National Healthcare Quality and Disparities Report
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Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (4)
- Ambulatory Care and Surgery (2)
- Antibiotics (2)
- Anxiety (1)
- Arthritis (1)
- Asthma (3)
- Behavioral Health (2)
- Blood Clots (1)
- Blood Pressure (1)
- Brain Injury (1)
- Cancer (3)
- Cardiovascular Conditions (2)
- Caregiving (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- (-) Children/Adolescents (39)
- Chronic Conditions (2)
- Clinician-Patient Communication (1)
- Colonoscopy (1)
- Communication (1)
- Comparative Effectiveness (1)
- COVID-19 (1)
- Critical Care (2)
- Data (1)
- Diabetes (1)
- Diagnostic Safety and Quality (2)
- Digestive Disease and Health (1)
- Disparities (1)
- Domestic Violence (1)
- Education: Patient and Caregiver (1)
- Electronic Health Records (EHRs) (1)
- Emergency Department (6)
- Evidence-Based Practice (1)
- Falls (1)
- Family Health and History (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Cost and Utilization Project (HCUP) (2)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (1)
- Heart Disease and Health (1)
- Hospital Discharge (1)
- Hospitalization (3)
- Hospital Readmissions (1)
- Hospitals (3)
- Human Immunodeficiency Virus (HIV) (4)
- Infectious Diseases (2)
- Injuries and Wounds (1)
- Intensive Care Unit (ICU) (4)
- Medicaid (1)
- Medical Errors (1)
- Medical Expenditure Panel Survey (MEPS) (1)
- Medication (5)
- Medication: Safety (1)
- Mortality (1)
- Neurological Disorders (2)
- Newborns/Infants (1)
- Outcomes (3)
- Palliative Care (1)
- Patient-Centered Outcomes Research (3)
- Patient Safety (2)
- Pneumonia (1)
- Prevention (2)
- Primary Care (1)
- Public Health (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (1)
- Respiratory Conditions (4)
- (-) Risk (39)
- Screening (1)
- Sepsis (4)
- Sex Factors (1)
- Sexual Health (2)
- Shared Decision Making (1)
- Sleep Problems (1)
- Social Determinants of Health (2)
- Social Media (1)
- Surgery (3)
- Tobacco Use (1)
- Trauma (1)
- Urinary Tract Infection (UTI) (1)
- Women (1)
- Young Adults (5)
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 39 Research Studies DisplayedCzosek RJ, Anderson JB, Baskar S
Predictors and outcomes of heart block during surgical stage I palliation of patients with a single ventricle: a report from the NPC-QIC.
This study investigated patient and surgical risks of heart block and its effect on 12-month transplant-free survival in children with a single ventricle. In total, 1423 patients were identified from the National Pediatric Cardiology Improvement Collaborative with and without heart block. One-year outcomes were analyzed. A very small percentage (2%) developed heart block during their surgical admission. Associated risk factors for block included heterotaxy syndrome and atrial flutter/fibrillation. Patients with complete heart block had lower 12-month survival, which wasn’t true for patients with second degree block. At 12 months of age, 43% of patients with heart block died and were more likely to experience mortality than patients without heart block.
AHRQ-funded; HS021114.
Citation: Czosek RJ, Anderson JB, Baskar S .
Predictors and outcomes of heart block during surgical stage I palliation of patients with a single ventricle: a report from the NPC-QIC.
Heart Rhythm 2021 Nov;18(11):1876-83. doi: 10.1016/j.hrthm.2021.05.019..
Keywords: Children/Adolescents, Heart Disease and Health, Cardiovascular Conditions, Surgery, Palliative Care, Risk, Outcomes
Reddy P, Mencin A, Lebwohl B
Risk factors for suboptimal bowel preparation for colonoscopy in pediatric patients.
Suboptimal bowel cleansing is common in children and can impact diagnostic and therapeutic outcomes. In this retrospective study, the investigators aimed to identify risk factors for suboptimal bowel preparation for colonoscopy in pediatric patients. The investigators concluded that Medicaid status and English as a second language were risk factors. They highlighted distinct associations from those reported in the adult literature including failure to thrive and younger age.
