Antimicrobial Stewardship, Otitis Media
Conditions
Brief summary
Randomized controlled trial involving 40 pediatric primary care clinicians with high rates of diagnosing and treating middle ear infections. Ten enrolled clinicians will be randomly assigned to each of 4 arms for a three-month trial: 1) personalized education and feedback about proper ear infection diagnosis; 2) use of a digital otoscope; 3) both education and feedback plus use of a digital otoscope; 4) control (no intervention).
Detailed description
Randomized controlled trial involving 40 pediatric primary care clinicians with rates of otitis media diagnosis and antibiotic prescribing in the top quartile of the entire clinician population of the Pediatric Physicians' Organization at Children's over the previous 12 months who consent to enroll in the trial after direct outreach from the study team. Ten enrolled clinicians will be randomly assigned to each of 4 arms for a three-month intervention period: 1) personalized education and feedback about proper otitis media diagnosis following criteria from the American Academy of Pediatrics; 2) use of the Wispr digital otoscope; 3) both education and feedback plus use of the Wispr digital otoscope; 4) control (no intervention).
Interventions
OTHEREducation with personalized performance feedback
Education about proper otitis media diagnosis following criteria from the American Academy of Pediatrics with personalized performance feedback on otitis media diagnosis and treatment rates delivered via email
DEVICEUse of digital otoscope
Use of the Wispr digital otoscope to diagnose otitis media in place of a traditional visual otoscope
Sponsors
Boston Children's Hospital
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
2x2 factorial design comparing effect of Wispr digital otoscope, education with performance feedback, both, or neither on diagnosis and antibiotic treatment of otitis media in young children.
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Pediatric primary care clinicians from the Pediatric Physicians' Organization at Children's with an Otitis Media Treatment Index for the previous 12 months in the top quartile of all Pediatric Physicians' Organization at Children's clinicians with at least 100 qualifying encounters in the year
Exclusion criteria
* Currently using any digital otoscope * More than one other clinician from the same practice participating in the trial
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in OMTI | 3 months | Proportion of encounters in children 6-59 months of age with any respiratory diagnosis who are diagnosed with otitis media and treated with a systemic antibiotic. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in overall antibiotic courses prescribed | 3 months | Courses of systemic antibiotics per 1000 children per year among children 6-59 months of age. |
| Change in overall prescribed antibiotic days | 3 months | Total days of systemic antibiotics per 1000 children per year among children 6-59 months of age. |
| Clinician confidence and satisfaction in diagnosing OM and preference for digital versus traditional otoscope | 3 months | Clinician responses to a pre- and post-intervention surveys regarding confidence in diagnosing otitis media and satisfaction with digital versus traditional otoscope. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORLouis Vernacchio, MD, MSc
Pediatric Physicians' Organization at Children's
Outcome results
None listed