brunwasser SM, Hollon SD
Effect of a cognitive-behavioral prevention program on depression 6 years after implementation among at-risk adolescents: a randomized clinical trial.
The objective of this paper is to determine whether a cognitive-behavioral prevention (CBP) program reduced the incidence of depressive episodes, increased depression-free days, and improved developmental competence 6 years after implementation. Over the 75-month follow-up, youths assigned to CBP had a lower incidence of depression; the CBP program's overall significant effect was driven by a lower incidence of depressive episodes during the first 9 months after enrollment.
AHRQ-funded; HS022990.
Citation: Brent DA, Brunwasser SM, Hollon SD .
Effect of a cognitive-behavioral prevention program on depression 6 years after implementation among at-risk adolescents: a randomized clinical trial.
JAMA Psychiatry 2015 Nov;72(11):1110-8. doi: 10.1001/jamapsychiatry.2015.1559.
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Keywords: Behavioral Health, Children/Adolescents, Depression, Patient-Centered Outcomes Research
Sharifi M, Marshall G, Goldman RE
Engaging children in the development of obesity interventions: exploring outcomes that matter most among obesity positive outliers.
The researchers explored outcomes and measures of success that matter most to 'positive outlier' children who improved their body mass index (BMI) despite living in obesogenic neighborhoods. They found that children identified bullying and negative peer comparisons related to physical appearance, clothing size, and athletic ability as motivating them to achieve a healthier weight, and they measured success as improvement in these domains. Positive relationships with friends and family facilitated both behavior change initiation and maintenance.
AHRQ-funded; HS022986.
Citation: Sharifi M, Marshall G, Goldman RE .
Engaging children in the development of obesity interventions: exploring outcomes that matter most among obesity positive outliers.
Patient Educ Couns 2015 Nov;98(11):1393-401. doi: 10.1016/j.pec.2015.06.007.
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Keywords: Children/Adolescents, Obesity, Family Health and History, Lifestyle Changes, Patient-Centered Outcomes Research
Khan A, Rogers JE, Melvin P
Physician and nurse nighttime communication and parents' hospital experience.
The researchers examined relationships between nighttime communication and parents’ inpatient experience. They found that parents provided the highest percentage of top ratings for the individual item pertaining to whether nurses listened to their concerns (70.5 percent strongly agreed) and the lowest such ratings for regular communication with nighttime doctors (31.4 percent excellent).
AHRQ-funded; HS022986; HS000063.
Citation: Khan A, Rogers JE, Melvin P .
Physician and nurse nighttime communication and parents' hospital experience.
Pediatrics 2015 Nov;136(5):e1249-58. doi: 10.1542/peds.2015-2391..
Keywords: Children/Adolescents, Clinician-Patient Communication, Patient-Centered Outcomes Research
Epstein RA, Fonnesbeck C, Potter S
Psychosocial interventions for child disruptive behaviors: a meta-analysis.
The researchers conducted a systematic review and meta-analysis to synthesize existing literature on the comparative effectiveness of psychosocial interventions for children and adolescents, 18 years of age with disruptive behavior disorders. It concluded that the 3 intervention categories were more effective than the control conditions. Interventions with a parent component, either alone or in combination with other components, were likely to have the largest effect.
AHRQ-funded; 290201200009I.
Citation: Epstein RA, Fonnesbeck C, Potter S .
Psychosocial interventions for child disruptive behaviors: a meta-analysis.
Pediatrics 2015 Nov;136(5):947-60. doi: 10.1542/peds.2015-2577..
Keywords: Behavioral Health, Children/Adolescents, Comparative Effectiveness, Patient-Centered Outcomes Research
Michelson KA, Monuteaux MC, Neuman MI
Glucocorticoids and hospital length of stay for children with anaphylaxis: a retrospective study.
The objective of this study was to evaluate whether glucocorticoid administration is associated with improved outcomes in children with anaphylaxis. The investigators found that the use of glucocorticoids was inversely associated with prolonged length of stay among children hospitalized with anaphylaxis, but was not associated with 3-day emergency department revisits among discharged children, thus supporting the use of glucocorticoids in children hospitalized with anaphylaxis.
AHRQ-funded; HS000063.
Citation: Michelson KA, Monuteaux MC, Neuman MI .
Glucocorticoids and hospital length of stay for children with anaphylaxis: a retrospective study.
J Pediatr 2015 Sep;167(3):719-24.e1-3. doi: 10.1016/j.jpeds.2015.05.033.
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Keywords: Children/Adolescents, Medication, Respiratory Conditions, Respiratory Conditions, Patient-Centered Outcomes Research
McConnochie KM, Ronis SD, Wood NE
Effectiveness and safety of acute care telemedicine for children with regular and special healthcare needs.
