Background: Pediatric lead exposure in the United States (U.S.) remains a preventable public health crisis. Shareable electronic clinical decision support (CDS) could improve lead screening and management. However, discrepancies between federal, state and local recommendations could present significant challenges for implementation.
Methods: We identified publically available guidance on lead screening and management. We extracted definitions for elevated lead and recommendations for screening, follow-up, reporting, and management. We compared thresholds and level of obligation for management actions. Finally, we assessed the feasibility of development of shareable CDS.
Results: We identified 54 guidance sources. States offered different definitions of elevated lead, and recommendations for screening, reporting, follow-up and management. Only 37 of 48 states providing guidance used the Center for Disease Control (CDC) definition for elevated lead. There were 17 distinct management actions. Guidance sources indicated an average of 5.5 management actions, but offered different criteria and levels of obligation for these actions. Despite differences, the recommendations were well-structured, actionable, and encodable, indicating shareable CDS is feasible.
Conclusion: Current variability across guidance poses challenges for clinicians. Developing shareable CDS is feasible and could improve pediatric lead screening and management. Shareable CDS would need to account for local variability in guidance.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6990572 | PMC |
| http://dx.doi.org/10.1186/s12889-020-8225-8 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Investigating Pb2 CAP-binding domain inhibitors from marine bacteria for targeting the influenza A H5N1.
PLoS One
January 2025
Special Infectious Agents Unit-BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
The ongoing increase in the prevalence and mutation rate of the influenza virus remains a critical global health issue. A promising strategy for antiviral drug development involves targeting the RNA-dependent RNA polymerase, specifically the PB2-cap binding domain of Influenza A H5N1. This study employs an in-silico approach to inhibit this domain, crucial for viral replication, using potential inhibitors derived from marine bacterial compounds.
View Article and Find Full Text PDFAssociation between Delayed Broad-Spectrum Gram-negative Antibiotics and Clinical Outcomes: How Much Does Getting It Right with Empiric Antibiotics Matter?
Clin Infect Dis
January 2025
Department of Epidemiology and Public Health, University of Maryland School of Maryland; Baltimore, MD.
Background: Clinicians often start unnecessarily broad-spectrum empiric Gram-negative antibiotics out of the concern that delaying effective therapy could lead to a worse clinical outcome. This study examined the consequences of delayed initiation of broad-spectrum Gram-negative antibiotics.
Methods: In a retrospective cohort of adult inpatients from 928 US hospitals, we compared clinical outcomes after (1) empiric narrow-spectrum antibiotics escalated to broad-spectrum antibiotics (delayed broad-spectrum therapy, DBT) and (2) empiric broad-spectrum antibiotics continued for at least 5 days (early broad-spectrum therapy, EBT) using Win Ratios.
Race and Ethnicity as Factors in Healthcare Discrimination in the United States: A Cross-Sectional Study.
J Racial Ethn Health Disparities
January 2025
Medical Group Population Health, University of Utah, Salt Lake City, UT, USA.
Background And Purpose: Discrimination is the unfair or prejudicial treatment of people and groups based on certain characteristics. Discrimination in health care can impede access to quality care for patients and lead to poor health outcomes. This study aimed to investigate factors, including race and ethnicity, associated with discrimination in health care in the United States.
View Article and Find Full Text PDFLarge-Scale Validation of the Feasibility of GPT-4 as a Proofreading Tool for Head CT Reports.
Radiology
January 2025
From the Departments of Biomedical Systems Informatics (S.K., Jaewoong Kim, C.H., D.Y.) and Neurology (Joonho Kim, J.Y.), Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea; Department of Radiology, Central Draft Physical Examination Office of Military Manpower Administration, Daegu, Republic of Korea (D.K.); Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science (H.J.S. Y.K., S.J.), and Center for Digital Health (H.J.S., D.Y.), Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea; Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (S.H.L.); Departments of Radiology (M.H.) and Neurology (S.J.L.), Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea; and Institute for Innovation in Digital Healthcare, Severance Hospital, Seoul, Republic of Korea (D.Y.).
Background The increasing workload of radiologists can lead to burnout and errors in radiology reports. Large language models, such as OpenAI's GPT-4, hold promise as error revision tools for radiology. Purpose To test the feasibility of GPT-4 use by determining its error detection, reasoning, and revision performance on head CT reports with varying error types and to validate its clinical utility by comparison with human readers.
View Article and Find Full Text PDFDevelopment of Potent and Selective CK1α Molecular Glue Degraders.
J Med Chem
January 2025
Department of Chemical and Systems Biology, Stanford Cancer Institute, School of Medicine Stanford University, Stanford, California 94305-6104, United States.
Molecular glue degraders (MGDs) are small molecules that facilitate proximity between a target protein and an E3 ubiquitin ligase, thereby inducing target protein degradation. Glutarimide-containing compounds are MGDs that bind cereblon (CRBN) and recruit neosubstrates. Through explorative synthesis of a glutarimide-based library, we discovered a series of molecules that induce casein kinase 1 alpha (CK1α) degradation.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!