This was a prospective study of children with blunt torso trauma with a goal of identifying high-risk and low-risk indicators of intra-abdominal injury (IAI). The long term objective of the study is to derive, validate, disseminate and implement decision support tools to optimize the evaluation of children with blunt torso trauma, which will lead to reduced morbidity and mortality. The overall objective of this particular study is to develop a clinical decision rule for appropriate use of abdominal computerized tomography (CT) scanning in children with blunt torso trauma. We will create a decision rule that identifies those children in need of emergent CT scan and treatment, while reducing the use of abdominal CT scans in those children with minimal risk of IAI. The study was funded by the Centers for Disease Control and Prevention. Patient enrollment began in May, 2007 and concluded in January 2010. The main paper, Identifying Children at Very Low Risk of Clinically Important Blunt Abdominal Injuries, was published in Annals of Emergency Medicine, in Feb 2013. The public use data set can be requested here.
Archives: PECARN Studies
ASSESS (Age Specific Screen for Ethanol and Substance Status) aims to validate the newly developed National Institute for Alcohol Abuse and Alcoholism (NIAAA) two-question screen for early detection of alcohol use and problems in 12-17 year olds in 16 PECARN pediatric emergency departments. Approximately 5000 youths presenting to participating PECARN pediatric emergency departments (PED) were enrolled over a 3 year period. Subjects completed the two-question screen along with an alcohol and other drug and behavior assessment battery. The advantage of the PED setting is the ability to capture high risk populations such as school dropouts and those without primary care or insurance, who often use PEDs for their medical care and are missed in other study settings. This study is funded by the National Institute for Alcohol Abuse and Alcoholism (NIAAA).
The Arginine Feasibility project was funded as part of an R34 clinical trials planning grant that will establish a protocol steering committee with expertise in Sickle Cell Disease (SCD) clinical trials, create a clinical network of sites with a strong track record of successful participation in multi-center trials, create an ED-based pain protocol, develop a data coordinating plan, identify safety and clinical endpoints and a completed protocol for a phase III clinical trial of L-arginine for the treatment of vaso-occlusive pain in children with SCD to be submitted for NIH funding. Specifically this study is creating a standardized ED-based pain therapy protocol based on NIH guidelines that will be utilized in the future phase III trial, collecting feasibility data on volume, time of visit and admission rates from high-volume PECARN and non-PECARN sites on all potentially eligible patients with SCD and collecting demographic and clinical data through a 20 patient chart review at each participating site. This study is funded through the NHLBI.
The ultimate goal of this project is to incorporate a RNA-based diagnostic technology (called transcriptional signatures) to distinguish between bacterial and non-bacterial infections in otherwise well-appearing febrile infants who present to the EDs. The project aims to create a PECARN wide infrastructure for conducting translational genomic research and demonstrate feasibility of screening, consenting, collecting, and processing of small volumes of blood samples to abstract high quality RNA from febrile infants. After initially defining bacterial and non-bacterial biosignatures, we will conduct a limited validation of these diagnostic biosignatures on an independent group of febrile infants. Patient enrollment began in 2008 and continued through May 2013. Analysis is in progress. This project is co-funded by NICHD.
Acute gastroenteritis (AGE) is a leading cause of malnutrition and death worldwide and affects millions of children in the US each year. Most AGE is viral in origin, and apart from care focused on rehydration and nausea, there are no therapies to reduce the severity of illness. The overall objective of this randomized, placebo-controlled, double-blind, multi-center study is to determine the efficacy and side effect profile of the probiotic, Lactobacillus rhamnosus GG (LGG), in children aged 3 to 48 months presenting to the ED with AGE. Patients were randomized to receive either LGG or placebo twice a day for 5 days, for a total of 10 doses. Nine-hundred and seventy-one children were enrolled in 10 PECARN sites over 4 years. Enrollment completed in Summer 2017. Analysis is in progress. This project is funded by the NICHD.