[Skip to Navigation]
November 2, 2020

Deimplementation in Pediatrics: Past, Present, and Future

Author Affiliations
  • 1Virginia Commonwealth University, Department of Pediatrics, Richmond
  • 2Virginia Commonwealth University, Department of Family Medicine and Population Health, Richmond
  • 3Stanford University School of Medicine, Palo Alto, California
JAMA Pediatr. 2021;175(3):230-232. doi:10.1001/jamapediatrics.2020.4681

The 20th century heralded major advancements in pediatric health care including vaccinations, antibiotics, and sophisticated radiographic studies. These interventions led to substantial improvements in child mortality. Yet, as medical interventions became more commonplace, concerns about negative health effects developed. As a result, many of the changes to pediatric practice in the 21st century have actually involved deimplementation, the process of reducing care that is harmful, ineffective, overused, or not cost-effective. Despite this progress, many practices persist that are not supported by evidence. This Viewpoint explores the historical drivers of deimplementation and proposes ways to further reduce the amount of low-value care delivered to children.

Add or change institution
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words