JAMA Pediatrics最新文献

{"title":"Vaping Cessation Methods Used by Adolescents.","authors":"Brian S Williams,Jesse T Kaye","doi":"10.1001/jamapediatrics.2025.1974","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.1974","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"20 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FDA Draft Guidelines for AI and the Need for Ethical Frameworks.","authors":"Anjali D Deshmukh,Jennifer K Wagner","doi":"10.1001/jamapediatrics.2025.1979","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.1979","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"30 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Reassuring and Misleading Myth of Familial Short Stature-Reply.","authors":"Elizabeth T Walsh,Lindsay A Thompson","doi":"10.1001/jamapediatrics.2025.1971","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.1971","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"48 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating a Large Language Model in Translating Patient Instructions to Spanish Using a Standardized Framework.","authors":"Mondira Ray,Daniel J Kats,Joss Moorkens,Dinesh Rai,Nate Shaar,Diane Quinones,Alejandro Vermeulen,Camila M Mateo,Ryan C L Brewster,Alisa Khan,Benjamin Rader,John S Brownstein,Jonathan D Hron","doi":"10.1001/jamapediatrics.2025.1729","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.1729","url":null,"abstract":"ImportancePatients and caregivers who use languages other than English in the US encounter barriers to accessing language-concordant written instructions after clinical visits. Large language models (LLMs), such as OpenAI's GPT-4o, may improve access to translated patient materials; however, rigorous evaluation is needed to ensure clinical standards are met.ObjectiveTo determine whether GPT-4o can generate high-quality Spanish translations of personalized patient instructions comparable to those performed by professional human translators.Design, Setting, and ParticipantsThis cross-sectional study compared LLM translations to professional human translations using equivalence testing. The personalized pediatric instructions used were derived from real clinical encounters at a large US academic medical center and translated between January 2023 and December 2023. Patient instructions in English were translated into Spanish by GPT-4o and professional human translators. The source English texts were translated using GPT-4o on August 2, 2024. Both sets of translations were evaluated by 3 independent professional medical translators.ExposurePatient instructions were translated using GPT-4o with an engineered prompt, and these translations were compared with those produced by professional human translators.Main Outcomes and MeasuresThe primary outcome was translation quality, assessed using the Multidimensional Quality Metrics (MQM) framework to generate an overall MQM score (rated on a 0-100 scale). Secondary outcomes included a general preference rating and error rates for types of translation errors.ResultsThis study included 20 source files of pediatric patient instructions. Equivalence testing showed no significant difference in translation quality between GPT-4o and human translations, with a mean difference of 1.6 points (90% CI, 0.7-2.5), falling within a predefined equivalence margin of plus or minus 5 MQM points. The LLM yielded fewer mistranslation errors, and a mean (SE) of 52% (6%) of professional translator ratings preferred the LLM translations.Conclusions and RelevanceIn this cross-sectional study, GPT-4o generated Spanish translations of pediatric patient instructions that were comparable in quality to those by professional human translators as evaluated using a standardized framework. While human review of LLM translation remains essential in health care, these findings suggest that GPT-4o could reduce the translation workload for Spanish, potentially freeing resources to support languages of lesser diffusion.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"47 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Errors in the Table.","authors":"","doi":"10.1001/jamapediatrics.2025.1995","DOIUrl":"10.1001/jamapediatrics.2025.1995","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"179 7","pages":"808"},"PeriodicalIF":24.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicaid Reimbursement for Maternal Depression Screening and Care for Postpartum Depression","authors":"Sarah H. Gordon, Sobin Lee, Nigel Deen, Megan B. Cole, Emily Feinberg, Alison Galbraith","doi":"10.1001/jamapediatrics.2025.1790","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.1790","url":null,"abstract":"ImportanceClinical guidelines recommend routine screening for postpartum depression (PPD) during well-child visits. All but 5 US states provide Medicaid reimbursement to pediatric practitioners for screening mothers for PPD during well-child visits, but little is known about how reimbursement affects screening, diagnosis, and treatment.ObjectiveTo evaluate the association between Medicaid reimbursement for PPD screening during well-child visits and screening, diagnosis, and treatment for mood or anxiety disorders in the postpartum year.Design, Setting, and ParticipantsThis cohort study used a difference-in-differences study design to analyze claims data and birth records obtained from the Colorado All Payer Claims Database for the period January 1, 2013, to December 31, 2019, for Medicaid-insured and commercially insured births that occurred between 2012 and 2018. Data were analyzed between February 16, 2024, and March 21, 2025.ExposureColorado Medicaid reimbursement for PPD screenings during well-child visits.Main Outcomes and MeasuresThe primary outcome was billed depression screens during well-child visits. Secondary outcomes were diagnoses of a postpartum mood or anxiety disorder and outpatient mental health care or prescription medication use during the postpartum year. We defined an indicator variable for before (2013) vs after (2014-2019) the Colorado Medicaid program began reimbursing for maternal depression screening during well-child visits on January 1, 2014.ResultsThis study included 137 867 births, 104 