AHRQ-funded; HS026121.
Citation: Reddy P, Mencin A, Lebwohl B .
Risk factors for suboptimal bowel preparation for colonoscopy in pediatric patients.
J Pediatr Gastroenterol Nutr 2021 Jul;73(1):e1-e6. doi: 10.1097/mpg.0000000000003114..
Keywords: Children/Adolescents, Colonoscopy, Risk, Diagnostic Safety and Quality
Cifra CL, Westlund E, Ten Eyck P
An estimate of missed pediatric sepsis in the emergency department.
AHRQ-funded; HS025753.
Citation: Cifra CL, Westlund E, Ten Eyck P .
An estimate of missed pediatric sepsis in the emergency department.
Diagnosis 2021;8(2):193-98. doi: 10.1515/dx-2020-0023..
Keywords: Children/Adolescents, Sepsis, Emergency Department, Diagnostic Safety and Quality, Medical Errors, Risk
Eigenmann PA, Ebisawa M, Greenhawt M
Addressing risk management difficulties in children with food allergies.
This rostrum article discusses various aspects faced by children with food allergies in the light of risk, and their practical implications. Facets discussed include oral food challenges. Precautionary allergen labeling (PAL) is a widespread strategy to reduce the potential risk of reactions due to traces. However, PAL is currently inefficient due to inconsistent labeling, also not indicating a clear maximum amount possibly present in the manufactured food. Also, cost-effectiveness needs to be considered in risk management, as many risk reduction procedures are clearly not cost-effective.
AHRQ-funded; HS024599.
Citation: Eigenmann PA, Ebisawa M, Greenhawt M .
Addressing risk management difficulties in children with food allergies.
Pediatr Allergy Immunol 2021 May;32(4):658-66. doi: 10.1111/pai.13455..
Keywords: Children/Adolescents, Risk
Lin CY, Xie J, Freedman SB
Predicting adverse outcomes for Shiga toxin-producing Escherichia coli infections in emergency departments.
Investigators assessed the performance of a hemolytic uremic syndrome (HUS) severity score among children with Shiga toxin-producing Escherichia coli (STEC) infections and HUS by stratifying them according to their risk of adverse events. They found that the HUS severity score was able to discriminate between high- and low-risk children less than 5 years old with STEC-associated HUS at a statistically acceptable level; however, it did not appear to provide clinical benefit at a meaningful risk threshold.
AHRQ-funded; HS026503.
Citation: Lin CY, Xie J, Freedman SB .
Predicting adverse outcomes for Shiga toxin-producing Escherichia coli infections in emergency departments.
J Pediatr 2021 May;232:200-06.e4. doi: 10.1016/j.jpeds.2020.12.077..
Keywords: Children/Adolescents, Infectious Diseases, Emergency Department, Risk
Javalkar K, Robson VK, Gaffney L
Socioeconomic and racial and/or ethnic disparities in multisystem inflammatory syndrome.
Researchers characterized the socioeconomic and racial and/or ethnic disparities impacting the diagnosis and outcomes of multisystem inflammatory syndrome in children (MIS-C). They found that lower socioeconomic status or higher social vulnerability index, Hispanic ethnicity, and Black race independently increased risk for MIS-C. They recommended additional studies to target interventions to improve health equity for children.
AHRQ-funded; HS000063.
Citation: Javalkar K, Robson VK, Gaffney L .
Socioeconomic and racial and/or ethnic disparities in multisystem inflammatory syndrome.
Pediatrics 2021 May;147(5). doi: 10.1542/peds.2020-039933..
Keywords: Children/Adolescents, Social Determinants of Health, Disparities, Racial and Ethnic Minorities, Risk
Daymont C, Balamuth F, Scott HF
Elevated heart rate and risk of revisit with admission in pediatric emergency patients.
