Evidence map›Paper›PMID 29330244›Full record

ArticleJournal of the American Board of Family Medicine : JABFM

Primary Care Physicians' Struggle with Current Adult Pneumococcal Vaccine Recommendations.

Laura P Hurley, Mandy A Allison, Tamara Pilishvili, Sean T O'Leary, Lori A Crane, Michaela Brtnikova, Brenda L Beaty, Megan C Lindley, Carolyn B Bridges, Allison Kempe

Abstract read
In one paragraph

Article in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

19 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  17. Challenges facing vaccinators in the 21Human vaccines & immunotherapeutics · 2019
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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

10 authors.

Laura P HurleyFrom the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora (LPH, MAA, STO, LAC, MB, BLB, AK); the Division of General Internal Medicine, Denver Health, Denver, CO (LPH); the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (TP, MCL, CBB); and the Departments of Pediatrics (MAA, STO, MB, AK) and Community and Behavioral Health (LAC), University of Colorado Anschutz Medical Campus, Aurora. Laura.Hurley@dhha.org.
Mandy A AllisonFrom the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora (LPH, MAA, STO, LAC, MB, BLB, AK); the Division of General Internal Medicine, Denver Health, Denver, CO (LPH); the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (TP, MCL, CBB); and the Departments of Pediatrics (MAA, STO, MB, AK) and Community and Behavioral Health (LAC), University of Colorado Anschutz Medical Campus, Aurora.
Tamara PilishviliFrom the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora (LPH, MAA, STO, LAC, MB, BLB, AK); the Division of General Internal Medicine, Denver Health, Denver, CO (LPH); the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (TP, MCL, CBB); and the Departments of Pediatrics (MAA, STO, MB, AK) and Community and Behavioral Health (LAC), University of Colorado Anschutz Medical Campus, Aurora.
Sean T O'LearyFrom the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora (LPH, MAA, STO, LAC, MB, BLB, AK); the Division of General Internal Medicine, Denver Health, Denver, CO (LPH); the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (TP, MCL, CBB); and the Departments of Pediatrics (MAA, STO, MB, AK) and Community and Behavioral Health (LAC), University of Colorado Anschutz Medical Campus, Aurora.
Lori A CraneFrom the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora (LPH, MAA, STO, LAC, MB, BLB, AK); the Division of General Internal Medicine, Denver Health, Denver, CO (LPH); the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (TP, MCL, CBB); and the Departments of Pediatrics (MAA, STO, MB, AK) and Community and Behavioral Health (LAC), University of Colorado Anschutz Medical Campus, Aurora.
Michaela BrtnikovaFrom the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora (LPH, MAA, STO, LAC, MB, BLB, AK); the Division of General Internal Medicine, Denver Health, Denver, CO (LPH); the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (TP, MCL, CBB); and the Departments of Pediatrics (MAA, STO, MB, AK) and Community and Behavioral Health (LAC), University of Colorado Anschutz Medical Campus, Aurora.
Brenda L BeatyFrom the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora (LPH, MAA, STO, LAC, MB, BLB, AK); the Division of General Internal Medicine, Denver Health, Denver, CO (LPH); the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (TP, MCL, CBB); and the Departments of Pediatrics (MAA, STO, MB, AK) and Community and Behavioral Health (LAC), University of Colorado Anschutz Medical Campus, Aurora.
Megan C LindleyFrom the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora (LPH, MAA, STO, LAC, MB, BLB, AK); the Division of General Internal Medicine, Denver Health, Denver, CO (LPH); the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (TP, MCL, CBB); and the Departments of Pediatrics (MAA, STO, MB, AK) and Community and Behavioral Health (LAC), University of Colorado Anschutz Medical Campus, Aurora.
Carolyn B BridgesFrom the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora (LPH, MAA, STO, LAC, MB, BLB, AK); the Division of General Internal Medicine, Denver Health, Denver, CO (LPH); the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (TP, MCL, CBB); and the Departments of Pediatrics (MAA, STO, MB, AK) and Community and Behavioral Health (LAC), University of Colorado Anschutz Medical Campus, Aurora.
Allison KempeFrom the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora (LPH, MAA, STO, LAC, MB, BLB, AK); the Division of General Internal Medicine, Denver Health, Denver, CO (LPH); the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (TP, MCL, CBB); and the Departments of Pediatrics (MAA, STO, MB, AK) and Community and Behavioral Health (LAC), University of Colorado Anschutz Medical Campus, Aurora.

Funding

Rapid-Cycle Survey Collaborative for Provider Input on Immunization Issues: Vaccine Policy Collaborative InitiativeU01IP001072 · IP · UNIVERSITY OF COLORADO DENVER · PI KEMPE, ALLISON · 2017 to 2019
$1.4M
Rapid-cycle Survey Collaborative for Provider Input on Immunization IssuesU01IP000849 · IP · UNIVERSITY OF COLORADO DENVER · PI KEMPE, ALLISON · 2014 to 2016
$1.3M
Intramural CDC HHS CC999999NCIRD CDC HHS U01 IP000849NCIRD CDC HHS U01 IP001072
6 · The paper itself

Abstract

introductionIn 2012, the Advisory Committee on Immunization Practices recommended 13-valent pneumococcal conjugate vaccine (PCV13) in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23) for at-risk adults ≥19; in 2014, it expanded this recommendation to adults ≥65. Primary care physicians' practice, knowledge, attitudes, and beliefs regarding these recommendations are unknown.

methodsPrimary care physicians throughout the U.S. were surveyed by E-mail and post from December 2015 to January 2016.

resultsResponse rate was 66% (617 of 935). Over 95% of respondents reported routinely assessing adults' vaccination status and recommending both vaccines. A majority found the current recommendations to be clear (50% "very clear," 38% "somewhat clear"). Twenty percent found the upfront cost of purchasing PCV13, lack of insurance coverage, inadequate reimbursement, and difficulty determining vaccination history to be "major barriers" to giving these vaccines. Knowledge of recommendations varied, with 83% identifying the PCV13 recommendation for adults ≥65 and only 21% identifying the recommended interval between PCV13 and PPSV23 in an individual <65 at increased risk.

conclusionsAlmost all surveyed physicians reported recommending both pneumococcal vaccines, but a disconnect seems to exist between perceived clarity and knowledge of the recommendations. Optimal implementation of these recommendations will require addressing knowledge gaps and reported barriers.

Indexed as

AdultAgedAge FactorsClinical CompetenceFemaleHealth Plan ImplementationHumansImmunization ScheduleMaleMiddle AgedPhysicians, Primary CarePneumococcal InfectionsPneumococcal VaccinesPractice Guidelines as TopicSurveys and QuestionnairesUnited States23-valent pneumococcal capsular polysaccharide vaccinePneumococcal VaccinesVaccines, ConjugateFamily PhysiciansInsurance CoveragePneumococcal VaccinesPrimary Care PhysiciansVaccination

Identifiers

PMID29330244
PMCPMC5774021

What OpenQuestion holds

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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.