Low-Value Care for Bronchiolitis
(CareBEST Trial)

Recruiting at 20 trial locations

Overseen ByTamara Perez, MSc

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: St. Justine's Hospital

Disqualifiers: Previous study participation

No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to understand the use of certain healthcare services in young children hospitalized with bronchiolitis, a common lung infection. The focus is on six services that might not always be necessary, such as specific tests and medications. Researchers seek to determine how often these services are used, their costs, and whether usage varies between patients and hospitals. Parents with infants aged over 28 days to under 12 months who are hospitalized with bronchiolitis might find this study suitable. As an unphased trial, this study offers parents the chance to contribute to important research that could enhance healthcare practices for young children.

Do I need to stop my child's current medications for this trial?

The trial information does not specify whether you need to stop your child's current medications. It's best to discuss this with the trial coordinators or your child's doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that many treatments for bronchiolitis in children might not be necessary, including tests or treatments that could do more harm than good. For example, antibiotics are often not recommended for bronchiolitis because it is usually caused by a virus, and antibiotics do not work against viruses.

Studies have found that the use of these unnecessary treatments varies widely between hospitals and doctors. One hospital might frequently use a certain test or treatment, while another might not use it at all. This variation suggests uncertainty about the safety and necessity of these treatments.

Some treatments might have side effects. For instance, using certain medications like systemic corticosteroids can lead to higher blood pressure or mood changes. It's important to understand that these treatments are not always needed and can sometimes cause more problems than they solve.

Families should know that these services may not help their child's condition and could lead to extra costs and side effects. The study aims to understand how these treatments are used and to potentially reduce unnecessary treatments in the future.¹ ² ³ ⁴ ⁵

Why are researchers excited about this trial?

Researchers are excited about this trial because it's exploring how different hospitals are managing bronchiolitis in infants. The goal is to identify variations in care and pinpoint practices that may not add value, which can help streamline treatments and improve outcomes. By understanding these differences, the trial aims to reduce unnecessary interventions and focus on what truly benefits young patients, potentially setting new standards for treating bronchiolitis.

What evidence suggests that these low-value healthcare services are used in treating bronchiolitis?

Research shows that many treatments for bronchiolitis in young children may not work as well as once thought. This trial will evaluate six different low-value health services for treating bronchiolitis. Studies have found that treatments like antibiotics, steroids, and some breathing therapies often fail to improve bronchiolitis. Despite this, more than half of the children still receive these treatments, which often provide little benefit and can cause unnecessary stress and costs. Therefore, it is important to study and reduce these less effective treatments to focus on what truly helps.¹ ⁵ ⁶ ⁷ ⁸

Who Is on the Research Team?

Olivier Drouin, MD, MSc, MPH

Principal Investigator

CHU Sainte-Justine Research Centre

Are You a Good Fit for This Trial?

Inclusion Criteria

My child is between 1 month and 12 months old.

My child is hospitalized with bronchiolitis.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Observation

Participants' medical charts are reviewed during hospitalization to analyze the use of low-value healthcare services.

Duration of hospital stay

Inpatient stay

Follow-up

Participants complete a questionnaire 30 days post-discharge to report any additional medical care required.

4 weeks

1 visit (virtual)

What Are the Treatments Tested in This Trial?

Interventions

Provision of any of six different low-value health services for treatment of bronchiolitis