ArticleArchives of disease in childhood2007
Effect of a clinical pathway on the hospitalisation rates of children with asthma: a prospective study.
Article in Archives of disease in childhood, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinical pathways for chronic cough in children.The Cochrane database of systematic reviews · 2014Pooled it
- A systematic review of the implementation and impact of asthma protocols.BMC medical informatics and decision making · 2014Pooled it
- Impact of a standardized emergency department asthma care pathway on health services utilization.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2025Article
- Evaluating the Clinical Impact of a Novel Pediatric Emergency Medicine Curriculum on Asthma Outcomes in Belize.Pediatric emergency care · 2022Article
- Article
- Five-year forward view: lessons from emergency care at the extremes of age.Journal of the Royal Society of Medicine · 2018Review
- Variation in the Treatment of Children Hospitalized With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis in the US.Arthritis care & research · 2017Article
- A Primer on Clinical Pathways.Hospital pharmacy · 2016Article
- Article
- DRUGS System Improving the Effects of Clinical Pathways: A Systematic Study.Journal of medical systems · 2016Article
- Asthma-related emergency department use: current perspectives.Open access emergency medicine : OAEM · 2016Review
- Improving timeliness for acute asthma care for paediatric ED patients using a nurse driven intervention: an interrupted time series analysis.BMJ quality improvement reports · 2016Article
- Testing and Treatment After Adolescent Sexual Assault in Pediatric Emergency Departments.Pediatrics · 2015Article
- Clinical pathway improves pediatrics asthma management in the emergency department and reduces admissions.The Journal of asthma : official journal of the Association for the Care of Asthma · 2015Article
- Oral antibiotics at discharge for children with acute osteomyelitis: a rapid cycle improvement project.BMJ quality & safety · 2014Article
- Emergency department crowding and younger age are associated with delayed corticosteroid administration to children with acute asthma.Pediatric emergency care · 2013Article
- Protocol for the asthma tools study: a pragmatic practice-based research network trial.Pragmatic and observational research · 2013Article
- The Saudi initiative for asthma - 2012 update: Guidelines for the diagnosis and management of asthma in adults and children.Annals of thoracic medicine · 2012Article
- Multicenter analysis of quality indicators for children treated in the emergency department for asthma.Pediatrics · 2012Article
- Educational and decision-support tools for asthma-management guideline implementation.Asia Pacific allergy · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo determine the effect of implementing a clinical pathway, using evidence-based clinical practice guidelines, for the emergency care of children and adolescents with asthma.
methodsA prospective, before-after, controlled trial was conducted, which included patients aged 1-18 years who had acute exacerbations of asthma treated in a tertiary care paediatric emergency department. Data were collected for identical 2-month seasonal periods before and after implementation of the clinical pathway to determine hospitalisation rate and other outcomes. For 2 weeks after emergency visits, the rate at which patients returned to emergency care for worsening asthma was evaluated. A multidisciplinary panel, using national guidelines and a systematic review, developed the pathway.
results267 patients were studied. The rate of hospitalisation was significantly lower in the post-implementation group (10/74; 13.5%) than in the pre-implementation control group (53/193; 27.5%; p = 0.02; number needed to treat 7.1). All reduction in hospitalisation occurred in children with moderate to severe asthma exacerbation. After implementation of the clinical pathway, the rate of administration of oral corticosteroids to patients with moderate or severe exacerbations increased from 71% to 92% (p = 0.01), and significantly more patients received beta2-agonists in the first hour (p = 0.02). No significant change in relapse to acute care occurred within 2 weeks (p = 0.19).
conclusionsAn evidence-based clinical pathway for children and adolescents with moderate to severe exacerbations of acute asthma markedly decreases their rate of hospitalisation without increased return to emergency care.
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