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AHRQ Research Studies Date
Topics
- (-) Adverse Drug Events (ADE) (16)
- Adverse Events (9)
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- Antimicrobial Stewardship (1)
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- Patient Safety (6)
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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 16 of 16 Research Studies DisplayedIng C, Landau R, DeStephano D
Prenatal exposure to general anesthesia and childhood behavioral deficit.
This study looked at the association of prenatal exposure to general anesthesia and childhood behavioral deficits. The Raine Study was an observational cohort study of children born in Perth, Western Australia with 2 generations of participations. The first generation (Gen1) were mothers enrolled during pregnancy, and the second generation (Gen2) were the children born from 1989 to 1992 with neuropsychological and behavioral tests evaluated at age 10. Six neuropsychological and behavioral tests were used with the Child Behavior Checklist (CBCL) as the main test. Among 2024 children with available outcome scores, 22 were prenatally exposed to general anesthesia. These children had higher CBCL Externalizing behavioral scores than unexposed children. Of the six tests used, only CBCL Externalizing behavioral scores remained significant after multiple comparisons adjustment.
AHRQ-funded; HS026493.
Citation: Ing C, Landau R, DeStephano D .
Prenatal exposure to general anesthesia and childhood behavioral deficit.
Anesth Analg 2021 Sep 1;133(3):595-605. doi: 10.1213/ane.0000000000005389..
Keywords: Children/Adolescents, Behavioral Health, Pregnancy, Adverse Drug Events (ADE), Adverse Events
Worsham CM, Woo J, Jena AB
Adverse events and emergency department opioid prescriptions in adolescents.
Understanding the risks associated with opioid prescription in adolescents is critical for informing opioid policy, but the risks are challenging to quantify given the lack of randomized trial data. Using a regression discontinuity design, the investigators exploited a discontinuous increase in opioid prescribing in the emergency department (ED) when adolescents transitioned from "child" to "adult" at age eighteen to estimate the effect of an ED opioid prescription on subsequent opioid-related adverse events.
AHRQ-funded; HS026753.
Citation: Worsham CM, Woo J, Jena AB .
Adverse events and emergency department opioid prescriptions in adolescents.
Health Aff 2021 Jun;40(6):970-78. doi: 10.1377/hlthaff.2020.01762..
Keywords: Children/Adolescents, Emergency Department, Opioids, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Practice Patterns
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
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
Toce MS, Michelson K, Hudgins J
Association of state-level opioid-reduction policies with pediatric opioid poisoning.
Opioid-reduction policies have been enacted by US states to address the opioid epidemic. Evidence of an association between policy implementation and decreased rates of pediatric opioid poisoning provides further justification for expanded implementation of these policies. The purpose of this study was to examine the association of 3 state-level opioid-reduction policies with the rate of opioid poisoning in children and adolescents.
AHRQ-funded; HS026503.
Citation: Toce MS, Michelson K, Hudgins J .
Association of state-level opioid-reduction policies with pediatric opioid poisoning.
JAMA Pediatr 2020 Oct;174(10):961-68. doi: 10.1001/jamapediatrics.2020.1980..
Keywords: Children/Adolescents, Opioids, Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Policy
Ing C, Ma X, Sun M
Exposure to surgery and anesthesia in early childhood and subsequent use of attention deficit hyperactivity disorder medications.
This study examines the association between higher rates of attention deficit hyperactivity disorder (ADHD) diagnosis and exposure to surgery and anesthesia before the age of 5. Longitudinal pharmacy data for children enrolled in Texas and New York Medicaid from 1999 to 2010 were used. They examined the association between a single exposure to anesthesia before age 5 years for 1 of 4 common pediatric surgical procedures: pyloromytomy, inguinal hernia repair, circumcisions outside the perinatal period, and tonsillectomy and/or adenectomy; and persistent ADHD medication use. A total of 213,435 children were included in the study. Children with a single exposure to anesthesia were 37% more likely than unexposed children to persistently use ADHD medication.
AHRQ-funded; HS022941.
Citation: Ing C, Ma X, Sun M .
Exposure to surgery and anesthesia in early childhood and subsequent use of attention deficit hyperactivity disorder medications.
Anesth Analg 2020 Sep;131(3):723-33. doi: 10.1213/ane.0000000000004619..
Keywords: Children/Adolescents, Behavioral Health, Medication, Surgery, Adverse Drug Events (ADE), Adverse Events
Vyles D, Antoon JW, Norton A
Children with reported penicillin allergy: public health impact and safety of delabeling.
