National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (4)
- Antimicrobial Stewardship (1)
- Cancer (2)
- Caregiving (1)
- Children/Adolescents (10)
- Comparative Effectiveness (2)
- Critical Care (2)
- Depression (1)
- Diabetes (1)
- Disabilities (1)
- Disparities (1)
- Education: Patient and Caregiver (1)
- Evidence-Based Practice (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Costs (1)
- Healthcare Utilization (1)
- Health Information Technology (HIT) (1)
- Health Insurance (1)
- Health Status (2)
- Home Healthcare (1)
- Hospital Discharge (2)
- Hospitals (1)
- Intensive Care Unit (ICU) (2)
- Labor and Delivery (3)
- Maternal Care (2)
- Medicaid (1)
- Medication (3)
- Medication: Safety (2)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (2)
- Mortality (2)
- Neonatal Intensive Care Unit (NICU) (5)
- Neurological Disorders (1)
- (-) Newborns/Infants (27)
- Obesity: Weight Management (1)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (4)
- Patient Safety (3)
- Payment (1)
- Pregnancy (4)
- Prevention (1)
- Quality Improvement (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (2)
- Respiratory Conditions (1)
- Risk (1)
- Screening (1)
- Shared Decision Making (1)
- Sickle Cell Disease (1)
- Social Determinants of Health (1)
- Stress (2)
- Substance Abuse (1)
- Surgery (1)
- Teams (2)
- Vaccination (2)
- Vulnerable Populations (1)
- Women (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 27 Research Studies DisplayedBurstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Profit J, Lee HC, Sharek PJ
Comparing NICU teamwork and safety climate across two commonly used survey instruments.
The objectives of this study were to assess variation in safety and teamwork climate and in the neonatal intensive care unit (NICU) setting, and compare measurement of safety culture scales using two different instruments (Safety Attitudes Questionnaire (SAQ) and Hospital Survey on Patient Safety Culture (HSOPSC)). It concluded that large variation and opportunities for improvement in patient safety culture exist across NICUs. Important systematic differences exist between SAQ and HSOPSC.
AHRQ-funded; HS014246.
Citation: Profit J, Lee HC, Sharek PJ .
Comparing NICU teamwork and safety climate across two commonly used survey instruments.
BMJ Qual Saf 2016 Dec;25(12):954-61. doi: 10.1136/bmjqs-2014-003924.
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Keywords: Hospitals, Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NICU), Newborns/Infants, Patient Safety, Teams
Quinn M, Gephart S
Evidence for implementation strategies to provide palliative care in the neonatal intensive care unit.
The authors sought to answer the clinical question: In neonatal intensive care, what evidence can be used to guide implementation of palliative care protocols? They found that successful team approaches included standardized order sets to initiate neonatal palliative care (NPC), NPC education for staff, and references to NPC guidelines or protocols.They recommended that barriers such as lack of interdisciplinary cooperation, lack of appropriate physical space, and lack of education be addressed during program development.
AHRQ-funded; HS022908.
Citation: Quinn M, Gephart S .
Evidence for implementation strategies to provide palliative care in the neonatal intensive care unit.
Adv Neonatal Care 2016 Dec;16(6):430-38. doi: 10.1097/anc.0000000000000354.
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Keywords: Evidence-Based Practice, Neonatal Intensive Care Unit (NICU), Newborns/Infants, Palliative Care
Sobotka SA, Msall ME
Supporting vulnerable children after life-threatening neonatal illness: opportunities for improving outcomes.
This article discusses two articles in the same issue, one involving kindergarten readiness after prematurity, and the other examining medical and surgical factors impacting children with congenital heart disease (CHD) and their later school age achievement test performance. The authors state that these two articles provide evidence for longitudinal support of infants who survive critical illness.
AHRQ-funded; HS023007.
Citation: Sobotka SA, Msall ME .
Supporting vulnerable children after life-threatening neonatal illness: opportunities for improving outcomes.
J Pediatr 2016 Nov;178:12-14. doi: 10.1016/j.jpeds.2016.07.037.
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Keywords: Children/Adolescents, Newborns/Infants, Patient-Centered Outcomes Research, Children/Adolescents, Vulnerable Populations
Garfield CF, Simon CD, Rutsohn J
Paternal and maternal testosterone in parents of NICU infants transitioning home.
This study examined testosterone levels for parents of very low-birth-weight infants, including links between salivary testosterone and infant factors (such as breast-feeding), psychosocial stress, and changes over time. Using multilevel modeling approaches, the researchers reported significant associations between paternal testosterone by time and psychosocial adjustment and between both paternal and maternal testosterone and infant feeding mode.
