{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:06Z","timestamp":1792785846135,"version":"4.5.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["289940"],"award-info":[{"award-number":["289940"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001502","name":"Blue Cross and Blue Shield of Michigan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001502","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Blue Care Network"},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["K08HS026530"],"award-info":[{"award-number":["K08HS026530"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Community-acquired pneumonia (CAP) is the top indication for inpatient antibiotic use and overuse. We describe the development of 2 electronic clinical quality measures (eCQMs) assessing the percentage of hospitalized patients with uncomplicated CAP who had unsupported antibiotic duration beyond 5 days and empiric antibiotics targeting methicillin-resistant Staphylococcus aureus and\/or Pseudomonas aeruginosa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Both eCQMs were developed based on clinical guidelines, literature, and expert feedback and then specified electronically. The eCQMs were applied to patient data from 2 academic medical centers and 109 Department of Veterans Affairs (VA) healthcare systems to evaluate importance, reliability, validity, and feasibility, as defined by the Centers for Medicare and Medicaid Services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across all hospitals, the mean percentage of eligible patients with unsupported excess duration and inappropriate empiric antibiotic use ranged from 40% to 55% and from 17% to 56%, respectively. Within the VA cohort, reliability (median [first\u2212tenth decile, n]) for duration and empiric eCQMs was high: 93% (63%\u201397%, 28 238) and 91% (63%\u201396%, 47 034), respectively. When compared to chart review at 1 academic hospital, both eCQMs had high sensitivity (96%, both) and specificity (92% and 93% for duration and empiric eCQMs, respectively). Feasibility was maximized by using only data elements in structured electronic health record fields. Some technically complex elements (eg, clinical stability) were retained for face validity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Two eCQMs identifying unsupported excess antibiotic duration and inappropriately broad empiric antibiotic use in patients with uncomplicated CAP had high importance, reliability, validity, and feasibility. These eCQMs could be benchmarked to assist antibiotic stewardship programs in understanding and improving their antibiotic use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag273","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T11:18:47Z","timestamp":1776511127000},"page":"e251-e259","source":"Crossref","is-referenced-by-count":3,"title":["Electronic Clinical Quality Measures of Antibiotic Use in Hospitalized Adults With Uncomplicated Community-Acquired Pneumonia"],"prefix":"10.1093","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7775-5696","authenticated-orcid":false,"given":"Andrea T","family":"White","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4542-992X","authenticated-orcid":false,"given":"Matthew","family":"Bidwell Goetz","sequence":"additional","affiliation":[{"name":"Infectious Diseases Section, VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5580-6739","authenticated-orcid":false,"given":"Makoto","family":"Jones","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Healthcare System Medicine Service, Infectious Diseases Section, , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda M","family":"Neuhauser","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7057-0728","authenticated-orcid":false,"given":"Claire","family":"Ciarkowski","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ratz","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research, Veterans Affairs Ann Arbor Health System , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwin","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School , Ann Arbor, Michigan ,","place":["USA"]},{"name":"Medicine Service, Veterans Affairs Ann Arbor Healthcare System , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8731-105X","authenticated-orcid":false,"given":"Lindsay A","family":"Petty","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Michigan Medical School , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tejal N","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Michigan Medical School , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9837-4187","authenticated-orcid":false,"given":"Mingyuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Data Science Services, University of Utah , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Kent","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Department of Internal Medicine, University of Utah , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1569-0978","authenticated-orcid":false,"given":"Chaorong","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine , Salt Lake City, Utah ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2545-0636","authenticated-orcid":false,"given":"Jennifer K","family":"Horowitz","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Department of Internal Medicine, University of Michigan Medical School , Ann Arbor, Michigan 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