Using Fitbit data from the the largest long-term study of brain development and child health in the United States, researchers employed machine learning to test whether physiological markers could accurately predict ADHD diagnoses.
A new study published in Frontiers in Child and Adolescent Psychiatry reveals that common wearable devices like Fitbits may hold the key to improving how we identify Attention-Deficit/Hyperactivity Disorder (ADHD) in adolescents. By analyzing patterns in heart rate, activity levels and energy expenditure, researchers were able to predict ADHD diagnoses with striking accuracy, offering a glimpse into a future where objective, real-time data supports earlier and more personalized mental healthcare.
A fresh approach to a common challenge
ADHD affects approximately 1 in 10 children and adolescents in the United States. It is typically diagnosed based on parent and teacher reports, clinical interviews and behavioral observations. While effective, these methods rely heavily on subjective interpretation and can sometimes miss important nuances in how symptoms appear over time. This study, led by Muhammad Mahbubur Rahman, PhD, and colleagues at Children’s National, sought to determine whether wearable health data could help fill that gap.
Turning Fitbit metrics into meaningful insights
The study used data from 450 adolescents who were part of the larger Adolescent Brain Cognitive Development (ABCD) study, the largest long-term study of brain development and child health in the United States. Each participant wore a Fitbit, which captured three key activity and physiological measures:
Resting Heart Rate (RHR) – the number of heart beats per minute while the body is at rest
Sedentary Time – time spent with little or no physical activity
Energy Expenditure – estimated calories burned through physical activity
When the researchers compared these measures between teens with and without ADHD, they found statistically significant differences. Teens with ADHD had consistently higher resting heart rates and showed distinctive patterns in both their movement and stillness.
To go further, the team applied a machine learning model to test whether these physiological markers could accurately predict ADHD diagnoses. The model performed extremely well with 89% accuracy, 88% precision, 90% recall and a 0.95 area under the curve (AUC). These results suggest that the combination of passive, continuous data and predictive modeling could serve as a valuable screening tool, particularly in settings where full clinical evaluations are difficult to access.
A path toward more accessible mental healthcare
The implications are big. If validated in larger and more diverse populations, wearable-derived data could offer a low-cost, low-burden way to flag teens who might benefit from further ADHD evaluation. This could lead to earlier support, fewer misdiagnoses and more tailored treatment strategies.
Importantly, this approach isn’t about replacing clinicians, it’s about giving them better tools. Real-world, real-time data from wearables could act as an additional layer of insight that supports more precise, individualized care. As wearable technology becomes more embedded in daily life, its role in healthcare, especially adolescent mental health, is poised to grow.
Dr. Tarini has extensively studied policies to optimize the delivery of genetic services for newborns and their families.
Children’s National Hospital named Beth A. Tarini, MD, MS, MBA, as the Richard and Agnes Hudson Endowed Chair in Health Services Research at Children’s National Hospital.
Dr. Tarini, a pediatrician, is the Co-Director of the Center for Translational Research in the Children’s National Research Institute, the hospital’s Director of Resident Research and a professor of pediatrics at George Washington University.
The big picture
Dr. Tarini joins a distinguished group of Children’s National physicians and scientists with an endowed chair. Children’s National is grateful to generous donors who have funded 51 professorships altogether.
Professorships support groundbreaking work on behalf of children and their families and foster new discoveries and innovations in pediatric medicine. These appointments carry prestige and honor that reflect the recipient’s achievements and the donor’s commitment to advancing and sustaining knowledge.
Why it matters
Dr. Tarini has extensively studied policies to optimize the delivery of genetic services for newborns and their families. She has obtained $10 million in federal and foundation funding. A national leader in her field, she has served as president of the Society for Pediatric Research and as an appointed member of the Advisory Committee on Heritable Disorders in Newborns and Children. In the latter role, she helped advise the Secretary of the U.S. Department of Health and Human Services on the most appropriate application of universal newborn screening tests, technologies, policies, guidelines and standards.
“It’s an honor to receive the Hudson Chair, which allows me to bridge research and real-world impact,” says Dr. Tarini. “With this support, I will continue working to translate scientific discovery into better genetic services and policy for all newborns and their families.”
The visionary investment from the estate of Richard and Agnes Hudson will ensure that Dr. Tarini and future chairholders can launch bold new initiatives to rapidly advance the field of health services research, elevate the hospital’s academic leadership and improve the health and well-being of children.
https://innovationdistrict.childrensnational.org/wp-content/uploads/2025/05/Beth-Tarini-feature.jpg300400Innovation Districthttps://innovationdistrict.childrensnational.org/wp-content/uploads/2023/12/innovationdistrict_logo-1-1030x165.pngInnovation District2025-05-19 10:54:132025-05-19 10:56:26Honor bestowed on Beth A. Tarini, MD, MS, MBA
Children’s National Hospital hosted its fifteenth annual Research, Education and Innovation Week from March 31–April 4, 2025, bringing together clinicians, scientists, educators and innovators from across the institution to celebrate discovery and collaboration. This year’s theme, “Empowering the Future in Pediatric Research and Innovation with Equity, Technology and a Global Reach,” served as a call to action for advancing science that improves child health both locally and around the world.
Each day of the week-long event featured thought-provoking lectures — now available to watch — dynamic panel discussions, interactive workshops and vibrant poster sessions, all highlighting the diverse and interdisciplinary work taking place across Children’s National.
Centering the patient and the planet
REI Week began on Monday with a powerful keynote lecture from Lynn R. Goldman, MD, MS, MPH, Michael and Lori Milken dean of the Milken Institute School of Public Health at the George Washington University. In her talk, “Children: Uniquely vulnerable to climate-related threats,” Dr. Goldman underscored the urgent need to protect children from the environmental hazards of a changing climate and to integrate climate science into pediatric care and advocacy.
At mid-morning, Mary-Anne “Annie” Hartley, MD, PhD, MPH, director of the LiGHT Laboratory at École Polytechnique Fédérale de Lausanne, introduced the “MOOVE” platform — Massive Open Online Validation and Evaluation of clinical LLMs. Her talk demonstrated how artificial intelligence, when rigorously validated, has the potential to transform clinical decision-making and global health equity.
Monday’s final keynote, “Zinc and childhood diarrhea,” was presented by Christopher Duggan, MD, MPH, director of the Division of Nutrition at Harvard Medical School. Dr. Duggan highlighted the global health impact of zinc supplementation in reducing childhood mortality — a reminder that simple, evidence-based interventions can save millions of lives.
In that first day, the first poster session of the week showcased projects in adolescent medicine, global health, infectious diseases, oncology and more. The session reflected the full breadth of research taking place across Children’s National.
Ambroise Wonkam, MD, PhD, professor of genetic medicine at Johns Hopkins University, then delivered Tuesday’s Global Health Keynote Lecture, “Harnessing our common African genomes to improve health and equity globally.” His work affirmed that inclusive genomics is key to building a healthier world.
Later, the Global Health Initiative event and GCAF Faculty Seminar encouraged attendees to pursue collaborative opportunities at home and abroad, reflecting the growing global footprint of Children’s National research programs.
Transforming education and care delivery
On Wednesday, Larrie Greenberg, MD, professor emeritus of pediatrics, kicked off the day with a Grand Rounds keynote on educational transformation: “Shouldn’t teachers be more collaborative with their learners?” He followed with a CAPE workshop exploring the effectiveness of case-based learning.
