Chan 2011.
| Methods | STUDY DESIGN: ITS Risk of Bias: MEDIUM |
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| Participants | PROVIDERS: all physicians in the hospital PARTICIPANTS: all patients CLINICAL PROBLEM: use of restricted antibiotics (amikacin, 3rd‐ and 4th‐generation cephalosporins, carbapenems, fluoroquinolones, glycopeptides, and piperacillin/tazobactam) SETTING: 1 university hospital in Taiwan | |
| Interventions | FORMAT, Interventions: educational outreach by review and recommend change; restrictive ‐ expert approval required plus review and make change Intervention Functions: education, enablement, persuasion, restriction DELIVERER: AMT COMPARISON: usual care DESIRED CHANGE: decrease excessive |
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| Outcomes | PRESCRIBING: Choice: DDD/1000 OBD of restricted antibiotics MICROBIAL: isolation rates Clostridium difficile, MRSA, and multidrug‐resistant gram‐negative bacteria |
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| Notes | ADDITIONAL DATA: no response from authors to request for additional data FINANCIAL SUPPORT: Funding: Chang Gung Memorial Hospital (Taoyuan, Taiwan) (grant CMRPG340236). Competing Interests: none declared Microbial Risk of Bias: HIGH (case definition clear, planned intervention but no data about infection control) |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Intervention independent (ITS) ? | Low risk | States in discussion that biggest limitation was lack of external controls, but that is common to all ITS studies. |
| Analysed appropriately (ITS) ? | Low risk | Re‐analysed |
| Shape of effect pre‐specified (ITS) ? | Low risk | Point of analysis was point of intervention. |
| Unlikely to affect data collection (ITS) ? | Unclear risk | DDD data from pharmacy computer, the same pre‐ and postintervention |
| Knowledge of the allocation adequately prevented(ITS)? | Low risk | DDD data from pharmacy computer, the same pre‐ and postintervention |
| Incomplete outcome data addressed (ITS) ? | Low risk | DDD data from pharmacy computer, the same pre‐ and postintervention |
| Free of selected reporting (ITS) ? | Low risk | DDD data from pharmacy computer, the same pre‐ and postintervention |
| Free of other bias (ITS) ? | Low risk | > 1 year data pre‐ and postintervention |