This study examines whether emergency department (ED) heart rate (HR) values can identify children at elevated risk of ED revisit with admission. The authors performed a retrospective cohort study of children ages 0-18 years discharged from a tertiary-care pediatric ED from 2013 to 2014. They created percentile curves for the last recorded HR for age using data from calendar year 2013 and used receiver operating characteristic (ROC) curves to characterize the performance of the percentiles for predicting ED revisit with admission within 72 hours. They evaluated 183,433 eligible ED visits and found that the last recorded HR for age had poor discrimination for predicting revisit with admission.
AHRQ-funded; HS023827.
Citation: Daymont C, Balamuth F, Scott HF .
Elevated heart rate and risk of revisit with admission in pediatric emergency patients.
Pediatr Emerg Care 2021 Apr;37(4):e185-e91. doi: 10.1097/pec.0000000000001552..
Keywords: Children/Adolescents, Emergency Department, Risk, Hospitalization
Richardson L, Parker EO, Zhou C
Electronic health risk behavior screening with integrated feedback among adolescents in primary care: randomized controlled trial.
Health risk behaviors are the most common sources of morbidity among adolescents. Adolescent health guidelines (Guidelines for Preventive Services by the AMA and Bright Futures by the Maternal Child Health Bureau) recommend screening and counseling, but the implementation is inconsistent. This study aimed to test the efficacy of electronic risk behavior screening with integrated patient-facing feedback on the delivery of adolescent-reported clinician counseling and risk behaviors over time.
AHRQ-funded; HS023383.
Citation: Richardson L, Parker EO, Zhou C .
Electronic health risk behavior screening with integrated feedback among adolescents in primary care: randomized controlled trial.
J Med Internet Res 2021 Mar 12;23(3):e24135. doi: 10.2196/24135..
Keywords: Children/Adolescents, Primary Care, Risk, Screening
Turi KN, Gebretsadik T, Ding T
Dose, timing, and spectrum of prenatal antibiotic exposure and risk of childhood asthma.
The potential for prenatal antibiotic exposure to influence asthma risk is not clear. The investigators aimed to determine the effect of timing, dose, and spectrum of prenatal antibiotic exposure on the risk of childhood asthma. The investigators concluded that increased cumulative dose, early pregnancy first course, and broad-spectrum antibiotic exposure were associated with childhood asthma risk.
AHRQ-funded; HS026395; HS018454.
Citation: Turi KN, Gebretsadik T, Ding T .
Dose, timing, and spectrum of prenatal antibiotic exposure and risk of childhood asthma.
Clin Infect Dis 2021 Feb 1;72(3):455-62. doi: 10.1093/cid/ciaa085.
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.
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Antibiotics, Medication, Risk
Horton DB, Xie F, Chen L
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
The purpose of this study was to quantify rates of incident treatment for diabetes mellitus, hypertension, and venous thromboembolism (VTE) associated with oral glucocorticoid exposure in children aged 1-18 years. Participants were identified using US Medicaid claims data and included more than 930,000 children diagnosed with autoimmune diseases or a nonimmune comparator condition. Findings showed strong dose-dependent relationships between current glucocorticoid exposure and all outcomes, suggesting strong relative risks, but low absolute risks, of newly-treated VTE, diabetes, and especially hypertension in children taking high-dose oral glucocorticoids.
AHRQ-funded; HS021110.
Citation: Horton DB, Xie F, Chen L .
Oral glucocorticoids and incident treatment of diabetes mellitus, hypertension, and venous thromboembolism in children.
Am J Epidemiol 2021 Feb 1;190(3):403-12. doi: 10.1093/aje/kwaa197..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Blood Clots, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Risk, Patient Safety, Blood Pressure
Sabbagh SE, Neely J, Chow A
Risk factors associated with Pneumocystis jirovecii pneumonia in juvenile myositis in North America.
