Although new disease modifying therapies offer promise, current management of cystic fibrosis (CF) lung disease is largely based on 2 strategies: first, decreasing the day-to-day burden of inflammation and mucus in the airways and, second, managing pulmonary exacerbations: acute episodes of increased symptoms thought to reflect periods of inflammation associated with bacterial infection. A mainstay of treating CF exacerbations has been using ≥1 intravenous antibiotics in the hospital accompanied by supportive measures, including intensified airway clearance. Investigators using the Epidemiologic Study of Cystic Fibrosis1 and the Cystic Fibrosis Foundation (CFF) Patient Registry2 have previously pointed out variation in CF care practices, particularly in therapies used for outpatient care. In this issue of Pediatrics, Cogen et al3 (“Characterization of Inpatient Cystic Fibrosis Pulmonary Exacerbations Using the Pediatric Health Information System Database”) use a novel data source from children’s hospitals to document surprising variation in many aspects of...
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February 2017
Commentary|
February 01 2017
The Hidden Value of Variation in Practice
John T. McBride, MD;
aRobert T. Stone Respiratory Center, Akron Children’s Hospital, Northeast Ohio Medical University, Akron, Ohio; and
Address correspondence to John T. McBride, MD, Department of Pediatrics, Akron Children’s Hospital, 2 Perkins Sq, Akron, Ohio 44308. E-mail: jtmcbride@gmail.com
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Dennis C. Stokes, MD
Dennis C. Stokes, MD
bLeBonheur Children’s Hospital, University of Tennessee Health Science Center, Memphis, Tennessee
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Address correspondence to John T. McBride, MD, Department of Pediatrics, Akron Children’s Hospital, 2 Perkins Sq, Akron, Ohio 44308. E-mail: jtmcbride@gmail.com
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relative to this article to disclose.
Pediatrics (2017) 139 (2): e20163876.
Article history
Accepted:
November 21 2016
Citation
John T. McBride, Dennis C. Stokes; The Hidden Value of Variation in Practice. Pediatrics February 2017; 139 (2): e20163876. 10.1542/peds.2016-3876
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