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. Pediatrics 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-centeredPredictors 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, 24: 949-956. 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 infantsFebrile 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 guidelinesInfantsDepartmentFeverEmergency
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 perspectiveRacial 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/
2022
Injury-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 settingPrevalence 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. Pediatrics 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
2018
Risk Stratification of Febrile Infants ≤60 Days Old Without Routine Lumbar Puncture
Aronson PL, Wang ME, Shapiro ED, Shah SS, DePorre AG, McCulloh RJ, Pruitt CM, Desai S, Nigrovic LE, Marble RD, Leazer RC, Rooholamini SN, Sartori LF, Balamuth F, Woll C, Neuman MI. Risk Stratification of Febrile Infants ≤60 Days Old Without Routine Lumbar Puncture. Pediatrics 2018, 142: e20181879. PMID: 30425130, PMCID: PMC6317769, DOI: 10.1542/peds.2018-1879.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsPhiladelphia criteriaFebrile infantsBacterial meningitisRisk stratificationCSF testingRochester criteriaEmergency departmentLower riskRoutine CSF testingCerebrospinal fluid testingComplex chronic conditionsRoutine lumbar punctureCase-control studyDate of visitLow-risk infantsLumbar punctureChronic conditionsHigh riskInfantsBacterial infectionsDay oldsFluid testingMeningitisRiskTime to Pathogen Detection for Non-ill Versus Ill-Appearing Infants ≤60 Days Old With Bacteremia and Meningitis
Aronson PL, Wang ME, Nigrovic LE, Shah SS, Desai S, Pruitt CM, Balamuth F, Sartori L, Marble RD, Rooholamini SN, Leazer RC, Woll C, DePorre AG, Neuman MI. Time to Pathogen Detection for Non-ill Versus Ill-Appearing Infants ≤60 Days Old With Bacteremia and Meningitis. Hospital Pediatrics 2018, 8: 379-384. PMID: 29954839, PMCID: PMC6145376, DOI: 10.1542/hpeds.2018-0002.Peer-Reviewed Original ResearchConceptsBacterial meningitisCerebrospinal fluidOverall low prevalenceIll appearanceChildren's HospitalClinical appearanceEmergency departmentBlood culturesMedical recordsBacteremiaLow prevalenceMeningitisInfantsDay oldsMicrobiology laboratoryDemographic characteristicsBloodPathogen detectionHospitalBacterial pathogensHoursLower proportionDaysPathogensInfectionEMERGENCY DEPARTMENT AND INPATIENT CLINICAL DECISION TOOLS FOR THE MANAGEMENT OF FEBRILE YOUNG INFANTS AMONG TERTIARY PEDIATRIC CENTERS ACROSS CANADA
Burstein B, Gravel J, Aronson P, Neuman M. EMERGENCY DEPARTMENT AND INPATIENT CLINICAL DECISION TOOLS FOR THE MANAGEMENT OF FEBRILE YOUNG INFANTS AMONG TERTIARY PEDIATRIC CENTERS ACROSS CANADA. Paediatrics & Child Health 2018, 23: e7-e8. PMCID: PMC5961157, DOI: 10.1093/pch/pxy054.019.Peer-Reviewed Original ResearchClinical decision toolTertiary pediatric centerCanadian tertiary pediatric centersFebrile young infantsEmergency departmentPediatric centersFebrile infantsInpatient settingClinical pathwayPractice variationYoung infantsOrder setsRespiratory viral testingC-reactive proteinAntibiotic treatment regimensLaboratory reference valuesNormal laboratory reference valuesChi-square testingNew diagnostic testsInter-centre differencesProcalcitonin testingHospital volumeProvider adherenceSurvey response rateTreatment regimensEpidemiology and Etiology of Invasive Bacterial Infection in Infants ≤60 Days Old Treated in Emergency Departments
Woll C, Neuman MI, Pruitt CM, Wang ME, Shapiro ED, Shah SS, McCulloh RJ, Nigrovic LE, Desai S, DePorre AG, Leazer RC, Marble RD, Balamuth F, Feldman EA, Sartori LF, Browning WL, Aronson PL, Collaborative F, Alpern E, Hayes K, Lee B, Lumb C, Mitchell C, Peaper D, Rooholamini S, Shin S, Williams D. Epidemiology and Etiology of Invasive Bacterial Infection in Infants ≤60 Days Old Treated in Emergency Departments. The Journal Of Pediatrics 2018, 200: 210-217.e1. PMID: 29784512, PMCID: PMC6109608, DOI: 10.1016/j.jpeds.2018.04.033.Peer-Reviewed Original ResearchConceptsInvasive bacterial infectionsThird-generation cephalosporinsMicrobiology laboratory databaseEmergency departmentBacterial infectionsBacterial meningitisPediatric emergency departmentCombination of ampicillinAntimicrobial treatment regimenCross-sectional studyGroup B streptococciElectronic medical record systemEmpiric treatmentMedical record systemTreatment regimenChildren's HospitalMost infantsMedical recordsB streptococciCerebrospinal fluidCommon pathogensInfantsAntimicrobial susceptibilityDay oldsInfection
2015
Association between Clinical Outcomes and Hospital Guidelines for Cerebrospinal Fluid Testing in Febrile Infants Aged 29-56 Days
Chua KP, Neuman MI, McWilliams JM, Aronson PL, Collaborative F, Thurm C, Williams D, Browning W, Nigrovic L, Alpern E, Tieder J, Feldman E, Shah S, Schondelmeyer A, Alessandrini E, McCulloh R, Myers A, Balamuth F, Hayes K. Association between Clinical Outcomes and Hospital Guidelines for Cerebrospinal Fluid Testing in Febrile Infants Aged 29-56 Days. The Journal Of Pediatrics 2015, 167: 1340-1346.e9. PMID: 26477870, PMCID: PMC5535778, DOI: 10.1016/j.jpeds.2015.09.021.Peer-Reviewed Original ResearchConceptsClinical practice guidelinesOlder febrile infantsFebrile infantsCerebrospinal fluid testingClinical outcomesCSF testingAdverse eventsFluid testingYoung febrile infantsCentral venous cathetersUS children's hospitalsSignificant differencesMedian annual household incomeRace/ethnicityAnnual household incomeHospital mortalityVenous cathetersBacterial meningitisMembrane oxygenationPrimary outcomeHospital guidelinesMechanical ventilationChildren's HospitalEmergency departmentPractice guidelines
2014
Variation in Care of the Febrile Young Infant <90 Days in US Pediatric Emergency Departments
Aronson PL, Thurm C, Alpern ER, Alessandrini EA, Williams DJ, Shah SS, Nigrovic LE, McCulloh RJ, Schondelmeyer A, Tieder JS, Neuman MI. Variation in Care of the Febrile Young Infant <90 Days in US Pediatric Emergency Departments. Pediatrics 2014, 134: 667-677. PMID: 25266437, DOI: 10.1542/peds.2014-1382.Peer-Reviewed Original ResearchConceptsFebrile young infantsPediatric emergency departmentUS pediatric emergency departmentsHospital-level variationEmergency departmentHospitalization ratesInterhospital variationYoung infantsAge groupsSignificant interhospital variationRetrospective cohort studyCerebrospinal fluid testingProportion of patientsQuality of careDays of ageInfants 29Substantial patientCohort studyED visitsOverall cohortPatient ageED managementDiagnosis codesInclusion criteriaModifiable source