Tag Archive for: data analysis

Smiling boy in hospital bed

Perspective: Rethinking racial benchmarks in pediatric safety events

Smiling boy in hospital bed

The research team estimated that 754 pediatric safety events could be avoided annually if all racial groups performed as well as the top-rated group for each type of safety event studied.

Quality and safety would improve in pediatric healthcare – for all races – if the practice of benchmarking outcomes and performance against white patients changed. Instead, investigators should consider using the best-performing group to improve healthcare disparities, according to a new Pediatrics perspective from a multi-center research team led by Children’s National Hospital.

The team examined seven pediatric safety indicators from their previous research, including postoperative infection and accidental lacerations. They determined the best-performing group was not always the white subset, but data in scientific research is often benchmarked against white patients. This can perpetuate racism and erroneously imply that white patients should define the standard for healthcare, the investigators found.

The patient benefit

The research team estimated that 754 pediatric safety events could be avoided annually if all racial groups performed as well as the top-rated group for each type of safety event studied. For some safety events, this would require benchmarking against Black, Hispanic, Asian and Pacific Islander populations.

“By looking at the data with a new lens, we believe that clinicians and researchers could make a major step forward in shrinking and eliminating disparities across pediatric healthcare,” said Kavita Parikh, M.D., MSHS, medical director of Quality & Safety Research and research director of the Division of Hospital Medicine at Children’s National. “If we can employ a more precise understanding of patient and family experience as they interact with the healthcare system, we can prevent negative outcomes that can impact entire lifetimes.”

What’s ahead

The multi-center team continues to work on ways to improve quality and safety at pediatric hospitals. With broad partnerships, the researchers hope to redesign national safety models to encourage hospitals to overcome health-equity hurdles, such as racism, language barriers and other social factors that lead to disparities.

“This call to action is not new, but it demands renewed urgency,” said Dr. Parikh, the first author of the perspective. “We propose future analyses that infuse antiracist principles with quality improvement and patient safety standards to design more effective interventions.”

You can read the complete perspective – “Analyzing Pediatric Safety Events Using Antiracist Principles” – in Pediatrics.

Pediatric research consortia unveil CAVATICA data platform

Javad Nazarian, PhD, MSC, joined peers from prestigious children’s hospitals from around the world.

Dr. Nazarian’s lab at Children’s is part of the CBTTC, which has helped in launching CAVATICA. Pictured (from left to right): Dr. Nazarian, Sabine Mueller, M.D., Ph.D. (PNOC Trial Director), Rishi Lulla, M.D. (CBTTC Executive Director), Francis Collins, M.D., Ph.D., (NIH Director), and Adam Resnick, PHD (CBTTC Scientific Director).

Earlier this week, The White House released the Cancer Moonshot report, which calls upon the public and private sectors to transform cancer research and care. Children’s National’s Javad Nazarian, Ph.D., M.S.C.,  joined peers from prestigious children’s hospitals from around the world at the news conference. Dr. Nazarian is a key player in the initiative, as his lab is part of the Children’s Brain Tumor Tissue Consortium (CBTTC) and is answering the call to action. The CBTTC and the Pacific Pediatric Neuro-Oncology Consortium, in partnership with Seven Bridges, announced the launch of CAVATICA, a data analysis platform that will help researchers to collaboratively access and share data about pediatric cancers, congenital disorders and rare diseases such as epilepsy and autism. More data will be connected than ever before—CAVATICA will interoperate with the Genomic Data Commons and other NIH data repositories. “It’s an exciting time for research,” says Dr. Nazarian.

Unlocking the ‘black box’ of NICU monitors to protect vulnerable preemies

MiningdatafromNICUmonitors

What’s Known
Around the world, some 15 million infants are born prematurely each year. Babies born prematurely can spend their first weeks to months of life in the neonatal intensive care unit (NICU) tethered to machines that closely monitor vital signs, such as breathing and heart rate.

After discharge, preemies have a very high risk of returning to the NICU, often due to breathing difficulties, such as experiencing excessively long pauses between breaths. Such acute life-threatening events are a major cause of preemies’ hospital readmission and may result in death.

What’s New
During infants’ NICU stays, cardiorespiratory monitors amass a mountain of data about each child. Through the unprecedented collaboration of researchers working in various divisions of Children’s National Health System, the team was able to unlock that black box of information by creating algorithms to extract data and by using retrospective analyses to tease out new insights. This multidisciplinary team has been able to predict with a greater degree of precision which babies are at higher risk of returning to the NICU after discharge. What these most vulnerable preemies have in common is the degree of maturation of their autonomic nervous system, which controls such involuntary actions as heart rate and breathing. The sympathetic nervous system, which the body leverages as it copes with the stress of life-threatening events (ALTE), also plays a role in these infants’ heightened vulnerability. Being able to identify these newborns earlier has the potential to lower readmissions and save lives.

Questions for Future Research
Q: How can further computer-based analyses of NICU monitor data be used to determine how preemies respond to routine activities, such as feeding to predict which infants have compromised cardiorespiratory systems?
Q: How can we develop a test to assess all premature infants for physiologic readiness for safe NICU discharge and, thus, prevent ALTE and sudden death in this vulnerable population?

Source: “Vagal Hypersensitivity in Premature Infants and Risk of Hospital Readmission Due to Acute Life-Threatening Events (ALTE).” G. Nino, R. Govindan, T. AlShargabi, M. Metzler, R. Joshi, G. Perez, A.N. Massaro, R. McCarter, and A. du Plessis. Presented during the 2016 Pediatric Academic Societies Annual Meeting, Baltimore, MD. May 2, 2016.