2024
Management of race, ethnicity, and language data in the pediatric emergency department
Gutman C, Hartford E, Gifford S, Ford V, Bouvay K, Pickett M, Tran T, Slade N, Piroutek M, Chung S, Roach B, Hincapie M, Hoffmann J, Lin K, Kotler H, Pulcini C, Rose J, Bergmann K, Cheng T, St. Pierre Hetz R, Yan X, Lou X, Fernandez R, Aronson P, Lion K, Group T. Management of race, ethnicity, and language data in the pediatric emergency department. Academic Emergency Medicine 2024 PMID: 38808384, DOI: 10.1111/acem.14947.Peer-Reviewed Original ResearchImproving Guideline-Concordant Care for Febrile Infants Through a Quality Improvement Initiative.
McDaniel C, Kerns E, Jennings B, Magee S, Biondi E, Flores R, Aronson P. Improving Guideline-Concordant Care for Febrile Infants Through a Quality Improvement Initiative. Pediatrics 2024, 153 PMID: 38682245, DOI: 10.1542/peds.2023-063339.Peer-Reviewed Original ResearchConceptsClinical practice guidelinesFebrile infantsAmerican Academy of Pediatrics clinical practice guidelineSecondary measuresAAP clinical practice guidelinesPediatrics clinical practice guidelineInvasive bacterial infectionsQI collaborativeIntervention bundleAdherence to specific recommendationsDischarge of infantsGuideline-concordant careInfants aged 8Clinical practice guideline recommendationsPrimary measureQuality improvementOral antibioticsEmergency department dischargePositive urinalysisAssociated with improvementsQualifying infantsQuality improvement initiativesAdministered antibioticsGuideline recommendationsCerebrospinal fluidChanging patterns of routine laboratory testing over time at children's hospitals
Tchou M, Hall M, Markham J, Stephens J, Steiner M, McCoy E, Aronson P, Shah S, Molloy M, Cotter J. Changing patterns of routine laboratory testing over time at children's hospitals. Journal Of Hospital Medicine 2024 PMID: 38643414, DOI: 10.1002/jhm.13372.Peer-Reviewed Original ResearchTesting ratesChildren's hospitalED revisitsLength of stayRetrospective cohort study of children aged 0Study of children aged 0Annual testing ratesLaboratory testing ratesPediatric Health Information System databaseHealth Information System databaseChildren aged 0Case mix indexInformation System databaseResource utilization trendsRetrospective cohort studyAged 0Group hospitalsPatient daysReadmission ratesPatient outcomesSeparate hospitalsHospitalSystem databaseUtilization trendsMulti-centerPredictors of Invasive Bacterial Infection in Febrile Infants Aged 2 to 6 Months in the Emergency Department
Green R, Sartori L, Florin T, Aronson P, Lee B, Chamberlain J, Hunt K, Michelson K, Nigrovic L. Predictors of Invasive Bacterial Infection in Febrile Infants Aged 2 to 6 Months in the Emergency Department. The Journal Of Pediatrics 2024, 270: 114017. PMID: 38508484, DOI: 10.1016/j.jpeds.2024.114017.Peer-Reviewed Original Research“Let us take care of the medicine”: A qualitative analysis of physician communication when caring for febrile infants
