Evidence map›Paper›PMID 37523381›Full record

Trial reportPloS one2023

A cluster randomized trial assessing the impact of personalized prescribing feedback on antibiotic prescribing for uncomplicated acute cystitis to family physicians.

Greg Carney, Malcolm Maclure, David M Patrick, Anat Fisher, Dana Stanley, Ken Bassett, Colin R Dormuth

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 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

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Audit and Feedback Interventions for Antibiotic Prescribing in Primary Care: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025
    Pooled it
  3. Trial
  4. Trial
  5. 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

7 authors.

Greg CarneyTherapeutics Initiative, University of British Columbia, Vancouver, BC, Canada.ORCID 0000-0002-7438-5172
Malcolm MaclureTherapeutics Initiative, University of British Columbia, Vancouver, BC, Canada.
David M PatrickBritish Columbia Centre for Disease Control, Vancouver, BC, Canada.
Anat FisherTherapeutics Initiative, University of British Columbia, Vancouver, BC, Canada.ORCID 0000-0001-9730-5107
Dana StanleyTherapeutics Initiative, University of British Columbia, Vancouver, BC, Canada.
Ken BassettTherapeutics Initiative, University of British Columbia, Vancouver, BC, Canada.
Colin R DormuthTherapeutics Initiative, University of British Columbia, Vancouver, BC, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the impact of personalized prescribing portraits on antibiotic prescribing for treating uncomplicated acute cystitis (UAC) by Family Physicians (FPs).

designCluster randomized control trial.

settingThe intervention was conducted in the primary care setting in the province of BC between December 2010 and February 2012.

participantsWe randomized 4 833 FPs by geographic location into an Early intervention arm (n = 2 417) and a Delayed control arm (n = 2 416).

interventionThe Education for Quality Improvement in Patient Care (EQIP) program mailed to each FP in BC, a 'portrait' of their individual prescribing of antibiotics to women with UAC, plus therapeutic recommendations and a chart of trends in antibiotic resistance.

main outcome measuresAntibiotic prescribing preference to treat UAC.

resultsImplementing exclusion criteria before and after a data system change in the Ministry of Health caused the arms to be unequal in size-intervention arm (1 026 FPs, 17 637 UAC cases); control arm (1 352 FPs, 25 566 UAC cases)-but they were well balanced by age, sex and prior rates of prescribing antibiotics for UAC. In the early intervention group probability of prescribing nitrofurantoin increased from 28% in 2010 to 38% in 2011, a difference of 9.9% (95% confidence interval [CI], 9.1% to 10.7. Ciprofloxacin decreased by 6.2% (95% CI: 5.6% to 6.9%) and TMP-SMX by 3.7% (95% CI: 3.1% to 4.2%). Among 295 FPs who completed reflective surveys, 52% said they were surprized by the E. coli resistance statistics and 57% said they planned to change their treatment of UAC.

conclusionThe EQIP intervention demonstrated that feedback of personal data to FPs on their prescribing, plus population data on antibiotic resistance, with a simple therapeutic recommendation, can significantly improve prescribing of antibiotics. Trial registration: ISRCTN 16938907.

Indexed as

CystitisPhysicians, FamilyAcute DiseaseAnti-Bacterial AgentsEscherichia coliFeedbackFemaleHumansInappropriate PrescribingPractice Patterns, Physicians'Anti-Bacterial Agents

Identifiers

PMID37523381
PMCPMC10389722

What OpenQuestion holds

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Registered trials

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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.