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https://www.readbyqxmd.com/read/28816917/factors-associated-with-developmental-behavioral-pediatricians-prescribing-psychotropic-medication-to-children-with-autism-spectrum-disorder-a-study-of-three-dbpnet-sites
#1
Carissa Jackel, Justine Shults, Susan Wiley, Jareen Meinzen-Derr, Marilyn Augustyn, Nathan Blum
OBJECTIVE: Psychotropic medications are frequently prescribed to children with autism spectrum disorder (ASD), but little is known about the prescribing practices of developmental-behavioral pediatricians (DBPs). Our objective was to determine whether clinical site, age, insurance, or comorbidities influenced DBPs prescribing psychotropic medication for children with ASD. METHODS: A retrospective analysis was performed using electronic health record data of all patients with ASD seen at 3 academic developmental-behavioral pediatrics (DBP) clinical programs from January 2010 to December 2011...
August 10, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28816912/distance-learning-adhd-quality-improvement-in-primary-care-a-cluster-randomized-trial
#2
Alexander G Fiks, Stephanie L Mayne, Jeremy J Michel, Jeffrey Miller, Manju Abraham, Andrew Suh, Abbas F Jawad, James P Guevara, Robert W Grundmeier, Nathan J Blum, Thomas J Power
OBJECTIVE: To evaluate a distance-learning, quality improvement intervention to improve pediatric primary care provider use of attention-deficit/hyperactivity disorder (ADHD) rating scales. METHODS: Primary care practices were cluster randomized to a 3-part distance-learning, quality improvement intervention (web-based education, collaborative consultation with ADHD experts, and performance feedback reports/calls), qualifying for Maintenance of Certification (MOC) Part IV credit, or wait-list control...
August 9, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28815363/the-use-of-natural-language-processing-on-pediatric-diagnostic-radiology-reports-in-the-electronic-health-record-to-identify-deep-venous-thrombosis-in-children
#3
Jorge A Gálvez, Janine M Pappas, Luis Ahumada, John N Martin, Allan F Simpao, Mohamed A Rehman, Char Witmer
Venous thromboembolism (VTE) is a potentially life-threatening condition that includes both deep vein thrombosis (DVT) and pulmonary embolism. We sought to improve detection and reporting of children with a new diagnosis of VTE by applying natural language processing (NLP) tools to radiologists' reports. We validated an NLP tool, Reveal NLP (Health Fidelity Inc, San Mateo, CA) and inference rules engine's performance in identifying reports with deep venous thrombosis using a curated set of ultrasound reports...
August 16, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28783810/adaptation-and-validation-of-a-pediatric-sequential-organ-failure-assessment-score-and-evaluation-of-the-sepsis-3-definitions-in-critically-ill-children
#4
Travis J Matics, L Nelson Sanchez-Pinto
Importance: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) uses the Sequential Organ Failure Assessment (SOFA) score to grade organ dysfunction in adult patients with suspected infection. However, the SOFA score is not adjusted for age and therefore not suitable for children. Objectives: To adapt and validate a pediatric version of the SOFA score (pSOFA) in critically ill children and to evaluate the Sepsis-3 definitions in patients with confirmed or suspected infection...
August 7, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28771646/assessing-disaster-preparedness-among-select-children-s-summer-camps-in-the-united-states-and-canada
#5
Megan Chang, Alan Sielaff, Stuart Bradin, Kevin Walker, Michael Ambrose, Andrew Hashikawa
OBJECTIVE: Children's summer camps are at risk for multiple pediatric casualties during a disaster. The degree to which summer camps have instituted disaster preparedness is unknown. We assessed disaster preparedness among selected camps nationally for a range of disasters. METHODS: We partnered with a national, web-based electronic health records system to send camp leadership of 315 camp organizations a 14-question online survey of disaster preparedness. One response from each camp was selected in the following order of importance: owner, director, physician, nurse, medical technician, office staff, and other...