Gutman C, Fernandez R, McFarlane A, Krajewski J, Lion K, Aronson P, Bylund C, Holmes S, Fisher C. “Let us take care of the medicine”: A qualitative analysis of physician communication when caring for febrile infants. Academic Pediatrics 2024 PMID: 38458491, DOI: 10.1016/j.acap.2024.03.002.Peer-Reviewed Original ResearchPatient-centered communicationPatient-centerednessPhysicians' assumptionsEmergency departmentThematic analysis of interview transcriptsParent-physician interactionsAnalysis of interview transcriptsAcademic pediatric emergency departmentIdentification of themesPediatric emergency departmentHealth inequalitiesPhysician communicationThematic saturationPhysicians' perceptionsED physiciansHealth careSemistructured interviewsInfant guidelinesThematic analysisInterview transcriptsPhysiciansCareHealthMethods approachManagement of febrile infantsPhlebotomy‐free days in children hospitalized with common infections and their association with clinical outcomes
Collins M, Hall M, Shah S, Molloy M, Aronson P, Cotter J, Steiner M, McCoy E, Tchou M, Stephens J, Markham J. Phlebotomy‐free days in children hospitalized with common infections and their association with clinical outcomes. Journal Of Hospital Medicine 2024, 19: 251-258. PMID: 38348499, PMCID: PMC11155307, DOI: 10.1002/jhm.13282.Peer-Reviewed Original ResearchCare of hospitalized childrenHospital quality measuresCross-sectional study of childrenPatient Refined Diagnosis Related GroupsPediatric Health Information System databaseHealth Information System databaseCross-sectional studyClinical outcomesDiagnosis Related GroupsInformation System databaseInterhospital transferIn-hospital mortalityMedical complexityStudy of childrenLaboratory blood testsTotal hospital LOSAssociated with outcomeAdjustment outcomesBlood testsOsteoarticular infectionsHospitalSystem databaseHospital LOSQuality measuresRelated groupsInfants With Hypothermia: Are They Just Like Febrile Infants?
Yankova L, Aronson P. Infants With Hypothermia: Are They Just Like Febrile Infants? Hospital Pediatrics 2024, 14: e161-e163. PMID: 38312018, DOI: 10.1542/hpeds.2023-007641.Commentaries, Editorials and LettersFebrile infants aged ≤60 days: evaluation and management in the emergency department.
Palladino L, Woll C, Aronson P. Febrile infants aged ≤60 days: evaluation and management in the emergency department. Pediatric Emergency Medicine Practice 2024, 21: 1-28. PMID: 38266065.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsBacterial infectionsManagement of febrile young infantsAmerican Academy of Pediatrics clinical practice guidelineYoung infantsFebrile young infantsPediatrics clinical practice guidelineEmergency departmentUrinary tract infectionRisk stratification toolPositive viral testClinical practice guidelinesTract infectionsViral testingEmergency cliniciansSevere outcomesAmerican AcademyInfectionPractice guidelinesInfantsDepartmentFeverEmergencyContaminant Organism Growth in Febrile Infants at Low Risk for Invasive Bacterial Infection
Singh N, Gutman C, Green R, Thompson A, Jackson K, Kalari N, Lucrezia S, Krack A, Corboy J, Cheng T, Duong M, St Pierre-Hetz R, Akinsola B, Kelly J, Sartori L, Yan X, Lou X, Lion K, Fernandez R, Aronson P, Group P. Contaminant Organism Growth in Febrile Infants at Low Risk for Invasive Bacterial Infection. The Journal Of Pediatrics 2024, 267: 113910. PMID: 38218368, DOI: 10.1016/j.jpeds.2024.113910.Peer-Reviewed Original Research
2023
Clinician Management Practices for Infants With Hypothermia in the Emergency Department.
