Evidence map›Paper›PMID 28122829›Full record

ArticleBMJ open2017

Qualitative study of primary care clinicians' views on point-of-care testing for C-reactive protein for acute respiratory tract infections in family medicine.

Victoria Hardy, Matthew Thompson, Gina A Keppel, William Alto, M Ashworth Dirac, Jon Neher, Christopher Sanford, Jaime Hornecker, Allison Cole

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 2 pooled it
4.1field-weighted citation impact, top 5% 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

41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 56 citations in OpenAlex.

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  5. C-reactive protein-guided antibiotic prescribing for COPD exacerbations: a qualitative evaluation.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
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  9. Reducing inappropriate antibiotic prescribing for children in primary care: a cluster randomised controlled trial of two interventions.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018
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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

9 authors at 4 institutions in 1 country.

Victoria HardyDepartment of Family Medicine, University of Washington, Seattle, Washington, USA.
Matthew ThompsonDepartment of Family Medicine, University of Washington, Seattle, Washington, USA.
Gina A KeppelDepartment of Family Medicine, University of Washington, Seattle, Washington, USA.
William AltoSeattle Indian Health Board, Seattle, Washington, USA.
M Ashworth DiracSwedish Family Medicine First Hill, Seattle, Washington, USA.
Jon NeherValley Family Medicine, Renton, Washington, USA.
Christopher SanfordDepartment of Family Medicine, University of Washington, Seattle, Washington, USA.
Jaime HorneckerFamily Medicine Residency, University of Wyoming, Casper, Wyoming, USA.
Allison ColeDepartment of Family Medicine, University of Washington, Seattle, Washington, USA.
University of Washington · USSeattle Indian Health Board · USSwedish Family Medicine Residency - Cherry Hill · USUniversity of Wyoming · US

Funding

Transform Dissemination and Implementation Science in CTSA ProgramsUL1TR002319 · NCATS · UNIVERSITY OF WASHINGTON · PI John K. Amory · 2017 to 2026
$100.0M
Institute of Translational Health SciencesUL1TR000423 · NCATS · UNIVERSITY OF WASHINGTON · PI DISIS, MARY L. · 2012 to 2016
$49.4M
NCATS NIH HHS UL1 TR000423NCATS NIH HHS UL1 TR002319
6 · The paper itself

Abstract

objectiveTo explore clinicians views of the barriers and facilitators to use of C-reactive protein (CRP) point-of-care tests (POCT) in US family medicine clinics for the management of acute respiratory tract infections (ARTIs) in adults.

settingFive family medicine clinics across two US states.

participants30 clinicians including 18 physicians, 9 physician residents, 2 physician assistants and 1 nurse practitioner, took part in the study.

designA qualitative study using a grounded theory approach to thematically analyse focus group interviews.

resultsThese clinicians had limited access to diagnostic tests for patients with ARTI, and very little knowledge of CRP POCT. Three major themes were identified and included the potential clinical role of CRP POCT, concerns related to implementing CRP POCT and evidence needed prior to wider adoption in family medicine. Clinicians believed CRP POCT could support decision-making for some presentations of ARTIs and patient populations when used in conjunction with clinical criteria. Clinicians had concerns about possible overuse and inaccuracy of CRP POCT which they believed might increase antibiotic prescribing rates. Other concerns identified included integration of the test with clinic workflows and cost-effectiveness.

conclusionsClinicians stand at the forefront of antibiotic stewardship efforts, but have few diagnostic tests to help them confidently manage ARTIs. CRP POCT may facilitate some aspects of clinical practice. Incorporating CRP POCT with clinical guidelines may strengthen utility of this test, when there is diagnostic uncertainty.

Indexed as

Attitude of Health PersonnelFamily PracticePhysicians, Primary CarePoint-of-Care TestingAdultAgedAnti-Bacterial AgentsClinical Decision-MakingC-Reactive ProteinFemaleFocus GroupsGrounded TheoryHumansMaleMiddle AgedPhysician AssistantsAnti-Bacterial AgentsC-Reactive ProteinINFECTIOUS DISEASES

Identifiers

PMID28122829
PMCPMC5278283
OpenAlexW2582690631

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.