Pediatrics Evidence Evolution

5 evidence evolution narratives tracing how landmark trials and guideline updates reshaped pediatrics practice.

Bronchiolitis Management

Less is more

Aggressive → evidence AGAINST bronchodilators/steroids → supportive only → high-flow

Beyond lifestyle-only

Lifestyle-only → metformin → liraglutide (SCALE Teen) → semaglutide (STEP TEENS)

Raising the bar

Variable → AAP 2004 → phototherapy debates → AAP 2022 revision (higher thresholds)

Selective over comprehensive

Full workup → AAP 2011 selective → RIVUR → NICE divergence → risk stratification

Combination and beyond

Methylphenidate → MTA study (1999) → amphetamines → atomoxetine/guanfacine → combinations