Aim/goal of project
The use of severity scoring tools has been commonly used to help clinicians assess severity of bronchiolitis; however there are limitations to current tools used. Very few tools have been validated and those that have are often modified to suit specific research, thus limiting the generalisability to other populations.
Primary aim was to determine the validity and reliability of a bronchiolitis scoring system in children aged <24 months presenting to Royal Darwin Hospital with bronchiolitis.
Secondary aims was to determine whether the score can predict the need for oxygen administration.

Hypothesis
A clinical severity scoring system for bronchiolitis that is valid and predictive of requirement for oxygen can be developed
 
Background
Bronchiolitis remains the most common acute lower respiratory tract infection (ALRTI). Northern Territory Indigenous infants have the highest reported hospitalisations of bronchiolitis globally affecting 352 per 1000 (1 in 5); rates higher than American Indians, Alaskan Natives and developing countries. In a retrospective study in Darwin, Indigenous children with bronchiolitis had more severe disease than non Indigenous children but there was no difference in viral pathogens.

Recognition of severity of bronchiolitis is essential for good management. However, assessing and describing respiratory severity of infant’s is challenging for health staff, in particular in remote communities. These remote practitioners vary widely in their levels of paediatric experience. Severity scoring tools have been used to help describe clinical parameters and clinical outcomes such as wheezing, retractions and respiratory rate; however they are complex and have been described for very short term assessment (i.e. minutes to hours). Applicability of these scoring tools to different populations and settings are arguably limited. Indeed, while many scores exist, there is currently no validated bronchiolitis scoring system that is beyond the immediate setting. Also none can be feasibly used in remote settings.

This study will help establish if a standardised severity scoring tool can be a useful predictor of disease severity for bronchiolitis in our setting and can transferable to other populations/settings.

Severity scoring systems: are they internally valid, reliable and predictive of oxygen use in children with acute bronchiolitis? By McCallum GB, Morris PS, Wilson CC, Versteegh LA, Ward LM, Chatfield MD, Chang AB