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Pediatric informatics

Nicholas L Rider, Di Miao, Margaret Dodds, Vicki Modell, Fred Modell, Jessica Quinn, Heidi Schwarzwald, Jordan S Orange
Background: Early diagnosis of primary immunodeficiency disease leads to reductions in illness and decreased healthcare costs. Analysis of electronic health record data may allow for identification of persons at risk of host-defense impairments from within the general population. Our hypothesis was that coded infection history would inform individual risk of disease and ultimately lead to diagnosis. Methods: In this study we assessed individual risk for primary immunodeficiency by analyzing diagnostic codes and pharmacy records from members ( n = 185,892) of a large pediatric health network...
2019: Frontiers in Pediatrics
Tengda Zhao, Xuhong Liao, Vladimir S Fonov, Qiushi Wang, Weiwei Men, Yanpei Wang, Shaozheng Qin, Shuping Tan, Jia-Hong Gao, Alan Evans, Sha Tao, Qi Dong, Yong He
In magnetic resonance (MR) imaging studies of child brain development, structural brain atlases usually serve as important references for the pediatric population, in which individual images are spatially normalized into a common or standard stereotactic space. However, the popular existing pediatric brain atlases (e.g., National Institutes of Health pediatric atlases, NIH-PD) are mostly based on MR images obtained from Caucasian populations and thus are not ideal for the characterization of the brains of Chinese children due to neuroanatomical differences related to genetic and environmental factors...
January 6, 2019: NeuroImage
M A Marques-Mejías, M Tomás-Pérez, I Hernández, I López, S Quirce
BACKGROUND: Children with asthma suffer from recurrent respiratory symptoms and exacerbations due to multiple environmental factors. The aim of this study is to describe the prevalence and triggers of asthma exacerbations and their management in cohort of pediatric patients attended in an emergency department (ED). METHODS: This was an observational, retrospective, single center study, conducted in the pediatric ED of the Hospital Universitario La Paz (Madrid, Spain) in 2015...
December 18, 2018: Journal of Investigational Allergology & Clinical Immunology
Matthew T Harting, Austin Wheeler, Todd Ponsky, Benedict Nwomeh, Chuck L Snyder, Nicholas E Bruns, Aaron Lesher, Samir Pandya, Belinda Dickie, Sohail R Shah
IMPORTANCE: Telemedicine is an emerging strategy for healthcare delivery that has the potential to expand access, optimize efficiency, minimize cost, and enhance patient satisfaction. OBJECTIVE: To review the current spectrum, potential strategies, and implementation process of telemedicine in pediatric surgery. DESIGN: Review and opinion design. SETTING: n/a. PARTICIPANTS: n/a. MAIN OUTCOMES AND MEASURES: n/a...
March 2019: Journal of Pediatric Surgery
Patrick G Lyons, Dana P Edelson, Matthew M Churpek
INTRODUCTION: Rapid response systems are commonly employed by hospitals to identify and respond to deteriorating patients outside of the intensive care unit. Controversy exists about the benefits of rapid response systems. AIMS: We aimed to review the current state of the rapid response literature, including evolving aspects of afferent (risk detection) and efferent (intervention) arms, outcome measurement, process improvement, and implementation. DATA SOURCES: Articles written in English and published in PubMed...
July 2018: Resuscitation
Hoi Ki Kiki Ho, Matthias Görges, Elodie Portales-Casamar
BACKGROUND: Health and health-related data collected as part of clinical care is a foundational component of quality improvement and research. While the importance of these data is widely recognized, there are many challenges faced by researchers attempting to use such data. It is crucial to acknowledge and identify barriers to improve data sharing and access practices and ultimately optimize research capacity. OBJECTIVE: To better understand the current state, explore opportunities, and identify barriers, an environmental scan of investigators at BC Children's Hospital Research Institute (BCCHR) was conducted to elucidate current local practices around data access and usage...
