2017 Update on Pediatric Medical Overuse: A Review

Abstract

Importance: Medical overuse has historically focused on adult health care, but interest in how children are affected by medical overuse is increasing. This review examines important research articles published in 2016 that address pediatric overuse.

Observations: A structured search of PubMed and a manual review of the tables of contents of 10 journals identified 169 articles related to pediatric overuse published in 2016, from which 8 were selected based on the quality of methods and potential harm to patients in terms of prevalence and magnitude. Articles were categorized by overtreatment, overmedicalization, and overdiagnosis. Findings included evidence of overtreatment with commercial rehydration solution, antidepressants, and parenteral nutrition; overmedicalization with planned early deliveries, immobilization of ankle injuries, and use of hydrolyzed infant formula; and evidence of overdiagnosis of hypoxemia among children recovering from bronchiolitis.

Conclusions and relevance: The articles were of high quality, with most based on randomized clinical trials. The potential harms associated with pediatric overuse were significant, including increased risk of infection, developmental disability, and suicidality.