{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:01:26Z","timestamp":1791396086884,"version":"4.3.3"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100000925","name":"Australian National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT22022415"],"award-info":[{"award-number":["GNT22022415"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021954","name":"Tour de Cure","doi-asserted-by":"publisher","award":["RSP-237-2024"],"award-info":[{"award-number":["RSP-237-2024"]}],"id":[{"id":"10.13039\/501100021954","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infectious diseases (ID) consultations are associated with improved patient outcomes. We aimed to determine whether ambiguous language affects adherence to recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study of consecutive ID consultations across four campuses of a 2500-bed hospital network in 2024. Ambiguous language use was quantified and described. The relationship between ambiguous language and adherence to recommendations was assessed using univariable and multivariable mixed effects logistic regression, with consult episode as a random effect. Other predictors of ambiguous language and adherence were assessed and adjusted for, including referring unit, consulting team demographics, recommendation type and number of recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 1087 recommendations were made across 250 consecutive consultations. Of these, 106\/1087 (9.8%) used ambiguous language, most commonly the expression \u201cconsider.\u201d Adherence was assessable in 977\/1087 recommendations. Adherence to assessable non-ambiguous recommendations was 87.2% (725\/903 [80.3%] completely followed, 62\/903 [6.9%] partially followed), whereas adherence to ambiguous recommendations was 59.5% (38\/74 [51.4%] totally followed, 6\/74 [8.1%] partially followed, P &amp;lt; .001).<\/jats:p>\n                    <jats:p>In multivariable analysis, recommendations containing ambiguous language were significantly less likely to be followed (adjusted odds ratio [OR] .16, 95% confidence interval [CI] .09\u2013.30, P &amp;lt; .001). Other significant predictors of adherence were therapeutic recommendation, and consultant seniority. There was no association between adherence and clinician gender, referring unit, or total number of recommendations. Use of ambiguous language was more frequent in recommendations that were not immediately actionable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ambiguous language in ID consults is frequent, and is associated with reduced adherence to recommendations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag400","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:42:35Z","timestamp":1782992555000},"page":"411-418","source":"Crossref","is-referenced-by-count":0,"title":["Reconsidering Ambiguous Language in Infectious Disease Consult Recommendations"],"prefix":"10.1093","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9166-9277","authenticated-orcid":false,"given":"Mitchell J","family":"Browne","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Monash Health , Clayton, VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph K","family":"Junckerstorff","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Monash Health , Clayton, VIC ,","place":["Australia"]},{"name":"Department of General Medicine, Monash Health , Clayton, VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen C","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Monash Health , Clayton, VIC ,","place":["Australia"]},{"name":"Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton , VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6642-5365","authenticated-orcid":false,"given":"Claire","family":"Dendle","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Monash Health , Clayton, VIC ,","place":["Australia"]},{"name":"Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton , VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2332-8186","authenticated-orcid":false,"given":"Aleece","family":"MacPhail","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Monash Health , Clayton, VIC ,","place":["Australia"]},{"name":"Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton , VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"2026100713430873000_ciag400-B1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.4103\/0974-777X.112266","article-title":"The pattern and impact of infectious diseases consultation on antimicrobial prescription","volume":"5","author":"Al-Tawfiq","year":"2013","journal-title":"J Glob Infect Dis"},{"key":"2026100713430873000_ciag400-B2","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1086\/520182","article-title":"Impact of infectious diseases specialists and microbiological data on the appropriateness of antimicrobial therapy for bacteremia","volume":"29","author":"Byl","year":"1999","journal-title":"Clin Infect Dis"},{"key":"2026100713430873000_ciag400-B3","doi-asserted-by":"crossref","first-page":"ofz408","DOI":"10.1093\/ofid\/ofz408","article-title":"Early infectious disease consultation is associated with lower mortality in patients with severe sepsis or septic shock who complete the 3-hour sepsis treatment bundle","volume":"6","author":"Madaline","year":"2019","journal-title":"Open Forum Infect Dis"},{"key":"2026100713430873000_ciag400-B4","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1093\/cid\/cit610","article-title":"Infectious diseases specialty intervention is associated with decreased mortality and lower healthcare costs","volume":"58","author":"Schmitt","year":"2014","journal-title":"Clin Infect Dis"},{"key":"2026100713430873000_ciag400-B5","doi-asserted-by":"crossref","first-page":"S588","DOI":"10.1093\/infdis\/jix326","article-title":"The value that infectious diseases physicians bring to the healthcare system","volume":"216","author":"McQuillen","year":"2017","journal-title":"J Infect Dis"},{"key":"2026100713430873000_ciag400-B6","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/0002-9343(83)91079-3","article-title":"The effectiveness of a consultation. 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