To increase the number of essential consult elements (ECEs) included in initial inpatient consultation requests between pediatric residents and fellows through implementation of a novel consult communication tool.

Literature review and previous needs assessment of pediatric residents and fellows were used to identify 4 specific ECEs. From February to June 2018, fellows audited verbal consult requests at a medium-sized, quaternary care children’s hospital to determine the baseline percentage of ECE components within consults. A novel consult communication tool containing all ECEs was then developed by using a modified situation-background-assessment-recommendation (SBAR) format. The SBAR tool was implemented over 3 plan-do-study-act cycles. Adherence to SBAR, inclusion of ECEs, and consult question clarity were tracked via audits of consult requests. A pre- and postintervention survey of residents and fellows was used to examine perceived miscommunication and patient care errors and overall satisfaction.

The median percentage of consults containing ≥3 ECEs increased from 50% preintervention to 100% postintervention with consult question clarity increasing from 52% to 92% (

< .001). see more Overall perception of consult miscommunication frequency decreased (52% vs 18%;

< .01), although there was no significant change in resident- or fellow-reported patient errors. SBAR maintained residents’ already high consult satisfaction (96% vs 92%;

= .39) and increased fellows’ consult satisfaction (51% vs 91%;

< .001).

Implementation of a standardized consult communication tool resulted in increased inclusion of ECEs. Use of the tool led to greater consult question clarity, decreased perceived miscommunication, and improved overall consult satisfaction.

Implementation of a standardized consult communication tool resulted in increased inclusion of ECEs. Use of the tool led to greater consult question clarity, decreased perceived miscommunication, and improved overall consult satisfaction.

The impact of the coronavirus disease 2019 pandemic on vaccination coverage, critical to preventing vaccine-preventable diseases, has not been assessed during the reopening period.

Vaccine uptake and vaccination coverage for recommended vaccines and for measles-containing vaccines at milestone ages were assessed in a large cohort of children aged 0 to 18 years in Southern California during January to August 2020 and were compared with those in the same period in 2019. Differences in vaccine uptake and vaccination coverage (recommended vaccines and measles-containing vaccines) in prepandemic (January to March), stay-at-home (April to May), and reopening (June to August) periods in 2020 and 2019 were compared.

Total and measles-containing vaccine uptake declined markedly in all children during the pandemic period in 2020 compared with 2019, but recovered in children aged 0 to 23 months. Among children aged 2 to 18 years, measles-containing vaccine uptake recovered, but total vaccine uptake remained lower.rs, and recall for needed vaccinations, particularly during virtual visits, will be required to increase vaccine uptake and vaccination coverage and reduce the risk of outbreaks of vaccine-preventable diseases.

Due to no existing data, we aimed to derive evidence to support test-retest reliability for the Health Assessment Questionnaire-Disability Index (HAQ-DI) and Medical Outcome Survey Short-Form-36 item physical functioning domain (SF-36 PF) in psoriatic arthritis (PsA).

We identified datasets that collected relevant data for test-retest reliability for HAQ-DI and SF-36 PF; and evaluated them using OMERACT Filter 2.1 methodology. We calculated intra-class correlation coefficients (ICC) as a measure of test-retest reliability. We then conducted a quality assessment and evaluated the adequacy of test-retest reliability performance.

Two datasets were identified for HAQ-DI and one for SF-36 PF in PsA. The quality of the datasets was good. The ICCs for HAQ-DI were excellent in both datasets 0.94 (95% CI 0.88 to 0.97) and 0.94 (95% CI 0.89 to 0.97). The ICC of SF-36 PF was good (0.89, 95% CI 0.76 to 0.95). The performance of test-retest reliability for both instruments was judged to be adequate.

The new data derived support good and reasonable test-retest reliability for HAQ-DI and SF-36 PF in PsA.

The new data derived support good and reasonable test-retest reliability for HAQ-DI and SF-36 PF in PsA.Recent decades have seen the introduction of many new therapeutics into pediatric rheumatology practice, particularly biologic disease-modifying antirheumatic drugs (bDMARD). These advances are a result of the biotechnological revolution in the pharmaceutical industry, specific legislation for the development of pediatric medicines, and large international collaborative networks.

In axial spondyloarthritis (axSpA), sacroiliac joint (SIJ) erosion is often followed by fat metaplasia in an erosion cavity (backfill), and subsequently ankylosis. We aimed to combine Spondyloarthritis Research Consortium of Canada (SPARCC) SIJ Structural score for Erosion, Backfill and Ankylosis into 3 versions of a novel preliminary Composite axSpA MRI SIJ Structural Damage Score (CSDS) and test these.

Thirty-three axSpA patients followed for 5 years after initiation of tumor necrosis factor inhibitor had MRI of SIJs at baseline, and yearly thereafter. Three versions of CSDSs were calculated based on different weightings of erosion, backfill and ankylosis Equal weighting CSDS

=(erosion x0.5)+backfill+ankylosis; Advanced stages weighting more CSDS

=(erosion x1)+(backfill x4)+(ankylosis x6); Advanced stages overruling earlier stages (“hierarchical”) with “<” meaning “overruled by” CSDS

=(erosion x1)<(backfill x4)<(ankylosis x6).

At baseline all CSDSs correlated positively with SPARCC Fat androgression by one composite score.

Delays in the diagnosis and treatment of psoriatic arthritis (PsA) are common. These delays contribute to impairments in quality of life and joint damage. This study aims to calculate the incidence rate of PsA over time and identify clinical features that may be used for PsA prediction in psoriasis patients.

The study population for PsA incidence analysis included 1128 participants enrolled in the Utah Psoriasis Initiative (UPI) between 2002 and 2014. Clinical evaluation and medical record review were performed to identify new cases of PsA after enrollment. For identifying psoriasis features associated with PsA, the population was restricted to 627 participants who did not have PsA before psoriasis phenotyping and had been followed up for subsequent PsA diagnosis. We conducted Cox proportional hazard regressions to estimate the hazard ratio (HR) of PsA associated with psoriasis characteristics and other health-related features.

PsA incidence rate increased for >60 years following psoriasis onset (trend p<0.