Ramgopal S, Graves C, Aronson P, Cruz A, Rogers A. Clinician Management Practices for Infants With Hypothermia in the Emergency Department. Pediatrics 2023, 152 PMID: 38009075, DOI: 10.1542/peds.2023-063000.Peer-Reviewed Original ResearchConceptsSerious bacterial infectionsManagement of infantsEmergency departmentTreatment preferencesRespiratory viral testingSimplex virus infectionUS pediatric hospitalsProportion of cliniciansDays of ageClinician testingFebrile infantsED cliniciansInfants 0Pediatric hospitalViral testingClinician comfortVirus infectionAntimicrobial administrationHypothermiaYoung infantsOlder infantsInfantsBacterial infectionsCliniciansAgePerspectives of Adolescents and Young Adults with Sickle Cell Disease and Clinicians on Improving Transition Readiness and a Videogame Intervention
Aronson P, Nolan S, Schaeffer P, Hieftje K, Ponce K, Calhoun C. Perspectives of Adolescents and Young Adults with Sickle Cell Disease and Clinicians on Improving Transition Readiness and a Videogame Intervention. Blood 2023, 142: 5116. DOI: 10.1182/blood-2023-173310.Peer-Reviewed Original ResearchAdult careSickle cell diseaseTransition readinessPatient engagementClinician experienceVideogame interventionCell diseaseMedical decisionsYoung adultsDisease-specific knowledgeQuaternary care hospitalYoung SCD patientsSuccessful home managementHigh rateParents/caregiversPain crisisCare hospitalPatient factorsSuccessful disease managementHealthcare utilizationSCD patientsClinical manifestationsEmergency departmentProvider judgmentClinician's perspectiveEffect Modifiers of the Association of High-Flow Nasal Cannula and Bronchiolitis Length of Stay.
Winer J, Richardson T, Berg K, Berry J, Chang P, Etinger V, Hall M, Kim G, Meneses Paz J, Treasure J, Aronson P. Effect Modifiers of the Association of High-Flow Nasal Cannula and Bronchiolitis Length of Stay. Hospital Pediatrics 2023, 13: 1018-1027. PMID: 37795554, PMCID: PMC10593863, DOI: 10.1542/hpeds.2023-007295.Peer-Reviewed Original ResearchConceptsEffect of HFNCICU servicesEffect modifiersHigh-flow nasal cannula therapyMulticenter retrospective cohort studyPediatric Health Information SystemAge groupsHigh-flow nasal cannulaNon-ICU patientsRetrospective cohort studyComplex chronic conditionsMultivariable Poisson regressionFuture prospective studiesPotential effect modifiersInitial desaturationInitial tachypneaCohort studyClinical factorsNasal cannulaHospital recordsProspective studyHospitalized childrenChronic conditionsHFNCPatientsRacial and Ethnic Differences in Insurer Classification of Nonemergent Pediatric Emergency Department Visits
Pomerantz A, De Souza H, Hall M, Neuman M, Goyal M, Samuels-Kalow M, Aronson P, Alpern E, Simon H, Hoffmann J, Wells J, Shanahan K, Gutman C, Peltz A. Racial and Ethnic Differences in Insurer Classification of Nonemergent Pediatric Emergency Department Visits. JAMA Network Open 2023, 6: e2311752. PMID: 37140920, PMCID: PMC10160869, DOI: 10.1001/jamanetworkopen.2023.11752.Peer-Reviewed Original ResearchConceptsUnique ED visitsED visitsPediatric ED visitsClaims algorithmHispanic childrenMore visitsReimbursement reductionsHispanic pediatric patientsNonemergent ED visitsCurrent Procedural Terminology codesEmergency department visitsPediatric emergency departmentPrimary care servicesProcedural Terminology codesWhite childrenProfessional reimbursementCommercial health insurerRetrospective cohortDate of birthDepartment visitsPediatric patientsStudy cohortEmergency departmentMedicaid databaseDiagnosis codesPrevalence of Urinary Tract Infection, Bacteremia, and Meningitis Among Febrile Infants Aged 8 to 60 Days With SARS-CoV-2
