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AHRQ Research Studies Date
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- Adverse Drug Events (ADE) (1)
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- (-) Children/Adolescents (11)
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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 11 of 11 Research Studies DisplayedNelson KE, Chakravarti V, Diskin C
Validation of neurologic impairment diagnosis codes as signifying documented functional impairment in hospitalized children.
This study’s objective was to assess the performance of previously published high-intensity neurologic impairment (NI) diagnosis codes in identification of hospitalized children with clinical NI. This retrospective study of 500 randomly selected discharges in 2019 was conducted at a freestanding children’s hospital. Charts were reviewed for: 1) NI discharge diagnosis codes and 2) documentation of clinical NI (a neurologic diagnosis and indication of functional impairment like medical technology). Diagnosis codes identified clinically documented NI with 88.1% specificity, and 79.4% sensitivity; negative predictive value (NPV) was 96.7%, and positive predictive value (PPV) was 49%. Including children with milder functional impaired results in NPV of 95.7% and PPV of 77.5%. Restriction to children with more severe functional impairment increased NPV and decreased PPV. Misclassification was mostly due to inclusion of children without functional impairments.
AHRQ-funded; HS025138.
Citation: Nelson KE, Chakravarti V, Diskin C .
Validation of neurologic impairment diagnosis codes as signifying documented functional impairment in hospitalized children.
Acad Pediatr 2022 Jul;22(5):782-88. doi: 10.1016/j.acap.2021.07.014..
Keywords: Children/Adolescents, Neurological Disorders, Diagnostic Safety and Quality
Diskin C, Malik K, Gill PJ
Research priorities for children with neurological impairment and medical complexity in high-income countries.
This paper describes a modified three-stage Delphi study using online surveys to identify the highest-priority clinical research areas related to children with neurological impairment and medical complexity among clinicians and caregivers. Round 1 comprised of a diverse international expert panel of 49 clinicians and 12 family caregivers suggesting clinical topics and related questions that require research to support this subgroup of children. A steering committee refined the suggestions, and then participants contributed to 1 (family caregivers) or 2 (clinicians) subsequent rounds to develop a prioritized list. A total of 601 responses were provided, with the responses distilled into 26 clinical topics comprising 126 related questions. Top clinical topics prioritized for research were irritability and pain, child mental health, disorders of tone, polypharmacy, sleep, aspiration, behavior, dysautonomia, and feeding intolerance. Ten specific research questions were also prioritized by the clinician expert panel.
AHRQ-funded; HS025138.
Citation: Diskin C, Malik K, Gill PJ .
Research priorities for children with neurological impairment and medical complexity in high-income countries.
Dev Med Child Neurol 2022 Feb; 64(2):200-08. doi: 10.1111/dmcn.15037..
Keywords: Children/Adolescents, Neurological Disorders
Bayer ND, Hall M, LI Y
Trends in health care use and spending for young children with neurologic impairment.
This retrospective study examined trends in health care use and spending for young children with neurologic impairment (NI) during their first 5 years of life. This study of 13,947 children with NI used data in the multistate IBM Medicaid MarketScan Database from 2009 to 2017. Inpatient service use decreased from 66.8% during the first year down to 5.8% during the fifth year. Emergency department (ED) use decreased more gradually from 67.8% during the first year to 44.4% during the fifth year. Per-member-per-year spending decreased from $83,352 during the first year down to $1944 in the fifth year.
AHRQ-funded; HS025138.
Citation: Bayer ND, Hall M, LI Y .
Trends in health care use and spending for young children with neurologic impairment.
Pediatrics 2022 Jan;149(1). doi: 10.1542/peds.2021-050905.
AHRQ-funded; HS025138..
AHRQ-funded; HS025138..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Utilization, Neurological Disorders
Warniment A, Steuart R, Rodean J
Variation in bacterial respiratory culture results in children with neurologic impairment.
The purpose of this study was to examine bacterial respiratory cultures in children with neurologic impairment (NI) (eg, cerebral palsy), both with and without tracheostomies, who were hospitalized with acute respiratory infections (ARIs) (eg, pneumonia) and to compare culture results across hospitals and age groups. The investigators concluded that the bacteriology of ARI in hospitalized children with NI differed from that of otherwise healthy children.
AHRQ-funded; HS025138; HS019862.
Citation: Warniment A, Steuart R, Rodean J .
Variation in bacterial respiratory culture results in children with neurologic impairment.
Hosp Pediatr 2021 Nov;11(11):e326-e33. doi: 10.1542/hpeds.2020-005314..
Keywords: Children/Adolescents, Respiratory Conditions, Neurological Disorders
Bradbury KR, Williams C, Leonard S
Emotional aspects of pediatric post-intensive care syndrome following traumatic brain injury.
This study assessed parent-reported emotional functioning in children with traumatic brain injury (TBI) and identified risk factors for emotional sequelae in the acute recovery phase. Results from logistic regression indicated that only elevated parent PTSD symptoms were a significant predictor for child anxiety and depressive symptoms. Anxiety and depressive symptoms were prevalent in the acute recovery phase of TBI. Consistent with previous research, elevations in anxiety and depressive symptoms were more related to psychosocial factors than to injury severity.
AHRQ-funded; HS022981.
Citation: Bradbury KR, Williams C, Leonard S .
Emotional aspects of pediatric post-intensive care syndrome following traumatic brain injury.
J Child Adolesc Trauma 2021 Jun;14(2):177-87. doi: 10.1007/s40653-020-00332-y..
Keywords: Children/Adolescents, Brain Injury, Trauma, Neurological Disorders
Srivastava S, Clark B, Landy-Schmitt C
Repetitive and self-injurious behaviors in children with Cornelia de Lange syndrome.
