COSMIN database

A Systematic Review of the Psychometric Properties of Bronchiolitis Assessment Tools

Davies, C., Waters, D., and Marshall, A.
AIM: To assess the psychometric properties of tools developed for the purpose of assessing infants with bronchiolitis.

BACKGROUND: Bronchiolitis is the leading cause of hospitalisation in infants under the age of one year. Several bronchiolitis assessment tools have been developed primarily for use in randomised control trials of medical treatments for infants with bronchiolitis, however the reliability and validity of many of these tools is not well reported.

DESIGN: Systematic review.

DATA SOURCES: CINAHL, MEDLINE, EMBASE and PubMed electronic databases were searched between January 1960 - December 2015 using the key words 'bronchiolitis' and 'assessment' or 'screen' or 'tool' or 'scale' or 'score'.

REVIEW METHODS: A systematic review of the psychometric properties of bronchiolitis assessment tools was undertaken using the COSMIN checklist.

RESULTS: Fourteen studies meeting the inclusion criteria were reviewed and the methodological quality of the studies and reported psychometric properties of 11 instruments were assessed. Overall, the reliability and validity of bronchiolitis assessment tools was poorly established. Although several studies reported that their tools had good inter-rater reliability, the methodological quality of these studies was generally poor. Only one study underwent psychometric testing that was assessed as being of excellent quality. The Respiratory Distress Assessment Index was deemed to have undergone the most rigorous psychometric testing but had poor to moderate construct validity and considerable test-retest error.

CONCLUSION: Current bronchiolitis assessment tools lack clearly established reliability and validity and may not be sensitive to clinically meaningful outcomes for patients. This article is protected by copyright. All rights reserved.
J Adv Nurs
1365-2648 (Electronic); 0309-2402 (Linking)
Publication year:
Biological and physiological variables:
Biological and physiological variables
Symptom status:
Emotional state
Physical state
Children (0-18)
Diseases of and symptoms related to the respiratory system
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
6 - Clinical rating scales
7 - Observations
CHWRS - Children’s Hospital of Wisconsin Respiratory Score
Dabbous Bronchiolitis Score
Liu Clinical Score
Modified Tal Clinical Score
RACS - Respiratory Assessment Change Score
RDAI -Respiratory Distress Assessment Index/Instrument (versions: mRDAI)
RDI - Respiratory Distress Index
Respiratory Score (versions: WRS - Wang RS; KRS - Kristjansson; Gadjos RS)
Tal Clinical Score