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Invited Commentary
Feb 25, 2013

Antibiotic Prescribing for Acute Respiratory Infections—Success That's Way Off the MarkComment on “A Cluster Randomized Trial of Decision Support Strategies for Reducing Antibiotic Use in Acute Bronchitis”

Author Affiliations

Author Affiliations: Division of General Medicine and Primary Care, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

JAMA Intern Med. 2013;173(4):273-275. doi:10.1001/jamainternmed.2013.1984

Success is going from failure to failure with no loss of enthusiasm.
Winston Churchill

Imagine for a minute. Imagine in 2013 that the national rate of aspirin use for secondary prevention of coronary artery disease (CAD) is 30%. Imagine that a well-designed, randomized controlled trial of clinical decision support increases the use of aspirin from 30% to 40%. Imagine that the sample size is sufficiently large so that the trial results in a P value of less than .01. Because this was a successful, statistically significant trial, imagine calls to disseminate this intervention with a goal of increasing aspirin use for outpatients with CAD nationwide to 40%.

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