Jessica M. Allan

All Publications

• Mislabeled Bag Urine Cultures and Antibiotic Treatment Decisions. Pediatrics Liang, D., Schroeder, A. R., Maleknia, L., Allan, J. M., Kane, M., Jones, V. G., Patel, R. J., Newman, T. B., Roberts, K. B., Wang, M. E. 2024

  View details for DOI 10.1542/peds.2024-066344

  View details for PubMedID 38919984

• Analysis of Pediatric Clinical Practice Guideline Authors by Gender, Race, and Ethnicity. Journal of women's health (2002) Martin, A. A., Jacobs, J. W., Armijo, P. R., Allan, J. M., Booth, G. S., Spector, N. D., Overholser, B., Silver, J. K. 2024

  Abstract

  Background and Objectives: Clinical practice guidelines (CPGs) have significantly influenced medical practice worldwide. Nevertheless, the authorship of CPGs produced by several medical societies has not been representative of the field and population they address, as women and individuals from racial and ethnic minority groups have been underrepresented as authors. We hypothesized that women and individuals from minoritized racial and ethnic groups would also be underrepresented as authors of CPGs produced by the American Academy of Pediatrics (AAP). Methods: In this cross-sectional study, the gender, race, and ethnic composition of authors and subcommittee participants of AAP-produced CPGs published from January 2010 through May 2023 were analyzed and compared to the 2010 and 2021 U.S. population and 2010 and 2022 U.S. medical school pediatric faculty. Results: Women (39.7%, 127/320 of all positions, and 42.5%, 85/200 of named author positions) and women physicians (35.2%, 101/287 of all positions, and 36.4%, 64/176 of named author positions) were significantly underrepresented-while men and men physicians were significantly overrepresented-from their respective composition in the U.S. Census and pediatric faculty. Women and women physicians from all racial and ethnic groups and men and men physicians from minority racial and ethnic groups were significantly underrepresented-from their respective composition in the U.S. Census and pediatric faculty. No Black man was identified as an author. Conclusions: Medical societies that produce CPGs should be cognizant of these inequities and ensure appropriate authorship diversity.

  View details for DOI 10.1089/jwh.2023.1132

  View details for PubMedID 38842430

• Gender Communication Differences on a Pediatric Provider Listserv. Hospital pediatrics Allan, J. M., Black, E., Lemieux, N., Gilliam, C. A., Yardley, J., Kim, J. L., Ganem, J., Black, N. P., Schroeder, A. R., Ralston, S., Fromme, H. B. 2024

  Abstract

  Gender-based communication differences are described in educational online communities, but have not been rigorously evaluated in medical online communities. Understanding gender differences in communication may provide insight into gender disparities in the medical profession. Our objective was to describe gender differences in post frequency, content, and language styles on the American Academy of Pediatrics Section on Hospital Medicine (SOHM) listserv.Posts were obtained from publicly available SOHM listserv archives. The first month of every quarter of 2019 and 2020 were reviewed. Two reviewers assigned a post topic (clinical, research, etc) and format (question vs statement) to all deidentified original posts (K = 1.0 topic, 0.89 format). Six trained reviewers assigned language styles (intraclass coefficient = 0.73, indicating good agreement).We analyzed 1592 posts: 287 original posts and 1305 responses. Frequency: Women authored 50% of posts. The 9 most frequent posters (7 men, 2 women) accounted for 19.5% of posts. Content: Men's posts had more words than women's (132.51 vs 112.3, P ≤ .01). Men were more likely to post about health policy and research (P < .001). Men were more likely to post statements compared with women (39% vs 21%, P < .001). Style: Men's posts were more likely to be coded adversarial (12.3% vs 5.5%, P < .001) authoritative (12.2% vs 6.5%, P < .001) or self-amplifying (6.5% vs 3.6%, P < .001).Women contribute disproportionately fewer posts to the American Academy of Pediatrics SOHM listserv compared with their percentage in the subspecialty. We noted significant gender differences in language style and content, which may impact career development and online community inclusion.