The objectives of this study were to: 1.) Review the relevant literature related to children with reported penicillin allergy 2.) Highlight the different ways in which children could be delabeled and 3.) Evaluate the public health impact that a penicillin allergy has for children. The investigators concluded that penicillin allergy was overdiagnosed, often incorrectly, and the label was frequently first applied during childhood.
AHRQ-funded; HS026395.
Citation: Vyles D, Antoon JW, Norton A .
Children with reported penicillin allergy: public health impact and safety of delabeling.
Ann Allergy Asthma Immunol 2020 Jun;124(6):558-65. doi: 10.1016/j.anai.2020.03.012..
Keywords: Children/Adolescents, Medication, Medication: Safety, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Public Health
Woods-Hill CZ, Koontz DW, King AF
Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a national survey.
Sending blood cultures in children at low risk of bacteremia can contribute to a cascade of unnecessary antibiotic exposure, adverse effects, and increased costs. In this study, the investigators aimed to describe practice variation, clinician beliefs, and attitudes about blood culture testing in critically ill children. They concluded that there is variation in blood culture practices in the pediatric ICU. Fear and reflexive habits are common drivers of cultures. These practices may contribute to over-testing for bacteremia.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Koontz DW, King AF .
Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a national survey.
Pediatr Crit Care Med 2020 Jan;21(1):e23-e29. doi: 10.1097/pcc.0000000000002176..
Keywords: Children/Adolescents, Critical Care, Antimicrobial Stewardship, Antibiotics, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Intensive Care Unit (ICU), Shared Decision Making
Wang SV, Abdurrob A, Spoendlin J
Methods for addressing "innocent bystanders" when evaluating safety of concomitant vaccines.
The need to develop methods for studying the safety of childhood immunization schedules has been recognized by the Institute of Medicine and Department of Health and Human Services. The recommended childhood immunization schedule includes multiple vaccines in a visit. A key concern is safety of concomitant (same day) versus separate day vaccination. This paper addressed a methodological challenge for observational studies using a self-controlled design to investigate the safety of concomitant vaccination.
AHRQ-funded; HS022193.
Citation: Wang SV, Abdurrob A, Spoendlin J .
Methods for addressing "innocent bystanders" when evaluating safety of concomitant vaccines.
Pharmacoepidemiol Drug Saf 2018 Apr;27(4):405-12. doi: 10.1002/pds.4399..
Keywords: Adverse Drug Events (ADE), Adverse Events, Children/Adolescents, Patient Safety, Vaccination
Pringle KD, Burke RM, Steiner CA
AHRQ Author: Steiner CA
Trends in rate of seizure-associated hospitalizations among children <5 years old before and after rotavirus vaccine introduction in the United Sates, 2000-2013.
Since rotavirus vaccine introduction, hospitalizations for treatment of acute gastroenteritis have decreased. Researchers assessed whether there has been an associated decrease in seizure-associated hospitalizations. Their analysis provides evidence for a decrease in seizure hospitalizations following rotavirus vaccine introduction in the United States, with the greatest impact in age groups with a high rotavirus-associated disease burden and during rotavirus infection season.
AHRQ-authored.
Citation: Pringle KD, Burke RM, Steiner CA .
Trends in rate of seizure-associated hospitalizations among children <5 years old before and after rotavirus vaccine introduction in the United Sates, 2000-2013.
J Infect Dis 2018 Jan 30;217(4):581-88. doi: 10.1093/infdis/jix589.
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Keywords: Adverse Drug Events (ADE), Children/Adolescents, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Vaccination
Westover AN, Nakonezny PA, Adinoff B
Impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents.
In this study of the impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents, the investigators found that adolescent stimulant medication users, compared to matched nonusers, demonstrated a trend toward decreased heart rate during submaximal exercise (which is potential evidence of chronic adaptation with stimulant exposure). There was no evidence for delayed heart rate recovery in this study, and thus, no evidence for decreased parasympathetic activity during initial exercise recovery.
AHRQ-funded; HS022418.
Citation: Westover AN, Nakonezny PA, Adinoff B .
Impact of stimulant medication use on heart rate and systolic blood pressure during submaximal exercise treadmill testing in adolescents.
J Child Adolesc Psychopharmacol 2016 Dec;26(10):889-99. doi: 10.1089/cap.2016.0064..
Keywords: Adverse Drug Events (ADE), Children/Adolescents, Blood Pressure, Medication, Medication: Safety
Pinyavat T, Warner DO, Flick RP
Summary of the update session on clinical neurotoxicity studies.
