Home Nursing, COVID-19, Vascular Anomalies, Telehealth, Thyroid Cancer

shafere1 [at] email.chop.edu (By Emily Shafer)

In this week’s In the News, CHOP researchers found variabilities in home nursing in children with complex medical conditions. PolicyLab projects COVID-19 resurgence without national strategies, and researchers highlight implementation of adolescent telehealth early in the pandemic. Rounding out this week, an expert in vascular anomalies joins CHOP, and researchers from the Pediatric Thyroid Center propose new treatment paradigm for pediatric thyroid cancer.

Home Nursing Varies Among Children With Complex Medical Conditions

Researchers at Children’s Hospital of Philadelphia identified significant variability between states in the receipt of home nursing among commercially insured children with medical complexity. The study appeared in Pediatrics.

Irit R. Rasooly,MD, attending physician in the Department of Pediatrics at CHOP, and her team found that the probability of receiving home nursing varied from 3.4% to 19.2% across states. Among those who did receive home nursing, the median number of nursing days also varied, ranging from 6.6 days to 24.5 days.

Dr. Rasooly discussed the study in a video abstract presented on the journal’s website.

“When you see such wide state-to-state variability, it begs the question about whether there are opportunities for state-level policies to improve access to home nursing,” Dr. Rasooly said.

COVID-19 Projections: National Strategies Necessary to Prevent Virus Resurgence

New COVID-19 projections from CHOP’s PolicyLab indicate that state-to-state strategies will fail over the next four weeks if national strategies are not implemented.

The model, which represents 71% of the population, suggests increased risk for the virus to resurge everywhere except for New England. Projections in known hotspots, including Miami and Houston, are all expected to worsen.

The data also show that transmission rates are rising in suburbs of major cities, and along major highway routes, including I-95 corridor and the I-80 corridor. Researchers also identified signs of case growth in Philadelphia and New York City, as well as in several college towns.

“Without national standards that combine physical distancing, enforceable masking policies, and gathering size limitations to reduce case counts to a manageable number for our healthcare systems, we are creating an untenable situation for the fall when the virus is only expected to become more contagious and deadly,” David Rubin, MD, MSCE, director of PolicyLab at CHOP, said in a press release.

For more information about the COVID-19 projection models, visit PolicyLab’s blog.

Expert in Vascular Anomalies Joins CHOP

Pediatric hematologist-oncologist Denise Adams, MD, an expert in vascular anomalies, joined CHOP to lead the Complex Vascular Anomalies Program (CVAP).

The CVAP was designated as a Frontier Program in 2019. It is a multidisciplinary program that researches breakthrough treatments and cures for children, adolescents, and young adults with rare, life-threatening tumors and malformations of the vasculature, including arteries, veins, capillaries, lymphatics, and combined lesions.

Dr. Adams comes to CHOP after co-leading the Vascular Anomalies Center at Boston Children’s Hospital since 2016. She was an associate professor of Pediatrics at Harvard Medical School. Prior to Boston Children’s, Dr. Adams was medical director of the Hemangioma and Vascular Malformation Center at Cincinnati Children’s Hospital, where she spent 13 years.

“Denise Adams has long been recognized as a leader in the field of complex vascular anomalies, and we are delighted she has come to lead CHOP’s innovative Frontier Program,” said Stephen P. Hunger, MD, chief of the Division of Oncology at CHOP, which oversees CVAP. “With her leadership, our goal is to develop groundbreaking treatments to improve the lives of children living with these conditions.”

To learn more about Dr. Adams and the CVAP, visit the CHOP press release.

Adolescent Telehealth Scale-Up Successful During Early COVID-19 Pandemic

Rapid adolescent telehealth scale-up was successfully implemented at CHOP during the first 30 days of the COVID-19 pandemic, researchers from PolicyLab found. The study appeared in the Journal of Adolescent Health.

Sarah M. Wood, MD, MSHP, faculty member at PolicyLab and instructor of Pediatrics at the University of Pennsylvania Perelman School of Medicine, and her team conducted the study, in which they compared rates of telehealth visit completion using data obtained from electronic health records. There were 392 telehealth visits for 331 unique patients between March 16 and April 15, and the appointment completion rate was 82%. There were no significant differences in telehealth visit completion rates by age, sex, gender, or insurance, but patients coded as non-white had lower visit completion rates than white patients.

“Our data demonstrate that rapid telehealth scale-up for adolescent medicine was achievable in response to the COVID-19 pandemic, suggesting a critical need for ongoing implementation and evaluation research to grow and sustain telehealth efforts safely and equitably across vulnerable adolescent populations,” the researchers wrote in the study.

CHOP Researchers Propose New Model to Treat Pediatric Thyroid Cancer

Researchers at CHOP, collaborating with several pediatric centers, proposed a new model for treating pediatric thyroid cancer. The review appeared in JAMA Otolaryngology.

Ken Kazahaya, MD, associate director of Pediatric Otolaryngology and co-lead surgeon for the Thyroid Center at CHOP, co-authored the review, in which the researchers propose that pediatric patients with invasive thyroid cancer would benefit from treatment with targeted therapies before or instead of surgery. The researchers propose a model for managing complex thyroid cancer, and they suggest an opportunity for clinical trials to explore the role of targeted therapies in this patient population.

“These novel oncogene-specific targeted therapies provide an opportunity for a paradigm shift in the treatment of patients who initially present with widely invasive disease at diagnosis, in whom surgery involves higher than usual risk,” said senior author Andrew J. Bauer, MD, medical director of the Pediatric Thyroid Center at CHOP.

Read more about the study here.

ICYMI

Catch up on our headlines from our July 2 In the News:

• Susan Coffin, MD, PhD, Discusses Children’s Role in COVID-19 Transmission
• Researchers Find Remote Monitoring Effectively Identifies Seizures in At-Risk Newborns
• Identifying Parents’ Preferences for Smoking Cessation Messages
• Center for Applied Genomics Receives Funding to Study Disease Risk

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