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Our objective was to perform an umbrella review of all meta\u2010analyses that included outpatient subanalyses or network meta\u2010analyses with medication treatment comparisons to study the clinical benefits of these deimplemented medications in the outpatient (i.e., primary care, urgent care, and emergency department) setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Searches were performed in the databases PubMed and Scopus and the Web search engine Google Scholar on the following three topics: albuterol and bronchiolitis, epinephrine and bronchiolitis, and hypertonic saline and bronchiolitis. Article types were limited to systematic reviews and meta\u2010analyses with outpatient subanalyses, with English language and age restrictions. The search strategy was based on the Population, Intervention, Comparator, Outcomes, Studies (PICOS) framework. The studies were uploaded to Rayyan, a Web\u2010based platform for managing articles of systematic reviews. Citation tracking and manual review of references were performed for the included studies. The meta\u2010analyses and network meta\u2010analyses were reviewed for outpatient subanalyses focused on clinical responses and risk of hospital admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 6 meta\u2010analyses for albuterol, 4 meta\u2010analyses for epinephrine, and 11 meta\u2010analyses for hypertonic saline were included. Our review identified evidence from predominantly low and moderate evidence meta\u2010analyses (assessed using GRADE and AMSTAR 2) indicating that all three deimplemented medications exhibit one or more therapeutic effects and benefits for infants with the bronchiolitis syndrome in the outpatient setting. Effect sizes ranged from medium to near medium. These clinical benefits include decreased hospital admissions and lower clinical severity scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Given the heterogeneity of patients under the umbrella term \u201cacute bronchiolitis\u201d and the potential for some patients to respond clinically to albuterol, hypertonic saline, and epinephrine, current evidence supports conducting therapeutic trials in infants with acute bronchiolitis in outpatient settings. However, further well\u2010designed and adequately powered randomized controlled trials and high\u2010quality meta\u2010analyses are still needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.27391","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T09:19:38Z","timestamp":1732699178000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Outpatient Medications Deimplemented by the AAP Bronchiolitis Guidelines: An Umbrella Review of Meta\u2010Analyses"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0425-1320","authenticated-orcid":false,"given":"Larry","family":"Mellick","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Augusta University Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4059-7115","authenticated-orcid":false,"given":"Paul","family":"Walsh","sequence":"additional","affiliation":[{"name":"Sutter Medical Center Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3927-9881","authenticated-orcid":false,"given":"Clista","family":"Clanton","sequence":"additional","affiliation":[{"name":"Charles M. 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