AHRQ-funded; HS023000.
Citation: Srivastava S, Clark B, Landy-Schmitt C .
Repetitive and self-injurious behaviors in children with Cornelia de Lange syndrome.
J Autism Dev Disord 2021 May;51(5):1748-58. doi: 10.1007/s10803-020-04617-x..
Keywords: Children/Adolescents, Neurological Disorders, Diagnostic Safety and Quality
Cavallaro SC, Monuteaux MC, Chaudhari PP
Use of neuroimaging for children with seizure in general and pediatric emergency departments.
Investigators sought to compare rates of head computed tomography (CT) scans for pediatric seizure between general and pediatric emergency departments (EDs). Subjects were patients 21 years of age or less who presented to an ED with a chief complaint or diagnosis of seizure. They investigators found that general EDs obtained CT scans of the head more often in patients with epilepsy, without fever, and without trauma. They concluded that children with seizure were more likely to undergo CT scans of the head at general EDs compared with pediatric EDs.
AHRQ-funded; HS026503.
Citation: Cavallaro SC, Monuteaux MC, Chaudhari PP .
Use of neuroimaging for children with seizure in general and pediatric emergency departments.
J Emerg Med 2021 Apr;60(4):478-84. doi: 10.1016/j.jemermed.2020.10.044..
Keywords: Children/Adolescents, Emergency Department, Imaging, Neurological Disorders
Berry JG, Difazio RL, Melvin P
Hospital resource use after hip reconstruction surgery in children with neurological complex chronic conditions.
This study assessed how co-occurring conditions influence recovery after hip reconstruction surgery in children with neurological complex chronic conditions (CCCs). This retrospective analysis of 4058 children age 4 years or older was conducted from 2015 to 2018 in 49 children’s hospitals. The presence of CCCs was assessed using the AHRQ Chronic Condition Indicator system. Outcomes looked for included postoperative hospital length of stay (LOS), 30 -day readmission rates, and median hospital costs. The most common co-occurring conditions were digestive (60.1%) and respiratory (37.9%). Median LOS increased 67% as co-existing conditions increased from one to four or more. Median hospital costs increased 41% and readmission rates increased 250%. Malnutrition was associated with the greatest increase in postoperative hospital use.
AHRQ-funded; HS024453.
Citation: Berry JG, Difazio RL, Melvin P .
Hospital resource use after hip reconstruction surgery in children with neurological complex chronic conditions.
Dev Med Child Neurol 2021 Feb;63(2):204-10. doi: 10.1111/dmcn.14712..
Keywords: Children/Adolescents, Chronic Conditions, Surgery, Hospital Readmissions, Hospitals, Neurological Disorders
Ing C, Jackson WM, Zaccariello MJ
Prospectively assessed neurodevelopmental outcomes in studies of anaesthetic neurotoxicity in children: a systematic review and meta-analysis.
This systematic review and meta-analysis tried to answer the question whether exposure to a single general anesthetic (GA) in early childhood causes long-term neurodevelopmental problems. Databases searched from inception to October 2019 were PubMed/MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Library. Outcomes common to at least three studies were evaluated using a random-effects meta-analyses. A total of 841 out of 1644 children who had a single exposure to GA were evaluated. Findings were that there were statistically significant increases in parent reports of behavioral problems but no difference in general intelligence.
AHRQ-funded; HS026493.
Citation: Ing C, Jackson WM, Zaccariello MJ .
Prospectively assessed neurodevelopmental outcomes in studies of anaesthetic neurotoxicity in children: a systematic review and meta-analysis.
Br J Anaesth 2021 Feb;126(2):433-44. doi: 10.1016/j.bja.2020.10.022..
Keywords: Children/Adolescents, Neurological Disorders, Medication, Adverse Drug Events (ADE), Adverse Events, Evidence-Based Practice, Outcomes
Azadani EN, Townsend J, Peng J
The association between traumatic dental and brain injuries in American children.
This study examined the association between dento-alveolar trauma (DAT) and traumatic brain injuries (TBIs) among children ages 0-18 years. The Nationwide Emergency Department Sample (NEDS), an HCUP dataset, was analyzed using ICD-9-CM codes for the 2010-2014 NEDS data. Out of 6,281,658 emergency department (ED) visits, DAT was recorded in 93,408 (1.5%) visits and TBI was recorded in 996,334 (15.9%) visits. Of the DAT-positive encounters, 7.5% had codes associated with TBI. Patients with DAT had 0.20 odds of having TBI compared with patients who did not DAT when all confounding variables were kept constant. Multiple injuries, being involved in motor vehicle crashes, and injuries due to assault were associated with higher odds of concomitant TBI in patients who sustained DAT.
AHRQ-funded; HS24263.
Citation: Azadani EN, Townsend J, Peng J .
The association between traumatic dental and brain injuries in American children.
Dent Traumatol 2021 Feb;37(1):114-22. doi: 10.1111/edt.12611..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Trauma, Neurological Disorders, Dental and Oral Health
Thomson J, Hall M, Nelson K
Timing of co-occurring chronic conditions in children with neurologic impairment.
Children with neurologic impairment (NI) are at risk for developing co-occurring chronic conditions, increasing their medical complexity and morbidity. In this study, the authors assessed the prevalence and timing of onset for those conditions in children with NI. They concluded that children with NI enrolled in Medicaid had substantial multimorbidity that developed early in life.
AHRQ-funded; HS025138.
Citation: Thomson J, Hall M, Nelson K .
Timing of co-occurring chronic conditions in children with neurologic impairment.
Pediatrics 2021 Feb;147(2):e2020009217. doi: 10.1542/peds.2020-009217..
Keywords: Children/Adolescents, Neurological Disorders, Chronic Conditions, Medicaid, Health Status