Clinical Epidemiology

Clinical epidemiology is the study of the patterns, causes, and effects of health and disease in patient populations and the relationships between exposures or treatments and health outcomes.

Areas of research include

•  disease screening and prevention

•  systematic review methodology

•  developing evidence-based practice and policy guidelines

•  implementation of practices and guidelines in health systems

•  development of patient-centered registries and data marts within health information systems

•  creating and testing patient decision aids

•  using patient data for quality improvement and research projects

Clinical Futures Projects Involving Clinical Epidemiology Methodology:

Examining Trends in Child Health Outcomes During COVID-19

A series of studies conducted by team members at The Possibilities Project used clinical epidemiology methods to characterize the impact of the COVID-19 pandemic on child health. The team leveraged CHOP’s large pediatric primary care network to identify how pediatric health care settings can support families in finding ways to address barriers to healthy lifestyles amid the COVID-19 pandemic. One article provides guidance and new approaches for pediatricians to aid families in finding ways to address the obstacles to healthy lifestyles. Another provides insight into the need for adolescent depression and suicide risk screenings for pediatricians to aid families in finding ways to identify and treat depression in their pediatric patients.

Faculty Contributors: George Dalembert, MD, MSHP, Alexander Fiks, MD, MSCE, Brian Jenssen, MD, MSHP, Stephanie Mayne, PhD, MPH

Neonatal Sepsis Risk Calculator

This body of work includes development and validation of a quantitative model to estimate the probability of neonatal early-onset sepsis based on maternal risk factors and the infant’s clinical presentation. The calculator has safely reduced unnecessary antibiotic use at birth and decreased the rate at which newborns are separated from mothers. More recent work has aimed at defining low infection risk in the preterm infant, and further reducing empirical use of antibiotics in NICU patients.

Faculty Contributors: Dustin Flannery, DO, MSCE, Jeffrey Gerber, MD, PhD, Sagori Mukhopadhyay, MD, MMSc, Karen Puopolo, MD, PhD

Disparities in Pregnancy and Birth Outcomes

Another area of Clinical Epidemiology investigation aims to explore disparities in healthcare access and outcomes based on race, ethnicity, and other socioeconomic and environmental factors. For example, maternal mortality is higher among Black than White people in the United States. One study sought to determine whether this disparity varied across hospital types. The data suggested that disparities were caused by excess mortality among Black patients within each hospital type, in addition to excess mortality in nonteaching, Black-serving hospitals where most Black patients deliver. Another study found that residential tree canopy coverage was associated with reduced perceived stress among urban-dwelling pregnant women with history of anxiety or depression. Maternal perceived stress has been found to be associated with preterm birth.

Faculty Contributors: Heather Burris, MS, MPH, and Scott Lorch, MD, MSCE