Category: Clinical Practice Guidelines

Clinical Practice Guidelines

Understanding the Effects of the COVID-19 Pandemic on Infant Development

June 6, 2022 498 Views0

As the COVID-19 pandemic nears the end of another year, it makes sense to wonder about the effect on children conceived and born in its shadow. Some of the consequences can be seen in the increasing rates of COVID-19 among infants and young children, particularly among those with comorbid medical conditions. But less obvious sequelae also should be considered: are infants born during the pandemic at greater risk for behavioral or neurodevelopmental problems, either due to exposure to maternal SARS-CoV-2 infection or to the more global effects of trauma and stress? Pregnant women and their infants are vulnerable to the effects of disasters, and evidence suggests that disasters affect maternal mental health and some perinatal health outcomes, particularly among highly exposed women. Prenatal...

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Clinical Practice Guidelines

Errors in the Introduction and Results

June 6, 2022 520 Views0

In the Research Letter titled “Association of Tax Preparation Service in a Pediatric Clinic With Increased Receipt of The Child Tax Credit,” which published online March 21, 2022, there were errors in the Introduction and Results sections. The third sentence of the Introduction incorrectly stated the percentage of eligible recipients who may be prevented from receiving the Child Tax Credit. The sentence should be “However, tax filing barriers (eg, parents who are not US citizens and lack internet access or technological devices) may prevent 2.3 to 5 million children from receiving the CTC.” The last sentence of the Results section incorrectly stated that the analysis was adjusted for race and ethnicity. The analysis was adjusted for race, sex, and age, not ethnicity. This article was corre...

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Clinical Practice Guidelines

Pediatric Hospital Admission and Role of Clinical Practice Guidelines

June 6, 2022 504 Views0

To the Editor I read with great interest the article by Kaiser et al describing pediatric hospitalization patterns in different hospital setups. In the data presented from 3768 US hospitals (Figure 1), an estimate of 34 704 of 1 777 023 nonbirth pediatric hospitalizations (1.95%) occurred because of neonatal hyperbilirubinemia (NHB). The prevalence rankings of NHB differed among hospitals (ranking 5 in urban nonteaching hospitals and rural hospitals, 7 in urban teaching hospitals, and 20 in freestanding children’s hospitals). On further analysis, NHB constituted 2.42 admissions (3447/1424) per rural hospital, 6.18 (7148/1156) per urban nonteaching hospital, 16.90 (18 844/1115) per urban teaching hospital, and 72.15 (5267/73) per freestanding children’s hospital. It was interesting to note ...

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Clinical Practice Guidelines

Use of Antenatal Corticosteroids for Risk of Preterm Birth—Is Timing Everything?

June 6, 2022 497 Views0

The administration of corticosteroids in women who are at risk for preterm birth is standard practice and considered “one of the most significant antenatal therapies available to improve newborn outcomes.” Antenatal corticosteroids accelerate fetal lung maturation and result in decreased perinatal death, neonatal death, and respiratory distress syndrome. Administration has also been demonstrated to reduce the risk of intraventricular hemorrhage and long-term developmental delays, although the level of evidence for these findings is lower.

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Clinical Practice Guidelines

Error in Figures

May 2, 2022 871 Views0

In the Original Investigation titled “Associations Between Screen Use and Child Language Skills: A Systematic Review and Meta-analysis,” published in the July 2020 issue, the child language labels in Figures 2, 3, and 4 were inadvertently reversed. The “higher child language” label was moved to the right side and the “lower child language” label to the left side. This article was corrected online.

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Clinical Practice Guidelines

JAMA Pediatrics —The Year in Review, 2021

May 2, 2022 596 Views0

I would have hoped this year would see the end of COVID-19, but we may now be, as they say, at the end of the beginning. Once again, in JAMA Pediatrics, the lion’s share of published content, article views and downloads, and citations have been for COVID-19–related articles. Editing during a pandemic has been a steep learning curve for journal editors and deciding what should be expedited and what will contribute new knowledge by the time it is published has been challenging. The fluidity and pace of the COVID-19 pandemic continue to fluster us all. We have begun to see the aftereffects of COVID-19 in pediatric populations as we are accepting and publishing research on the virus’s cognitive and socioemotional effects as well as the postacute sequalae of COVID-19 infection. Many of the earl...