May 14, 2018: JMIR Medical Informatics
Lisa Lestishock, Alison Moriarty Daley, Patience White
INTRODUCTION: This study examined the perspectives of pediatric nurse practitioners (PNPs) regarding the needs of adolescents, parents/caregivers, clinicians, and institutions in the health care transition (HCT) process for adolescents/young adults. METHODS: PNPs (N = 170) participated in a luncheon for those interested in transition at an annual conference. Small groups discussed and recorded their perspectives related to health care transition from adolescent to adult services...
May 2018: Journal of Pediatric Health Care
Vibha Anand, Andrew S Zeft, Steven J Spalding
We previously described an informatics tool (PROBE) to automate screening for behavioral risks for pain in children and adolescents. PROBE was deployed for a one year pilot study in our pediatric specialty care practice. Here we describe evaluation of this tool to assess self-report of pain, chronic disease activity and behavioral risks in 109 patients who sought routine care in the busy outpatient pediatric rheumatology practice of our large healthcare system. Results show that patients who self-report poorer self-efficacy and coping skills and night-time awakenings have significantly higher odds (8 and 5 times higher respectively) of reporting chronic pain even after accounting for their chronic disease activity...
2017: Studies in Health Technology and Informatics
Taito Kitano, Hiroki Nishikawa, Masayuki Onaka, Mariko Ishihara, Atsuko Nishiyama, Sayaka Yoshida
BACKGROUND: Although the mumps vaccine has not been included in the national immunization program (NIP) in Japan, it has been shown that a two-dose routine vaccine program would be highly cost-effective. In this study, we carried outa questionnaire-based study to investigate how many Japanese parents want the mumps vaccine to be included in the NIP with proper information. METHODS: The questionnaire was given to parents who visited the Pediatrics or neonatal intensive care unit of Nara Prefecture General Medical Center, Nara City, Japan, between 1 March 2017 and 31 August 2017...
April 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Vojtech Huser, Michael G Kahn, Jeffrey S Brown, Ramkiran Gouripeddi
This paper summarizes content of the workshop focused on data quality. The first speaker (VH) described data quality infrastructure and data quality evaluation methods currently in place within the Observational Data Science and Informatics (OHDSI) consortium. The speaker described in detail a data quality tool called Achilles Heel and latest development for extending this tool. Interim results of an ongoing Data Quality study within the OHDSI consortium were also presented. The second speaker (MK) described lessons learned and new data quality checks developed by the PEDsNet pediatric research network...
2018: Pacific Symposium on Biocomputing
F Cipriani, C Mastrorilli, S Tripodi, G Ricci, S Perna, V Panetta, R Asero, A Dondi, A Bianchi, N Maiello, M Miraglia Del Giudice, T Frediani, F Macrì, S Lucarelli, I Dello Iacono, M F Patria, E Varin, D Peroni, L Chini, V Moschese, R Bernardini, G Pingitore, U Pelosi, M Tosca, F Paravati, I Sfika, A Di Rienzo Businco, C Povesi Dascola, P Comberiati, S Frediani, C Lambiase, M C Verga, D Faggian, M Plebani, M Calvani, C Caffarelli, P M Matricardi
BACKGROUND: Grass pollen-related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities, and response to treatment. The component-resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood. METHODS: We examined 1120 children (age 4-18 years) with SARg...
March 2018: Allergy
Jessica Knight-Perry, Brian R Branchford, Dianne Thornhill, Stacey L Martiniano, Scott D Sagel, Michael Wang
INTRODUCTION: Pediatric venous thromboembolism (VTE) is a rare but serious medical condition. Cystic fibrosis (CF) is a risk for recurrent pediatric VTE and has potential thrombophilic tendency. However, much remains unknown, including incidence and intrapopulation risk factors. METHODS: A retrospective cohort of pediatric CF patients followed at Children's Hospital Colorado from January 1st 2003 through May 20th 2016 was examined. Cases were identified by informatics and validated manually...