In the Jill Joseph Grand Rounds Lecture, Deena J. Chisolm, PhD, director of the Center for Child Health Equity at Nationwide Children’s Hospital, challenged attendees to move beyond dialogue into action in her talk, “Health equity: A scream to a whisper?,” reminding researchers and clinicians that advocacy and equity must be foundational to care.
The day continued with a poster session spotlighting medical education, neonatology, urology and neuroscience, among other fields.
Posters and pathways to progress
Throughout the week, poster sessions highlighted cutting-edge work across dozens of pediatric disciplines. These sessions gave attendees the opportunity to engage directly with investigators and reflect on the shared mission of discovery across multiple disciplines, including:
The REI Week 2025 Awards Ceremony celebrated outstanding contributions in research, mentorship, education and innovation. The winners in each category were:
POSTER SESSION AWARDS
Basic & Translational Research
Faculty: Benjamin Liu, PhD
“Genetic Conservation and Diversity of SARS-CoV-2 Envelope Gene Across Variants of Concern”
Faculty: Steve Hui, PhD
“Brain Metabolites in Neonates of Mothers with COVID-19 Infection During Pregnancy”
Faculty: Raj Shekhar, PhD
“StrepApp: Deep Learning-Based Identification of Group A Streptococcal (GAS) Pharyngitis”
Post docs/Fellows/Residents: Dae-young Kim, PhD
“mhGPT: A Lightweight Domain-Specific Language Model for Mental Health Analysis”
Post docs/Fellows/Residents: Leandros Boukas, MD, PhD
“De Novo Variant Identification From Duo Long-Read Sequencing: Improving Equitable Variant Interpretation for Diverse Family Structures”
Staff: Naseem Maghzian
“Adoptive T Lymphocyte Administration for Chronic Norovirus Treatment in Immunocompromised Hosts (ATLANTIC)”
Graduate Students: Abigail Haffey
“Synergistic Integration of TCR and CAR T Cell Platforms for Enhanced Adoptive Immunotherapy in Brain Tumors”
High School/Undergraduate Students: Medha Pappula
“An ADHD Diagnostic Interface Based on EEG Spectrograms and Deep Learning Techniques”
Clinical Research
Faculty: Folasade Ogunlesi, MD
“Poor Air Quality in Sub-Saharan Africa is Associated with Increase Health Care Utilization for Pain in Sickle Cell Disease Patients”
Faculty: Ayman Saleh, MD
“Growth Parameters and Treatment Approaches in Pediatric ADHD: Examining Differences Across Race”
Post docs/Fellows/Residents: Nicholas Dimenstein, MD, MPH
“Pre-Exposure Prophylaxis (PrEP) Eligibility in the Pediatric Emergency Department”
Staff: Tayla Smith, MPH
“The Public Health Impact of State-Level Abortion and Firearm Laws on Health Outcomes”
Graduate Students: Natalie Ewing
“Patterns of Bacteriuria and Antimicrobial Resistance in Patients Presenting for Primary Cloacal Repair: Is Assisted Bladder Emptying Associated with Bacteriuria?”
Graduate Students: Manuela Iglesias, MS
“Exploring the Relationship Between Child Opportunity Index and Bayley-III Scores in Young Children”
High School/Undergraduate Students: Nicholas Lohman
“Preliminary Findings: The Efficacy, Feasibility and Acceptability of Group Videoconference Cognitive Behavioral Therapy with Exposure and Response Prevention for Treating Obsessive-Compulsive Disorder Among Children and Young People”
Community-Based Research
Faculty: Sharon Shih, PhD “Assessing Pediatric Behavioral Health Access in DC using Secret Shopper Methodology”
Post docs/Fellows/Residents: Georgios Sanidas, MD “Arrested Neuronal Maturation and Development in the Cerebellum of Preterm Infants”
Staff: Sanam Parwani
“Intersectionality of Gender and Sexuality Diversity in Autistic and Non-Autistic Individuals”
Graduate Student: Margaret Dearey “Assessing the Burden of Period Poverty for Youth and Adolescents in Washington, DC: A Pilot Study”
Quality and Performance Improvement
Faculty: Nichole L. McCollum, MD
“A Quality Improvement Study to Increase Nurse Initiated Care from Triage and Improve Timeliness to Care”
Post docs/Fellows/Residents: Hannah Rodriguez, MD
“Reducing Unnecessary Antibiotic Use in a Level IV NICU”
Staff: Amber K. Shojaie, OTD, OTR/L
“Implementing Dynamic Axilla Splints in a Large Burn Patient”
Meleah Boyle, PhD, MPH
“Understanding and Addressing Environmental Sustainability to Protect the Health of the Children’s National and Global Communities”
Eiman Abdulrahman, MD
“Research Capacity Building to Improve Pediatric Emergency and Critical Care in Ethiopia”
Pilot Awards
Alexander Andrews, MD
“EEG as a Diagnostic and Prognostic Marker in Severe Pediatric Malaria, Blantyre Malawi”
Daniel Donoho, MD & Timothy Singer, MD
“Feasibility Study of a Novel Artificial Intelligence-Based Educational Platform to Improve Neurosurgical Operative Skills in Tanzania”
Hasan Syed, MD
“Bridging the Gap an Educational Needs Assessment for Pediatric Neurosurgery Training in Pakistan”
Sofia Perazzo, MD & Lamia Soghier, MD, MEd, MBA
“QI Mentorship to Improve Pediatric Screening and Follow-up in Rural Argentina”
Benjamin Liu, PhD
“AI-Empowered Real-Time Sequencing Assay for Rapid Detection of Schistosomiasis in Senegal”
Rae Mittal, MD
“Assessment and Enhancement of Proficiency in Emergency Child Neurology Topics for Post-Graduate Emergency Medicine Trainees in India”
Innovation Day ignites bold thinking
Thursday, REI Week shifted to the Children’s National Research & Innovation Campus for Innovation Day, a celebration of how bold ideas and collaborative culture can accelerate progress in pediatric medicine.
REI Week 2025 reaffirmed the values that define Children’s National: a commitment to excellence, collaboration and equity in pediatric research and care. As discoveries continue to emerge from our hospital and our research campuses, the connections built and ideas sparked during this week will help shape the future of pediatric health — locally and globally.
By elevating voices from the bedside to the bench, with the support of the executive sponsors Nathan Kuppermann, MD, MBChB, Catherine Bollard, MBChB, MD, Kerstin Hildebrandt, MSHS, Linda Talley, MS, RN, NE-BC and David Wessel, MD, REI Week demonstrated that we must embrace the community in all aspects of our work. Because we know that there are answers we can only get from the patients that we serve—and we need to be their voice.
Research, Education & Innovation Week will be back next year on April 13-17, 2026.
Posters at the REI Week 2025 Monday, March 31 poster session.
Panelists discuss innovation during REI Week 2025.
Global Health Initiative community engagement event during REI Week 2025.
Chris Rees presents his REI Week 2025 lecture.
Nathan Kuppermann listens to a presenter during the REI Week 2025 Tuesday, April 1, poster session.
Michelle Riley-Brown, Nathan Kuppermann, Catherine Bollard and Naomi Luban on stage during the REI Week 2025 awards ceremony.