August 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28716477/2017-aha-acc-key-data-elements-and-definitions-for-ambulatory-electronic-health-records-in-pediatric%C3%A2-and-congenital-cardiology-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-data-standards
#6
Jeffrey R Boris, Marie J Béland, Lisa J Bergensen, Steven D Colan, Joanna Dangel, Curtis J Daniels, Christopher Davis, Allen D Everett, Rodney Franklin, J William Gaynor, Darryl T Gray, Jennifer C Hirsch-Romano, Jeffrey P Jacobs, Marshall Jacobs, Howard Jeffries, Otto Nils Krogmann, Edwin A Lomotan, Leo Lopez, Ariane Marelli, Gerard R Martin, G Paul Matherne, Constantine Mavroudis, Ken McCardle, Gail D Pearson, Geoffrey Rosenthal, John S Scott, Gerald A Serwer, Stephen S Seslar, Robert Shaddy, Timothy Slesnick, David F Vener, Henry L Walters, Paul M Weinberg
No abstract text is available yet for this article.
July 10, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28711345/working-at-the-intersection-of-context-culture-and-technology-provider-perspectives-on-antimicrobial-stewardship-in-the-emergency-department-using-electronic-health-record-clinical-decision-support
#7
Phillip Chung, Jean Scandlyn, Peter S Dayan, Rakesh D Mistry
BACKGROUND: Antibiotic stewardship programs (ASPs) have not been fully developed for the emergency department (ED), in part the result of the barriers characteristic of this setting. Electronic health record-based clinical decision support (EHR CDS) represents a promising strategy to implement ASPs in the ED. We aimed to determine the cultural beliefs and structural barriers and facilitators to implementation of antimicrobial stewardship in the pediatric ED using EHR CDS. METHODS: Interviews and focus groups were conducted with hospital and ED leadership, attending ED physicians, nurse practitioners, physician assistants, and residents at a single health system in Colorado...
July 12, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28710700/enhancing-state-medical-home-capacity-through-a-care-coordination-technical-assistance-model
#8
Susan Berry, Patti Barovechio, Emily Mabile, Tri Tran
Introduction A practice-based care coordination (CC) model was developed by Louisiana's Title V Children's Special Health Services (CSHS) program to meet the overwhelming needs of the New Orleans post-Katrina population. The pilot clinic demonstrated an improvement in medical home (MH) capacity over the course of 3 months. The purpose of the current study is to evaluate the replicability of the model and sustainability of MH improvement over at least 2 years, while identifying factors that may modify the effect of the intervention...
July 14, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28710153/2017-aha-acc-key-data-elements-and-definitions-for-ambulatory-electronic-health-records-in-pediatric-and-congenital-cardiology-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-data-standards
#9
REVIEW
Jeffrey R Boris, Marie J Béland, Lisa J Bergensen, Steven D Colan, Joanna Dangel, Curtis J Daniels, Christopher Davis, Allen D Everett, Rodney Franklin, J William Gaynor, Darryl T Gray, Jennifer C Hirsch-Romano, Jeffrey P Jacobs, Marshall Jacobs, Howard Jeffries, Otto Nils Krogmann, Edwin A Lomotan, Leo Lopez, Ariane Marelli, Gerard R Martin, G Paul Matherne, Constantine Mavroudis, Ken McCardle, Gail D Pearson, Geoffrey Rosenthal, John S Scott, Gerald A Serwer, Stephen S Seslar, Robert Shaddy, Timothy Slesnick, David F Vener, Henry L Walters, Paul M Weinberg
No abstract text is available yet for this article.
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28701350/effectiveness-of-interventions-to-improve-medication-use-during-rapid-sequence-intubation-in-a-pediatric-emergency-department
#10
Michelle C Caruso, Jenna R Dyas, Matthew R Mittiga, Andrea S Rinderknecht, Benjamin T Kerrey
PURPOSE: Results of a study to determine whether checklist-based interventions improved the selection and administration of rapid-sequence intubation (RSI) medications in a pediatric emergency department (ED) are reported. METHODS: A retrospective study of data collected during a quality-improvement project was conducted. Data sources included the electronic health record and video review. The central intervention was use of a 21-item RSI checklist, which included guidance for the physician team leader on medication selection and timing...
