Improving adherence to otitis media guidelines with clinical decision support and physician feedback.

Abstract:

OBJECTIVE:To assess the effects of electronic health record-based clinical decision support (CDS) and physician performance feedback on adherence to guidelines for acute otitis media (AOM) and otitis media with effusion (OME). METHODS:We conducted a factorial-design cluster randomized trial with primary care practices (n = 24) as the unit of randomization and visits as the unit of analysis. Between December 2007 and September 2010, data were collected from 139,305 otitis media visits made by 55,779 children aged 2 months to 12 years. When activated, the CDS system provided guideline-based recommendations individualized to the patient's history and presentation. Monthly physician feedback reported adherence to guideline-based care, changes over time, and comparisons to others in the practice and network. RESULTS:Comprehensive care (all recommended guidelines were adhered to) was accomplished for 15% of AOM and 5% of OME visits during the baseline period. The increase from baseline to intervention periods in adherence to guidelines was larger for CDS compared with non-CDS visits for comprehensive care, pain treatment, adequate diagnostic evaluation for OME, and amoxicillin as first-line therapy for AOM. Although performance feedback was associated with improved antibiotic prescribing for AOM and pain treatment, the joint effects of CDS and feedback on guideline adherence were not additive. There was marked variation in use of the CDS system, ranging from 5% to 45% visits across practices. CONCLUSIONS:Clinical decision support and performance feedback are both effective strategies for improving adherence to otitis media guidelines. However, combining the 2 interventions is no better than either delivered alone.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Forrest CB,Fiks AG,Bailey LC,Localio R,Grundmeier RW,Richards T,Karavite DJ,Elden L,Alessandrini EA

doi

10.1542/peds.2012-1988

subject

Has Abstract

pub_date

2013-04-01 00:00:00

pages

e1071-81

issue

4

eissn

0031-4005

issn

1098-4275

pii

peds.2012-1988

journal_volume

131

pub_type

杂志文章,随机对照试验
  • Clinical-echocardiographic correlations in acute rheumatic fever.

    abstract::Thirty-three children with acute rheumatic fever were studied using echocardiography to characterize heart involvement in this disease. Among 26 subjects with a first episode of acute rheumatic fever, 18 had a clinical diagnosis of carditis and six had heart failure. Heart failure usually resulted from valvular incomp...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Vardi P,Markiewicz W,Weiss Y,Levi J,Benderly A

    更新日期:1983-05-01 00:00:00

  • The national immunization program of The Netherlands.

    abstract::After a brief explanation of the immunization policy in the Netherlands, the national immunization program is described, with special attention given to coupling of the municipal population records with a computerized database of individual immunization records at the provincial level. The Dutch program achieves cover...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Verbrugge HP

    更新日期:1990-12-01 00:00:00

  • Regulation of growth of 7- to 36-month-old children by energy and fat intake in the prospective, randomized STRIP baby trial.

    abstract:OBJECTIVE:To study the fat and energy intakes of children between 7 and 36 months of age with different growth patterns. METHODS:In the Special Turku coronary Risk factor Intervention Project for Babies, children were randomized to intervention (n = 540) and control groups (n = 522) at age 7 months. The intervention w...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1542/peds.100.5.810

    authors: Niinikoski H,Viikari J,Rönnemaa T,Helenius H,Jokinen E,Lapinleimu H,Routi T,Lagström H,Seppänen R,Välimäki I,Simell O

    更新日期:1997-11-01 00:00:00

  • Impact of visual impairment on measures of cognitive function for children with congenital toxoplasmosis: implications for compensatory intervention strategies.

    abstract:OBJECTIVES:The purpose of this work was to determine whether visual impairment caused by toxoplasmic chorioretinitis is associated with impaired performance of specific tasks on standardized tests of cognitive function. If so, then we worked to determine whether there are patterns in these difficulties that provide a l...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2005-1530

    authors: Roizen N,Kasza K,Karrison T,Mets M,Noble AG,Boyer K,Swisher C,Meier P,Remington J,Jalbrzikowski J,McLeod R,Kipp M,Rabiah P,Chamot D,Estes R,Cezar S,Mack D,Pfiffner L,Stein M,Danis B,Patel D,Hopkins J,Holfels E

    更新日期:2006-08-01 00:00:00

  • Biopterin synthesis defects: problems in diagnosis.

