Frontiers in Pediatrics最新文献

{"title":"Healthcare providers' insights on pediatric care quality in Gaza hospitals: integrating evidence-based practices and illness management, health information systems, and referral efficiency.","authors":"Saeed Y Eleyyan, Bothyna B ELssyed Etewa, Fatma Al'Haj Ahmad, Abdel Hamid El Bilbeisi","doi":"10.3389/fped.2025.1587984","DOIUrl":"https://doi.org/10.3389/fped.2025.1587984","url":null,"abstract":"<p><strong>Background: </strong>The quality of pediatric care in Gaza hospitals is a critical concern, especially given the region's limited resources and ongoing political instability. This study aimed to assess healthcare providers' perspectives on the quality of pediatric care in Gaza's major hospitals, focusing on the integration of evidence-based practices (EBPs) and illness management, health information systems (HIS), and referral efficiency.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 2023 at three major pediatric hospitals in the Gaza Strip: Al-Nasr Pediatric Hospital, EL-Dorra Pediatric Hospital, and Al-Rantisi Specialized Pediatric Hospital. A structured interview-based questionnaire was used to collect data from the healthcare providers. Three domains of the World Health Organization (WHO) integrated tool, \"Standards for Improving the Quality of Care for Children in Health Facilities\" was employed to assess pediatric care quality. Statistical analysis was performed using SPSS version 26.</p><p><strong>Results: </strong>The study's participants (336 healthcare providers) were predominantly male (59.5%), with an average age of 36.2 ± 8.73 years. Most were nurses (71%), but only a small fraction (0.6%) were pediatric nurses. A significant portion (64.6%) held a bachelor's degree, and a majority (83.3%) had not pursued specialized studies in pediatric care. However, more than half (58.3%) had attended pediatric care training courses, and 23.2% had less than five years of experience. Findings revealed that the integration of EBPs was inconsistent, with only 66.7% of participants reporting proper triage and assessment of emergency cases. Illness management, particularly in areas like malnutrition and anemia, showed significant gaps, with less than 60% adherence to standard practices. The HIS was underdeveloped, with 69.4% of providers reporting accurate medical records, and only 63.7% indicated proper use of data for quality improvement. Referral efficiency was also compromised, with only 65.2% of providers reporting timely referrals.</p><p><strong>Conclusion: </strong>While some progress has been made in pediatric care quality in Gaza, significant gaps remain in evidence-based practice, illness management, HIS functionality, and referral efficiency. Addressing these challenges requires improved infrastructure, resource allocation, and enhanced training for healthcare providers.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1587984"},"PeriodicalIF":2.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Somatic <i>NLRP3</i> mosaicism in patients with \"mutation-negative\" CAPS: insights from a single centre UK cohort.","authors":"Sonia Melo Gomes, Juan I Arostegui, Ana Mensa-Vilaro, Ebun Omoyinmi, Ying Hong, Dara McCreary, Dorota Rowczenio, Philip Hawkins, Paul Brogan","doi":"10.3389/fped.2025.1598748","DOIUrl":"https://doi.org/10.3389/fped.2025.1598748","url":null,"abstract":"<p><strong>Introduction: </strong>Knowledge about mosaicism in cryopyrin-associated periodic syndromes (CAPS) has expanded significantly with the use of next generation sequencing technologies. The aim of this study was to assess the contribution of mosaicism in a paediatric cohort of patients with a clinical diagnosis of CAPS and no <i>NLRP3</i> mutations identified through conventional DNA sequencing.</p><p><strong>Methods: </strong>Mosaicism was assessed by amplicon-based deep sequencing (ADS) on DNA extracted from different tissues overtime. Targeted gene panels (TGPs) and whole-exome sequencing (WES) were used for comparison of detection methods.</p><p><strong>Results: </strong>In 40% (4/10) of the cohort a post-zygotic <i>NLRP3</i> mutation leading to somatic mosaicism was found by ADS. Three of the detected <i>NLRP3</i> mutations had been previously described only in somatic form and one both as germline and somatic. Mean mutant allelic frequencies (MAF) at diagnosis varied between 3.1-14.5% in whole blood, with all mutations being present in other tissues tested. In 3 patients, mosaicism was evaluated over time in whole blood, with results confirming mosaicism stability in 2 patients, and a MAF increase in 1 patient (from 1.9% to 5%). TGPs identified 4/4 cases of mosaicism whilst WES detected only 1/3.