Brandy Salmon presents on innovation programs at Virginia Tech during the REI Week 2025 Innovation Day.
Catherine Bollard listens to a presenter during the REI Week 2025 Monday, March 21 poster session.
Ambroise Wonkman poses for a picture with Children’s National staff.
Tanzeem Choudhury presenting during REI Week 2025.
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The Children’s National 2023-2024 Academic Annual Report show on a tablet.
Children’s National Hospital has released its 2023-2024 Academic Annual Report, showcasing a year of transformative progress in pediatric medicine. The report highlights achievements across its research centers, institutes and Innovation Ventures, underscoring the hospital’s role as a leader in advancing child health through innovation and collaboration.
“This year’s report reflects the remarkable progress we have made in advancing the frontiers of pediatric medicine,” said Nathan Kuppermann, MD, MPH, Chief Academic Officer and Chair of Pediatrics. “It highlights groundbreaking work across our research centers, institutes, and Innovation Ventures, showcasing the collaborative spirit that drives our mission forward. These achievements underscore our shared commitment to delivering transformative research and the best possible outcomes for children and families.”
Delivering across centers
The report captures the contributions of each of Children’s National’s research centers, each pushing the boundaries of pediatric healthcare:
Center for Cancer & Immunology Research (CCIR): Delivering on the promise of cell and gene therapies, offering innovative treatments for pediatric cancers and immune disorders.
Center for Genetic Medicine Research (CGMR): Advancing pediatric genetic medicine through interdisciplinary efforts, addressing complex genetic conditions with cutting-edge science.
Center for Neuroscience Research (CNR): A year of growth in scientific excellence, advancing the understanding of brain development and neurological conditions.
Center for Prenatal, Neonatal & Maternal Health Research (CPHNMR): Revolutionizing neonatal care with its pioneering infant brain health neuromonitoring program.
Center for Translational Research (CTR): Facilitating groundbreaking work by new K awardees and driving translational research to bridge the gap between discovery and clinical care.
Sheikh Zayed Institute for Pediatric Surgical Innovation (SZI): Leading the way in advanced research projects in pediatric surgery, pushing technological boundaries to improve outcomes for children worldwide.
Taking the lead in innovation through collaboration
Innovation Ventures at Children’s National is advancing pediatric health security, addressing unique challenges with transformative solutions. Meanwhile, the Children’s National Research & Innovation Campus (CNRIC) continues to thrive as a hub for discovery and collaboration, hosting conferences on topics like artificial intelligence in healthcare, cell and gene therapy, and pediatric epilepsy research.
A vision for the future
The report also highlights Children’s National’s focus on integrating cutting-edge technologies like artificial intelligence into its research and clinical practices, as well as addressing global health challenges such as the effects of climate change on children’s health. These efforts reflect the hospital’s commitment to improving outcomes for children everywhere through innovation, teamwork, and forward-thinking leadership.
The 2023-2024 Academic Annual Report serves as a testament to the dedication and expertise of the Children’s National community, showcasing how collaboration and innovation are shaping the future of pediatric healthcare.
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Some students may be exposed to nearly twice the annual dose of natural background radiation, estimated by the U.S. Nuclear Regulatory Commission at 3.1 mSv (310 mrem).
A Children’s National Hospital researcher teamed up with a high school student from Bethlehem, Pa., to shed light on radon, a silent health risk that may be present in some schools.
They examined radon levels in five eastern Pennsylvania school districts. The neighborhoods surrounding all 37 public schools had average radon levels exceeding the federal action level, or 4.0 pCi/L. According to their findings, the same could be true of the school buildings.
In a new research letter published in JAMA Network Open, researchers found some students may be exposed to nearly twice the annual dose of natural background radiation, estimated by the U.S. Nuclear Regulatory Commission at 3.1 mSv (310 mrem).
An odorless and invisible gas, radon is the leading cause of lung cancer among nonsmokers and the second overall cause of lung cancer nationwide. Its greatest danger lies in prolonged exposure, a risk amplified in school settings where children and teachers spend extensive hours. The U.S. Environmental Protection Agency (EPA) estimates more than 70,000 classrooms have high short-term radon levels.
“This study highlights the urgent need for radon testing in schools,” said Beth Tarini, M.D., M.S., M.B.A., co-director of the Center for Translational Research at Children’s National and the manuscript’s senior author. “Unchecked exposure to radon in these settings could have significant short- and long-term health effects, particularly for children.”
The EPA has found that approximately 20% of schools nationwide have done some testing, and only . In the Washington, D.C., region, Dr. Tarini says testing is often done:
The District of Columbia requires public schools to test for radon and publicize the results. If the results are above the federal limit of >4pCi/L, the schools are required to mitigate the risk.
Maryland doesn’t require schools to test for radon, but some schools test. The state’s largest school district — Montgomery County Public Schools — has been testing for radon since the late 1980s and retests facilities every five years.
In Virginia, the commonwealth requires public schools to test for radon, make the results public and report the results to the state.
Brian Yang, the study’s first author, called for action in Pennsylvania and regions with known radon risks.
“This research underscores the need to test radon levels in schools and, if necessary, mitigate,” said Yang, a senior at Moravian Academy in Bethlehem, Pa. “Addressing this invisible and under-recognized threat should be a public health priority.”
https://innovationdistrict.childrensnational.org/wp-content/uploads/2024/12/kids-in-school-CNRI.jpg385685Innovation Districthttps://innovationdistrict.childrensnational.org/wp-content/uploads/2023/12/innovationdistrict_logo-1-1030x165.pngInnovation District2024-12-09 10:58:462024-12-09 11:00:02Radon in school: A hidden worry for eastern Pennsylvania students
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.”
Dr. Tarini will also receive the 2025 Norman J. Siegel New Member Outstanding Science Award for her considerable contributions to pediatric science during the APS Presidential Plenary at the Pediatric Academic Societies 2025 Meeting in Honolulu, Hawaii, April 24 – April 28.
“I am deeply honored to receive the Norman J. Siegel New Member Outstanding Science Award from the American Pediatric Society,” said Dr. Tarini. “This recognition is a testament to the steadfast encouragement and support I have received from my mentors, colleagues, and family throughout my journey. I consider the opportunity to conduct research that optimizes health services for children and their families a privilege and a joy.”
APS members are recognized child health leaders of extraordinary achievement who work together to shape the future of academic pediatrics. Current members nominate new members by recognizing individuals who have distinguished themselves as child health leaders, teachers, scholars, policymakers and clinicians.
“I am deeply honored to be selected as a member of the American Pediatric Society,” said Dr. Zaveri. “I look forward to the opportunity to engage with esteemed leaders in pediatrics across various disciplines as we work together to advance the society’s mission and contribute to the growth of pediatrics through research and mentorship.”
Benefits of APS membership include:
Recognition and acknowledgment as a leader in pediatrics: APS members include individuals who have distinguished themselves as academic leaders, teachers and researchers whose contributions to academic pediatrics have garnered national and international recognition.
A network of child health professionals: Membership in APS is dedicated to the advancement of child health through the promotion of pediatric research, recognition of achievement and cultivation of excellence through advocacy, scholarship, education and leadership development.
