Evidence map›Paper›PMID 12183309›Full record

Trial reportBMJ (Clinical research ed.)2002

Cluster randomised controlled trial of tailored interventions to improve the management of urinary tract infections in women and sore throat.

Signe Flottorp, Andrew D Oxman, Kari Håvelsrud, Shaun Treweek, Jeph Herrin

Open access · bronzeAbstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 26 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 26 pooled it
6.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 26 syntheses or guidelines pooled it, 153 citations in OpenAlex.

  1. Pooled it
  2. Tailored interventions to address determinants of practice.The Cochrane database of systematic reviews · 2026
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  6. Strategies to reduce the use of low-value medical tests in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
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  9. Patient-mediated interventions to improve professional practice.The Cochrane database of systematic reviews · 2018
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  14. Tailored interventions to address determinants of practice.The Cochrane database of systematic reviews · 2015
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  19. Effect of point-of-care computer reminders on physician behaviour: a systematic review.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2010
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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Signe FlottorpDepartment of Health Services Research, Norwegian Directorate for Health and Social Welfare, PO Box 8054 Dep, N-0031 Oslo, Norway. signe.flottorp@shdir.no
Andrew D Oxman
Kari Håvelsrud
Shaun Treweek
Jeph Herrin
Norwegian Directorate of Health · NOBarron Associates (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the effectiveness of tailored interventions to implement guidelines for urinary tract infections in women and sore throat.

designUnblinded, cluster randomised pretest-post-test trial.

setting142 general practices in Norway.

participants72 practices received interventions to implement guidelines for urinary tract infection and 70 practices received interventions to implement guidelines for sore throat, serving as controls for each other. 59 practices in the urinary tract infection group and 61 practices in the sore throat group completed the study. Outcomes were measured in 16 939 consultations for sore throat and 9887 consultations for urinary tract infection.

interventionsInterventions were developed to overcome identified barriers to implementing the guidelines. The main components of the tailored interventions were patient educational material, computer based decision support and reminders, an increase in the fee for telephone consultations, and interactive courses for general practitioners and practice assistants.

main outcome measuresChanges in rates of use of antibiotics, laboratory tests, and telephone consultations.

resultsPatients in the sore throat group were 3% less likely to receive antibiotics after the intervention. Women with symptoms of urinary tract infection in the intervention group were 5.1% less likely to have a laboratory test ordered. No significant differences were found between the groups for the other outcomes. Large variation was found across the included practices in the rates of antibiotic prescription, use of laboratory tests and telephone consultations, and in the extent of change for all three outcome measures.

conclusionsPassively delivered, complex interventions targeted at identified barriers to change had little effect in changing practice.

Indexed as

Practice Guidelines as TopicAdolescentAdultClinical Laboratory TechniquesCluster AnalysisFamily PracticeFemaleHumansLogistic ModelsMiddle AgedNorwayPharyngitisPractice Patterns, Physicians'Quality of Health CareReferral and ConsultationTreatment Outcome

Identifiers

PMID12183309
PMCPMC117890
OpenAlexW2146745032

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.