Pneumocystis jirovecii pneumonia (PJP) is associated with significant morbidity and mortality in adult myositis patients; however, there are few studies examining PJP in juvenile myositis [juvenile idiopathic inflammatory myopathy (JIIM)]. The purpose of this study was to determine the risk factors and clinical phenotypes associated with PJP in JIIM. The investigators concluded that having PJP was associated with more immunosuppressive therapy, anti-MDA5 autoantibodies, Asian race and certain clinical features, including digital infarcts, cutaneous ulcerations and interstitial lung disease.
AHRQ-funded; HS000063.
Citation: Sabbagh SE, Neely J, Chow A .
Risk factors associated with Pneumocystis jirovecii pneumonia in juvenile myositis in North America.
Rheumatology 2021 Feb;60(2):829-36. doi: 10.1093/rheumatology/keaa436..
Keywords: Children/Adolescents, Pneumonia, Respiratory Conditions, Risk
Rinke ML, Heo M, Saiman L
Pediatric ambulatory central line-associated bloodstream infections.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-0524.
This study looked at ambulatory pediatric central line-associated bloodstream infection (CLABSI) incidence density, risk factors, and outcomes. This retrospective cohort with nested case-control study used data from 5 sites from 2010 through 2015. Chart review was used to confirm central line (CL) use and adjudicated CLABSIs. Out of 4600 potential at-risk children, 247 (15%) experienced 466 ambulatory CLABSIs. Incidence density was highest among patients with tunneled externalized catheters versus peripherally inserted central catheters and totally implanted devices. Clinic visits and low albumin levels were potentially associated with CLABSI. Prophylactic antimicrobial agents for underlying conditions within the preceding 30 days and operating room CL placement were inversely associated with CLABSI. A total of 396 patients were hospitalized because of ambulatory CLABSI with an 8-day median length of stay.
This study looked at ambulatory pediatric central line-associated bloodstream infection (CLABSI) incidence density, risk factors, and outcomes. This retrospective cohort with nested case-control study used data from 5 sites from 2010 through 2015. Chart review was used to confirm central line (CL) use and adjudicated CLABSIs. Out of 4600 potential at-risk children, 247 (15%) experienced 466 ambulatory CLABSIs. Incidence density was highest among patients with tunneled externalized catheters versus peripherally inserted central catheters and totally implanted devices. Clinic visits and low albumin levels were potentially associated with CLABSI. Prophylactic antimicrobial agents for underlying conditions within the preceding 30 days and operating room CL placement were inversely associated with CLABSI. A total of 396 patients were hospitalized because of ambulatory CLABSI with an 8-day median length of stay.
AHRQ-funded; HS024432.
Citation: Rinke ML, Heo M, Saiman L .
Pediatric ambulatory central line-associated bloodstream infections.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-0524..
Keywords: Children/Adolescents, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Ambulatory Care and Surgery, Risk, Sepsis
Selden TM, Berdahl TA, Fang Z
AHRQ Author: Selden TM, Berdahl TA, Fang Z
The risk of severe COVID-19 within households of school employees and school-age children.
Across the United States, school districts are grappling with questions of whether and how to reopen elementary and secondary schools in the 2020-21 academic year. Using pre-pandemic household data, the authors examined how often persons at risk of severe coronavirus disease 2019 (COVID-19) were connected to schools, either as employees or by living in the same households as school employees or school-age children.
AHRQ-authored.
Citation: Selden TM, Berdahl TA, Fang Z .
The risk of severe COVID-19 within households of school employees and school-age children.
Health Aff 2020 Nov;39(11):2002-09. doi: 10.1377/hlthaff.2020.01536..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, COVID-19, Public Health, Risk, Infectious Diseases
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.
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
Daigle CH, Fiadjoe JE, Laverriere EK
Difficult bag-mask ventilation in critically ill children is independently associated with adverse events.
