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Acad Pediatr. 2018 Jul;18(5):569-576. doi: 10.1016/j.acap.2018.02.008. Epub 2018 Mar 15.

PCORnet Antibiotics and Childhood Growth Study: Process for Cohort Creation and Cohort Description.

Author information

1
Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass. Electronic address: jblock1@partners.org.
2
Applied Clinical Research Center, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pa.
3
Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass; Environmental Influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health, Bethesda, Md.
4
North Fork Local School District, Utica, Ohio.
5
School of Public Health, Oregon Health & Science University/Portland State University, Portland, Ore.
6
Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
7
Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
8
Therapeutics Research and Infectious Disease Epidemiology Group, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
9
Department of Population Health, New York University School of Medicine, New York, NY.
10
Department of Pediatrics, Boston University School of Medicine, Boston, Mass.
11
Department of Preventive Medicine, Rush Medical College, Chicago, Ill.
12
Strategic Clinical Initiatives, Health Choice Network, Terr Doral, Fla.
13
College of Medicine, University of Florida, Gainesville, Fla.
14
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colo.
15
Denver Public Health, Denver, Colo.
16
Department of Pediatrics, University of Colorado School of Medicine, Denver, Colo.
17
Department of Public Health Sciences, Loyola University, Chicago, Ill.
18
Nationwide Children's Hospital, Columbus, Ohio.
19
Center for Health Research, Kaiser Permanente North West, Portland, Ore.
20
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tenn.
21
Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, Md.
22
Pennington Biomedical Research Center, Baton Rouge, La.
23
American Museum of Natural History, New York, NY.
24
Department of Epidemiology and Population Health, Montefiore, Bronx, NY.
25
Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Fla.
26
Kaiser Permanente Washington Health Research Institute, Seattle, Wash.
27
Health Partners Institute.
28
Center for Health and Social Sciences, University of Chicago Medicine, Chicago, Ill.
29
Department of Pediatrics, New York University School of Medicine, New York, NY.
30
Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa.
31
Department of Pediatrics, St Louis Children's Hospital, St Louis, Mo.
32
RTI International, Research Triangle Park, NC.
33
OCHIN Inc, Portland, Ore.
34
Research Informatics Department, Seattle Children's Hospital, Seattle, Wash.
35
Case Western Reserve University and University Hospitals of Cleveland, Cleveland, Ohio.
36
University of Texas Health Science Center at San Antonio, San Antonio, Tex.
37
Children's Hospital of Philadelphia, Philadelphia, Pa.
38
Louisiana Public Health Institute, New Orleans, La.
39
Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, Ill.
40
Heart Institute, Cincinnati Children's Hospital, Cincinnati, Ohio.
41
NorthShore University HealthSystem, Evanston, Ill.
42
MassGeneral Hospital for Children and Harvard Medical School, Boston, Mass.
43
Medical College of Wisconsin, Milwaukee, Wis.
44
Baylor Scott & White Health, Fort Worth, Tex.
45
Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, SC.
46
Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wis.
47
Nemours Children's Health System, Jacksonville, Fla.
48
University of Texas, Health Science Center of Houston, Houston, Tex.

Abstract

OBJECTIVES:

The National Patient-Centered Clinical Research Network (PCORnet) supports observational and clinical research using health care data. The PCORnet Antibiotics and Childhood Growth Study is one of PCORnet's inaugural observational studies. We sought to describe the processes used to integrate and analyze data from children across 35 participating institutions, the cohort characteristics, and prevalence of antibiotic use.

METHODS:

We included children in the cohort if they had at least one same-day height and weight measured in each of 3 age periods: 1) before 12 months, 2) 12 to 30 months, and 3) after 24 months. We distributed statistical queries that each institution ran on its local version of the PCORnet Common Data Model, with aggregate data returned for analysis. We defined overweight or obesity as age- and sex-specific body mass index ≥85th percentile, obesity ≥95th percentile, and severe obesity ≥120% of the 95th percentile.

RESULTS:

A total of 681,739 children met the cohort inclusion criteria, and participants were racially/ethnically diverse (24.9% black, 17.5% Hispanic). Before 24 months of age, 55.2% of children received at least one antibiotic prescription; 21.3% received a single antibiotic prescription; 14.3% received 4 or more; and 33.3% received a broad-spectrum antibiotic. Overweight and obesity prevalence was 27.6% at age 4 to <6 years (n = 362,044) and 36.2% at 9 to <11 years (n = 58,344).

CONCLUSIONS:

The PCORnet Antibiotics and Childhood Growth Study is a large national longitudinal observational study in a diverse population that will examine the relationship between early antibiotic use and subsequent growth patterns in children.

KEYWORDS:

antibiotics; body mass index; childhood growth; childhood obesity; electronic health records; research infrastructure

PMID:
29477481
DOI:
10.1016/j.acap.2018.02.008
[Indexed for MEDLINE]
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