Bright Futures: Guidelines for Health Supervision of Children

Fleming, Juanita W.

doi:10.1097/00005721-199611000-00005

Cited by 5 publications

(4 citation statements)

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“…The first module that we developed covered the vast majority of routine preventive services for children. [1] Subsequently, modules have been developed for detecting and managing maternal depression, parental smoking, obesity, adolescent depression, developmental delay, autism, attention deficit hyperactivity disorder, domestic violence, and many others. Please see Table 1 for a complete list.…”

Section: Translating Guidelines Into Arden Syntaxmentioning

confidence: 99%

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Pediatric decision support using adapted Arden Syntax

Anand

Carroll

Biondich

et al. 2018

Artificial Intelligence in Medicine

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Background Pediatric guidelines based care is often overlooked because of the constraints of a typical office visit and the sheer number of guidelines that may exist for a patient’s visit. In response to this problem, in 2004 we developed a pediatric computer based clinical decision support system using Arden syntax medical logic modules (MLM). Methods The Child Health Improvement through Computer Automation system (CHICA) screens patient families in the waiting room and alerts the physician in the exam room. Here we describe adaptation of Arden Syntax to support production and consumption of patient specific tailored documents for every clinical encounter in CHICA and describe the experiments that demonstrate the effectiveness of this system. Results As of this writing CHICA has served over 44,000 patients at 7 pediatric clinics in our healthcare system in the last decade and its MLMs have been fired 6,182,700 times in “produce” and 5,334,021 times in “consume” mode. It has run continuously for over 10 years and has been used by 755 physicians, residents, fellows, nurse practitioners, nurses and clinical staff. There are 429 MLMs implemented in CHICA, using the Arden syntax standard. Studies of CHICA’s effectiveness include several published randomized controlled trials. Conclusions Our results show that the Arden Syntax standard provided us with an effective way to represent pediatric guidelines for use in routine care. We only required minor modifications to the standard to support our clinical workflow. Additionally, Arden Syntax implementation in CHICA facilitated the study of many pediatric guidelines in real clinical environments.

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Section: Translating Guidelines Into Arden Syntaxmentioning

confidence: 99%

“…Logically, then, scores of preventive care guidelines for children exist. [1][2][3][4] Unfortunately, these guidelines are often not followed in routine care. [5] This is for two main reasons.…”

Section: Introductionmentioning

confidence: 99%

Pediatric decision support using adapted Arden Syntax

Anand

Carroll

Biondich

et al. 2018

Artificial Intelligence in Medicine

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“…The Bright Futures Guidelines were developed to support primary care practices in providing well-child and adolescent care. 17 The Bright Futures is the recommended clinical screening tool by the Affordable Care Act and assesses multiple health risks, including determinants for diabetes. 17,18 Although the questionnaire contains questions related to dietary habits, these questions are structured as yes/sometimes/no responses.…”

mentioning

confidence: 99%

“…17 The Bright Futures is the recommended clinical screening tool by the Affordable Care Act and assesses multiple health risks, including determinants for diabetes. 17,18 Although the questionnaire contains questions related to dietary habits, these questions are structured as yes/sometimes/no responses. Nutrition questions were modified by a dietitian to quantify the daily frequency of consumption of foods that may contribute to T2D.…”

mentioning

confidence: 99%

Associations between Diet Behaviors and Measures of Glycemia, in Clinical Setting, in Obese Adolescents

et al. 2016

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Objective: To determine the influence of dietary behaviors, assessed in a clinical setting, on measures of glycemia in overweight and obese adolescents.Study Design: The study is a retrospective, cross-sectional chart review. Eligible participants were overweight youth (N = 146, age 9-21 years) who attended the Youth Diabetes Prevention Clinic in Indianapolis, IN. Glycemic status was assessed during a 2-hour oral glucose tolerance test (OGTT). In the Bright Futures Questionnaire, a recommended clinical tool for assessing unhealthy behaviors in youth, nutrition-specific questions were modified to quantify dietary habits. Associations between dietary habits and measures of glycemia were determined using multiple linear regression models. Skewed data are presented as geometric means and 95% confidence intervals.Results: Of the 146 adolescents who were assessed [60% girls, age 13.7 years (13.3, 14.0), BMI 33.9 kg/m 2 (33.3, 34.5)], 40% were diagnosed with prediabetes. Higher intake of dessert foods was associated with increased glucose levels at 2 hours following the OGTT (b = 0.23, p = 0.004), and higher intake of packaged snack foods was associated with elevated levels of hemoglobin A1c (b = 0.04, p = 0.04), independent of adiposity.Conclusions: In obese youth, high intakes of dessert and packaged snack items were associated with elevated concentrations of glucose at 2 hours following the OGTT and hemoglobin A1c. Findings demonstrate the usefulness of a modified Bright Futures Questionnaire, used in a clinical setting, for identifying dietary behaviors associated with hyperglycemia in obese adolescents.ClinicalTrials.gov registration number: NCT02535169

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