</p><p><strong>Discussion: </strong>Somatic <i>NLRP3</i> mosaicism was present in 40% of this paediatric cohort, confirming the key role of this phenomenon in disease pathogenesis and in genetic confirmation of CAPS diagnosis. MAFs can be extremely low, which warrants caution regarding lower detection limits of the sequencing techniques utilized. Mosaicism level may vary over time in some patients, with diagnostic and potential therapeutic implications.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1598748"},"PeriodicalIF":2.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A space-gamified approach to examine muscle contraction behaviour in children and adolescents with spastic cerebral palsy: feasibility, acceptability and repeatbility.","authors":"Jule Heieis, Ibrahim Duran, Eckhard Schönau, Christoph Fritzsche, Bettina Götz, Laura Kehe, Moritz Meier, Karoline Spiess, Wilhelm Bloch, Jörn Rittweger","doi":"10.3389/fped.2025.1520162","DOIUrl":"https://doi.org/10.3389/fped.2025.1520162","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebral palsy (CP) is the most common disease affecting mobility among children. However, relatively little is known about the muscle phenotype and the resulting impairments in muscle function of this population. We therefore examined feasibility and acceptability of a muscle testing protocol that is based on the muscle examinations of astronauts and in bed-rest studies in children and adolescents with CP (clinical trial registry number DRKS00031107).</p><p><strong>Methods: </strong>Twelve participants, aged between 8 and 18 years, with CP and age-matched able-bodied counterparts (Ctrl) have been included to the study. They completed testing procedures on two visits. Participants performed isometric maximum voluntary contractions, step and ramp contractions in plantarflexion on a custom build dynamometer. The tasks were visualized using a torque-controlled video game. We computed steadiness, defined as standard deviation of the fluctuations, and slope, as well as the achieved MVC. Data were statistically analyzed via Intraclass correlation coefficient (ICC) for between-visit analysis and Mann-Whitney U test for between-group analysis.</p><p><strong>Results: </strong>One participant of the CP group was not able to perform the tasks and dropped out for the second visit. Especially younger children and children with cognitive impairments were not able to adequately answer the acceptance questionnaire. The MVC of Ctrl was higher in both visits and was excellently repeatable. During step contractions Ctrl showed lower fluctuations in both visits. Also, during ascending ramp contractions Ctrl showed less fluctuations but only at visit 1. During descending ramp contractions steadiness was better in Ctrl at both visits. Performance parameters were all poorly repeatable, because the CP group improved their performance in all tasks at visit 2.</p><p><strong>Discussion: </strong>Application of our gamified muscle testing protocol was well acceptable and mostly feasible. Contrasting with constant isometric contractions and decreasing ramp contractions, the performance of children with CP during ascending ramp contractions improved to the level of control subjects within 2 visits. A crucial prerequisite to perform successful measurements are good cognitive skills and at least one familiarization visit.</p><p><strong>Clinical trial registration: </strong>https://www.drks.de/DRKS00031107, identifier (DRKS00031107).</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1520162"},"PeriodicalIF":2.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Two episodes of hyperinflammation in an infant consistent with multisystem inflammatory syndrome in children: recurrence or rather two different diseases?","authors":"Markus-Johann Dechant, Holger Michel, Michael Kabesch, Michael Melter, Stephan Gerling","doi":"10.3389/fped.2025.1559244","DOIUrl":"https://doi.org/10.3389/fped.2025.1559244","url":null,"abstract":"<p><p>Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory disease that occurs after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report a 9-month-old male infant with two episodes of hyperinflammatory disease, each involving the coronary arteries, within a short period of time during the SARS-CoV-2 pandemic. Although both episodes met the official criteria for MIS-C, this case illustrates the difficulty in distinguishing MIS-C from its main differential diagnosis, Kawasaki disease (KD). Recurrence of postviral hyperinflammatory disease is rare. Compared with KD, the recurrence of MIS-C is even rarer, but clinicians should be aware of this possibility. Our case also emphasizes the need to follow up these patients closely and to detect sequelae regularly, especially cardiovascular sequelae, at an early stage.