  View details for DOI 10.1542/hpeds.2023-007630

  View details for PubMedID 38832428

• Association Between Gender and Salary Among Pediatric Hospital Medicine Physicians. Hospital pediatrics Forster, C. S., Polak, C. A., Chen, C., Kim, J. L., Allan, J. M., Gold, J. M., Ruch-Ross, H. S., Fromme, H. B., Huang, B., Schondelmeyer, A. C. 2024

  Abstract

  Gender-based disparities in salary exist in multiple fields of medicine. However, there is limited data examining gender inequities in salary in pediatric hospital medicine (PHM). Our primary objective was to assess whether gender-based salary differences exist in PHM. The secondary objective was to assess if, among women, the differences in salary varied on the basis of leadership positions or self-identified race and ethnicity.We conducted a survey-based, cross-sectional study of pediatric hospitalists in December 2021. Our primary outcomes were base and total salary, adjusted for the reported number of average weekly work hours. We performed subanalyses by presence of a leadership position, as well as race. We used a weighted t test using inverse probability weighting to compare the outcomes between genders.A total of 559 eligible people responded to our survey (51.0%). After propensity score weighting, women's mean base salary was 87.7% of men's base (95% confidence interval [CI] 79.8%-96.4%, P < .01), and women's total salary was 85.6% of men's total (95% CI 73.2%-100.0%, P = .05) salary. On subgroup analysis of respondents with a leadership position, women's total salary was 80.6% of men's total salary (95% CI 68.7%-94.4%, P < .01). Although women who identified as white had base salaries that were 86.6% of white men's base salary (95% CI 78.5%-95.5%, P < .01), there was no gender-based difference noted between respondents that identified as nonwhite (88.4% [69.9%-111.7%] for base salary, 80.3% [57.2% to 112.7%]).Gender-based discrepancies in salary exists in PHM, which were increased among those with leadership roles. Continued work and advocacy are required to achieve salary equity within PHM.

  View details for DOI 10.1542/hpeds.2023-007567

  View details for PubMedID 38832448

• Gender and work-life balance: Results of a national survey of pediatric hospitalists. Journal of hospital medicine Kim, J. L., Forster, C. S., Allan, J. M., Schondelmeyer, A., Ruch-Ross, H., Barone, L., Fromme, H. B. 2024

  Abstract

  In medicine, difficulty integrating work and home can lead to decreased job satisfaction, diminished well-being, and increased turnover. Understanding the experience of pediatric hospitalists can provide insights into building a stable, long-term workforce. We aim to examine gender differences in work-life balance and parental leave for physicians practicing Pediatric Hospital Medicine.METHODS: This was a cross-sectional survey study of 1096 pediatric hospitalists. Responses were collected via an online survey platform and summarized using descriptive statistics, including frequency distributions and measures of central tendency. A multivariable logistic regression was used to examine associated variables and work-life balance satisfaction. We analyzed free responses on parental leave to provide nuance to quantitative survey data.RESULTS: Five hundred and sixty-five respondents (52% response rate) completed the survey with 71% women. 343 (62%) prioritize work-life balance in career decision-making. Women report taking on more household responsibilities than their partners (41.4% vs. 8.4%; p<.001) including a larger percentage of caregiving and domestic tasks. Female gender and performing <50% caregiving were associated with decreased work-life balance satisfaction; performing <50% domestic tasks increased satisfaction. Median parental leaves were 4 weeks, with men taking significantly shorter leaves (3.5 vs. 6 weeks; p<.001) and more "paid back" time off.CONCLUSION: Work-life balance is an important factor in career decisions for men and women. Women perceive carrying a larger load at home. Qualitative results suggest that parental leave may be inadequate in length and salary support for men and women. This study adds insights into work-life integration in PHM.

  View details for DOI 10.1002/jhm.13413

  View details for PubMedID 38800852

• Mitigating Burnout Imperative for Retention of Hospitalists. WMJ : official publication of the State Medical Society of Wisconsin Martin, A. A., Landry, A., Englander, M., Allan, J. M. 2024; 123 (2): 67

  View details for PubMedID 38718229

• Gender Representation Among Editors of Major Pediatric Journals. JAMA network open Allan, J. M., Jacobs, J. W., Spector, N. D., Rodrigues Armijo, P., Booth, G. S., Silver, J. K. 2023; 6 (7): e2321533

  Abstract

  This cross-sectional study analyzes inequities in the gender of editors for 3 major pediatric journals.

