Optimisation des tests diagnostiques pour les nourrissons fébriles : vers des soins axés sur le patient et la famille

 

Brett Burstein

Institut de recherche du Centre universitaire de santé McGill

 

Domaine : santé de la mère, des enfants et des adolescents

Programme Chercheurs-boursiers cliniciens - Junior 1

Concours 2019-2020

Nearly 2% of all term infants will present to an Emergency Department with fever within their first 3 months of life.  Although the majority of these infants have self-limited viral illnesses, approximately 10% harbour potentially life-threatening serious bacterial infections.  High-risk infants cannot be identified on the basis of history and physical exam alone.  Decisions must be made regarding the extent of investigations as well as the need for antibiotic treatment and hospitalization.  The medical workup of all febrile young infants is invasive, stressful for parent and child, and associated with complications and significant resource utilization.  Published guidelines developed 30 years ago provide conflicting recommendations and predate the availability of newer diagnostic tests that offer an enhanced ability to identify high-risk infants.  Moreover, existing guidelines do not incorporate parental preferences or opportunities for shared decision-making.  There are currently no nationally endorsed Canadian guidelines for the management of febrile young infants, and as a result there is significant variation in care.

My Research Program aims to improve and standardize the care of febrile young infants in Canada, aligned with parental preferences and in view of family-centered outcomes.  The overarching goals of my Research Program are to:

  1. Determine how to safely reduce invasive testing and hospitalization for febrile young infants using currently available and newer diagnostic tools; and,
  2. Better understand parental preferences and identify barriers and facilitators for shared decision-making.

Optimizing our use of existing and emerging diagnostic tests to reduce unnecessary invasive procedures and hospitalizations has important implications for families and system-wide resource utilization.