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Clinical Practice Guidelines

Genetic Testing in Newborns Moves From Rare to Routine Application

May 2, 2022 1092 Views0

Newborns have at times been leaders and at others stragglers in the application of genetic testing. The onset of routine testing by the newborn screen in the 1950s heralded a new era in which presymptomatic testing for genetic diagnoses could enhance outcomes and in some cases even spare the child from developmental delay by the introduction of a special diet. In the 1970s, pioneering geneticists introduced cytogenetic analysis, which could detect aneuploidy, making the diagnosis of trisomy a routine adjunct of care. Subsequent advances in the method allowed high-resolution karyotype analysis and extended the utility to even small regions of the chromosome being deleted, duplicated, or rearranged. This was followed in the late 20th century by application of diagnosis-related tests based on...

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Clinical Practice Guidelines

Increasing Meaningful Representation of Children in Clinical Trials

May 2, 2022 505 Views0

Clinical trials are required to determine safety and effectiveness for therapeutic interventions to be used in clinical care. Racially and ethnically diverse research participation reflective of the US population at a minimum is essential to ensure that medical discovery leads to safe and effective interventions for all US patients. Rees et al hypothesized that racial and ethnic minoritized children would be underrepresented in published clinical trials. They performed a cross-sectional study of published articles reporting the results of pediatric clinical trials published in 5 leading general pediatric journals and 5 leading general medical journals over a 10-year period. The top journals by impact factor were assessed: JAMA Pediatrics, Lancet Child & Adolescent Health, Pediatrics, J...

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Clinical Practice Guidelines

Use of Irradiated Red Blood Cell Blood Transfusions in Newborns to Improve Intracerebral Saturation

May 2, 2022 995 Views0

Since the 1950s, neonatal intensive care practitioners have worked to preserve brain oxygenation. The physiological rationale that red blood cell (RBC) transfusion improved oxygen carrying capacity was a tantalizing prospect. In this issue of JAMA Pediatrics, Saito-Benz et al renew such hopes in a novel proof-of-concept randomized clinical trial (RCT) of irradiating RBCs on the day of transfusion (which the authors termed fresh irradiation) to boost cerebral oxygen saturation. Their PICOT (population/patient, intervention, comparison, outcome, and time) question was whether stable very low-birth-weight preterm infants requiring a top-up transfusion who received freshly irradiated RBCs showed an improvement in the noninvasively measured brain oxygenation compared to those who received routi...

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Clinical Practice Guidelines

Higher Risk of Mortality for Individuals Diagnosed With ASD or ADHD Demands a Public Health Prevention Strategy

April 4, 2022 399 Views0

In this issue of JAMA Pediatrics, Catalá-López et al report the findings of a systematic review and meta-analysis assessing the risk of mortality among persons with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) and their first-degree relatives. The takeaway message is not subtle or nuanced, but clear, direct, and sobering—individuals with ASD or ADHD frequently die of preventable natural causes (eg, cardiac events) and unnatural causes (eg, unintentional injury, suicide). As such, this knowledge demands widespread recognition and the implementation of systematic screening and preventive approaches. Higher mortality rates have been documented in the field of ASD for longer than they have in the field of ADHD, owing to the well-established higher risks for...

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Clinical Practice Guidelines

Sounding the Alarm for Children’s Mental Health During the COVID-19 Pandemic

April 4, 2022 326 Views0

Increasingly, research confirms the negative effects of COVID-19 safety measures on the mental health of children and adolescents. Saunders and colleagues call for an urgent response to the increasing sustained demand for mental health services inclusive of substance use and developmental disorders. The authors’ population-based cross-sectional study used linked administrative and health data to examine changes in utilization of physician-provided mental health services for 2.5 million children and adolescents aged 3 to 17 years in Ontario, Canada. From March 2020 through February 2021, the authors found a rapid and sustained 10% increase in outpatient mental health service utilization by children and adolescents compared with prior rates. Similar trends were not observed for acute mental ...

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Clinical Practice Guidelines

Interpreting Weight, Height, and Body Mass Index Percentiles in the CDC Growth Charts

April 4, 2022 394 Views0

To the Editor Hendrickson and Pitt expressed concern that a child whose height and weight are both at the US Centers for Disease Control and Prevention (CDC)–defined 97th percentile would have a body mass index (BMI) above the 85th percentile of the CDC growth charts rather than in the normal weight range. Although the authors suggested that this seemingly counterintuitive observation may be the result of different data sets in the growth charts or a weakness of the BMI formula, the association of BMI z score with to z scores for weight and height was addressed by Cole in 2002. I further examined the associations between these sex- and age-standardized z scores for weight, height, and BMI and compared the association of body fat with both BMI z score and a metric based on the weight percen...

