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Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach
Unexpected events of breath, tone, and skin color change in infants are a cause of considerable distress to the caregiver and there is still debate on their appropriate management. The aim of this study is to survey the trend in prevention, decision-making, and management of brief resolved unexplain...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926945/ https://www.ncbi.nlm.nih.gov/pubmed/33671771 http://dx.doi.org/10.3390/life11020171 |
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author | Prezioso, Giovanni Perrone, Serafina Biasucci, Giacomo Pisi, Giovanna Fainardi, Valentina Strisciuglio, Caterina Marzano, Francesco Nonnis Moretti, Sabrina Pisani, Francesco Tchana, Bertrand Argentiero, Alberto Neglia, Cosimo Caffarelli, Carlo Bertolini, Patrizia Bersini, Maria Teresa Canali, Andrea Voccia, Emanuele Squarcia, Antonella Ghi, Tullio Verrotti, Carla Frusca, Tiziana Cecchi, Rossana Giordano, Giovanna Colasanti, Filomena Roccia, Ilenia Palanza, Paola Esposito, Susanna |
author_facet | Prezioso, Giovanni Perrone, Serafina Biasucci, Giacomo Pisi, Giovanna Fainardi, Valentina Strisciuglio, Caterina Marzano, Francesco Nonnis Moretti, Sabrina Pisani, Francesco Tchana, Bertrand Argentiero, Alberto Neglia, Cosimo Caffarelli, Carlo Bertolini, Patrizia Bersini, Maria Teresa Canali, Andrea Voccia, Emanuele Squarcia, Antonella Ghi, Tullio Verrotti, Carla Frusca, Tiziana Cecchi, Rossana Giordano, Giovanna Colasanti, Filomena Roccia, Ilenia Palanza, Paola Esposito, Susanna |
author_sort | Prezioso, Giovanni |
collection | PubMed |
description | Unexpected events of breath, tone, and skin color change in infants are a cause of considerable distress to the caregiver and there is still debate on their appropriate management. The aim of this study is to survey the trend in prevention, decision-making, and management of brief resolved unexplained events (BRUE)/apparent life-threatening events (ALTE) and to develop a shared protocol among hospitals and primary care pediatricians regarding hospital admission criteria, work-up and post-discharge monitoring of patients with BRUE/ALTE. For the study purpose, a panel of 54 experts was selected to achieve consensus using the RAND/UCLA appropriateness method. Twelve scenarios were developed: one addressed to primary prevention of ALTE and BRUE, and 11 focused on hospital management of BRUE and ALTE. For each scenario, participants were asked to rank each option from ‘1’ (extremely inappropriate) to ‘9’ (extremely appropriate). Results derived from panel meeting and discussion showed several points of agreement but also disagreement with different opinion emerged and the need of focused education on some areas. However, by combining previous recommendations with expert opinion, the application of the RAND/UCLA appropriateness permitted us to drive pediatricians to reasoned and informed decisions in term of evaluation, treatment and follow-up of infants with BRUE/ALTE, reducing inappropriate exams and hospitalisation and highlighting priorities for educational interventions. |
format | Online Article Text |
id | pubmed-7926945 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79269452021-03-04 Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach Prezioso, Giovanni Perrone, Serafina Biasucci, Giacomo Pisi, Giovanna Fainardi, Valentina Strisciuglio, Caterina Marzano, Francesco Nonnis Moretti, Sabrina Pisani, Francesco Tchana, Bertrand Argentiero, Alberto Neglia, Cosimo Caffarelli, Carlo Bertolini, Patrizia Bersini, Maria Teresa Canali, Andrea Voccia, Emanuele Squarcia, Antonella Ghi, Tullio Verrotti, Carla Frusca, Tiziana Cecchi, Rossana Giordano, Giovanna Colasanti, Filomena Roccia, Ilenia Palanza, Paola Esposito, Susanna Life (Basel) Article Unexpected events of breath, tone, and skin color change in infants are a cause of considerable distress to the caregiver and there is still debate on their appropriate management. The aim of this study is to survey the trend in prevention, decision-making, and management of brief resolved unexplained events (BRUE)/apparent life-threatening events (ALTE) and to develop a shared protocol among hospitals and primary care pediatricians regarding hospital admission criteria, work-up and post-discharge monitoring of patients with BRUE/ALTE. For the study purpose, a panel of 54 experts was selected to achieve consensus using the RAND/UCLA appropriateness method. Twelve scenarios were developed: one addressed to primary prevention of ALTE and BRUE, and 11 focused on hospital management of BRUE and ALTE. For each scenario, participants were asked to rank each option from ‘1’ (extremely inappropriate) to ‘9’ (extremely appropriate). Results derived from panel meeting and discussion showed several points of agreement but also disagreement with different opinion emerged and the need of focused education on some areas. However, by combining previous recommendations with expert opinion, the application of the RAND/UCLA appropriateness permitted us to drive pediatricians to reasoned and informed decisions in term of evaluation, treatment and follow-up of infants with BRUE/ALTE, reducing inappropriate exams and hospitalisation and highlighting priorities for educational interventions. MDPI 2021-02-22 /pmc/articles/PMC7926945/ /pubmed/33671771 http://dx.doi.org/10.3390/life11020171 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Prezioso, Giovanni Perrone, Serafina Biasucci, Giacomo Pisi, Giovanna Fainardi, Valentina Strisciuglio, Caterina Marzano, Francesco Nonnis Moretti, Sabrina Pisani, Francesco Tchana, Bertrand Argentiero, Alberto Neglia, Cosimo Caffarelli, Carlo Bertolini, Patrizia Bersini, Maria Teresa Canali, Andrea Voccia, Emanuele Squarcia, Antonella Ghi, Tullio Verrotti, Carla Frusca, Tiziana Cecchi, Rossana Giordano, Giovanna Colasanti, Filomena Roccia, Ilenia Palanza, Paola Esposito, Susanna Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach |
title | Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach |
title_full | Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach |
title_fullStr | Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach |
title_full_unstemmed | Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach |
title_short | Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach |
title_sort | management of infants with brief resolved unexplained events (brue) and apparent life-threatening events (alte): a rand/ucla appropriateness approach |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926945/ https://www.ncbi.nlm.nih.gov/pubmed/33671771 http://dx.doi.org/10.3390/life11020171 |
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