ArticleBMC medical informatics and decision making2008
Improving antibiotic prescribing for adults with community acquired pneumonia: Does a computerised decision support system achieve more than academic detailing alone?--A time series analysis.
Article in BMC medical informatics and decision making, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 11 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 11 syntheses or guidelines pooled it.
- A systematic review and meta-analysis to identify behavioural content and active ingredients of antimicrobial stewardship education and training interventions in hospital-based care settings.Antimicrobial resistance and infection control · 2025Pooled it
- Pooled it
- Academic Detailing Interventions and Evidence-Based Prescribing: A Systematic Review.JAMA network open · 2025Pooled it
- The role of information systems in emergency department decision-making-a literature review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- Antimicrobial stewardship programs in emergency departments: how do we measure antimicrobial use? A systematic review.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2021Pooled it
- Use of interrupted time series methods in the evaluation of health system quality improvement interventions: a methodological systematic review.BMJ global health · 2020Pooled it
- Scope and Influence of Electronic Health Record-Integrated Clinical Decision Support in the Emergency Department: A Systematic Review.Annals of emergency medicine · 2019Pooled it
- What maximizes the effectiveness and implementation of technology-based interventions to support healthcare professional practice? A systematic literature review.BMC medical informatics and decision making · 2018Pooled it
- Interventions to improve antibiotic prescribing practices for hospital inpatients.The Cochrane database of systematic reviews · 2017Pooled it
- The effectiveness of computerised decision support on antibiotic use in hospitals: A systematic review.PloS one · 2017Pooled it
- Systematic review of clinical decision support interventions with potential for inpatient cost reduction.BMC medical informatics and decision making · 2013Pooled it
- Impact of an integrated electronic Clinical Decision Support System with proactive Antimicrobial Stewardship Feedback on prescribing appropriateness: a 2-year single-centre time-series analysis.JAC-antimicrobial resistance · 2026Article
- Personalised management of community-acquired pneumonia and the role of Clinical Decision Support Software.BMJ open respiratory research · 2026Review
- Understanding antibiotic prescribing in the inpatient setting: a synthesis of evidence on determinants and interventions.Antimicrobial resistance and infection control · 2026Article
- Limitations in the use of automated mental status detection for clinical decision support.International journal of medical informatics · 2023Article
- The Interventions and Challenges of Antimicrobial Stewardship in the Emergency Department.Antibiotics (Basel, Switzerland) · 2023Review
- Physician Compliance With a Computerized Clinical Decision Support System for Anemia Management of Patients With End-stage Kidney Disease on Hemodialysis: Retrospective Electronic Health Record Observational Study.JMIR formative research · 2023Article
- Antimicrobial stewardship in Australia: the role of qualitative research in programme development.JAC-antimicrobial resistance · 2021Review
- Article
- Evaluation of machine learning solutions in medicine.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe ideal method to encourage uptake of clinical guidelines in hospitals is not known. Several strategies have been suggested. This study evaluates the impact of academic detailing and a computerised decision support system (CDSS) on clinicians' prescribing behaviour for patients with community acquired pneumonia (CAP).
methodsThe management of all patients presenting to the emergency department over three successive time periods was evaluated; the baseline, academic detailing and CDSS periods. The rate of empiric antibiotic prescribing that was concordant with recommendations was studied over time comparing pre and post periods and using an interrupted time series analysis.
resultsThe odds ratio for concordant therapy in the academic detailing period, after adjustment for age, illness severity and suspicion of aspiration, compared with the baseline period was OR = 2.79 [1.88, 4.14], p < 0.01, and for the computerised decision support period compared to the academic detailing period was OR = 1.99 [1.07, 3.69], p = 0.02. During the first months of the computerised decision support period an improvement in the appropriateness of antibiotic prescribing was demonstrated, which was greater than that expected to have occurred with time and academic detailing alone, based on predictions from a binary logistic model.
conclusionDeployment of a computerised decision support system was associated with an early improvement in antibiotic prescribing practices which was greater than the changes seen with academic detailing. The sustainability of this intervention requires further evaluation.
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