Author: macpedsrrt

An introduction to working with pediatric administrative data with ICES McMaster

Bran Sivapathasundaram & Priya Premranjith
With Tim Miuccio, Aaron Jones, & Richard Perez

ICES McMaster is a health services research facility that provides researchers and trainees with access to over 100 health-related database holdings that can be linked for a comprehensive overview of health care delivery and outcomes in Ontario. Some health service databases include the entire Ontario population eligible for universal health coverage – 13 million people annually. The breadth and scope of ICES data is a resource for population-based evidence to inform health policy, planning and evaluation.  ICES McMaster is a joint collaboration of ICES and McMaster University, with its academic hospitals, Hamilton Health Sciences and St. Joseph’s Health Care Hamilton.

Rituximab induced hypogammaglobulinemia

Dr. Leena Ahmed, PGY2

Supervisor: Dr. Jenny Garkaby, Assistant Professor, Pediatrics, McMaster University

Rituximab, a monoclonal antibody targeting CD20 on B cells, is commonly used in the treatment of autoimmune, hematological, and oncological disorders. However, its impact on B-cell function can lead to secondary hypogammaglobulinemia, increasing patients’ susceptibility to infections and immune system irregularities. While this condition was once considered temporary, there is growing evidence of persistent hypogammaglobulinemia in some individuals after rituximab treatment. Despite the recognized risk, consistent monitoring of immunoglobulin levels before and after treatment is not always practiced, and there is limited guidance on identifying patients at higher risk of long-term hypogammaglobulinemia. This study underscores the importance of pre-treatment immunoglobulin testing and regular post-treatment monitoring to better manage and mitigate this risk.

The challenges of stopping trials for benefit: A closer look at the immediate Kangeroo Mother Care trial

Dr. Lehana Thabane, Professor, Health Research Methods, Evidence, and Impact

The main objective of the talk is to discuss the challenges of stopping trials early for benefit. We will use the immediate Kangeroo Mother Care (iKMC) trial recently published in NEJM as an example to address the following issues:

• What are the ethical implications of not stopping early given the importance of adhering to the trial protocol?). 
• How robust is the evidence from trials stopped early for benefit?
• When is it appropriate to stop trial early for benefit?
• Knowing that stopping early is associated with biases, how can we optimize our approach monitoring of trials to avoid this?
• How do we balance the ethics of stopping early vs the pursuit of scientific truth of getting it right?
• What are the scientific implications of stopping early?

Pathways to Success: Supporting Youth with Disabilities or Chronic Health Conditions in Their Transition to Adulthood

Dr. Michelle Batthish, Associate Professor, Pediatrics, McMaster University

The transition from adolescence to adulthood can be a challenging period for many young people. However, for youth with disabilities or chronic health conditions, transition may look different due to ongoing healthcare visits and barriers in access to appropriate supports, services, accommodations, and resources.  Since the course of youth with disabilities or chronic health conditions during their transition to adulthood can vary, we need to look at what is meaningful to them and explore how the interactions with their environment promote or prevent successful transition. The objective of this study will be to explore successful transition to adulthood among youth with disabilities or chronic health conditions. We will explore this topic from the themes of healthcare and community participation (including educational and occupational). 

Implementation of Parent Groups to Type 1 Diabetes Education Pathway

Dr. Jennifer Butler, PGY2

Supervisor: Dr. Karen McAssey, Associate Professor, Pediatrics, McMaster University

This presentation will review a study in progress. Within the Pediatric Diabetes team, we are working on a quality improvement project to add a psychoeducational parent group session to the existing diabetic education pathway. This study will assess parental self-efficacy and levels of distress following these new sessions.

Learning Objectives:
1. Review the literature describing the impact a newly diagnosed T1DM family member has on parents and siblings
2. Explore previous psychoeducational parent group studies

Spotlight on the 2021-22 CoRE Builder Team Grants: Progress & Insights

Join us for an insightful presentation featuring the recipients of the 2021-22 CoRE Builder Team Grants. They will share their progress and findings on important child health research.

Presenters:

• Drs. Mohamed Eltorki & Lucy Giglia: Comparison of Ketorolac at Three Doses in Children with Acute Pain: A Randomized Controlled Trial (KETO-DOSE TRIAL).
• Dr. Rahul Chanchlani: Long Term Cardiovascular Outcomes in Children and Adolescents Diagnosed with Hypertension in Ontario: A Propensity-Matched Cohort study.
• Drs. Michelle Batthish & Kate Prowse (presentation by Dr. Karen Beattie): Development and validation of a parent transition readiness tool – Parent Transition-Q.

