Evidence map›Paper›PMID 32704514›Full record

ArticleOpen forum infectious diseases2020

Effective Antimicrobial StewaRdship StrategIES (ARIES): Cluster Randomized Trial of Computerized Decision Support System and Prospective Review and Feedback.

Shi Thong Heng, Joshua Wong, Barnaby Young, Hui Lin Tay, Sock Hoon Tan, Min Yi Yap, Christine B Teng, Brenda Ang, Tau Hong Lee, Hui Ling Tan and 3 more

Open access · goldAbstract read
In one paragraph

Article in Open forum infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.7field-weighted citation impact, top 25% 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

6 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Observational
  3. Review
  4. Article
  5. Machine Learning and Antibiotic Management.Antibiotics (Basel, Switzerland) · 2022
    Article
  6. 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

13 authors at 3 institutions in 1 country.

Shi Thong HengDepartment of Pharmacy, Tan Tock Seng Hospital, Singapore.
Joshua WongOffice of Clinical Epidemiology, Analytics, and kNowledge (OCEAN), Tan Tock Seng Hospital, Singapore.
Barnaby YoungDepartment of Infectious Diseases, National Centre for Infectious Disease, Singapore.ORCID 0000-0003-1010-2230
Hui Lin TayDepartment of Pharmacy, Tan Tock Seng Hospital, Singapore.
Sock Hoon TanDepartment of Pharmacy, Tan Tock Seng Hospital, Singapore.
Min Yi YapDepartment of Pharmacy, Tan Tock Seng Hospital, Singapore.
Christine B TengDepartment of Pharmacy, Tan Tock Seng Hospital, Singapore.
Brenda AngDepartment of Infectious Diseases, National Centre for Infectious Disease, Singapore.
Tau Hong LeeDepartment of Infectious Diseases, National Centre for Infectious Disease, Singapore.
Hui Ling TanDepartment of Anaesthesiology, Intensive Care and Pain Medicine, Tan Tock Seng Hospital, Singapore.
Thomas W LewDepartment of Anaesthesiology, Intensive Care and Pain Medicine, Tan Tock Seng Hospital, Singapore.
David Chien LyeDepartment of Infectious Diseases, National Centre for Infectious Disease, Singapore.
Tat Ming NgDepartment of Pharmacy, Tan Tock Seng Hospital, Singapore.ORCID 0000-0002-4570-3266
Tan Tock Seng Hospital · SGNational Centre for Infectious Diseases · SGNational University of Singapore · SG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProspective review and feedback (PRF) of antibiotic prescriptions and compulsory computerized decision support system (CDSS) are 2 strategies of antimicrobial stewardship. There are limited studies investigating their combined effects. We hypothesized that the use of on-demand (voluntary) CDSS would achieve similar patient outcomes compared with automatically triggered (compulsory) CDSS whenever broad-spectrum antibiotics are ordered.

methodsA parallel-group, 1:1 block cluster randomized crossover study was conducted in 32 medical and surgical wards from March to August 2017. CDSS use for piperacillin-tazobactam or carbapenem in the intervention clusters was at the demand of the doctor, while in the control clusters CDSS use was compulsory. PRF was continued for both arms. The primary outcome was 30-day mortality.

resultsSix hundred forty-one and 616 patients were randomized to voluntary and compulsory CDSS, respectively. There were no differences in 30-day mortality (hazard ratio [HR], 0.87; 95% CI, 0.67-1.12), re-infection and re-admission rates, antibiotic duration, length of stay, or hospitalization cost. The proportion of patients receiving PRF recommendations was not significantly lower in the voluntary CDSS arm (62 [10%] vs 81 [13%];

conclusionsVoluntary broad-spectrum antibiotics with PRF via CDSS did not result in differing clinical outcomes, antibiotic duration, or length of stay. However, in the setting of low antibiotic appropriateness, compulsory CDSS may be beneficial.

Indexed as

antimicrobial stewardshipappropriate antibioticscluster randomized controlled trialscomputerized decision supportprospective review and feedback

Identifiers

PMID32704514
PMCPMC7368373
OpenAlexW3040426862

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.