Engagement, Peer Production, and the Learning Healthcare System
Published March 2014
Seid M, Margolis PA, Opipari-Arrigan L. Engagement, peer production, and the learning healthcare system. JAMA Pediatr 2014;168(3):201-202
Physicians deliver about half of indicated care, and patients do about half of what it takes to stay healthy, despite the best intentions and tireless efforts of both physicians and patients. The learning healthcare system (LHS) has been proposed as a solution.
Implementable strategies and exploratory considerations to reduce costs associated with anti-TNF therapy in inflammatory bowel disease
Published May 2014
Park KT, Crandall WV, Fridge J, Leibowitz IH, Tsou M, Dykes D, Hoffenberg EJ, Kappelman MD, Colletti RB. Implementable strategies and exploratory considerations to reduce costs associated with anti-TNF therapy in inflammatory bowel disease. Inflamm Bowel Dis 2014; 20:946-51
A health care system is needed where care is based on the best available evidence and is delivered reliably, efficiently, and less expensively (best care at lower cost). In gastroenterology, anti-tumor necrosis factor agents represent the most effective medical therapeutic option for patients with moderate-to-severe inflammatory bowel disease (IBD), but are very expensive and account for nearly a quarter of the cost of IBD care, representing a major area of present and future impact in direct health care costs.
Effectiveness of anti-TNF for Crohn’s disease: research in a pediatric learning health system
Published July 2014
Forrest CB, Crandall WV, Bailey LC, Zhang P, Joffe MM, Colletti RB et al. Effectiveness of anti-TNF for Crohn’s disease: research in a pediatric learning health system. Pediatrics 2014; 134:37-44
ImproveCareNow (ICN) is the largest pediatric learning health system in the nation and started as a quality improvement collaborative. To test the feasibility and validity of using ICN data for clinical research, we evaluated the effectiveness of anti-tumor necrosis factor-α (anti-TNFα) agents in the management of pediatric Crohn disease (CD).
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PEDSnet: How A Prototype Pediatric Learning Health System Is Being Expanded Into A National Network
Published July 2014
Forrest CB, Margolis P, Seid M, Colletti RB. PEDSnet: How a prototype pediatric learning health system is being expanded into a national network. Health Affairs 2014; 33:1171-7
Except for a few conditions, pediatric disorders are rare diseases. Because of this, no single institution has enough patients to generate adequate sample sizes to produce generalizable knowledge.
Seasonality and pediatric inflammatory bowel disease
Published July 2014
Lee GJ, Dotson JL, Kappelman MD, King E, Pratt JE, Colletti RB, Bistrick S, Burkam JL, Crandall WV, the ImproveCareNow Network. Seasonality and pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2014; 59:25-8
Seasonal and geographic variations of inflammatory bowel disease (IBD) exacerbations have been described in adults, with inconsistent findings. We sought to determine whether disease activity in pediatric-onset IBD is associated with a seasonal pattern.
Routine use of tiopurines in maintaining remission in pediatric Crohn's disease
Published July 21, 2014
Boyle BM, Kappelman MD, Colletti RB, Baldassano RN, Milov DE, Crandall WV. Routine use of thiopurines in maintaining remission in pediatric Crohn's disease. World J Gastroenterol 2014; 20:9185-90
The multi-center Pediatric Inflammatory Bowel Disease Network (PIBDNet) cohort study prospectively collected data on thiopurine naïve patients initiating mercaptopurine (6MP) or azathioprine. Patients with a diagnosis of Crohn’s disease (CD) were included in our study upon entering remission as determined by physician global assessment (PGA) within 365 d of initiation of thiopurines.
Use of the emergency department in pediatric inflammatory bowel disease
Published September 2014
Hoffenberg EJ, Park KT, Fridge J, Leibowitz I, Tsou M, Dykes D, Kappelman M, Colletti RB. Use of the emergency department in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2014;59: 324–326
We sought to characterize emergency department (ED) encounters for pediatric inflammatory bowel disease (IBD) to identify areas for prevention.