AHRQ-funded; R21 HS020316.
Citation: Garfield CF, Simon CD, Rutsohn J .
Paternal and maternal testosterone in parents of NICU infants transitioning home.
J Perinat Neonatal Nurs 2016 Oct/Dec;30(4):349-58. doi: 10.1097/jpn.0000000000000218.
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Keywords: Newborns/Infants, Stress, Caregiving, Hospital Discharge
Carmody D, Pastore AN, Landmeier KA
Patients with KCNJ11-related diabetes frequently have neuropsychological impairments compared with sibling controls.
This study compared neurodevelopmental outcomes in patients with KCNJ11 mutations and their sibling controls. It found that patients with KCNJ11-related diabetes without global developmental delay had significant differences compared with sibling controls on a range of assessments including IQ, measures of academic achievement and executive function.
AHRQ-funded; HS023007.
Citation: Carmody D, Pastore AN, Landmeier KA .
Patients with KCNJ11-related diabetes frequently have neuropsychological impairments compared with sibling controls.
Diabet Med 2016 Oct;33(10):1380-6. doi: 10.1111/dme.13159.
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Keywords: Children/Adolescents, Diabetes, Disabilities, Neurological Disorders, Newborns/Infants
Pinyavat T, Warner DO, Flick RP
Summary of the update session on clinical neurotoxicity studies.
During the Fifth Pediatric Anesthesia Neurodevelopmental Assessment Symposium, experts and stakeholders met to present and discuss recent advances made in the study of neurodevelopmental outcomes after exposure to anesthetic drugs in infants and children. This article summarizes the update of 5 ongoing clinical studies: General Anesthesia compared to Spinal Anesthesia, Toxicity of Remifentanil and Dexmedetomidine, Mayo Anesthesia Safety in Kids, the University of California San Francisco human cohort study, and Columbia University Medical Center Neonatal Magnetic Resonance Imaging study.
AHRQ-funded; HS022941.
Citation: Pinyavat T, Warner DO, Flick RP .
Summary of the update session on clinical neurotoxicity studies.
J Neurosurg Anesthesiol 2016 Oct;28(4):356-60. doi: 10.1097/ana.0000000000000347.
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Keywords: Newborns/Infants, Children/Adolescents, Medication: Safety, Adverse Drug Events (ADE), Medication
Hinton CF, Homer CJ, Thompson AA
AHRQ Author: Dougherty D
A framework for assessing outcomes from newborn screening: on the road to measuring its promise.
The researchers proposed a framework for assessing outcomes for the health and well-being of children identified through newborn screening programs. As an example, they applied the framework to sickle cell disease and phenylketonuria, two diverse conditions with different outcome measures and potential sources of data. They concluded that their paper presented a customizable outcomes framework for organizing measures for newborn screening condition-specific health outcomes, and an approach to identifying sources and challenges to populating those measures.
AHRQ-authored.
Citation: Hinton CF, Homer CJ, Thompson AA .
A framework for assessing outcomes from newborn screening: on the road to measuring its promise.
Mol Genet Metab 2016 Aug;118(4):221-9. doi: 10.1016/j.ymgme.2016.05.017.
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Keywords: Children/Adolescents, Health Status, Newborns/Infants, Screening, Sickle Cell Disease
Sloan CD, Gebretsadik T, Rosas-Salazar C
Seasonal timing of infant bronchiolitis, apnea and sudden unexplained infant death.
The researchers analyzed ecological associations between timing of Sudden Unexplained Infant Death (SUID) cases, bronchiolitis, and apnea healthcare visits. They found a temporal relationship between infant bronchiolitis and apnea, but no peak in SUID cases during peaks of bronchiolitis. They concluded that consistent trends between bronchiolitis, apnea, and SUID were not established due to small numbers of SUID cases.
AHRQ-funded; HS018454.
Citation: Sloan CD, Gebretsadik T, Rosas-Salazar C .
Seasonal timing of infant bronchiolitis, apnea and sudden unexplained infant death.
PLoS One 2016 Jul 12;11(7):e0158521. doi: 10.1371/journal.pone.0158521.
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Keywords: Newborns/Infants, Respiratory Conditions, Mortality
Ing C, Sun LS, Friend AF
Adverse events and resource utilization after spinal and general anesthesia in infants undergoing pyloromyotomy.
This study compared spinal anesthesia (SA) versus general anesthesia (GA) in infants undergoing pyloromyotomy. It concluded that infants undergoing pyloromyotomy with SA had shorter operating room times and postoperative length of stay, no significant differences in adverse event rates, and decreased exposure to IV and inhaled anesthetics, although SA infants often still required supplemental anesthetics.
