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Related Experiment Videos

Diagnosis and testing in bronchiolitis: a systematic review.

W Clayton Bordley1, Meera Viswanathan, Valerie J King

  • 1Departments of Pediatrics and Surgery, Division of Emergency Medicine, Duke University Medical Center, DUMC Box 3096, Durham, NC 27710, USA. Clay.Bordley@duke.edu

Archives of Pediatrics & Adolescent Medicine
|February 6, 2004
PubMed
Summary

Diagnostic testing for bronchiolitis, including respiratory syncytial virus tests and chest x-rays, lacks clear evidence of improving patient outcomes. Further studies are needed to establish the utility of these diagnostic tools.

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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Diagnostic Medicine

Background:

  • Bronchiolitis diagnosis relies on clinical presentation.
  • The utility of diagnostic and supportive laboratory testing remains unclear.

Purpose of the Study:

  • Systematically review data on diagnostic and supportive testing in bronchiolitis management.
  • Assess the clinical utility of these tests.

Main Methods:

  • Literature search (1980-2002) in MEDLINE and Cochrane Database.
  • Expert panel defined admissibility criteria.
  • Data extraction and integrity checks performed on 82 trials.

Main Results:

  • Rapid respiratory syncytial virus tests show good sensitivity/specificity, but impact on outcomes is unproven.

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  • Chest x-ray abnormalities are common (20-96%) but do not reliably predict disease severity or type.
  • Limited data exist on complete blood cell counts in bronchiolitis management.

    • Conclusions:

    • Despite abundant data, clear indications and outcome impacts for diagnostic testing are undefined.
    • Prospective studies are necessary to determine the utility of testing in bronchiolitis.