    abstract::Hyperphenylalaninemia due to a biopterin synthesis defect was detected in an infant with decreased biopterin and increased neopterin levels in plasma and urine. Tetrahydrobiopterin (BH4) administration normalized plasma phenylalanine levels. CSF biopterin and neurotransmitter metabolite levels were normal and with the...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Hoganson G,Berlow S,Kaufman S,Milstien S,Schuett V,Matalon R,Naylor E,Seifert W

    更新日期:1984-12-01 00:00:00

  • Early Intervention, Parent Talk, and Pragmatic Language in Children With Hearing Loss.

    abstract:BACKGROUND AND OBJECTIVES:Pragmatic language skills form the foundation for conversational competence, whereas deficits in this area are associated with behavioral problems and low literacy skills. Children who are deaf or hard of hearing demonstrate significant delays in this critical area of language. Our purpose wit...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2020-0242F

    authors: Yoshinaga-Itano C,Sedey AL,Mason CA,Wiggin M,Chung W

    更新日期:2020-11-01 00:00:00

  • Validity of mass blood pressure screening in children.

    abstract::The validity of a mass blood pressure screening program carried out on Dallas high school students who were followed for at least 3 years is reported. Blood pressure results on initial screening in the tenth grade were related to outcome blood pressure status. The frequency of initial blood pressure elevation (systoli...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Fixler DE,Laird WP

    更新日期:1983-10-01 00:00:00

  • Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice.

    abstract::Perinatal depression (PND) is the most common obstetric complication in the United States. Even when screening results are positive, mothers often do not receive further evaluation, and even when PND is diagnosed, mothers do not receive evidence-based treatments. Studies reveal that postpartum depression (PPD), a subs...

    journal_title:Pediatrics

    pub_type: 杂志文章,评审

    doi:10.1542/peds.2018-3259

    authors: Earls MF,Yogman MW,Mattson G,Rafferty J,COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY HEALTH.

    更新日期:2019-01-01 00:00:00

  • Parenting and early development among children of drug-abusing women: effects of home intervention.

    abstract:OBJECTIVE:To evaluate the efficacy of home intervention with drug-abusing women on parenting behavior and attitudes, and on children's development. DESIGN:A randomized, clinical trial of 60 drug-abusing women recruited prenatally and randomized into an intervention (n = 31) or comparison (n = 29) group. There were no ...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Black MM,Nair P,Kight C,Wachtel R,Roby P,Schuler M

    更新日期:1994-10-01 00:00:00

  • Adiposity and different types of screen time.

    abstract:OBJECTIVE:Few prospective studies have examined separate forms of screen time in relation to adiposity. Our objective was to assess independent relations of television, electronic games (video/computer), and digital versatile disc (DVD)/videos and total screen time with change in adolescent BMI. METHODS:Using data fro...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2013-0887

    authors: Falbe J,Rosner B,Willett WC,Sonneville KR,Hu FB,Field AE

    更新日期:2013-12-01 00:00:00

  • A controlled trial of high-intensity double-surface phototherapy on a fluid bed versus conventional phototherapy in neonatal jaundice.

    abstract:OBJECTIVE:To evaluate a simple, relatively inexpensive method using the fluid bed to provide high-intensity double-surface (HIDS) phototherapy and to confirm that the method described is more effective than conventional phototherapy (CPT) in the treatment of neonatal hyperbilirubinemia. DESIGN:Prospective controlled s...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章

    doi:

    authors: Garg AK,Prasad RS,Hifzi IA

    更新日期:1995-06-01 00:00:00

  • Genome-wide expression profiles in very low birth weight infants with neonatal sepsis.

    abstract:BACKGROUND:Bacterial sepsis is associated with high morbidity and mortality in preterm infants. However, diagnosis of sepsis and identification of the causative agent remains challenging. Our aim was to determine genome-wide expression profiles of very low birth weight (VLBW) infants with and without bacterial sepsis a...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2013-2552

    authors: Cernada M,Serna E,Bauerl C,Collado MC,Pérez-Martínez G,Vento M

    更新日期:2014-05-01 00:00:00

  • Clinical and virologic features of hepatitis C virus infection associated with intravenous immunoglobulin.

    abstract:OBJECTIVE:To characterize the clinical features of hepatitis C virus (HCV) infection associated with the administration of intravenous immunoglobulin (IVIG) in patients with varied immunodeficiencies. DESIGN:Prospective collection of clinical and virologic data in patients determined to have HCV exposure associated wi...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Jonas MM,Baron MJ,Bresee JS,Schneider LC

    更新日期:1996-08-01 00:00:00

  • From the American Academy of Pediatrics: Technical report--Secondhand and prenatal tobacco smoke exposure.

    abstract::Secondhand tobacco smoke (SHS) exposure of children and their families causes significant morbidity and mortality. In their personal and professional roles, pediatricians have many opportunities to advocate for elimination of SHS exposure of children, to counsel tobacco users to quit, and to counsel children never to ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2009-2120

    authors: Best D,Committee on Environmental Health.,Committee on Native American Child Health.,Committee on Adolescence.

