National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Alcohol Use (1)
- Ambulatory Care and Surgery (1)
- Anxiety (1)
- Asthma (2)
- Behavioral Health (3)
- Cancer (2)
- Caregiving (1)
- Care Management (2)
- (-) Children/Adolescents (17)
- Comparative Effectiveness (1)
- Diagnostic Safety and Quality (2)
- Digestive Disease and Health (1)
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- Evidence-Based Practice (5)
- Healthcare-Associated Infections (HAIs) (1)
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- Injuries and Wounds (1)
- Medication (4)
- Medication: Safety (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Neurological Disorders (2)
- Newborns/Infants (2)
- Nutrition (2)
- Outcomes (2)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (2)
- Patient Safety (1)
- Prevention (1)
- Registries (1)
- Respiratory Conditions (2)
- Stress (1)
- Substance Abuse (1)
- Surgery (1)
- Trauma (1)
- (-) Treatments (17)
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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 17 of 17 Research Studies DisplayedTreadwell JR, Kessler SK, Wu M
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this systematic review study was to assess the effectiveness and harms of pharmacologic and dietary treatments for epilepsy in children aged 1-36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 to identify studies reporting data on children aged 1-36 months receiving pharmacologic or dietary treatments for epilepsy. Twenty-three studies met the inclusion criteria. The study found that Levetiracetam leads to seizure freedom in some infants but the data on 6 other medications (lamotrigine, phenytoin, rufinamide, stiripentol, topiramate, and vigabatrin) were too limited to allow conclusions about their effectiveness. Three medications (lamotrigine, levetiracetam, and topiramate) were rarely discontinued due to adverse effects, and severe events were also rare. In the category of diets, the ketogenic diet lead to seizure freedom in some infants and both the ketogenic diet and modified Atkins diet reduced average seizure frequency.
AHRQ-funded; 75Q80120D00002.
Citation: Treadwell JR, Kessler SK, Wu M .
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
Neurology 2023 Jan 3;100(1):e16-e27. doi: 10.1212/wnl.0000000000201026..
Keywords: Children/Adolescents, Neurological Disorders, Newborns/Infants, Medication, Nutrition, Treatments, Evidence-Based Practice
Tsou AY, Kessler SK, Wu M
Surgical treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this article was to summarize the findings of a systematic review commissioned by the American Epilepsy Society to evaluate evidence and describe evidence gaps for surgical treatments for epilepsy in children aged 1 to 36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 and included studies reporting data on children aged 1 month to 36 months or less enrolled in surgical interventions or neurostimulation for epilepsy. Eighteen studies met inclusion criteria. The review found that seizure freedom for infants undergoing hemispherectomy/hemispherotomy ranged from 7% to 76% at 1 year after surgery. For non-hemispheric surgeries seizure freedom ranged from 40% to 70%. Over half of infants undergoing hemispherectomy/hemispherotomy achieved a favorable outcome (Engel I or II, ILAE I to IV, or >50% seizure reduction) at follow-up of over 1 year. The researchers note that the studies had important limitations. The researchers concluded that while evidence remains sparse and low quality, some infants achieve seizure freedom after surgery and 50% or greater achieve favorable outcomes.
AHRQ-funded; 75Q80120D00002.
Citation: Tsou AY, Kessler SK, Wu M .
Surgical treatments for epilepsies in children aged 1-36 months: a systematic review.
Neurology 2023 Jan 3;100(1):e1-e15. doi: 10.1212/wnl.0000000000201012..
Keywords: Children/Adolescents, Newborns/Infants, Surgery, Treatments, Evidence-Based Practice
Campbell JI, Tabatneck M, Sun M
Increasing use of interferon gamma release assays among children ≥2 years of age in a setting with low tuberculosis prevalence.
This article describes a retrospective cohort study that examined interferon gamma release assays (IGRAs) use to diagnose tuberculosis (TB) infection in children aged 2–17. The objectives of the study were to evaluate whether testing approaches for TB has changed since 2015. Electronic health records were used to identify IGRAs and tuberculin skin tests (TSTs) completed by children in two Boston-area academic health systems. The researchers observed that the proportion of IGRA tests increased between 2015 and 2021 in this low TB-prevalence setting. Testing in public versus private insurance, inpatient/subspecialty settings, lower age, and non-English preferred language were associated with an increased chance of receiving an IGRA. Findings suggest that the TST is being “retired,” and that education and support for primary care clinicians could improve equitable access to IGRA testing for children.
AHRQ-funded; HS000063.
Citation: Campbell JI, Tabatneck M, Sun M .
