Trial reportNature medicine2024
A digital health algorithm to guide antibiotic prescription in pediatric outpatient care: a cluster randomized controlled trial.
Trial report in Nature medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05144763 (Dynamic Clinical Decision Support Algorithms to Manage Sick Children in Primary Health Care Settings in Tanzania), which is not on this map. Cited by 27 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Dynamic Clinical Decision Support Algorithms to Manage Sick Children in Primary Health Care Settings in Tanzania
Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Implementation, adoption and impact of clinical decision support system for antibiotic prescribing in primary care: a systematic review.The Journal of antimicrobial chemotherapy · 2026Pooled it
- Digital patient safety interventions in primary care: a systematic review and meta-analysis.BMC medicine · 2026Pooled it
- Innovative technologies to address neglected tropical diseases in African settings with persistent sociopolitical instability.Nature communications · 2024Pooled it
- Effects of a comprehensive antibiotic stewardship program on antibiotic prescribing for acute respiratory infections in rural facilities: a cluster randomized trial.Nature medicine · 2026Trial
- Trial
- Digital innovations and health information systems: Lessons learned from implementing ALMANACH in Nigeria.PLOS digital health · 2026Article
- Antibiotic and healthcare exposure impact on dynamics of third-generation cephalosporin-resistant Enterobacterales colonisation in Cambodian children: a six-month cohort study.Antimicrobial resistance and infection control · 2026Article
- Article
- Article
- Article
- Better, not just fewer: Rethinking antibiotic prescribing.PLoS medicine · 2026Article
- Digital health and consumer health informatics: past and future.Medical research archives · 2026Article
- Resources consumption and environmental impacts of the DYNAMIC digital health intervention aimed at improving quality of care for sick children in Tanzania: a life cycle assessment.Frontiers in digital health · 2026Article
- Antibiotic stewardship and point-of-care testing for children in 25 low-income and lower-middle-income countries: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- medAL-suite: A software solution for creating and deploying complex clinical decision support algorithms.BMC medical informatics and decision making · 2025Article
- Article
- Article
- Development and implementation of a digital clinical decision support system to increase the quality of primary healthcare delivery in a refugee setting in Chad.BMC primary care · 2025Article
- Implementation of Smart Triage combined with a quality improvement program for children presenting to facilities in Kenya and Uganda: An interrupted time series analysis.PLOS digital health · 2025Article
- State of the Art of Antimicrobial and Diagnostic Stewardship in Pediatric Setting.Antibiotics (Basel, Switzerland) · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Excessive antibiotic use and antimicrobial resistance are major global public health threats. We developed ePOCT+, a digital clinical decision support algorithm in combination with C-reactive protein test, hemoglobin test, pulse oximeter and mentorship, to guide health-care providers in managing acutely sick children under 15 years old. To evaluate the impact of ePOCT+ compared to usual care, we conducted a cluster randomized controlled trial in Tanzanian primary care facilities. Over 11 months, 23,593 consultations were included from 20 ePOCT+ health facilities and 20,713 from 20 usual care facilities. The use of ePOCT+ in intervention facilities resulted in a reduction in the coprimary outcome of antibiotic prescription compared to usual care (23.2% versus 70.1%, adjusted difference -46.4%, 95% confidence interval (CI) -57.6 to -35.2). The coprimary outcome of day 7 clinical failure was noninferior in ePOCT+ facilities compared to usual care facilities (adjusted relative risk 0.97, 95% CI 0.85 to 1.10). There was no difference in the secondary safety outcomes of death and nonreferred secondary hospitalizations by day 7. Using ePOCT+ could help address the urgent problem of antimicrobial resistance by safely reducing antibiotic prescribing. Clinicaltrials.gov Identifier: NCT05144763.
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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.