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Clinical Practice Guidelines

Interpreting Weight, Height, and Body Mass Index Percentiles in the CDC Growth Charts—Reply

April 4, 2022 551 Views0

In Reply We appreciate Akinbami, Ogden, and Freedman’s thoughtful comments on our article. As Akinbami and Ogden note, back-to–birth weight conversations generally do not specifically reference growth charts, so perhaps our title would have better referred to conversations about growth rather than growth charts. However, we stand by our conclusion that an overly literal focus on back-to–birth weight rules may lead to unwarranted concern among parents of infants with high birth weight. Our title reflects our primary observation that there are challenges surrounding our conversations about growth, not that there are errors in the growth charts themselves. As pediatric generalists with a research focus on clinical communication, our goal was to draw attention to common sources of confusion in...

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Clinical Practice Guidelines

Early Detection in Childhood Lead Exposure Relies on Timely Testing—Reply

March 7, 2022 351 Views0

In Reply We appreciate the favorable response from Whitley et al regarding our study, which showed that half of the 1.1 million children tested across the US had detectable blood lead levels (BLL). We concluded, “To eliminate the effect of lead exposure on all children’s health, the US must focus efforts to prevent children from being exposed to lead, beginning in areas where risk is highest.” The Office of Inspector General of the US Department of Health and Human Services report cited by Whitley et al highlights a gap in required BLL screening tests among Medicaid-enrolled children in 5 states. Subsequently, the Centers for Medicare and Medicaid Services stated that it would monitor performance data for BLL screening tests in Medicaid-enrolled children nationally. It would then identify ...

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Clinical Practice Guidelines

Combating a Global Pandemic Will Require Global Representation

March 7, 2022 360 Views0

The COVID-19 pandemic has highlighted the importance of international research collaborations to quickly understand and successfully combat emerging and reemerging infectious pathogens globally. As SARS-CoV-2, the causative agent of COVID-19, spread across the world, the number of collaborative international studies defining the impact of COVID-19 have increased rapidly. From these studies, we have gained valuable information regarding the spectrum of clinical disease and the underlying risk factors associated with SARS-CoV-2–induced morbidity and mortality. These data have been important to guide public health interventions globally. However, despite the extensive geographic reach of SARS-CoV-2, low- and middle-income countries (LMICs) and inclusion of subgroups such as children have ofte...

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Clinical Practice Guidelines

Long-term Psychological Morbidity Among Children Surviving Critical Illness and Injury

March 7, 2022 364 Views0

Peter Safar, one of the fathers of critical care, once astutely noted that critical illness neither begins nor ends at the walls of the intensive care unit or even the hospital. Children may begin their encounter with critical illness with the ongoing impact of preexisting chronic comorbid conditions. They then experience organ dysfunction that dictates the intensity and duration of critical care and serves as an important antecedent for risk of mortality and long-term morbidity. Interventions required to support organ dysfunction, such as sedation to facilitate mechanical ventilation, similarly may be associated with adverse long-term sequalae among children surviving critical illness. In addition, the health of family dynamics after hospital discharge plays an important role in a child’s...

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Clinical Practice Guidelines

Early Detection in Childhood Lead Exposure Relies on Timely Testing

March 7, 2022 357 Views0

To the Editor Hauptman et al found that children with public insurance have greater odds of detectable and elevated blood lead levels (BLLs) than children with private insurance. A recently released report from the US Department of Health and Human Services Office of Inspector General (OIG) report reviewing blood lead screening tests in 5 large states for federal fiscal years 2015 to 2018 found that 38% of 1.8 million Medicaid-enrolled children did not receive a blood lead screening test at ages 12 and 24 months as Medicaid requires. Thus, the number of children with public insurance that have detectable and elevated BLLs may be even higher and the disparities even more stark than noted in Hauptman et al.

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Clinical Practice Guidelines

Sugar-Sweetened Beverage Taxes and Population Health Outcomes

February 7, 2022 333 Views0

In 2014, Mexico became the first country in the Americas to tax the sugar-sweetened beverage (SSB) industry, sparking a cascade of SSB excise taxes in the US and globally. Rigorous evaluations have demonstrated that Mexico’s SSB tax increased SSB prices and reduced purchasing and consumption. Evaluations in at least 5 US jurisdictions and 7 countries have also demonstrated that these taxes reduce SSB sales and purchases. Consequently, SSB taxes are expected to result in improvements in population health in the years that follow (eg, lower incidence of conditions associated with SSB consumption, such as obesity and type 2 diabetes). However, data on the health impacts of SSB taxes are limited. One study of Mexico’s tax detected a lower probability of dental caries following tax implementati...

