2017 Update on Pediatric Medical Overuse: A Review

Area of Science:

• Pediatric Medicine
• Health Services Research
• Medical Ethics

Background:

• Medical overuse, historically centered on adult healthcare, is gaining attention regarding its impact on children.
• Increasing interest in pediatric overuse necessitates a review of recent research.
• Understanding the scope and consequences of medical overuse in children is crucial.

Purpose of the Study:

• To review high-quality research articles published in 2016 concerning pediatric medical overuse.
• To identify and categorize instances of overtreatment, overmedicalization, and overdiagnosis in pediatric care.
• To assess the prevalence, magnitude, and potential harms of pediatric overuse.

Main Methods:

• A structured literature search of PubMed was conducted.
• Manual review of tables of contents from 10 relevant journals.
• Selection of 8 high-quality articles from 169 identified, focusing on potential patient harm.

Main Results:

• Identified overtreatment with rehydration solutions, antidepressants, and parenteral nutrition.
• Found evidence of overmedicalization in early deliveries, ankle injury immobilization, and infant formula use.
• Documented overdiagnosis of hypoxemia in children with bronchiolitis.

Conclusions:

• Selected articles were of high quality, many based on randomized clinical trials.
• Pediatric overuse presents significant potential harms, including increased infection risk, developmental disability, and suicidality.
• The findings underscore the need for careful consideration of medical interventions in pediatric care.