Risks and decisions in pediatrics


Martin Chalumeau


Beyond the neonatal period, children have the lowest mortality rate of the different ages of life, are often ill, especially in early childhood and are physiologically immature. Serious events (deaths, diagnostic delays, drugs adverse effects) are therefore not anticipated. Thus, preventive strategies, diagnostic procedures and treatments must be highly effective but also as limited and safe as possible since the outcome is favorable in the vast majority of cases. Furthermore, the maturation of pediatric patients makes clinical signs less performant, pharmacological data from adults not transposable, and the long-term consequences of sub-optimal strategies potentially disastrous.

Principal objective

The objective of our research is to provide new knowledge to support the best public health and clinical decisions in pediatrics by an accurate evaluation of risks and benefit-risk balance of care strategies. Our research is intended for application in routine pediatric practice at all levels of care: preventive programs at the population level, office visits, emergency departments, or hospitalizations. Our methods combine the evaluation of existing strategies and practices, and the derivation and validation of innovative approaches for the purpose of optimizing routine care.

Principal themes

Our current and future works focus on several topics, chosen because of their importance as a cause of morbidity/mortality or their burden in the population:

  1. fever risks and management
  2. growth monitoring as an early detection test
  3. determinants and consequences of diagnostic delays of cancer
  4. reduction of unnecessary antibiotics in ambulatory settings
  5. iron deficiency diagnosis and prevention strategies

Principal data sources

Ad hoc studies.

Main publications since 2012

Staff members

M Chalumeau (pediatrician, epidemiologist, PU-PH Paris-Descartes), R Carbajal (pediatrician, PU-PH Paris Pierre et Marie Curie), C Gras-Leguen (pediatrician, PU-PH Nantes), JF Brasme (pediatrician, epidemiologist, PH Angers), J Cohen (pediatrician, epidemiologist, CCA), R Guedj (pediatrician, epidemiologist, CCA), E Launay (pediatrician, epidemiologist, MCU-PH Nantes), P Scherdel (epidemiologist), F Lorton (pediatrician, doctoral student), AS Sacri (pediatrician, doctoral student), N Trinh (pharmacist, doctoral student).

Main collaborations

  • PREDISTREP : R Cohen and C Lévy (Association Clinique et Thérapeutique Infantile du Val-de-Marne ACTIV, St-Maur)
  • CARMA : B Blondel (Epopé Team), L Gouya (Labex Grex), S Hercberg (CRESS), C Lévy (ACTIV), A Bocquet (Comité de nutrition – Société Française de Pédiatrie et Association Française de Pédiatrie Ambulatoire -AFPA-, Besançon), M de Montalembert (CHU Necker)
  • DIACAN : L Fasse, J Grill and D Valteau-Couanet (Onco-Pédiatrie, Institut Gustave Roussy, Villejuif and réseau Cancer Pédiatrie Île-de-France), M Arnoult (Société Française de Médecine Générale -SFMG-), G Ibanez (Société de Formation Thérapeutique du Généraliste -SFTG-), R Assathiany (AFPA)
  • EBGM : B Heude (Inserm, CRESS), R Brauner (Endocrinologie pédiatrique, Fondation Rothschild, Université Paris Descartes), O Goulet (Gastro-entérologie pédiatrique, CHU Necker), JF Salaun (AFPA), M Arnoult (SFMG), G Ibanez (SFTG), R Assathiany (AFPA)
  • DIABACT : A Martinot (Urgences Pédiatriques, CHRU Lille), R Assathiany (AFPA)
  • DIAMETH: P Ravaud (CRESS team 5 and French EQUATOR Center)