AHRQ-funded; HS022941.
Citation: Ing C, Sun LS, Friend AF .
Adverse events and resource utilization after spinal and general anesthesia in infants undergoing pyloromyotomy.
Reg Anesth Pain Med 2016 Jul-Aug;41(4):532-7. doi: 10.1097/aap.0000000000000421.
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Keywords: Newborns/Infants, Surgery, Medication, Medication: Safety, Adverse Drug Events (ADE)
Reich PJ, Boyle MG, Hogan PG
Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge.
Methicillin-resistant Staphylococcus aureus (MRSA) infections cause significant morbidity and mortality in neonatal intensive care units (NICUs). The researchers characterized the clinical and molecular epidemiology of MRSA strains colonizing NICU patients. They found that community-acquired MRSA strains are prominent in the NICU and associated with distinct risk factors.
AHRQ-funded; HS021736; HS024269.
Citation: Reich PJ, Boyle MG, Hogan PG .
Emergence of community-associated methicillin-resistant Staphylococcus aureus strains in the neonatal intensive care unit: an infection prevention and patient safety challenge.
Clin Microbiol Infect 2016 Jul;22(7):645.e1-8. doi: 10.1016/j.cmi.2016.04.013.
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Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Neonatal Intensive Care Unit (NICU), Patient Safety, Prevention, Antimicrobial Stewardship, Newborns/Infants, Healthcare-Associated Infections (HAIs)
Witt WP, Mandell KC, Wisk LE
Infant birthweight in the US: the role of preconception stressful life events and substance use.
The purpose of this study was to determine the relationships among preconception stressful life events (PSLEs), women's alcohol and tobacco use before and during pregnancy, and infant birthweight. It concluded that PSLEs and women's tobacco use before and during pregnancy are independent risk factors for having a lower birthweight baby.
AHRQ-funded; HS000063; HS000083.
Citation: Witt WP, Mandell KC, Wisk LE .
Infant birthweight in the US: the role of preconception stressful life events and substance use.
Arch Womens Ment Health 2016 Jun;19(3):529-42. doi: 10.1007/s00737-015-0595-z.
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Keywords: Newborns/Infants, Pregnancy, Stress, Substance Abuse, Women
Newman TB, Wickremasinghe AC, Walsh EM
Retrospective cohort study of phototherapy and childhood cancer in Northern California.
The researechers investigated the association between neonatal phototherapy use and childhood cancer. They concluded that although phototherapy use was associated with increased cancer rates (particularly nonlymphocytic leukemia), control for confounding variables eliminated or attenuated the associations. Nonetheless, the possibility of even partial causality suggests that avoiding unnecessary phototherapy may be prudent.
AHRQ-funded; HS020618.
Citation: Newman TB, Wickremasinghe AC, Walsh EM .
Retrospective cohort study of phototherapy and childhood cancer in Northern California.
Pediatrics 2016 Jun;137(6):pii: e20151354. doi: 10.1542/peds.2015-1354.
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Keywords: Children/Adolescents, Newborns/Infants, Cancer, Adverse Events
Freedman S
Capacity and utilization in health care: the effect of empty beds on neonatal intensive care admission.
In this paper, the author exploited short-term variation in Neonatal Intensive Care Unit (NICU) capacity that is unlikely to be correlated with unobserved demand determinants. He found that available NICU beds have little to no effect on NICU utilization for the sickest infants, but do increase utilization for those in the range of birth weights where admission decisions are likely to be more discretionary.
AHRQ-funded; HS018266.
Citation: Freedman S .
Capacity and utilization in health care: the effect of empty beds on neonatal intensive care admission.
Am Econ J Econ Policy 2016 May 1;8(2):154-85. doi: 10.1257/pol.20120393.
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Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Healthcare Utilization, Critical Care, Shared Decision Making
Hu T, Decker SL, Chou SY
AHRQ Author: Decker SL
Medicaid pay for performance programs and childhood immunization status.
This national study examined the effects of pay for performance (P4P) programs on childhood immunization rates. It found no overall effect of Medicaid P4P on the chance that children aged 19-35 months had completed the 4:3:1:3:3:1 vaccination series. However, there was a 4 percentage point increase in the chance that a child 19-23 months had completed the series.
AHRQ-authored.
Citation: Hu T, Decker SL, Chou SY .
Medicaid pay for performance programs and childhood immunization status.