  View details for DOI 10.1001/jamanetworkopen.2023.21533

  View details for PubMedID 37399015

• Clinical course of children 1-24 months old with positive urine cultures without pyuria. Academic pediatrics Wang, M. E., Jones, V. G., Kane, M., Allan, J. M., Maleknia, L., Patel, R., Ip, W., Newman, T. B., Roberts, K. B., Schroeder, A. R. 2023

  Abstract

  To describe the clinical course of children with positive urine cultures without pyuria who were not given antibiotics initially, identify predictors of subsequent antibiotic treatment, and evaluate the association between subsequent treatment and urinary tract infection (UTI) within 30 days.We conducted a multicenter retrospective cohort study of children 1-24 months old who had positive urine cultures without pyuria and who were not started on antibiotics upon presentation to 3 healthcare systems from 2010-2021. Outcomes included clinical status at the time urine cultures resulted, escalation of care (emergency department visit or hospitalization) and subsequent antibiotic treatment within 7 days, and subsequent UTI within 30 days of presentation.Of 202 included children, 61% were female and median age was 9 months. Of 151 patients with clinical status information when cultures resulted, 107 (70.8%, 95% confidence interval [CI] 62.9-77.9%) were improved. Two of 202 children (1.0%, 95% CI 0.2-4.0%) experienced care escalation. Antibiotics were started in 142 (82.2%) children and treatment was associated with prior UTI (risk ratio [RR] 1.20, 95% CI 1.15-1.26) and lack of improvement (RR 1.22, 95% CI 1.13-1.33). Subsequent UTI was diagnosed in 2 of 164 (1.2%, 95% CI 0.1-4.3%) treated and 0 of 36 (0%, 95% CI 0-9.7%) untreated children.Seventy percent of children with positive urine cultures without pyuria improved before starting antibiotics, however >80% were ultimately treated. Future research should study the impact of diagnostic stewardship interventions and various urine testing strategies to optimize management of children evaluated for UTI.Seventy percent of children with positive urine cultures without pyuria improved before starting antibiotics, however >80% were ultimately treated. Future research should study the impact of diagnostic stewardship interventions to optimize management of children evaluated for UTI.

  View details for DOI 10.1016/j.acap.2023.06.023

  View details for PubMedID 37354950

• Fixing the System: Strategies to Support Women in Academic Medicine. Hospital pediatrics Allan, J. M., Jain, S., Jagsi, R., Shaughnessy, E. E. 2022

  Abstract

  "It feels like we are constantly treading water to just stay afloat and get by." (Female, Parent, Faculty, 6-10 years in practice)1 Gender disparities are well documented in academic medicine, including the representation of women in authorship, speaking opportunities, and other measures of academic productivity.2,3 Unfortunately, the COVID-19 pandemic has further exacerbated this gender divide,4 which threatens women's career advancement and risks accelerating the attrition of women from academic medicine.5 Women faculty with children are particularly vulnerable and more likely than faculty without children to consider departing academic medicine.6 Although the societal view of women as caregivers is not new, the increased demands placed on caregivers during the COVID-19 pandemic have been unprecedented. In this month's issue of Hospital Pediatrics, Sharp et al. describe a survey study revealing that women pediatricians who were parents were significantly more likely to report decreased academic productivity during the COVID-19 pandemic compared to men with children.1 The authors' qualitative thematic analysis of free text responses provides further insight into key stress points for women physicians during the pandemic. While the focus of Sharp et al.'s survey was on childcare, the highlighted points of stress likely also apply to women in other caregiving roles, such as caring for elderly parents. The authors call for intentional change from institutions, grant funding agencies, medical societies, journals, and leaders to support all women in medicine. We review key strategies that each of these stakeholders can take to promote meaningful and sustainable change.

  View details for DOI 10.1542/hpeds.2022-006890

  View details for PubMedID 36100980

• Gender Distribution of Scholarship and Measures of National Recognition in Hospital Medicine. Hospital pediatrics Kim, J. L., Allan, J. M., Fromme, H. B., Forster, C. S., Shaughnessy, E., Ralston, S. 2022; 12 (2): 117-124