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1559244"},"PeriodicalIF":2.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of asthma education grounded in virtual reality technology upon the quality of life of pediatric patients with bronchial asthma.","authors":"Huijuan Wang, Qing Dong, Xiaowei Wang","doi":"10.3389/fped.2025.1588562","DOIUrl":"https://doi.org/10.3389/fped.2025.1588562","url":null,"abstract":"<p><strong>Objective: </strong>Asthma education stands as a pivotal element in the long - term management of asthma. This research endeavors to delve into the influence of virtual reality (VR) technology - based asthma education on the quality of life of children suffering from bronchial asthma.</p><p><strong>Methods: </strong>81 children with bronchial asthma from the Sixth Hospital of Shijiazhuang (Aug 2023-Aug 2024) were randomly divided into VR (40 cases) and asthma education (41 cases) groups. The latter received conventional education, while the former used VR technology. C - ACT, CDI, SCARED, MMAS - 8, and PAQLQ were used for assessment. Surveys on help - seeking times and VR device satisfaction were also conducted.</p><p><strong>Results: </strong>After and three months after the intervention, the VR group had higher C - ACT scores, more well - controlled asthma cases, lower CDI scores, fewer children with poor medication adherence, and higher MMAS - 8 scores than the asthma education group. Whether with severe or mild asthma, VR - based education improved C - ACT scores and the number of well - controlled cases. The VR group also had higher PAQLQ scores in symptoms, activity limitation, emotional function, and overall score. They accessed educational materials more often. 92.5% of parents/guardians were satisfied with VR devices and the program.</p><p><strong>Conclusion: </strong>Implementing VR technology - based asthma education for children with bronchial asthma can enhance the asthma control status, effectively mitigate the children's negative emotions, augment medication adherence, and ultimately elevate their quality of life.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1588562"},"PeriodicalIF":2.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Centralization and transport of critically ill pediatric patients.","authors":"Ryo Kamidani, Hideshi Okada","doi":"10.3389/fped.2025.1601875","DOIUrl":"10.3389/fped.2025.1601875","url":null,"abstract":"<p><strong>Background: </strong>Caring for critically ill pediatric patients requires specialized expertise, centralized facilities, and efficient transport systems. The centralization of pediatric intensive care units in tertiary centers has enhanced clinical outcomes, resource efficiency, and standardized care. In this study, we provided an updated review of the increase in need for specialized pediatric transport teams.</p><p><strong>Methods: </strong>We searched PubMed for peer-reviewed literature on the treatment and transport of critically ill pediatric patients, as well as websites of government agencies involved in reporting population prospects. The following search terms were used: pediatric intensive care units, specialized pediatric transport teams, centralization, and helicopter emergency medical services. Thereafter, an inductive qualitative content analysis was performed.</p><p><strong>Results: </strong>High-volume pediatric intensive care units are associated with lower risk-adjusted mortality rates and more efficient resource utilization. However, over-centralization may reduce quality. Effective patient transport depends on skilled personnel, coordination, and stabilization, regardless of the team's composition. Therefore, transport methods should be selected based on a patient's condition, distance, and regional resources. Although helicopters enable rapid transport, they pose risks such as patient-related adverse events, operational hazards, and high costs. Additionally, recent studies questioned the \"golden hour\" concept, emphasizing stabilization and timely care over speed. Telemedicine plays a crucial role in reducing unnecessary transfers, optimizing resources, and improving access to specialized care.