Accepted for Publication: March 7, 2012.
Author Contributions: Ms Miskin and Dr Kuppermann had full access to all the data in the study and take responsibility for the integrity of the data. Ms Miskin takes responsibility for the accuracy of the data analysis. Study concept and design: Natale, Joseph, Rogers, and Kuppermann. Acquisition of data: Rogers, Mahajan, Cooper, Wisner, Hoyle, Atabaki, Dayan, Holmes, and Kuppermann. Analysis and interpretation of data: Natale, Joseph, Rogers, Miskin, and Kuppermann. Drafting of the manuscript: Natale, Joseph, Rogers, Miskin, and Kuppermann. Critical revision of the manuscript for important intellectual content: Natale, Joseph, Rogers, Mahajan, Cooper, Wisner, Miskin, Hoyle, Atabaki, Dayan, Holmes, and Kuppermann. Statistical analysis: Miskin. Obtained funding: Kuppermann. Administrative, technical, and material support: Natale, Joseph, Rogers, Mahajan, Cooper, Wisner, Hoyle, Atabaki, Dayan, Holmes, and Kuppermann.
Financial Disclosure: None reported.
Funding/Support: This work was supported by grant R40MC02461 from the Health Resources and Services Administration's Maternal and Child Health Bureau, Emergency Medical Services for Children, and Division of Research, Education, and Training. The Pediatric Emergency Care Applied Research Network is supported by cooperative agreements U03MC00001, U03MC00003, U03MC00006, U03MC00007, and U03MC00008 from the Health Resources and Services Administration's Maternal and Child Health Bureau and Emergency Medical Services for Children.
PECARN Group Members: The participating centers (and site investigators who contributed to acquisition of data and provided administrative, technical, or material support) are listed in alphabetical order. Atlantic Health System Morristown Memorial Hospital, Morristown, New Jersey: Michael Gerardi, MD. Bellevue Hospital Center, New York, New York: Michael Tunik, MD, and James Tsung, MD. Calvert Memorial Hospital, Prince Frederick, Maryland: Kraug Melville, MD. Children's Hospital Boston, Boston, Massachusetts: Lois Lee, MD, MPH. Children's Hospital of Michigan, Detroit: Prashant Mahajan, MD, MPH, MBA. Children's Hospital of New York Presbyterian, New York, New York: Peter S. Dayan, MD, MSc. Children's Hospital of Philadelphia, Philadelphia, Pennsylvania: Frances Nadel, MD. Children's Memorial Hospital, Chicago, Illinois: Elizabeth Powell, MD, MPH. Children's National Medical Center, Washington, DC: Shireen M. Atabaki, MD, MPH, and Kathleen Brown, MD. Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio: Todd F. Glass, MD, MS. Harlem Hospital Center, New York, New York: Arthur Cooper, MD. Helen DeVos Children's Hospital, East Lansing, Michigan: John D. Hoyle Jr, MD. Holy Cross Hospital, Silver Spring, Maryland: Elizabeth Jacobs, MD. Howard County Medical Center, Columbus, Maryland: David Monroe, MD. Hurley Medical Center, Flint, Michigan: Dominic Borgialli, DO, MPH. Medical College of Wisconsin/Children's Hospital of Wisconsin, Milwaukee: Marc Gorelick, MD, MSCE, and Subhankar Bandyopadhyay, MD. St Barnabas Health Care System, Livingston, New Jersey: Michael Bachman, MD, and Neil Schamban, MD. State University of New York–Upstate Medical University, Syracuse: James Callahan, MD. University of California, Davis, Medical Center, Sacramento: James F. Holmes, MD, MPH, and Nathan Kuppermann, MD, MPH. University of Maryland, College Park: Richard Lichenstein. University of Michigan, Ann Arbor: Rachel Stanley, MD, MHSA. University of Rochester, Rochester, New York: Mohamed Badawy, MD, and Lynn Babcock-Cimpello, MD, MPH. University of Utah/Primary Children's Medical Center, Salt Lake City: Jeffrey Schunk, MD. Washington University/St Louis Children's Hospital, St Louis, Missouri: Kimiberly S. Quayle, MD, and David Jaffe, MD. Women and Children's Hospital of Buffalo, Buffalo, New York: Kathleen Lillis, MD.
Previous Presentations: This study was presented in part at the American Academy of Pediatrics 2011 National Conference and Exhibition; October 14, 2011; Boston, Massachusetts; and at the 2011 American College of Emergency Physicians Research Forum; October 16, 2011; San Francisco, California.
Additional Contributions: We thank Rene Enriquez, BS, Sally Jo Zuspan, RN, MSN, the PECARN research coordinators, and the clinicians who enrolled children in the study.