This study looked at the epidemiology, risk factors, and clinical implications of difficult bag-mask ventilation among critically ill children. The prevalence and risk factors are described as well as its association with adverse tracheal intubation-associated events and oxygen desaturation in PICU patients. This retrospective review used observational data collected from a multicenter tracheal intubation database (National Emergency Airway Registry for Children) from January 2013 to December 2018 from 46 international PICUs. Difficult bag-mask ventilation was reported in 9.5% of 15,810 patients undergoing tracheal intubation with bag-mask ventilation. Difficult bag-mask ventilation was more commonly reported with increasing age, those with a primary respiratory diagnosis/indication for tracheal intubation, presence of difficulty airway features, more experienced provider level, and tracheal intubations without use of neuromuscular blockade. Specific intubation-associated or oxygen desaturation events occurred in 40.2% of patients with reported difficult bag-mask ventilation versus 19.8% in patients without difficult bag-mask ventilation.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Daigle CH, Fiadjoe JE, Laverriere EK .
Difficult bag-mask ventilation in critically ill children is independently associated with adverse events.
Crit Care Med 2020 Sep;48(9):e744-e52. doi: 10.1097/ccm.0000000000004425..
Keywords: Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Risk
Oates GR, Baker E, Rowe SM
Tobacco smoke exposure and socioeconomic factors are independent predictors of pulmonary decline in pediatric cystic fibrosis.
This longitudinal study evaluates the effects of tobacco smoke exposure and socioeconomic factors on pulmonary decline in pediatric cystic fibrosis (CF). Data from the CF Foundation Patient Registration was obtained for patients who were 6-18 years old at the end of 2016. Lung function measures (ppFEV(1)) for 10,895 individuals was calculated at each attained age. At age 6, lung function was 4.7% lower among smoke-exposed children than among unexposed with this deficit continuing through age 18. Smoke exposure and socioeconomic factors had independent, additive associations with lung function. Factors that declined ppFEV(1) include smoke exposure (2.4%), lower paternal education (4.9%), public insurance (0.3%), and increased 0.2% with each $10,000 annual household income.
AHRQ-funded; HS023009.
Citation: Oates GR, Baker E, Rowe SM .
Tobacco smoke exposure and socioeconomic factors are independent predictors of pulmonary decline in pediatric cystic fibrosis.
J Cyst Fibros 2020 Sep;19(5):783-90. doi: 10.1016/j.jcf.2020.02.004..
Keywords: Children/Adolescents, Respiratory Conditions, Tobacco Use, Social Determinants of Health, Risk
Rinke ML, Oyeku SO, Heo M
Pediatric ambulatory catheter-associated urinary tract infections (CAUTIs): incidence, risk factors, and patient outcomes.
Catheter-associated urinary tract infections (CAUTIs) occur frequently in pediatric inpatients, and they are associated with increased morbidity and cost. Few studies have investigated ambulatory CAUTIs, despite at-risk children utilizing home urinary catheterization. This retrospective cohort and case-control study determined incidence, risk factors, and outcomes of pediatric patients with ambulatory CAUTI. The investigators concluded that pediatric ambulatory CAUTIs occurred in 18% of patients with catheters; they were associated with morbidity and healthcare utilization. Ambulatory indwelling catheter CAUTI incidence exceeded national inpatient incidence.
AHRQ-funded; HS024432.
Citation: Rinke ML, Oyeku SO, Heo M .
Pediatric ambulatory catheter-associated urinary tract infections (CAUTIs): incidence, risk factors, and patient outcomes.
Infect Control Hosp Epidemiol 2020 Aug;41(8):891-99. doi: 10.1017/ice.2020.204..
Keywords: Children/Adolescents, Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Healthcare-Associated Infections (HAIs), Risk, Ambulatory Care and Surgery, Adverse Events
Greenzang KA, Fasciano KM, Block SD
Early information needs of adolescents and young adults about late effects of cancer treatment.
This study evaluated the importance, quality, and implications of information about late effects in adolescents and young adults (AYA) recently diagnosed with cancer. Surveying AYAs with cancer who were 15 to 29 years old and were treated at the Dana-Farber Cancer Institute, researchers found that most AYAs with cancer value early information about the risks of late effects and infertility, yet many patients felt that they had not received high-quality information about these topics. They recommended the development of age-appropriate late-effect communication strategies that recognize high AYA distress to address the gap between desired information and perceived information quality.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Fasciano KM, Block SD .