Am J Prev Med 2016 May;50(5 Suppl 1):S51-7. doi: 10.1016/j.amepre.2016.01.012.
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Keywords: Newborns/Infants, Children/Adolescents, Medicaid, Vaccination, Payment, Health Insurance
Garfield CF, Lee YS, Kim HN
Supporting parents of premature infants transitioning from the NICU to home: a pilot randomized control trial of a smartphone application.
This study determined whether parents of Very Low Birth Weight (VLBW) infants in the Neonatal Intensive Care Unit (NICU) transitioning home with the NICU-2-Home smartphone application have greater parenting self-efficacy, are better prepared for discharge and have shorter length of stay (LOS) than control parents. It found that a smartphone application can improve parenting self-efficacy, discharge preparedness, and LOS with improved benefits based on usage.
AHRQ-funded; HS020316.
Citation: Garfield CF, Lee YS, Kim HN .
Supporting parents of premature infants transitioning from the NICU to home: a pilot randomized control trial of a smartphone application.
Internet Interv 2016 May;4(Pt 2):131-37. doi: 10.1016/j.invent.2016.05.004.
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Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Health Information Technology (HIT), Home Healthcare, Hospital Discharge
Servan-Mori E, Sosa-Rubi SG, Najera-Leon E
Timeliness, frequency and content of antenatal care: which is most important to reducing indigenous disparities in birth weight in Mexico?
The authors estimated the potential for added weight gain among indigenous infants if their mothers received timely, frequent, and complete antenatal care (ANC). They found that the frequency of ANC was positively associated with birth weight for all women but complete ANC appears to differentially affect indigenous women at the bottom of the birth weight distribution.
AHRQ-funded; HS017582.
Citation: Servan-Mori E, Sosa-Rubi SG, Najera-Leon E .
Timeliness, frequency and content of antenatal care: which is most important to reducing indigenous disparities in birth weight in Mexico?
Health Policy Plan 2016 May;31(4):444-53. doi: 10.1093/heapol/czv082.
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Keywords: Disparities, Maternal Care, Racial and Ethnic Minorities, Newborns/Infants, Obesity: Weight Management
Salemi JL, Pathak EB, Salihu HM
Infant outcomes after elective early-term delivery compared with expectant management.
The purpose of the study was to compare the risk of neonatal morbidity and infant mortality between elective early-term deliveries and those expectantly managed and delivered at 39 weeks of gestation or greater. It concluded that the issues surrounding the timing and reasons for delivery initiation are complicated and each pregnancy unique. Furthermore, it cautions against a general avoidance of all elective early-term deliveries.
AHRQ-funded - HS019997.
Citation: Salemi JL, Pathak EB, Salihu HM .
Infant outcomes after elective early-term delivery compared with expectant management.
Obstet Gynecol 2016 Apr;127(4):657-66. doi: 10.1097/aog.0000000000001331.
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Keywords: Newborns/Infants, Mortality, Pregnancy, Labor and Delivery, Adverse Events
Bartsch SM, Hotez PJ, Hertenstein DL
Modeling the economic and epidemiologic impact of hookworm vaccine and mass drug administration (MDA) in Brazil, a high transmission setting.
The authors evaluated the potential economic and epidemiologic impact of a preventive hookworm vaccine. A pediatric hookworm vaccine drastically decreased hookworm prevalence in children. A booster in adulthood further reduced the overall prevalence and nearly eliminated hookworm infection in children. The authors conclude that a human hookworm vaccine would provide both health benefits and cost savings.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Hotez PJ, Hertenstein DL .
Modeling the economic and epidemiologic impact of hookworm vaccine and mass drug administration (MDA) in Brazil, a high transmission setting.
Vaccine 2016 Apr 27;34(19):2197-206. doi: 10.1016/j.vaccine.2016.03.018.
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Keywords: Vaccination, Healthcare Costs, Children/Adolescents, Newborns/Infants
Popoola VO, Colantuoni E, Suwantarat N
Active surveillance cultures and decolonization to reduce staphylococcus aureus infections in the neonatal intensive care unit.
The researchers examined the impact of methicillin-susceptible S. aureus (MSSA) decolonization on the incidence of MSSA infection and to measure the prevalence of mupirocin resistance. They found that active surveillance cultures and decolonization may be effective in decreasing S. aureus infections in NICUs.
AHRQ-funded; HS022872.
Citation: Popoola VO, Colantuoni E, Suwantarat N .
Active surveillance cultures and decolonization to reduce staphylococcus aureus infections in the neonatal intensive care unit.
