Evidence map›Paper›PMID 36358209›Full record

ArticleAntibiotics (Basel, Switzerland)2022

Look-Back and Look-Forward Durations and the Apparent Appropriateness of Ambulatory Antibiotic Prescribing.

Adriana Guzman, Tiffany Brown, Ji Young Lee, Michael A Fischer, Mark W Friedberg, Kao-Ping Chua, Jeffrey A Linder

Abstract read
In one paragraph

Article in Antibiotics (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

7 authors.

Adriana GuzmanDepartment of Medicine, Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60202, USA.
Tiffany BrownDepartment of Medicine, Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60202, USA.
Ji Young LeeDepartment of Medicine, Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60202, USA.
Michael A FischerDepartment of Medicine, Section of General Internal Medicine, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA.
Mark W FriedbergBlue Cross Blue Shield of Massachusetts, Boston, MA 02199, USA.
Kao-Ping ChuaSusan B. Meister Child Health and Evaluation Research Center, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI 48109, USA.ORCID 0000-0002-4081-272X
Jeffrey A LinderDepartment of Medicine, Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60202, USA.ORCID 0000-0003-2217-184X

Funding

The Claude D. Pepper Older Americans Independence Center (OAIC) at Northwestern UniversityP30AG059988 · NIA · NORTHWESTERN UNIVERSITY AT CHICAGO · PI MCDERMOTT, MARY MCGRAE · 2020 to 2024
$7.1M
ToolBox Detect: Low Cost Detection of Cognitive Decline in Primary Care SettingsR01AG069762 · NIA · NORTHWESTERN UNIVERSITY AT CHICAGO · PI GERSHON, RICHARD, NOWINSKI, CINDY J. · 2020 to 2025
$6.4M
Use of Behavioral Economics in Repeat SARS-CoV-2 Antibody Testing in Disadvantaged CommunitiesR33AG057395 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI DOCTOR, JASON N., SULLIVAN, MARK D · 2019 to 2021
$3.3M
Behavioral Economics Applications to Geriatrics Leveraging EHRs (BEAGLE)R33AG057383 · NIA · NORTHWESTERN UNIVERSITY AT CHICAGO · PI PERSELL, STEPHEN · 2019 to 2021
$2.1M
Using Default Opioid Prescription Settings to Limit Excessive Opioid Prescribing to Adolescents and Young AdultsK08DA048110 · NIDA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHUA, KAO-PING · 2019 to 2023
$983k
Agency for Healthcare Research and Quality R01HS024930AHRQ HHS HHSP233201500020IAHRQ HHS R01 HS024930AHRQ HHS R01 HS026506AHRQ HHS R01 HS028127NIA NIH HHS P30 AG059988NIA NIH HHS R01 AG069762NIA NIH HHS R33 AG057383NIA NIH HHS R33 AG057395NIDA NIH HHS K08 DA048110
6 · The paper itself

Abstract

Ambulatory antibiotic stewards, researchers, and performance measurement programs choose different durations to associate diagnoses with antibiotic prescriptions. We assessed how the apparent appropriateness of antibiotic prescribing changes when using different look-back and look-forward periods. Examining durations of 0 days (same-day), -3 days, -7 days, -30 days, ±3 days, ±7 days, and ±30 days, we classified all ambulatory antibiotic prescriptions in the electronic health record of an integrated health care system from 2016 to 2019 (714,057 prescriptions to 348,739 patients by 2391 clinicians) as chronic, appropriate, potentially appropriate, inappropriate, or not associated with any diagnosis. Overall, 16% percent of all prescriptions were classified as chronic infection related. Using only same-day diagnoses, appropriate, potentially appropriate, inappropriate, and not-associated antibiotics, accounted for 14%, 36%, 22%, and 11% of prescriptions, respectively. As the duration of association increased, the proportion of appropriate antibiotics stayed the same (range, 14% to 18%), potentially appropriate antibiotics increased (e.g., 43% for -30 days), inappropriate stayed the same (range, 22% to 24%), and not-associated antibiotics decreased (e.g., 2% for -30 days). Using the longest look-back-and-forward duration (±30 days), appropriate, potentially appropriate, inappropriate, and not-associated antibiotics, accounted for 18%, 44%, 20%, and 2% of prescriptions, respectively. Ambulatory programs and studies focused on appropriate or inappropriate antibiotic prescribing can reasonably use a short duration of association between an antibiotic prescription and diagnosis codes. Programs and studies focused on potentially appropriate antibiotic prescribing might consider examining longer durations.

Indexed as

anti-bacterial agentsantimicrobial stewardshipcohort studiesdrug utilizationquality of healthcare

Identifiers

PMID36358209
PMCPMC9686988

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.