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Clinical Practice Guidelines

Poverty and Firearm-Related Deaths Among US Youth

February 7, 2022 349 Views0

In the midst of the global COVID-19 pandemic, attention has drifted away from the endemic problem of firearm-related morbidity and mortality in the US. The Centers for Disease Control and Prevention reported in 2019, the most recent year for which data were available, that 39 707 people died of firearm-related injuries, of whom 19.8% were children and youth aged 5 to 24 years. The number of nonfatal injuries is not accurately known because of the lack of comprehensive data. As reported by Barrett and colleagues in this issue of JAMA Pediatrics, communities with high rates of poverty are disproportionately affected by firearm violence. Nearly 1 in 7 children lived in poverty in 2019, but poverty was disproportionately experienced by Alaska Native or American Indian children (20.6%), Black c...

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Clinical Practice Guidelines

Social Interventions and Health Care Utilization for Child Asthma

February 7, 2022 326 Views0

Social determinants of health are the causes of discrepancies in pediatric health outcomes. Upstream determinants, or causes, typically include complex societal issues, such as racism and poverty. Midstream determinants are typically the result of upstream determinants but are potentially more modifiable social risks for poor health outcomes (eg, housing instability, food insecurity, educational attainment, incarceration, and exposure to violence). Addressing midstream social risks to improve outcomes—for example, improving social cohesion (eg, building social support networks) among community members—has been associated with improved physical health and psychological well-being.

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Clinical Practice Guidelines

Childhood Obesity Interventions

January 4, 2022 348 Views0

The epidemic of childhood obesity remains a significant public health challenge worldwide. In the US, rates of obesity among children of all age groups have tripled from the period 1976 to 1980 to the period 2015 to 2018. In nearly all of Europe, obesity in children aged 5 to 19 years has increased rapidly from 1980 to 2016. Before the COVID-19 pandemic, studies reported that these rising trends may be plateauing (albeit at a high level); decreasing activity and poor nutrition during the pandemic, however, might be reversing those gains. Even before pandemic-related effects, several trend analyses have shown a continuously rising prevalence of child overweight and obesity in low- and middle-income countries. Rising global overweight and obesity in childhood has profound implications; they ...

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Clinical Practice Guidelines

Improving Foster Care Outcomes via Cross-Sector Data and Interoperability

January 4, 2022 359 Views0

Social workers, educators, legal advocates, and physicians and other health care professionals depend on data to diagnose concerns, develop treatment plans, and evaluate outcomes for foster children, who account for 425 000 children in the US annually. However, data concerning child welfare issues are often substantially decentralized, protected, and even suppressed in the US, limiting the effectiveness of interventions and subsequent social and health outcomes. Research inquiry and implementation of effective polices are limited by the lack of a population health infrastructure to establish the evidence for a more effective US child welfare system. While health information exchanges are used by third-party payers in managing risk of their subscribers, these data, with rare exception, have...

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Clinical Practice Guidelines

Incorrect Affiliation and Address

January 4, 2022 386 Views0

In the article titled “Avoidant Restrictive Food Intake Disorder—What Are We Missing? What Are We Waiting for?” published online October 11, 2021, in JAMA Pediatrics, the author’s first affiliation and mailing address were given incorrectly. The corrected affiliation now reads, “Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Tufts Children’s Hospital, Boston, Massachusetts,” and the corrected mailing address now reads, “Laura K. Grubb, MD, MPH, Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Tufts Children’s Hospital, 800 Washington St, PO Box 351, Boston, MA 02132 (lgrubb@tuftsmedicalcenter.org).” The article has been corrected online.

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Clinical Practice Guidelines

Misspelled Author Name in the Byline

January 4, 2022 377 Views0

In the Original Investigation “Maternal and Neonatal Morbidity and Mortality Among Pregnant Women With and Without COVID-19 Infection: The INTERCOVID Multinational Cohort Study,” published in the August 2021 issue, there was an error in the byline. The 46th author given as “Enrico Ferrazi, MD,” should have appeared as “Enrico Ferrazzi, MD.” This article has been corrected online.

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Clinical Practice Guidelines

On Masks and Emotion Recognition

January 4, 2022 385 Views0

This study by Schneider et al attempted to answer an important question: Are preschool children’s abilities to recognize emotions significantly hampered by mask wearing? Although it is a well-controlled laboratory experiment, the approach used does not perfectly simulate real life where the tone of voice and the movement of faces would convey additional cues to children. Given the small effect sizes (especially compared with the overall rate of correct responses), these results provide ample reassurance that masks are unlikely to inhibit children’s ability to understand emotions.

