Evaluation of an Evidence-based Guideline for Bronchiolitis

Abstract

An evidence-based clinical practice guideline for managing bronchiolitis was highly successful in modifying care during its first year of implementation.guideline, bronchiolitis, evidence-based medicine, pediatrics, outcome research.

Effectiveness of Quality Improvement in Hospitalization for Bronchiolitis: A Systematic Review

“…The characteristics of the 14 studies [25][26][27][28][29][30][31][32][33][34][35][36][37][38] in this review are described in Table 1, including our qualitative assessment of the categorical type of intervention (described later in further detail): primarily educational (providing voluntary guidelines, presenting conferences); involving significant process change (implementing standardized order sets); and involving significant process change plus the use of a respiratory score. A respiratory score was loosely defined as any multicomponent numerical representation of respiratory effort.…”

“…Simpson et al 32 presented data included in a larger study (Kotagal et al 31 ) and is described but was excluded from the data analysis. Data presented in the 1999 study by Perlstein et al 26 was also included in the 2000 study by Perlstein et al 27 and are analyzed in our report primarily from the 2000 article, except for one measure (doses per patient of bronchodilator), which is only reported in the 1999 article. Muething et al 33 …”

“…27,34 Costs were analyzed in 4 studies, all using differing methods. Four studies reported decreased charges or costs associated with the intervention, 26,27,30,36 and 1 study reported no change. 25 …”

A systematic review of predictive modeling for bronchiolitis

“…14% to 40% of bronchiolitis patients will eventually have asthma [25,196], with the association persisting into adulthood [196][197][198][199][200][201][202][203]. In young children, asthma is heralded by acute bronchiolitis in 90% of cases, one third of which require hospitalization [204].…”

“…With proper implementation, clinical practice guidelines for bronchiolitis can reduce healthcare resource usage by up to 77% without negatively impacting clinical outcomes or patient family's satisfaction [23,[25][26][27][28]. However, due to an insufficient level of detail and limited amounts of evidence, existing clinical practice guidelines provide guidance for a limited number of patients and still rely heavily on individualized clinician judgment.…”