PCORI Answers Critical Questions
From infancy and childhood through adolescence, children and their caregivers have changing needs and preferences for care—even without a serious health condition. To explore those issues, PCORI funds studies to help children and those who care for them answer critical healthcare questions, such as:
Parent: I’m concerned about the long-term effects of antibiotics, including how they may contribute to weight gain. What is the latest information on how antibiotic overuse may increase my child’s risk of having obesity?
Pediatrician: Many of my patients are Latino children who have asthma. What are the most effective ways of educating my patients and their parents about how to control asthma symptoms?
Child Psychologist: I often recommend cognitive behavioral therapy (CBT) for my patients who have obsessive compulsive disorder. Is CBT performed both in my office and in the patient’s home more effective than office-based therapy alone?
Evidence Updates from PCORI-Funded Studies
|Choosing the Best Option for Managing Mild Persistent Asthma in Children
Asthma is a common chronic illness among children in the US, with disproportionate impact among racial and ethnic minorities. A recent PCORI-funded study, which focused exclusively on African-American children, who have traditionally been underserved in research and have had worse asthma-related health outcomes than other children, looked at two different approaches to managing mild persistent asthma. A pair of Evidence Updates is now available to help support conversations between parents and clinicians about choosing the best option for managing mild persistent asthma in children.
Study Results that Support Better-Informed Decisions
|Informing Treatment of Juvenile Arthritis
Clinicians and patients have been uncertain about the optimal time to start biologics for polyarticular juvenile idiopathic arthritis (pJIA). However, results from a PCORI-funded study, published in Arthritis & Rheumatology, provide useful new evidence about first-line treatment options for this disease. Researchers compared the effectiveness of three treatment approaches among 400 children with pJIA. The approaches included starting patients on a non-biologic disease-modifying antirheumatic drug (DMARD) only, starting patients with a DMARD and a biologic medication, and starting patients with a biologic only. After one year, the approaches did not differ significantly in achieving clinically inactive disease without the use of glucorticoids, and patients reported decreased pain interference levels and increased mobility with all three approaches.
|The Effect of Treatment Duration for Newborn Infants Who Have Seizures
Every year, about 16,000 newborns in the United States have seizures. Medications can treat seizures but can also have serious side effects and may harm children’s brain development. A PCORI-funded study at University of Michigan compared functional development outcomes of 270 newborns who developed seizures due to acute brain injury in the first days to weeks after birth and were treated with antiseizure medication (ASM) prior to hospital discharge and those who continued ASM after hospital discharge. Reporting in JAMA Neurology, the study found that after two years, children in both groups did not differ significantly in their functional development and risk of epilepsy. These results support discontinuation of ASM prior to hospital discharge for most newborns with acute symptomatic neonatal seizures.
Children's Health Study Spotlights
People living with intellectual and developmental disabilities (IDD) and their families often face barriers to participating in their own communities. These challenges can include a building’s design that makes entry difficult to misperceptions about a person’s behavior. An occupational therapist is leading a PCORI-funded project to make community participation easier for people with IDD and their families.
Hospital staff look for signs of abuse in children cared for in emergency rooms but don’t always order standard tests that help detect child abuse. This study found that clinicians were more likely to check for and report suspected abuse when prompted by an alert system built into the hospital’s electronic health record. PCORI is now funding a project to implement the system in other children’s hospitals.
When bacteria cause an ear, nose, or throat infection in children, a clinician may prescribe narrow- or broad-spectrum antibiotics. This study found that narrow-spectrum antibiotics worked just as well as broad-spectrum antibiotics. Also, children taking narrow-spectrum antibiotics had fewer side effects than children taking broad-spectrum antibiotics.