The utility of elective flexible bronchoscopy to improve quality of life and clinical outcomes for children: A systematic review

Rahul J. Thomas, Stephanie T. Yerkovich, Vikas Goyal, Anne B. Chang, Cameron Rutter, Ian Brent Masters, Julie M. Marchant

Research output: Contribution to journalReview articlepeer-review

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Abstract

Introduction: Elective flexible bronchoscopy (FB) is now widely available and standard practice for a variety of indications in children with respiratory conditions. However, there is limited evidence regarding the utility of elective FB in children. This systematic review (SRs) aimed to determine the utility of FB on its impact in clinical decision making and quality of life (QoL).

Methods: We searched Pubmed, Cochrane central register of controlled trials, Embase, World Health Organization Clinical Trials Registry Platform and Cochrane database of SRs from inception to April 20, 2023. We included SRs and randomized controlled trials (RCTs) that used parallel group design (comparing use of elective FB vs. no FB, or a wait-list approach [early FB vs. usual wait FB]) in children aged ≤ 18 years. Our protocol was prospectively registered and used Cochrane methodology for systemic reviews of interventions. 

Results: Our search identified 859 articles; 102 duplicates were removed, and 753 articles were excluded by title and abstract. Four full text articles were reviewed and subsequently excluded, as none met the inclusion criteria outlined in our patient, intervention, comparator, outcome measures framework.

Conclusions: There is a paucity of high-quality RCT evidence to support the routine use of elective FB in children with respiratory conditions. However, available retrospective and a single prospective study demonstrate the high utility of FB in the elective pediatric setting.

Registration: PROSPERO CRD42021291305.

Original languageEnglish
Pages (from-to)1589-1595
Number of pages7
JournalPediatric Pulmonology
Volume59
Issue number6
Early online date2024
DOIs
Publication statusPublished - Jun 2024

Bibliographical note

Funding Information:
This study was not funded. Rahul J. Thomas has a postgraduate scholarship (for PhD) from the National Health and Medical Research Council (NHMRC) Australia (APP1190908) and a PhD top‐up scholarship from Children's Health Foundation (CHF), Queensland (RPC00072). ABC is supported by a NHMRC Practitioner fellowship (Number 1154302). Anne B. Chang has received unrelated grants from the NHMRC and other fees to the institution from work relating to being an IDMC member of an unlicensed vaccine/molecules (GSK), Moderna and Astra‐Zeneca an advisory member of study design for other unlicensed potential therapeutic drugs (Zambon and BI). Julie M. Marchant was supported Lung Foundation Australia Hope Research Fund Andrew Harrison Fellowship in Bronchiectasis Research 2021. Julie M. Marchant and Stephanie T. Yerkovich are supported by the NHMRC Center for Research Excellence for bronchiectasis (AusBREATHE, grant number 1170958). Vikas Goyal is supported by a Queensland Advancing Research Fellowship and a Royal Australasian College of Physicians' Early Career Fellowship (2022REF00054). Open access publishing facilitated by Queensland University of Technology, as part of the Wiley ‐ Queensland University of Technology agreement via the Council of Australian University Librarians.

Publisher Copyright:
© 2024 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.

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