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Clinical Practice Guidelines

Appropriateness of Opioid Prescription in Children, Adolescents, and Younger Adults—The Elephant in the Room

December 6, 2021 356 Views0

To the Editor We appreciated the article by Renny and colleagues assessing temporal trends in opioid prescribing practices in children, adolescents, and younger adults. In their conclusion, the authors state that there is a need for pediatric- and adolescent-specific guidelines and focused research in this unique population.

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Clinical Practice Guidelines

Appropriateness of Opioid Prescription in Children, Adolescents, and Younger Adults—The Elephant in the Room—Reply

December 6, 2021 575 Views0

In Reply We read with interest the commentary from Cortellazzo Wiel et al and thank them for highlighting an important point regarding our research on opioid prescribing practices in youth. The authors comment on the importance of opioid prescribing in certain settings, while also emphasizing avoidance of opioids when alternative pain management options are present. We agree that opioid prescribing must be evidence based, with recognition that opioids are an appropriate treatment for children with specific conditions (particularly severe acute pain; certain chronic diseases, such as cancer; and palliative care), but that their use should be counterbalanced with an understanding of potential opioid-related risks, including adverse effects, intentional or unintentional overdose, and risk of ...

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Clinical Practice Guidelines

Avoidant Restrictive Food Intake Disorder—What Are We Missing? What Are We Waiting For?

December 6, 2021 366 Views0

The diagnosis of avoidant restrictive food intake disorder (ARFID) materialized with the 2013 publication of the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) by the American Psychiatric Association. Simply stated, ARFID is an eating or feeding disturbance characterized by lack of interest in or avoidance of food that results in inadequate weight or weight loss, significant nutritional deficiency, dependence on supplemental nutrition or alternative feeding methods, and marked interference with psychosocial functioning. Avoidant restrictive food intake disorder is aversion or phobia that may have a triggering event. It is not picky eating, adherence to a culturally sanctioned practice, or lack of available nutritious food sources, and it is not about weight o...

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Clinical Practice Guidelines

Error in Introduction

December 6, 2021 376 Views0

The Original Investigation titled “Effect of Whole-Genome Sequencing on the Clinical Management of Acutely Ill Infants With Suspected Genetic Disease: A Randomized Clinical Trial” was corrected to fix the first paragraph of the Introduction, which had incorrectly indicated that NICU costs were approximately $26 billion annually; the correct value is $17 billion, which reflects the cost of neonatal hospitalizations inclusive of those in the NICU. An irrelevant reference associated with the erroneous text was also removed.

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Clinical Practice Guidelines

The Effect of BabySeq on Pediatric and Genomic Research

November 1, 2021 346 Views0

In this issue of JAMA Pediatrics, Pereira et al report on a sizable group of healthy newborns screened with whole-exome sequencing (WES) shortly after birth whose world—and the world of their parents—did not end in psychological and emotional Armageddon (so far). Does this mean that we are ready to offer WES to each of the 4 million infants born annually in the US? No. Does it mean that we have made a critical first step in understanding the potential benefits and harms of screening newborns with WES? Absolutely.

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Clinical Practice Guidelines

Validation of the Association of Oral Corticosteroid Bursts With Adverse Events in Children—Reply

November 1, 2021 349 Views0

In Reply We thank Lin and Wei for their interest in our article. Our study provided real-world evidence of an association between oral corticosteroid bursts (defined as oral corticosteroid use for 14 days or less) and gastrointestinal bleeding, sepsis, and pneumonia. We suggested that when prescribing oral corticosteroids, clinicians consider these potential adverse events.

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Clinical Practice Guidelines

Children as Transmitters of COVID

November 1, 2021 401 Views0

The iconic article “Cuddlers, Touchers, and Sitters” (formerly entitled “Modes of Transmission of Respiratory Syncytial Virus”) by Hall and Douglas stands to this day as one of the simplest recitations of the behavior of respiratory viruses and children. With an elegant and simple study design, Hall and Douglas vividly demonstrated that it’s the interactions between susceptible and infected persons that drive much of viral transmission. For those who do not recall this study, Hall and Douglas examined the likelihood of transmission from an infant infected with respiratory syncytial virus (RSV) to an adult caretaker who either sat with the infant on their lap, touched the infant while they laid in their crib, or sat next to the crib. We can now predict the outcomes—cuddlers were the most li...

