Pediatric Research in Office Settings

Pediatric Research in Office Settings (PROS), founded in 1986, is the American Academy of Pediatrics’ (AAP) practice-based research network. Two programmatic areas are pragmatic clinical studies in real-world practice-settings and secondary data analysis through the Comparative Effectiveness Research through Collaborative Electronic Reporting (CER²) consortium. Children’s Hospital of Philadelphia is the data coordinating center for CER² and multiple other PROS studies.

All PROS participating practices are primarily engaged in general pediatrics and include office-based practices, hospital-based ambulatory care centers, medical-school-based practices, and community health clinics. Children seen in PROS practices are representative of those cared for in ambulatory office–based pediatric primary care in the United States.

PROS has scientific and administrative personnel to facilitate meeting project deadlines. PROS is governed by a Steering Committee and operated by a staff team based in Primary Care Research at AAP. PROS has repeatedly demonstrated an ability to coordinate research between investigators at different sites and to manage data collection in many geographically diverse settings. PROS has the capacity to collect data from large samples of study participants, prepare datasets, and provide initial statistical analyses.

PROS practitioners representing AAP chapters (Chapter Coordinators) meet yearly to help develop new studies and provide feedback on ongoing projects.

The collaborative relationship between CHOP, in particular CHOP’s primary care practice-based research network, the Pediatric Research Consortium (PeRC), and PROS was formalized through their participation in an Agency for Healthcare Research and Quality (AHRQ)-funded P01-funded project that created a joint Center for Pediatric Practice and Learning with national reach.

PROS has had a history of success for more than 30 years, enhanced through its collaboration with CHOP, which demonstrates the network’s ability to effectively complete and evaluate clinical trials. During this time, AAP PROS network has successfully:  

• Completed more than 30 trials
• Informed clinical guidelines for puberty screening, hypertension, and other areas
• Improved child health and clinical practice in primary care in areas including:
  • obesity treatment
  • teen driving
  • child abuse screening
  • child safety/injury prevention
  • vision and hearing screening
  • treatment of fever in infants.

Research Project Highlights:

Large practice-based randomized trials:

• Judicious Antibiotic Use, in partnership with CHOP investigators Jeff Gerber, Robert Grundmeier, and Alexander Fiks
• Obesity Treatment, in partnership with CHOP investigator Robert Grundmeier
• Influenza Vaccination, Alexander Fiks, multiple principal investigators
• HPV Vaccination, Alexander Fiks, multiple principal investigators
• Child poverty/Social determinants of health.

Electronic Health Record studies:

• Pediatric medication use and safety, in partnership with CHOP investigator Robert Grundmeier
• A novel metric for benchmarking antibiotic use to inform outpatient stewardship, in partnership with CHOP investigators Jeff Gerber (PI), Alexander Fiks, Robert Grundmeier, and Stephanie Mayne.