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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
101 to 125 of 229 Research Studies DisplayedMarin JR, Lewiss RE
Point-of-care ultrasonography by pediatric emergency medicine physicians.
This article announces that the American Academy of Pediatrics (AAP) has recently published in the journal Pediatrics the first guideline for point-of-care ultrasonography (US) use by pediatric emergency medicine (PEM) physicians. The AAP policy statement and accompanying technical report provide background and a framework for PEM physicians, who currently use or are planning to incorporate point-of-care US into their practice.
AHRQ-funded; HS023498.
Citation: Marin JR, Lewiss RE .
Point-of-care ultrasonography by pediatric emergency medicine physicians.
Acad Emerg Med 2015 May;22(5):623-4. doi: 10.1111/acem.12659..
Keywords: Children/Adolescents, Children/Adolescents, Emergency Medical Services (EMS), Emergency Department, Children/Adolescents
Cauley RP, Potanos K, Fullington N
Pulmonary support on day of life 30 is a strong predictor of increased 1 and 5-year morbidity in survivors of congenital diaphragmatic hernia.
The researchers aimed to determine if the degree of pulmonary support (PS) on day of life 30 (DOL-30) could be a simple cross-institutional tool for identifying those patients with a higher risk of long-term morbidity. They found that PS on DOL-30 is a strong independent predictor of morbidity at 1 and 5-years and may be used as a simple prognostic tool to identify high-risk infants.
AHRQ-funded; HS019485.
Citation: Cauley RP, Potanos K, Fullington N .
Pulmonary support on day of life 30 is a strong predictor of increased 1 and 5-year morbidity in survivors of congenital diaphragmatic hernia.
J Pediatr Surg 2015 May;50(5):849-55. doi: 10.1016/j.jpedsurg.2014.12.007..
Keywords: Children/Adolescents, Mortality, Outcomes
Roxbury CR, Yang J, Salazar J
Safety and postoperative adverse events in pediatric otologic surgery: analysis of American College of Surgeons NSQIP-P 30-day outcomes.
This study described safety and postoperative sequelae of pediatric otologic surgery and identify predictive factors for postoperative events. It found that pediatric otologic procedures are common and have low rates of global 30-day postoperative events. Tympanomastoidectomy and cochlear implantation have the highest risk of 30-day readmission.
AHRQ-funded; HS022932.
Citation: Roxbury CR, Yang J, Salazar J .
Safety and postoperative adverse events in pediatric otologic surgery: analysis of American College of Surgeons NSQIP-P 30-day outcomes.
Otolaryngol Head Neck Surg 2015 May;152(5):790-5. doi: 10.1177/0194599815575711..
Keywords: Adverse Events, Children/Adolescents, Surgery, Patient Safety, Children/Adolescents, Quality Improvement
Mohd Roffeei SH, Abdullah N, Basar SK
Seeking social support on Facebook for children with autism spectrum disorders (ASDs).
This study examined the types of social support messages exchanged between parents and/or caregivers of children with Autism Spectrum Disorders (ASDs) who communicate via Facebook. It found that the highest percentage of messages offered dealt with informational support (30.7 percent) followed by emotional support (27.8 percent). Network and esteem support messages were responsible for 20.97 percent and 20.2 percent, respectively.
AHRQ-funded; HS018809.
Citation: Mohd Roffeei SH, Abdullah N, Basar SK .
Seeking social support on Facebook for children with autism spectrum disorders (ASDs).
Int J Med Inform 2015 May;84(5):375-85. doi: 10.1016/j.ijmedinf.2015.01.015..
Keywords: Social Media, Children/Adolescents, Caregiving, Telehealth, Autism
Wang JW, Hogan PG, Hunstad DA
Vitamin D sufficiency and Staphylococcus aureus infection in children.
Vitamin D sufficiency may be one of a myriad of host and environmental factors that can be directly impacted to reduce the frequency of S. aureus skin and soft tissue infection. The researchers found that children with vitamin D deficiency or insufficiency [25-hydroxyvitamin D <30 ng/mL] were more likely to present with recurrent, rather than primary, S. aureus skin or soft tissue infection.
