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

Growth Charts for Children With Down Syndrome in the United States

down_graphResults of the Down Syndrome Growing Up Study, which compiled 1520 measurements on 637 participants from 25 states (but mostly Pennsylvania) to create weight, height, head circumference, and body-mass index charts for children with Down syndrome through age 20 years. Comparisons to the old 1988 DS growth charts are illustrated. A supplement provides graphs and tables.

Zemel 2015 (Pediatrics) | PubMed 26504127 | Author Search

Ways to Identify Children with Medical Complexity and the Importance of Why

Comparison of 4 examples of diagnosis classification systems that have been used to identify the health problems in children with medical complexity: (1) Complex chronic conditions (CCCs), an open-source set of childhood conditions that are strongly associated with mortality, morbidity, functional limitations, high health resource utilization, and use of a complex care clinical program; (2) Clinical risk groups (CRGs), a proprietary system of hierarchical pediatric diagnosis groups ranging from healthy children without a chronic condition to unhealthy children with a catastrophic chronic condition that is associated with high morbidity and mortality; (3) Chronic condition indicators (CCIs), developed by the Agency for Healthcare Research and Quality, an open source diagnosis classification system that dichotomizes ∼14 000 ICD9 and ∼68 000 ICD10 diagnosis codes into chronic and non chronic conditions; and Patient medical complexity algorithm (PMCA), developed by Seattle Children’s Hospital, an open source, pediatric-specific, diagnosis classification system that uses ICD9 codes to group children into 1 of 3 categories: complex, chronic disease; noncomplex, chronic disease; and nonchronic disease.

Berry 2015 (J. Pediatrics) | PubMed 26028285 | Author Search