Methodology of the Updated and Expanded Australasian Bronchiolitis Guideline

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BACKGROUND: Bronchiolitis is the most common reason for hospital admission in infants in Australia and Aotearoa New Zealand (AoNZ), with care historically affected by practice variation, including use of ineffective therapies. The Paediatric Research in Emergency Departments International Collaborative (PREDICT) developed the first Australasian (Australia, AoNZ) bronchiolitis guideline in 2016, providing evidence-based guidance on the management of infants (< 12 months of age), presenting or admitted to hospital with bronchiolitis. In 2022, PREDICT initiated a guideline update to include new evidence and expand the scope to include intensive care (up to intubation), management of SARS-CoV-2 co-infection, and respiratory syncytial virus prevention. AIM: This article outlines the methodology used in the guideline update, following AGREE and CheckUp reporting standards. METHODS: A Guideline Advisory Group and Guideline Development Committee, consisting of 29 clinical and methodological experts from Australasia, developed the guideline with consumer input. Forty-one scoping questions on 25 topics were investigated. Systematic searches were performed by a subject librarian across five electronic databases (last search 24/01/24). Screening of 13,932 new articles occurred independently, in duplicate in two stages. The results of 431 articles were synthesized narratively and quantitatively where appropriate, per topic. Risk of bias was evaluated using appropriate tools. GRADE methodology was used to assess evidence quality and develop the recommendations, which were finalised through consensus voting across three guideline development meetings. RESULTS: The update produced 41 recommendations (33 evidence-based, 8 consensus-based; including 11 new and 7 with key revisions), covering bronchiolitis investigations, management and RSV prevention. Interest-holder groups consulted on the recommendations. CONCLUSION: The Australasian Bronchiolitis Guideline was updated and expanded according to AGREE and CheckUp reporting standards.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.