Advocacy for child health: In order to speak with one voice on behalf of child health, APS provides representation in Washington, D.C., through the Pediatric Policy Council which combines the advocacy efforts of the APS, the Society for Pediatric Research, the Association of Medical School Pediatric Department Chairs and the Academic Pediatric Association.
“I am grateful to accept this honor from the APS,” said Dr. Koutroulis. “As both a physician and a researcher, I look forward to collaborating with distinguished experts within this network to help advance the development of pediatric care.”
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By becoming highly “pediatric ready,” emergency departments could prevent the deaths of 2,143 children each year with an annual cost between $0 and $12 per child resident, depending on the state.
In emergencies, children have distinct needs. Yet 83% of emergency departments (EDs) nationwide are not fully prepared to meet them. A new study has found that bridging that gap, known as becoming highly “pediatric ready,” could prevent the deaths of 2,143 children each year with an annual cost between $0 and $12 per child resident, depending on the state.
“Our country can afford it, and we owe it to our children to do it,” says the study’s senior author Nathan Kuppermann, M.D., chair of Pediatrics and chief academic officer at Children’s National Hospital.
The research team – led by Oregon Health & Science University and Children’s National – analyzed data from 4,840 EDs, focusing on 669,019 children at risk for death upon seeking care. Using predictive models, they assessed how every ED achieving high pediatric readiness – defined as scoring at least 88 out of 100 on the National Pediatric Readiness Project assessment – could impact mortality rates.
“The National Pediatric Readiness Project outlines essential pediatric capabilities for EDs, such as the availability of essential pediatric equipment and pediatric-specific training,” says Dr. Kuppermann, an emergency medicine physician. “While a perfect score of 100 is ideal, past research shows a score of 88 or higher can reduce mortality risk by up to 76% for ill children and 60% for injured children.”
Why it matters
In Maryland, an additional cost of $1.10 per child could save 17 pediatric lives annually, adjusted for population size. In Virginia, $2.42 per child could save 29 lives annually, and $1.59 per child in the District of Columbia could save 16 lives annually. The research team said strategies for implementing the findings would require regulation, incentives and policy-based initiatives.
“This study builds on a growing body of research demonstrating that every hospital can and must be ready for children’s emergencies,” says lead author Craig Newgard, M.D., M.P.H., an emergency physician at Oregon Health & Science University. “For the first time, we have comprehensive national and state-by-state data that emphasizes both the urgency and feasibility of this work.”
The patient benefit
“Our country can afford it, and we owe it to our children to do it,” says the study’s senior author Nathan Kuppermann, M.D., chair of Pediatrics and chief academic officer at Children’s National Hospital.
By applying the potential reduction in mortality associated with high readiness to the number of children at risk of death, the researchers identified the number of lives that could be saved each year. State-specific estimates, adjusted for population size, ranged from 0 preventable deaths in Delaware to 69 in South Dakota.
“Achieving high readiness levels can be challenging for small emergency departments with fewer resources, typically in more rural areas. The result is significant inequity and large healthcare deserts in pediatric emergency care across the United States,” Dr. Kuppermann says. “Yet we found the cost of elevating care to the highest quartile of pediatric readiness is not very high.”
What’s next
The study authors estimate achieving universal high pediatric readiness across the United States would cost approximately $207 million annually. Per-child costs by state to raise ED readiness from current levels ranged from $0 to $12 per year.
“This research emphasizes the urgent need for widespread investment in pediatric readiness,” says Kate Remick, M.D., co-author and emergency physician with the Dell School of Medicine at the University of Texas at Austin. “The National Pediatric Readiness Project has provided a roadmap for improvement. But we need the full engagement of clinicians, healthcare administrators, policymakers and families to make universal pediatric readiness a reality.”
The study outlines several strategies to improve pediatric emergency care, such as integrating high pediatric readiness into hospital accreditation requirements and incentivizing readiness through performance-based reimbursement models.
This study was funded by a Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) Emergency Medical Services for Children Targeted Issue grant (H34MC33243-01-01) and an HHS National Institutes of Health (NIH) Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) grant (R24 HD085927). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HHS, HRSA, NIH, or the U.S. Government.
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“It is an absolute honor and privilege to be elected to the National Academy of Medicine,” Dr. Goyal said. “I am committed to NAM’s mission of using science to inform policy for the achievement of health equity.”
The National Academy of Medicine (NAM) has elected Monika Goyal, M.D., M.S.C.E., to its international body of 2,400 leaders in medical sciences, healthcare and public health. One of the highest honors for physicians, the achievement is reserved for individuals who have demonstrated outstanding professional commitment and service.
Dr. Goyal, emergency medicine physician and co-director of the Center for Translational Research at Children’s National Hospital, was recognized for her national leadership in research focused on pediatric firearm injury prevention. She has spotlighted the burden of firearm violence on child health and advanced pediatric equity science. Her research has led to the development of interventions to address healthcare inequities.
“It is an absolute honor and privilege to be elected to the National Academy of Medicine,” Dr. Goyal said. “I am committed to NAM’s mission of using science to inform policy for the achievement of health equity.”
The big picture
The National Academy of Sciences established NAM in 1970 as the Institute of Medicine. The diverse organization requires that at least one-quarter of its membership be selected from fields outside the health professions, including law, engineering, social sciences and the humanities. NAM elected 90 regular and 10 international members during its recent annual meeting.
NAM works with the National Academy of Sciences and National Academy of Engineering. Upon election, NAM members commit to volunteering their services for National Academies activities.
Why we’re excited
“I am thrilled that Dr. Goyal is joining me in this incredible body that works to provide independent, objective analysis on complex scientific problems and public policy decisions,” said NAM member Nathan Kuppermann, M.D., M.P.H., chief academic officer and chair of Pediatrics at Children’s National. “Dr. Goyal’s contributions to pediatric health will be an incredible asset to the organization.”
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Children’s National Hospital in Washington, D.C., was ranked as a top hospital in the nation by the U.S. News & World Report 2024-25 Best Children’s Hospitals annual rankings. This marks the eighth straight year Children’s National has made the Honor Roll list. The Honor Roll is a distinction awarded to only 10 children’s hospitals nationwide.
This year, U.S. News ended ordinal rankings on its Honor Roll. Instead of assigning a numerical rank from 1 to 10, all hospitals on the Honor Roll will be recognized as having attained the highest standards of care in the nation.
In addition, Children’s National tied for #1 pediatric hospital in the Mid-Atlantic region, which includes New York, New Jersey, Delaware, Pennsylvania, the District of Columbia, West Virginia and Virginia. It’s also best in the Mid-Atlantic in Neonatology.
For the fourteenth straight year, Children’s National ranked in 10 specialty services. New this year, U.S. News included behavioral health as a service line in the rankings. Since it’s the first year, there are no ordinal rankings for behavioral health, but the Children’s National program was named one of the top 50 programs in the country.
“In my first year here, I witnessed what makes Children’s National so special — our commitment to collaboration, empowering one another, and charting a bold path forward for pediatric care,” said Michelle Riley-Brown, MHA, FACHE, president and chief executive officer of Children’s National. “I’m proud U.S. News again recognized Children’s National as one of the top in the nation and the highest-ranked pediatric hospital in D.C., Maryland and Virginia. Together, we’ll continue to push the boundaries of care, research and innovation to make a difference for those who matter most — the kids.”
The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals and recognizes the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News.
