Systematic Review of Guidelines on the Management of Bronchiolitis in Children_Chinese Journal of Evidence-Based Medicine

Authors：

 DINGXiang-yu ¹ ,  FENGChao ¹ , ZHANGGu-ying ¹ , ZHAOYue ²

1. Department of Pharmacy, Children's Hospital of Hebei Province, Shijiazhuang 050031, China;
2. Department of Medical Service, Children's Hospital of Hebei Province, Shijiazhuang 050031, China;

Corresponding?author：

FENGChao, Email: 158037021@qq.com

Keywords：

Bronchiolitis; Children; Clinical practice guideline; Evidence-based medicine; AGREE II

DOI：

10.7507/1672-2531.20160183

Video：

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Objective To systematically review the methodological quality of guidelines on the management of bronchiolitis in children, then to compare the recommendations and to provide a reference for clinical use. Methods Guidelines concerning bronchiolitis were electronically retrieved in CNKI, VIP, WanFang Data, CBM, PubMed, EMbase, Medlive, GIN (Guidelines International Network), CGC (China Guideline Chearinghouse), NGC (National Guideline Clearinghouse), AAP (American Academy of Pediatrics), NICE (National Institute for Health and Clinical Excellence) and WHO (World Health Organization) from inception to December 2015. The methodological quality of included guidelines were evaluated according to the AGREE II instrument, and the differences between recommendations were compared. Results Eight guidelines on bronchiolitis were included, Among them, one guideline was developed by UK, two by US, one by Spain, two by Australia, one by Scottish and one by South Africa. Five of them were evidence-based (EB) guidelines, and 3 were non-EB guidelines. Domain 4 (clarity of presentation) showed the highest scores (81%), then scope and purpose (74%), stakeholder involvement (56%), rigor of development (52%), editorial independence (43%), and scores (42%) were the lowest in domain 3 (applicability). The recommendations of managements and medicines for bronchiolitis were basically consistent, but there were individual differences suggested. Conclusion In these guidelines, the domain score better is "clarity of presentation" and "scope and purpose ", but the other areas should need to improve. Current our country only has an expert consensus of bronchiolitis, which should be further improved. It's urgent to develop evidence-based guidelines which conforms to the situation of our country, in order to make evidence-based medicine implementation in clinical practice.

Citation： DINGXiang-yu, FENGChao, ZHANGGu-ying, ZHAOYue. Systematic Review of Guidelines on the Management of Bronchiolitis in Children. Chinese Journal of Evidence-Based Medicine, 2016, 16(10): 1207-1215. doi: 10.7507/1672-2531.20160183 Copy

1.	Zore JJ, Hall CB. Bronchiolitis: recent evidence on diagnosis and management. Pediatrics, 2010, 125(2): 342-349.
2.	李秀蘭. 利巴韋林與氯苯那敏霧化吸入輔助治療毛細支氣管炎. 中國實用醫刊, 2016, 43(1): 123.
3.	陳麗紅, 朱屹峰. 普米克令舒、萬托林聯合甲強龍輔助治療小兒毛細支氣管炎的效果觀察. 中國醫藥指南, 2016, 14(3): 120.
4.	龐智東. 小兒毛細支氣管炎的藥物治療新進展. 現代診斷與治療, 2015, 26(1): 65-67.
5.	李衛國, 李宇寧, 張秀敏, 等. AGREE Ⅱ評價9個兒童青少年維生素D臨床實踐指南及推薦意見共識和差異. 中國循證兒科雜志, 2012, 7(5): 372-379.
6.	陳尹, 胡世蓮, 李幼平, 等. 全球藥物干預治療單純性高血壓指南的系統評價. 中國循證醫學雜志, 2012, 12(10): 1180-1194.
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8.	National Institute for Health and Care Excellence (NICE). Bronchiolitis in children. 2015, NG9.
9.	Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics, 2014, 134(5): e1474-e1502.
10.	Working Group of the Practice Guideline on Acute Bronchiolitis. Clinical practice guideline on acute bronchiolitis. Agency for Healthcare Research and Quality, 2010, NGC-9313.
11.	Cincinnati Children's Hospital Medical Center. Evidence-based care guideline management of first time episode bronchiolitis in infants less than 1 year of age. Agency for Healthcare Research and Quality, 2010, NGC-8674.
12.	Turner T, Wilkinson F, Harris C, et al. Evidence based guideline for the management of bronchiolitis. J Aust Fam Physician, 2008, 37(6): 6-13.
13.	Scottish Intercollegiate Guidelines Network (SIGN). Bronchiolitis in children. SIGN, 2006.
14.	Ministry of Health, NSW. Infants and children-acute management of bronchiolitis, second edition. 19-Jan-2017.
15.	Green RJ, Zar HJ, Jeena PM, et al. South African guideline for the diagnosis, management and preventon of acute viral bronchiolitis in children. S Afr Med J, 2010, 100(5): 320-325.
16.	National Institute for Health and Clinical Excellence. Process and methods guides: the guideline manual. 2012, Available at: https://www.nice.org.uk/article/pmg6/chapter/1.
17.	World Health Organization. WHO handbook for guideline development. Geneva: WHO Press, 2015.
18.	陳耀龍, 楊克虎, 田金徽, 等. 循證實踐指南的制定：國際經驗與中國實踐. 蘭州大學學報(醫學版), 2016, 42(1): 29-34.
19.	Jiang L, Krumholz HM, Li X, et al. Achieving best outcomes for patients with cardiovascular disease in China by enhancing the quality of medical care and establishing a learning health-care system. Lancet, 2015, 386(10002): 1493-1505.
20.	張伶俐, 李幼平, 張川, 等. 中國兒童臨床指南現狀分析及循證臨床指南評價. 中國循證醫學雜志, 2011, 11(9): 991-999.