085 of which were paid by Medicaid and 33 782 of which were paid by commercial insurance. The mean (SD) age of mothers in the Medicaid-insured group during the 2013 prepolicy period was 25.6 (5.7) years compared with 31.7 (4.7) years among mothers in the commercially insured group; during the postpolicy period, the mean (SD) ages were 26.5 (5.7) years and 32.1 (4.4) years, respectively. During the prepolicy period, for births insured by Medicaid vs commercial insurance, the mothers were more likely to have been born outside the US (14.2% vs 10.3%; <jats:italic>P</jats:italic> = .01), reside in a more rural area (14.5% vs 8.1%; <jats:italic>P</jats:italic> < .001), have not completed high school or college (24.8% vs 1.1%; <jats:italic>P</jats:italic> < .001), and have a lower income (80.3% vs 8.2%; <jats:italic>P</jats:italic> < .001). In adjusted difference-in-differences models, reimbursement for maternal depression screening during well-child visits among Medicaid-insured mothers was associated with a 9.60–percentage point (ppt) (95% CI, 9.10-10.00 ppt) increase in the probability of billed depression screens during well-child visits (<jats:italic>P</jats:italic> < .001), 0.18 (95% CI, 0.17-0.19) additional billed well-child visit depression screens per birth (ie, 18 additional screens per 100 births), a 2.5-ppt (95% CI, 1.40-3.50 ppt) increase in the probability of being diagnosed with a p","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"39 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144516264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Call for Applications for the JAMA Pediatrics Editorial Fellowship.","authors":"Dimitri A Christakis,Andrea F Duncan","doi":"10.1001/jamapediatrics.2025.1809","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.1809","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"40 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144521412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Errors in Editorial.","authors":"","doi":"10.1001/jamapediatrics.2025.2344","DOIUrl":"10.1001/jamapediatrics.2025.2344","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Intravenous Fluid Use in the Emergency Department During Hurricane Helene","authors":"Abidatou Diasso-Adamou, Frank Gonzalez, Alexandra T. Geanacopoulos, Mark I. Neuman, Chris A. Rees, Timothy T. Phamduy, Pradip P. Chaudhari, Kelly R. Bergmann, Oluwakemi Badaki-Makun, Daniel J. Shapiro, Mohamed Eltorki, Elizabeth M. Keating, Kathleen A. Noorbakhsh, Sriram Ramgopal","doi":"10.1001/jamapediatrics.2025.1636","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.1636","url":null,"abstract":"This cross-sectional study explores changes in intravenous fluid use and clinical outcomes of pediatric patients treated in US emergency departments after Hurricane Helene in 2024.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"38 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Sleep and White Matter in the Link Between Screen Time and Depression in Childhood and Early Adolescence","authors":"João Paulo Lima Santos, Adriane M. Soehner, Candice L. Biernesser, Cecile D. Ladouceur, Amelia Versace","doi":"10.1001/jamapediatrics.2025.1718","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.1718","url":null,"abstract":"ImportanceWith the widespread adoption of screen-based devices among adolescents, there is growing concern that more screen time could contribute to mental health problems such as depression. It is thus critical to identify potential mediating factors that could help explain this potential risk relationship. Recent evidence indicates that more screen time could impact sleep duration and brain structural connectivity (ie, white matter organization), which are critical for emotional health. Notably, sleep duration is a modifiable behavior that health care providers can easily target.ObjectiveTo identify the association between screen time during late childhood and depressive symptoms in early adolescence, and to investigate whether these associations are mediated by sleep duration and white matter organization.Design, Setting, and ParticipantsThis prospective study was conducted from January 2024 to June 2024. Data from the Adolescent Behavior Cognitive Development (ABCD) Study were used to identify clinical and neuroimaging characteristics of participants at late childhood (T1; defined as aged 9-10 years) and early adolescence (T2; defined as age 11-13 years). Children and their parent/caregiver were recruited across 21 US cities. Participants with no past/current psychiatric disorders at T1 were selected for analyses. Initial analyses were conducted in 2024 and finalized in February 2025.Main Outcomes and MeasureOutcomes included screen time assessed using a self-report questionnaire, sleep duration assessed using the Munich Chronotype Questionnaire, and depressive symptoms characterized using the Child Behavior Checklist. Neurite orientation dispersion and density imaging and a tract profile approach were used to characterize the orientation dispersion index of 3 white matter tracts that are known to be implicated with depression: cingulum bundle, forceps minor, and uncinate fasciculus.ResultsAnalyses included 976 participants (460 children [47.1%] were female, mean [SD] age was 9.9 [0.6] years at T1 and 11.9 [0.6] years at T2). Each additional hour of daily screen time at T1 was associated with a 0.12-point (95% CI, 0.04-0.20; <jats:italic>P</jats:italic> = .008) increase in Child Behavior Checklist depressive score at T2. Shorter sleep duration and worse cingulum bundle organization (greater orientation dispersion index) at T2 mediated 36.4% (95% CI, 18.2%-63.6%) of the association between more screen time and more depressive symptoms.Conclusions and RelevanceResults of this study show that more screen time in late childhood was associated with more depressive symptoms, potentially due to shorter sleep and worse white matter organization during early adolescence. These findings emphasize the importance of promoting healthy habits and balancing screen time with adequate sleep.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"49 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}