Aronson P, Louie J, Kerns E, Jennings B, Magee S, Wang M, Gupta N, Kovaleski C, McDaniel L, McDaniel C, Agbim C, Amadasun O, Beam N, Beamon B, Becker H, Bedard E, Biondi E, Boulet J, Bray-Aschenbrenner A, Brooks R, Chen C, Corboy J, Dawlabani N, De Angulo G, Demie S, Drexler J, Dudley N, Ellis A, Fath K, Frauenfelder A, Gill J, Graf T, Grageda M, Greening H, Griffin A, Groen A, Guernsey III D, Gustafson S, Hancock W, Iyer S, Jaiyeola P, Jayanth A, Jennings R, Kachan-Liu S, Kamat A, Kennedy I, Khateeb L, Khilji O, Kleweno E, Kumar A, Kwon S, La A, Laeven-Sessions P, Le K, Leazer R, Levasseur K, Lewis E, Maalouli W, Mackenzie B, Mahoney K, Margulis D, Maskin L, McCarty E, Monroy A, Morrison J, Myszewski J, Nadeau N, Nagappan S, Newcomer K, Nordstrom M, Nguyen D, O'Day P, Oumarbaeva-Malone Y, Parlin U, Peters S, Piroutek M, Quarrie R, Rice K, Romano T, Rooholamini S, Schroeder C, Segar E, Seitzinger P, Sharma S, Simpson B, Singh P, Sobeih Y, Sojar S, Srinivasan K, Sterrett E, Swift-Taylor M, Szkola S, Thull-Freedman J, Topoz I, Vayngortin T, Veit C, Ventura-Polanco Y, Wallace Wu A, Weiss L, Wong E, Zafar S. Prevalence of Urinary Tract Infection, Bacteremia, and Meningitis Among Febrile Infants Aged 8 to 60 Days With SARS-CoV-2. JAMA Network Open 2023, 6: e2313354. PMID: 37171815, PMCID: PMC10182434, DOI: 10.1001/jamanetworkopen.2023.13354.Peer-Reviewed Original ResearchConceptsPrevalence of UTIUrinary tract infectionSARS-CoV-2SARS-CoV-2-positive infantsSARS-CoV-2 testingFebrile infantsBacterial meningitisTract infectionsSARS-CoV-2 positivityMulticenter cross-sectional studyInflammatory marker levelsMedical record reviewProportion of infantsCross-sectional studyQuality improvement initiativesRecord reviewEmergency departmentMarker levelsLower proportionBacteremiaMAIN OUTCOMEMeningitisInfantsAge groupsBacterial infections149 A Mixed Methods Analysis of Disparities in the Management of Low-Risk Febrile Infants
Gutman C, Aronson P, Lion K, Fisher C, McFarlane A, Bylund C, Fernandez R. 149 A Mixed Methods Analysis of Disparities in the Management of Low-Risk Febrile Infants. Journal Of Clinical And Translational Science 2023, 7: 45-45. PMCID: PMC10129715, DOI: 10.1017/cts.2023.230.Peer-Reviewed Original ResearchLow-risk febrile infantsStandard of careFebrile infantsPhysician-parent communicationMulticenter cross-sectional studyInvasive bacterial infectionsPediatric emergency departmentCross-sectional studyEmergency departmentLumbar puncturePhysician interviewsModifiable targetsModifiable driversProfessional interpretationInfant raceInfantsBacterial infectionsPhysician behaviorHealth disparitiesLogistic regressionHealth equityFuture interventionsCareInfluence management decisionsResults/Variation in stool testing for children with acute gastrointestinal infections
Markham J, Hall M, Collins M, Shah S, Molloy M, Aronson P, Cotter J, Steiner M, McCoy E, Tchou M, Stephens J. Variation in stool testing for children with acute gastrointestinal infections. Journal Of Hospital Medicine 2023, 18: 473-482. PMID: 36988413, DOI: 10.1002/jhm.13087.Peer-Reviewed Original ResearchConceptsAcute gastrointestinal infectionsStool testingLength of stayGastrointestinal infectionsHospitalized childrenTesting ratesUtilization outcomesPediatric Health Information System databaseHealth Information System databaseOverall testing rateCross-sectional studyStool studiesDiagnostic stewardshipAcute careChildren's HospitalInformation System databaseMAIN OUTCOMEHospitalInfectionIndividual hospitalsOutcomesSignificant differencesChildrenSystem databaseTesting group
2022
Trends in Prevalence of Bacterial Infections in Febrile Infants During the COVID-19 Pandemic.