October 2017: Thrombosis Research
Wendy J Haylett
An antileukemic agent prescribed for pediatric oncology patients during the maintenance phase of therapy for acute lymphoblastic leukemia, 6-mercaptopurine (6-MP), is highly influenced by genetic variations in the thiopurine S-methyltransferase enzyme. As such, 6-MP must be dosed so that patients with 1 or 2 inactive thiopurine S-methyltransferase alleles will not incur an increased risk for myelosuppression or other toxicities. Informatics tools such as clinical decision support systems are useful for the application of this and similar pharmacogenetics information to the realm of nursing and clinical practice for safe and effective patient care...
September 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
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...
September 2017: Journal of Pediatrics
Alexander J Towbin, Laurie A Perry, David B Larson
The modern radiology department is built around the flow of information. Ordering providers request imaging studies to be performed, technologists complete the work required to perform the imaging studies, and radiologists interpret and report on the imaging findings. As each of these steps is performed, data flow between multiple information systems, most notably the radiology information system (RIS), the picture archiving and communication system (PACS) and the voice dictation system. Even though data flow relatively seamlessly, the majority of our systems and processes are inefficient...
June 2017: Pediatric Radiology
Kathleen M Schieffer, James R Connor, James A Pawelczyk, Deepa L Sekhar
Purpose: A correlation between iron deficiency anemia (IDA) and sudden sensorineural hearing loss (SNHL) was described in adults. In this study, we examined if there is a relationship between IDA and hearing loss in the pediatric population. Method: This was a retrospective cohort study of data collected from the Informatics for Integrating Biology and the Bedside database from 2011 to 2016. Children and adolescents 4-21 years old seen at Penn State Milton S. Hershey Medical Center, Hershey, PA, were examined for hearing loss and IDA status...
June 13, 2017: American Journal of Audiology
A S Marinho, C Sousa, A Coelho, J Barbosa-Sequeira, M Recamán, F Carvalho
INTRODUCTION: Sialorrhea is a medical problem and can become a social issue, common in children with neurological disabilities. The bilateral submandibulectomy is one of the available treatment options for managing this pathology. AIM OF THE STUDY: The aim of this study is to evaluate the effectiveness of bilateral submandibulectomy in the management of sialorrhea in children with neurological disabilities through the parents' satisfaction grade. PATIENTS AND METHODS: We retrospectively analyzed 91 bilateral submandibulectomies for a period of time of 10 years (2004-2015)...
July 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Ari H Pollack, Andrew Miller, Sonali R Mishra, Wanda Pratt
Participatory design, a method by which system users and stakeholders meaningfully contribute to the development of a new process or technology, has great potential to revolutionize healthcare technology, yet has seen limited adoption. We conducted a design session with eleven physicians working to create a novel clinical information tool utilizing participatory design methods. During the two-hour session, the physicians quickly engaged in the process and generated a large quantity of information, informing the design of a future tool...
2016: AMIA ... Annual Symposium Proceedings
Andrew D Miller, Ari H Pollack, Wanda Pratt
Although hospital care is carefully documented and that information is electronically available to clinicians, few information systems exist for patients and their families to use while they are in the hospital. Information often appears trapped within the hospital room. In this paper, we present findings from three participatory design sessions that we conducted with former patients, their parents, and clinicians from a large children's hospital. Participants discussed challenges they faced getting information while in the hospital, and then designed possible technological solutions...
2016: AMIA ... Annual Symposium Proceedings
Matthew K Hong, Lauren Wilcox, Clayton Feustel, Karen Wasileski-Masker, Thomas A Olson, Stephen F Simoneaux
Supporting adolescent patient engagement in care is an important yet underexplored topic in consumer health informatics. Personal Health Records (PHRs) show potential, but designing PHR systems to accommodate both emerging adults and their parents is challenging. We conducted a mixed-methods study with teenage adolescent patients (ages 13-17) with cancer and blood disorders, and their parents, to investigate their experiences with My-Chart, a tethered PHR system. Through analyses of usage logs and independently-conducted surveys and interviews, we found that patients and parents both valued MyChart, but had different views about the role of the PHR for care communication and management, and different attitudes about its impact on the patient's ability to manage care...
2016: AMIA ... Annual Symposium Proceedings
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