National Healthcare Quality and Disparities Report
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Topics
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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
226 to 245 of 245 Research Studies DisplayedLee GJ, Dotson JL, Kappelman MD
Seasonality and pediatric inflammatory bowel disease.
The researchers sought to determine whether disease activity in pediatric-onset inflammatory bowel disease (IBD) is associated with a seasonal pattern. Studying 1325 patients with Crohn disease and 587 patients with ulcerative colitis, their findings do not support any strong associations between season of the year and disease activity in pediatric IBD.
AHRQ-funded; HS020024.
Citation: Lee GJ, Dotson JL, Kappelman MD .
Seasonality and pediatric inflammatory bowel disease.
J Pediatr Gastroenterol Nutr 2014 Jul;59(1):25-8. doi: 10.1097/mpg.0000000000000362.
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Keywords: Children/Adolescents, Digestive Disease and Health, Children/Adolescents
Cottrell EK, O'Brien K, Curry M
Understanding safety in prehospital emergency medical services for children.
This paper adds to the qualitative understanding of the nature of and contributors to safety events in the prehospital emergency care of children. The findings of this study suggest that factors at the systems, team, child/family, and individual provider level system contribute to errors in prehospital emergency care. These factors may be modifiable through interventions and systems improvements.
AHRQ-funded; HS019456.
Citation: Cottrell EK, O'Brien K, Curry M .
Understanding safety in prehospital emergency medical services for children.
Prehosp Emerg Care 2014 Jul-Sep;18(3):350-8. doi: 10.3109/10903127.2013.869640.
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Keywords: Care Management, Children/Adolescents, Emergency Medical Services (EMS), Quality of Care, Patient Safety
Larkin I, Ang D, Avorn J
Restrictions on pharmaceutical detailing reduced off-label prescribing of antidepressants and antipsychotics in children.
The researchers estimated the effect of anti-detailing policies on off-label prescribing of antidepressants and antipsychotics by pediatricians and by child and adolescent psychiatrists in the period January 2006-June 2009. They found that prescriptions for off-label use of promoted drugs fell by 11 percent and that prescriptions for on-label use of promoted drugs fell by 34 percent. Conversely, prescriptions for on-label use of nonpromoted drugs rose by 14 percent, and those for off-label use of nonpromoted drugs rose by 35 percent. They concluded that these results suggest that pharmaceutical sales representatives promoted drugs not approved for pediatric use and that policies that restrict detailing by those representatives reduced such off-label prescribing.
AHRQ-funded; HS018465.
Citation: Larkin I, Ang D, Avorn J .
Restrictions on pharmaceutical detailing reduced off-label prescribing of antidepressants and antipsychotics in children.
Health Aff 2014 Jun;33(6):1014-23. doi: 10.1377/hlthaff.2013.0939.
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Keywords: Medication, Children/Adolescents, Communication, Policy, Practice Patterns
Hendrix KS, Carroll AE, Downs SM
Screen exposure and body mass index status in 2- to 11-year-old children.
This study was designed to test whether screen exposure predicts pediatric obesity risk in 2- to 11-year-old children. It found that having a TV in the bedroom was significantly related to an increased risk for BMI percentile greater than 85. However, it did not find that same association for watching more than 2 hours of TV or computer a day.
AHRQ-funded; HS017939; HS018453; HS020640
Citation: Hendrix KS, Carroll AE, Downs SM .
Screen exposure and body mass index status in 2- to 11-year-old children.
Clin Pediatr. 2014 Jun;53(6):593-600. doi: 10.1177/0009922814526973..
Keywords: Children/Adolescents, Obesity, Lifestyle Changes
Boyer DL, Nishisaki A
Evaluating patient outcomes in medical education research: mission impossible?*.
This editorial examines evaluation of the impact of pediatric supplemental crisis resource management (CRM) training among first- and second-year residents. The author suggests that increasing CRM training and using debriefing for skill retention may link this training to patient outcomes.
AHRQ-funded; HS022464
Citation: Boyer DL, Nishisaki A .
Evaluating patient outcomes in medical education research: mission impossible?*.