Aronson P, Kerns E, Jennings B, Magee S, Wang M, McDaniel C. Trends in Prevalence of Bacterial Infections in Febrile Infants During the COVID-19 Pandemic. Pediatrics 2022, 150 PMID: 36353853, DOI: 10.1542/peds.2022-059235.Peer-Reviewed Original ResearchConceptsUrinary tract infectionInvasive bacterial infectionsCOVID-19 prevalenceFebrile infantsOdds of UTIPrevalence of UTIBacterial infectionsMulticenter cross-sectional studyEmergency department visitsMonths of presentationCoronavirus disease 2019 (COVID-19) pandemicCross-sectional studyDisease 2019 pandemicUTI prevalenceTract infectionsBacterial meningitisDepartment visitsLower oddsPrepandemic levelsInfantsInfants 8MeningitisBacteremiaLogistic regressionPrevalenceInjury-Related Pediatric Emergency Department Visits in the First Year of COVID-19.
Wells J, Rodean J, Cook L, Sills M, Neuman M, Kornblith A, Jain S, Hirsch A, Goyal M, Fleegler E, DeLaroche A, Aronson P, Leonard J. Injury-Related Pediatric Emergency Department Visits in the First Year of COVID-19. Pediatrics 2022, 150 PMID: 35836331, DOI: 10.1542/peds.2021-054545.Peer-Reviewed Original ResearchConceptsInjury-related visitsInjury-related ED visitsHospital emergency departmentEmergency departmentED visitsSARS-CoV-2 pandemic periodAcute respiratory syndrome coronavirus 2 pandemicSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemicChildren's hospital emergency departmentPediatric Health Information SystemUnited States children's hospitalsPrimary discharge diagnosisMechanism of injurySprains/strainsPediatric emergency departmentCoronavirus 2 pandemicCross-sectional studySARS-CoV-2 pandemicFirst yearPatient characteristicsChildren's HospitalDischarge diagnosisInjury patternsInjury typeAdministrative databasesDisparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol
Gutman C, Lion K, Aronson P, Fisher C, Bylund C, McFarlane A, Lou X, Patterson M, Lababidi A, Fernandez R. Disparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol. BMJ Open 2022, 12: e063611. PMID: 36127098, PMCID: PMC9490627, DOI: 10.1136/bmjopen-2022-063611.Peer-Reviewed Original ResearchConceptsLow-risk febrile infantsFebrile infantsEmergency departmentClinical carePediatric Emergency Medicine Collaborative Research CommitteeFlorida Institutional Review BoardLocal institutional review board approvalPediatric ED physiciansInstitutional review board approvalMultivariable logistic regressionCross-sectional studyPhysician-patient communicationReview board approvalClinical guideline implementationMethods study protocolInstitutional review boardMulticenter analysisPrimary outcomeED physiciansPhysician assessmentRecommended careGuideline implementationLumbar punctureStudy protocolEmergency settingVariation in bacterial pneumonia diagnoses and outcomes among children hospitalized with lower respiratory tract infections
Cotter J, Hall M, Shah S, Molloy M, Markham J, Aronson P, Stephens J, Steiner M, McCoy E, Collins M, Tchou M. Variation in bacterial pneumonia diagnoses and outcomes among children hospitalized with lower respiratory tract infections. Journal Of Hospital Medicine 2022, 17: 872-879. PMID: 35946482, DOI: 10.1002/jhm.12940.Peer-Reviewed Original ResearchConceptsBacterial community-acquired pneumoniaLower respiratory tract infectionsCommunity-acquired pneumoniaRespiratory tract infectionsProportion of childrenTract infectionsDiagnosis groupsMulticenter cross-sectional studyLength of stayCross-sectional studyCause revisitsClinical outcomesBlood testsChildren's HospitalViral causeCaP diagnosisChest radiographsMAIN OUTCOMEMultivariable regressionPneumonia diagnosisHospitalDiagnosisOutcomesReadmissionSignificant differences