ArticleJournal of the American Medical Informatics Association : JAMIA
Acute infections in primary care: accuracy of electronic diagnoses and electronic antibiotic prescribing.
Article in Journal of the American Medical Informatics Association : JAMIA. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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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.
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Who cites it
20 citing papers in PubMed, 44 citations in OpenAlex.
- Trial
- A randomized trial of electronic clinical reminders to improve medication laboratory monitoring.Journal of the American Medical Informatics Association : JAMIATrial
- Respiratory tract infections in Norwegian primary care 2006-2015: a registry-based study.Scandinavian journal of primary health care · 2022Article
- Antibiotic prescribing for respiratory tract infection across a national primary care network in 2019.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2022Article
- Article
- E-Health Tools to Improve Antibiotic Use and Resistances: A Systematic Review.Antibiotics (Basel, Switzerland) · 2020Review
- How well do ICD-9 physician claim diagnostic codes identify confirmed pertussis cases in Alberta, Canada? A Canadian Immunization Research Network (CIRN) Study.BMC health services research · 2017Article
- Necessity of office visits for acute respiratory infections in primary care.Family practice · 2016Article
- Association between pre-hospital vitamin D status and hospital-acquired new-onset delirium.The British journal of nutrition · 2015Article
- Association between prehospital vitamin D status and hospital-acquired Clostridium difficile infections.JPEN. Journal of parenteral and enteral nutrition · 2015Article
- Association between prehospital vitamin D status and hospital-acquired bloodstream infections.The American journal of clinical nutrition · 2013Article
- Conversion of a single-facility pediatric antimicrobial stewardship program to multi-facility application with computerized provider order entry and clinical decision support.Applied clinical informatics · 2013Article
- Association between hyperkalemia at critical care initiation and mortality.Intensive care medicine · 2012Article
- Self-reported familiarity with acute respiratory infection guidelines and antibiotic prescribing in primary care.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2010Article
- Antiviral and antibiotic prescribing for influenza in primary care.Journal of general internal medicine · 2009Article
- Accuracy of physician billing claims for identifying acute respiratory infections in primary care.Health services research · 2008Article
- Clinical decision support to improve antibiotic prescribing for acute respiratory infections: results of a pilot study.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2007Article
- Assessing the Validity of Electronic Medical Records for Identifying High Antibiotic Prescribers in Primary Care.Journal of primary care & community healthArticle
- "Smart Forms" in an Electronic Medical Record: documentation-based clinical decision support to improve disease management.Journal of the American Medical Informatics Association : JAMIAArticle
- Accuracy of phenotyping chronic rhinosinusitis in the electronic health record.American journal of rhinology & allergyArticle
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo maximize effectiveness, clinical decision-support systems must have access to accurate diagnostic and prescribing information. We measured the accuracy of electronic claims diagnoses and electronic antibiotic prescribing for acute respiratory infections (ARIs) and urinary tract infections (UTIs) in primary care.
designA retrospective, cross-sectional study of randomly selected visits to nine clinics in the Brigham and Women's Practice-Based Research Network between 2000 and 2003 with a principal claims diagnosis of an ARI or UTI (N = 827). MEASUREMENTS: We compared electronic billing diagnoses and electronic antibiotic prescribing to the gold standard of blinded chart review.
resultsClaims-derived, electronic ARI diagnoses had a sensitivity of 98%, specificity of 96%, and positive predictive value of 96%. Claims-derived, electronic UTI diagnoses had a sensitivity of 100%, specificity of 87%, and positive predictive value of 85%. According to the visit note, physicians prescribed antibiotics in 45% of ARI visits and 73% of UTI visits. Electronic antibiotic prescribing had a sensitivity of 43%, specificity of 93%, positive predictive value of 90%, and simple agreement of 64%. The sensitivity of electronic antibiotic prescribing increased over time from 22% in 2000 to 58% in 2003 (p for trend < 0.0001).
conclusionClaims-derived, electronic diagnoses for ARIs and UTIs appear accurate. Although closing, a large gap persists between antibiotic prescribing documented in the visit note and the use of electronic antibiotic prescribing. Barriers to electronic antibiotic prescribing in primary care must be addressed to leverage the potential that computerized decision-support systems offer in reducing costs, improving quality, and improving patient safety.
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Registered trials
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.