In This Issue
Research Spotlight: Updates to the Common Rule
CPCE in the News:
Children's Hospitals More Likely to Give Recommended Antibiotics for Pneumonia
CPCE in the News: Pros and Cons of ‘Medicare for All’
Upcoming Events
Recent Publications
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Updates to the Common Rule
Full implementation of the revised Federal Policy for the Protection of Human Subjects (the Common Rule) will take effect January 21, 2019. The revisions, which are meant to reflect the vast changes to the research landscape since the Common Rule was first adopted in 1991, include updates to categories of research which qualify for exempt review, informed consent requirements, continuing review requirements, and single IRB review for multi-center studies. Full details about the revisions are available at the
Federal Register, and for NIH implementation, see
NOT-OD-19-050.
At CHOP, the Institutional Review Board (IRB) team is revising its electronic IRB system, standard operating procedures, templates, and
webpage to comply with the new regulations. In addition, Heather Cathrall, MBE, CIP, assistant director of IRB Operations, provided a guest post for the CHOP Research Institute’s Cornerstone blog. Read the full post
here.
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Children's Hospitals More Likely to Give Recommended Antibiotics for Pneumonia
Kids with pneumonia may be more likely to receive recommended antibiotics when they're treated at a children's hospital than when they're seen elsewhere, suggests new
study from
Dr. Jeffrey Gerber and colleagues. This research, recently published in
JAMA Pediatrics, found that only 27% of children admitted to non-children’s hospitals received guideline-concordant therapy compared with 61% in children’s hospitals. Since 2011, U.S. guidelines have recommended narrow spectrum antibiotics for kids hospitalized for pneumonia. "Narrow-spectrum antibiotics are recommended over broad-spectrum antibiotics because narrow-spectrum antibiotics provide similar (and sometime better) clinical cure rates, are less likely to cause antibiotic-resistance, typically have fewer side effects (like diarrhea), and are less expensive," said senior study author Dr. Jeffrey Gerber. This discrepancy in antibiotic prescribing practices may represent an important target for antimicrobial stewardship efforts.
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Pros and Cons of 'Medicare for All'
The Affordable Care Act was passed to provide affordable health coverage for more Americans, but many Americans remain uninsured, and there are complaints about the complexity of the system. CPCE Core Faculty member and PolicyLab Director
David Rubin, MD, MSCE spoke with WHYY’s RadioTimes about rising healthcare costs, single-payer healthcare, "Medicare for All," Medicaid, and how ObamaCare could be fixed.
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Upcoming Events
Using Behavioral Economics and Digital Health to Address Teen Vaping and Smoking: Preliminary Findings and Lessons Learned
Date: Friday, February 8, 2019
Time: 12:00 pm - 1:00 pm
Location: Roberts Center for Pediatric Research, 1st Floor, Room 1-120A
Center for Pediatric Clinical Effectiveness, PolicyLab & the mHealth Research Affinity Group (RAG) will be hosting a seminar, "Using Behavioral Economics and Digital Health to Address Teen Vaping and Smoking: Preliminary Findings and Lessons Learned," presented by
Brian Jenssen, MD, MSHP. Additional information is available
here.
Please RSVP to
CPCE@email.chop.edu.
CPCE & PolicyLab Visiting Speaker Series: Dr. Gabriel Escobar
Date: February 22, 2019
Time: 12:00 pm - 1:00 pm
Location: Roberts Center for Pediatric Research, 1-120 A&B
Gabriel J. Escobar, MD, is a research scientist at the Kaiser Permanente Northern California Division of Research, director of the Division of Research Systems Research Initiative; and Regional Director for Hospital Operations Research for Kaiser Permanente Northern California. Dr. Escobar's research interests include risk adjustment, predictive modeling, severity-of-illness scoring, the use of comprehensive inpatient and outpatient electronic medical records for health services research, and the use of real-time decision support tools that are embedded in the electronic record.
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Recent Publications
Parental pressure is often cited as a reason for why pediatricians overuse antibiotics for children with acute respiratory tract infection (ARTI). Here, CPCE researchers including Associate Directors
Dr. Jeffrey Gerber and
Dr. Alexander Fiks examined parent perceptions of antibiotics at the time of their child's presentation with an ARTI. Parents involved in the study expressed a sense of caution about antibiotics and an awareness that they should be used judiciously, indicating that parents are aware of the downsides of antibiotics and might be willing to partner with healthcare providers to improve appropriate use.
Respiratory virus infections (RVIs) pose a threat to children undergoing hematopoietic stem cell transplantation (HSCT). In this era of sensitive molecular diagnostics, the incidence and outcome of HSCT recipients who are hospitalized with RVI (H-RVI) are not well described.
Dr. Brian Fisher and colleagues assembled a retrospective observational cohort of pediatric HSCT recipients and reviewed their medical charts for H-RVI events within 1 year after their transplant to calculate the incidence of H-RVI. Results of this suggest that H-RVIs are relatively common in pediatric HSCT recipients and contribute to significant morbidity and death. These data should help inform interventional studies specific to each viral pathogen.
Noonan syndrome is a genetic disorder that affects many areas of the body. It is characterized by mildly unusual facial features, short stature, heart defects, bleeding problems, skeletal malformations, and many other signs and symptoms. Children with Noonan syndrome are known to have increased risk for lymphatic disorders, the extent and nature of which are poorly understood. The objective of this study, from CPCE’s
Dr. Andrew Glatz,
Dr. Hansel Otero, and colleagues, was to describe the imaging findings of the central lymphatic abnormalities in children with Noonan syndrome who underwent central lymphatic imaging.
Central line-associated bloodstream infections (CLABSIs) are the most frequent pediatric hospital-acquired infections and are associated with significant morbidity and healthcare costs. The aim of this study, from CPCE Director
Dr. Theoklis Zaoutis and colleagues, was to determine the attributable length of stay and cost for CLABSIs in pediatric patients in Greece, for which there is currently a paucity of data.
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About CPCE
We are a pediatric research center dedicated to discovering and sharing knowledge about best practices in pediatric care by facilitating, organizing and centralizing the performance of clinical effectiveness research -- research aimed at understanding the best ways to prevent, diagnose and treat diseases in children. CPCE’s multidisciplinary team conducts research on a diverse range of clinical effectiveness topics.
CPCE E-News is edited by
Holly Burnside. Please feel free to contact us with questions or feedback.
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