Our work aims to improve the quality of pediatric health and mental health services for children afflicted by chronic medical or psychiatric conditions.  We study the development and implementation of clinical informatics, assessment tools and patient engagement strategies in enhancing outcomes for children, adolescents and their families.  We focus on care for high risk families in public sector and primary care services. Dr. Gardner's group focuses on developing psychometric and informatic tools to advance these goals. Specific projects include designing new automated patient evaluation and monitoring tools, clinician decision support and methods of evaluating outcomes.

In a separate line of research, the Gardner laboratory conducts empirical research on research ethics.

Pediatric PROMIS: Advancing the Measurement and Conceptualization of Child Health

As part of its roadmap initiative, the NIH established the Patient-Reported Outcomes Measurement Information System (PROMIS) network to develop methods for efficiently and validly examining health outcomes from the perspectives of patients themselves.  Our research will contribute to the development of a version of PROMIS for children, which reflects, in part, the reality that many chronic diseases begin early in life.  A pediatric version of PROMIS will make it possible to monitor trajectories of health and disease across developmental periods, science that is currently almost nonexistent. This work is likely to dramatically enhance understanding of disease processes, effects of interventions, and prevention efforts.

RFA-RM-08-023 (Gardner)
FUNDING PERIOD: 09/01/09 – 08/31/13             
FUNDING AGENCY: NIH, subcontract from CHOP (C. Forrest PI) to the Research Institute at Nationwide Children’s Hospital

Pharmaceutical Safety Tracking (PhaST): Managing Medications for Patient Safety

PhaST is an automated system for monitoring how medications, specifically anti-depressants, are used in children and teens. The use of anti-depressants in children and adolescents has been under intense scrutiny since questions were raised about an increased risk of suicide in young patients taking the drugs. Close monitoring and frequent doctor visits have been recommended for children and teens taking anti-depressants. However, some families may not time or resources for this frequent — often weekly —monitoring. In addition, overstretched child mental health systems may not be able to supply the necessary physician visits.

To ensure children are taking medications properly and to detect early signs of problems, the PhaST program uses an interactive voice response telephone system to contact parents or teenage patients. The system requires simple yes or no answers to questions about the medications and their side effects. When a parent or patient indicates a problem, the system alerts a trained psychiatric nurse to contact the patient or parent and when necessary, contact the patient’s physician or hospital emergency services. By using health information technology, the PhaST project can assist clinicians in closely monitoring children taking antidepressant drugs so that adverse effects such as a risk of suicide can be detected early, ultimately preventing harm to patients.

1 R18 HS017258-01 (William Gardner)
Funding Period: 09/04/2007 - 08/25/2010
Funding Agency: AHRQ

Investigator, Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, OH

Dr. Gardner is an investigator in the Center for Innovation in Pediatric Practice, Director of Biostatistics, and is Professor of Pediatrics, Psychology, and Psychiatry at The Ohio State University. He is a developmental and quantitative psychologist who studies pediatric mental health services. His research focuses on methods to assess children in pediatric settings, disorders commonly seen in office settings, and interventions to improve the quality of children’s primary mental health care. These interventions often use information technology to enhance communication between doctors and patients. Dr. Gardner’s current statistical research is focused on the use of item response theory and computerized adaptive tests for mental health assessment. Dr. Gardner also conducts empirical research on research ethics, including authorship ethics and the effects of financial conflicts of interest on clinical trials.

Odgers CL, Mulvey EP, Skeem JL, Gardner W, Lidz CW, Schubert C. Capturing the ebb and flow of psychiatric symptoms with dynamical systems models. Am J Psychiatry. 2009 May;166(5):575-82. Epub 2009 Apr 15

Stevens J, Wang W, Fan L, Edwards M, Campo J, Gardner W. Parental attitudes toward children’s use of antidepressants and psychotherapy. Journal of Child and Adolescent Psychopharmacology. 2009 Jun;19(3):289-96.

Kelleher KJ, Gardner WP. Thinking systematically about early identification.           J Adolesc Health. 2009 Jun. 44(6):516-7.

Kelleher KJ, Greenhouse J, Bridge J, Gardner W, Klima J, McInerny T. Letter: Safety of Antidepressents. Pediatrics. 2009:123(4):1223-4.

Chisolm D, Klima J, Gardner W, Kelleher K. Adolescent Behavioral Risk Screening and Use of Health Services. Adm Policy Ment Health. 2009 Nov;36(6):374-80.

Pajer K, Stein S, Tritt K, Chang CN, Wang W, Gardner W. Conduct disorder in girls: neighborhoods, family characteristics, and parenting behaviors.

Child Adolesc Psychiatry Ment Health. 2008 Oct 6;2(1):28.

Chisolm DJ, Gardner W, Julian T, Kelleher KJ. Adolescent satisfaction with computer-assisted behavioral risk screening in primary care. Child Adolesc Ment Health. 2008;13(4):163-8

Greenhouse JB, Kaizar EE, Kelleher KJ, Seltman H, Gardner W. Generalizing from clinical trial data: A case study. The risk of suicidality among pediatric antidepressant users. Stat Med. 2008 May 20;27(11):1801-13.

Chen G, Sinclair S, Smith G, Kelleher KJ, Pajer KA, Gardner W, Xiang H.           Personality disorders and nonfatal unintentional injuries among

U.S. adults. Inj Prev. 2008;14:180-4.

Pajer KA, Chang J, Gardner W, Wang W, Leininger L, Yeates KO. Neuropsychological function in adolescent girls with conduct disorder.

Stevens J, Kelleher KJ, Gardner W, Chisolm D, McGeehan J, Pajer KA, et al. Trial of computerized screening for adolescent behavioral concerns. Pediatrics. 2008 Jun;121(6):1099-1105.

Pajer K, Tabbah R, Gardner W, Rubin RT, Czambel RK, Wang Y. Adrenal androgen and gonadal hormone levels in adolescent girls with conduct disorder. Psychoneuroendocrinology. 2006 Nov;31(10):1245-1256.