Uçkay 2009.
Methods | STUDY DESIGN: ITS Risk of Bias: HIGH |
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Participants | PROVIDERS: all physicians in one orthopaedic unit PARTICIPANTS: all patients in one orthopaedic unit CLINICAL PROBLEM: suspected bone and joint infection SETTING: 1 hospital in Switzerland | |
Interventions | FORMAT: Interventions: educational outreach by review and recommend change. The intervention is reported in 2 phases, the 1st delivered by "Dedicated ID specialist and one internist" and the 2nd delivered by "ID specialist with experience in Infection Control". Intervention Functions: enablement, persuasion DELIVERER: specialist (ID) physician COMPARISON: usual care DESIRED CHANGE: decrease excessive | |
Outcomes | PRESCRIBING: Choice: use of IV and oral antibiotics in DDD/1000 OBD | |
Notes | FINANCIAL SUPPORT: Funding: none.Competing Interests: none declared. ADDITIONAL DATA: email response from authors with additional data about the intervention |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Intervention independent (ITS) ? | Unclear risk | Insufficient information to assess |
Analysed appropriately (ITS) ? | Low risk | Time series analysis with ARIMA modelling |
Shape of effect pre‐specified (ITS) ? | Low risk | Point of intervention was point of analysis. |
Unlikely to affect data collection (ITS) ? | Unclear risk | Outcome data were from routine pharmacy systems. |
Knowledge of the allocation adequately prevented(ITS)? | Low risk | Outcome data were from routine pharmacy systems. |
Incomplete outcome data addressed (ITS) ? | Low risk | Outcome data were from routine pharmacy systems. |
Free of selected reporting (ITS) ? | High risk | The information in Table 1 does not include total antibiotic use or cost, so cannot be used to support the claims made in the paper. |
Free of other bias (ITS) ? | High risk | < 1 year pre‐intervention data Insufficient information to assess. In particular, it is not clear what difference the "ID specialist with experience in Infection Control" would make compared with "Dedicated ID specialist and one internist". |