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Impact of Chest Radiography for Children with Lower Respiratory Tract Infection: A Propensity Score Approach

BACKGROUND: Management of acute respiratory tract infection varies substantially despite this being a condition frequently encountered in pediatric emergency departments. Previous studies have suggested that the use of antibiotics was higher when chest radiography was performed. However none of thes...

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Autores principales: Ecochard-Dugelay, Emmanuelle, Beliah, Muriel, Boisson, Caroline, Perreaux, Francis, de Laveaucoupet, Jocelyne, Labrune, Philippe, Epaud, Ralph, Ducou-Lepointe, Hubert, Bouyer, Jean, Gajdos, Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008561/
https://www.ncbi.nlm.nih.gov/pubmed/24788944
http://dx.doi.org/10.1371/journal.pone.0096189
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author Ecochard-Dugelay, Emmanuelle
Beliah, Muriel
Boisson, Caroline
Perreaux, Francis
de Laveaucoupet, Jocelyne
Labrune, Philippe
Epaud, Ralph
Ducou-Lepointe, Hubert
Bouyer, Jean
Gajdos, Vincent
author_facet Ecochard-Dugelay, Emmanuelle
Beliah, Muriel
Boisson, Caroline
Perreaux, Francis
de Laveaucoupet, Jocelyne
Labrune, Philippe
Epaud, Ralph
Ducou-Lepointe, Hubert
Bouyer, Jean
Gajdos, Vincent
author_sort Ecochard-Dugelay, Emmanuelle
collection PubMed
description BACKGROUND: Management of acute respiratory tract infection varies substantially despite this being a condition frequently encountered in pediatric emergency departments. Previous studies have suggested that the use of antibiotics was higher when chest radiography was performed. However none of these analyses had considered the inherent indication bias of observational studies. OBJECTIVE: The aim of this work was to assess the relationship between performing chest radiography and prescribing antibiotics using a propensity score analysis to address the indication bias due to non-random radiography assignment. METHODS: We conducted a prospective study of 697 children younger than 2 years of age who presented during the winter months of 2006–2007 for suspicion of respiratory tract infection at the Pediatric Emergency Department of an urban general hospital in France (Paris suburb). We first determined the individual propensity score (probability of having a chest radiography according to baseline characteristics). Then we assessed the relation between radiography and antibiotic prescription using two methods: adjustment and matching on the propensity score. RESULTS: We found that performing a chest radiography lead to more frequent antibiotic prescription that may be expressed as OR = 2.3, CI [1.3–4.1], or as an increased use of antibiotics of 18.6% [0.08–0.29] in the group undergoing chest radiography. CONCLUSION: Chest radiography has a significant impact on the management of infants admitted for suspicion of respiratory tract infection in a pediatric emergency department and may lead to unnecessary administration of antibiotics.
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spelling pubmed-40085612014-05-09 Impact of Chest Radiography for Children with Lower Respiratory Tract Infection: A Propensity Score Approach Ecochard-Dugelay, Emmanuelle Beliah, Muriel Boisson, Caroline Perreaux, Francis de Laveaucoupet, Jocelyne Labrune, Philippe Epaud, Ralph Ducou-Lepointe, Hubert Bouyer, Jean Gajdos, Vincent PLoS One Research Article BACKGROUND: Management of acute respiratory tract infection varies substantially despite this being a condition frequently encountered in pediatric emergency departments. Previous studies have suggested that the use of antibiotics was higher when chest radiography was performed. However none of these analyses had considered the inherent indication bias of observational studies. OBJECTIVE: The aim of this work was to assess the relationship between performing chest radiography and prescribing antibiotics using a propensity score analysis to address the indication bias due to non-random radiography assignment. METHODS: We conducted a prospective study of 697 children younger than 2 years of age who presented during the winter months of 2006–2007 for suspicion of respiratory tract infection at the Pediatric Emergency Department of an urban general hospital in France (Paris suburb). We first determined the individual propensity score (probability of having a chest radiography according to baseline characteristics). Then we assessed the relation between radiography and antibiotic prescription using two methods: adjustment and matching on the propensity score. RESULTS: We found that performing a chest radiography lead to more frequent antibiotic prescription that may be expressed as OR = 2.3, CI [1.3–4.1], or as an increased use of antibiotics of 18.6% [0.08–0.29] in the group undergoing chest radiography. CONCLUSION: Chest radiography has a significant impact on the management of infants admitted for suspicion of respiratory tract infection in a pediatric emergency department and may lead to unnecessary administration of antibiotics. Public Library of Science 2014-05-02 /pmc/articles/PMC4008561/ /pubmed/24788944 http://dx.doi.org/10.1371/journal.pone.0096189 Text en © 2014 Ecochard-Dugelay et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Ecochard-Dugelay, Emmanuelle
Beliah, Muriel
Boisson, Caroline
Perreaux, Francis
de Laveaucoupet, Jocelyne
Labrune, Philippe
Epaud, Ralph
Ducou-Lepointe, Hubert
Bouyer, Jean
Gajdos, Vincent
Impact of Chest Radiography for Children with Lower Respiratory Tract Infection: A Propensity Score Approach
title Impact of Chest Radiography for Children with Lower Respiratory Tract Infection: A Propensity Score Approach
title_full Impact of Chest Radiography for Children with Lower Respiratory Tract Infection: A Propensity Score Approach
title_fullStr Impact of Chest Radiography for Children with Lower Respiratory Tract Infection: A Propensity Score Approach
title_full_unstemmed Impact of Chest Radiography for Children with Lower Respiratory Tract Infection: A Propensity Score Approach
title_short Impact of Chest Radiography for Children with Lower Respiratory Tract Infection: A Propensity Score Approach
title_sort impact of chest radiography for children with lower respiratory tract infection: a propensity score approach
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008561/
https://www.ncbi.nlm.nih.gov/pubmed/24788944
http://dx.doi.org/10.1371/journal.pone.0096189
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