An observational study of antibiotic prescribing behavior and the Hawthorne effect
An observational study of antibiotic prescribing behavior and the Hawthorne effect
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DOI：
10.1111/1475-6773.10482
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发表时间：
2002-12-01
影响因子：
3.4
通讯作者：
McGlynn, EA
中科院分区：
文献类型：
--
作者：
Mangione-Smith, R;Elliott, MN;McGlynn, EA
目标.评估前瞻性、观察性研究程序（包括问卷和录音）是否与医生诊断决策和抗生素处方的不同模式相关。数据来源/设置。(1)调查数据来自急性上呼吸道疾病儿童治疗模式的前瞻性观察研究（10/96-3/97）和（2）观察研究期间（10/96-3/97）和一年后（10/97-3/98）发生的相同问题的未观察到的遭遇的回顾性病历摘要数据。十名儿科医生在两个社区的做法进行了研究。将病历中记录的诊断模式和观察性研究以外访视（同一时间段和一年后）的抗生素处方与观察性研究期间的诊断模式和抗生素处方进行比较。数据收集/提取方法。对于观察性研究（10/96-2/97），从医生在访视后立即完成的问卷中获得诊断和治疗选择。对于非研究的接触（10/96-3/97和10/97-3/98），数据是从观察性研究完成后一年的病历中提取的。与回顾性分析相比，观察性研究中使用抗生素的病毒病例比例低29个百分点（p
Objectives. To assess whether prospective, observational study procedures, including questionnaires and audio recording, are associated with different patterns of physician diagnostic decision making and antibiotic prescribing.Data Sources/Setting. (1) Survey data from a prospective observational study of treatment patterns for children with acute upper respiratory illnesses (10/96-3/97) and(2) retrospective medical record abstraction data of nonobserved encounters for the same problems occurring during (10/96-3/97) and one year after (10/97-3/98) the observational study period. Ten pediatricians in two community practices were studied.Study Design. Patterns of diagnoses recorded in the medical record and antibiotics ordered for visits occurring outside of the observational study (same time period and one year later) were compared with the pattern of diagnoses and antibiotics ordered during the observational study.Data Collection/Extraction Methods. For the observational study (10/96-2/97), diagnosis and treatment choices were obtained from questionnaires completed by physicians immediately following the visit. For the nonstudy encounters (10/96-3/97 and 10/97-3/98), data were abstracted from medical records one year after the observational study was completed.Principal Findings. The proportion of viral cases in which an antibiotic was prescribed was 29 percentage points lower for the observational study compared to the retrospective analysis (p