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- Asthma (2)
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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 7 of 7 Research Studies DisplayedOwora AH, Li R R, Tepper RS
Impact of time-varying confounders on the association between early-life allergy sensitization and the risk of current asthma: a post hoc analysis of a birth cohort.
The purpose of this study was to explore whether allergen avoidance in infants genetically predisposed to asthma can weaken the increased risk of current asthma that is associated with early-life allergy sensitization. The researchers utilized a post hoc analysis to estimate the average causal effect of early-life allergy sensitization and allergen avoidance on the risk of current asthma. The study found that that the odds of current asthma were higher among children with an early-life allergy sensitization at 7 years of age. No differences were demonstrated at 15-years of age. Overall, the odds of current asthma were lower among children randomized to the Canadian Asthma Primary Prevention Study (CAPPS) intervention. CAPPS was developed to decrease exposure in the first year of infancy to indoor aeroallergens and to promote prolonged breastfeeding and delayed introduction of milk and solid foods. The study also found that female children had 28% lower odds of current asthma than male children. The researchers concluded that early life is a vital time when allergy sensitization may provoke pathogenesis towards school-age asthma onset, and allergen avoidance during the same period may reduce the risk of current asthma. Confounding due to time-varying allergy sensitization states and asthma-related treatment exposure may explain some of the null associations reported in previous research.
AHRQ-funded; HS026390.
Citation: Owora AH, Li R R, Tepper RS .
Impact of time-varying confounders on the association between early-life allergy sensitization and the risk of current asthma: a post hoc analysis of a birth cohort.
Allergy 2022 Oct;77(10):3141-44. doi: 10.1111/all.15403..
Keywords: Asthma, Respiratory Conditions, Children/Adolescents, Risk
Dikranian L, Barry S, Ata A
Sars-CoV-2 with concurrent respiratory viral infection as a risk factor for a higher level of care in hospitalized pediatric patients.
This study’s objective was to evaluate if the presence of concurrent respiratory viral infections in pediatric patients admitted to the hospital with SARS-CoV-2 was associated with an increased rate of ICU level of care. Data from 67 participating hospitals was provided through The Society of Critical Care Medicine Discovery Network Viral Infection and Respiratory Illness Universal Study database. A total of 922 patients were included, with 391 requiring ICU level care and 31 having concurrent non-SARS-CoV-2 viral coinfection. After accounting for age, positive blood culture, positive sputum culture, preexisting chronic medical conditions, the presence of a viral respiratory coinfection was associated with increased need for ICU care.
AHRQ-funded; HS026485.
Citation: Dikranian L, Barry S, Ata A .
Sars-CoV-2 with concurrent respiratory viral infection as a risk factor for a higher level of care in hospitalized pediatric patients.
Pediatr Emerg Care 2022 Sep;38(9):472-76. doi: 10.1097/pec.0000000000002814..
Keywords: COVID-19, Children/Adolescents, Respiratory Conditions, Risk
Wang HS, Panagides J, Cahill D
Dietary risk factors for pediatric kidney stones: a case-control study.
This study’s objective was to perform a case-control study of the association of dietary nutrients with pediatric urolithiasis. Researchers obtained dietary information from pediatric urolithiasis patients and healthy controls; survey results were converted to standard nutrient intakes. Findings showed that higher dietary intake of calcium, sodium, and beta carotene, and lower potassium intake were associated with pediatric urolithiasis.
AHRQ-funded; HS000063.
Citation: Wang HS, Panagides J, Cahill D .
Dietary risk factors for pediatric kidney stones: a case-control study.
J Urol 2022 Aug;208(2):434-40. doi: 10.1097/ju.0000000000002687..
Keywords: Children/Adolescents, Nutrition, Kidney Disease and Health, Risk
Bucholz EM, Toomey SL, McCulloch CE EM, Toomey SL, McCulloch CE
Adjusting for social risk factors in pediatric quality measures: adding to the evidence base.
The purpose of this study was to evaluate a method for incorporating social risk variables into a pediatric measure of utilization from the Pediatric Quality Measures Program (PQMP). The researchers utilized data from California Medicaid claims (2015-16) and Massachusetts All Payer Claims Database (2014-2015) to assess health plan performance using the Pediatric Asthma Emergency Department Use measure. The study found that of 133 health plans serving 404,649 pediatric patients with asthma, 7% to 13% changed performance categories after social risk adjustment. Health plans that shifted to higher performance categories cared for lower socioeconomic status (SES) patients, while those that shifted to lower performance categories cared for higher SES patients. The study concluded that adjustment for social risk factors shifted performance rankings on the PQMP Pediatric Asthma Emergency Department Use measure for a large number of health plans.
