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A systematic review of clinical practice guidelines for the diagnosis and management of Bronchiolitis

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dc.contributor.authorKirolos, Amir
dc.contributor.authorManti, Sara
dc.contributor.authorBlacow, Rachel
dc.contributor.authorTse, Gabriel
dc.contributor.authorWilson, Thomas
dc.contributor.authorLister, Martin
dc.contributor.authorCunningham, Steve
dc.contributor.authorCampbell, Alasdair
dc.contributor.authorNair, Harish
dc.contributor.authorReeves, Rachel M
dc.contributor.authorFernandes, Ricardo M.
dc.contributor.authorCampbell, Harry
dc.contributor.authorDouglas, Anne
dc.contributor.authorMeijer, Adam
dc.contributor.authorFischer, Thea Kølsen
dc.contributor.authorHeikkinen, Terho
dc.contributor.authorGiaquinto, Carlo
dc.contributor.authorKnirsch, Charles
dc.contributor.authorStoszek, Sonia
dc.contributor.authorLeach, Amanda
dc.contributor.authorDemont, Clarisse
dc.contributor.authorGallichan, Scott
dc.contributor.authorAerssens, Jeroen
dc.contributor.authorBeutels, Philippe
dc.contributor.authorBont, Louis
dc.contributor.authorPollard, Andrew
dc.contributor.authorOpenshaw, Peter
dc.contributor.authorHackett, Judy
dc.contributor.authorRosen, Brian
dc.contributor.authorMolero, Eva
dc.date.accessioned2021-12-09T15:42:21Z
dc.date.available2021-12-09T15:42:21Z
dc.date.issued2020
dc.description© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.pt_PT
dc.description.abstractBackground: Bronchiolitis is the leading cause of hospital admission for respiratory disease among infants aged <1 year. Clinical practice guidelines can benefit patients by reducing the performance of unnecessary tests, hospital admissions, and treatment with lack of a supportive evidence base. This review aimed to identify current clinical practice guidelines worldwide, appraise their methodological quality, and discuss variability across guidelines for the diagnosis and management of bronchiolitis. Methods: A systematic literature review of electronic databases EMBASE, Global Health, and Medline was performed. Manual searches of the gray literature, national pediatric society websites, and guideline-focused databases were performed, and select international experts were contacted to identify additional guidelines. The Appraisal of Guidelines for Research and Evaluation assessment tool was used by 2 independent reviewers to appraise each guideline. Results: Thirty-two clinical practice guidelines met the selection criteria. Quality assessment revealed significant shortcomings in a number of guidelines, including lack of systematic processes in formulating guidelines, failure to state conflicts of interest, and lack of consultation with families of affected children. There was widespread agreement about a number of aspects, such as avoidance of the use of unnecessary diagnostic tests, risk factors for severe disease, indicators for hospital admission, discharge criteria, and nosocomial infection control. However, there was variability, even within areas of consensus, over specific recommendations, such as variable thresholds for oxygen therapy. Guidelines showed significant variability in recommendations for the pharmacological management of bronchiolitis, with conflicting recommendations over whether use of nebulized epinephrine, hypertonic saline, or bronchodilators should be routinely trialled. Conclusions: Future guidelines should aim to be compliant with international standards for clinical guidelines to improve their quality and clarity and to promote their adoption into practice. Variable recommendations between guidelines may reflect the evolving evidence base for bronchiolitis management, and platforms should be created to understand this variability and promote evidence-based recommendations.pt_PT
dc.description.sponsorshipThis work was supported by the Innovative Medicines Initiative 2 Joint Undertaking (grant 116019 to RESCEU), which is supported by the European Union’s Horizon 2020 Research and Innovation Programme and the European Federation of Pharmaceutical Industries and Associationspt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Infect Dis. 2020 Oct 7;222(Suppl 7):S672-S679pt_PT
dc.identifier.doi10.1093/infdis/jiz240pt_PT
dc.identifier.eissn1537-6613
dc.identifier.issn0022-1899
dc.identifier.urihttp://hdl.handle.net/10451/50315
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford University Presspt_PT
dc.relation116019pt_PT
dc.relation.publisherversionhttps://academic.oup.com/jidpt_PT
dc.subjectBronchiolitispt_PT
dc.subjectDiagnosispt_PT
dc.subjectGuidelinespt_PT
dc.subjectTreatmentpt_PT
dc.titleA systematic review of clinical practice guidelines for the diagnosis and management of Bronchiolitispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPageS679pt_PT
oaire.citation.issueSupplement_7pt_PT
oaire.citation.startPageS672pt_PT
oaire.citation.titleThe Journal of Infectious Diseasespt_PT
oaire.citation.volume222pt_PT
person.familyNameFernandes
person.givenNameRicardo
person.identifier309018
person.identifier.orcid0000-0002-7253-6475
person.identifier.ridC-7501-2015
person.identifier.scopus-author-id24436565500
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication862be38f-2247-424c-b26c-d3bdda4474be
relation.isAuthorOfPublication.latestForDiscovery862be38f-2247-424c-b26c-d3bdda4474be

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