Use of Computerized Clinical Decision Support for Diagnostic Stewardship in Clostridioides difficile testing: an Academic Hospital Quasi-Experimental Study
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.
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 WORDSdiagnostic stewardship overdiagnosis Clostridium difficile clinical decision support
Compliance with Ethical Standards
Conflict of Interest
The authors declare no conflicts of interest.
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