Low-value Care, and Variation in Practice for Children Hospitalized With Bronchiolitis
CareBEST
1 other identifier
observational
3,000
1 country
15
Brief 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:
- Are there factors that predict the use of these services?
- What are the costs of the use of these services?
- How much variability is there between different patients, different doctors, and between hospitals in the use of these 6 low-value health services ?
- 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?
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for all trials
Started Feb 2024
Typical duration for all trials
15 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
February 13, 2024
CompletedFirst Submitted
Initial submission to the registry
May 30, 2024
CompletedFirst Posted
Study publicly available on registry
July 17, 2024
CompletedPrimary Completion
Last participant's last visit for primary outcome
May 1, 2026
CompletedStudy Completion
Last participant's last visit for all outcomes
June 1, 2027
ExpectedJuly 23, 2025
July 1, 2025
2.2 years
May 30, 2024
July 18, 2025
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
The proportion of eligible patients receiving each of the six low-value health services
The primary outcome of the study is the proportion of patients receiving each of the six low-value health services during their hospitalization for bronchiolitis: 1) respiratory virus testing; 2) chest x-ray; 3) continuous pulse oximetry; 4) short-acting beta-agonists; 5) systemic corticosteroids; and 6) antibiotics.
24 months
Secondary Outcomes (21)
Transfer to the ICU
24 months
Use of CPAP, BiPAP, or mechanical ventilation during admission.
24 months
Cardiac arrest
24 months
Death
24 months
Return visits
24 months
- +16 more secondary outcomes
Study Arms (15)
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 Children
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 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 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.
Interventions
This prospective observational will have six separate primary outcomes acting as exposures, (or interventions).The exposures are the the provision of any of the six low-value health services: 1) respiratory virus testing; 2) chest x-ray; 3) continuous pulse oximetry; 4) short-acting beta-agonists; 5) systemic corticosteroids; and 6) antibiotics.
Eligibility Criteria
Children aged \>28 days to \<12 months with an admission diagnosis of bronchiolitis.
You may qualify if:
- Children aged \>28 days to \<12 months
- Children admitted to a pediatric inpatient ward with an admission diagnosis of bronchiolitis
You may not qualify if:
- \- Children previously recruited for the study, either during a previous bronchiolitis admission or for the same incident of bronchiolitis, while admitted to another study site.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- St. Justine's Hospitallead
- Children's Hospital of Eastern Ontariocollaborator
- Maternal Infant Child and Youth Research Networkcollaborator
- The Hospital for Sick Childrencollaborator
- Unity Health Torontocollaborator
Study Sites (15)
Alberta Children's Hospital
Calgary, Alberta, T3B 6A8, Canada
Stollery Children's Hospital
Edmonton, Alberta, T6G 2B7, Canada
British Columbia Children's Hospital
Vancouver, British Columbia, V6H 3N1, Canada
IWK Health
Halifax, Nova Scotia, B3K 6R8, Canada
McMaster Children's Hospital
Hamilton, Ontario, L8N 3Z5, Canada
Kingston Health Science Centre
Kingston, Ontario, K7L 2V7, Canada
Children's Hospital of Western Ontario (London Health Science Centre)
London, Ontario, N6C 0B2, Canada
Lakeridge Health
Oshawa, Ontario, L1G 8A2, Canada
Children's Hospital of Eastern Ontario
Ottawa, Ontario, K1H 8L1, Canada
Hospital for Sick Children
Toronto, Ontario, M5G 1E8, Canada
Centre hospitalier Cité-de-la-Santé
Laval, Quebec, H7M 3L9, Canada
Hôpital Maisonneuve-Rosemont
Montreal, Quebec, H1T 2M4, Canada
CHU Sainte-Justine
Montreal, Quebec, H3T 1C5, Canada
Montreal Children's Hospital
Montreal, Quebec, H4A 3J1, Canada
Centre Hospitalier Université Laval - Centre Mère-Enfant Soleil
Québec, Quebec, G1V 4G2, Canada
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Olivier Drouin, MD, MSc, MPH
CHU Sainte-Justine Research Centre
Central Study Contacts
Study Design
- Study Type
- observational
- Observational Model
- COHORT
- Time Perspective
- PROSPECTIVE
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Pediatrician and Clinical Assistant Professor, Departments of Paediatrics and Department of Social and Preventive Medicine
Study Record Dates
First Submitted
May 30, 2024
First Posted
July 17, 2024
Study Start
February 13, 2024
Primary Completion
May 1, 2026
Study Completion (Estimated)
June 1, 2027
Last Updated
July 23, 2025
Record last verified: 2025-07
Data Sharing
- IPD Sharing
- Will not share