2025
Timing of repeat epinephrine to inform paediatric anaphylaxis observation periods: a retrospective cohort study
Dribin T, Sampson H, Zhang Y, Boyd S, Zhang N, Michelson K, Neuman M, Brousseau D, Mistry R, Freedman S, Aronson P, Bergmann K, Boswell B, Chinta S, Chua W, Cohen A, Cohen J, Daggett A, Davis J, Freeman J, Khanna K, Knoles C, Kwan K, Larsen C, Lee J, Lubell T, Metcalf A, Moake M, Nesiama J, Ngo T, Pulcini C, Russo C, Singh N, Srivastava G, Strutt J, Thapar V, Vander Wyst C, Walsh P, Wolnerman Y, Schnadower D, Academy of Pediatrics P, Kanngiesser A, McGarghan F, Dulchavsky A, Costalez J, DesPain A, Armanious M, Haghnazarian E, Brown-Whitehorn T, Weigert R, Dayan P, Meltzer J, Chowdhury N, Benedetti J, Sinziana C, Handorf A, Ruthford M, Devens M, Mecham C, Holland J, Casas T, Brown J, Panda P, Morrow A, Maready M, Nathani Y, Stevens M, Abraham G, Yen K, Cooper-Sood J, Woolf S. Timing of repeat epinephrine to inform paediatric anaphylaxis observation periods: a retrospective cohort study. The Lancet Child & Adolescent Health 2025, 9: 484-496. PMID: 40506197, DOI: 10.1016/s2352-4642(25)00139-7.Peer-Reviewed Original ResearchConceptsElectronic medical recordsEmergency departmentRetrospective cohort studyCohort studyMedical recordsDocumentation of symptomsCardiovascular involvementHealth-care facilitiesEpinephrine doseAcute allergic reactionsNational Institutes of HealthCumulative incidenceNational Center for Advancing Translational SciencesInstitutes of HealthChildren aged 6 monthsClinical ModificationHospital wardsIncidence rateICD-10Observation periodPrimary outcomeAllergic reactionsSecondary to medicationsInitiation to discontinuationKaplan-Meier analysisRisk Factors for Serious Bacterial Infections Among Young Infants With Hypothermia: Protocol for a Multicenter, Retrospective Case-Control Study
Ramgopal S, Aronson P, Lorenz D, Rogers A, Cruz A. Risk Factors for Serious Bacterial Infections Among Young Infants With Hypothermia: Protocol for a Multicenter, Retrospective Case-Control Study. JMIR Research Protocols 2025, 14: e66722. PMID: 40536806, DOI: 10.2196/66722.Peer-Reviewed Original ResearchConceptsEpidemiology of SBIHerpes simplex virusCase-control studyEmergency departmentYoung infantsMultivariable prediction modelRetrospective nested case-control studyBacterial infectionsRetrospective case-control studyManagement of young infantsNested case-control studyUrinary tract infectionOptimal cutoff valueSerious bacterial infectionsSoft tissue infectionsOutcome measuresPediatric Emergency Medicine Collaborative Research CommitteeReceiver operating characteristic curvePediatric emergency departmentOperating characteristics curveUS children's hospitalsMixed effects logistic regressionHSV-positiveBlood culturesPredicting SBIRisk of Bacterial Infections in Febrile Infants 61 to 90 Days Old With Respiratory Viruses.
Aronson P, Mahajan P, Nielsen B, Olsen C, Meeks H, Grundmeier R, Kuppermann N. Risk of Bacterial Infections in Febrile Infants 61 to 90 Days Old With Respiratory Viruses. 2025, 156 PMID: 40506050, DOI: 10.1542/peds.2025-070617.Peer-Reviewed Original ResearchConceptsPrevalence of urinary tract infectionUrinary tract infectionPediatric Emergency Care Applied Research NetworkRespiratory viral testingRespiratory viral infectionsFebrile infantsBacterial meningitisRespiratory virusesSARS-CoV-2Viral testingViral infectionSARS-CoV-2-positive infantsBacterial infectionsRisk of bacterial infectionPrevalence of bacteremiaPrevalence of bacterial infectionRespiratory syncytial virusBlood culturesTract infectionsPositive infantsSyncytial virusNegative infantsBacteremiaMeningitisInfantsUrine Dipstick for the Diagnosis of Urinary Tract Infection in Febrile Infants Aged 2 to 6Â Months.
Hunt K, Green R, Sartori L, Aronson P, Chamberlain J, Florin T, Michelson K, Monuteaux M, Chaudhari P, Nigrovic L. Urine Dipstick for the Diagnosis of Urinary Tract Infection in Febrile Infants Aged 2 to 6 Months. 2025, 155 PMID: 40122108, DOI: 10.1542/peds.2024-068671.Peer-Reviewed Original ResearchConceptsDiagnosis of urinary tract infectionUrinary tract infectionUrine WBC countUrine dipstickUrine cultureAged 2 to 6Receiver operating characteristicWhite blood cellsTract infectionsColony-forming unitsUrine white blood cellsWBC countCatheterized urine culturePositive urine dipstickInitial treatment decisionsAccurate diagnostic testCross-sectional studyBacterial uropathogensFebrile infantsLaboratory urinalysisTreatment decisionsDiagnostic testsEmergency departmentUrinalysisUrine
2024
Disparities in Guideline Adherence for Febrile Infants in a National Quality Improvement Project.