“For nearly two decades, U.S. News has published Best Children’s Hospitals to empower the parents and caregivers of children with complex medical needs,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “Children’s hospitals appearing on the U.S. News Honor Roll have a track record of delivering unparalleled specialized care.”
The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.
The Children’s National specialty services that U.S. News ranked in the top 10 nationally are:
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Global health leaders from Children’s National Hospital joined Malawian clinical experts in a two-day think tank to improve the care of children with seizures in the southern African nation. Details were published recently in a perspective in the American Journal of Tropical Medicine and Hygiene.
“The meeting was eye-opening,” said Douglas Postels, M.D., a pediatric neurologist and faculty member with the Center for Translational Research at Children’s National. “Outcomes are changed when we collaborate directly and work through the best solutions for clinical care in low-resource settings. You must weigh what clinics need, what they can implement, and the impact on public health.”
The big picture
Dr. Postels does research and provides clinical care at Queen Elizabeth Central Hospital (QECH), the largest public hospital in Malawi. “Queen’s” is the only medical setting in a country of over 20 million people where an electroencephalogram (EEG) and specialty pediatric neurology services are available. QECH is an essential — and often overtaxed — component of neurological care in Malawi. Cerebral malaria, epilepsy and seizures from birth asphyxia drive the need for neurological evaluations.
EEG is available at QECH for all hospitalized children and is principally used to evaluate for subclinical seizures in those who are comatose. One of three trained technicians acquires the EEG, which is electronically sent to the United States for interpretation. Under best-case scenarios, the turnaround time between EEG collection and interpretation from a neurologist in the U.S. is about two hours. However, many obstacles can slow results, including misaligned schedules across time zones, internet outages and other complications.
With the support of the Center for Translational Research, Dr. Postels brought five U.S.-based colleagues to Africa to meet with Malawian clinicians to better understand local clinical care needs. A think tank of U.S. and Malawian clinicians worked together to consider research directions and priorities for neurology care and EEG services. Their conversation focused extensively on integrating technology in the places where it will be most clinically useful.
The fine print
Dr. Postels’ research group aims to aid in the clinical care of Malawian children with epilepsy and to make EEG accessible outside of Queen’s hospital. They hope to eventually create a point-of-care EEG system, linking a method of EEG acquisition that requires little training to apply with a software-based interpretation system.
Expanding the use of EEG in Malawi and throughout Africa has numerous clinical applications. Malawian clinicians hoped that EEG could be made available at their local hospitals and folded into a more comprehensive care algorithm for children at risk of seizures — “one aspect of a ‘packet of care’ that included better overall understanding of seizures, criteria for administration of antiseizure medications, and transfer to the central hospital,” according to the journal article.
Malawian clinicians were also interested in using EEG to detect increased intracranial pressure after head trauma, as neuroimaging services are nearly as rare as EEG in Malawi. One pediatrician also wanted to use EEG to guide the treatment of neonatal seizures, which are common in children with birth asphyxia, and to use EEG as a prognostic biomarker.
“We hope to empower Malawian clinicians with clinical research skills and experiences so that they can lead and direct future discussions with patients, parents and stakeholders to advance neurologic care and research in their country,” Dr. Postels and his team wrote.
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Nathan Kuppermann, M.D., M.P.H., is taking on a pivotal role at Children’s National Hospital as executive vice president, the new chief academic officer (CAO) and chair of Pediatrics to continue growing the institution’s reputation as a world-class research hospital. He brings more than 30 years of clinical experience in pediatric emergency medicine and research to the leadership role, where he will oversee nearly 2,000 active research projects at the Children’s National Research Institute.
Dr. Kuppermann knows that science drives cures and improved outcomes. Early in his career, he received enhanced research training at the Harvard School of Public Health, where he laid the groundwork to become a globally recognized clinical researcher. He has studied when to order CT scans for children with head, abdominal and neck trauma to minimize radiation exposure, how to best manage children with diabetic ketoacidosis, infants with febrile illnesses and other complex questions in pediatric emergency medicine that require a multidisciplinary research approach to improve clinical care.
Dr. Kupperman is thrilled to join the scientific community in the nation’s capital, which he sees as a global city where he can authentically share his culturally rich background. He is the son of Brazilian immigrants — a chemical physicist and an organic chemist — and he married a pediatric endocrinologist whose parents are from Mexico and Germany. They have three daughters, and their youngest was adopted from Guatemala. As a family, they travel extensively, and he cares deeply about global health, having served as associate dean for Global Health at UC Davis.
A high school point guard who still plays basketball, Dr. Kuppermann runs his team’s offense on the court, choreographing the flow of each game to optimize his team’s strengths. The position requires peripheral vision to get the ball to the right player and make everyone look good. He sees parallels with his new role as CAO.
Q: What is your approach to research in pediatric healthcare?
A: Fundamentally, my philosophy around research is that we all need to collaborate. When I started doing my own research, I realized over time that to have big, impactful studies, two things had to happen: First, you need to work with people who have expertise beyond your own. I’m a big believer in team science and bench-to-bedside research, collaborating with people with complementary research skills.
Second, I realized that in pediatric research, you must collaborate in research networks to ensure your sample size has enough patients and patients from diverse populations to have definitive results and generalizable data.
Q: What values will you bring to the new role?
A: Three key elements come to mind. First, I’m a big believer in transparent communication, which is the root of everything good in life, whether it’s with your science, your friendships or your family.
I’m a big believer in team science. We all have certain areas of expertise, but if we want to combine our expertise to impact children and improve their health, we need to work together in teams, bringing together basic science researchers, clinicians, information technology specialists, knowledge-translation specialists and disseminators.
Finally, I am a cheerleader for science. As you develop your own science, you also are responsible for leading the next generation of scientists. I’ve spent as much time being a scientific mentor as I have working to discover new knowledge through scientific inquiry.
Q: You talk extensively about your family’s international roots and how it drives your work. What is the role of diversity in medicine and how does that guide you?
A: Diversity is fundamental to healthcare. We in the medical community recognize the disparities in the care we deliver, which I’ve studied in my research. Diversity must not only be a research focus, but our teams must be diverse to better investigate — and work to resolve — these inequities of care.
Children’s National is both a hospital that is mindful of its immediate community and an institution that greatly values the diversity of its patients and its staff. It’s also highly ranked in research and cares deeply about global health, all of which are drivers in my work.
When I considered the potential of coming to Children’s National, I thought I might be able to help this already great institution further its mission by serving its immediate community, growing and developing its global health programs, and taking research here from its already great bones and accomplishments to the next level.
Q: What approach do you bring to clinical care?
A: When I do a research study and enroll patients into a clinical trial, I think about the patient and others the research can impact. I frequently think of a quote by the late Paul Brodeur, a scientific writer who wrote a lot about asbestos, which is very powerful and meaningful to me: “Statistics are humans with the tears wiped away.”
And what it means to me is that we must be mindful as researchers that we’re talking about humans with our research. We’re not just talking about numbers, and we’re not just talking about getting grants and papers. We’re talking about how we can elevate the evidence and translate it to the bedside to improve the lives of humans.
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As CTR co-directors, Drs. Goyal and Tarini will lead the hospital’s mission to advance translational science, clinical research and community health. They will begin their new roles on July 1.
