{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:27:23Z","timestamp":1791926843038,"version":"4.3.4"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Croup is one of the most common respiratory complaints in pediatric emergency departments (EDs), yet little is known about clinical practice guidelines (CPGs) for this condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>To describe variation in CPGs across US children\u2019s hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We describe the prevalence and features of CPGs among hospitals that submit data to the Pediatric Health Information System. Each hospital was contacted between January 10, 2022, and April 25, 2022, for their most recent croup CPG and any revisions. Characteristics reported were based on the most recent CPG revision. Characteristics included treatment recommendations, utilization measures, ED observation times, and admission criteria. Interrater reliability between reviewers was reported as percentage agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Thirty-eight hospitals (79.2%) responded to our query, of which 20 (52.6%) had croup CPGs. Interrater reliability was moderate\u2013high for categorizing the indication for racemic epinephrine (RE) (19 of 20; 95%), the minimum number of RE doses recommended before admission (15 of 20; 75%), and ED observation time (19 of 20; 95%), and was 100% for all other characteristics. Three CPGs (15.0%) recommended 1 RE dose, 14 (70.0%) recommended 2 RE doses, and 3 (15.0%) recommended 3 RE doses before hospital admission. Thirteen (65%) CPGs recommended RE for stridor at rest, whereas 7 (30%) recommended RE for any degree of stridor. Fourteen (70%) CPGs recommended an ED observation time &amp;lt;2 hours, 3 (15%) recommended 2 to 4 hours, and 2 (10%) recommended &amp;gt;4 hours. Few CPGs (15%) recommended use of standardized croup clinical scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Substantial variation exists among croup CPGs. Our results may inform future efforts to standardize croup CPGs across centers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/hpeds.2023-007221","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T04:12:39Z","timestamp":1691381559000},"page":"e241-e245","source":"Crossref","is-referenced-by-count":9,"title":["Variation in Organizational Clinical Practice Guidelines for Croup"],"prefix":"10.1542","volume":"13","author":[{"given":"Kelly R.","family":"Bergmann","sequence":"first","affiliation":[{"name":"aDepartments of Pediatric Emergency Medicine"},{"name":"bValue and Clinical Excellence, Children\u2019s Minnesota, Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Lefchak","sequence":"additional","affiliation":[{"name":"aDepartments of Pediatric Emergency Medicine"},{"name":"bValue and Clinical Excellence, Children\u2019s Minnesota, Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Nickel","sequence":"additional","affiliation":[{"name":"cChildren\u2019s Minnesota Research Institute, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shea","family":"Lammers","sequence":"additional","affiliation":[{"name":"aDepartments of Pediatric Emergency Medicine"},{"name":"bValue and Clinical Excellence, Children\u2019s Minnesota, Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dave","family":"Watson","sequence":"additional","affiliation":[{"name":"cChildren\u2019s Minnesota Research Institute, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle Z.","family":"Hester","sequence":"additional","affiliation":[{"name":"bValue and Clinical Excellence, Children\u2019s Minnesota, Minneapolis Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"issue":"9","key":"2023112714095361200_b1","first-page":"575","article-title":"Croup: diagnosis and management","volume":"97","author":"Smith","year":"2018","journal-title":"Am Fam Physician"},{"key":"2023112714095361200_b2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1471-2296-9-10","article-title":"Measuring the financial burden of acute cough in pre-school children: a cost of illness study","volume":"9","author":"Hollinghurst","year":"2008","journal-title":"BMC Fam Pract"},{"issue":"4","key":"2023112714095361200_b3","doi-asserted-by":"crossref","first-page":"e20163582","DOI":"10.1542\/peds.2016-3582","article-title":"Variation in inpatient croup management and 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