AHRQ-funded; HS021736.
Citation: Wang JW, Hogan PG, Hunstad DA .
Vitamin D sufficiency and Staphylococcus aureus infection in children.
Pediatr Infect Dis J 2015 May;34(5):544-5. doi: 10.1097/inf.0000000000000667..
Keywords: Vitamins and Supplements, Children/Adolescents
Fiks AG, Zhang P, Localio AR
Adoption of electronic medical record-based decision support for otitis media in children.
The authors characterized adoption of an otitis media clinical decision support (CDS) system, the impact of performance feedback on adoption, and the effects of adoption on guideline adherence. The performance feedback increased CDS adoption, but additional strategies are needed to integrate CDS into primary care workflows.
AHRQ-funded; HS017042
Citation: Fiks AG, Zhang P, Localio AR .
Adoption of electronic medical record-based decision support for otitis media in children.
Health Serv Res. 2015 Apr;50(2):489-513. doi: 10.1111/1475-6773.12240..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Ear Infections, Electronic Health Records (EHRs), Health Information Technology (HIT)
Rinke ML, Chen AR, Milstone AM
Bringing central line-associated bloodstream infection prevention home: catheter maintenance practices and beliefs of pediatric oncology patients and families.
The researchers investigated (1) the extent to which best-practice central line maintenance practices were employed in the homes of pediatric oncology patients and by whom, (2) caregiver beliefs about central line care and central line-associated blood stream infection (CLABSI) risk, (3) barriers to optimal central line care by families, and (4) educational experiences and preferences regarding central line care. They concluded that interventions aimed at reducing ambulatory CLABSIs should target appropriate educational experiences for adult caregivers and patients and identify ways to improve compliance with best-practice care.
AHRQ-funded; HS021282.
Citation: Rinke ML, Chen AR, Milstone AM .
Bringing central line-associated bloodstream infection prevention home: catheter maintenance practices and beliefs of pediatric oncology patients and families.
Jt Comm J Qual Patient Saf 2015 Apr;41(4):177-85.
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Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Patient Safety, Ambulatory Care and Surgery, Quality Improvement
Gance-Cleveland B, Aldrich H, Schmiege S
Clinician adherence to childhood overweight and obesity recommendations by race/ethnicity of the child.
This study describes school-based health center (SBHC) providers’ adherence to obesity guidelines. Providers (n = 28) were from SBHCs in six states serving children 5–12 years of age. Body mass index percentage was documented on 73 percent of charts and blood pressure percentage on 30.5 percent. Providers accurately diagnosed 40 percent overweight and 49.3 percent obese children.
AHRQ-funded; HS018646.
Citation: Gance-Cleveland B, Aldrich H, Schmiege S .
Clinician adherence to childhood overweight and obesity recommendations by race/ethnicity of the child.
J Spec Pediatr Nurs 2015 Apr;20(2):115-22. doi: 10.1111/jspn.12107..
Keywords: Children/Adolescents, Guidelines, Obesity, Prevention
Kempe A, Saville AW, Dickinson LM
Collaborative centralized reminder/recall notification to increase immunization rates among young children: a comparative effectiveness trial.
The objectives of this study were to compare the effectiveness and cost-effectiveness of a collaborative centralized (CC) reminder/recall approach with that of a practice-based (PB) reminder recall approach for increasing immunization rates among preschool-aged children. It found that a CC reminder/recall notification was more effective and more cost-effective than a PB system, although the effect size was modest.
AHRQ-funded; HS021138
Citation: Kempe A, Saville AW, Dickinson LM .
Collaborative centralized reminder/recall notification to increase immunization rates among young children: a comparative effectiveness trial.
JAMA Pediatr. 2015 Apr;169(4):365-73. doi: 10.1001/jamapediatrics.2014.3670..
Keywords: Children/Adolescents, Comparative Effectiveness, Vaccination
Nykiel-Bailey SM, McAllister JD, Schrock CR
Difficult airway consultation service for children: steps to implement and preliminary results.