July 12, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28699944/improving-the-readability-of-pediatric-hospital-medicine-discharge-instructions
#11
Ndidi Unaka, Angela Statile, Karen Jerardi, Devesh Dahale, Joan Morris, Brianna Liberio, Ashley Jenkins, Blair Simpson, Randi Mullaney, Jodi Kelley, Michelle Durling, Jennifer Shafer, Patrick Brady
BACKGROUND: Readable discharge instructions may help caregivers understand and implement care plans following hospitalization. Many caregivers of hospitalized children, however, have limited literacy. We aimed to increase the percentage of discharge instructions written at 7th grade level or lower for hospital medicine patients from 13% to 80% in 6 months. METHODS: Quality improvement efforts targeted a 42-bed unit at the community satellite of our large, urban academic hospital...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28699564/detecting-clinically-relevant-new-information-in-clinical-notes-across-specialties-and-settings
#12
Rui Zhang, Serguei V S Pakhomov, Elliot G Arsoniadis, Janet T Lee, Yan Wang, Genevieve B Melton
BACKGROUND: Automated methods for identifying clinically relevant new versus redundant information in electronic health record (EHR) clinical notes is useful for clinicians and researchers involved in patient care and clinical research, respectively. We evaluated methods to automatically identify clinically relevant new information in clinical notes, and compared the quantity of redundant information across specialties and clinical settings. METHODS: Statistical language models augmented with semantic similarity measures were evaluated as a means to detect and quantify clinically relevant new and redundant information over longitudinal clinical notes for a given patient...
July 5, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28653504/clinical-effectiveness-of-the-massachusetts-childhood-obesity-research-demonstration-initiative-among-low-income-children
#13
Elsie M Taveras, Meghan Perkins, Shikha Anand, Jennifer A Woo Baidal, Candace C Nelson, Neil Kamdar, Jo-Ann Kwass, Steven L Gortmaker, Jessica L Barrett, Kirsten K Davison, Thomas Land
OBJECTIVE: To examine the extent to which a clinical intervention resulted in reduced BMI z scores among 2- to 12-year-old children compared to routine practice (treatment as usual [TAU]). METHODS: The Massachusetts Childhood Obesity Research Demonstration (MA-CORD) project is a multifaceted initiative to prevent childhood obesity among low-income children. At the federally qualified community health centers (FQHCs) of two communities (Intervention Site #1 and #2), the following were implemented: (1) pediatric weight management training, (2) electronic decision supports for clinicians, (3) on-site Healthy Weight Clinics, (4) community health worker integration, and (5) healthful clinical environment changes...
July 2017: Obesity
https://www.readbyqxmd.com/read/28644180/mucosal-healing-in-clinical-practice-a-single-center-pediatric-ibd-experience
#14
Savini L Santha, Prabhu R Shankar, Anqi Pan, Bess Schoen, Subra Kugathasan, Cary G Sauer
BACKGROUND: Mucosal healing (MH) is associated with improved clinical outcomes in patients with Crohn's disease (CD) and ulcerative colitis (UC). MH as a target for treatment has been suggested, although there is little pediatric data. The goal of this study was to evaluate MH in clinical practice in pediatric patients with inflammatory bowel disease in clinical remission. METHODS: A retrospective review of electronic health record data was performed on all patients with CD or UC who underwent at least 2 colonoscopies from 2010 through 2016...