1. Zore JJ, Hall CB. Bronchiolitis: recent evidence on diagnosis and management. Pediatrics, 2010, 125(2): 342-349.
2. 李秀蘭. 利巴韋林與氯苯那敏霧化吸入輔助治療毛細支氣管炎. 中國實用醫刊, 2016, 43(1): 123.
3. 陳麗紅, 朱屹峰. 普米克令舒、萬托林聯合甲強龍輔助治療小兒毛細支氣管炎的效果觀察. 中國醫藥指南, 2016, 14(3): 120.
4. 龐智東. 小兒毛細支氣管炎的藥物治療新進展. 現代診斷與治療, 2015, 26(1): 65-67.
5. 李衛國, 李宇寧, 張秀敏, 等. AGREE Ⅱ評價9個兒童青少年維生素D臨床實踐指南及推薦意見共識和差異. 中國循證兒科雜志, 2012, 7(5): 372-379.
6. 陳尹, 胡世蓮, 李幼平, 等. 全球藥物干預治療單純性高血壓指南的系統評價. 中國循證醫學雜志, 2012, 12(10): 1180-1194.
7. 王維, 陳青山, 劉治民. 應用Excel完成組內相關系數ICC的計算和評價. 中國衛生統計, 2008, 25(3): 314-315.
8. National Institute for Health and Care Excellence (NICE). Bronchiolitis in children. 2015, NG9.
9. Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics, 2014, 134(5): e1474-e1502.
10. Working Group of the Practice Guideline on Acute Bronchiolitis. Clinical practice guideline on acute bronchiolitis. Agency for Healthcare Research and Quality, 2010, NGC-9313.
11. Cincinnati Children's Hospital Medical Center. Evidence-based care guideline management of first time episode bronchiolitis in infants less than 1 year of age. Agency for Healthcare Research and Quality, 2010, NGC-8674.
12. Turner T, Wilkinson F, Harris C, et al. Evidence based guideline for the management of bronchiolitis. J Aust Fam Physician, 2008, 37(6): 6-13.
13. Scottish Intercollegiate Guidelines Network (SIGN). Bronchiolitis in children. SIGN, 2006.
14. Ministry of Health, NSW. Infants and children-acute management of bronchiolitis, second edition. 19-Jan-2017.
15. Green RJ, Zar HJ, Jeena PM, et al. South African guideline for the diagnosis, management and preventon of acute viral bronchiolitis in children. S Afr Med J, 2010, 100(5): 320-325.
16. National Institute for Health and Clinical Excellence. Process and methods guides: the guideline manual. 2012, Available at: https://www.nice.org.uk/article/pmg6/chapter/1.
17. World Health Organization. WHO handbook for guideline development. Geneva: WHO Press, 2015.
18. 陳耀龍, 楊克虎, 田金徽, 等. 循證實踐指南的制定：國際經驗與中國實踐. 蘭州大學學報(醫學版), 2016, 42(1): 29-34.
19. Jiang L, Krumholz HM, Li X, et al. Achieving best outcomes for patients with cardiovascular disease in China by enhancing the quality of medical care and establishing a learning health-care system. Lancet, 2015, 386(10002): 1493-1505.
20. 張伶俐, 李幼平, 張川, 等. 中國兒童臨床指南現狀分析及循證臨床指南評價. 中國循證醫學雜志, 2011, 11(9): 991-999.

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