Low-value Care, and Variation in Practice for Children Hospitalized with Bronchiolitis
BronchiolitisLow-value care is defined as the use of a health service, such as diagnostics and treatments, for which the harms or costs outweigh the benefits. In pediatrics, investigations or treatments can be unpleasant or traumatizing to the child, can prolong the time spent in hospital, and can create a cascade of further futile investigations and treatments. Several of the commonly used diagnostics and treatments in bronchiolitis are considered low-value, making it a great model to study low-value care in pediatrics.
The purpose of CareBEST is to study the use of 6 low-value healthcare services in children aged 1 to 12 months hospitalized with bronchiolitis, their costs, and measure the variability in practice of these services.
The main questions this study aims to answer are:
1. How frequently are 6 low-value care health services used in children hospitalized with bronchiolitis? These 6 low-value care health services are: 1) respiratory virus testing; 2) chest x-rays; 3) continuous pulse oximetry; 4) short-acting beta-agonists; 5) systemic corticosteroids; and 6) antibiotics.
* Are there factors that predict the use of these services?
* What are the costs of the use of these services?
2. How much variability is there between different patients, different doctors, and between hospitals in the use of these 6 low-value health services ?
3. Are differences in use of low-value health services associated with patient and family characteristics (like race and ethnicity, socioeconomic status, language), and do these contribute to disparities in care?
Participants will have their infant's medical chart reviewed during their hospitalization. They will also have 2 short questionnaires to complete, once during their child's admission to the hospital, and one 30 days later to ask about whether their child required any additional medical care.
This analysis will provide a better understanding of treatment of bronchiolitis in Canada and help in the development of effective interventions to reduce low-value care.
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Participation Requirements
-
Sex:
ALL -
Eligible Ages:
28 to 1
Participation Criteria
Inclusion Criteria:
* Children aged \>28 days to \<12 months
* Children admitted to a pediatric inpatient ward with an admission diagnosis of bronchiolitis
Exclusion Criteria:
- Children previously recruited for the study, either during a previous bronchiolitis admission or for the same incident of bronchiolitis, while admitted to another study site.
Study Location
IWK Health
IWK HealthHalifax, Nova Scotia
Canada
Contact Study Team
Sarah Manos, MD
Trillium Health Partners
Trillium Health PartnersMississauga, Ontario
Canada
Contact Study Team
Ann Bayliss, MD
Centre hospitalier Cité-de-la-Santé
Centre hospitalier Cité-de-la-SantéLaval, Quebec
Canada
Contact Study Team
Camille Bédard-Gauthier, MD
Centre Hospitalier Université Laval - Centre Mère-Enfant Soleil
Centre Hospitalier Université Laval - Centre Mère-Enfant SoleilQuébec, Quebec
Canada
Contact Study Team
Josée-Anne Gagnon, MD
British Columbia Children's Hospital
British Columbia Children's HospitalVancouver, British Columbia
Canada
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Matthew Carwana, H.BSc, MD
Children's Hospital of Western Ontario (London Health Science Centre)
Children's Hospital of Western Ontario (London Health Science Centre)London, Ontario
Canada
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Breanna Chen, MD
Hospital for Sick Children
Hospital for Sick ChildrenToronto, Ontario
Canada
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Sanjay Mahant, MD MSc
Peter Gill, MD DPhil MSc
Montreal Children's Hospital
Montreal Children's HospitalMontréal, Quebec
Canada
Contact Study Team
Patricia Li, MD, MSc
Evelyn Constantin, MD, MSC
Alberta Children's Hospital
Alberta Children's HospitalCalgary, Alberta
Canada
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McMaster Children's Hospital
McMaster Children's HospitalHamilton, Ontario
Canada
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Gita Wahi, MD
Lakeridge Health
Lakeridge HealthOshawa, Ontario
Canada
Contact Study Team
Mahmoud Sakran, MD
Hôpital Maisonneuve-Rosemont
Hôpital Maisonneuve-RosemontMontréal, Quebec
Canada
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Marc-André Turcot, MD
Hôpital Saint-Eustache
Hôpital Saint-EustacheSaint-Eustache, Quebec
Canada
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Stollery Children's Hospital
Stollery Children's HospitalEdmonton, Alberta
Canada
Contact Study Team
Karen Forbes, MD MEd
Kingston Health Science Centre
Kingston Health Science CentreKingston, Ontario
Canada
Contact Study Team
Anupam Sehgal, MD
Children's Hospital of Eastern Ontario
Children's Hospital of Eastern OntarioOttawa, Ontario
Canada
Contact Study Team
Melanie Buba, MD
CHU Sainte-Justine
CHU Sainte-JustineMontréal, Quebec
Canada
Contact Study Team
Olivier Drouin, MD, MSc, MPH
Hôpital Régional de St-Jérôme
Hôpital Régional de St-JérômeSaint-Jérôme, Quebec
Canada
Contact Study Team
Maria Jimena Penaloza, MD
- Study Sponsored By
- St. Justine's Hospital
- Participants Required
- More Information
- Study ID:
NCT06506474