McDaniel C, Truschel L, Kerns E, Polanco Y, Liang D, Gutman C, Cunningham S, Rooholamini S, Thull-Freedman J, Jennings B, Magee S, Aronson P. Disparities in Guideline Adherence for Febrile Infants in a National Quality Improvement Project. 2024, 154 PMID: 39155728, PMCID: PMC11350103, DOI: 10.1542/peds.2024-065922.Peer-Reviewed Original ResearchConceptsQuality improvementDelivery of evidence-based careStandard careEmergency departmentNational quality improvement projectNon-Hispanic black infantsEvidence-based careQuality improvement projectDocumentation of follow-upAssociation of raceNon-Hispanic white infantsClinical practice guidelinesCross-sectional studyPediatrics clinical practice guidelineQI collaborativeEquitable deliveryGuideline implementationFollow-upEthnic disparitiesGuideline adherenceGuideline-concordantIntervention periodAmerican Academy of Pediatrics clinical practice guidelineImprovement projectPractice guidelinesDisposition and Follow-up for Low-Risk Febrile Infants: A Secondary Analysis of a Multicenter Study.
Kannikeswaran N, Spencer P, Tedford N, Truschel L, Chu J, Dingeldein L, Waseem M, Chow J, Lababidi A, Theiler C, Bhalodkar S, Yan X, Lou X, Fernandez R, Aronson P, Lion K, Gutman C. Disposition and Follow-up for Low-Risk Febrile Infants: A Secondary Analysis of a Multicenter Study. Hospital Pediatrics 2024, 14: e379-e384. PMID: 39113626, PMCID: PMC11358591, DOI: 10.1542/hpeds.2024-007850.Peer-Reviewed Original ResearchConceptsFebrile infantsFollow-upPrimary care providersElectronic health record documentationElectronic health recordsDischarged infantsEmergency departmentED dispositionLow riskAmerican Academy of Pediatrics guidelinesInvasive bacterial infectionsSecondary analysisCross-sectional studyMulticenter studyPost-discharge follow-upPediatric guidelinesWeekday visitsBacterial infectionsInfantsQuality of careAmerican AcademyMulticenterCare planningCare providersPatient-centeredImproving 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. 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 fluidFebrile 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 guidelinesInfantsDepartmentFeverEmergencyPerspectives of Adolescents and Young Adults With Sickle Cell Disease and Clinicians on Improving Transition Readiness With a Video Game 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 With a Video Game Intervention. Journal Of Pediatric Hematology/Oncology 2024, 46: e147-e155. PMID: 38237001, DOI: 10.1097/mph.0000000000002810.Peer-Reviewed Original ResearchConceptsVideo game interventionPediatric to adult careOptimize self-efficacyGame interventionPatient engagementSelf-efficacyAdult careIdentified 4 main themesMedical decisionsImprove transition readinessYoung adultsExperiences of cliniciansQuaternary-care hospitalSickle cell diseaseData saturationTransition readinessMultilevel determinantsSemistructured interviewsClinician experienceHome managementCareInductive analysisCell diseaseDecision-makingIntervention
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. 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 infectionsCliniciansAgeEffect 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 infectionsVariation 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, PMCID: PMC11340271, 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. 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. 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, PMCID: PMC11366396, 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 differencesPrevalence and Management of Invasive Bacterial Infections in Febrile Infants Ages 2 to 6 Months
Green R, Sartori L, Lee B, Linn A, Samuels M, Florin T, Aronson P, Chamberlain J, Michelson K, Nigrovic L. Prevalence and Management of Invasive Bacterial Infections in Febrile Infants Ages 2 to 6 Months. Annals Of Emergency Medicine 2022, 80: 499-506. PMID: 35940993, DOI: 10.1016/j.annemergmed.2022.06.014.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsCase-control studyBacterial infectionsFebrile infantsInfants 2Emergency departmentEligible patient encountersOlder febrile infantsCerebrospinal fluid culturesInfection prevalenceAge-matched infantsEvidence-based guidelinesInfants ages 2Months of ageLow-value testingFebrile neonatesOverall cohortRetrospective cohortSecondary outcomesPrimary outcomeAntibiotic administrationBacterial cultureFluid cultureCerebrospinal fluidLower risk
2019
A Prediction Model to Identify Febrile Infants ≤60 Days at Low Risk of Invasive Bacterial Infection
Aronson PL, Shabanova V, Shapiro ED, Wang ME, Nigrovic LE, Pruitt CM, DePorre AG, Leazer RC, Desai S, Sartori LF, Marble RD, Rooholamini SN, McCulloh RJ, Woll C, Balamuth F, Alpern ER, Shah SS, Williams DJ, Browning WL, Shah N, Neuman MI. A Prediction Model to Identify Febrile Infants ≤60 Days at Low Risk of Invasive Bacterial Infection. 2019, 144: e20183604. PMID: 31167938, PMCID: PMC6615531, DOI: 10.1542/peds.2018-3604.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsAbsolute neutrophil countFebrile infantsControl patientsNeutrophil countUrinalysis resultsBacterial infectionsAbnormal urinalysis resultsNormal urinalysis resultsComplex chronic conditionsCase-control studyMultiple logistic regressionDate of visitEmergency departmentChronic conditionsCerebrospinal fluidLower riskInfantsLogistic regressionPatientsHospitalScoresInfectionDaysLow probability
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