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Invited Commentary
Feb 25, 2013

Antibiotic Prescribing for Acute Respiratory Infections—Success That's Way Off the Mark: Comment 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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