In This Issue
Research Spotlight: CPCE Marks a Decade of Answering 'What Works?' in Healthcare
CPCE in the News: Early-Onset Group B Strep Infections Drop in US Neonates
CPCE in the News: Pediatricians Push for Laws to Prevent Teen Vaping
Upcoming Events
Recent Publications
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CPCE Marks a Decade of Answering 'What Works?' in Healthcare
The Children's Hospital of Philadelphia Research Institute has released the 2018 Research Institute Annual Report, including a feature on CPCE's 10-year anniversary.
Over the past decade, CPCE has promoted antibiotic stewardship by providing achievable benchmarks and high-impact targets for improving antibiotic prescribing, then developing and implementing effective interventions. CPCE’s
Promoting Antibiotic Stewardship in Pediatric Outpatient Settings report summarizes seven years of research to improve the effectiveness and acceptability of outpatient antimicrobial stewardship.
The puzzling growing incidence of
pediatric kidney stones has become another area of emphasis for CPCE. With uncertainty of how to best evaluate children with suspected kidney stones and effectively decrease recurrence for patients whose first stone developed during childhood, CPCE seeks to address these knowledge gaps. Research includes studies on the role of temperature and antibiotics in kidney stone risk and mobile device hydration reminders for adolescents.
CPCE also strives to close the knowledge gap in pediatric HIV prevention and treatment research, as data for best practices center on adult cases. In particular, researchers are addressing challenges with
treatment adherence among adolescents with HIV, as well as increasing the information needed to make pediatric formulations of newer HIV medications available and to understand which medicines work best in this population.
Understanding the pros and cons of physiologic monitoring has drawn CPCE’s attention as well. When healthcare workers experience
alarm fatigue, they become overwhelmed, distracted by, or desensitized to the numbers of alarms that monitors activate, which can lead to delayed response times or missed alarms. A CHOP-led team used a video-based approach to gather data on staff response times and false alarm rates.
Read about additional CPCE research on our
website and find the full 2018 Research Institute Annual Report
here.
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Group B
Streptococcus (GBS) is a leading infectious cause of morbidity and mortality among infants in the US. From 2006 to 2015 there was a substantial decline in GBS early-onset disease (EOD) in infants; however, over 20% of infants with EOD did not receive intrapartum antibiotic prophylaxis (IAP) despite having indications for it. IAP guidelines call for "routine screening of pregnant women for vaginal/rectal colonization with GBS with intrapartum antibiotic prophylaxis (IAP) to reduce vertical GBS transmission and subsequent invasive disease in the infant," noted
Dr. Sagori Mukhopadhyay and
Dr. Karen Puopolo in an
editorial. Mukhopadhyay and Puopolo emphasized in their editorial that prevention of GBS disease remains incomplete, noting "missed opportunities and biologic limitations that contribute to residual GBS EOD" as one of two major issues that drive GBS IAP policies.
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Strong limits on marketing and sales are needed to control and prevent teens' use of electronic cigarettes, says a new policy statement from the
American Academy of Pediatrics. The surge in vaping among American teens threatens to turn back five decades of public health gains in reducing tobacco use. "Nicotine is highly addictive, and we know that the earlier that someone uses nicotine products in childhood, the more difficult it is to quit later," said
Dr. Brian Jenssen, lead author of the new policy statement. The statement urges pediatricians to screen youth for e-cigarette use and warn them about the health risks.
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Upcoming Events
Using Behavioral Economics and Digital Health to Address Teen Vaping and Smoking: Preliminary Findings and Lessons Learned
Date: Friday, February 8, 2019
Time: 12:00 pm - 1:00 pm
Location: CHOP Roberts Center for Pediatric Research, 1st Floor, Room 1-120A
Center for Pediatric Clinical Effectiveness, PolicyLab & the mHealth Research Affinity Group (RAG) will be hosting a seminar, "Using Behavioral Economics and Digital Health to Address Teen Vaping and Smoking: Preliminary Findings and Lessons Learned," presented by
Brian Jenssen, MD, MSHP. Additional information is available
here.
Please RSVP to
CPCE@email.chop.edu.