Increasing use of interferon gamma release assays among children ≥2 years of age in a setting with low tuberculosis prevalence.
Pediatr Infect Dis J 2022 Dec;41(12):e534-e37. doi: 10.1097/inf.0000000000003685..
Keywords: Children/Adolescents, Treatments, Respiratory Conditions, Infectious Diseases
Campbell JI, Sandora TJ, Haberer JE
A scoping review of paediatric latent tuberculosis infection care cascades: initial steps are lacking.
This literature review looked at current studies on the diagnosis and treatment of pediatric latent tuberculosis infection (TB infection), commonly known as the TB infection care cascade. The authors conducted a systematic search of several medical databases and included articles and meeting abstracts that studied children and adolescents 21 years or younger who were screened for or diagnosed with TB infection. They identified 146 studies examining steps in the pediatric TB infection care cascade, including 31 in children living in low- and middle-income countries. Most literature described the final cascade step, which is treatment initiation to completion. Strengths and gaps were identified and future research in examining cascade steps upstream of treatment initiation was recommended.
AHRQ-funded; HS000063.
Citation: Campbell JI, Sandora TJ, Haberer JE .
A scoping review of paediatric latent tuberculosis infection care cascades: initial steps are lacking.
BMJ Glob Health 2021 May;6(5). doi: 10.1136/bmjgh-2020-004836..
Keywords: Children/Adolescents, Respiratory Conditions, Diagnostic Safety and Quality, Treatments, Care Management, Evidence-Based Practice
Heneghan MB, Hussain T, Barrera L
Access to technology and preferences for an mHealth intervention to promote medication adherence in pediatric acute lymphoblastic leukemia: approach leveraging behavior change techniques.
This study’s objectives were to examine access to mobile technology and preferences for an mHealth intervention to improve medication adherence in pediatric acute lymphoblastic leukemia (ALL). Parents of children with ALL as well as adolescents and young adults (AYAs) with ALL who received maintenance chemotherapy were given a cross-sectional survey. Findings showed that parents, adolescents, and AYAs reported ubiquitous access to mobile technology and strong interest in multiple adherence-specific mHealth app features. Parents and AYAs provided valuable insight into preferred features for a multifunctional behavioral intervention to promote medication adherence in pediatric ALL.
AHRQ-funded; HS023011.
Citation: Heneghan MB, Hussain T, Barrera L .
Access to technology and preferences for an mHealth intervention to promote medication adherence in pediatric acute lymphoblastic leukemia: approach leveraging behavior change techniques.
J Med Internet Res 2021 Feb 18;23(2):e24893. doi: 10.2196/24893..
Keywords: Children/Adolescents, Young Adults, Caregiving, Cancer, Medication, Patient Adherence/Compliance, Health Information Technology (HIT), Treatments
Steele DW, Becker SJ, Danko KJ
Brief behavioral interventions for substance use in adolescents: a meta-analysis.
Adolescents with problematic substance use (SU) are at risk for far-reaching adverse outcomes. The objective of this study was to synthesize the evidence regarding the effects of brief behavioral interventions for adolescents (12-20 years) with problematic SU. The investigators concluded that the use of a behavioral intervention called motivational interviewing reduced heavy alcohol use, alcohol use days, and SU-related problems in adolescents but did not reduce cannabis use days.
AHRQ-funded; 290201500002I.
Citation: Steele DW, Becker SJ, Danko KJ .
Brief behavioral interventions for substance use in adolescents: a meta-analysis.
Pediatrics 2020 Oct;146(4):e2020351. doi: 10.1542/peds.2020-0351..
Keywords: Children/Adolescents, Substance Abuse, Alcohol Use, Treatments
Greenhawt M, Kim EH, Campbell DE
Improvements in eliciting dose across baseline sensitivities following 12 months of epicutaneous immunotherapy (EPIT) in peanut-allergic children aged 4 to 11 years.
The post hoc analyses presented in this article evaluated eliciting dose changes after epicutaneous immunotherapy treatment in peanut-allergic children in clinical trials in a more insightful way than a binomial endpoint approach allows. Findings showed that, for each entry eliciting dose (ED), patients treated daily for 12 months were able to achieve 2- to 6-fold greater ED increases versus placebo. The raw proportion of patients in the treatment group who were able to achieve an ED 1000 mg after 12 months was higher compared with placebo for every entry ED of 3 mg or greater.
AHRQ-funded; HS024599.
Citation: Greenhawt M, Kim EH, Campbell DE .
Improvements in eliciting dose across baseline sensitivities following 12 months of epicutaneous immunotherapy (EPIT) in peanut-allergic children aged 4 to 11 years.
