Continuous Pulse Oximetry Monitoring in Bronchiolitis Patients Not Receiving Oxygen —Reply

In Reply Dr Keim-Malpass and colleagues raise interesting points about our study of continuous pulse oximetry monitoring in bronchiolitis. First, they comment that the evidence underlying the American Academy of Pediatrics recommendation against continuous pulse oximetry is weak and that parents find physiologic monitoring reassuring; therefore, calls for deimplementation are unwarranted. This logic suggests that weak evidence of harm (without evidence of benefit) and parent preference justify implementation of a medical intervention. We disagree. Similar logic likely contributed to the overprescribing of antibiotics for mild respiratory illnesses, overuse of home apnea monitoring for well infants, and computerized tomography scans after minor head injuries, all of which are now discouraged by the Choosing Wisely campaign. Clinicians caring for children bear the sometimes difficult responsibility of effectively communicating with and educating parents when interventions are appealing but lack benefit and may cause harm.
Source: JAMA - Category: General Medicine Source Type: research