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Clinical Practice Guidelines

A Definitive Answer to the Effect of Screen Time on Concussion Recovery

November 1, 2021 415 Views0

The issue of screen time in concussion management has been debated for more than 2 decades, camouflaged in guidelines regarding cognitive rest and lacking specifics regarding the extent to which screen time should be limited and the duration of these limitations. The most common guidelines for concussion management published by the Concussion in Sport Group in 2017 do not mention the word screen and acknowledge the lack of evidence for any form of cognitive rest, stating, “The basis for recommending physical and cognitive rest is that rest may ease discomfort during the acute recovery period by mitigating post-concussion symptoms and/or that rest may promote recovery by minimizing brain energy demands post-concussion. There is currently insufficient evidence that prescribing complete rest ...

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Clinical Practice Guidelines

Implications of SARS-CoV-2 Viral Load in Children

October 4, 2021 403 Views0

The SARS-CoV-2 pandemic has impacted the medical, economic, social, and political landscape worldwide. Despite public health measures to contain the virus, including masks, hand hygiene, school closures, and stay-at-home orders, COVID-19 was the third leading cause of death in the US in 2020. Although early data suggested that children accounted for only 2% of COVID-19 cases, more recent reports have indicated that 13% of diagnosed cases in the US have occurred in children. Additionally, the number of COVID-19 hospitalizations among children is similar to that observed in a typical influenza season, and COVID-19 deaths in children exceed the total observed in any single influenza season. In March 2020, in an attempt to curb the exponential growth of the COVID-19 pandemic, kindergarten thro...

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Clinical Practice Guidelines

Pediatric COVID-19 Disparities and Prioritizing Equity—Children Are Not Spared

September 7, 2021 376 Views0

The COVID-19 pandemic has been characterized by disproportionally higher rates of disease, hospitalization, and death among adults from historically marginalized racial/ethnic groups. Whether a similar association exists in children is not as well established because data that directly examine race/ethnicity and pediatric COVID-19 risk and also account for socioeconomic factors are sparse. Given the uncertainty around the natural history and prognosis of COVID-19 in children, understanding how race/ethnicity and socioeconomic status influence pediatric outcomes will help determine who is most at risk so that equitable care can be provided.

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Clinical Practice Guidelines

Errors in Introduction and End Matter

August 2, 2021 367 Views0

In a Research Letter, “Assessing the Agreement of 5 Ideal Body Weight Calculations for Selecting Medication Dosages for Children With Obesity,” published in the June 2019 issue of JAMA Pediatrics, there was an error in the introduction. The phrase “for children shorter than 5 ft, the IBW in kilograms is calculated as ([height in inches]2 × 1.65)/1000” should have read “for children shorter than 5 ft, the IBW in kilograms is calculated as ([height in centimeters]2 × 1.65)/1000.” The error has been corrected online. In addition, Author Contributions information missing from the article has been added online.

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Clinical Practice Guidelines

Error in Table

August 2, 2021 374 Views0

In the Original Investigation titled “Novel Variant Findings and Challenges Associated With the Clinical Integration of Genomic Testing: An Interim Report of the Genomic Medicine for Ill Neonates and Infants (GEMINI) Study,” published in the May 2021 issue of JAMA Pediatrics, there was an error in Table 4. For patients 38 and 54, G6PD is an x-linked recessive disorder instead of autosomal recessive. This article was corrected online.

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Clinical Practice Guidelines

Error in Dates in Figures

August 2, 2021 378 Views0

In the Research Letter titled “Assessing Child Abuse Hotline Inquiries in the Wake of COVID-19: Answering the Call,” published online May 3, 2021, in JAMA Pediatrics, there were errors in the dates presented in the Figure. In panels A and B, April 9 has been revised to April 1, and May 13 has been revised to May 6. In panel B, the April 1 marker has been placed at week 14, not week 15. The Figure caption has been revised from “Phone call and text inquiries are plotted as number of inquiries per week between March 1, 2019, and May 27, 2019, and March 1, 2020, and May 26, 2020,” to “Phone call and text inquiries are plotted as number of inquiries per week between January 1, 2019, and May 27, 2019, and January 1, 2020, and May 26, 2020.” All other information in the Figure was correct and is ...

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Clinical Practice Guidelines

Nonauthor Collaborator Supplement Added

August 2, 2021 520 Views0

In the Original Investigation titled “Epidemiology, Clinical Features, and Disease Severity in Patients With Coronavirus Disease 2019 (COVID-19) in a Children’s Hospital in New York City, New York,” published in the October 2020 issue of JAMA Pediatrics, a Supplement was added that lists the members of the Columbia Pediatric COVID-19 Management Group. This article was corrected online.

