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Clin Pediatr (Phila). 2019 May 23:9922819850462. doi: 10.1177/0009922819850462. [Epub ahead of print]

Physician Compliance With Bronchiolitis Guidelines in Pediatric Emergency Departments.

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1 Saint Louis University School of Medicine, Saint Louis, MO, USA.
2 Saint Louis University Institute of Biosecurity, Saint Louis, MO, USA.


An online survey was administered through the American Academy of Pediatrics (AAP) Section of Emergency Medicine Survey Listserv in Fall, 2017. Overall compliance was measured as never using chest X-rays, viral testing, bronchodilators, or systemic steroids. Practice compliance was measured as never using those modalities in a clinical vignette. Chi-square tests assessed differences in compliance between modalities. t tests assessed differences on agreement with each AAP statement. Multivariate logistic regression determined factors associated with overall compliance. Response rate was 47%. A third (35%) agreed with all 7 AAP statements. There was less compliance with ordering a bronchodilator compared with chest X-ray, viral testing, or systemic steroid. There was no association between compliance and either knowledge or agreement with the guideline. Physicians with institutional bronchiolitis guidelines were more likely to be practice compliant. Few physicians were compliant with the AAP bronchiolitis guideline, with bronchodilator misuse being most pronounced. Institutional bronchiolitis guidelines were associated with physician compliance.


bronchiolitis; clinical practice guideline; compliance; pediatric emergency department; survey


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