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

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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

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2.	李秀兰. 利巴韦林与氯苯那敏雾化吸入辅助治疗毛细支气管炎. 中国实用医刊, 2016, 43(1): 123.
3.	陈丽红, 朱屹峰. 普米克令舒、万托林联合甲强龙辅助治疗小儿毛细支气管炎的效果观察. 中国医药指南, 2016, 14(3): 120.
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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.	陈耀龙, 杨克虎, 田金徽, 等. 循证实践指南的制定：国际经验与中国实践. 兰州大学学报(医学版), 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.	张伶俐, 李幼平, 张川, 等. 中国儿童临床指南现状分析及循证临床指南评价. 中国循证医学杂志, 2011, 11(9): 991-999.

1. Zore JJ, Hall CB. Bronchiolitis: recent evidence on diagnosis and management. Pediatrics, 2010, 125(2): 342-349.
2. 李秀兰. 利巴韦林与氯苯那敏雾化吸入辅助治疗毛细支气管炎. 中国实用医刊, 2016, 43(1): 123.
3. 陈丽红, 朱屹峰. 普米克令舒、万托林联合甲强龙辅助治疗小儿毛细支气管炎的效果观察. 中国医药指南, 2016, 14(3): 120.
4. 庞智东. 小儿毛细支气管炎的药物治疗新进展. 现代诊断与治疗, 2015, 26(1): 65-67.
5. 李卫国, 李宇宁, 张秀敏, 等. AGREE Ⅱ评价9个儿童青少年维生素D临床实践指南及推荐意见共识和差异. 中国循证儿科杂志, 2012, 7(5): 372-379.
6. 陈尹, 胡世莲, 李幼平, 等. 全球药物干预治疗单纯性高血压指南的系统评价. 中国循证医学杂志, 2012, 12(10): 1180-1194.
7. 王维, 陈青山, 刘治民. 应用Excel完成组内相关系数ICC的计算和评价. 中国卫生统计, 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. 陈耀龙, 杨克虎, 田金徽, 等. 循证实践指南的制定：国际经验与中国实践. 兰州大学学报(医学版), 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. 张伶俐, 李幼平, 张川, 等. 中国儿童临床指南现状分析及循证临床指南评价. 中国循证医学杂志, 2011, 11(9): 991-999.

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