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...
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Format: | Article |
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MDPI AG
2021-02-01
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Series: | Life |
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Online Access: | https://www.mdpi.com/2075-1729/11/2/171 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Giovanni Prezioso Serafina Perrone Giacomo Biasucci Giovanna Pisi Valentina Fainardi Caterina Strisciuglio Francesco Nonnis Marzano Sabrina Moretti Francesco Pisani Bertrand Tchana Alberto Argentiero Cosimo Neglia Carlo Caffarelli Patrizia Bertolini Maria Teresa Bersini Andrea Canali Emanuele Voccia Antonella Squarcia Tullio Ghi Carla Verrotti Tiziana Frusca Rossana Cecchi Giovanna Giordano Filomena Colasanti Ilenia Roccia Paola Palanza Susanna Esposito |
spellingShingle |
Giovanni Prezioso Serafina Perrone Giacomo Biasucci Giovanna Pisi Valentina Fainardi Caterina Strisciuglio Francesco Nonnis Marzano Sabrina Moretti Francesco Pisani Bertrand Tchana Alberto Argentiero Cosimo Neglia Carlo Caffarelli Patrizia Bertolini Maria Teresa Bersini Andrea Canali Emanuele Voccia Antonella Squarcia Tullio Ghi Carla Verrotti Tiziana Frusca Rossana Cecchi Giovanna Giordano Filomena Colasanti Ilenia Roccia Paola Palanza Susanna Esposito Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach Life ALTE BRUE pediatric emergency RAND/UCLA appropriateness method SIDS |
author_facet |
Giovanni Prezioso Serafina Perrone Giacomo Biasucci Giovanna Pisi Valentina Fainardi Caterina Strisciuglio Francesco Nonnis Marzano Sabrina Moretti Francesco Pisani Bertrand Tchana Alberto Argentiero Cosimo Neglia Carlo Caffarelli Patrizia Bertolini Maria Teresa Bersini Andrea Canali Emanuele Voccia Antonella Squarcia Tullio Ghi Carla Verrotti Tiziana Frusca Rossana Cecchi Giovanna Giordano Filomena Colasanti Ilenia Roccia Paola Palanza Susanna Esposito |
author_sort |
Giovanni Prezioso |
title |
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_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_sort |
management of infants with brief resolved unexplained events (brue) and apparent life-threatening events (alte): a rand/ucla appropriateness approach |
publisher |
MDPI AG |
series |
Life |
issn |
2075-1729 |
publishDate |
2021-02-01 |
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. |
topic |
ALTE BRUE pediatric emergency RAND/UCLA appropriateness method SIDS |
url |
https://www.mdpi.com/2075-1729/11/2/171 |
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doaj-0c9e40e2367d4a999cab78d3fac5150c2021-02-23T00:04:58ZengMDPI AGLife2075-17292021-02-011117117110.3390/life11020171Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness ApproachGiovanni Prezioso0Serafina Perrone1Giacomo Biasucci2Giovanna Pisi3Valentina Fainardi4Caterina Strisciuglio5Francesco Nonnis Marzano6Sabrina Moretti7Francesco Pisani8Bertrand Tchana9Alberto Argentiero10Cosimo Neglia11Carlo Caffarelli12Patrizia Bertolini13Maria Teresa Bersini14Andrea Canali15Emanuele Voccia16Antonella Squarcia17Tullio Ghi18Carla Verrotti19Tiziana Frusca20Rossana Cecchi21Giovanna Giordano22Filomena Colasanti23Ilenia Roccia24Paola Palanza25Susanna Esposito26Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyUnit of Neonatology, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyPediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29122 Piacenza, ItalyPediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyPediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyDepartment of Woman, Child and General and Specialistic Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDepartment of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, 43126 Parma, ItalyUnit of Neonatology, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyPediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyCardiology Unit, Parma Hospital, 43126 Parma, ItalyPediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyPediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyPediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyOncohematology Unit, Parma Hospital, 43126 Parma, ItalyPrimary Care Pediatrics, AUSL of Parma, 43126 Parma, ItalyPrimary Care Pediatrics, AUSL of Parma, 43126 Parma, ItalyPrimary Care Pediatrics, AUSL of Parma, 43126 Parma, ItalyUnit of Neuropsychiatry of Children and Adolescents, AUSL Parma, 43126 Parma, ItalyObstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyWoman Health Unit, AUSL Parma, 43126 Parma, ItalyObstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyLegal Medicine Section, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyPathology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyUnit of Neonatology, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyUnit of Neonatology, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyUnit of Neuroscience, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyPediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, ItalyUnexpected 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.https://www.mdpi.com/2075-1729/11/2/171ALTEBRUEpediatric emergencyRAND/UCLA appropriateness methodSIDS |