Practice Variation in Developmental Pediatrics
Practice Variation in the Assessment and Management of Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorders by Developmental Pediatricians: A DBPNet Study.
Context: Determining variations in medical practice is one strategy that has been helpful in identifying potential areas for intervention to improve the quality or efficiency of health care delivery. There are no studies of variation in developmental and behavioral (DB) pediatricians practices for the assessment and management of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorders (ASD). A newly formed 12-site research consortium, the Developmental-Behavioral Pediatrics Research Network (DBPNet), provides an opportunity to identify these variations in practice across a national network of DB pediatrics programs.
Objectives: The primary aims of this study are to describe practices and identify variations in the practices of DB pediatricians related to the assessment and management of ADHD andASD. Specific objectives include: 1) identifying the assessments DB pediatricians perform or review prior to making a diagnosis; 2) identifying tests recommended after DB pediatricians make a diagnosis; 3) identifying the medications and doses used in the management of these conditions or related comorbidities. Secondary objectives relate to identifying clinician, patient, or site factors that are associated with differences in practice including assessing the relationship between medications and dosages used with a patient’s age, weight, height, andBMI.
Study Design: This is a prospective descriptive study of the clinical practices of DB pediatricians at DBPNet sites
Setting/Participants: Attending physicians at all of the 12 DBPNet sites who are board certified or board eligible in DB pediatrics or neurodevelopmental disabilities will be eligible to participate.
Study Interventions and Measures: The main study outcome measures will be a Diagnostic Encounter Survey and Follow-up Encounter survey completed by the DB pediatrician that will describe: demographic information, chief complaint and type of visit, diagnosis and comorbidities, assessments done or reviewed, child vital signs, medications and doses, providers involved in the evaluation, and the amount of attending physician time involved in the evaluation.