Low-value Care, and Variation in Practice for Children Hospitalized with Bronchiolitis - a Multicentric Prospective Observational Study

Status: Recruiting
Location: See all (18) locations...
Intervention Type: Diagnostic test
Study Type: Observational
SUMMARY

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.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 28 days
Maximum Age: 1
Healthy Volunteers: f
View:

• Children aged \>28 days to \<12 months

• Children admitted to a pediatric inpatient ward with an admission diagnosis of bronchiolitis

Locations
Other Locations
Canada
Alberta Children's Hospital
ACTIVE_NOT_RECRUITING
Calgary
Stollery Children's Hospital
NOT_YET_RECRUITING
Edmonton
IWK Health
NOT_YET_RECRUITING
Halifax
McMaster Children's Hospital
RECRUITING
Hamilton
Kingston Health Science Centre
NOT_YET_RECRUITING
Kingston
Centre hospitalier Cité-de-la-Santé
RECRUITING
Laval
Children's Hospital of Western Ontario (London Health Science Centre)
NOT_YET_RECRUITING
London
Trillium Health Partners
NOT_YET_RECRUITING
Mississauga
CHU Sainte-Justine
RECRUITING
Montréal
Hôpital Maisonneuve-Rosemont
NOT_YET_RECRUITING
Montréal
Montreal Children's Hospital
NOT_YET_RECRUITING
Montréal
Lakeridge Health
NOT_YET_RECRUITING
Oshawa
Children's Hospital of Eastern Ontario
NOT_YET_RECRUITING
Ottawa
Centre Hospitalier Université Laval - Centre Mère-Enfant Soleil
NOT_YET_RECRUITING
Québec
Hôpital Saint-Eustache
NOT_YET_RECRUITING
Saint-eustache
Hôpital Régional de St-Jérôme
NOT_YET_RECRUITING
Saint-jérôme
Hospital for Sick Children
NOT_YET_RECRUITING
Toronto
British Columbia Children's Hospital
RECRUITING
Vancouver
Contact Information
Primary
Olivier Drouin, MD, MSc, MPH
olivier.drouin.hsj@ssss.gouv.qc.ca
514 345-4931
Backup
Tamara Perez, MSc
tamara.perez.hsj@ssss.gouv.qc.ca
Time Frame
Start Date: 2024-02-13
Estimated Completion Date: 2027-06
Participants
Target number of participants: 3000
Treatments
Children admitted to CHU Sainte-Justine
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to McMaster Children's Hospital
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to British Columbia Children's Hospital
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to IWK Children's Hospital
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to CHU de Quebec University Laval Hospital
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to Montreal Children's Hospital
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to Children's Hospital of Eastern Ontario
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to Kingston Health Sciences Centre
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to The Hospital for Sick Kids
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to Children's Hospital of Western Ontario
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to Alberta Children's Hospital
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to Stollery Children's Hospital
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children Admitted to Hôpital Maisonneuve-Rosemont
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to Hôpital St-Jérôme
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to Hôpital Saint-Eustache
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to Cité-de-la-Santé
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children Admitted to Trillium Health Partners
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Children admitted to Lakeridge Health
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis, admitted to a general pediatric inpatient unit, not previously recruited for the study.
Related Therapeutic Areas
Sponsors
Collaborators: Maternal Infant Child and Youth Research Network, Unity Health Toronto, Children's Hospital of Eastern Ontario, The Hospital for Sick Children
Leads: St. Justine's Hospital

This content was sourced from clinicaltrials.gov