Evidence map›Paper›PMID 24921412›Full record

ArticleJournal of perinatology : official journal of the California Perinatal Association2014

Variation in treatment of neonatal abstinence syndrome in US children's hospitals, 2004-2011.

S W Patrick, H C Kaplan, M Passarella, M M Davis, S A Lorch

Abstract read
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In one paragraph

Article in Journal of perinatology : official journal of the California Perinatal Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 1 pooled it
17.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 1 synthesis or guideline pooled it, 131 citations in OpenAlex.

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  12. The Cost of Opioid Use in High-Risk Hospitalized Infants.The Journal of surgical research · 2024
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  16. Association of medication-assisted treatment and short acting opioids with newborn head circumference and birth weight.Journal of perinatology : official journal of the California Perinatal Association · 2023
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1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

S W Patrick1] Department of Pediatrics, Vanderbilt University, Nashville, TN, USA [2] Mildred Stahlman Division of Neonatology, Vanderbilt University, Nashville, TN, USA [3] Vanderbilt Center for Health Services Research, Nashville, TN, USA.
H C Kaplan1] Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA [2] James M Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
M PassarellaCenter for Outcomes Research, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
M M Davis1] Child Health Evaluation and Research (CHEAR) Unit, Department of Pediatrics and Communicable Diseases, University of Michigan Health System, Ann Arbor, MI, USA [2] Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI, USA [3] Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
S A Lorch1] Center for Outcomes Research, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA [2] Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA [3] Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
Children's Hospital of Philadelphia · USCincinnati Children's Hospital Medical Center · USUniversity of Michigan–Ann Arbor · USVanderbilt University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveNeonatal abstinence syndrome (NAS) is a drug withdrawal syndrome experienced by opioid-exposed infants. There is no standard treatment for NAS and surveys suggest wide variation in pharmacotherapy for NAS. Our objective was to determine whether different pharmacotherapies for NAS are associated with differences in outcomes and to determine whether pharmacotherapy and outcome vary by hospital. STUDY

designWe used the Pediatric Health Information System Database from 2004 to 2011 to identify a cohort of infants with NAS requiring pharmacotherapy. Mixed effects hierarchical negative binomial models evaluated the association between pharmacotherapy and hospital with length of stay (LOS), length of treatment (LOT) and hospital charges, after adjusting for socioeconomic variables and comorbid clinical conditions.

resultOur cohort included 1424 infants with NAS from 14 children's hospitals. Among hospitals in our sample, six used morphine, six used methadone and two used phenobarbital as primary initial treatment for NAS. In multivariate analysis, when compared with NAS patients initially treated with morphine, infants treated with methadone had shorter LOT (incidence rate ratio (IRR) = 0.55; P < 0.0001) and LOS (IRR = 0.60; P < 0.0001). Phenobarbital as a second-line agent was associated with increased LOT (IRR = 2.09; P<0.0001), LOS (IRR = 1.78; P < 0.0001) and higher hospital charges (IRR = 1.84; P < 0.0001). After controlling for case-mix, hospitals varied in LOT, LOS and hospital charges.

conclusionWe found variation in hospital in treatment for NAS among major US children's hospitals. In analyses controlling for possible confounders, methadone as initial treatment was associated with reduced LOT and hospital stay.

Indexed as

ComorbidityFemaleHospital ChargesHospitals, PediatricHumansInfant, NewbornLength of StayMaleMultivariate AnalysisNeonatal Abstinence SyndromePhenobarbitalPractice Patterns, Physicians'Retrospective StudiesUnited StatesPhenobarbital

Identifiers

PMID24921412
OpenAlexW1965307957

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.