Moving the field forward
“It is truly an honor to lead the CTR at such a pivotal moment in pediatric health,” said Dr. Goyal, an emergency medicine specialist and health services researcher. “I look forward to helping Children’s National lead the science on advancing health equity for the patients, families and communities we serve, both locally and nationally.”
As the largest of the six centers within the Children’s National Research Institute, CTR is pivotal in finding groundbreaking ways to improve health across pediatric medicine. Using a “bench to bedside” approach, the CTR faculty strives to seamlessly translate science from the laboratory bench to the patient’s bedside, moving pediatric medicine forward as expeditiously as possible to bring advances into the community.
“CTR is uniquely positioned to solve the biggest healthcare issues facing our pediatric patients,” said Dr. Tarini, a pediatrician and national leader in newborn screening research and policy. “I look forward to leading our diverse faculty of physicians and researchers as they leverage their front-line experience and innovative research to improve child health.”
Why we’re excited
Dr. Tarini joined Children’s National in 2018 and is currently the associate director for CTR. She was recently promoted to tenured professor of Pediatrics at George Washington University and has extensively studied policies to optimize the delivery of genetic services to families of newborns. In January, Dr. Tarini was appointed to a National Academies of Sciences, Engineering and Medicine Committee to examine the current landscape of newborn screening systems, processes and research in the United States. Dr. Tarini has obtained $10 million in federal and foundation funding, and she has served as president of the Society for Pediatric Research.
Dr. Goyal joined Children’s National in 2012. She is the inaugural endowed chair for Women in Science and Health and has served as the associate division chief for Academic Affairs and Research within the Emergency Department since 2018. She was recently promoted to tenured professor of Pediatrics and Emergency Medicine at George Washington University. Dr. Goyal is a nationally renowned equity science scholar and has published over 130 peer-reviewed manuscripts. She has secured more than $25 million in federal and foundation funding to address disparities in adolescent sexual health, pain management and firearm violence.
Children’s National leads the way
Catherine Bollard, M.D., M.B.Ch.B., interim chief academic officer, said she looks forward to seeing the advances in pediatric health guided by these two outstanding researchers. “By harnessing the immense talent within Children’s National for our search, we found two exceptional leaders in Drs. Goyal and Tarini,” Dr. Bollard said. “Their work promoting research that accelerates discovery across the continuum of bench, bedside and community has already made a significant impact.”
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Children with life-limiting rare diseases and their caregivers face tremendous stress and anxiety about the heart-breaking decisions before them. A new intervention – designed at Children’s National Hospital to support the palliative needs of these families – improved their spiritual and emotional well-being, according to new research published in the journal, Pediatrics.
Called FACE Rare (FAmily CEntered Pediatric Advance Care Planning Intervention for Rare Diseases), the counseling tools were found to be safe, effective and increased feelings of peace among families in this underserved population.
“Seventy-four percent of the families in that intervention group reported feelings of sadness, yet 100% reported our pilot intervention was a worthwhile experience,” said Maureen Lyon, Ph.D., a clinical psychologist and principal investigator at the Center for Translational Research at Children’s National. “If you’re talking about the possibility that the worst thing in the world would happen to you – that your child might die, and what you would want for them – the families found that our intervention helped. They had a place to process their feelings and consider what would be important to their child.”
The big picture
A rare disease is defined as any condition affecting fewer than 200,000 people in the United States. In pediatrics, these diseases often require constant caregiving and require families to face the cruel reality that the diagnosis may be life-limiting. In such cases, clinical teams often decide that conversations about advanced care planning (ACP) are needed.
The pilot-phase, randomized trial enrolled patients from Children’s National between 2021 and 2023. Research nurses underwent two days of training to be certified in the new intervention. Families assigned to the new approach received three, weekly 60-minute sessions and were evaluated using evidence-based assessment tools, including the Carer Support Needs Assessment Tool/Action Plan and the Next Steps: Respecting Choices Pediatric ACP Conversation. Measures of anxiety and spiritualization were tracked, and families returned after three months for follow-up.
Patients had a range of diagnoses that put tremendous strain on the caregivers, including complex digestive disorders, white-matter diseases and rare forms of epilepsy. Yet the caregivers expressed similar challenges: having time for themselves during the day, knowing what to expect in the future for their child’s care, and managing financial, legal and work issues.
What we found
Reinforcing the need to improve engagement and support for these families, the investigative team found that those who received the FACE Rare intervention reported higher levels of spiritual meaning and peace than those who received “treatment as usual.” All families living below the poverty line reported greater anxiety, and noteworthy to the team, black caregivers were less likely to report caregiver distress than non-black caregivers.
Dr. Lyon said future research needs to understand better how families respond to the challenges of rare diseases and unique social determinants of health that can change the approach to care.
“In some cultures, and families, having strong feelings is discouraged,” Dr. Lyon said. “We want to give families and caregivers space to have these emotions and think about what would be important for their child, if the worst were to happen. They appreciated that they participated in the program and had the space to consider these difficult questions.”
Read the full study, “Advance Care Planning for Children with Rare Diseases: A Pilot RCT,” in Pediatrics.
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CareFirst BlueCross BlueShield (CareFirst), one of the largest not-for-profit healthcare organizations in the nation, and Children’s National Hospital, a top-ranked children’s hospital located in Washington, D.C., announced a new alliance that’s taking a unique approach to help address the youth mental health crisis and improve health outcomes.
As part of this alliance, CareFirst has increased the reimbursement for preventive and mental health care for primary care providers who go through specialized mental health training focused on depression, suicide prevention, anxiety, ADHD and eating disorders. The training is offered through the Pediatric Health Network, the clinically integrated network of healthcare providers for Children’s National, to its more than 1,500 members including more than 700 primary care physicians.
In 2021, U.S. Surgeon General Dr. Vivek Murthy issued an advisory detailing an urgent youth mental health crisis. Unfortunately, access to pediatric mental health care is a national challenge, and for children and families, timely and effective support can be elusive. Empowering primary care providers with specialized training will help break down barriers and reshape care delivery.
“Providers face challenges due to limited resources and insufficient support in addressing pediatric mental health needs. CareFirst’s commitment to increasing reimbursement for mental health care underscores the integral role of primary care providers in this space,” says Nathaniel Beers, M.D., executive vice president for Community and Population Health for Children’s National Hospital. “With these trainings, our providers gain the knowledge, tools and confidence to handle sensitive conversations, offer vital support and make informed referrals when needed.”
The alliance executes a value-based care payment model for the Children’s National network of community physicians, enhancing benefits to offer more value to physicians and patients while aiming to drive improved outcomes, patient experience and coordination in care. By embedding mental health care within the familiar confines of primary care settings, this initiative ensures children receive timely interventions in an environment they trust.
This work to improve access to mental health services is just one part of the broader unique payer-provider alliance between CareFirst and Children’s National to address healthcare disparities and social determinants of health. Targeted pediatric interventions are set upon three pillars:
Value-based care
Community health initiatives
Member benefit enhancements
Each pillar is delivered and informed by experts from both organizations with distinct tactics and funding designed for three key priority health conditions:
Behavioral and mental health
Diabetes
Infant mortality
“As the lines continue to blur between payers and providers, with vertical integration and the reimbursement shift from volume to value, insurers and hospitals need to continue to evolve their relationships with each other,” said Brian Wheeler, executive vice president of Health Services for CareFirst. “This model aims to address the need for affordable healthcare, employing a patient-centric approach that encourages seamless treatment for the patient and provider.”
