Evaluation of Medication Dose Alerts in Pediatric Inpatients

A categorization of alerts generated from inpatient orders at a medium-sized pediatric hospital in 2010 using a vendor-provided computerized provider order entry software with a custom-developed set of 13,530 alerts, 89% of which were maximum-dose alerts. Over the year of data collection there were 182,308 orders for 1092 medications. 6.1% of orders produced an alert. 73.4% of those were dose-range alerts, which users complied with only 8.5% of the time. Overall, providers disregarded 92.4% of alerts of all types.

Scharnweber 2013 (Link) (Int J Med Inform) | PubMed 23643148 | Author Search

Computer-Aided Recognition of Facial Attributes for Fetal Alcohol Spectrum Disorders

Comparison of computer-based facial recognition software of facial images against standard, manual examination in fetal alcohol spectrum disorders. Areas-under-the-curve values for individual receiver-operating characteristic curves revealed the computer-aided system to be comparable to the manual method in detecting patients with FASD. Cases of alcohol-related neurodevelopmental disorder were identified more efficiently by the computer-aided system in comparison to the manual method.

Valentine 2017 (Pediatrics) | PubMed 29187580 | Author Search

Autism Screening With Online Decision Support by Primary Care Pediatricians Aided by M-CHAT/F

An evaluation of the Modified Checklist for Autism in Toddlers (M-CHAT) With Follow-up Interview (M-CHAT/F) as administered by primary-care pediatricians during typical checkups. Comparing the PCP performance to that of trained research assistants, sensitivity, specificity, positive predictive value (PPV), and overall accuracy for M-CHAT/F showed significant equivalence.

Sturner 2016 (Pediatrics) | PubMed 27542847 | Author Search

Pediatric Weight Errors and Resultant Medication Dosing Errors in the Emergency Department

A retrospective study of 79,000 ED encounters at a children’s hospital and two general hospitals. The intent of the study was to characterize the frequency of weight errors and to determine of the children’s hospital was any better at correcting errors than the general hospitals. The findings were that weight errors were uncommon (0.63% of all weights, as defined by the weight being a new extreme value on the growth chart) in the 3 EDs, but they led to identifiable weight-based medication-dosing errors with the potential to cause harm. The rates of error where similar across hospitals, and it looked like the children’s hospital was slightly better at intercepting errors once they were committed. Common weight errors included the weight in pounds being substituted for the weight in kilograms and decimal placement errors.

Hirata 2017 (Link) | PubMed 28976456 | Author Search

Trends in Anthropometric Measures Among US Children 6 to 23 Months, 1976–2014

Aimed to describe trends in length-for-age, weight-for-age, weight-for-length, and early childhood weight gain among US children aged 6 to 23 months from NHANES data ranging from 1976 to 2014. Between 1976–1980 and 2011–2014, there were no significant trends in low or high weight-for-age and weight-for-length, whereas the percent with high length-for-age decreased (5.5% to 3.7%). Non-Hispanic black children gained more weight between birth and survey participation in 2011–2014 versus 1988–1994.

Akinbami 2017 (Pediatrics) | PubMed 28213608 | Author Search

Prescription Errors before and after Introduction of Electronic Medication Alert System in a Pediatric Emergency Department

The objective of this was to compare prescription error rates before and after introduction of computerized provider order entry on a pediatric emergency department. Error assessment was limited to errors with potential to cause life-threatening injury, failure of therapy, or an adverse drug effect. 29.6% of prescriptions generated an alert, with an almost 90% false-positive rate. 7,268 medication orders before and 7,292 after were compared, showing a significant reduction in the errors per 100 prescriptions (10.4 before vs. 7.3 after; absolute risk reduction = 3.1, 95% confidence interval [CI] = 2.2 to 4.0)

Sethuraman 2015 (Link) | PubMed 25998704 | Author Search

Diagnostic Errors in Primary Care Pediatrics: Project RedDE

This study examined the prevalence of three diagnostic errors or missed opportunities to diagnose in pediatric primary care practices (adolescent depression, elevated blood pressure, and sexually-transmitted infection lab results). They found that these errors were common. Providers did not follow up abnormal STI laboratory values for 11% of patients and did not address adolescent depression in 62% of visits. Providers did not document recognition of an elevated BP in 51% of patients with elevated BP

Rinke 2017 (Acad Pediatrics) | PubMed 28804050 | Author Search