A systematic review of predictive modeling for bronchiolitis

Abstract

Purpose: Bronchiolitis is the most common cause of illness leading to hospitalization in young children. At present, many bronchiolitis management decisions are made subjectively, leading to significant practice variation among hospitals and physicians caring for children with bronchiolitis. To standardize care for bronchiolitis, researchers have proposed various models to predict the disease course to help determine a proper management plan. This paper reviews the existing state of the art of predictive modeling for bronchiolitis. Predictive modeling for respiratory syncytial virus (RSV) infection is covered whenever appropriate, as RSV accounts for about 70% of bronchiolitis cases.Methods: A systematic review was conducted through a PubMed search up to April 25, 2014. The literature on predictive modeling for bronchiolitis was retrieved using a comprehensive search query, which was developed through an iterative process.Search results were limited to human subjects, the English language, and children (birth-18 years). Results:The literature search returned 2,312 references in total. After manual review, 168 of these references were determined to be relevant and are discussed in this paper. We identify several limitations and open problems in predictive modeling for bronchiolitis, and provide some preliminary thoughts on how to address them, with the hope to stimulate future research in this domain. Conclusions:Many problems remain open in predictive modeling for bronchiolitis. Future studies will need to address them to achieve optimal predictive models.

Point of care diaphragm ultrasound in infants with bronchiolitis: A prospective study

“…Therefore, an accurate and rapid assessment of the diaphragm is a potentially useful tool for clinicians especially in emergency settings. This is particularly useful if we consider the described subjectivity of the most used clinical parameters in the evaluation of bronchiolitis in the ED . In fact, hospital admissions for infants with bronchiolitis have increased significantly in recent years while the admission rates to intensive care units remained mostly unchanged, suggesting that the increasing admission rate may be related to a changing health services landscape and probably the so called defensive medicine, rather than an increase in the overall severity of bronchiolitis.…”

Decision Support Systems for Predicting Erectile Dysfunction

“…Nobody has ever introduced a CDSS for ED into clinical setting. More clinical information and lab test data are useful for increasing the predictive performance of the CDSSs [14,16]. Hsu et al [14] reported that demographic information, physiological and disease variables, and care and treatment factors were demonstrated to be effective in predicting successful ventilator weaning with a sensitivity as high as 87.7%.…”

“…Hsu et al [14] reported that demographic information, physiological and disease variables, and care and treatment factors were demonstrated to be effective in predicting successful ventilator weaning with a sensitivity as high as 87.7%. Luo et al [16] argued that lab test data were expected to help increase the accuracy of predictive models for bronchiolitis. The lab test data of the NHIRD adopted in this study are not available currently, making the predictive performance of designed CDSSs greatly compromised.…”

The modified respiratory index score (RIS) guides resource allocation in acute bronchiolitis

“…The ability to predict for a true need for hospitalization would guide the allocation of resources. Specifically, this would include the need for airway intervention (both invasive and non‐invasive respiratory support), intravenous fluid administration, and the need for oxygen administration …”