Early information needs of adolescents and young adults about late effects of cancer treatment.
Cancer 2020 Jul 15;126(14):3281-88. doi: 10.1002/cncr.32932..
Keywords: Children/Adolescents, Young Adults, Cancer, Education: Patient and Caregiver, Clinician-Patient Communication, Communication, Risk
Bushnell GA, Gerhard T, Crystal S
Benzodiazepine treatment and fracture risk in young persons with anxiety disorders.
This study examined whether benzodiazepine treatment increases fall and fracture risk in young persons as it has been shown to do in older adults. They examined whether children (6-17 years) and young adults (18-24) recently diagnosed with anxiety disorder had an increased fracture risk. A cohort of commercially insured children and young adults who had initiated use of benzodiazepine or SSRIs were followed for 3 months, or until fracture, treatment discontinuation or switching or disenrollment occurred. The cohort consisted of 120,715 children and 179,768 young adults. There was an increased fracture rate found in children, but not young adults.
AHRQ-funded; HS026001.
Citation: Bushnell GA, Gerhard T, Crystal S .
Benzodiazepine treatment and fracture risk in young persons with anxiety disorders.
Pediatrics 2020 Jul;146(1):e20193478. doi: 10.1542/peds.2019-3478..
Keywords: Children/Adolescents, Young Adults, Medication, Falls, Injuries and Wounds, Risk, Anxiety, Behavioral Health
Ni Y, Barzman D, Bachtel A
Finding warning markers: Leveraging natural language processing and machine learning technologies to detect risk of school violence.
In their earlier research, the authors developed a risk assessment program to interview subjects, identify risk and protective factors, and evaluate risk for school violence; their current study focused on developing natural language processing (NLP) and machine learning technologies to automate the risk assessment process. They found that, by analyzing the content from subject interviews, the NLP and machine learning algorithms showed good capacity for detecting risk of school violence. The feature selection uncovered multiple warning markers that could deliver useful clinical insights to assist personalizing intervention. Consequently, the developed approach offered the promise of an accurate and scalable computerized screening service for preventing school violence.
AHRQ-funded; HS024983.
Citation: Ni Y, Barzman D, Bachtel A .
Finding warning markers: Leveraging natural language processing and machine learning technologies to detect risk of school violence.
Int J Med Inform 2020 Jul;139:104137. doi: 10.1016/j.ijmedinf.2020.104137..
Keywords: Children/Adolescents, Domestic Violence, Risk
Hartman ME, Williams CN, Hall TA
Post-intensive-care syndrome for the pediatric neurologist.
The investigators are working to create awareness and help mitigate post-intensive-care syndrome in pediatric patients who had experienced primary neurological injury and also help their parents and siblings. In this paper they review current knowledge regarding post-intensive-care syndrome in pediatrics and its risk factors. They describe their experience establishing Pediatric Neurocritical Care Recovery Programs at two large academic centers. They also provide a battery of validated tests to identify and manage the different aspects of post-intensive-care syndrome in pediatrics.
AHRQ-funded; HS022981.
Citation: Hartman ME, Williams CN, Hall TA .
Post-intensive-care syndrome for the pediatric neurologist.
Pediatr Neurol 2020 Jul;108:47-53. doi: 10.1016/j.pediatrneurol.2020.02.003..
Keywords: Children/Adolescents, Neurological Disorders, Intensive Care Unit (ICU), Critical Care, Risk
Lindell RB, Nishisaki A, Weiss SL
Risk of mortality in immunocompromised children with severe sepsis and septic shock.
This study’s objective was to assess the risk of mortality for immunocompromised children admitted to the hospital with septic shock or sepsis. This retrospective multicenter cohort study used eighty-three centers in the Virtual Pediatric systems database. The cohort included children admitted to the pediatric intensive care unit (PICU) with severe sepsis or septic shock from 2012-2016. Across 83 centers, 10,768 PICU admissions with an International Classification of Diseases, 9th Revision, Clinical Modification code for severe sepsis or septic shock were identified; with 3,021 of these patients (28%) having an immunocompromised diagnosis. PICU mortality rates varied widely by center, and those centers with a higher mean number of sepsis patients per month in a center had a lower PICU mortality rate. Multiple prior malignancies, hemophagocytic lymphohistiocytosis, congenital immunodeficiency, and hematopoietic cell transplant are conditions independently associated with an increased odds of PICU mortality in children with severe sepsis or septic shock.