AHRQ-funded; HS025297; HS025299.
Citation: Bucholz EM, Toomey SL, McCulloch CE EM, Toomey SL, McCulloch CE .
Adjusting for social risk factors in pediatric quality measures: adding to the evidence base.
Acad Pediatr 2022 Apr;22(3s):S108-s14. doi: 10.1016/j.acap.2021.09.023..
Keywords: Children/Adolescents, Quality Measures, Quality of Care, Risk, Social Determinants of Health
Kleinman LC, Howell EA
Equity and the hazard of veiled injustice: a methodological reflection on risk adjustment.
The researchers report that in the context of quality improvement research, risk adjustment (RA) methods can obscure disparities in health care. In this study the researchers address the impact of considering equity when conducting risk adjustments in pediatric health, and describe the danger of veiled justice, a type of overadjustment that takes place when risk adjustments obscure real disparities because more than one covariate, such as race and socioeconomic status, are on related causal paths. Underadjustment can occur when these same structural characteristics are not addressed when calculating models of payment. The purpose of this study was to describe the literature and present a conceptual framework that identifies these two problems for validity related to the interactions between risk adjustment and health equity in pediatric health care. The researchers conclude that the science of quality improvement must address issues of health equity as an essential construct, with the development of a specific conceptual model. Statistical analysis should be interpreted using the conceptual model, and the dynamics of child development and life course should also be addressed, as well as additional contextual and process factors such as the role of caregivers and public insurance, the epidemiology of the disease, family financial status, and others. The goal of RA is to make valid conclusions such that observed differences can be attributed to the relevant causes. When higher risk is attributed to social determinants and not disease differences, RA can obscure disparities (veiled injustice) and differences at the population level and experienced by individuals are falsely hidden. Not addressing these same structural characteristics when calculating models of payment can lead to patterns of underadjustment. The authors advise that these 2 sides of a similar coin reveal the critical importance of both the underlying model and the capacity to reliably evaluate disparities and quality.
AHRQ-funded; HS020518; 233201550088A.
Citation: Kleinman LC, Howell EA .
Equity and the hazard of veiled injustice: a methodological reflection on risk adjustment.
Pediatrics 2022 Mar;149(Suppl 3). doi: 10.1542/peds.2020-045948G.
Keywords: Children/Adolescents, Disparities, Racial and Ethnic Minorities, Risk
Carpenter K, Scavotto M, McGovern A
Early parental knowledge of late effect risks in children with cancer.
This study assessed early parental knowledge of late effect risks in children with cancer. The cohort included parents of children receiving cancer treatment at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. The parents were surveyed about their knowledge of their child’s likelihood of eight late effects. Only 11 out of 96 parents correctly identified all their child’s risk for the eight late effects. Five of eight effects were the median number of correctly identified late effect risks. Among the 21 parents whose children were at risk for ototoxicity, 95% correctly identified this risk. Conversely, parents were less knowledgeable about risks of second malignancy, cardiac toxicity, neurocognitive impairment, and infertility.
AHRQ-funded; HS022986.
Citation: Carpenter K, Scavotto M, McGovern A .
Early parental knowledge of late effect risks in children with cancer.
Pediatr Blood Cancer 2022 Feb;69(2):e29473. doi: 10.1002/pbc.29473..
Keywords: Children/Adolescents, Cancer, Risk, Education: Patient and Caregiver, Health Literacy
Wu AC, Li L, Fung V
Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids.
The researchers compared the effectiveness of different controller medication regimens under real-life conditions. They found that the risk of emergency department visits, hospitalizations, and oral corticosteroids did not differ between children who initiated leukotriene antagonist and those who initiated inhaled corticosteroid. These findings may be explainable by leukotriene antagonist having similar effectiveness as inhaled corticosteroid in real-life usage.
AHRQ-funded; HS019669.
Citation: Wu AC, Li L, Fung V .
Use of leukotriene receptor antagonists are associated with a similar risk of asthma exacerbations as inhaled corticosteroids.
J Allergy Clin Immunol Pract 2014 Sep-Oct;2(5):607-13. doi: 10.1016/j.jaip.2014.05.009..
Keywords: Comparative Effectiveness, Medication, Children/Adolescents, Asthma, Risk