Publications by authors named "Susan C Lipsett"
Article Synopsis
- The study aims to identify pediatric physicians' thresholds for conducting chest radiographs and prescribing antibiotics in cases of community-acquired pneumonia (CAP) in children, emphasizing the importance of these thresholds in clinical prediction model implementation.* -
- A survey was conducted with 208 pediatric emergency physicians who assessed 8 clinical vignettes and indicated their decisions regarding chest radiographs and antibiotic treatments, both before and after being informed of a validated prediction model's estimated probabilities for CAP.* -
- Results showed that knowledge of the prediction model led to lower thresholds for both testing (from 17.6% to 13.5%) and treatment (from 66.1% to 58.0%), suggesting the potential for integrating these thresholds into future
Article Synopsis
- The study examines the effectiveness of antibiotics in treating pediatric pneumonia in children and adolescents, specifically comparing outcomes for those who received antibiotics versus those who did not.
- Data was collected from a multistate claims database for Medicaid-insured individuals under 17 years old who were diagnosed with pneumonia between 2017 and 2019, taking into account factors to minimize bias.
- Results showed that treatment failure rates were slightly higher in children who did not receive antibiotics (10.7%) compared to those who did (8.7%), although the difference was not clinically significant.
Background: It is unknown which factors are associated with chest radiograph (CXR) and antibiotic use for suspected community-acquired pneumonia (CAP) in children. We evaluated factors associated with CXR and antibiotic preferences among clinicians for children with suspected CAP using case scenarios generated through artificial intelligence (AI).
Methods: We performed a survey of general pediatric, pediatric emergency medicine, and emergency medicine attending physicians employed by a private physician contractor.
Community-acquired pneumonia (CAP) is often considered for children presenting to the emergency department (ED) with respiratory symptoms. It is unclear how often children are diagnosed with CAP following an ED visit for respiratory illness. We performed a retrospective case-control study to evaluate 7-day CAP diagnosis among children 3 months to 18 years discharged from the ED with respiratory illness from 2011 to 2021 and who receive care at 4 hospital-affiliated primary care clinics.
View Article and Find Full Text PDFBackground: Emerging evidence suggests that initial oral and intravenous (IV) antibiotics have similar efficacy in pediatric community-acquired pneumonia (CAP), but further data are needed.
Objective: We determined the association between hospital-level initial oral antibiotic rates and outcomes in pediatric CAP.
Designs, Settings, And Participants: This retrospective cohort study included children hospitalized with CAP at 43 hospitals in the Pediatric Health Information System (2016-2022).
Study Objective: The workload of clinical documentation contributes to health care costs and professional burnout. The advent of generative artificial intelligence language models presents a promising solution. The perspective of clinicians may contribute to effective and responsible implementation of such tools.
View Article and Find Full Text PDFBackground: Current guidelines and recent studies on pediatric pneumonia pertain to children older than 3 months of age. Little information exists regarding the diagnostic evaluation, management, and outcomes of infants less than 90 days with pneumonia.
Methods: We compared infants <90 days of age diagnosed with pneumonia across 38 US children's hospitals from 2016 to 2021 to children 90 days to 5 years of age.
Article Synopsis
- The study aimed to assess the impact of the 2011 PIDS/IDSA guidelines for treating pediatric community-acquired pneumonia (CAP), specifically focusing on aminopenicillin use and reduced reliance on chest X-rays.
- Data was collected from a national hospital database between 2009 and 2021, evaluating antibiotic therapy and diagnostic practices among children aged 3 months to 18 years with CAP.
- Results showed an increase in aminopenicillin prescriptions alongside a decrease in blood cultures and chest X-ray use, but overall diagnostic practices didn't change much, suggesting a need for better implementation of the guidelines in clinical settings.
Objective: Chest radiograph (CXR) is often performed for the evaluation of community-acquired pneumonia (CAP) in the ED setting. We sought to evaluate the association of undergoing CXR with 7-day hospitalization after emergency department (ED) discharge among patients with CAP.
Methods: This was a retrospective cohort study including children 3 months to 17 years discharged from any ED within 8 states from 2014 to 2019.
Objectives: Procalcitonin (PCT) was approved by the Food and Drug Administration in 2016. We assessed changes in PCT utilization over time in emergency departments (EDs) at US Children's Hospitals and identified the most common conditions associated with PCT testing.
Methods: We performed a cross-sectional study of children <18 years of age presenting to 1 of 33 EDs contributing data to the Pediatric Health Information System between 2016 and 2020.