The next major program in development is focused on improving diabetes care through early diagnosis to lessen vulnerability and severity and improve long-term positive health outcomes.
Community health initiatives will continue to be developed through the Children’s National Child Health Advocacy Institute and Community Health programs with the support of CareFirst’s philanthropic efforts.
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Catherine Limperopoulos, Ph.D., was drawn to understanding the developing brain, examining how early adverse environments for a mother can impact the baby at birth and extend throughout its entire lifetime. She has widened her lens – and expanded her team – to create the new Center for Prenatal, Neonatal & Maternal Health Research at Children’s National Hospital.
“Despite the obvious connection between mothers and babies, we know that conventional medicine often addresses the two beings separately. We want to change that,” said Dr. Limperopoulos, who also directs the Developing Brain Institute. “Given the current trajectory of medicine toward precision care and advanced imaging, we thought this was the right moment to channel our talent and resources into understanding this delicate and highly dynamic relationship.”
Moving the field forward
Since its establishment in July 2023, the new research center has gained recognition through high-impact scientific publications, featuring noteworthy studies exploring the early phases of human development.
Dr. Limperopoulos has been at the forefront of groundbreaking research, directing attention to the consequences of maternal stress on the unborn baby and the placenta. In addition, under the guidance of Kevin Cook, Ph.D., investigators published a pivotal study on the correlation between pain experienced by premature infants in the Neonatal Intensive Care Unit and the associated risks of autism and developmental delays.
Another area of research has focused on understanding the impact of congenital heart disease (CHD) on prenatal brain development, given the altered blood flow to the brain caused by these conditions during this period of rapid development. Led by Josepheen De Asis-Cruz, M.D., Ph.D., a research team uncovered variations in the functional connectivity of the brains of infants with CHD. In parallel, Nickie Andescavage, M.D., and her team employed advanced imaging techniques to identify potential biomarkers in infants with CHD, holding promise for guiding improved diagnostics and postnatal care. Separately, she is investigating the impact of COVID-19 on fetal brain development.
In the months ahead, the team plans to concentrate its efforts on these areas and several others, including the impact of infectious disease, social determinants of health and protecting developing brains from the negative impacts of maternal stress, pre-eclampsia and other conditions prevalent among expectant mothers.
Assembling a team
Given its robust research plan and opportunities for collaboration, the center pulled together expertise from across the hospital’s faculty and has attracted new talent from across the country, including several prominent faculty members:
Katherine L. Wisner, M.S., M.D., has accumulated extensive knowledge on the impact of maternal stress on babies throughout her career, and her deep background in psychiatry made her a natural addition to the center. While Dr. Wisner conducts research into the urgent need to prioritize maternal mental health, she will also be treating mothers as part of the DC Mother-Baby Wellness Initiative — a novel program based at Children’s National that allows mothers to more seamlessly get care for themselves and participate in mother-infant play groups timed to align with their clinical appointments.
Catherine J. Stoodley, B.S., M.S., D.Phil., brings extensive research into the role of the cerebellum in cognitive development. Dr. Stoodley uses clinical studies, neuroimaging, neuromodulation and behavioral testing to investigate the functional anatomy of the part of the brain responsible for cognition.
Katherine M. Ottolini, M.D., attending neonatologist, is developing NICU THRIVE – a research program studying the effects of tailored nutrition on the developing newborn brain, including the impact of fortifying human milk with protein, fat and carbohydrates. With a grant from the Gerber Foundation, Dr. Ottolini is working to understand how personalized fortification for high-risk babies could help them grow.
Early accolades
The new center brings together award-winning talent. This includes Yao Wu, Ph.D., who recently earned the American Heart Association’s Outstanding Research in Pediatric Cardiology award for her groundbreaking work in CHD, particularly for her research on the role of altered placental function and neurodevelopmental outcomes in toddlers with CHD. Dr. Wu became the third Children’s National faculty member to earn the distinction, joining an honor roll that includes Dr. Limperopoulos and David Wessel, M.D., executive vice president and chief medical officer.
Interim Chief Academic Officer Catherine Bollard, M.D., M.B.Ch.B., said the cross-disciplinary collaboration now underway at the new center has the potential to make a dramatic impact on the field of neonatology and early child development. “This group epitomizes the Team Science approach that we work tirelessly to foster at Children’s National,” Dr. Bollard said. “Given their energetic start, we know these scientists and physicians are poised to tackle some of the toughest questions in maternal-fetal medicine and beyond, which will improve outcomes for our most fragile patients.”
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Breakthroughs at the Research & Innovation Campus continued as our researchers worked tirelessly to develop new treatments and therapies that will transform the lives of children and families around the world.
Taking a look at the breakthroughs happening in our now six research centers, we spotlighted the following stories:
Reflecting on decades of progress in the blood, marrow and cell therapy programs at Children’s National. Our researchers have made significant strides in this field, and we are proud to be at the forefront of these life-saving treatments.
In genetic medicine, we continue to be a beacon of hope for families facing rare and complex conditions. Our researchers are making incredible breakthroughs that are changing the landscape of pediatric medicine.
We are also proud to share the $90 million award received from an anonymous donor to support pediatric brain tumor research. The predominant focus of this award is to develop new treatments that will improve outcomes for children with this devastating disease.
This year, we opened a new Center that enhances our research capabilities in the field of Prenatal, Neonatal & Maternal Health Research. We are excited about the possibilities this new center will bring and look forward to the discoveries that will emerge from it.
In addition, we are driving future pandemic readiness with the NIH funded Pediatric Pandemic Network. Our researchers are using cutting-edge technology and innovative approaches to prepare for the next pandemic and protect children.
We are also exploring the potential of artificial intelligence (AI) in pediatric breakthroughs. Our researchers are using machine learning and other AI techniques to develop new treatments and therapies that will transform the lives of children.
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The research team found that patients who are Black and Medicaid-insured patients experienced the greatest disparities in postoperative sepsis, a rare complication in which patients suffer from infection that can cause multi-organ failure.
Evaluating more than 5 million pediatric hospital stays nationwide, researchers found children who are Black, Hispanic or insured with Medicaid face a greater risk of health events after surgeries than white patients, according to a new study published in the journal Pediatrics.
“We looked at the data, and we calculated the risks,” said Kavita Parikh, M.D., MSHS, medical director of Quality & Safety Research, research director of the Division of Hospital Medicine and first author on the multi-institute study. “Despite decades of focus on eliminating medical errors, we know that children continue to suffer substantial harms in hospital settings, and our study highlights where children who are Black, Hispanic or insured with Medicaid are at the greatest risk.”
The big picture
The study analyzed data from more than 5.2 million hospitalizations collected by the 2019 Kids’ Inpatient Database, a national repository of data on hospital stays. It includes a 10% sample of newborns and an 80% sample of other pediatric discharges from 4,000 U.S. hospitals. More than 80% of patients were younger than 1 year of age.
The research team found that patients who are Black and Medicaid-insured patients experienced the greatest disparities in postoperative sepsis, a rare complication in which patients suffer from infection that can cause multi-organ failure. Patients who are Hispanic experienced the greatest disparity in postoperative respiratory failure, a complication that can limit breathing and ventilation.