Pediatr Crit Care Med. 2014 May;15(4):382-4. doi: 10.1097/pcc.0000000000000116..
Keywords: Education: Continuing Medical Education, Outcomes, Children/Adolescents, Training
Hwang TJ, Kesselheim AS, Bourgeois FT
Postmarketing trials and pediatric device approvals.
The authors sought to describe the current state of trial evidence underpinning the approval of pediatric devices. They found that most high-risk pediatric devices are approved on the basis of trials in patients 18 years of age or older, with few pediatric patients exposed to the devices before market availability. Also, few postmarketing studies require additional study in pediatric patients.
AHRQ-funded; HS018465.
Citation: Hwang TJ, Kesselheim AS, Bourgeois FT .
Postmarketing trials and pediatric device approvals.
Pediatrics 2014 May;133(5):e1197-202. doi: 10.1542/peds.2013-3348.
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Keywords: Children/Adolescents, Medical Devices, Patient Safety, Children/Adolescents
Humiston SG, Poehling KA, Szilagyi PG
School-located influenza vaccination: can collaborative efforts go the distance?
This commentary discusses school-located influenza vaccination during the school day and includes the survey results from Kempe et al., in the same issue. The authors conclude that increasing influenza vaccination rates will require vaccinating “outside the box,” utilizing a site in which school-aged youth already tend to congregate.
AHRQ-funded; HS021163.
Citation: Humiston SG, Poehling KA, Szilagyi PG .
School-located influenza vaccination: can collaborative efforts go the distance?
Acad Pediatr 2014 May-Jun;14(3):219-20. doi: 10.1016/j.acap.2014.03.004.
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Keywords: Children/Adolescents, Influenza, Vaccination
Kirkendall ES, Spires WL, Mottes TA
Development and performance of electronic acute kidney injury triggers to identify pediatric patients at risk for nephrotoxic medication-associated harm.
The authors described an approach and provided a technical framework for the creation of risk-stratifying acute kidney injury (AKI) triggers and the development of an application to manage the AKI trigger data. Their report summarizes the construction of a trigger-based application, the performance of the triggers, and the challenges uncovered during the design, build, and implementation of the system.
AHRQ-funded; HS021114.
Citation: Kirkendall ES, Spires WL, Mottes TA .
Development and performance of electronic acute kidney injury triggers to identify pediatric patients at risk for nephrotoxic medication-associated harm.
Appl Clin Inform 2014 Apr 2;5(2):313-33. doi: 10.4338/aci-2013-12-ra-0102.
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Keywords: Adverse Drug Events (ADE), Children/Adolescents, Medication, Health Information Technology (HIT), Electronic Health Records (EHRs)
Jackson DJ, Hartert TV, Martinez FD
Asthma: NHLBI workshop on the primary prevention of chronic lung diseases.
This article reports on the state of primary prevention research in asthma, with emphasis on specific recommendations for research priorities and interventions that could be undertaken now. The emphasis of this work was on prevention of disease onset, and because the majority of asthma begins during preschool years, this document focuses on childhood asthma.
AHRQ-funded; HS018454, HS022093
Citation: Jackson DJ, Hartert TV, Martinez FD .
Asthma: NHLBI workshop on the primary prevention of chronic lung diseases.
Ann Am Thorac Soc. 2014 Apr;11 Suppl 3:S139-45. doi: 10.1513/AnnalsATS.201312-448LD..
Keywords: Asthma, Prevention, Children/Adolescents, Chronic Conditions
Agwu AL, Neptune A, Voss C
CD4 counts of nonperinatally HIV-infected youth and young adults presenting for HIV care between 2002 and 2010.
This study of nonperinatally HIV-infected 12- to 24-year-olds presenting for care at HIV Research Network (HIVRN) sites between 2002 and 2010 sought to determine if fewer nPHIV–infected youth are presenting for care at lower CD4 counts. It found that the proportion of nPHIV-infected youth presenting to HIVRN sites with a CD4 count less than 350 cells/mm3 remained essentially unchanged between 2002 and 2010.
AHRQ-funded; 290010012.
Citation: Agwu AL, Neptune A, Voss C .
