JAMA: Statistics and Research Methods Topic Collection

Contrasts in Child Health Care and Child Health Research

Zylke JW, Rivara FP, Bauchner H. — Wed, 01 May 2013 00:00:00 GMT

Pediatrics is a specialty of contrasts. Pediatricians care for preterm infants who weigh no more than a pound or two and older adolescents who weigh 100 times that amount. Health care professionals who care for children endeavor to keep healthy children healthy, providing anticipatory guidance about injury prevention or giving vaccinations, while they also provide care for children with serious illnesses, whether complex chronic conditions that will affect the child and his or her family for the entirety of their lives or devastating diseases such as cancer.

Creation and Retention of the Next Generation of Physician-Scientists for Child Health Research Physician-Scientists for Child Health Research

Cornfield DN, Lane R, Abman SH. — Wed, 01 May 2013 00:00:00 GMT

Academic pediatrics is motivated by a vision wherein the children of tomorrow are healthier than those of today. The physician-scientist is uniquely well positioned to create and translate discoveries into care. Over the last 30 years, proportionately fewer physician-scientists capable of sustaining a research program have committed to a hypothesis-driven research career focused on child-health issues. Since the 1980s, the percentage of physicians dedicating significant components of a professional life to research has declined from approximately 5% to 1.5%. Pediatrics may be more affected than other medical specialties. Despite more trainees, the population of physician-scientists is aging and the absolute number is declining. In 1980, 25% of research program grants were awarded to physicians older than 50 years, compared with 50% at present. The implications of these trends are substantial.

The Transformation of Child Health Research Innovation, Market Failure, and the Public Good Transformation of Child Health Research

Stoll BJ, Stevenson DK, Wise PH. — Wed, 01 May 2013 00:00:00 GMT

Despite a remarkable record of accomplishments, the pediatric research community faces mounting evidence that the nature and scope of current research are inadequate. The Editorial “Challenges to Excellence in Child Health Research,” by Zylke et al, casts this paradox in sharp relief by summarizing a series of articles suggesting that the quality and number of pediatric research studies lag behind research focused on adults. For measurable and sustainable gains in child health, pediatric research should be informed by the changing epidemiology of childhood illness, the need to monitor both survival and long-term outcomes, and the increasing recognition of pediatric origins of adult chronic disease and social determinants of health. Recent advances in genetics, imaging, and bioinformatics provide new venues for productive research. Moreover, the status of children in society must be elevated and the political will necessary to provide adequate financial support for research enhanced.

Restoring Science to the National Children's Study Restoring Science to the NCS

Paneth N. — Wed, 01 May 2013 00:00:00 GMT

The unhappy state of the National Children's Study (NCS) has been described in several recent publications. Authorized by Congress in 2000, but not fully funded until 2007, this ambitious National Institutes of Health (NIH) study has consumed years of planning efforts, produced many reports and white papers, and spent close to a billion dollars.