Development and validation of the Liverpool infant bronchiolitis severity score: a research protocol

Miert, Clare van; Abbott, Janice; Verheoff, Francine; Lane, Steven; Carter, Bernie; McNamara, Paul

doi:10.1111/jan.12387

Cited by 13 publications

(10 citation statements)

References 51 publications

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“…If this is the case, it would be inappropriate to validate some of the existing instruments in a more comprehensive and proper way, as proposed by Bekhof et al [3], and it would be more appropriate to develop a new instrument by means of a conceptual framework and using qualitative methods to identify important items and domains associated with bronchiolitis severity. With respect to this, there is a promising instrument aimed at evaluating the severity of bronchiolitis (the Liverpool infant bronchiolitis severity score) [18] that is being planned to incorporate all recommended scale development and psychometric methods and is to be developed and validated in the next few years.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of instruments aimed at evaluating the severity of bronchiolitis

Rodríguez‐Martínez

Sossa-Briceño

Niño

2018

Paediatric Respiratory Reviews

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Summary Objective No recent studies have performed a systematic review of all available instruments aimed at evaluating the severity of bronchiolitis. The objective of the present study was to perform a systematic review of instruments aimed at evaluating the severity of bronchiolitis and to evaluate their measurement properties. Methods A systematic search of the literature was performed in order to identify studies in which an instrument for evaluating the severity of bronchiolitis was described. Instruments were evaluated based on their reliability, validity, utility, endorsement frequency, restrictions in range, comprehension, and lack of ambiguity. Results A total of 77 articles, describing a total of 32 different instruments were included in the review. The number of items included in the instruments ranged from 2 to 26. Upon analyzing their content, respiratory rate turned out to be the most frequently used item (in 26/32, 81.3% of the instruments), followed by wheezing (in 25/32, 78.1% of the instruments). In 18 (56.3%) instruments, there was a report of at least one of their measurement properties, mainly reliability and utility. Taking into consideration the information contained in the instruments, as well as their measurement properties, one was considered to be the best one available. Conclusions Among the 32 instruments aimed at evaluating the severity of bronchiolitis that were identified and systematically examined, one was considered to be the best one available. However, there is an urgent need to develop better instruments and to validate them in a more comprehensive and proper way.

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Section: Discussionmentioning

confidence: 99%

Systematic review of instruments aimed at evaluating the severity of bronchiolitis

Rodríguez‐Martínez

Sossa-Briceño

Niño

2018

Paediatric Respiratory Reviews

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“…This should include a validated severity score. 148 3. The benefit of high-flow oxygen, used at one centre during this study, is still uncertain, although it is rapidly being adopted in many hospitals in the UK and worldwide.…”

Section: Strengths and Weaknesses Compared With Earlier Systematic Rementioning

confidence: 99%

Saline in Acute Bronchiolitis RCT and Economic evaluation: hypertonic saline in acute bronchiolitis – randomised controlled trial and systematic review

Everard

Hind

Ugonna

et al. 2015

Health Technol Assess

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BackgroundAcute bronchiolitis is the most common cause of hospitalisation in infancy. Supportive care and oxygen are the cornerstones of management. A Cochrane review concluded that the use of nebulised 3% hypertonic saline (HS) may significantly reduce the duration of hospitalisation.ObjectiveTo test the hypothesis that HS reduces the time to when infants were assessed as being fit for discharge, defined as in air with saturations of > 92% for 6 hours, by 25%.DesignParallel-group, pragmatic randomised controlled trial, cost–utility analysis and systematic review.SettingTen UK hospitals.ParticipantsInfants with acute bronchiolitis requiring oxygen therapy were allocated within 4 hours of admission.InterventionsSupportive care with oxygen as required, minimal handling and fluid administration as appropriate to the severity of the disease, 3% nebulised HS every ± 6 hours.Main outcome measuresThe trial primary outcome was time until the infant met objective discharge criteria. Secondary end points included time to discharge and adverse events. The costs analysed related to length of stay (LoS), readmissions, nebulised saline and other NHS resource use. Quality-adjusted life-years (QALYs) were estimated using an existing utility decrement derived for hospitalisation in children, together with the time spent in hospital in the trial.Data sourcesWe searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and other databases from inception or from 2010 onwards, searched ClinicalTrials.gov and other registries and hand-searchedChest,PaediatricsandJournal of Paediatricsto January 2015.Review methodsWe included randomised/quasi-randomised trials which compared HS versus saline (± adjunct treatment) or no treatment. We used a fixed-effects model to combine mean differences for LoS and assessed statistical heterogeneity using theI2statistic.ResultsThe trial randomised 158 infants to HS (n = 141 analysed) and 159 to standard care (n = 149 analysed). There was no difference between the two arms in the time to being declared fit for discharge [median 76.6 vs. 75.9 hours, hazard ratio (HR) 0.95, 95% confidence interval (CI) 0.75 to 1.20] or to actual discharge (median 88.5 vs. 88.7 hours, HR 0.97, 95% CI 0.76 to 1.23). There was no difference in adverse events. One infant developed bradycardia with desaturation associated with HS. Mean hospital costs were £2595 and £2727 for the control and intervention groups, respectively (p = 0.657). Incremental QALYs were 0.0000175 (p = 0.757). An incremental cost-effectiveness ratio of £7.6M per QALY gained was not appreciably altered by sensitivity analyses. The systematic review comprised 15 trials (n = 1922) including our own. HS reduced the mean LoS by –0.36 days (95% CI –0.50 to –0.22 days). High levels of heterogeneity (I2 = 78%) indicate that the result should be treated cautiously.ConclusionsIn this trial, HS had no clinical benefit on LoS or readiness for discharge and was not a cost-effective treatment for acute bronchiolitis. Claims that HS achieves small reductions in LoS must be treated with scepticism.Future workWell-powered randomised controlled trials of high-flow oxygen are needed.Study registrationThis study is registered as NCT01469845 and CRD42014007569.Funding detailsThis project was funded by the NIHR Health Technology Assessment (HTA) programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 66. See the HTA programme website for further project information.

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“…A literature search was performed on PubMed using the search terms described in Table 1. This revealed 338 papers, and among them, 15 papers were relevant to our topic [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. We undertook a manual search of the reference lists of the relevant papers and a Google Scholar search and identified a further [4,[23][24][25][26].…”

Section: F U L L S E a R C H D E S C R I P T I O N A N D S E A R C H mentioning

confidence: 99%

Can a Respiratory Severity Score Accurately Assess Respiratory Distress in Children with Bronchiolitis in a Resource-Limited Setting?

Hakizimana

Saint

Miert

et al. 2019

Journal of Tropical Pediatrics

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Development and validation of the Liverpool infant bronchiolitis severity score: a research protocol

Cited by 13 publications

References 51 publications

Systematic review of instruments aimed at evaluating the severity of bronchiolitis

Systematic review of instruments aimed at evaluating the severity of bronchiolitis

Saline in Acute Bronchiolitis RCT and Economic evaluation: hypertonic saline in acute bronchiolitis – randomised controlled trial and systematic review

Can a Respiratory Severity Score Accurately Assess Respiratory Distress in Children with Bronchiolitis in a Resource-Limited Setting?

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