Evidence map›Paper›PMID 27235297›Full record

Trial reportBMJ open2016

Protocol for a pragmatic cluster randomised controlled trial for reducing irrational antibiotic prescribing among children with upper respiratory infections in rural China.

Guanyang Zou, Xiaolin Wei, Joseph P Hicks, Yanhong Hu, John Walley, Jun Zeng, Helen Elsey, Rebecca King, Zhitong Zhang, Simin Deng and 5 more

Open access · goldAbstract readPragmatic Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 13% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Tailored interventions to address determinants of practice.The Cochrane database of systematic reviews · 2026
    Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
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

15 authors at 6 institutions in 3 countries.

Guanyang ZouChina Global Health Research and Development, Shenzhen, China.
Xiaolin WeiChina Global Health Research and Development, Shenzhen, China Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Joseph P HicksNuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
Yanhong HuSchool of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.
John WalleyNuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
Jun ZengGuangxi Autonomous Region Centre for Disease Control and Prevention, Nanning, China.
Helen ElseyNuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
Rebecca KingNuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
Zhitong ZhangChina Global Health Research and Development, Shenzhen, China.
Simin DengChina Global Health Research and Development, Shenzhen, China.
Yuanyuan HuangChina Global Health Research and Development, Shenzhen, China.
Claire BlacklockNuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
Jia YinSchool of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China.
Qiang SunCentre for Health Management and Policy, Shandong University, Jinan, China.
Mei LinGuangxi Autonomous Region Centre for Disease Control and Prevention, Nanning, China.
Nuffield Health · GBChinese University of Hong Kong · CNGuangxi Center for Disease Prevention and Control · CNUniversity of Leeds · GBShandong University · CNUniversity of Toronto · CA

Funding

Medical Research Council MR/M022161/1Wellcome Trust
6 · The paper itself

Abstract

introductionIrrational use of antibiotics is a serious issue within China and internationally. In 2012, the Chinese Ministry of Health issued a regulation for antibiotic prescriptions limiting them to <20% of all prescriptions for outpatients, but no operational details have been issued regarding policy implementation. This study aims to test the effectiveness of a multidimensional intervention designed to reduce the use of antibiotics among children (aged 2-14 years old) with acute upper respiratory infections in rural primary care settings in China, through changing doctors' prescribing behaviours and educating parents/caregivers. METHODS AND ANALYSIS: This is a pragmatic, parallel-group, controlled, cluster-randomised superiority trial, with blinded evaluation of outcomes and data analysis, and un-blinded treatment. From two counties in Guangxi Province, 12 township hospitals will be randomised to the intervention arm and 13 to the control arm. In the control arm, the management of antibiotics prescriptions will continue through usual care via clinical consultations. In the intervention arm, a provider and patient/caregiver focused intervention will be embedded within routine primary care practice. The provider intervention includes operational guidelines, systematic training, peer review of antibiotic prescribing and provision of health education to patient caregivers. We will also provide printed educational materials and educational videos to patients' caregivers. The primary outcome is the proportion of all prescriptions issued by providers for upper respiratory infections in children aged 2-14 years old, which include at least one antibiotic. ETHICS AND DISSEMINATION: The trial has received ethical approval from the Ethics Committee of Guangxi Provincial Centre for Disease Control and Prevention, China. The results will be disseminated through workshops, policy briefs, peer-reviewed publications, local and international conferences. TRIAL REGISTRATION NUMBER: ISRCTN14340536; Pre-results.

Indexed as

Acute DiseaseAdolescentAnti-Bacterial AgentsCaregiversChildChild, PreschoolChinaDrug Utilization ReviewEducation, Medical, ContinuingHumansInappropriate PrescribingPractice Guidelines as TopicPractice Patterns, Physicians'Prescription Drug MisusePrimary Health CareResearch DesignAnti-Bacterial AgentsAntibioticsChinaClustered randomized control trialPRIMARY CARERational use

Identifiers

PMID27235297
PMCPMC4885273
OpenAlexW2402520568

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.