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Clinical Practice Guidelines

Errors in the Abstract, Key Points, and Text

July 6, 2021 426 Views0

In the Original Investigation titled “Association of Oral Corticosteroid Bursts With Severe Adverse Events in Children,” which published online April 19, 2021, the word “cohort” should be removed from the first sentence of the Design, Setting, and Participants paragraph of the Abstract, from the first sentence of the Findings of the Key Points, from the first sentence of the Discussion, and from the first sentence of the Conclusions. This article was corrected online.

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Clinical Practice Guidelines

Error in Results

July 6, 2021 427 Views0

In the Research Letter titled “Association of Preconception Paternal Alcohol Consumption With Increased Fetal Birth Defect Risk,” published online April 19, 2021, the number of couples classified as having paternal alcohol consumption was updated from 165 151 to 164 151, and the percentage was changed from 31.2% to 31.0% in the Results and Discussion sections. This article was corrected online.

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Clinical Practice Guidelines

Revitalizing Adolescent Health Behavior After the COVID-19 Pandemic

July 6, 2021 427 Views0

In a prospective cohort study of public high school students in Northern California, Chaffee et al observed a decline in physical activity frequency during the stay-at-home orders related to the COVID-19 pandemic, but no change was observed in the frequency of substance use (ie, e-cigarettes, other tobacco, cannabis, and alcohol). The direct consequences of COVID-19 infection have received unprecedented scientific attention, but the indirect consequences that countermeasures to stem the spread of COVID-19 have had on health-related behaviors are less understood and may have long-term health consequences. The study by Chaffee et al helps address a critical gap in the understanding of how stay-at-home restrictions have had unintended implications for health-related behaviors in youth. We con...

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Clinical Practice Guidelines

Rotavirus Vaccines—Going Strong After 15 Years

July 6, 2021 438 Views0

This editorial is dedicated to the hope that the new COVID-19 vaccines will be as successful as rotavirus vaccines in protecting against disease. Based on their high burden of mortality in low-income countries and hospitalization in the middle-income to high-income countries, rotavirus was marked as a key target for vaccine development shortly after identification in 1973. The first efforts to develop a live attenuated vaccine met with an initial hiccup because of the association of the vaccine with intussusception, but sustained success soon followed. Since licensure of RotaTeq in 2006 and Rotarix in 2008, rotavirus vaccines have been introduced in more than 100 countries. In an article in this issue of JAMA Pediatrics, Sun et al have conducted a thorough evaluation of the comparative ben...

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Clinical Practice Guidelines

Longitudinal Treatment Engagement for Youths in the Juvenile Justice System

July 6, 2021 390 Views0

The burden of psychiatric disorders on an individual’s life is substantial. Not only does a psychiatric disorder affect a person’s mood, but the presence of a psychiatric disorder plays a role in virtually every area of an individual’s life, including romantic and social relationships as well as educational and job opportunities. The presence of psychiatric disorders in vulnerable populations is exacerbated by involvement in the justice system. The Northwestern Juvenile Project has been an invaluable source for researchers, clinicians, and advocates to understand how the course of adolescent development is impacted by justice system involvement, particularly among youths with psychiatric disorders.

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Clinical Practice Guidelines

Growth Hormone Use in Childhood and Adult Cardiovascular Disease—Reply

June 7, 2021 396 Views0

In Reply We have with great interest read the letter by Malozowski and Lightbourne about our study on long-term cardiovascular morbidity in patients previously treated with childhood growth hormone (GH) and would, first of all, like to thank the authors for having taken interest in our study. However, we would also like to clarify some misconceptions. Malozowski and Lightbourne state as critical limitations that we have failed to account for short stature, information about height by sex, and other hormonal deficiencies. We disagree with this description because we have indeed taken these issues into account.

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Clinical Practice Guidelines

Growth Hormone Use in Childhood and Adult Cardiovascular Disease

June 7, 2021 417 Views0

To the Editor As highlighted by Grimberg, the article by Tidblad et al has similar limitations to prior reports showing associations between childhood growth hormone (GH) exposure and untoward health events in adulthood. Critical limitations include the failure to account for short stature and inadequate information on height by sex and other hormonal deficiencies. Thyroid hormones, cortisol, sex steroids, and many medications commonly used in conjunction with GH that may have had an effect on the encountered findings were not considered. Additionally, a stronger comparator using health status comparisons with control participants when recombinant GH was not available could have accounted for these deficiencies and supported the conclusions.