Background: Limited data exist to inform antibiotic selection among people with cystic fibrosis (CF) with airway infection by multiple CF-related microorganisms. This study aimed to determine among children with CF co-infected with methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (Pa) if the addition of anti-MRSA antibiotics to antipseudomonal antibiotic treatment for pulmonary exacerbations (PEx) would be associated with improved clinical outcomes compared with antipseudomonal antibiotics alone.
Methods: Retrospective cohort study using data from the CF Foundation Patient Registry-Pediatric Health Information System linked dataset.
Background: Despite the increased availability of diagnostic tests for respiratory viruses, their clinical utility for children with community-acquired pneumonia (CAP) remains uncertain.
Objective: To identify patterns of respiratory virus testing across children's hospitals prior to the COVID-19 pandemic and to determine whether hospital-level rates of viral testing were associated with clinical outcomes.
Design, Setting, And Participants: Multicenter retrospective cohort study of children hospitalized for CAP at 19 children's hospitals in the United States from 2010-2019.
Background And Objectives: Several studies have revealed the success of nonoperative management (NOM) of uncomplicated appendicitis in children. Large studies of current NOM utilization and its outcomes in children are lacking.
Methods: We queried the Pediatric Health Information System database to identify children <19 years of age with a diagnosis code for appendicitis.
Background/objectives: Chest radiograph (CXR) is routinely performed among children with suspected pneumonia, though it is not clear how specific radiographic findings impact antibiotic treatment for pneumonia. We evaluated the impact of viral radiographic features on antibiotic treatment among children undergoing pneumonia evaluation in the emergency department (ED).
Methods: Children presenting to a pediatric ED who underwent a CXR for pneumonia evaluation were prospectively enrolled.
Background: The diagnosis of pneumonia in children is challenging, given the wide overlap of many of the symptoms and physical examination findings with other common respiratory illnesses. We sought to derive and validate the novel Pneumonia Risk Score (PRS), a clinical tool utilizing signs and symptoms available to clinicians to determine a child's risk of radiographic pneumonia.
Methods: We prospectively enrolled children 3 months to 18 years in whom a chest radiograph (CXR) was obtained in the emergency department to evaluate for pneumonia.
Objectives: To describe testing and treatment practices for () among children hospitalized with community-acquired pneumonia (CAP).
Methods: We conducted a retrospective cohort study using the Pediatric Health Information Systems database. We included children 3 months to 18 years old hospitalized with CAP between 2012 and 2018 and excluded children who were transferred from another hospital and those with complex chronic conditions.
Objective: To compare the accuracy of computer versus physician predictions of hospitalization and to explore the potential synergies of hybrid physician-computer models.
Materials And Methods: A single-center prospective observational study in a tertiary pediatric hospital in Boston, Massachusetts, United States. Nine emergency department (ED) attending physicians participated in the study.
Objective: To identify practice patterns in the duration of prescribed antibiotics for the treatment of ambulatory children with community-acquired pneumonia (CAP) and to compare the frequency of adverse clinical outcomes between children prescribed short-vs prolonged-duration antibiotics.
Study Design: We performed a retrospective cohort study from 2010-2016 using the IBM Watson MarketScan Medicaid Database, a claims database of publicly insured patients from 11 states. We included children 1-18 years old with outpatient CAP who filled a prescription for oral antibiotics (n = 121 846 encounters).
Objectives: To assess the characteristics of children hospitalized with complicated pneumonia at US children's hospitals and compare these characteristics with those of children hospitalized with community-acquired pneumonia (CAP).
Methods: We identified children hospitalized with complicated pneumonia (parapneumonic effusion, empyema, necrotizing pneumonia, or lung abscess) or CAP across 34 hospitals between 2011 and 2019. We evaluated differences in patient characteristics, antibiotic selection, and outcomes between children with complicated pneumonia and CAP.
Background And Objectives: Children with deep neck infections (DNIs) are increasingly being managed nonsurgically with intravenous antibiotics. Our objective was to examine variation in the management of children with DNIs across US children's hospitals.
Methods: We conducted a retrospective cohort study using the Pediatric Health Information System database.
In this multicenter study of 1783 children diagnosed with ovarian torsion from 2012 to 2017, 402 children (22.5%) underwent oophorectomy. The odds of oophorectomy were higher in children under 11 years of age, children with public insurance, and children with complex chronic conditions.
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