Schouten 2007.
| Methods | STUDY DESIGN: cluster RCT, hospital level Risk of Bias: MEDIUM |
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| Participants | PROVIDERS: all physicians PARTICIPANTS: 827 patients with lower respiratory tract infection (before intervention, 212 intervention, 166 control; after intervention, 276 intervention, 166 control). 6 clusters (hospitals) CLINICAL PROBLEM: patients with lower respiratory tract infection SETTING: 6 hospitals in the Netherlands | |
| Interventions | FORMAT: Interventions: audit and feedback; educational meetings with dissemination of guideline; educational outreach by academic detailing; reminders (physical, desktop on computers, and pocket card)
Intervention Functions: education, enablement, environmental restructuring, persuasion
DELIVERER: AMT
COMPARISON: usual care
DESIRED CHANGE: decrease excessive (choice and streamlining) and increase effective (timeliness) POWER CALCULATION: no information |
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| Outcomes | PRESCRIBING: Choice: % patients compliant with guideline for selected drug, timing (within 4 h of presentation), switching from IV to oral and streamlining CLINICAL: Balancing: mortality, length of stay |
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| Notes | FINANCIAL SUPPORT: Funding: The Netherlands Organisation for Health Research and Development (Zon/Mw; 2300.0024). Competing Interests: none declared ADDITIONAL DATA: no response from authors to request for additional data |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Blinded researcher coin flip, hospital level |
| Allocation concealment (selection bias) | Low risk | Allocation at hospital level |
| Blinding (performance bias and detection bias) All outcomes | Unclear risk | No information |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Outcome data for all patients |
| Selective reporting (reporting bias) | Unclear risk | All relevant outcomes reported. |
| Other bias | Low risk | |
| Baseline Outcomes similar? | Low risk | Table 3, also pair‐matched clusters for important variables |
| Free of contamination? | Low risk | Allocation at hospital level |
| Baseline characteristics similar? | Low risk | No clinically relevant differences |