The article demonstrates how to implement a consultative service focusing on difficult airway (DAW) identification, management and education. The initial 3-month experience confirmed that a majority of pediatric DAW events are associated with congenital or acquired abnormalities. Through appropriate consultation and leadership, the Difficult Airway Service was able to physically and electronically identify pediatric patients with a DAW and provide management.
AHRQ-funded; HS022265.
Citation: Nykiel-Bailey SM, McAllister JD, Schrock CR .
Difficult airway consultation service for children: steps to implement and preliminary results.
Paediatr Anaesth 2015 Apr;25(4):363-71. doi: 10.1111/pan.12625..
Keywords: Care Management, Children/Adolescents, Respiratory Conditions, Patient Safety, Risk
Rodriguez MI, Darney BG, Elman E
Examining quality of contraceptive services for adolescents in Oregon's family planning program.
This study assessed the quality of care provided to adolescents (10–19 years old) compared to women (aged 20–25 years) who accessed services in Oregon's Contraceptive Care (CCare) program. It found that although adolescents served by CCare are more likely to initiate contraception, they are less likely to receive long-acting reversible contraception (LARC) than women aged 20–25 years.
AHRQ-funded; HS017582.
Citation: Rodriguez MI, Darney BG, Elman E .
Examining quality of contraceptive services for adolescents in Oregon's family planning program.
Contraception 2015 Apr;91(4):328-35. doi: 10.1016/j.contraception.2014.12.008..
Keywords: Children/Adolescents, Sexual Health, Quality of Care, Women
Gauguet S, Ahmed AA, Zhou J
Group A streptococcal bacteremia without a source is associated with less severe disease in children.
The authors analyzed characteristics of 86 Group A streptococcal bacteremia cases at Boston Children's Hospital from 1992 to 2012. They found that children with bacteremia without a source (30% of cases) were less likely to have severe disease than children with focal infections.
AHRQ-funded; HS013908.
Citation: Gauguet S, Ahmed AA, Zhou J .
Group A streptococcal bacteremia without a source is associated with less severe disease in children.
Pediatr Infect Dis J 2015 Apr;34(4):447-9. doi: 10.1097/inf.0000000000000587.
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Keywords: Children/Adolescents, Hospitalization, Infectious Diseases, Outcomes
Selden TM, Dubay L, Miller GE
AHRQ Author: Selden TM, Miller GE
Many families may face sharply higher costs if public health insurance for their children is rolled back.
If possible cuts to the Children’s Health Insurance Program (CHIP) and elimination of the Affordable Care Act’s “maintenance of effort” provisions regarding Medicaid and CHIP take place; this study shows that many families would face sharply higher costs of providing insurance coverage for their children.
AHRQ Author
Citation: Selden TM, Dubay L, Miller GE .
Many families may face sharply higher costs if public health insurance for their children is rolled back.
Health Aff. 2015 Apr;34(4):697-706. doi: 10.1377/hlthaff.2015.0003..
Keywords: Children's Health Insurance Program (CHIP), Healthcare Costs, Children/Adolescents
Fiks AG, Mayne SL, Karavite DJ
Parent-reported outcomes of a shared decision-making portal in asthma: a practice-based RCT.
This study evaluated the feasibility, acceptability, and impact of MyAsthma, an EHR-linked patient portal supporting shared decision-making for pediatric asthma. It found that parents of children with moderate to severe persistent asthma used the portal more than others; 92 percent were satisfied with MyAsthma. Parents reported that use improved their communication with the office, ability to manage asthma, and awareness of the importance of ongoing attention to treatment.
AHRQ-funded; HS021645.
Citation: Fiks AG, Mayne SL, Karavite DJ .
Parent-reported outcomes of a shared decision-making portal in asthma: a practice-based RCT.
Pediatrics 2015 Apr;135(4):e965-73. doi: 10.1542/peds.2014-3167..
Keywords: Asthma, Children/Adolescents, Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT)
McDonagh MS, Blazina I, Dana T
Screening and routine supplementation for iron deficiency anemia: a systematic review.
