ArticlePloS one2019
Validating a popular outpatient antibiotic database to reliably identify high prescribing physicians for patients 65 years of age and older.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Spillover From an Intervention on Antibiotic Prescribing for Family Physicians: A Post Hoc Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2025Trial
- Universal Free Contraception Coverage Policy, Out-of-Pocket Payments, and Costs.JAMA health forum · 2026Article
- Association between high-intensity antibiotic prescribing and prescribing of psychotropic drugs in children: a population-based study.BMJ paediatrics open · 2026Article
- Overview of Methods for Assessing Antimicrobial Use in Outpatient Settings in High-Income Countries: A Narrative Review.Antibiotics (Basel, Switzerland) · 2025Review
- Universal Pharmacare and Contraceptive Dispensations Among Youth.JAMA pediatrics · 2025Article
- Effect of universal no-cost coverage on use of long-acting reversible contraception and all prescription contraception: population based, controlled, interrupted time series analysis.BMJ (Clinical research ed.) · 2025Article
- Monitoring community antibiotic consumption in Belgium: reimbursement versus retail data (2013-22).The Journal of antimicrobial chemotherapy · 2025Article
- Top publications for advancing state and local health department antimicrobial stewardship programs.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Trends in diabetes medication prescribing from 2018 to 2021: A cross-sectional analysis.PloS one · 2024Article
- Understanding the differential effect of local socio-economic conditions on the relation between prescription opioid supply and drug overdose deaths in US counties.Addiction (Abingdon, England) · 2023Article
- Variability in changes in physician outpatient antibiotic prescribing from 2019 to 2021 during the COVID-19 pandemic in Ontario, Canada.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Quantifying antibiotic use in typhoid fever in India: a cross-sectional analysis of private sector medical audit data, 2013-2015.BMJ open · 2022Article
- The impact of COVID-19 on community antibiotic use in Canada: an ecological study.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2022Article
- Antimicrobial stewardship in rural and remote primary health care: a narrative review.Antimicrobial resistance and infection control · 2021Review
- Academic detailing to improve appropriate opioid prescribing: a mixed-methods process evaluation.CMAJ openArticle
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- Interprovincial variation in antibiotic use in Canada, 2019: a retrospective cross-sectional study.CMAJ openArticle
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9 authors.
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Abstract
objectiveMany jurisdictions lack comprehensive population-based antibiotic use data and rely on third party companies, most commonly IQVIA. Our objective was to validate the accuracy of the IQVIA Xponent antibiotic database in identifying high prescribing physicians compared to the reference standard of a highly accurate population-wide database of outpatient antimicrobial dispensing for patients ≥65 years.
methodsWe conducted this study between 1 March 2016 and 28 February 2017 in Ontario, Canada. We evaluated the agreement and correlation between the databases using kappa statistics and Bland-Altman plots. We also assessed performance characteristics for Xponent to accurately identify high prescribing physicians with sensitivity, specificity, positive predictive value (PPV), and negative predictive value.
resultsWe included 9,272 physicians. The Xponent database has a specificity of 92.4% (95%CI 92.0%-92.8%) and PPV of 77.2% (95%CI 76.0%-78.4%) for correctly identifying the top 25th percentile of physicians by antibiotic volume. In the sensitivity analysis, 94% of the top 25th percentile physicians in Xponent were within the top 40th percentile in the reference database. The mean number of antibiotic prescriptions per physician were similar with a relative difference of -0.4% and 2.7% for female and male patients, respectively. The error was greater in rural areas with a relative difference of -8.4% and -5.6% per physician for female and male patients, respectively. The weighted kappa for quartile agreement was 0.68 (95%CI 0.67-0.69).
conclusionWe validated the IQVIA Xponent antibiotic database to identify high prescribing physicians for patients ≥65 years, and identified some important limitations. Collecting accurate population-based antibiotic use data will remain vital to global antimicrobial stewardship efforts.
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