# Using Small Area Variation Analysis to Investigate Sources of Practice Variation for Febrile Infants at Risk for Invasive Bacterial Infections

> **NIH NIH K23** · UNIVERSITY OF ROCHESTER · 2024 · $166,946

## Abstract

PROJECT SUMMARY
Febrile infants are at risk for potentially fatal invasive bacterial infections, but clinical decisions vary widely and
thousands of infants may experience harms from under-testing or over-treatment. Practice variation costs up to
$700 billion each year and is associated with poor outcomes, low-quality care, and inequities. However, there
is a paucity of research examining the extent to which key sources contribute to practice variation, particularly
for febrile infants. Addressing this gap in knowledge is an essential first step to improve the effectiveness,
efficiency, and equity in care for febrile infants. Dr. Yaeger is a board-certified pediatric hospitalist whose prior
research has focused on understanding how clinical and social factors can improve child health outcomes.
This K23 Mentored Patient-Oriented Research Career Development Award will allow him to learn new
methods to investigate sources of practice variation, understand subsequent effects, and ultimately devise
interventions to reduce practice variation, improve outcomes, and decrease costs, thereby improving equity for
all febrile infants. The proposed studies and career development plan will directly support the candidate's goal
of becoming an independent clinician-investigator and expert in clinical decision-making and child health
equity. To achieve this goal, he has assembled an inter-disciplinary mentoring team from the University of
Rochester Departments of Family Medicine, Public Health Sciences, and Emergency Medicine. In addition to
completing relevant coursework, workshops, longitudinal training programs, and individual didactic sessions,
Dr. Yaeger will gain expertise from his team, who will guide him in achieving his Training and Career Goals.
These goals include gaining expertise and skills in: 1) decision science; 2) multi-level modeling, and; 3) mixed
methods. His research plan seeks to understand the extent to which disease rates, local supply of resources,
clinical characteristics, parent/caregiver preferences, and local practice culture contribute to practice variation
in febrile infants. The aims are: 1) To estimate practice variation and the extent to which disease rates and
local resources explain practice variation; 2) To examine contextual factors associated with practice variation;
3) To investigate the effect of a national clinical practice guideline on practice variation. He will accomplish Aim
1 using a state-wide, population-based administrative dataset and small area variation analysis framework to
estimate the extent to which key sources of practice variation contribute to differences in clinical decision-
making. In Aim 2, he will use a mixed methods approach to identify contextual factors that may contribute to
clinical decisions affecting practice variation. In Aim 3, he will investigate the extent to which a national clinical
practice guideline reduces practice variation. These career development activities, mentorship, and resul...

## Key facts

- **NIH application ID:** 10846800
- **Project number:** 5K23HD107182-02
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** Jeffrey Paul Yaeger
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $166,946
- **Award type:** 5
- **Project period:** 2023-05-23 → 2027-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10846800

## Citation

> US National Institutes of Health, RePORTER application 10846800, Using Small Area Variation Analysis to Investigate Sources of Practice Variation for Febrile Infants at Risk for Invasive Bacterial Infections (5K23HD107182-02). Retrieved via AI Analytics 2026-06-23 from https://api.ai-analytics.org/grant/nih/10846800. Licensed CC0.

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