The goal of this study was to review the evidence regarding the benefits and harms of screening and routine supplementation for IDA for the US Preventive Services Task Force. It found that no studies assessed the benefits or harms of screening or the association between improvement in impaired iron status and clinical outcomes.
AHRQ-funded; 290201200015I.
Citation: McDonagh MS, Blazina I, Dana T .
Screening and routine supplementation for iron deficiency anemia: a systematic review.
Pediatrics 2015 Apr;135(4):723-33. doi: 10.1542/peds.2014-3979..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Screening, Vitamins and Supplements
Heerman WJ, White RO, Barkin SL
Advancing informed consent for vulnerable populations.
The authors suggest an innovative approach that uses low health-literacy communication strategies and visual aids to augment and potentially replace the traditional approach to informed consent. This approach involves: (1) the use of effective health communication and low-literacy techniques, (2) the use of visual aids and graphics to promote understanding and guide the reader toward key study concepts, and (3) careful attention to child dissenting behaviors.
AHRQ-funded; HS022990.
Citation: Heerman WJ, White RO, Barkin SL .
Advancing informed consent for vulnerable populations.
Pediatrics 2015 Mar;135(3):e562-4. doi: 10.1542/peds.2014-3041..
Keywords: Children/Adolescents, Communication, Health Literacy, Obesity, Research Methodologies
Yang NH, Dharmar M, Kuppermann N
Appropriateness of disposition following telemedicine consultations in rural emergency departments.
The researchers compared the overall and stratified observed-to-expected hospital admission ratios between telemedicine and telephone cohorts of acutely ill and injured children. They found that there were no statistically significant differences between the observed-to-expected admission ratios using Pediatric Risk of Admission II and Revised Pediatric Emergency Assessment Tool.
AHRQ-funded; HS013179; HS019712.
Citation: Yang NH, Dharmar M, Kuppermann N .
Appropriateness of disposition following telemedicine consultations in rural emergency departments.
Pediatr Crit Care Med 2015 Mar;16(3):e59-64. doi: 10.1097/pcc.0000000000000337..
Keywords: Children/Adolescents, Emergency Medical Services (EMS), Hospitalization, Rural Health, Telehealth
Tarquinio KM, Howell JD, Montgomery V
Current medication practice and tracheal intubation safety outcomes from a prospective multicenter observational cohort study.
The objective of this study was to evaluate the association of medication selection on specific tracheal intubation–associated events across pediatric intensive care units. It found that fentanyl, midazolam, and ketamine were the most commonly used induction agents, and the majority of tracheal intubations involved neuromuscular blockade. Ketamine use was not associated with lower prevalence of hypotension.
AHRQ-funded; HS022464; HS021583.
Citation: Tarquinio KM, Howell JD, Montgomery V .
Current medication practice and tracheal intubation safety outcomes from a prospective multicenter observational cohort study.
Pediatr Crit Care Med 2015 Mar;16(3):210-8. doi: 10.1097/pcc.0000000000000319..
Keywords: Children/Adolescents, Patient Safety, Intensive Care Unit (ICU), Adverse Events, Medication
Brady PW, Zix J, Brilli R
Developing and evaluating the success of a family activated medical emergency team: a quality improvement report.
The researchers aimed to develop a reliable process for family-activated medical emergency teams (METs) and to evaluate its effect on MET call rate and subsequent transfer to the intensive care unit (ICU). They found that children with family-activated METs were transferred to the ICU less commonly than those with clinician MET calls. Families, like clinicians, most commonly called MET for concerns of clinical deterioration; however, families also identified lack of response from clinicians and a dismissive interaction between team and family.
AHRQ-funded; HS021114.
Citation: Brady PW, Zix J, Brilli R .
Developing and evaluating the success of a family activated medical emergency team: a quality improvement report.
BMJ Qual Saf 2015 Mar;24(3):203-11. doi: 10.1136/bmjqs-2014-003001.