</p><p><strong>Conclusions: </strong>As aging populations and declining birth rates reshape healthcare needs, the demand for specialized pediatric transport and telemedicine increases. Future strategies must address regional disparities, enhance cost-effectiveness, and integrate advanced technologies such as artificial intelligence to ensure equitable and high-quality pediatric care.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1601875"},"PeriodicalIF":2.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous video recording with simultaneous amplitude-integrated EEG monitoring to improve seizure recognition in newborns.","authors":"Anup Kage, Yesenia C Santana, Ivone L Malcolm, Caroline Francia, Michael Yoong, David Wertheim, Divyen Shah","doi":"10.3389/fped.2025.1585606","DOIUrl":"10.3389/fped.2025.1585606","url":null,"abstract":"<p><strong>Introduction: </strong>Seizures in newborn infants are considered a neurological emergency requiring prompt treatment to limit exacerbation of brain injury. Digital monitors incorporating limited channel raw EEG and amplitude-integrated EEG (aEEG/EEG) are widely used. This study aimed to determine if continuous video recording with simultaneous aEEG/EEG recording enhances seizure recognition.</p><p><strong>Methods: </strong>Newborns at risk of seizures who underwent neuromonitoring with aEEG/EEG were prospectively recruited to an observational study in a tertiary neonatal centre. Video recordings were commenced after obtaining written consent from parents.</p><p><strong>Results: </strong>Simultaneous video recordings with aEEG/EEG were obtained in 15/47 newborns recruited to study. A total of 116 electrographic seizure episodes were detected on aEEG/EEG when a total of 56 episodes of abnormal movements were noted on video recordings. Only 8 of these abnormal movements had simultaneous electrographic seizures on aEEG.</p><p><strong>Conclusion: </strong>Use of simultaneous video and aEEG/EEG recordings in newborns at risk of seizures is feasible. It not only assists confirmation of the presence of seizures but may also help in identifying movements associated with abnormal neurology that are not seizures.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1585606"},"PeriodicalIF":2.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction models for intraventricular hemorrhage in very preterm infants: a systematic review.","authors":"Ping Xiong, Yonggang Wei, Lei Li, Houxin Kang, Zhangbin Yu, Hong Tang, Yuanlin Pu","doi":"10.3389/fped.2025.1605145","DOIUrl":"10.3389/fped.2025.1605145","url":null,"abstract":"<p><strong>Objective: </strong>To provide an overview and critical appraisal of prediction models for Intraventricular hemorrhage (IVH) in very preterm infants.</p><p><strong>Methods: </strong>Our comprehensive literature search encompassed PubMed (MEDLINE), Embase, Web of Science, the Cochrane Library along with targeted searches of the Chinese Medical Association's online journal platform (up to 8 February 2025). We examined relevant citations during full-text review and thoroughly evaluated them for inclusion. We included studies that reported the development and/or validation of predictive models for IVH in preterm infants born at <32 weeks. We extracted the data independently based on the TRIPOD-SRMA checklist. We checked for risk of bias and applicability independently using the Prediction model Risk Of Bias Assessment.</p><p><strong>Results: </strong>A total of 30 prediction models from 11 studies reporting on model development and 2 models from 2 studies reporting on external validation were included in the analysis. The most frequently reported outcome in both model development studies (54.5%) and model validation studies (50%) was IVH I-IV. The most frequently used predictors in the models were gestational age (43.33%), followed by sex (36.67%), antenatal corticosteroids (33.33%), diastolic blood pressure (33.33%), birth weight (30%), and mean airway pressure (30%). The median C-statistic reported at model development was 0.83 (range 0.74-0.99). The majority of the included studies had a high risk of bias, mainly due to suboptimal analysis and mishandling of missing data. Furthermore, small sample sizes and insufficient numbers of event patients were observed in both types of studies. No meta-analysis was performed because no two studies validated the same model in comparable populations. We summarized performance metrics (e.g., C-statistic) descriptively.