Correctly Identifying Hospitalized Pediatric Patients With Tobacco Smoke Exposure: The First Step in Addressing Parental Tobacco Use.

Abstract

In their study in this issue of Hospital Pediatrics , Mahabee-Gittens et al1 compared tobacco smoke exposure (TSE) based on parental self-report in a convenience sample of pediatric patients who were hospitalized with TSE based on biochemical confirmation with levels of child salivary cotinine, a biomarker of nicotine. The study revealed poor sensitivity and specificity of parental self-report of TSE (reported in the electronic health record [EHR]), compared with measured cotinine levels. Only 67% of patients with positive cotinine levels were identified as having TSE by parental self-report, as documented in the EHR. In contrast, 77% of children with parental report of TSE who were hospitalized had positive cotinine levels. The authors concluded that almost 40% of children were misclassified in the EHR as not …