Infect Control Hosp Epidemiol 2016 Apr;37(4):381-7. doi: 10.1017/ice.2015.316..
Keywords: Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Methicillin-Resistant Staphylococcus aureus (MRSA), Newborns/Infants
Joyner BL, Oden RP, Moon RY
Reasons for pacifier use and non-use in African-Americans: does knowledge of reduced SIDS risk change parents' minds?
The authors sought to investigate African-American parental reasons for pacifier use or non-use. They recommended that providers supply information about the benefits of pacifiers and concluded that establishing for parents any plausible link between the protective mechanism of pacifiers and SIDS pathophysiology may be important in promoting pacifier use.
AHRQ-funded; HS016892.
Citation: Joyner BL, Oden RP, Moon RY .
Reasons for pacifier use and non-use in African-Americans: does knowledge of reduced SIDS risk change parents' minds?
J Immigr Minor Health 2016 Apr;18(2):402-10. doi: 10.1007/s10903-015-0206-0.
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Keywords: Education: Patient and Caregiver, Newborns/Infants, Newborns/Infants, Racial and Ethnic Minorities, Risk
Sanders RC, Jr., Nett ST, Davis KF
Family presence during pediatric tracheal intubations.
The researchers described the current practice of family presence (FP) during tracheal intubation (TI) and evaluated the association with procedural and clinician (including physician, respiratory therapist, and nurse practitioner) outcomes across multiple pediatric intensive care units (PICUs). They found that FP was not associated with first attempt success, adverse TI-associated events, oxygen desaturation (<80%), or higher team stress level.
AHRQ-funded; HS022464; HS022469; HS021583.
Citation: Sanders RC, Jr., Nett ST, Davis KF .
Family presence during pediatric tracheal intubations.
JAMA Pediatr 2016 Mar 7;170(3):e154627. doi: 10.1001/jamapediatrics.2015.4627.
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Keywords: Newborns/Infants, Children/Adolescents, Critical Care, Adverse Events, Patient-Centered Outcomes Research
Cheng ER, Park H, Wisk LE
Examining the link between women's exposure to stressful life events prior to conception and infant and toddler health: the role of birth weight.
The authors suggested a pathway may exist among maternal exposure to stressful life events prior to conception (PSLEs), infant birth weight, and subsequent offspring health. Infant and toddler health outcomes were assessed at 9 and 24 months, including overall health status, special healthcare needs, and severe health conditions. The analysis suggested a chains-of-risk model in which women's exposure to PSLEs increased the risk for giving birth to a very low birth weight infant, adversely affecting infant and toddler health.
AHRQ-funded; HS000063; HS00083.
Citation: Cheng ER, Park H, Wisk LE .
Examining the link between women's exposure to stressful life events prior to conception and infant and toddler health: the role of birth weight.
J Epidemiol Community Health 2016 Mar;70(3):245-52. doi: 10.1136/jech-2015-205848.
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Keywords: Maternal Care, Women, Labor and Delivery, Newborns/Infants, Newborns/Infants
Chinnadurai S, Sathe NA, Surawicz T
Laser treatment of infantile hemangioma: a systematic review.
This systematic review of studies of laser treatment of infantile hemangioma concluded that the studies primarily addressed different laser modalities compared with observation or other laser modalities. Pulsed dye laser was the most commonly studied laser type, but multiple variations in treatment protocols did not allow for demonstration of superiority of a single method.
AHRQ-funded; 290201200009I.
Citation: Chinnadurai S, Sathe NA, Surawicz T .
Laser treatment of infantile hemangioma: a systematic review.
Lasers Surg Med 2016 Mar;48(3):221-33. doi: 10.1002/lsm.22455.
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Keywords: Comparative Effectiveness, Cancer, Newborns/Infants
Chinnadurai S, Fonnesbeck C, Snyder KM
Pharmacologic interventions for infantile hemangioma: a meta-analysis.
The objective of this report was to meta-analyze studies of pharmacologic interventions for children with infantile hemangiomas (IH). It concluded that propranolol was effective at reducing IH size compared with placebo, observation, and other treatments including steroids in most studies. Corticosteroids demonstrated moderate effectiveness at reducing IH size/volume.
AHRQ-funded; 290201200009I.
Citation: Chinnadurai S, Fonnesbeck C, Snyder KM .
Pharmacologic interventions for infantile hemangioma: a meta-analysis.
Pediatrics 2016 Feb;137(2):e20153896. doi: 10.1542/peds.2015-3896.
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Keywords: Medication, Children/Adolescents, Newborns/Infants, Comparative Effectiveness, Patient-Centered Outcomes Research