    更新日期:2009-11-01 00:00:00

  • Thyroid screening for early discharged infants.

    abstract:OBJECTIVE:As neonatal discharge before 24 hours of life becomes commonplace, the rejection of congenital hypothyroidism (CH) screening specimens obtained too early has created the need for numerous additional tests. We sought to determine whether the specimens obtained before 24 hours could be used safely. METHODS:Dur...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Saslow JG,Post EM,Southard CA

    更新日期:1996-07-01 00:00:00

  • Metoclopramide effect on faltering milk production by mothers of premature infants.

    abstract::Metoclopramide treatment has been shown to augment milk production by stimulating prolactin secretion in women in whom lactational insufficiency develops after a full-term pregnancy. The effect of metoclopramide therapy in 23 women who were delivered of premature infants (birth weight 1,314 +/- 115 g, gestational age ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Ehrenkranz RA,Ackerman BA

    更新日期:1986-10-01 00:00:00

  • Growth hormone increases breast milk volumes in mothers of preterm infants.

    abstract:AIMS:To determine the galactopoietic response to recombinant human growth hormone (hGH) in mothers of premature infants with inadequate lactation. STUDY DESIGN:Prospective placebo-controlled, double-blind trial. SUBJECTS:Twenty healthy mothers on no concurrent medication, with infants born between 26 and 34 weeks' ge...

    journal_title:Pediatrics

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Gunn AJ,Gunn TR,Rabone DL,Breier BH,Blum WF,Gluckman PD

    更新日期:1996-08-01 00:00:00

  • Cross-Cultural Differences in Communication About a Dying Child.

    abstract::There are more migrants, refugees, and immigrants adrift in the world today than at any time in the recent past. Doctors and hospitals must care for people from many different cultures, countries, and religious backgrounds. We sometimes find our own deeply held beliefs and values challenged. In this "Ethics Rounds," w...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2017-0690

    authors: Cochran D,Saleem S,Khowaja-Punjwani S,Lantos JD

    更新日期:2017-11-01 00:00:00

  • Correlates of objectively measured sedentary behavior in US preschool children.

    abstract:OBJECTIVE:To identify correlates of objectively measured sedentary behavior in a diverse sample of preschool children. METHODS:A total of 331 children (51% male, 51% black) from a wide range of ethnic and socioeconomic backgrounds in greater Columbia, South Carolina, were recruited for this study. Sedentary behavior (...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2011-0748

    authors: Byun W,Dowda M,Pate RR

    更新日期:2011-11-01 00:00:00

  • Prenatal cocaine exposure and child behavior.

    abstract:OBJECTIVE:The aim of this study was to evaluate previous teacher reports that children exposed to cocaine prenatally have more problem behaviors. METHODS:A historical, prospective design was used. Maternal subjects (n = 116) of 6-year-old singleton, term (>/=36 weeks) children, and the children's first-grade teachers ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.102.4.945

    authors: Delaney-Black V,Covington C,Templin T,Ager J,Martier S,Sokol R

    更新日期:1998-10-01 00:00:00

  • A treatable metabolic cause of encephalopathy: cobalamin C deficiency in an 8-year-old male.

    abstract::Neurologic regression in a previously healthy child may be caused by metabolic or neurodegenerative disorders, many of which have no definitive treatment. We report a case of a previously healthy 8-year-old boy who presented with a month-long history of waxing and waning encephalopathy and acute regression, followed b...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2013-1427

    authors: Krueger JM,Piantino J,Smith CM,Angle B,Venkatesan C,Wainwright MS

    更新日期:2015-01-01 00:00:00

  • Respiratory failure and hypercoagulability in a toddler with Lemierre's syndrome.

    abstract::A 3.5-year-old healthy boy with 4 days of fever was referred to the emergency department for respiratory distress. The physical examination was remarkable for stupor, tachycardia, tachypnea, and dyspnea. Initial blood tests showed pancytopenia. He rapidly developed torticollis. Computerized tomography of the neck reve...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2004-2505

    authors: Schmid T,Miskin H,Schlesinger Y,Argaman Z,Kleid D

    更新日期:2005-05-01 00:00:00

  • Clinical report--guidelines for the ethical conduct of studies to evaluate drugs in pediatric populations.

    abstract::The proper ethical conduct of studies to evaluate drugs in children is of paramount importance to all those involved in these types of studies. This report is an updated revision to the previously published guidelines from the American Academy of Pediatrics in 1995. Since the previous publication, there have been grea...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2010-0082

    authors: Shaddy RE,Denne SC,Committee on Drugs and Committee on Pediatric Research.