J Allergy Clin Immunol Pract 2020 Oct;8(9):3219-21. doi: 10.1016/j.jaip.2020.05.030..
Keywords: Children/Adolescents, Treatments
Santosa KB, Keane AM, Keller M
Inpatient versus outpatient management of negative pressure wound therapy in pediatric patients.
Negative pressure wound therapy (NPWT) is commonly used to manage complex wounds in the pediatric population. With recently developed portable NPWT devices, providers have the opportunity to transition NPWT to the outpatient setting. However, there are no studies describing outpatient NPWT in pediatric patients. Therefore, the purpose of this study was to leverage a population-level analysis to advance current knowledge about outpatient NPWT use in pediatric patients.
AHRQ-funded; HS019455.
Citation: Santosa KB, Keane AM, Keller M .
Inpatient versus outpatient management of negative pressure wound therapy in pediatric patients.
J Surg Res 2020 Oct;254:197-205. doi: 10.1016/j.jss.2020.04.025..
Keywords: Children/Adolescents, Injuries and Wounds, Treatments, Care Management, Ambulatory Care and Surgery, Hospitalization
Heneghan MB, Hussain T, Barrera L
Applying the COM-B model to patient-reported barriers to medication adherence in pediatric acute lymphoblastic leukemia.
This study examined parent- and patient-reported barriers to oral chemotherapy adherence with children with pediatric acute lymphoblastic leukemia (ALL). The medicine most often used was 6-mercaptopurine (6-MP). Forty-nine parents and 15 patients were surveyed and most reported at least one adherence barrier. Most of the barriers were about meeting other patients with ALL or meeting other parents. Patients also reported difficulty in finding out what their medications are, and what 6-MP does. These barriers can lead to relapse if they are not addressed.
AHRQ-funded; HS023011.
Citation: Heneghan MB, Hussain T, Barrera L .
Applying the COM-B model to patient-reported barriers to medication adherence in pediatric acute lymphoblastic leukemia.
Pediatr Blood Cancer 2020 May;67(5):e28216. doi: 10.1002/pbc.28216..
Keywords: Children/Adolescents, Treatments, Cancer, Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research
Johnson MD, Zorc JJ, Nelson DS
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
Researchers examined the use, efficacy, and safety of intravenous magnesium sulfate (IVMg) in children with asthma whose emergency department (ED) management is recorded in the Pediatric Emergency Care Applied Research Network (PECARN) Registry. They found that, in PECARN Registry EDs, administration of IVMg occurred late in ED treatment, for a minority of the children likely to benefit, with variation between sites, which suggested the current clinical role for IVMg in preventing hospitalization was limited. Discharge after IVMg administration would likely be safe. They recommended further research to assess the efficacy and safety of early IVMg administration.
AHRQ-funded; HS020270.
Citation: Johnson MD, Zorc JJ, Nelson DS .
Intravenous magnesium in asthma pharmacotherapy: variability in use in the PECARN Registry.
J Pediatr 2020 May;220:165-74.e2. doi: 10.1016/j.jpeds.2020.01.062..
Keywords: Children/Adolescents, Asthma, Medication, Emergency Department, Registries, Treatments, Patient Safety, Medication: Safety
Whiteside SPH, Sim LA, Morrow AS
A meta-analysis to guide the enhancement of CBT for childhood anxiety: exposure over anxiety management.
Cognitive behavior therapy (CBT) is the most empirically supported therapy for childhood anxiety disorders (CADs) but has not reliably outperformed other credible interventions. The current study used meta-analysis to examine the frequency with which the most common treatment components are included in outcome studies and the relation of these components to symptom improvement.
AHRQ-funded; 290201500013I.
Citation: Whiteside SPH, Sim LA, Morrow AS .
A meta-analysis to guide the enhancement of CBT for childhood anxiety: exposure over anxiety management.
Clin Child Fam Psychol Rev 2020 Mar;23(1):102-21. doi: 10.1007/s10567-019-00303-2..
Keywords: Children/Adolescents, Anxiety, Behavioral Health, Treatments, Patient-Centered Outcomes Research, Evidence-Based Practice
Rudd BN, Last BS, Gregor C
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
The objectives of the current study are to (a) evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) delivered from 2013 to 2016 in 15 behavioral health agencies on youth PTSD as well as general mental health symptoms and functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. This study is the first benchmarking study of TF-CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF-CBT to urban community settings that serve youth in poverty.
AHRQ-funded; HS000084.
Citation: Rudd BN, Last BS, Gregor C .
