Optimizing health care for children with spina bifida.

The health care needs of children with spina bifida are complex. They need specialists, generalists, and an integrated system to deliver this complex care and to align and inform all the providers. Most research in spina bifida has been focused on narrow medical outcomes; it has been noncollaborative, based on small samples of convenience, with no comparison groups, and without consistent standards of measurement. Models of health, like the World Health Organization International Classification of Functioning, Disability, and Health Model can help to broaden the scope of future research. Using methods from other pediatric conditions like the patient registry (cystic fibrosis), gene bank (autism), and collaborative research (leukemia), researchers can improve the quality of future studies. Research questions related to the process of care and to specific nonsurgical conditions associated with spina bifida are reviewed in this article.