A Clinical Prediction Rule for Rebound Hyperbilirubinemia Following Inpatient Phototherapy

A report of a prediction rule for rebound hyperbilirubinemia (return of total serum bilirubin to phototherapy threshold within 72 hours of phototherapy termination) in newborns of at least 35 weeks’ gestation. Authors studied a group of ~7000 infants, 4.6% of whom had rebound hyperbilirubinemia. The formula is calculated as: 15 points if gestational age less than 38 weeks, minus 7 × (age in days at phototherapy initiation) minus 4 × (AAP phototherapy threshold − TSB at phototherapy termination) + 50. This score in turn can be applied to a curve (pictured) to predict rebound hyperbilirubinemia.

Chang 2016 (Pediatrics) | PubMed | Author Search

Measuring Prevention More Broadly: An Empirical Assessment of CHIPRA Core Measures

Using claims data from the Alabama Children’s Health Insurance Program, calculated each of four quality measures under two alternative definitions: (1) the formal claims-based guidelines outlined in the CMS Technical Specifications, and (2) a broader definition of appropriate claims for identifying preventive service use. Concludes: Differences in CHIP design and structure, across states and over time, may limit the usefulness of select claims-based core measures for detecting disparities accurately (Medicare and Medicaid Research Review).

Menachemi 2013 (Link) | PubMed 24800161 | Author Search

Pediatric Complex Chronic Conditions Classification System Version 2: Updated for ICD-10 and Complex Medical Technology Dependence and Transplantation

An ICD-10 update of the pediatric complex chronic conditions (CCC) classification system from 2000. The system includes diagnostic and procedural codes that incorporate a new neonatal CCC category as well as domains of complexity arising from technology dependence or organ transplantation. Linked electronic supplementary material provides SAS and Stata code, plus tabular information on codes.

Feudtner 2014 (BMC Pediatrics) | PubMed 25102958 | Author Search

Impact of Electronic Health Record-Based Alerts on Influenza Vaccination for Children With Asthma

A prospective, cluster-randomized trial of the use of a flu-shot reminder alert in pediatric primary care, showing only modest effects. Vaccination opportunities in children with asthma increased from 14.4% to 18.6% at intervention sites and from 12.7% to 16.3% at control sites, a 0.6% greater improvement. The authors conclude that if one is using an immunization reminder system, “the addition of an influenza reminder system may be helpful, especially in the setting of urban resident-teaching practices.”

Fiks 2009 (Pediatrics) | PubMed 19564296 | Author Search

Reliability of Telemedicine in the Assessment of Seriously Ill Children

An evaluation of the telemedicine (vs. in-person) application of the Yale Observation Scale and the Respiratory Observation Checklist in febrile children age 2 to 36 months. ,as implemented via a telemedicine system. Strong agreement was found between bedside and telemedicine observers. Excellent agreement between bedside and telemedicine observers was found for the impression of respiratory distress.

Siew 2016 (Pediatrics) | PubMed 26908666 | Author Search

New Technologies as a Strategy to Decrease Medication Errors: How Do they Affect Adults and Children Differently?

A review of techniques used to reduce medication errors in pediatrics. Within the limitations of the heterogeneous system that makes up information technology for child health, the authors conclude that CPOE and accompanying decision support can help but also creates new types of error (World Journal of Pediatrics).

Ruano 2015 (Link) | PubMed 26684316 | Author Search

Anthropometric Charts for Infants Born Between 22 and 29 Weeks’ Gestation

Based on data from the Vermont Oxford Network from 183,243 racially diverse, singleton infants born in the US without congenital malformations. Tends to represent smaller infants compared to older charts; this is likely due to the increased survival of small infants over time. Provides norms for Asian, Black, and White infants.

Boghossian 2016 (Pediatrics) | PubMed 27940694 | Author Search