CD4 counts of nonperinatally HIV-infected youth and young adults presenting for HIV care between 2002 and 2010.
JAMA Pediatr 2014 Apr;168(4):381-3. doi: 10.1001/jamapediatrics.2013.4531..
Keywords: Human Immunodeficiency Virus (HIV), Children/Adolescents, Evidence-Based Practice
Bardach NS, Coker TR, Zima BT
Common and costly hospitalizations for pediatric mental health disorders.
The objectives of this study were to describe pediatric mental health hospitalizations at general medical facilities admitting children nationally; to assess which pediatric mental health diagnoses are frequent and costly at these hospitals; and to examine whether the most frequent diagnoses are similar to those at free-standing children's hospitals. The investigators identified the child mental health inpatient diagnoses with the highest frequency and highest costs as depression, bipolar disorder, and psychosis, with substance abuse an important comorbid diagnosis.
AHRQ-funded; HS020506.
Citation: Bardach NS, Coker TR, Zima BT .
Common and costly hospitalizations for pediatric mental health disorders.
Pediatrics 2014 Apr;133(4):602-9. doi: 10.1542/peds.2013-3165..
Keywords: Children/Adolescents, Healthcare Costs, Hospitalization, Behavioral Health
Bardach NS, Coker TR, Zima BT
Common and costly hospitalizations for pediatric mental health disorders.
The objectives of this study were to describe pediatric mental health hospitalizations at general medical facilities admitting children nationally; to assess which pediatric mental health diagnoses are frequent and costly at these hospitals; and to examine whether the most frequent diagnoses are similar to those at free-standing children's hospitals. The investigators identified the child mental health inpatient diagnoses with the highest frequency and highest costs as depression, bipolar disorder, and psychosis, with substance abuse an important comorbid diagnosis.
AHRQ-funded; HS020506.
Citation: Bardach NS, Coker TR, Zima BT .
Common and costly hospitalizations for pediatric mental health disorders.
Pediatrics 2014 Apr;133(4):602-9. doi: 10.1542/peds.2013-3165..
Keywords: Children/Adolescents, Healthcare Costs, Hospitalization, Behavioral Health
Panozzo CA, Becker-Dreps S, Pate V
Direct, indirect, total, and overall effectiveness of the rotavirus vaccines for the prevention of gastroenteritis hospitalizations in privately insured US children, 2007-2010.
This study demonstrated how direct, indirect, total, and overall effectiveness estimates and absolute benefits of rotavirus vaccines vary through the years following vaccine introduction. It found that direct effectiveness of 1 or more doses of rotavirus vaccine in preventing rotavirus gastroenteritis hospitalizations ranged from 87 to 92 percent each year.
AHRQ-funded; HS017950
Citation: Panozzo CA, Becker-Dreps S, Pate V .
Direct, indirect, total, and overall effectiveness of the rotavirus vaccines for the prevention of gastroenteritis hospitalizations in privately insured US children, 2007-2010.
Am J Epidemiol. 2014 Apr 1;179(7):895-909. doi: 10.1093/aje/kwu001..
Keywords: Comparative Effectiveness, Vaccination, Children/Adolescents, Hospitalization
Schwenk H, Ramirez-Avila L, Sheu SH
Progressive multifocal leukoencephalopathy in pediatric patients: case report and literature review.
Progressive multifocal leukoencephalopathy is a rare, demyelinating disease of the central nervous system caused by JC virus. Fewer than 30 cases have been reported in HIV- and non-infected children. The researchers report the case of a 15-year-old girl with progressive multifocal leukoencephalopathy and AIDS who presented with nystagmus, dysarthria and ataxia. They also include a literature review.
AHRQ-funded; HS019485.
Citation: Schwenk H, Ramirez-Avila L, Sheu SH .
Progressive multifocal leukoencephalopathy in pediatric patients: case report and literature review.
Pediatr Infect Dis J 2014 Apr;33(4):e99-105. doi: 10.1097/inf.0000000000000237..
Keywords: Comparative Effectiveness, Children/Adolescents, Case Study, Outcomes
Nett S, Emeriaud G, Jarvis JD
Site-level variance for adverse tracheal intubation-associated events across 15 North American PICUs: a report from the national emergency airway registry for children*.