CPCE & PolicyLab Visiting Speaker Series: Dr. Gabriel Escobar
Date: February 22, 2019
Time: 12:00 pm - 1:00 pm
Location: CHOP Roberts Center for Pediatric Research, 1-120 A&B
Gabriel J. Escobar, MD, is a research scientist at the Kaiser Permanente Northern California Division of Research, director of the Division of Research Systems Research Initiative; and Regional Director for Hospital Operations Research for Kaiser Permanente Northern California. Dr. Escobar's research interests include risk adjustment, predictive modeling, severity-of-illness scoring, the use of comprehensive inpatient and outpatient electronic medical records for health services research, and the use of real-time decision support tools that are embedded in the electronic record.
Save the Date: Career Pathways in Global Health
Date: April 6, 2019
Time: 10:00 am - 1:00 pm
Location: Perry World House, 3803 Locust Walk, Philadelphia, PA
Global health is less about geography and more of a lens through which one approaches health care delivery and outcomes in the larger global context. The career paths in this field are as vast as the topic itself. Come learn about the career trajectories and work lives of featured speakers regarding local and global public health research and practice. More details available
online.
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Recent Publications
Health behaviors play an important role in cancer prevention. Research from CPCE’s
Dr. Lisa Schwartz and colleagues compared health behaviors (smoking, alcohol use, fruit and vegetable intake, and exercise frequency) and breast self-exam between girls with breast cancer family history (BCFH+) and without (BCFH-) and assessed associates of behaviors across all girls. They found that adolescent girls from BCFH+ families reported similar health behaviors to BCFH− peers, indicating that they are not translating their higher perceived risk into cancer control behaviors. Interventions with teens and parents that target modifiable variables such as controllability perceptions, maternal modeling, and communication may relate to better health behaviors and reduced future breast cancer risk.
In the wake of the rapid rise of e-cigarettes over the past decade, the tobacco industry has launched its latest response to the documented harms of cigarette smoking: heat-not-burn (HNB) tobacco products. Although information regarding health harms and benefits should come from sources independent of the tobacco industry, the vast majority of currently PubMed-indexed publications on “heat-not-burn” are published by Philip Morris or other tobacco industry companies. In this
Pediatrics Perspective, CPCE and PolicyLab faculty member
Dr. Brian Jenssen highlights the need for additional, unbiased information about the potential harms of heat-not-burn tobacco products.
Surgical site infection is the second most common healthcare-associated infection and data from the
Centers for Disease Control and Prevention (CDC) shows that it complicates approximately 5% of surgical operations each year. Currently, no specific guidelines on antimicrobial prophylaxis in pediatric surgery have been published. This study from
Dr. Theoklis Zaoutis and colleagues aims to determine the effectiveness of an Antimicrobial Stewardship Program based on a clinical pathway to improve appropriateness in perioperative antibiotic prophylaxis in a pediatric surgical center.
Advances in technology are continuously transforming medical care, including pediatric emergency medicine. Here,
Dr. Robert Grundmeier and colleagues review recent advances in technology that have had great impact on the practice of pediatric emergency medicine, including point-of-care ultrasound examination, innovative devices to facilitate procedures and examinations, and electronic health record tools, such as timely clinical decision-making support and patient tracking.
The Rochester criteria were developed to identify febrile infants aged 60 days or younger at low-risk of bacterial infection and do not include cerebrospinal fluid testing. Prior studies have not specifically assessed criteria performance for bacteremia and bacterial meningitis (invasive bacterial infection). The objective of this study from
Dr. Fran Balamuth and colleagues from the Febrile Young Infant Research Collaborative was to determine the sensitivity of the Rochester criteria for detection of invasive bacterial infection.
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About CPCE
We are a pediatric research center dedicated to discovering and sharing knowledge about best practices in pediatric care by facilitating, organizing and centralizing the performance of clinical effectiveness research -- research aimed at understanding the best ways to prevent, diagnose and treat diseases in children. CPCE’s multidisciplinary team conducts research on a diverse range of clinical effectiveness topics.
CPCE E-News is edited by
Holly Burnside. Please feel free to contact us with questions or feedback.
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