For the third straight year, Boston Children’s Hospital took first place in 2017-2018 in the 11th annual ranking of the best pediatric hospitals by US News & World Report.The magazine’s so-called honor roll, released today, held few surprises. As in the previous 2 years, Boston Children’s was trailed by Children’s Hospital of Philadelphia, Cincinnati Children’s Hospital Medical Center, and Texas Children’s Hospital, Houston, in that order. Four other hospitals were repeats from last year, while Johns Hopkins Children’s Center and the Children’s National Medical Center in Washington, DC, made the honor roll again after brief absences.Boston Children’s HospitalChildren’s Hospital of PhiladelphiaCincinnati Children’s Hospital Medical CenterTexas Children’s Hospital, HoustonJohns Hopkins Children’s CenterChildren’s Hospital Los AngelesAnn and Robert H. Lurie Children’s Hospital of ChicagoNationwide Children’s Hospital, Columbus, OhioChildren’s Hospital of Pittsburgh of UPMCChildren’s National Medical CenterUS News bases its honor roll on how pediatric hospitals rank in each of 10 specialties, with points assigned to their positions — 25 points for first place in a given specialty, 24 points for second, and so on. The 10 hospitals with the most points across the 10 specialties appear in the honor roll.The methodology is a departure from last year’s, when a hospital had to score in the top 10% of at least three specialties to qualify for the honor roll. Last year’s rankings also used a different point system.The top children’s hospitals in the 10 specialties are as follows:Cancer: St. Jude Children’s Research HospitalCardiology and heart surgery: Texas Children’s Hospital, HoustonDiabetes and endocrinology: Children’s Hospital of PhiladelphiaGastroenterology and gastrointestinal surgery: Boston Children’s HospitalNeonatology: Children’s National Medical CenterNephrology: Boston Children’s HospitalNeurology and neurosurgery: Boston Children’s HospitalOrthopedics: Boston Children’s HospitalPulmonology: Children’s Hospital of PhiladelphiaUrology: Boston Children’s HospitalThe rankings within the 10 specialties mostly reflect objective quality measures, such as clinical outcomes, patient volume, infection control, adequate staffing of nurses, efficiency and coordination of care, and compliance with best practices. A hospital’s reputation within a specialty, as gleaned from physician surveys, accounts for 15% of its score.