The APA actively supports research related to child health care delivery,
children with special vulnerabilities, health promotion, and environmental
health. Highlights from 2007 include CORNET (Continuity Research NETwork),
the Pediatric Research in Inpatient Settings (PRIS) Network, and Young
investigator Grants. CORNET has 77 pediatric training programs enrolled
and includes 95 continuity practice sites. The number of CORNET training
programs per APA region ranges from 3 to 12. The PRIS Network is a
hospitalist research group formed through a collaborative effort of
the APA, the AAP, and the Society of Hospital Medicine (SHM). The Young
Investigator Grants supports the research of junior investigators;
this year 47 applications were submitted and six were funded.
CORNET
(Continuity Research NETwork) - Janet Serwint, MD
CORNET has had another productive year. Currently 77 pediatric training
programs are enrolled that include 95 continuity practice sites. The
number of training programs per APA region ranges from 3-12 programs.
Our fifth manuscript has been accepted for publication:
“Measuring
primary care of children in pediatric resident continuity practices:
A CORNET Study”, Scott D Krugman, Andrew
Racine, Sharon
Dabrow, Sandra Sanguino, W Meyer, M Seid, and Janet
Serwint JR for the
CORNET Investigators, Pediatrics, (in press).
Two
additional manuscripts are in preparation from this study with Scott
Krugman as
the lead investigator, including “Identification of
Primary Care Provider and Quality of Care” and “Quality
of Care and Resident Level of Training”. All participating site investigators
have the opportunity to participate as a co-author on one of the manuscripts
providing they meet authorship requirements.
CORNET
was well represented at the 2007 PAS meeting with a poster presentation
and workshop. The poster entitled,” Hispanic patients receive high
quality care in resident continuity practices, with authors Sott
Krugman,
Wendy L. Hobson, Lynn C. Garfunkel, Janet
R. Serwint and Lilia Parra-Roide was presented on Sunday, 5/06/2007. Bill
Stratbucker presented a workshop
along with Janet R. Serwint, S. Feigelman, Susan
D. Krugman, John Olsson,
and Nui Dhepysawan entitled, “You CAN do Research
within your Continuity Clinics: a CORNET Primer”, on May 8, 2007 from 8:30-11:30am. Several
ideas for future CORNET projects were developed.
“The
Bright Futures Study” funded
by the Maternal and Child Health Bureau is progressing well. Thirty-three
pediatric training programs
and over 270 pediatric residents have been recruited to participate in
this randomized controlled trial that will evaluate an educational curriculum
on Bright Futures concepts. The multi-center study requires IRB approval
from all sites and recruitment of patients should begin this fall. The
PI and Co-PI are Hank Bernstein and Janet Serwint.
CORNET
is also collaborating with the PROS network of the AAP on the study,
Secondary Sexual Characteristics in Boys (SSCIB). Nine CORNET
practice sites have enrolled thus far. It is exciting to be collaborating
with PROS on a study protocol and hope that this is the first of many
future collaborations.
The
4th annual CORNET Meeting took place immediately after the PAS meeting
in Toronto. We were fortunate to have Benard Dreyer as the APA Research
Committee Chair join the CORNET Steering Committee. Upcoming projects
that were discussed and approved by the CORNET Executive Committee
include: a randomized controlled trial for application of fluoride
varnish, a
resident and preceptor survey concerning decision making about asthma
treatment, and a randomized controlled trial to decrease aggression
in early childhood.
The
APA is in the third of a five-year agreement with the American Academy
of Pediatrics to provide $15,000 annually for costs related
to a meeting
of the CORNET Advisory Committee. Janet Serwint is the principal
investigator.
The
APA continues in the second year of a four year grant from the Maternal
and Child Health Research Program (MCHR) Targeted Issues
to study the
effects of the Bright Futures Guidelines for Health Supervision
of Infants, Children and Adolescents on the quality of health promotion
and preventive
services delivered by pediatric residents in clinical outpatient
settings. The award in the amount of $171,999 per year. Co-investigators
are
Janet Serwint and Hank Bernstein.
PRIS
- Chris Landrigan, MD, MPH
The Pediatric Research in Inpatient Settings (PRIS) Network is a hospitalist
research group that was formed through a collaborative effort of the
APA, the AAP, and the Society of Hospital Medicine (SHM). Our mission
is to improve the quality of care for hospitalized children by developing
the evidence base for inpatient pediatric care. Over 80 hospitals and
200 hospitalists in the U.S. and Canada currently participate in PRIS.
