{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T14:31:39Z","timestamp":1776868299151,"version":"3.51.2"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2019,5,11]],"date-time":"2019-05-11T00:00:00Z","timestamp":1557532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100007543","name":"Agence Nationale de S\u00e9curit\u00e9 du M\u00e9dicament et des Produits de sant\u00e9","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007543","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Raisonner pour Mieux Prescrire les Antibiotiques"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Clinical decision support systems (CDSS) implementing clinical practice guidelines (CPGs) have 2 main limitations: they target only patients for whom CPGs provide explicit recommendations, and their rationale may be difficult to understand. These 2 limitations result in poor CDSS adoption. We designed AntibioHelp\u00ae as a CDSS for antibiotic treatment. It displays the recommended and nonrecommended antibiotics, together with their properties, weighted by degree of importance as outlined in the CPGs. The aim of this study was to determine whether AntibioHelp\u00ae could increase the confidence of general practitioners (GPs) in CPG recommendations and help them to extrapolate guidelines to patients for whom CPGs provide no explicit recommendations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We carried out a 2-stage crossover study in which GPs responded to clinical cases using CPG recommendations either alone or with explanations displayed through AntibioHelp\u00ae. We compared error rates, confidence levels, and response times.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 64 GPs. When no explicit recommendation existed for a particular situation, AntibioHelp\u00ae significantly decreased the error rate (\u221241%, P value\u2009=\u20096x10\u221213), and significantly increased GP confidence (+8%, P value\u2009=\u2009.02). This CDSS was considered to be usable by GPs (SUS score = 64), despite a longer interaction time (+9\u201322 seconds). By contrast, AntibioHelp\u00ae had no significant effect if there was an explicit recommendation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion\/Conclusion<\/jats:title>\n                  <jats:p>The visualization of weighted antibiotic properties helps GPs to extrapolate recommendations to patients for whom CPGs provide no explicit recommendations. It also increases GP confidence in their prescriptions for these patients. Further evaluations are required to determine the impact of AntibioHelp\u00ae on antibiotic prescriptions in real clinical practice.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocz057","type":"journal-article","created":{"date-parts":[[2019,4,10]],"date-time":"2019-04-10T11:13:30Z","timestamp":1554894810000},"page":"1010-1019","source":"Crossref","is-referenced-by-count":17,"title":["Helping GPs to extrapolate guideline recommendations to patients for whom there are no explicit recommendations, through the visualization of drug properties. The example of AntibioHelp\u00ae in bacterial diseases"],"prefix":"10.1093","volume":"26","author":[{"given":"Rosy","family":"Tsopra","sequence":"first","affiliation":[{"name":"Universit\u00e9 Paris 13, SMBH, Bobigny, France"},{"name":"AP-HP, Assistance Publique des H\u00f4pitaux de Paris, Paris, France"}]},{"given":"Karima","family":"Sedki","sequence":"additional","affiliation":[{"name":"LIMICS, Universit\u00e9 Paris 13, Sorbonne Universit\u00e9, Inserm, Bobigny, France"}]},{"given":"M\u00e9lanie","family":"Courtine","sequence":"additional","affiliation":[{"name":"LIMICS, Universit\u00e9 Paris 13, Sorbonne Universit\u00e9, Inserm, Bobigny, France"}]},{"given":"Hector","family":"Falcoff","sequence":"additional","affiliation":[{"name":"Soci\u00e9t\u00e9 de Formation Th\u00e9rapeutique du G\u00e9n\u00e9raliste (SFTG), Paris, France"}]},{"given":"Antoine","family":"De Beco","sequence":"additional","affiliation":[{"name":"Soci\u00e9t\u00e9 de Formation Th\u00e9rapeutique du G\u00e9n\u00e9raliste (SFTG), Paris, France"}]},{"given":"Ronni","family":"Madar","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris 13, SMBH, Bobigny, France"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Mecha\u00ef","sequence":"additional","affiliation":[{"name":"AP-HP, H\u00f4pital Avicenne, Service de Maladies Infectieuses, Bobigny, F93000, France"},{"name":"IAME - UMR 1137, Paris, France"}]},{"given":"Jean-Baptiste","family":"Lamy","sequence":"additional","affiliation":[{"name":"LIMICS, Universit\u00e9 Paris 13, Sorbonne Universit\u00e9, Inserm, Bobigny, France"}]}],"member":"286","published-online":{"date-parts":[[2019,5,11]]},"reference":[{"issue":"4","key":"2020110613065250300_ocz057-B1","first-page":"277","article-title":"The antibiotic resistance crisis","volume":"40","author":"Ventola","year":"2015","journal-title":"P T"},{"key":"2020110613065250300_ocz057-B2","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/j.1469-0691.2008.01959.x","article-title":"Appropriate vs inappropriate antimicrobial therapy","volume":"14 (Suppl 3)","author":"Davey","year":"2008","journal-title":"Clin Microbiol Infect"},{"key":"2020110613065250300_ocz057-B3"},{"key":"2020110613065250300_ocz057-B4"},{"issue":"1","key":"2020110613065250300_ocz057-B5","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1111\/j.1469-0691.2010.03179.x","article-title":"Junior doctors\u2019 knowledge and perceptions of antibiotic resistance and prescribing: a survey in France and Scotland","volume":"17","author":"Pulcini","year":"2011","journal-title":"Clin Microbiol Infect"},{"issue":"5","key":"2020110613065250300_ocz057-B6","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1093\/fampra\/cmm040","article-title":"Socially responsible antibiotic choices in primary care: a qualitative study of GPs\u2019 decisions to prescribe broad-spectrum and fluroquinolone antibiotics","volume":"24","author":"Wood","year":"2007","journal-title":"Fam Pract"},{"issue":"7182","key":"2020110613065250300_ocz057-B7","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1136\/bmj.318.7182.527","article-title":"Potential benefits, limitations, and harms of clinical guidelines","volume":"318","author":"Woolf","year":"1999","journal-title":"BMJ"},{"issue":"8","key":"2020110613065250300_ocz057-B8","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.cmi.2017.02.028","article-title":"A systematic review of clinical decision support systems for antimicrobial management: are we failing to investigate these interventions appropriately?","volume":"23","author":"Rawson","year":"2017","journal-title":"Clin Microbiol Infect"},{"key":"2020110613065250300_ocz057-B9","doi-asserted-by":"crossref","first-page":"10.","DOI":"10.1186\/1472-6947-4-10","article-title":"Algorithms for optimizing drug therapy","volume":"4","author":"Wanger","year":"2004","journal-title":"BMC Med Inform Decis Mak"},{"issue":"17","key":"2020110613065250300_ocz057-B10","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1001\/jama.2016.4151","article-title":"Prevalence of Inappropriate Antibiotic Prescriptions Among US Ambulatory Care Visits, 2010-2011","volume":"315","author":"Fleming-Dutra","year":"2016","journal-title":"JAMA"},{"issue":"10","key":"2020110613065250300_ocz057-B11","doi-asserted-by":"crossref","DOI":"10.1001\/jama.286.10.1181","article-title":"Antibiotic treatment of adults with sore throat by community primary care physicians: a national survey, 1989\u20131999","volume":"286","author":"Linder","year":"2001","journal-title":"JAMA"},{"issue":"7","key":"2020110613065250300_ocz057-B12","doi-asserted-by":"crossref","first-page":"525","DOI":"10.7326\/0003-4819-138-7-200304010-00008","article-title":"Changing use of antibiotics in community-based outpatient practice, 1991\u20131999","volume":"138","author":"Steinman","year":"2003","journal-title":"Ann Intern Med"},{"issue":"15","key":"2020110613065250300_ocz057-B13","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1001\/jama.282.15.1458","article-title":"Why don\u2019t physicians follow clinical practice guidelines? 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