August 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28638518/automated-reporting-of-trainee-metrics-using-electronic-clinical-systems
#15
Jonathan C Levin, Jonathan Hron
BACKGROUND: The Accreditation Council for Graduate Medical Education has called for increased emphasis on reporting objective performance measures to trainees and programs. However, reporting of objective measures, including clinical volume, is largely omitted from training programs. OBJECTIVE: To use automated electronic medical systems at a tertiary pediatric care hospital to create a dashboard that reports objective trainee and program metrics, including clinical volume and diagnoses in a pediatrics residency...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28634427/leveraging-food-and-drug-administration-adverse-event-reports-for-the-automated-monitoring-of-electronic-health-records-in-a-pediatric-hospital
#16
Huaxiu Tang, Imre Solti, Eric Kirkendall, Haijun Zhai, Todd Lingren, Jaroslaw Meller, Yizhao Ni
The objective of this study was to determine whether the Food and Drug Administration's Adverse Event Reporting System (FAERS) data set could serve as the basis of automated electronic health record (EHR) monitoring for the adverse drug reaction (ADR) subset of adverse drug events. We retrospectively collected EHR entries for 71 909 pediatric inpatient visits at Cincinnati Children's Hospital Medical Center. Natural language processing (NLP) techniques were used to identify positive diseases/disorders and signs/symptoms (DDSSs) from the patients' clinical narratives...
2017: Biomedical Informatics Insights
https://www.readbyqxmd.com/read/28632576/understanding-the-constipation-conundrum-predictors-of-obtaining-an-abdominal-radiograph-during-the-emergency-department-evaluation-of-pediatric-constipation
#17
Claire A MacGeorge, Daniel C Williams, Natalie Vajta, Kristen Morella, Paul G Thacker, Scott Russell, William T Basco, David G Bundy
OBJECTIVES: Many children with constipation who are evaluated in emergency departments (EDs) receive an abdominal radiograph (AR) despite evidence-based guidelines discouraging imaging. The objectives of this study were to identify predictors associated with obtaining an AR and to determine if ARs were associated with a longer length of stay (LOS) among children with constipation evaluated in the ED. METHODS: A review of billing and electronic health records was conducted in an academic pediatric ED for children ages 0 to 17 years who had a primary discharge diagnosis of constipation from July 2013 to June 2014...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28629687/sensitivity-and-specificity-of-empiric-treatment-for-sexually-transmitted-infections-in-a-pediatric-emergency-department
#18
Kristen Breslin, Lisa Tuchman, Katie L Hayes, Gia Badolato, Monika K Goyal
OBJECTIVE: To determine test characteristics of provider judgment for empiric antibiotic provision to patients undergoing testing for a sexually transmitted infection. STUDY DESIGN: We conducted a retrospective cross-sectional electronic health record review of all patients aged 13-19 years who had Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) testing sent from an urban, academic pediatric emergency department in 2012. We abstracted data, including patient demographics, chief complaint, sexually transmitted infection test results, and treatment...
June 16, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28625502/a-computable-phenotype-improves-cohort-ascertainment-in-a-pediatric-pulmonary-hypertension-registry
#19
Alon Geva, Jessica L Gronsbell, Tianxi Cai, Tianrun Cai, Shawn N Murphy, Jessica C Lyons, Michelle M Heinz, Marc D Natter, Nandan Patibandla, Jonathan Bickel, Mary P Mullen, Kenneth D Mandl
OBJECTIVES: To compare registry and electronic health record (EHR) data mining approaches for cohort ascertainment in patients with pediatric pulmonary hypertension (PH) in an effort to overcome some of the limitations of registry enrollment alone in identifying patients with particular disease phenotypes. STUDY DESIGN: This study was a single-center retrospective analysis of EHR and registry data at Boston Children's Hospital. The local Informatics for Integrating Biology and the Bedside (i2b2) data warehouse was queried for billing codes, prescriptions, and narrative data related to pediatric PH...
June 15, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28604931/motor-vehicle-crash-risk-among-adolescents-and-young-adults-with-attention-deficit-hyperactivity-disorder
#20
Allison E Curry, Kristina B Metzger, Melissa R Pfeiffer, Michael R Elliott, Flaura K Winston, Thomas J Power
Importance: Attention-deficit/hyperactivity disorder (ADHD) often persists into adolescence, when motor vehicle crash risk peaks. We know little about when adolescents with ADHD get licensed and, once they do, the extent to which they have increased crash risk compared with adolescents without ADHD. Objectives: To examine the association between ADHD and both driver licensing and crash involvement and whether it varies by sex, licensing age, and/or being prescribed ADHD medication at licensure...
August 1, 2017: JAMA Pediatrics
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