PITCH Lab

Led by Dr. Eric Coon, the Pragmatic Intervention Trials for Children Hospitalized With Common Conditions (PITCH lab is dedicated to improving medical care for children hospitalized with common conditions, such as bronchiolitis and pneumonia. We study medical interventions that are in widespread, real-world use, but have not been evaluated by rigorous research methods. We endeavor to study these interventions using pragmatic randomized trial designs whenever possible.

Explore Our Research

Post-hospitalization follow-up

Automatic vs PRN (pro re nata or “as-needed”) post-hospitalization follow-up is one of the most common dilemmas faced by hospitalized children, their parents, and their medical providers. Automatic follow-up has long been the default approach. However, automatic follow-up leaves families out of the decision-making and can be burdensome for them. PRN follow-up empowers families to monitor their child’s symptoms after hospital discharge and decide if a post-hospitalization follow-up is needed. Until recently, the effectiveness and safety of PRN follow-up was unknown.

Our team is at the forefront of research examining the comparative effectiveness of automatic and PRN post-hospitalization follow-up. Dr. Coon led the Bronchiolitis Follow-up Intervention Trial (BeneFIT), a multicenter RCT demonstrating that PRN follow-up is safe and effective for children hospitalized with bronchiolitis, a leading cause of hospitalization. Our team is leading the Follow-up Automatically vs As-Needed Comparison (FAAN-C or “fancy”) trial. FAAN-C is a nationwide 14-hospital RCT that builds on BeneFIT. FAAN-C is comparing automatic vs PRN follow-up for children hospitalized with other common infections, including pneumonia, skin and soft tissue infection, UTI and gastroenteritis. FAAN-C has been ahead of schedule for enrollment since recruitment started in 2022 and will ultimately randomize 2,674 participants. This makes FAAN-C one of the largest trials ever for children hospitalized with common conditions. Our team is also leading I-DECIDE, a multicenter RCT comparing two different implementation strategies designed to increase PRN follow-up for children hospitalized with bronchiolitis.

Increasing pragmatic trials

Randomized controlled trials (RCTs) generate the highest-quality evidence to guide medical decisions. Unfortunately, very few RCTs have been conducted involving children hospitalized with common conditions. As a result, everyday tests and treatments given to children hospitalized with common conditions are guided by lower quality evidence.

Our team is laying a foundation to support more RCTs for children hospitalized with common conditions. We focus on tests and treatments that are already in widespread practice and can be evaluated in real-world clinical settings using pragmatic RCTs. Dr. Coon led a national multidisciplinary conference series funded by the Agency for Healthcare Research and Quality. This conference series identified and prioritized >60 RCT questions for children hospitalized with common conditions. Dr. Coon also led a national team of investigators in developing a strategy called High Efficiency RandOmIzed Controlled (HEROIC) trials. The HEROIC strategy is designed to increase pragmatic RCTs for children hospitalized with common conditions.