Evidence map›Paper›PMID 41215605›Full record

ArticleJournal of hospital medicine2026

Low-value care and variation in practice in the care of children hospitalized with bronchiolitis in Canada (CareBEST): Protocol for a multi-center prospective cohort study.

Branden Bonham, Tamara Perez, Michelle Bailey, Nick Barrowman, Christopher Bonafide, Ariane Boutin, Melanie Buba, Francine Buchanan, Matthew Carwana, Breanna A Chen and 30 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of hospital medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

40 authors.

Branden BonhamCentre de recherche Azrieli, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Montréal, Québec, Canada.
Tamara PerezCentre de recherche Azrieli, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Montréal, Québec, Canada.ORCID https://orcid.org/0000-0002-9892-3043
Michelle BaileyDepartment of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Nick BarrowmanClinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
Christopher BonafideClinical Futures, a Center of Emphasis in the CHOP Research Institute, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Ariane BoutinDepartment of Pediatric Emergency Medicine, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Montréal, Québec, Canada.
Melanie BubaClinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
Francine BuchananDivision of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Matthew CarwanaDepartment of Pediatrics, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
Breanna A ChenDivision of Paediatric Hospital Medicine, Western University, Ontario, London, Canada.
Evelyn ConstantinResearch Institute of the McGill University Health Centre, McGill University, Montréal, Québec, Canada.
Kim de Castris GarciaChild Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
Francesca Del GiorgioDepartment of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada.
Zachary DionisopoulosChild Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
Christine FahimInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada.
Karen L ForbesDepartment of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.ORCID https://orcid.org/0000-0003-2595-4196
Jeremy N FriedmanDivision of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Josée Anne GagnonDepartment of Pediatrics, CHU de Québec, Université Laval, Québec City, Québec, Canada.
Peter J GillDivision of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-6253-1312
Mei HanClinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.ORCID https://orcid.org/0009-0007-6442-5023
Nelly HuynhFaculty of Dentistry, University of Montréal, Montréal, Québec, Canada.
Maria KaraceperDivision of Pediatric Medicine, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Terry P KlassenJim Pattison Children's Hospital, Saskatoon, Saskatchewan, Canada.
Isabelle LahaieCentre de recherche Azrieli, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Montréal, Québec, Canada.
Patricia LiDepartment of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada.ORCID https://orcid.org/0000-0003-1791-9411
Myla MorettiInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, The University of Toronto, Toronto, Ontario, Canada.
Sanjay MahantDivision of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0003-0487-5835
Sarah ManosDivision of General Pediatrics, IWK Health Centre, Halifax, Nova Scotia, Canada.
Hayat MekhiciCentre de recherche Azrieli, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Montréal, Québec, Canada.
Chris NovakDepartment of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Olivia OstrowDivision of Pediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Caroline QuachCentre de recherche Azrieli, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Montréal, Québec, Canada.ORCID https://orcid.org/0000-0002-1170-9475
Julie QuetClinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
Mahmoud SakranDepartment of Pediatrics, Lakeridge Health, Oshawa, Ontario, Canada.
Anupam SeghalDepartment of Pediatrics, Kingston Health Science Centre, Queen's University, Kingston, Ontario, Canada.
Alan R ShroederDivision of Pediatric Hospital Medicine, Lucile Packard Children's Hospital, Stanford University, Stanford, California, USA.
Marc-André TurcotDepartment of Pediatrics, Faculty of Medicine, Maisonneuve-Rosemont Hospital, Montréal, Québec, Canada.
Gita WahiDepartment of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Olivier DrouinCentre de recherche Azrieli, Centre Hospitalier Universitaire (CHU) Sainte-Justine, Montréal, Québec, Canada.ORCID https://orcid.org/0000-0003-1429-9341
Canadian Pediatric Inpatient Research Network (PIRN)

Funding

CIHR PJT-190223
6 · The paper itself

Abstract

introductionLow-value care refers to health services for which the potential harms or costs outweigh the benefits of use. Bronchiolitis is the most common and among the most costly causes of pediatric hospitalizations. Evidence consistently shows that many common tests and treatments used to manage bronchiolitis do not improve outcomes. Further, differential use of low-value care between patients may perpetuate care inequities. In Canada, rates of low-value care use in children hospitalized with bronchiolitis, and differences in care across hospitals, clinicians, and patient subgroups, remain poorly characterized.

objectiveTo understand practice patterns for six low-value health services in the care of children aged 1-12 months hospitalized for bronchiolitis: respiratory virus testing; chest X-rays; continuous pulse oximetry; short-acting beta-agonists; systemic corticosteroids; and antibiotics.

methodsWe are conducting a multi-center prospective cohort study of children admitted with bronchiolitis in 15 Canadian hospitals. We will use chart reviews to compare low-value care use between hospitals and clinicians, and caregiver surveys to compare between sociodemographic groups. Questionnaires will also collect caregiver perspectives on their child's bronchiolitis care, including role in medical decision-making and understanding of treatment decisions. DISCUSSION: Our study will provide critical information on the usage and variation in delivery of low-value care for bronchiolitis in Canada, elucidating potential care inequities. Findings will inform the development of interventions to address such inequities, and improve opportunity costs for health systems. Enrollment began in October 2024 and is projected to be completed in May 2026, with analyses and reporting shortly following.

Indexed as

BronchiolitisHospitalizationPractice Patterns, Physicians'CanadaFemaleHumansInfantMaleMulticenter Studies as TopicProspective Studies

Identifiers

PMID41215605
PMCPMC13064588

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.