ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024
Development of Patient Safety Measures to Identify Inappropriate Diagnosis of Common Infections.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Electronic Clinical Quality Measures of Antibiotic Use in Hospitalized Adults With Uncomplicated Community-Acquired Pneumonia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Clinical and diagnostic evaluation of flank pain in female patients: a retrospective cohort study of 3350 patients.BMC women's health · 2026Article
- Appropriate use of Doxy-PEP and inappropriate antibiotic self-medication for STI management: insights from a LGBTQIA+ survey in Italy.BMC public health · 2026Article
- Evaluation of diagnostic accuracy using routine laboratory parameters.Bioinformation · 2026Article
- [Epidemiological and clinical management aspects related to urinary tract infections diagnosed in the emergency department in elderly patients in Spain: Results of the EDEN-36 study].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Article
- Article
- Navigating performance measures for ambulatory antimicrobial stewardship: a review of HEDIS® and other metrics the steward should know.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Review
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Authors and funding
14 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundInappropriate diagnosis of infections results in antibiotic overuse and may delay diagnosis of underlying conditions. Here we describe the development and characteristics of 2 safety measures of inappropriate diagnosis of urinary tract infection (UTI) and community-acquired pneumonia (CAP), the most common inpatient infections on general medicine services.
methodsMeasures were developed from guidelines and literature and adapted based on data from patients hospitalized with UTI and CAP in 49 Michigan hospitals and feedback from end-users, a technical expert panel (TEP), and a patient focus group. Each measure was assessed for reliability, validity, feasibility, and usability.
resultsTwo measures, now endorsed by the National Quality Forum (NQF), were developed. Measure reliability (derived from 24 483 patients) was excellent (0.90 for UTI; 0.91 for CAP). Both measures had strong validity demonstrated through (a) face validity by hospital users, the TEPs, and patient focus group, (b) implicit case review (ĸ 0.72 for UTI; ĸ 0.72 for CAP), and (c) rare case misclassification (4% for UTI; 0% for CAP) due to data errors (<2% for UTI; 6.3% for CAP). Measure implementation through hospital peer comparison in Michigan hospitals (2017 to 2020) demonstrated significant decreases in inappropriate diagnosis of UTI and CAP (37% and 32%, respectively, P < .001), supporting usability.
conclusionsWe developed highly reliable, valid, and usable measures of inappropriate diagnosis of UTI and CAP for hospitalized patients. Hospitals seeking to improve diagnostic safety, antibiotic use, and patient care should consider using these measures to reduce inappropriate diagnosis of CAP and UTI.
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