  Abstract

  Our specific aim was to assess the gender distribution of aspects of scholarly productivity and professional standing for pediatric hospital medicine over a 5-year period. We also evaluated for correlation between the makeup of editorial boards, conference planning committees, and chosen content.We reviewed scholarly publications, presentations, editorial boards, planning committees, awardees, and society leadership in pediatric hospital medicine from 2015 to 2019 and determined gender using published methods to assess for differences between observed proportions of women authors and presenters and the proportion of women in the field.The field of pediatric hospital medicine at large is 69% women (95% confidence internal [CI] 68%-71%), and an estimated 57% of senior members are women (95% CI 54%-60%). We evaluated 570 original science manuscripts and found 67% (95% CI 63%-71%) women first authors and 49% (95% CI 44%-53%) women senior authors. We evaluated 1093 presentations at national conferences and found 69% (95% CI 65%-72%) women presenters of submitted content and 44% (95% CI 37%-51%) women presenters of invited content. Senior authorship and invited speaking engagements demonstrated disproportionately low representation of women when compared with senior members of the field (senior authorship, P = .002; invited presenters, P < .001). Strong positive correlation between gender composition of conference planning committees and selected content was also noted (r = 0.94).Our study demonstrated representative gender distribution for some aspects of scholarly productivity in pediatric hospital medicine; however, a lack of gender parity exists in senior roles.

  View details for DOI 10.1542/hpeds.2021-006278

  View details for PubMedID 35013745

• Gender Equity in Pediatric Hospital Medicine: What History Tells Us. Hospital pediatrics Kim, J. L., Allan, J. M., Fromme, H. B. 2021

  View details for DOI 10.1542/hpeds.2021-006144

  View details for PubMedID 34740883

• Gender Distribution in Pediatric Hospital Medicine Leadership. Journal of hospital medicine Allan, J. M., Kim, J. L., Ralston, S. L., Black, N. M., Blankenburg, R., Shaughnessy, E. E., Fromme, H. B. 2021; 16 (1): 31–33

  Abstract

  Pediatric Hospital Medicine (PHM), a field early in its development and with a robust pipeline of women, is in a unique position to lead the way in gender equity. We describe the proportion of women in divisional and fellowship leadership positions at university-based PHM programs (n = 142). When compared with the PHM field at large, women appear to be underrepresented as PHM division/program leaders (70% vs 55%; P< .001) but not as fellowship directors (70% vs 66%; P > .05). Women appear proportionally represented in associate/assistant leadership roles when compared with the distribution of the PHM field at large. Tracking these trends overtime is essential to advancing the field.

  View details for DOI 10.12788/jhm.3555

  View details for PubMedID 33357327

• Sustainability of a Clinical Examination-Based Approach for Ascertainment of Early Onset Sepsis in Late Preterm and Term Neonates. The Journal of pediatrics Frymoyer, A. n., Joshi, N. S., Allan, J. M., Cohen, R. S., Aby, J. L., Kim, J. L., Benitz, W. E., Gupta, A. n. 2020

  View details for DOI 10.1016/j.jpeds.2020.05.055

  View details for PubMedID 32511960

• Collective Action and Effective Dialogue to Address Gender Bias in Medicine. Journal of hospital medicine Gold, J. M., Allan, J. M., Ralston, S. L., Fromme, H. B., Desai, A. D. 2019; 14 (10): 630–32

  View details for DOI 10.12788/jhm.3331

  View details for PubMedID 31577221

• Management of Chorioamnionitis-Exposed Infants in the Newborn Nursery Using a Clinical Examination-Based Approach. Hospital pediatrics Joshi, N. S., Gupta, A., Allan, J. M., Cohen, R. S., Aby, J. L., Kim, J. L., Benitz, W. E., Frymoyer, A. 2019

  Abstract

  BACKGROUND: Antibiotic use in well-appearing late preterm and term chorioamnionitis-exposed (CE) infants was reduced by 88% after the adoption of a care approach that was focused on clinical monitoring in the intensive care nursery to determine the need for antibiotics. However, this approach continued to separate mothers and infants. We aimed to reduce maternal-infant separation while continuing to use a clinical examination-based approach to identify early-onset sepsis (EOS) in CE infants.METHODS: Within a quality improvement framework, well-appearing CE infants ≥35 weeks' gestation were monitored clinically while in couplet care in the postpartum unit without laboratory testing or empirical antibiotics. Clinical monitoring included physician examination at birth and nurse examinations every 30 minutes for 2 hours and then every 4 hours until 24 hours of life. Infants who developed clinical signs of illness were further evaluated and/or treated with antibiotics. Antibiotic use, laboratory testing, and clinical outcomes were collected.RESULTS: Among 319 initially well-appearing CE infants, 15 (4.7%) received antibiotics, 23 (7.2%) underwent laboratory testing, and 295 (92.5%) remained with their mothers in couplet care throughout the birth hospitalization. One infant had group B Streptococcus EOS identified and treated at 24 hours of age based on new-onset tachypnea and had an uncomplicated course.CONCLUSIONS: Management of well-appearing CE infants by using a clinical examination-based approach during couplet care in the postpartum unit maintained low rates of laboratory testing and antibiotic use and markedly reduced mother-infant separation without adverse events. A framework for repeated clinical assessments is an essential component of identifying infants with EOS.

