ArticleThe Journal of the Oklahoma State Medical Association2018
Off-Label Medication use in Children, More Common than We Think: A Systematic Review of the Literature.
Article in The Journal of the Oklahoma State Medical Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
70 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Model-Informed Precision Dosing in Pediatric Patients: Current Software Tools and Bedside Guided Application.Paediatric drugs · 2026Pooled it
- Off-Label Medicine Use in Pediatric Anesthesia-Recommendations of the World Federation of Societies of Anaesthesiologists (WFSA) Paediatric Committee.Paediatric anaesthesia · 2026Guideline
- Guideline for the management of pediatric off-label use of drugs in China (2021).BMC pediatrics · 2022Guideline
- A Complex Intervention to Prevent Medication-Related Hospital Admissions.Deutsches Arzteblatt international · 2023Trial
- Facilitating Expedited Drug Approval-the Past, Present, and Future of Clinical Trials for Pediatric Rheumatic Disease.Arthritis care & research · 2026Article
- Off-Label Use of Medicines in Pediatrics: Necessary and Not "Off-Knowledge".The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2026Article
- Characteristics of Dupilumab-Treated Patients with Atopic Dermatitis Over Time: A Cross-Sectional Assessment of Potential Channeling Bias upon Pediatric Label Extension.Dermatology and therapy · 2026Article
- Suitability of Oral Formulations Available to Children at the Time of Pediatric Labeling.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2026Article
- Deprescribing Psychiatric Medications in Youth: A Feasibility Study.Community mental health journal · 2026Article
- Promises, Pitfalls, and Paths Forward for the Pediatric Research Equity Act.JAMA health forum · 2026Article
- Physician Perceptions and Intentions in Response to Unsupportive Data for Off-label Uses: An Experimental Study with Primary Care Providers and Oncologists.Therapeutic innovation & regulatory science · 2026Article
- Off-label prescribing in Italian pediatric practice: insights from a nationwide survey.European journal of pediatrics · 2025Article
- Identifying Pediatric Drug Safety Knowledge Gaps: An Integrated Approach Leveraging Real-World Data, a Biomedical Knowledge Base, and Postmarketing Surveillance Data.Pharmacotherapy · 2025Article
- Utilization of Child-Appropriate Medicines: Use of Pediatric Use Marketing Authorisation (PUMA) Products in Croatia.Journal of clinical medicine · 2025Article
- Pediatric Pharmacy Association 2025 KIDs List of Key Potentially Inappropriate Drugs in Pediatrics.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Experience and lessons learned relating to investigational product supply in the design and delivery of a paediatric investigator-initiated clinical trial.Contemporary clinical trials communications · 2025Article
- A review on the role of extrapolation as basis for paediatric marketing authorization applications of medicines in the EU.British journal of clinical pharmacology · 2025Review
- Off-label drug use in palliative medicine: Delphi study for the consensus of evidence-based treatment recommendations.Palliative medicine · 2025Article
- Harmonizing the methodology and metrics definitions across pediatric clinical trials networks, an important step towards better health outcomes in children.Pediatric research · 2025Article
- Access to child-appropriate medicines: an exploratory survey of the use of paediatric use marketing authorisation products in the UK.European journal of pediatrics · 2025Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
contentClinician prescribing of off-label medications is common due to a lack of pediatric-specific data regarding the dosing, efficacy and safety of medications regularly prescribed to children.
objectiveThis systematic review summarizes the published incidence of off-label medication use in children from the past 10 years. We also performed a retrospective chart review to determine the incidence of off-label prescriptions for children seen in the OU Physicians clinics. DATA SOURCES: We conducted a literature search of PubMed and OVID Medline from 2007 to 2017. Search terms included off-label use of medications and all child. For the local review, the outpatient electronic medical record (EMR) was queried. STUDY SELECTION: Studies were eligible for inclusion if the study included children < 18 years of age, defined off-label use in the paper, and included the incidence of off-label drug use. DATA EXTRACTION: Each review author extracted the study data from their assigned studies. For the retrospective chart review, the EMR was queried for patients <21 years of age who had a clinic visit and received a new prescription during 2017.
resultsWe identified 31 studies, with off-label prescription rates from 3.2 % to 95%. The local retrospective chart review included 1,323 prescriptions; 504 were off-label (38.1%) and 819 were approved. The frequency of off-label prescriptions does not differ significantly between the meta-analysis from the systematic review and the local retrospective chart review (30.9% vs 38.1%).
conclusionsThe use of off-label medications in children remains a common practice for pediatric providers.
Identifiers
31379392PMC6677268What OpenQuestion holds
Registered trials
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.