~1385 spots leftby May 2026

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

(CareBEST Trial)

Recruiting at17 trial locations
OD
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.

Research Team

OD

Olivier Drouin, MD, MSc, MPH

Principal Investigator

CHU Sainte-Justine Research Centre

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

Who Is Running the Clinical Trial?

St. Justine's Hospital

Lead Sponsor

Trials
205
Recruited
87,300+

Dr. Marc Girard

St. Justine's Hospital

Chief Medical Officer since 2018

MD from Université de Montréal

Dr. Fabrice Brunet profile image

Dr. Fabrice Brunet

St. Justine's Hospital

Chief Executive Officer since 2009

Medical studies at Faculty of Medicine Cochin Port Royal, University of Paris V; Management studies at Paris Business School, Harvard Public Health School of Management, and University of Toronto

Maternal Infant Child and Youth Research Network

Collaborator

Trials
1
Recruited
3,000+

The Hospital for Sick Children

Collaborator

Trials
724
Recruited
6,969,000+
Dr. Ronald D. Cohn profile image

Dr. Ronald D. Cohn

The Hospital for Sick Children

Chief Executive Officer since 2019

MD from University of Düsseldorf, Germany

Dr. Lennox Huang profile image

Dr. Lennox Huang

The Hospital for Sick Children

Chief Medical Officer since 2016

MD from McGill University

Children's Hospital of Eastern Ontario

Collaborator

Trials
134
Recruited
61,000+
Dr. Vera Etches profile image

Dr. Vera Etches

Children's Hospital of Eastern Ontario

Chief Executive Officer

MD from the University of Western Ontario

Dr. Carrol Pitters

Children's Hospital of Eastern Ontario

Chief Medical Officer since 2010

MD from the University of the West Indies

Unity Health Toronto

Collaborator

Trials
572
Recruited
470,000+
Dr. Sharon Straus profile image

Dr. Sharon Straus

Unity Health Toronto

Chief Medical Officer

MD and MSc in Clinical Epidemiology, University of Toronto

Altaf Stationwala profile image

Altaf Stationwala

Unity Health Toronto

Chief Executive Officer

Bachelor's degree in Health Administration, University of Ottawa