Respiratory infections in children have been a focus of high-value care improvement efforts. These infections are extremely common, predominantly viral and self-limited, and often drive testing and treatment not supported by evidence. Bronchiolitis care, in particular, is characterized by excessive variability and waste, and clinical guidelines1 and consensus recommendations2 have become increasingly supportive of minimal intervention. Seemingly benign tests (eg, chest radiographs and continuous pulse oximetry) and treatments (eg, antibiotics and bronchodilators) for bronchiolitis are not risk-free, and when performed frequently, can have a substantial effect on health care costs.
Schroeder AR, Ralston SL. Viral Testing for Pediatric Respiratory InfectionsWhy Precise Diagnoses Do Not Always Translate to Patient Benefit. JAMA. 2017;318(5):472–473. doi:10.1001/jama.2017.3985