Let’s say you want to buy a new television. You probably would do some digging and compare each brand’s best features and consult reviews from other consumers before making a purchase. The decision-making process isn’t always as straightforward, however, when you’re faced with making a choice about your healthcare. Compelling information about the benefits and harms of a medical test, therapy, or healthcare service may not be readily available.
That’s why the Center for Pediatric Clinical Effectiveness (CPCE) at Children’s Hospital of Philadelphia participates in research projects to help build objective evidence about which treatment options or healthcare delivery approaches work best. Twice a year, the CPCE Pilot Grant Program offers funding opportunities to CHOP investigators conducting clinical effectiveness studies. The recipient of the Fall 2016 Pilot Grant Awards are Ruth Abaya, MD, MPH; Yeh-Chung (Dan) Chang, MD; and Sheila Quinn, DO.
Read on to learn more about the awardees and their studies.
Ruth Abaya, MD, MPH
Dr. Abaya is an attending physician in the department of Emergency Medicine at CHOP and a CHOP pediatric emergency medicine specialist at St. Mary’s Hospital. Her research interests include how asthma patients, families, and providers make decisions that influence their medical care. Recent studies have identified a variety of regimens available to children discharged from emergency departments after treatment for asthma, presenting the opportunity to simplify and standardize the approach.
Dr. Abaya’s pilot study award, titled “Determining the optimal frequency of dexamethasone therapy in the treatment of young children with intermittent asthma discharged from the emergency department,” will determine whether a single standard dose of dexamethasone is non-inferior to a two-dose regimen for the management of mild to moderate asthma exacerbations in young children with intermittent asthma discharged from the emergency department.
The results of this study will help to determine whether further standardization of corticosteroid dosage in young patients with mild asthma helps to minimize unnecessary exposure and to reduce healthcare costs and undue burden to families. If successful, this study will inform treatment guidelines for asthma for young children and potentially reduce their steroid exposure. This study will also better describe the short-term outcomes of mild to moderate exacerbations in children with intermittent asthma both by symptoms and quality of life measure to guide future treatment trials.
Dr. Abaya received her MD and master’s of Public Health degrees from the Feinberg School of Medicine at Northwestern University. She completed her residency in Pediatrics at the Combined Residency Program in Boston and a fellowship in Emergency Medicine at CHOP. Dr. Abaya’s work has been recognized with several awards, including the James A. Stockman III Award for Excellence in Pediatrics and Child Health and the Fred Lovejoy Resident Research and Education Grant. She is a member of the American Academy of Pediatrics.
Yeh-Chung (Dan) Chang, MD
Dr. Chang is a fellow with the division of Infectious Diseases at CHOP. His research interests revolve around the epidemiology of vaccine-preventable respiratory diseases. Through a current grant funded by the National Institutes of Health, he has obtained various training experiences in clinical epidemiology, biostatistics, database management, review of protocols, and clinical outcomes.
Dr. Chang’s pilot study is on “The effect of a clinical pathway and rapid influenza polymerase chain reaction testing on rates of readmission to the pediatric emergency department and subsequent hospitalizations.” Outcomes from neither clinical pathways nor the rapid influenza test have been well described in the pediatric population.
Influenza affects much of the pediatric population yearly; therefore this study will be extremely useful in determining whether these new methods significantly affect clinical outcomes. Appropriate oseltamivir use, the goal of both the pathway and rapid test implementation, will also be studied to see if it independently leads to improved outcomes. Oseltamivir is a medication used to treat influenza infection.
Dr. Chang received his MD from the Robert Wood Johnson Medical School and completed his residency in pediatrics at the University of Texas Southwestern Medical Center. He is currently pursuing a master’s degree in Clinical Epidemiology at the University of Pennsylvania. He is a member of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics.
Sheila Quinn, DO
Dr. Quinn is an adolescent medicine fellow in the Craig-Dalsimer Division of Adolescent Medicine at CHOP. Her research and clinical interests include the reproductive health and transitions of care for young people with chronic disease. Her pilot grant award is titled, “Resilience as a Mediator in Healthcare Transitions Among Adolescent and Young Adult Kidney Transplant Recipients.” Despite numerous challenges, most adolescent kidney transplant recipients are successful in transitioning from pediatric to adult healthcare. There is a critical need to identify the factors that help these patients thrive.
The study will characterize a patient-centered definition of successful healthcare transition among adolescent and young adult kidney transplant recipients, and compare it to conventional provider-driven outcomes definitions. The study also aims to identify which key constructs of the American Academy of Pediatrics’ resilience framework contribute to successful healthcare transition when using a patient-centered definition and conventional provider-driven outcome measures.
The results of this study will help to generate a hypothesis regarding the role of resilience in successful navigation of healthcare transition among youth and how these protective factors can be targeted in future intervention studies. If successful, the pilot study can be used to inform future research that will specifically test the efficacy of this model for a broader adolescent patient population across many disease studies.
Dr. Quinn received her DO from the Philadelphia College of Osteopathic Medicine. She completed her residency in Internal Medicine-Primary Care at Yale-New Haven Hospital. Dr. Quinn has published several abstracts and papers and has received several awards, including the John W. Bracket Award for Resident Teacher and the Gary Vernon Ralph Memorial Humanism in Medicine Award. She is a member of the Society for Adolescent Health and Medicine, the American College of Physicians, and the Society of General Internal Medicine.
The purpose of the CPCE Pilot Grant Program is to promote and support fellows, junior faculty, and other CHOP Research investigators in clinical effectiveness pilot research studies that will attract external support for large-scale studies. Clinical effectiveness research is defined as research designed to produce evidence of what works best for treating, diagnosing, and preventing disease.
CHOP investigators from all Hospital departments and divisions, including fellows in their final year of fellowship transitioning to Hospital-affiliated faculty, are encouraged to apply for the next Pilot Grant Award, which accepts applications for the spring cycle in early April and the fall cycle in early October. For more information about the Pilot Grant Program, please contact Megan Foley.