</p><p><strong>Conclusion: </strong>The included studies may still be flawed to a certain extent. It is recommended that future studies augment the sample size and number of events, whilst ensuring that any missing data is addressed in a rational manner. Furthermore, the statistical analysis should be optimised, and the study made transparent for the purpose of model generalisation.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1605145"},"PeriodicalIF":2.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of and risk factors for adolescent scoliosis from a multi-year school screening programme in Eastern China.","authors":"Rong Xu, Jianghui Li, Weihong Wang, Lijun Zhang, Hua Liu","doi":"10.3389/fped.2025.1524073","DOIUrl":"10.3389/fped.2025.1524073","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the occurrence of adolescent scoliosis (AS) and identify possible associated factors in Eastern China.</p><p><strong>Methods: </strong>The screening technique involved performing forward bending tests and using scoliometer data. Adolescents at risk for scoliosis based on the screening were advised to undergo an x-ray examination for diagnosis confirmation.</p><p><strong>Results: </strong>Between 2019 and 2023, a total of 90,635 adolescents, comprising 41,836 females and 48,799 males, aged 11-18, underwent screening. Among the screened adolescents in Eastern China, the overall prevalence of scoliosis was 0.62%, with 0.99% in females and 0.30% in males. Independently associated factors were identified as female gender (OR = 1.319, 95% CI 1.031-1.686, <i>P</i> = 0.027), BMI ≤ 20 (OR = 2.959, 95% CI 2.271-3.855, <i>P</i> < 0.001), a tendency to incline towards one side (OR = 2.129, 95% CI 1.564-2.898, <i>P</i> < 0.001), and a habit of bending over the desk (OR = 1.523, 95% CI 1.079-2.150, <i>P</i> = 0.017).</p><p><strong>Conclusion: </strong>The current study found that the occurrence rate of AS in Eastern China is 0.62%. Female adolescents who are thin and tall and have poor learning posture are more susceptible to developing scoliosis.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1524073"},"PeriodicalIF":2.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of remote at-home oscillometric blood pressure monitoring in community-dwelling children aged 3-17.","authors":"Emily H Ho, Berivan Ece, Caroline Clingan, Anne Zola, Zutima Tuladhar, Magdalena Ewa Kupczyk, Linda S Adair, Richard Gershon","doi":"10.3389/fped.2025.1565266","DOIUrl":"10.3389/fped.2025.1565266","url":null,"abstract":"<p><strong>Background: </strong>As hypertension becomes more prevalent, remote assessment of blood pressure (BP) has been proposed as a method to improve BP management in the pediatric population. We investigated the reliability of at-home BP monitoring in children ages 3-17.</p><p><strong>Methods: </strong>This study was conducted at six sites across the United States. Children participated in three BP measurements on one occasion by caregivers at home and, on another separate occasion, by trained examiners in a clinic setting. The results were averaged and classified according to the 2017 Pediatric Hypertension Guidelines as normal BP, elevated BP, stage 1 hypertension, or stage 2 hypertension. We collapsed participants with elevated BP, stage 1 hypertension, or stage 2 hypertension into one group: above-normal. We examined the agreement between the caregivers' and examiners' BP readings and the ease of the measurement process.</p><p><strong>Results: </strong>One hundred eighteen (118) children participated in this study (48.3% male; mean age 9.65 ± 4.52 years). Most caregivers (78%-93%) and examiners (88%-99%) rated elements of BP measurement as \"easy\" or \"very easy\". Caregiver and examiners' agreement on BP classification as normal or above-normal ranged from 75.00% to 90.16% across age groups. Caregiver and examiner BP concordance significantly differed by age group (<i>p</i> = .03) and was lower among children with above-normal BPs.</p><p><strong>Conclusions: </strong>Overall, most aspects of the remote BP measurement process were rated as easy, suggesting that remote monitoring of BP in children is feasible. Concordance of BP measurements by caregivers and examiners was high for children in the normal BP range. More research is needed on the reliability of home BP monitoring across the pediatric age range for those with above-normal BP.</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"13 ","pages":"1565266"},"PeriodicalIF":2.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}