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
Am J Community Psychol 2019 Dec;64(3-4):438-50. doi: 10.1002/ajcp.12370..
Keywords: Children/Adolescents, Behavioral Health, Trauma, Stress, Outcomes, Treatments
Kuzniewicz MW, Niki H, Walsh EM
Hyperbilirubinemia, phototherapy, and childhood asthma.
The purpose of this retrospective cohort study was to quantify the associations of both hyperbilirubinemia and phototherapy with childhood asthma with total serum bilirubin (TSB) levels. Infants born after at least 35 weeks’ gestation within the Kaiser Permanente Northern California health system between 2010 and 2014 made up the study population. Cox models were used to estimate hazard ratios for a diagnosis of asthma. The researchers conclude that moderate levels of hyperbilirubinemia are associated with increased risk of asthma, but this association was not seen at higher levels. No dose-response relationship was observed.
AHRQ-funded; HS020618.
Citation: Kuzniewicz MW, Niki H, Walsh EM .
Hyperbilirubinemia, phototherapy, and childhood asthma.
Pediatrics 2018 Oct;142(4). doi: 10.1542/peds.2018-0662..
Keywords: Asthma, Children/Adolescents, Treatments
Goode AP, Coeytaux RR, Maslow GR
Nonpharmacologic treatments for attention-deficit/hyperactivity disorder: a systematic review.
The authors assessed the comparative effectiveness of non-pharmacologic treatments for attention-deficit/hyperactivity disorder (ADHD) among individuals 17 years of age and younger. Non-pharmacologic treatments they identified included neurofeedback, cognitive training, cognitive behavioral therapy, child or parent training, dietary omega fatty acid supplementation, and herbal and/or dietary approaches. They identified no new guidance regarding the comparative effectiveness of non-pharmacologic treatments, concluding that, despite wide use, there are significant gaps in knowledge regarding the effectiveness of ADHD non-pharmacologic treatments.
AHRQ-funded; 290201500004I.
Citation: Goode AP, Coeytaux RR, Maslow GR .
Nonpharmacologic treatments for attention-deficit/hyperactivity disorder: a systematic review.
Pediatrics 2018 Jun;141(6). doi: 10.1542/peds.2018-0094.
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Keywords: Children/Adolescents, Behavioral Health, Comparative Effectiveness, Treatments, Evidence-Based Practice
Stone B, Hester G, Jackson D
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Gastroesophageal reflux (GER), aspiration, and secondary complications lead to morbidity and mortality in children with neurologic impairment (NI), dysphagia, and gastrostomy feeding. Fundoplication and gastrojejunal (GJ) feeding can reduce risk. A comparison of GJ to fundoplication using first-year postprocedure reflux-related hospitalization (RRH) rates found that in children with NI, GER, and dysphagia,:fundoplication and GJ feeding have similar RRH outcomes.
AHRQ-funded; HS019862.
Citation: Stone B, Hester G, Jackson D .
Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment.
Hosp Pediatr 2017 Mar;7(3):140-48. doi: 10.1542/hpeds.2016-0126.
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Keywords: Children/Adolescents, Digestive Disease and Health, Neurological Disorders, Nutrition, Outcomes, Treatments
Farbman KS, Michelson KA
Anaphylaxis in children.
Anaphylaxis is a serious allergic reaction that can be life threatening. The authors reviewed the most recent evidence regarding the diagnosis, treatment, monitoring, and prevention of anaphylaxis in children. It concluded that epinephrine remains the mainstay of anaphylaxis treatment, and adjuvant medications should not be used in its place.
AHRQ-funded; HS000063.
Citation: Farbman KS, Michelson KA .
Anaphylaxis in children.
Curr Opin Pediatr 2016 Mar 8;28(3):294-7. doi: 10.1097/mop.0000000000000340..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Prevention, Treatments
Finnell SM, Rosenman MB, Christenson JC
Decolonization of children after incision and drainage for MRSA abscess: a retrospective cohort study.
The researchers sought to determine whether decolonization following incision and drainage (I&D) for methicillin-resistant Staphylococcus aureus (MRSA) abscess decreases repeat I&D and MRSA-positive cultures in children. They found that no statistically significant association between referral to the Pediatric Infectious Disease Service for decolonization and the outcomes.
AHRQ-funded; HS020014.
Citation: Finnell SM, Rosenman MB, Christenson JC .
Decolonization of children after incision and drainage for MRSA abscess: a retrospective cohort study.
Clin Pediatr 2015 May;54(5):445-50. doi: 10.1177/0009922814556059..
Keywords: Children/Adolescents, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Treatments