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Healthcare Research and Quality

Our aim is to improve healthcare quality by optimizing treatment and diagnostic practices and enhancing efficiency. We do this by identifying gaps in care and investigating the processes, interventions, and structures that impact patient outcomes and healthcare delivery. Our group primarily focuses on healthcare registry data. To address the complex needs and challenges within healthcare, our research spans multiple disciplines, including medicine, public health, epidemiology, and economics.

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We are undertaking a rigorous nationwide investigation utilizing electronic health records (EHR) and conducting systematic reviews aimed at evaluating evidence-based medical practices, healthcare quality, and adherence to clinical guidelines in patient care. Our primary focus is on the field of pediatric infectious diseases and atopic diseases.

Bilbery (wild "European" blueberry) © Péter Csonka

In one of our main projects, the SULA project, we focus on antibiotics that are the most prescribed class of drugs for children, with the majority initiated outside of hospital settings. Three out of four courses are used to treat respiratory infections, which account for over 80% of all infections in children under 15 years of age. The overuse of antibiotics for common and often self-limiting pediatric infections represents a significant public health concern. Despite this, there is a surprising lack of up-to-date data on antibiotic prescriptions for children in Finland, both in public and private sectors. To influence clinical practices and implement effective interventions, more precise, visit- and indication-specific national data are needed on the diagnosis and treatment of infectious diseases in children. The SULA-project aims to: 1) investigate antibiotic prescribing practices for children in the private sector; 2) assess the quality of diagnostic methods; 3) identify risk factors contributing to deviations from treatment guidelines; and 4) evaluate the cost impacts of diagnostic tests and treatments. The study population comprises children under 18 years who received antibiotic prescriptions from Terveystalo, a largest private healthcare service providing company in Finland, between 2017 and 2023. Data will be sourced from the nationwide patient register and partially from Kela. Our dataset encompasses approximately 275,000 visits.  The findings will facilitate more precise and effective interventions necessary to improve the quality of pediatric care and reduce costs for both patients and society. Subsequent actions will include specialty-specific training, integration of guideline-supportive prompts in electronic health records to assist clinical decision-making, and other electronic tools that support adherence to treatment guidelines.

The upcoming FinnATOPY project will be uniquely oriented towards an in-depth exploration of conditions related to asthma, allergies, and various other atopic diseases. For further insights into this enterprise, please refer to the additional resources provided.

Recent Publications
(Healthcare Quality & EBM)

  • Hamelmann E, Csonka P, Roberts G, Vogelberg C, Cichocka-Jarosz E, Just J, Jeseňák M. High burden of respiratory allergy in children warrants early identification and treatment with allergen immunotherapy. Respir Med. 2024 Sep 24:107812. doi: 10.1016/j.rmed.2024.107812.

  • Lee B, Turner S, Borland M, Csonka P, Grigg J, Guilbert TW, Jartti T, Oommen A, Twynam-Perkins J, Lewis S, Cunningham S. Efficacy of oral corticosteroids for acute preschool wheeze: a systematic review and individual participant data meta-analysis of randomised clinical trials. Lancet Respir Med. 2024 Mar 22:S2213-2600(24)00041-9. doi: 10.1016/S2213-2600(24)00041-9.

  • Csonka P, Hamelmann E, Turkalj M, Roberts G, Mack DP. SQ sublingual immunotherapy tablets for children with allergic rhinitis: A review of phase three trials. Acta Paediatr. 2024 Mar 26. doi: 10.1111/apa.17221.

  • Poutanen R, Korppi M, Csonka P, Pauniaho S-L, Renko M, Palmu S. Use of antibiotics contrary to guidelines in children's lower respiratory tract infections in different health care settings. Eur J Pediatr. 2023. doi: 10.1007/s00431-023-05099-6.

  • Korppi M, Palmu S, Heikkilä P, Csonka P. Antibiotic prescriptions for child sinusitis varied between specialties after Finnish guidelines were updated in 2018. Acta Paediatr. 2023;112:1041-1048. doi: 10.1111/apa.16641

  • Csonka P, Palmu S, Heikkilä P, Huhtala H, Korppi M. Outpatient Antibiotic Prescribing for 357,390 Children with otitis media. Pediatr Infect Dis J. 2022;41:947-952. doi: 10.1097/INF.0000000000003693

  • Nikkilä A, Lohi O, Nieminen N, Csonka P. Trends in ferritin measurements in children and adolescents: a Finnish 9-year observational study. Acta Paediatr. 2022;111:1933-1940. doi: 10.1111/apa.16454

  • Korppi M, Heikkilä P, Palmu S, Huhtala H, Csonka P. Antibiotic prescribing for children with upper respiratory tract infection: a Finnish nation-wide 7-year observational study. Eur J Pediatr. 2022;181:2981-2990. doi: 10.1007/s00431-022-04512-w

  • Korppi M, Heikkilä P, Palmu S, Huhtala H, Csonka P. Antibiotic prescriptions for children with lower respiratory tract infections fell from 2014-2020 but misuse was still an issue. Acta Paediatr. 2022;111:1230-1237. doi: 10.1111/apa.16323

  • Csonka P, Korppi M. Electronic health record databases provide a platform for intervention studies. Acta Paediatr. 2022;111:1104-1106. doi: 10.1111/apa.16329.

  • Csonka P, Heikkilä P, Koskela S, Palmu Sauli, Lajunen N, Riihijärvi S, Huhtala H, Korppi M. Cough and cold medicine prescription rates can be significantly reduced by active intervention. Eur J Pediatr. 2022;181:1531-1539. doi: 10.1007/s00431-021-04344-0

  • Palmu S, Heikkilä P, Kivistö JE, Poutanen R, Korppi M, Renko M, Csonka P. Cough medicine prescriptions for children were significantly reduced by a systematic intervention that reinforced national recommendations. Acta Paediatr. 2022;111:1248-1249. doi: 10.1111/apa.16284

  • Poutanen R, Virta T, Heikkilä P, Pauniaho Satu-Liisa, Csonka P, Korppi M, Renko M, Palmu S. National Current Care Guidelines for paediatric lower respiratory tract infections reduced the use of chest radiographs but local variations were observed. Acta Paediatr. 2021;110:1594-1600. doi: 10.1111/apa.15692

  • Kivistö J, Poutanen R, Protudjer JL, Csonka P, Korppi M, Renko M, Palmu S. Current Care Guidelines had no immediate effects on antitussive prescriptions to Finnish children. Acta Paediatr. 2021;110:2445-2447. doi: 10.1111/apa.15829

  • Csonka P, Tapiainen T, Mäkelä M, Lehtimäki L. Heterogeneity of emergency treatment practices in wheezing preschool children. Acta Paediatr. 2021;110:2448-2454. doi: 10.1111/apa.15915

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