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Harnessing the wisdom of crowds can improve guideline compliance of antibiotic prescribers and support antimicrobial stewardship

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journal contribution
posted on 24.03.2021, 16:35 by Eva Krockow, Ralf HJM Kurvers, Stefan M Herzog, Juliane E Kammer, Ryan A Hamilton, Nathalie Thilly, Gabriel Macheda, Celine Pulcini
Antibiotic overprescribing is a global challenge contributing to rising levels of antibiotic resistance and mortality. We test a novel approach to antibiotic stewardship. Capitalizing on the concept of “wisdom of crowds”, which states that a group’s collective judgement often outperforms the average individual, we test whether pooling treatment durations recommended by different prescribers can improve antibiotic prescribing. Using international survey data from 787 expert antibiotic prescribers, we run computer simulations to test the performance of the wisdom of crowds by comparing three data aggregation rules across different clinical cases and group sizes. We also identify patterns of prescribing bias in recommendations about antibiotic treatment durations to quantify current levels of overprescribing. Our results suggest that pooling the treatment recommendations (using the median) could improve guideline compliance in groups of three or more prescribers. Implications for antibiotic stewardship and the general improvement of medical decision-making are discussed. Clinical applicability is likely to be greatest in the context of hospital ward rounds and larger, multidisciplinary team meetings, where complex patient cases are discussed and existing guidelines provide limited guidance.

History

Citation

Sci Rep 10, 18782 (2020). https://doi.org/10.1038/s41598-020-75063-z

Author affiliation

Department of Neuroscience, Psychology and Behaviour, College of Life Sciences

Version

VoR (Version of Record)

Published in

Scientific Reports

Volume

10

Publisher

Nature Publishing Group

issn

2045-2322

Acceptance date

09/10/2020

Copyright date

2020

Available date

24/03/2021

Language

en