Prioritising Recommendations for Conversion to Living Mode in the Australasian Bronchiolitis Guideline: A Modified Delphi Study

ABSTRACT Background The Australasian Bronchiolitis Guideline (ABG) provides evidence‐based recommendations for managing one of the most frequent reasons for infant hospitalisation. As traditional guidelines age, they suffer from lack of relevance when new evidence is available but not incorporated. To address this limitation a guideline, or parts thereof, can be converted into a “living” mode, where new evidence is regularly incorporated into recommendations, enabling faster translation to practice. This study aimed to prioritise ABG recommendations for conversion to a living mode. Method Members of the 2025 ABG Guideline Advisory Group and Guideline Development Committee were invited to participate in an online, modified Delphi study. Panellists ranked 38 recommendations as low, medium, or high priority for conversion to a living mode across two rounds. A consensus threshold of ≥ 75% agreement was used. Data collection ceased once consensus was reached on ≥ 4 recommendations for conversion. Results Twenty‐five of 29 (86%) experts responded in round one and 20/25 (80%) in round two. Panel diversity was maintained throughout voting rounds. At round one, consensus was reached to convert three recommendations to a living format and 11/38 recommendations were excluded. At round two, one additional recommendation was prioritised for conversion and 16/24 were excluded. Consensus was not reached on seven recommendations. Conclusion Four key management recommendations will be converted to a living mode: high‐flow therapy, combined glucocorticoid/adrenaline therapy, oxygen saturation targets, and chest X‐ray in intensive care settings. These recommendations will be regularly updated as new evidence becomes available, supporting a more rapid translation to clinical practice.

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Journal
Clinical and Public Health Guidelines
Published
2026-03-16
DOI
https://doi.org/10.1002/gin2.70065
Primary Topic
Respiratory viral infections research
Type
article
Field-Weighted Citation Impact
0.00
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article

Prioritising Recommendations for Conversion to Living Mode in the Australasian Bronchiolitis Guideline: A Modified Delphi Study

Ken Peacock, David W. Thomas, Nigel W. Crawford, Trevor Duke et al.
Clinical and Public Health Guidelines
Respiratory viral infections research
article

Prioritising Recommendations for Conversion to Living Mode in the Australasian Bronchiolitis Guideline: A Modified Delphi Study

Ken Peacock, David W. Thomas, Nigel W. Crawford, Trevor Duke, Emma Tavender, Annie Smith, Catherine Wilson, Libby Haskell, Simon S. Craig, J. Alsweiler, Franz E Babl, Anna Lithgow, Rebecca L. Starkie, Sonja Crone, Dianne Crellin, Ed Oakley, Elizabeth Cotterell, Kate Loveys, Alexandra Wallace, Sharon O'Brien, Tomas Ratoni, Meredith L. Borland, Shane George, Stuart R. Dalziel, Michael Zhang
article en

Abstract

ABSTRACT Background The Australasian Bronchiolitis Guideline (ABG) provides evidence‐based recommendations for managing one of the most frequent reasons for infant hospitalisation. As traditional guidelines age, they suffer from lack of relevance when new evidence is available but not incorporated. To address this limitation a guideline, or parts thereof, can be converted into a “living” mode, where new evidence is regularly incorporated into recommendations, enabling faster translation to practice. This study aimed to prioritise ABG recommendations for conversion to a living mode. Method Members of the 2025 ABG Guideline Advisory Group and Guideline Development Committee were invited to participate in an online, modified Delphi study. Panellists ranked 38 recommendations as low, medium, or high priority for conversion to a living mode across two rounds. A consensus threshold of ≥ 75% agreement was used. Data collection ceased once consensus was reached on ≥ 4 recommendations for conversion. Results Twenty‐five of 29 (86%) experts responded in round one and 20/25 (80%) in round two. Panel diversity was maintained throughout voting rounds. At round one, consensus was reached to convert three recommendations to a living format and 11/38 recommendations were excluded. At round two, one additional recommendation was prioritised for conversion and 16/24 were excluded. Consensus was not reached on seven recommendations. Conclusion Four key management recommendations will be converted to a living mode: high‐flow therapy, combined glucocorticoid/adrenaline therapy, oxygen saturation targets, and chest X‐ray in intensive care settings. These recommendations will be regularly updated as new evidence becomes available, supporting a more rapid translation to clinical practice.

Clinical and Public Health GuidelinesVol. 3(2)
Griffith University (AU), Royal Children's Hospital (AU), University of Auckland (NZ), The University of Queensland (AU), The University of Melbourne (AU), The University of Western Australia (AU), Parks Victoria (AU), Gold Coast Hospital (AU), Princess Margaret Hospital for Children (AU), John Hunter Hospital (AU), Women's and Children's Hospital (AU), Monash Medical Centre (AU), Waikato Hospital (NZ), Rotorua Hospital (NZ), Northern Sydney Local Health District (AU), Royal Darwin Hospital (AU), Starship Children's Health (NZ), Institute for Respiratory Health (AU), Sydney Children’s Hospitals Network (AU), Southland Hospital (NZ), Murdoch Children's Research Institute (AU), Melbourne Health (AU), Perth Children's Hospital, Monash University (AU), Poultry CRC (AU), Australian Catholic University (AU), University of New England (AU)
Openalex Percentile: Top 22%
Respiratory viral infections research
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