During the Fifth Pediatric Anesthesia Neurodevelopmental Assessment Symposium, experts and stakeholders met to present and discuss recent advances made in the study of neurodevelopmental outcomes after exposure to anesthetic drugs in infants and children. This article summarizes the update of 5 ongoing clinical studies: General Anesthesia compared to Spinal Anesthesia, Toxicity of Remifentanil and Dexmedetomidine, Mayo Anesthesia Safety in Kids, the University of California San Francisco human cohort study, and Columbia University Medical Center Neonatal Magnetic Resonance Imaging study.
AHRQ-funded; HS022941.
Citation: Pinyavat T, Warner DO, Flick RP .
Summary of the update session on clinical neurotoxicity studies.
J Neurosurg Anesthesiol 2016 Oct;28(4):356-60. doi: 10.1097/ana.0000000000000347.
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Keywords: Newborns/Infants, Children/Adolescents, Medication: Safety, Adverse Drug Events (ADE), Medication
Dai D, Feinstein JA, Morrison W
Epidemiology of polypharmacy and potential drug-drug interactions among pediatric patients in ICUs of U.S. children's hospitals.
The authors studied the characteristics and prevalence of exposure of pediatric patients to polypharmacy and potential drug-drug interactions in pediatric intensive care units (PICUs). They found that many PICU patients are exposed to substantial polypharmacy and potential drug-drug interactions. Future research should identify the risk of adverse drug events following specific potential drug-drug interaction exposures.
AHRQ-funded; HS018425.
Citation: Dai D, Feinstein JA, Morrison W .
Epidemiology of polypharmacy and potential drug-drug interactions among pediatric patients in ICUs of U.S. children's hospitals.
Pediatr Crit Care Med 2016 May;17(5):e218-28. doi: 10.1097/pcc.0000000000000684.
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Keywords: Adverse Drug Events (ADE), Children/Adolescents, Intensive Care Unit (ICU), Medication, Medication: Safety
Linden S, Bussing R, Kubilis P
Risk of suicidal events with atomoxetine compared to stimulant treatment: a cohort study.
The researchers analyzed whether the observed increased risk of suicidal ideation in clinical trials translates into an increased risk of suicidal events in pediatric patients treated with atomoxetine compared with stimulants in 26 Medicaid programs. They found that first- and second-line treatment of youths age 5 to 18 with atomoxetine compared with stimulants was not significantly associated with an increased risk of suicidal events.
AHRQ-funded; HS018506; HS016097.
Citation: Linden S, Bussing R, Kubilis P .
Risk of suicidal events with atomoxetine compared to stimulant treatment: a cohort study.
Pediatrics 2016 May;137(5):pii: e20153199. doi: 10.1542/peds.2015-3199.
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Keywords: Adverse Drug Events (ADE), Medication, Children/Adolescents, Comparative Effectiveness, Patient-Centered Outcomes Research
Basco WT, Jr., Garner SS, Ebeling M
Evaluating the potential severity of look-alike, sound-alike drug substitution errors in children.
The authors' objective was to determine the degree of potential harm pediatricians ascribe to specific ambulatory look-alike, sound-alike (LASA) drug substitution errors. They concluded that pediatricians have identified LASA drug substitutions that pose a high potential risk of harm to children, thus allowing future efforts to prioritize pediatric LASA errors that can be screened prospectively in outpatient pharmacies.
AHRQ-funded; HS018841.
Citation: Basco WT, Jr., Garner SS, Ebeling M .
Evaluating the potential severity of look-alike, sound-alike drug substitution errors in children.
Acad Pediatr 2016 Mar;16(2):183-91. doi: 10.1016/j.acap.2015.06.014.
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Keywords: Children/Adolescents, Medication, Medication: Safety, Adverse Drug Events (ADE), Children/Adolescents
Downes KJ, Goldstein SL, Vinks AA
Increased vancomycin exposure and nephrotoxicity in children: therapeutic does not mean safe.
The authors argue that a tenuous balance exists between the successful treatment of infection and the safe administration of vancomycin in the most vulnerable patients. Furthermore, prospective controlled trials are needed to identify and validate the optimal pharmacokinetic/pharmacodynamic (PK/PD) targets for vancomycin in children. Also, infectious diseases specialists need to be cognizant of the untoward effects of nephrotoxic acute kidney injury in children.
AHRQ-funded; HS021114.
Citation: Downes KJ, Goldstein SL, Vinks AA .
Increased vancomycin exposure and nephrotoxicity in children: therapeutic does not mean safe.
J Pediatric Infect Dis Soc 2016 Mar;5(1):65-7. doi: 10.1093/jpids/piu122.
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Keywords: Adverse Drug Events (ADE), Antibiotics, Children/Adolescents, Medication, Medication: Safety