    更新日期:2010-04-01 00:00:00

  • Evolution in the recognition of infantile hypertrophic pyloric stenosis.

    abstract:PURPOSE:To analyze changes in the clinical condition at presentation and methods of establishing the diagnosis of infantile hypertrophic pyloric stenosis (IHPS). METHODS:Retrospective review of patients who underwent pyloromyotomy (PM) for suspected IHPS at two institutions from 1969 through 1994 was performed. For th...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.100.2.e9

    authors: Hulka F,Campbell TJ,Campbell JR,Harrison MW

    更新日期:1997-08-01 00:00:00

  • Fibromyalgia syndrome in children and adolescents: clinical features at presentation and status at follow-up.

    abstract:OBJECTIVES:To 1) describe the characteristic features of fibromyalgia syndrome (FS) in a pediatric population, 2) note similarities and differences with FS in adults, and 3) determine outcome after treatment. SETTING AND DESIGN:The Pediatric Rheumatology Clinic at the University of Rochester Medical Center is staffed ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.101.3.377

    authors: Siegel DM,Janeway D,Baum J

    更新日期:1998-03-01 00:00:00

  • Primary care physician supply and children's health care use, access, and outcomes: findings from Canada.

    abstract:OBJECTIVES:To describe the relationship of primary care physician (PCP) supply for children and measures of health care access, use, and outcomes. METHODS:We conducted a population-based, cross-sectional study of all Ontario children from 2003 to 2005. We used health administrative data to calculate county-level suppl...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2009-2821

    authors: Guttmann A,Shipman SA,Lam K,Goodman DC,Stukel TA

    更新日期:2010-06-01 00:00:00

  • Is my child normal yet? Correlates of vulnerability.

    abstract::There are some children whose parents believe them to be unusually susceptible to medical or developmental problems--"vulnerable"--despite a lack of objective evidence of any difficulty. The "vulnerable child syndrome" refers to a constellation of behaviors that are thought to develop as a result of this excessive par...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:

    authors: Perrin EC,West PD,Culley BS

    更新日期:1989-03-01 00:00:00

  • Corneal abrasions in young infants.

    abstract:OBJECTIVES:We sought to determine the prevalence of corneal abrasions and possible associations with fingernail length, demographic information, sleeping, and crying among young infants. METHODS:Parents of 1- to 12-week-old infants without symptoms who were presenting for well-child visits completed a brief questionna...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2008-2023

    authors: Shope TR,Rieg TS,Kathiria NN

    更新日期:2010-03-01 00:00:00

  • A randomized comparison of nitrous oxide plus hematoma block versus ketamine plus midazolam for emergency department forearm fracture reduction in children.

    abstract:OBJECTIVES:Ketamine provides effective and relatively safe sedation analgesia for reduction of fractures in children in the emergency department. However, prolonged recovery and adverse effects suggest the opportunity to develop alternative strategies. We compared the efficacy and adverse effects of ketamine/midazolam ...

    journal_title:Pediatrics

    pub_type: 杂志文章,随机对照试验

    doi:10.1542/peds.2005-1694

    authors: Luhmann JD,Schootman M,Luhmann SJ,Kennedy RM

    更新日期:2006-10-01 00:00:00

  • Considering complementary and alternative medicine alternatives in cases of life-threatening illness: applying the best-interests test.

    abstract::In this article we explore decision-making about treatment when a child faces a life-threatening illness but conventional treatment presents substantial risk and uncertain benefit. When is it acceptable for parents to decide to use complementary and alternative medicine as an alternative, rather than a complement, to ...

    journal_title:Pediatrics

    pub_type: 杂志文章

    doi:10.1542/peds.2010-2720F

    authors: Gilmour J,Harrison C,Asadi L,Cohen MH,Aung S,Vohra S

    更新日期:2011-11-01 00:00:00