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Clinical Practice Guidelines

The Swinging Pendulum of Postnatal Corticosteroid Use

June 7, 2021 380 Views0

The pattern of postnatal corticosteroid (PNC) use for bronchopulmonary dysplasia (BPD) follows a pendulum swinging from overt optimism 30 years ago over PNC’s benefits to the current pessimism over PNC’s apparent risks. Bronchopulmonary dysplasia affects 30% to 45% of extremely low-gestational-age newborns (born <28 weeks’ gestational age) and remains among the most common and intractable sequelae of preterm birth. This chronic lung disease results from a variety of antenatal and postnatal exposures, including infection and inflammation. Such insults, when combined with the immature lungs’ aberrant reparative processes, are associated with reduced alveolar surface area and long-term functional morbidities. Bronchopulmonary dysplasia is also associated with delayed brain maturation and d...

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Clinical Practice Guidelines

Error in the Text

June 7, 2021 436 Views0

In the Original Investigation titled “A Budget Impact Analysis of Gene Therapy for Sickle Cell Disease: The Medicaid Perspective,” which published online March 22, 2021, there was an error in the Introduction section. The third sentence in the fourth paragraph of that section should read: “A gene therapy using the same lentiviral vector received conditional approval from the European Medicines Agency in 2019 for the treatment of transfusion-dependent β-thalassemia.” This article was corrected online.

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Clinical Practice Guidelines

JAMA Pediatrics —The Year in Review, 2020

May 3, 2021 462 Views0

For the last 3 years, I have begun this review by stating it has been an extraordinary year for JAMA Pediatrics. I mean it this time! The calendar year coincides almost perfectly with the start of the coronavirus disease 2019 (COVID-19) pandemic, and for all of the misery it brought, it also generated an enormous amount of research. We received more than 1000 COVID-19–related manuscripts from all over the world. In part because of these, our overall submissions were up 53%, and our acceptance rate for the year was 5% (down from 8% last year). In 2020, the top-viewed articles were all related to COVID-19, as were 2 of the top 3 articles by Altmetric score (a measure of news and social media attention) and the top 3 most cited articles. There remain unanswered questions related to COVID-19, ...

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Clinical Practice Guidelines

Error in Methods Section and Figure

May 3, 2021 405 Views0

In the Original Investigation titled “Assessment of Exposure to High-Performing Schools and Risk of Adolescent Substance Use: A Natural Experiment,” there were errors in the Methods section and Figure 1. In the Methods section, the number of potential participants identified should be 1995 instead of 1996, and the number of ineligible participants should be 486 instead of 487. Likewise, in Figure 1, the total number of potential participants should be 1995, and the number of ineligible patients should be 486. In addition, the number of individuals unable to be contacted or had moved should be 319 rather than 320. Under intervention baseline, the number of individuals who were unable to be reached and individuals who refused were switched. This article was corrected online.

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Clinical Practice Guidelines

Clarifications of Terms and for Interpreting Incidence Rate Ratios

May 3, 2021 668 Views0

In the Original Investigation, “Association of the Timing of School Closings and Behavioral Changes With the Evolution of the Coronavirus Disease 2019 Pandemic in the US,” published online first on February 22, 2021, in JAMA Pediatrics, there were errors in the text for description of the incidence rate ratios (IRRs). In the Abstract and main text, “delay of 1 day” and “day of delay” have been corrected to “advance of 1 day” and “each day earlier.” The term “days since” has been corrected to “each day earlier” in the text and defined in the legend of the Table as “how much earlier in the pandemic either school closures, gathering bans, or work reductions happened. Each 1-unit increase in a ‘days since’ variable represents 1 day earlier that the change happened.” These corrections do not af...

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Clinical Practice Guidelines

Error in Figure

May 3, 2021 428 Views0

In the Research Letter entitled “Prevalence of Spanking in US National Samples of 35-Year-Old Parents From 1993 to 2017,” a percentage symbol was erroneously included in the y-axis label of the Figure. This symbol was removed and the y-axis label now reads “Weighted prevalence, SE.” This article was corrected online.

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Clinical Practice Guidelines

Diagnosing Childhood Tuberculosis

May 3, 2021 399 Views0

Prior to 2012, there were no reliable estimates of the incidence of tuberculosis in the world’s children. Using the only available information, in 2013, the World Health Organization estimated there were approximately 500 000 annual cases and 89 000 deaths among children not living with HIV; there were no data to even estimate the mortality among children living with HIV. Throughout the next several years, modeling studies suggested that the rates of cases and mortality were much higher. Using these techniques, in 2019, the World Health Organization estimated there were 1.2 million annual cases and 230 000 annual deaths from tuberculosis in children younger than 15 years. One study estimated that 96% of the children who died never received treatment, mostly because they were never diagnose...

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