Plausible factors cited include structural racism in the U.S. healthcare system, clinician bias, insufficient cultural responsiveness, communication barriers and limited access to high-quality healthcare.
What’s ahead
The study – “Disparities in Racial, Ethnic, and Payor Groups for Pediatric Safety Events in U.S. Hospitals” – is foundational in understanding what is happening among pediatric patients. Dr. Parikh said that researchers now must conduct further studies into these alarming disparities and qualitative work to understand drivers, with the action-oriented goal of developing interventions to improve patient safety in the hospital for all children.
“We brought together leaders in pediatric medicine, health policy and public health to analyze this data, and we are committed to taking the next steps to improve outcomes for pediatric patients,” Dr. Parikh said. “It will take more patient-centered work and research, resources and multifaceted strategies to resolve these worrying disparities for our pediatric patients nationwide.”
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The next generation of cardiometabolic biomarkers should pave the way for earlier detection of risk factors for conditions such as obesity, diabetes and heart disease in children.
American Heart Association statement finds potential future measures, reiterates importance of heart-healthy lifestyle from birth through adulthood.
The next generation of cardiometabolic biomarkers should pave the way for earlier detection of risk factors for conditions such as obesity, diabetes and heart disease in children, according to a new scientific statement from the American Heart Association published in the journal Circulation.
“The rising number of children with major risk factors for cardiometabolic conditions represents a potential tsunami of preventable disease for our healthcare system,” says the statement’s lead author Michele Mietus-Snyder, M.D., a preventive cardiologist and clinical research scientist at Children’s National Hospital. “But by the time a child is identified based on today’s clinical biomarkers, it’s often too late to reverse the disease trajectory.”
The big picture
The scientific statement included biomarkers that met three criteria:
Early and precise clinical detection of metabolic abnormalities before a child begins to show the current clinical signs such as high body mass index (BMI), blood pressure or cholesterol.
Mechanistic intervention targets providing immediate risk measures and giving clinicians new targets to personalize and optimize interventions.
Modifiable biomarkers that are capable of tracking progression toward or away from cardiometabolic health.
The statement’s identified biomarkers included measures of:
Epigenetic, or environmental, factors
Gut microbiome health
Small particle metabolites in the body
Different types of lipids and their impacts on cell membranes
Inflammation and inflammatory mediators
The authors proposed these biomarkers with the goal of “expanding awareness to include a whole new realm of biomarkers that precede the traditional risk factors we currently rely upon, such as BMI, blood pressure, cholesterol and blood sugar,” says Mietus-Snyder. “Ideally, these new biomarkers will be added to the array of measures used in clinical research to better assess their value for earlier identification and prevention of global patterns of cardiometabolic health and risk.”
Why it matters
The next generation cardiometabolic biomarkers outlined by the authors are all currently used in research studies and would need to be validated for clinical use. However, Mietus-Snyder notes that the data already collected from these biomarkers in research can make a difference in clinical practice by enhancing our understanding of the deep metabolic roots for children at risk.
Evidence reviewed in the statement shows the risk factors children are exposed to, even before birth, can set the stage for cardiovascular and metabolic health across the lifespan.
Interestingly, all the different factors reviewed have been found to alter the functioning of the mitochondria — the complex organelles responsible for producing the energy for the body that every cell and organ system in turn needs to function. Every class of biomarkers reviewed is also favorably influenced by heart-healthy nutrition, a simple but powerful tool known to improve mitochondrial function.
What’s next
Even as the new so-called ‘omic’ biomarkers reviewed in this statement are developed for clinical applications, there are things clinicians can do to optimize them and improve mitochondrial function, according to Mietus-Snyder.
Most important is to strengthen the collective dedication of care providers to removing the barriers that prevent people, especially expecting mothers and children, from living heart-healthy lifestyles.
We have long known lifestyle factors influence health. Even as complicated metabolic reasons for this are worked out, families can reset their metabolism by decreasing sedentary time and increasing activity, getting better and screen-free sleep, and eating more real foods, especially vegetables, fruits and whole grains, rich in fiber and nutrients, with fewer added sugars, chemicals, preservatives and trans fats. Clinicians can work with their patients to set goals in these areas.
“We know diet and lifestyle are effective to some degree for everyone but terribly underutilized. As clinicians, we have compelling reasons to re-dedicate ourselves to advocating for healthy lifestyle interventions with the families we serve and finding ways to help them implement them as early as possible. The evidence shows the sooner we can intervene for cardiometabolic health, the better.”
https://innovationdistrict.childrensnational.org/wp-content/uploads/2023/10/doctor-listening-to-childs-heart-feature.png300400Innovation Districthttps://innovationdistrict.childrensnational.org/wp-content/uploads/2023/12/innovationdistrict_logo-1-1030x165.pngInnovation District2023-10-31 14:28:362023-10-31 14:31:20Earlier detection of cardiometabolic risk factors for kids may be possible through next generation biomarkers
Children with autism face significant barriers to accessing evaluations and intervention services.
An article in the journal Pediatrics reviews the outcomes from a collective, targeted advocacy approach to improving access to autism supports and resources for children and their families in Washington, D.C. The effort was led by Children’s National Hospital and engaged a multidisciplinary team from within the hospital and across a wide range of community sectors.
What this means
Children’s National and DC Autism Parents worked collaboratively with a coalition of organizations from the broader District of Columbia community to address some of the biggest challenges and barriers that prevent autistic children and their families from receiving the resources and support they need in the nation’s capital.
Why it matters
Children with autism face significant barriers to accessing evaluations and intervention services often because of confusing referral processes, lack of centralized coordination across organizations serving children with autism, insurance coverage gaps, multiyear waitlists for diagnostic services and limited provider knowledge about autism. Racism and systemic inequities also persist in autism care across the United States.
Long and growing wait times in autism diagnostic clinics and lack of centralized care coordination for autistic children are prevalent across the District of Columbia, and as a result, many children and families in the region continue to lack access to the support they need.
What’s unique
The study describes multiyear efforts (2017–2022) to improve autism care throughout the District of Columbia using a collective impact framework to unite organizations from different sectors. This approach features the creation of a common agenda (including defining goals and priorities), shared measurement, mutually reinforcing activities, continuous communication and infrastructure support.
Together, the group members sought to address barriers and overcome challenges at multiple levels of the healthcare system at the same time by focusing advocacy in three specific areas:
Population- and community-level services to build capacity and connect providers and families to needed resources.
Direct services that provide innovative, gap-filling supports to children and families as a stopgap until the necessary supports can be more sustainably provided across the board.
Bottom line
While more work is needed to continue expanding the availability of needed services, the findings from this initial effort can inform the next steps in Washington, D.C., and serve as a model for a collective framework approach for autism services in other parts of the United States.
https://innovationdistrict.childrensnational.org/wp-content/uploads/2023/10/child-evaluation-Feature.png300400Innovation Districthttps://innovationdistrict.childrensnational.org/wp-content/uploads/2023/12/innovationdistrict_logo-1-1030x165.pngInnovation District2023-10-05 13:04:092023-10-05 13:18:13Using a multisystem approach to improve access to autism care in Washington, D.C.
Children’s National Hospital has expanded its class of 
Children’s National Hospital in Washington, D.C., was ranked as a top hospital in the nation by the 
The Children’s National Research Institute released its 