This observational study of 15 pediatric intensive care units (PICUs) found that substantial site-level variance exists in tracheal intubation practice, adverse tracheal intubation associated-events and severe tracheal intubation associated-events. After adjusting for patient and provider characteristics, neither PICU size nor presence of fellowship training program explained site-level variance.
AHRQ-funded; HS021583
Citation: Nett S, Emeriaud G, Jarvis JD .
Site-level variance for adverse tracheal intubation-associated events across 15 North American PICUs: a report from the national emergency airway registry for children*.
Pediatr Crit Care Med. 2014 May;15(4):306-13. doi: 10.1097/pcc.0000000000000120..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Registries, Adverse Events
Li L, Vollmer WM, Butler MG
A comparison of confounding adjustment methods for assessment of asthma controller medication effectiveness.
Using three confounding adjustment procedures—covariate-adjusted regression, propensity score regression, and high-dimemsional propensity score regression—on a population of 24,680 children with asthma, researchers found that patients treated with leukotriene antagonists were no more likely than those treated with inhaled corticosteroids to experience adverse outcomes.
AHRQ-funded; HS019669
Citation: Li L, Vollmer WM, Butler MG .
A comparison of confounding adjustment methods for assessment of asthma controller medication effectiveness.
Am J Epidemiol. 2014 Mar 1;179(5):648-59. doi: 10.1093/aje/kwt323..
Keywords: Comparative Effectiveness, Outcomes, Children/Adolescents, Asthma, Medication
Dougherty D, Chen X, Gray DT
AHRQ Author: Dougherty D, Gray DT
Child and adolescent health care quality and disparities: are we making progress?
The authors sought to examine trends over time in health care quality and disparities by race, Hispanic ethnicity, income, insurance, gender, rurality, and special health care needs. Using data from the 2011 National Healthcare Quality Report and Naitonal Healthcare Disparities Reprot, they found that there was some progress in health care quality and reducing disparities in children's health care quality from 2000 to 2009, but opportunities for targeting improvement strategies remain.
AHRQ-authored.
Citation: Dougherty D, Chen X, Gray DT .
Child and adolescent health care quality and disparities: are we making progress?
Acad Pediatr 2014 Mar-Apr;14(2):137-48. doi: 10.1016/j.acap.2013.11.008.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Disparities, Quality of Care
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Bauer NS, Carroll AE, Downs SM
Understanding the acceptability of a computer decision support system in pediatric primary care.
In this study, the investigators examine the attitudes and opinions of pediatric users' toward the Child Health Improvement through Computer Automation (CHICA) system, a computer decision support system linked to an electronic health record in four community pediatric clinics. The investigators found that pediatric users appreciated the system's automation and enhancements that allowed relevant and meaningful clinical data to be accessible at point of care.
AHRQ-funded; HS018453; HS017939.
Citation: Bauer NS, Carroll AE, Downs SM .
Understanding the acceptability of a computer decision support system in pediatric primary care.
J Am Med Inform Assoc 2014 Jan-Feb;21(1):146-53. doi: 10.1136/amiajnl-2013-001851..
Keywords: Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care
Lawrence JM, Black MH, Zhang JL
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
The researchers explored the utility of different algorithms for diabetes case identification by using electronic health records. They found that case identification accuracy was highest in 75% of bootstrapped samples for those who had 1 or more outpatient diabetes diagnoses or 1 or more insulin prescriptions and in 25% of samples for those who had 2 or more outpatient diabetes diagnoses and 1 or more antidiabetic medications.
AHRQ-funded; HS019859.
Citation: Lawrence JM, Black MH, Zhang JL .
Validation of pediatric diabetes case identification approaches for diagnosed cases by using information in the electronic health records of a large integrated managed health care organization.
Am J Epidemiol 2014 Jan;179(1):27-38. doi: 10.1093/aje/kwt230..
Keywords: Children/Adolescents, Diabetes, Chronic Conditions, Electronic Health Records (EHRs), Health Information Technology (HIT), Diagnostic Safety and Quality