AHRQ-funded; HS024511; HS026939; HS021583; HS022464.
Citation: Lindell RB, Nishisaki A, Weiss SL .
Risk of mortality in immunocompromised children with severe sepsis and septic shock.
Crit Care Med 2020 Jul;48(7):1026-33. doi: 10.1097/ccm.0000000000004329..
Keywords: Children/Adolescents, Mortality, Sepsis, Risk, Intensive Care Unit (ICU), Hospitalization, Hospitals
Hill LM, Maseko B, Chagomerana M
HIV risk, risk perception, and PrEP interest among adolescent girls and young women in Lilongwe, Malawi: operationalizing the PrEP cascade.
The objective of this study was to understand the level of interest in oral pre-exposure prophylaxis (PrEP) among adolescent girls and young women (AGYW) at highest HIV risk and the potential role of perceived risk in motivating PrEP interest. Findings highlighted key relationships between epidemiologic HIV risk, risk perception, and interest in PrEP. The high number of participants with risk scores below the high-risk cutoff who both expressed high perceived risk and interest in PrEP suggested that the demand for PrEP among AGYW may not be well-aligned with epidemiologic risk.
AHRQ-funded; HS000032.
Citation: Hill LM, Maseko B, Chagomerana M .
HIV risk, risk perception, and PrEP interest among adolescent girls and young women in Lilongwe, Malawi: operationalizing the PrEP cascade.
J Int AIDS Soc 2020 Jun;23 Suppl 3:e25502. doi: 10.1002/jia2.25502..
Keywords: Human Immunodeficiency Virus (HIV), Risk, Prevention, Women, Children/Adolescents, Young Adults
Greenzang KA, Al-Sayegh H, Ma C
Parental considerations regarding cure and late effects for children with cancer.
The purpose of this study was to learn how parents and physicians consider late-effects risks against a potential survival benefit when making treatment decisions. Parents of children with cancer and physicians at Dana-Farber/Boston Children's Cancer and Blood Disorders Center were surveyed. Investigators found that avoidance of severe neurocognitive impairment was the predominant driver of parent and physician treatment preferences, even over an increased chance of cure. They concluded that their study highlights the importance of exploring parental late-effects priorities when discussing treatment options.
AHRQ-funded; HS022986.
Citation: Greenzang KA, Al-Sayegh H, Ma C .
Parental considerations regarding cure and late effects for children with cancer.
Pediatrics 2020 May;145(5):e20193552. doi: 10.1542/peds.2019-3552..
Keywords: Children/Adolescents, Cancer, Shared Decision Making, Caregiving, Risk
Donovan BM, Abreo A, Ding T
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
This study examined the association between dose, timing and type of infant antibiotic use and the risk of childhood asthma. The study examined a cohort of 152,622 children enrolled in the Tennessee Medicaid Program. At least 79% had at least one antibiotic prescription fill during infancy. There was a 20% increase in odds of childhood asthma for each additional antibiotic filled. There was no significant association between timing, formulation, anaerobic coverage and class of antibiotics and childhood asthma. However, broad spectrum antibiotic fills increased the odds of development of childhood asthma compared to narrow spectrum only fills.
AHRQ-funded; HS018454.
Citation: Donovan BM, Abreo A, Ding T .
Dose, timing, and type of infant antibiotic use and the risk of childhood asthma.
Clin Infect Dis 2020 Apr 10;70(8):1658-65. doi: 10.1093/cid/ciz448..
Keywords: Newborns/Infants, Children/Adolescents, Antibiotics, Medication, Asthma, Respiratory Conditions, Risk, Chronic Conditions