  View details for PubMedID 30833294

• Clinical Monitoring of Well-Appearing Infants Born to Mothers With Chorioamnionitis PEDIATRICS Joshi, N. S., Gupta, A., Allan, J. M., Cohen, R. S., Aby, J. L., Weldon, B., Kim, J. L., Benitz, W. E., Frymoyer, A. 2018; 141 (4)

  View details for DOI 10.1542/peds.2017-2056

  View details for Web of Science ID 000429276200008

• Clinical Monitoring of Well-Appearing Infants Born to Mothers With Chorioamnionitis. Pediatrics Joshi, N. S., Gupta, A. n., Allan, J. M., Cohen, R. S., Aby, J. L., Weldon, B. n., Kim, J. L., Benitz, W. E., Frymoyer, A. n. 2018; 141 (4)

  Abstract

  The risk of early-onset sepsis is low in well-appearing late-preterm and term infants even in the setting of chorioamnionitis. The empirical antibiotic strategies for chorioamnionitis-exposed infants that are recommended by national guidelines result in antibiotic exposure for numerous well-appearing, uninfected infants. We aimed to reduce unnecessary antibiotic use in chorioamnionitis-exposed infants through the implementation of a treatment approach that focused on clinical presentation to determine the need for antibiotics.Within a quality-improvement framework, a new treatment approach was implemented in March 2015. Well-appearing late-preterm and term infants who were exposed to chorioamnionitis were clinically monitored for at least 24 hours in a level II nursery; those who remained well appearing received no laboratory testing or antibiotics and were transferred to the level I nursery or discharged from the hospital. Newborns who became symptomatic were further evaluated and/or treated with antibiotics. Antibiotic use, laboratory testing, culture results, and clinical outcomes were collected.Among 277 well-appearing, chorioamnionitis-exposed infants, 32 (11.6%) received antibiotics during the first 15 months of the quality-improvement initiative. No cases of culture result-positive early-onset sepsis occurred. No infant required intubation or inotropic support. Only 48 of 277 (17%) patients had sepsis laboratory testing. The implementation of the new approach was associated with a 55% reduction (95% confidence interval 40%-65%) in antibiotic exposure across all infants ≥34 weeks' gestation born at our hospital.A management approach using clinical presentation to determine the need for antibiotics in chorioamnionitis-exposed infants was successful in reducing antibiotic exposure and was not associated with any clinically relevant delays in care or adverse outcomes.

  View details for PubMedID 29599112

• Anti-Ge3 causes late-onset hemolytic disease of the newborn: the fourth case in three Hispanic families. Transfusion Pate, L. L., Myers, J. C., Palma, J. P., Viele, M., Galel, S. A., Ferrer, Z., Gonzalez, C. L., Benitz, W. E., Garratty, G., Fontaine, M. J. 2013; 53 (10): 2152-2157

  Abstract

  BACKGROUND: The Gerbich (Ge) blood group system consists of 11 antigens carried on red blood cell (RBC) membrane glycophorins C and D; of these, Ge:3 antigen is of high prevalence, and the anti-Ge3 is found to be clinically significant. CASE REPORT: A 34-week neonate born to a Hispanic mother with anti-Ge3 developed late-onset hemolysis with hyperbilirubinemia and was successfully treated with transfusions from her mother. Relevant clinical findings and laboratory results for this case are summarized and compared to three other previously reported cases; all babies were born from a mother of Hispanic ethnicity. CONCLUSION: Hemolytic disease of the fetus and new born associated with anti-Ge3 is rare but should be considered when working up a broadly reactive RBC antibody screen in women of Hispanic ethnicity. Early identification of pregnant women with anti-Ge3 is recommended for prenatal transfusion planning and close monitoring of the newborn infant for evidence of late-onset anemia.

  View details for DOI 10.1111/trf.12027

  View details for PubMedID 23241141