Evidence map›Paper›PMID 37737186›Full record

ArticleJournal of eating disorders2023

Modification of an inpatient medical management protocol for pediatric Avoidant/Restrictive Food Intake Disorder: improving the standard of care.

Sasha Gorrell, Siena S Vendlinski, Arianna S Thompson, Amanda E Downey, Rachel Kramer, Lisa Hail, Sharon Clifton, Sarah Forsberg, Erin E Reilly, Elizabeth Saunders and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of eating disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
3.4field-weighted citation impact, top 7% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Avoidant/Restrictive Food Intake Disorder: Review and Recent Advances.Focus (American Psychiatric Publishing) · 2024
    Review
  7. Eating Disorders: Updates and Innovations.Focus (American Psychiatric Publishing) · 2024
    Article
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

12 authors at 1 institution in 1 country.

Sasha GorrellDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA. Sasha.Gorrell@ucsf.edu.
Siena S VendlinskiDepartment of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Arianna S ThompsonSchool of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Amanda E DowneyDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA.
Rachel KramerDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA.
Lisa HailDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA.
Sharon CliftonDepartment of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Sarah ForsbergDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA.
Erin E ReillyDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA.
Elizabeth SaundersDepartment of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Sara M BuckelewDepartment of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
Daniel Le GrangeDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th St., San Francisco, CA, 94143, USA.
University of California, San Francisco · US

Funding

UCSD Leading the Advancement of Underrepresented Neuroscientists for Change (LAUNCH) Faculty Development ProgramR25NS117367 · NINDS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Victoria B Risbrough, Joann Trejo · 2020 to 2026
$1.6M
Using Computational Modeling to Test Reinforcement Learning as a Predictor of Response in Family-Based Treatment for Adolescent Anorexia NervosaK23MH131871 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Erin E. Reilly · 2022 to 2026
$982k
Neural Correlates of Reinforcement Learning Specific to Hyperactivityin Adolescent Anorexia NervosaK23MH126201 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GORRELL, SASHA CATHERINE · 2021 to 2025
$848k
NIMH NIH HHS K23 MH126201NIMH NIH HHS K23MH126201NIMH NIH HHS K23 MH131871NIMH NIH HHS K23MH131871NINDS NIH HHS R25 NS117367
6 · The paper itself

Abstract

backgroundNo guidelines currently exist that represent a standardization of care for Avoidant/Restrictive Food Intake Disorder (ARFID) on an inpatient service. Unique features of this diagnosis (e.g., sensory sensitivity contributing to involuntary emesis) suggest that established protocols that were developed for anorexia nervosa might be less effective for adolescents with ARFID. To inform improved inpatient medical stabilization and care for these patients, we first provide an overview of clinical characteristics for patients with ARFID who presented to a pediatric hospital for inpatient eating disorder care. We use these descriptives to outline the rationale for, and executions of, modifications to an inpatient protocol designed to flexibly meet the needs of this clinical population.

methodsChart review with descriptive statistics were conducted for patients who had received an ARFID diagnosis from March 2019 to March 2023 (N = 32, aged 9-23). We then present a case series (n = 3) of adolescents who either transitioned to a novel adjusted protocol from an original standard of care on the inpatient service, or who received only the standard protocol.

resultsThe sample was aged M(SD) = 15.6 (3.3) years, 53% male, and a majority (69%) presented with the ARFID presentation specific to fear of negative consequences. On average, patients had deviated from their growth curve for just over two years and presented with mean 76% of their estimated body weight. Of those requiring nasogastric tube insertion during admission (n = 8, 25%), average duration of tube placement was 15 days. From within this sample, case series data suggest that the adjusted protocol will continue to have a positive impact on care trajectory among adolescents admitted for ARFID including improved weight gain, reduction of emesis, and improved food intake.

conclusionsFindings demonstrate the likely need to tailor established medical inpatient protocols for those with ARFID given different symptom presentation and maintenance factors compared to patients with anorexia nervosa. Further research is warranted to explore the longer-term impact of protocol changes and to inform standardization of care for this high priority clinical population across care sites.

Indexed as

AdolescentsARFIDEating disordersInpatient protocolInpatient treatment

Identifiers

PMID37737186
PMCPMC10514937
OpenAlexW4386945257

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.