Results Summary and Professional Abstract
Results of This Project
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Picking the Easier Way to Fight Serious Infections in Children
This feature story highlights how doctors sometimes prescribe antibiotics delivered intravenously, while new research suggests oral antibiotics can be as effective, with fewer complications.
Treating Serious Infections in Children
Study Principal Investigator Ron Keren, MD, MPH and his team compared oral antibiotics with IV antibiotics received via a central line in children after hospitalization for bone disease. .
Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.
The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments.
Peer review identified the following strengths and limitations in the report:
- The awardee addressed reviewers’ concerns about the generalizability of study results and the report’s inadequate emphasis on study population characteristics in the final report. Reviewers noted that the study population consisted of children considered low risk for reinfection or treatment failure, who only make up about 25-30 percent of all children requiring antibiotics for serious infections. The awardee responded that the study protocol and published papers clearly indicated that the children in this study were low risk.
- The awardee addressed comments from the statistical reviewer by referring the reader to previously published papers that have details on study methods and analyses.
- Responding to reviewer requests for more details on the methods for insuring consistency and limiting interrater variability, the awardee added language describing chart reviewers’ training. The awardee also noted that the team did not measure how often different raters disagreed in their reviews of medical charts.
- The investigator did not respond to reviewers’ questioning of the conclusion that there were no differences in treatment failure on oral antibiotics between hospitals that had low versus high use of peripherally inserted central catheters. The lack of sample sizes for this comparison and the wide confidence intervals for the odds ratio did not provide sufficient evidence to warrant this conclusion.
Conflict of Interest Disclosures
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