The authors assessed the hypothesis that effectiveness and safety of the Health-e-Access telemedicine model for care of children with special healthcare needs (CSHCN) with acute illness equaled those for care of children in regular childcare and schools (CRS). They concluded that observations support safety and effectiveness of Health-e-Access telemedicine for both CSHCN and CRS.
AHRQ-funded; HS016871; HS015165; HS018912.
Citation: McConnochie KM, Ronis SD, Wood NE .
Effectiveness and safety of acute care telemedicine for children with regular and special healthcare needs.
Telemed J E Health 2015 Aug;21(8):611-21. doi: 10.1089/tmj.2014.0175.
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Keywords: Critical Care, Children/Adolescents, Patient Safety, Patient-Centered Outcomes Research, Telehealth
Thienprayoon R, Lee SC, Leonard D
Hospice care for children with cancer: where do these children die?
The primary aim of this report is to describe the location of death in a cohort of children with cancer who enrolled in hospice, the factors significantly associated with death at home, and trends in hospice retention in this cohort. It found that one quarter of those children with cancer who enrolled with an outpatient hospice service returned to the hospital and died in an acute care setting; 5 children died in the ICU.
AHRQ-funded; HS022418.
Citation: Thienprayoon R, Lee SC, Leonard D .
Hospice care for children with cancer: where do these children die?
J Pediatr Hematol Oncol 2015 Jul;37(5):373-7. doi: 10.1097/mph.0000000000000331..
Keywords: Children/Adolescents, Cancer, Patient-Centered Outcomes Research
Christian RB, Gaynes BN, Saavedra LM
Use of antipsychotic medications in pediatric and young adult populations: future research needs.
This article describes and prioritizes future research needs regarding antipsychotic treatment in youth, focusing on within-class and between-class drug comparisons with regard to key population subgroups, efficacy and effectiveness outcomes, and adverse event outcomes. Future research needs are delineated in detail as well as study designs that could be used to address them.
AHRQ-funded; 290200710056I.
Citation: Christian RB, Gaynes BN, Saavedra LM .
Use of antipsychotic medications in pediatric and young adult populations: future research needs.
J Psychiatr Pract 2015 Jan;21(1):26-36. doi: 10.1097/01.pra.0000460619.10429.4c..
Keywords: Medication, Children/Adolescents, Behavioral Health, Comparative Effectiveness, Patient-Centered Outcomes Research
Shah RK, Stey AM, Jantana KR
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
This study evaluated perioperative outcomes in pediatric otolaryngology through analysis of records residing in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS-NSQIP) database. It found that although the overall rate of major postoperative morbidity in pediatric otolaryngology is low, the following areas may be targeted for targeted quality-improvement interventions: tracheostomy, airway reconstruction, mastoidectomy, and abscess drainage.
AHRQ-funded; HS022932
Citation: Shah RK, Stey AM, Jantana KR .
Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.
JAMA Otolaryngol Head Neck Surg. 2014 Nov;140(11):1019-26. doi: 10.1001/jamaoto.2014.2067..
Keywords: Surgery, Children/Adolescents, Quality Improvement, Outcomes, Patient-Centered Outcomes Research
Mannion ML, Xie F, Curtis JR
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
The researchers investigated temporal trends in medication use among children diagnosed with juvenile idiopathic arthritis (JIA). They found that the use of tumor necrosis factor inhibitors (TNFi) in the treatment of JIA increased 2- to 3-fold from 2005 to 2012. New TNFi use was associated with decreased NSAID and oral glucocorticoids use. TNFi may be replacing, rather than complementing, methotrexate in the treatment of many patients.
AHRQ-funded; HS018517.
Citation: Mannion ML, Xie F, Curtis JR .
Recent trends in medication usage for the treatment of juvenile idiopathic arthritis and the influence of tumor necrosis factor inhibitors.
J Rheumatol 2014 Oct;41(10):2078-84. doi: 10.3899/jrheum.140012.
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Keywords: Children/Adolescents, Medication, Patient-Centered Outcomes Research, Practice Patterns, Arthritis
Feudtner C, Freedman J, Kang T
Comparative effectiveness of senna to prevent problematic constipation in pediatric oncology patients receiving opioids: a multicenter study of clinically detailed administrative data.
The researcher investigated senna’s effectiveness, compared with other prophylactic oral bowel medications, in reducing opioid-induced constipation in pediatric cancer patients. They found that initiating senna therapy within two days of starting opioids, compared with initiating another oral bowel medication, was significantly associated with a lower risk of problematic constipation.
AHRQ-funded; HS018425.
Citation: Feudtner C, Freedman J, Kang T .
Comparative effectiveness of senna to prevent problematic constipation in pediatric oncology patients receiving opioids: a multicenter study of clinically detailed administrative data.
J Pain Symptom Manage 2014 Aug;48(2):272-80. doi: 10.1016/j.jpainsymman.2013.09.009..
Keywords: Cancer, Children/Adolescents, Comparative Effectiveness, Patient-Centered Outcomes Research, Medication