. Author manuscript; available in PMC: 2021 May 14.

Published in final edited form as: J Am Med Dir Assoc. 2020 Jan 20;21(5):675–682.e1. doi: 10.1016/j.jamda.2019.12.004

Table 1.

Clinical Information Incorporated into the Discrete Choice Scenarios by Resident Characteristic

Resident Characteristic	Type of Information	Evidence-based Information^a
Resident Characteristic	Type of Information	Indication to Prescribe	Indication to Not Prescribe
Urinalysis	• Negative leukocyte esterase, negative nitrates, urine results pending^b	No	Yes^1,2
	• Positive leukocyte esterase, positive nitrates, urine results pending	Yes³	No
	• Positive leukocyte esterase, negative nitrates, urine results pending	Equivocal³	No
	• Unavailable/Not performed	No	No

Body Temperature	• Temperature is 97.5°F	No	Yes^4,5
Body Temperature	• Temperature is 101.5°F	Yes^3,6–8	No
	• Temperature is 99.5°F	Yes^3,8,9	No
	• Temperature is 96.5°F	No	No

Lower Urinary Tract Status	• No lower urinary tract signs or symptoms	No	Yes^4,5
	• Painful or difficult urination	Yes^3,6–8,10	No
	• Obvious blood in urine	Yes^3,11	Yes⁸
	• Change in urine clarity or odor	No	Yes¹¹
	• New or worsening frequency	Yes^6,7,10,11	No

Physical Examination	• Normal physical exam	No	Yes^5,12
Physical Examination	• New suprapubic tenderness or costovertebral angle tenderness	Yes^6–8,10,11	No
	• New or increased area of redness and warmth on left lower leg	No	Yes⁴
	• New or increased cough and work of breathing	No	Yes⁴

Antibiotic Request^c13–19	• No antibiotic request from either resident, family, or nurse	No	No
Antibiotic Request^c13–19	• Antibiotic request from family and nurse	No	No
	• Antibiotic request from resident and nurse	No	No
	• Antibiotic request from resident	No	No
	• Antibiotic request from family	No	No
	• Antibiotic request from nurse but not resident or family	No	No

Mental Status	• Usual state of health	No	Yes^4,5
	• New or worsening confusion	Yes^6,7,10	Yes²⁰/Equivocal^21,22
	• New or worsening agitation	Yes^6,7,10	Yes⁸
	• Sleeping more than usual	No	Yes⁸

UTI Risk	• No history of UTIs or current indwelling catheters	No	No
	• Current indwelling catheter and history of three UTIs over the past year	Equivocal^23,24	No
	• History of three UTIs over past year but no current indwelling catheter	No	No
	• Current indwelling catheter but no history of prior UTIs over past year	Equivocal^23,24	No

Functional Status	• Usual state of health	No	Yes^4,5
Functional Status	• New or worsening difficulties with ambulation or transfers	No	Yes⁸
	• New or increased falls	No	Yes⁸
	• Reduced intake of food and liquids	No	Yes⁸
	• New or increased resistance to care	No	Yes

Goals of Care	• Comfort care measures	No	Yes³
	• Full scope of treatment	No	No
	• Limited additional interventions	No	No

Resident Type	• 84 year-old cognitively-intact man	No	No
	• 84 year-old man with dementia	Equivocal^24,25	Equivocal²⁶
	• 84 year-old cognitively-intact woman	Equivocal²⁴	No
	• 84 year-old woman with dementia	Equivocal^24,25	Equivocal²⁶

Evidence-based Information could either be in favor or against prescribing antibiotics, a “yes” response means evidence favors that column, “equivocal” response means evidence is mixed, and a “no” means there is no evidence for that type of information being related to that column.

Italicized items represent DCE reference category.

Although antibiotic request is neither an indication for antibiotic prescribing or not prescribing, it is known to influence prescribing and so was included for that reason.