We welcome new participants and proposals for multi-center research
projects both from hospitalists and from any clinical or health services
researchers with an interest in the quality of hospital care. Further
information, including details of how to submit a proposal, is available
on the PRIS website – hosted by the APA – at http://www.ambpeds.org/site/research/research_PRIS.htm
Over
the past 12 months, the level of activity in PRIS has greatly increased,
spurred by our new Network Manager, Nui Dhepyasuwan, whose work with
PRIS is being generously supported by the APA. Several projects have
been proposed in the past 12 months, and are now in various stages of
development:
-
We are currently in the process of surveying all members about
their practice patterns, rounding styles, and involvement in
sedation; (PRIS
Triennial Survey: co-PIs: Chris Landrigan, Children’s
Hospital Boston and Mary Ottolini, Children’s
National Medical Center)
- A study of complex pneumonia and parapneumoic effusion has been
approved by PRIS and is being submitted to an external foundation
for funding.
This study plans to evaluate both the epidemiology of parapneumoic
effusion in the post-pneumococcal vaccine era, and test the hypothesis
that children
treated with early VATS have improved outcomes compared with
those managed expectantly (PI: Samir Shah, CHOP);
- In
collaboration with the Emergency Department network EMNet, we are
planning a study of
the inpatient management of children with
bronchiolitis; R01 funding has been tentatively secured for
this project (P.I. Carlos
Camargo (EMNet/Massachusetts General Hospital); co-PI: Jonathan
Mansbach (PRIS&EMNet/ Children’s Hospital Boston));
- A
study of the epidemiology of hospitalist inpatient practice is planned,
using
administrative data from across hospitalist services
(PI: Jack
Percelay, Hunterdon Medical Center)
We look forward to receiving additional study proposals, and launching
our first multi-center studies this coming year. If you are interested
in being a part of this network, or have a research proposal, please
email Chris Landrigan at christopher.landrigan@childrens.harvard.edu and Nui Dhepyasuwan at nui@ambpeds.org.
Young
investigator Grants - Benard Dreyer, MD
Process:
The YIG Awards this year went through a multi-step process that the research
committee oversaw.
- Step 1: Announcement was sent out in September. 47 applications were
submitted for the first part of the review process. The following were
reviewers for the initial round: Benard Dreyer, Bill Cooper, Bob Jacobson,
Bruce Lamphear, Danielle Laraque, David Wood, Denise Dougherty, Lee
Pachter, Matt Davis, Michael Cabana, Peter Szilagyi, Shari Barkin,
Scott Shipman,
and Simon Hambidge. At least 5 reviewers were assigned to each of the
abstracts. Peter Szilagyi re-designed the rating form for the first
step of the review based on feedback from the Board. The first review
process
was completed by early November. Based on scoring of these abstracts,
18 proposals were invited to submit full proposals by December 15th.
- Step 2: Assignment to “Regular APA” and
AHRQ categories for second review was done by committee chair. 11 proposals
were in the
Regular APA group and 7 in the AHRQ group. $27,000 of funding was available
from AHRQ, and $30-35,000 from the APA. Depending on scoring, 3-4 proposals
were to be funded in each category.
- Step
3: Second review. Two review committees were set up, one for the
regular APA full proposals and one for the AHRQ full proposals. Reviewers
for the regular APA full proposals included Peter Szilagyi, Michael
Cabana,
Shari Barkin, Scott Shipman, Michael Hambidge, and Benard Dreyer.
Reviewers for the AHRQ full proposals included Bill Cooper, Bruce
Lanphear, David
Wood, Denise Dougherty, Michael Cabana, and Benard Dreyer. Each reviewer
was a primary reviewer for one or two proposals and a secondary reviewer
on another 1-2 proposals. Each reviewer read all proposals in the
assigned group. Conference calls were scheduled for each group (APA,
AHRQ) during
which scores were shared, and consensus was reached on rank order.
The top three proposals of in each category were proposed for funding.
Because
there was not a close score (a 4th proposal that scored very close
to the 3rd ranking proposal), there was no discussion on either group
of
funding a 4th proposal and reducing funding for all proposals.
- Step
4: notification. Letters of grant award or non-funding were sent
all applicants, along with “pink sheets” compiled from
detailed comments of primary and secondary reviewers, on March
12, 2006. Kelly
Cooper greatly assisted in the entire process.
The following proposals were funded through the YIG process:
| Investigator |
Institution |
Title
of Proposal |
Amount |
Funder |
| Amanda
Dempsey |
U.
Michigan |
Evaluating
risk fact-based strategies for HPV vaccination |
10,000 |
APA |
| Helene
Greves |
U.
Washington |
Measuring
the impact of school physical activity policies: can we identify
best practices through behavior outcomes? |
9,981 |
APA |
| Najah
Musacchio |
Children’s
Memorial / Northwestern |
Text
message reminders to improve adolescent clinic attendance |
8,700 |
APA |
| Srilakshmi
Gnansekaran |
Harvard
Medical School |
Child
health policy and asthma: a multilevel analysis |
9,200 |
AHRQ |
| Stephen
Pont |
Vanderbilt
U. |
Healthcare
encounters due to diarrheal illness in children |
9,953 |
AHRQ |
| Sheela
Sathayanarayana |
U.
Washington |
Is
ambient air pollutant exposure associated with preterm and
small for gestational age birth in the Puget Sound air basin? |
9,996 |
AHRQ |
|
