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Use of Computerized Clinical Decision Support for Diagnostic Stewardship in Clostridioides difficile testing: an Academic Hospital Quasi-Experimental Study

  • Anne E. Friedland
  • Sara Brown
  • Danielle R. Glick
  • Martha C. Lusby
  • Daniel Lemkin
  • Surbhi Leekha
Concise Research Reports

INTRODUCTION

Overdiagnosis of Clostridioides difficile as a cause of healthcare-associated diarrhea is a prevalent problem in the USA due to increasing use of highly sensitive nucleic acid amplification tests, combined with a low threshold for testing of patients in the absence of significant diarrhea and in the presence of laxatives.1, 2, 3 Others have reported on efforts at reducing unnecessary C. difficile testing through computerized clinical decision support (CCDS), with variable results.4, 5 We conducted a quasi-experimental study to evaluate the impact of CCDS on appropriateness of C. difficile testing.

METHODS

This study was part of a quality improvement project at our 750-bed tertiary-care academic hospital, and was determined to be non-human subjects research by the University of Maryland IRB. Among consecutive hospitalized patients undergoing C. difficiletesting from 2/19/16 to 3/19/16, charts were reviewed for presence of clinically significant diarrhea (i.e., ≥ 3 loose...

KEY WORDS

diagnostic stewardship overdiagnosis Clostridium difficile clinical decision support 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest.

References

  1. 1.
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Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Anne E. Friedland
    • 1
  • Sara Brown
    • 1
  • Danielle R. Glick
    • 1
  • Martha C. Lusby
    • 1
  • Daniel Lemkin
    • 2
  • Surbhi Leekha
    • 2
  1. 1.University of Maryland Medical CenterBaltimoreUSA
  2. 2.University of Maryland School of MedicineBaltimoreUSA

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