The Collaborative Research Excellence (CoRE) Builder Team Grants is an internal fund enabled by a philanthropic investment that aims to foster child health research across multiple clinical divisions and areas of research excellence in the McMaster Department of Pediatrics.

Implementation of syphilis point-of-care testing in an urban low-barrier prenatal clinic

Dr. Laura Erdman, Assistant Professor, Pediatrics

This presentation will describe a study in progress: a prospective single arm trial evaluating implementation of syphilis point-of-care testing at the Maternity Centre of Hamilton, which provides prenatal care to pregnant people affected by social determinants of health. This exploratory study will assess acceptability, feasibility, and effectiveness of point-of-care testing for facilitating same-day treatment initiation for syphilis-positive clients. Knowledge mobilization strategies are in development with community partners.

Learning Objectives:
1. How to optimize study design while considering ethical issues around marginalized study populations and a stigmatized infection?
2. ⁠How to ensure meaningful and respectful community consultation in the context of research timelines?

Pediatric meta-research: Advancing clinical insights

Dr. Lawrence Mbuagbaw, Associate Professor, Health Research Methods, Evidence, and Impact

This presentation delves into the field of research on research or meta-epidemiology, focusing on its application in pediatric research. Meta-epidemiology examines the methodological quality, reporting quality and biases across multiple studies to improve the reliability of clinical evidence. By analyzing pediatric studies, we can identify common pitfalls, assess the consistency of findings, and enhance the robustness of clinical research.

Learning Objectives:
1. To understand the principles of meta research
2. ⁠To be able design a methodological study
3. To be able to critique a methodological study

Dr. Lawrence Mbuagbaw is an Associate Member of the Department of Pediatrics and works as one of our valued Biostatisticians, reviewing grant applications for research methodology and providing advice and data analytics on various research projects throughout the department. Lawrence is a Research Methods Scientist in Clinical Epidemiology and Biostatistics. He trained at the Faculty of Medicine and Biomedical Sciences (FMBS) in Cameroon (MD; 2005); the Hebrew University of Jerusalem (MPH; 2009); and McMaster University (PhD in Health Research Methodology; 2014). He is an associate professor at McMaster University where he teaches courses in biostatistics and randomized trials; associate professor extraordinary of Epidemiology and Biostatistics at Stellenbosch University; and research methods scientist in the Research Institute of St Joseph’s Health Care Hamilton (SJHH) where he provides methodological and statistical support for other researchers as the Director of the Biostatistics Unit. 

Exploring the educational value of the Longitudinal CanMEDS Curriculum in the McMaster Pediatrics Residency Program:  An Appreciative Inquiry Approach

Dr. Faith Olaniyan, PGY3

Supervisors: Dr. Brittany Howson-Jan, Assistant Professor, Pediatrics, McMaster University; Dr. Joanna Humphreys, Assistant Professor, Pediatrics, McMaster University; Dr. Elif Bilgic, Assistant Professor, Pediatrics, McMaster University

The study aims to evaluate the Longitudinal CanMEDS Curriculum (LCC) by assessing its effectiveness and educational value for residents. It uses the Appreciative Inquiry (AI) approach, focusing on strengths and opportunities for improvement, with a four-phase process: discovery, dream, design, and destiny. The objective is to understand residents’ and facilitators’ perceptions of the LCC’s educational value, identifying beneficial aspects, areas for improvement, and any barriers to successful implementation.

Learning Objectives:
1.  Gain Insight from residents and staff into the implementation of LCC
2. ⁠Raise awareness regarding the upcoming survey
3. Facilitate discussion on the study objectives and methodology

Investigating the Relationship Between Device-Measured Movement Behaviours and the Quality of Life of Autistic Children

Leili Hadayeghi, MSc Student

Supervisor: Dr. Brian Timmons, Professor, Pediatrics, McMaster University

This study will explore the relationship between movement behaviours (i.e. physical activity, sleep, sedentary/screen time) and the quality of life in autistic children. Participants will wear waist-worn accelerometers for 7 days to measure movement behaviour outcomes. Quality of life will be measured using the PedsQL. Findings aim to provide insights into how movement behaviours impact overall well-being in autistic children, with potential implications for developing tailored interventions to improve their health outcomes.

Learning Objectives:
1. Learn about the importance of movement behaviours for autistic children
2. Gain insight into ways of improving the quality of life of autistic children
3. Learn about the significance of utilizing device-based measures for capturing movement behaviours and understanding their compositional nature