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Low-value Care, and Variation in Practice for Children Hospitalized with Bronchiolitis

Bronchiolitis

Low-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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Conditions de participation

  • Sexe:

    ALL

  • Âges admissibles:

    28 to 1

Critères de participation

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.

Lieu de l'étude

IWK Health
IWK Health
Halifax, Nova Scotia
Canada

Contactez l'équipe d'étude

Primary Contact

Sarah Manos, MD

[email protected]
Backup Contact

Sarah Manos, MD

Trillium Health Partners
Trillium Health Partners
Mississauga, Ontario
Canada

Contactez l'équipe d'étude

Backup Contact

Ann Bayliss, MD

Primary Contact

Ann Bayliss, MD

[email protected]
Centre hospitalier Cité-de-la-Santé
Centre hospitalier Cité-de-la-Santé
Laval, Quebec
Canada

Contactez l'équipe d'étude

Primary Contact

Camille Bédard-Gauthier, MD

[email protected]
Backup Contact

Camille Bédard-Gauthier, MD

Centre Hospitalier Université Laval - Centre Mère-Enfant Soleil
Centre Hospitalier Université Laval - Centre Mère-Enfant Soleil
Québec, Quebec
Canada

Contactez l'équipe d'étude

Backup Contact

Josée-Anne Gagnon, MD

Primary Contact

Josée-Anne Gagnon, MD

[email protected]
British Columbia Children's Hospital
British Columbia Children's Hospital
Vancouver, British Columbia
Canada

Contactez l'équipe d'étude

Backup Contact

Matthew Carwana, H.BSc, MD

Primary Contact

Matthew Carwana, H.BSc, MD

[email protected]
Backup Contact

Candice Wiedman

[email protected]
Children's Hospital of Western Ontario (London Health Science Centre)
Children's Hospital of Western Ontario (London Health Science Centre)
London, Ontario
Canada

Contactez l'équipe d'étude

Primary Contact

Breanna Chen, MD

[email protected]
Backup Contact

Breanna Chen, MD

Hospital for Sick Children
Hospital for Sick Children
Toronto, Ontario
Canada

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Backup Contact

Sanjay Mahant, MD MSc

Primary Contact

Peter Gill, MD DPhil MSc

Backup Contact

Shamama Raza

[email protected]
Montreal Children's Hospital
Montreal Children's Hospital
Montréal, Quebec
Canada

Contactez l'équipe d'étude

Backup Contact

Evelyn Constantin, MD, MSc

[email protected]
Primary Contact

Patricia Li, MD, MSc

[email protected]
Backup Contact

Patricia Li, MD, MSc

Backup Contact

Evelyn Constantin, MD, MSC

Alberta Children's Hospital
Alberta Children's Hospital
Calgary, Alberta
Canada

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McMaster Children's Hospital
McMaster Children's Hospital
Hamilton, Ontario
Canada

Contactez l'équipe d'étude

Backup Contact

Gita Wahi, MD

Primary Contact

Gita Wahi, MD

[email protected]
Backup Contact

Fariha Chowdhury

[email protected]
Lakeridge Health
Lakeridge Health
Oshawa, Ontario
Canada

Contactez l'équipe d'étude

Primary Contact

Mahmoud Sakran, MD

[email protected]
Backup Contact

Mahmoud Sakran, MD

Hôpital Maisonneuve-Rosemont
Hôpital Maisonneuve-Rosemont
Montréal, Quebec
Canada

Contactez l'équipe d'étude

Backup Contact

Marc-André Turcot, MD

Primary Contact

Marc-André Turcot, MD

[email protected]
Hôpital Saint-Eustache
Hôpital Saint-Eustache
Saint-Eustache, Quebec
Canada

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Primary Contact

Marie-Eve Lapointe

[email protected]
Stollery Children's Hospital
Stollery Children's Hospital
Edmonton, Alberta
Canada

Contactez l'équipe d'étude

Backup Contact

Karen Forbes, MD MEd

Primary Contact

Karen Forbes, MD MEd

[email protected]
Kingston Health Science Centre
Kingston Health Science Centre
Kingston, Ontario
Canada

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Primary Contact

Anupam Sehgal, MD

Children's Hospital of Eastern Ontario
Children's Hospital of Eastern Ontario
Ottawa, Ontario
Canada

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Backup Contact

Melanie Buba, MD

Primary Contact

Melanie Buba

[email protected]
CHU Sainte-Justine
CHU Sainte-Justine
Montréal, Quebec
Canada

Contactez l'équipe d'étude

Primary Contact

Tamara Perez, MSc

[email protected]
Backup Contact

Isabelle Lahaie, MSc

[email protected]
Backup Contact

Olivier Drouin, MD, MSc, MPH

Hôpital Régional de St-Jérôme
Hôpital Régional de St-Jérôme
Saint-Jérôme, Quebec
Canada

Contactez l'équipe d'étude

Backup Contact

Maria Jimena Penaloza, MD

Backup Contact

Maria Jimena Penaloza, MD

[email protected]
Primary Contact

Marie-Eve Lapointe

[email protected]
Étude parrainée par
St. Justine's Hospital
Participants recherchés
Plus d'informations
ID de l'étude: NCT06506474