~1385 spots leftby May 2026

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

(CareBEST Trial)

Recruiting in Palo Alto (17 mi)
+17 other locations
Overseen byOlivier Drouin, MD, MSc, MPH
Age: < 18
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: St. Justine's Hospital
No Placebo Group

Trial Summary

What is the purpose of this trial?

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. They will additionally be asked to complete a questionnaire on their perceptions regarding their child's care while hospitalized, including the use of shared-decision making and their understanding of and involvement in the care decisions made. 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 Criteria

Inclusion Criteria

My child is between 1 month and 12 months old.
My child is hospitalized with bronchiolitis.

Treatment Details

Participant Groups
15Treatment groups
Experimental Treatment
Group I: Children admitted to The Hospital for Sick ChildrenExperimental Treatment0 Interventions
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.
Group II: Children admitted to Stollery Children's HospitalExperimental Treatment1 Intervention
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.
Group III: Children admitted to Montreal Children's HospitalExperimental Treatment1 Intervention
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.
Group IV: Children admitted to McMaster Children's HospitalExperimental Treatment1 Intervention
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.
Group V: Children admitted to Lakeridge HealthExperimental Treatment1 Intervention
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.
Group VI: Children admitted to Kingston Health Sciences CentreExperimental Treatment1 Intervention
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.
Group VII: Children admitted to IWK Children's HospitalExperimental Treatment1 Intervention
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.
Group VIII: Children admitted to Cité-de-la-SantéExperimental Treatment1 Intervention
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.
Group IX: Children admitted to Children's Hospital of Western OntarioExperimental Treatment1 Intervention
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.
Group X: Children admitted to Children's Hospital of Eastern OntarioExperimental Treatment1 Intervention
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.
Group XI: Children admitted to CHU de Quebec University Laval HospitalExperimental Treatment1 Intervention
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.
Group XII: Children admitted to CHU Sainte-JustineExperimental Treatment1 Intervention
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.
Group XIII: Children admitted to British Columbia Children's HospitalExperimental Treatment1 Intervention
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.
Group XIV: Children admitted to Alberta Children's HospitalExperimental Treatment1 Intervention
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.
Group XV: Children Admitted to Hôpital Maisonneuve-RosemontExperimental Treatment1 Intervention
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.

Find a Clinic Near You

Research Locations NearbySelect from list below to view details:
British Columbia Children's HospitalVancouver, Canada
Trillium Health PartnersMississauga, Canada
Hospital for Sick ChildrenToronto, Canada
Montreal Children's HospitalMontréal, Canada
More Trial Locations
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Who Is Running the Clinical Trial?

St. Justine's HospitalLead Sponsor
Maternal Infant Child and Youth Research NetworkCollaborator
The Hospital for Sick ChildrenCollaborator
Children's Hospital of Eastern OntarioCollaborator
Unity Health TorontoCollaborator

References