Pilot study of a web-based antibiotic decision management guide.

Area of Science:

• Medical Informatics
• Clinical Decision Support

Background:

• Increasing use of electronic medical information resources by healthcare professionals.
• Portable handheld computers enhance access to medical knowledge at the point of patient care.
• Limited understanding of mobile medical information tools' impact on physician learning and decision-making.

Purpose of the Study:

• To evaluate the impact of a mobile medical information tool on physician learning and antibiotic decision-making accuracy.
• To assess the effectiveness of the Johns Hopkins Antibiotic Guide (JHABX) on a personal digital assistant (PDA) in an intensive care setting.

Main Methods:

• A 6-month prospective, randomized pilot study involving 12 trauma and critical care Fellows.
• Randomization of six Fellows to use the JHABX on a Blackberry PDA and six to a non-PDA control group.
• Evaluation of knowledge scores and antibiotic decision accuracy at 3 and 6 months.

Main Results:

• PDA users showed significant improvement in test scores compared to baseline and the non-PDA group at 3 and 6 months.
• Antibiotic decision accuracy improved from 66% to 86.6% among JHABX users, particularly for respiratory, blood, and skin infections.
• No significant improvement in test scores was observed in the control group.

Conclusions:

• Web-based handheld technology effectively supports infectious disease clinical practice.
• Resident physician knowledge and antibiotic decision selection accuracy improved with JHABX use in an intensive care setting.
• Further research on point-of-care technology's impact on patient outcomes is warranted.