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Keywords: Communication, Emergency Medical Services (EMS), Hospitals, Children/Adolescents, Quality Improvement
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
Radesky J, Miller AL, Rosenblum KL
Maternal mobile device use during a structured parent-child interaction task.
The authors examined associations of maternal mobile device use with the frequency of mother-child interactions during a structured laboratory task. They found that mobile device use was common and associated with fewer interactions with children during a structured interaction task, particularly nonverbal interactions and during introduction of an unfamiliar food.
AHRQ-funded; HS022242.
Citation: Radesky J, Miller AL, Rosenblum KL .
Maternal mobile device use during a structured parent-child interaction task.
Acad Pediatr 2015 Mar-Apr;15(2):238-44. doi: 10.1016/j.acap.2014.10.001.
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Keywords: Children/Adolescents, Communication, Family Health and History
Ragsdale L, Zhong W, Morrison W
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
The researchers conducted a retrospective study in which they examined the prescribing patterns of opioid and sedation medications among 37,459 children who died in 430 hospitals in the US 2007-2011. Their study reveals an overall high prevalence of exposure to opioid and sedation medications among pediatric terminal hospitalizations, yet with slightly less than one-half of patients receiving both opioids and sedatives daily near the end of life.
AHRQ-funded; HS018425.
Citation: Ragsdale L, Zhong W, Morrison W .
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
J Pediatr 2015 Mar;166(3):587-93.e1. doi: 10.1016/j.jpeds.2014.10.017..
Keywords: Children/Adolescents, Hospitalization, Medication, Opioids, Pain, Palliative Care
Hendrix KS, Downs SM, Carroll AE
Pediatricians' responses to printed clinical reminders: does highlighting prompts improve responsiveness?
The authors tested whether selectively highlighting clinical decision support prompts in yellow would improve physicians' responsiveness. They found that highlighting reminder prompts did not increase physicians' responsiveness. They suggested possible explanations and offer alternative strategies to increasing physician responsiveness to prompts.
AHRQ-funded; HS020640; HS018453; HS017939.
Citation: Hendrix KS, Downs SM, Carroll AE .
Pediatricians' responses to printed clinical reminders: does highlighting prompts improve responsiveness?
Acad Pediatr 2015 Mar-Apr;15(2):158-64. doi: 10.1016/j.acap.2014.10.009.
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Keywords: Clinical Decision Support (CDS), Children/Adolescents, Primary Care, Practice Patterns, Quality Improvement
Rust G, Zhang S, McRoy L
Potential savings from increasing adherence to inhaled corticosteroid therapy in Medicaid-enrolled children.
This study simulated the cost impact of achieving various levels of increase in inhaled corticosteroid therapy (ICS-Rx) adherence levels among elementary school–aged children (5-12 years) initially receiving a new ICS-Rx for asthma. It found that increasing the proportion of children who maintain higher adherence to 40 percent would generate savings of $95 per child per year.
AHRQ-funded; HS022444.
Citation: Rust G, Zhang S, McRoy L .
Potential savings from increasing adherence to inhaled corticosteroid therapy in Medicaid-enrolled children.
Am J Manag Care 2015 Mar;21(3):173-80..
Keywords: Children/Adolescents, Asthma, Patient Adherence/Compliance, Healthcare Costs, Medicaid
Garfield LD, Brown DS, Allaire BT
Psychotropic drug use among preschool children in the Medicaid program from 36 states.
The researchers examined utilization of the most commonly used psychotropic medications among children aged 4 years and younger. They determined the prevalence of and indications for psychotropic medication among preschool children in Medicaid. Their study found that preschoolers are receiving psychotropic medications despite limited evidence supporting safety or efficacy. Medications for attention-deficit disorder/attention-deficit hyperactivity disorder treatment were most common.
AHRQ-funded; HS020269.
Citation: Garfield LD, Brown DS, Allaire BT .
Psychotropic drug use among preschool children in the Medicaid program from 36 states.
Am J Public Health 2015 Mar;105(3):524-9. doi: 10.2105/ajph.2014.302258..
Keywords: Children/Adolescents, Medication, Medicaid, Behavioral Health