New tools to measure discrepancy between prescribing practices and guideline recommendations.
OBJECTIVE
To study the performance of a new method designed to measure discrepancy between real prescriptions and evidence-based reference treatments.


METHODS
Two different indices (additive and multiplicative) are proposed to summarize deviation between prescription and reference. Deviations thought to be observed in a population of prescribers are simulated in diverse hypothetical situations in the presence or absence of evidence-based references. The performances of both indices are compared and their sensitivities to change are explored.


RESULTS
Both indices are sensitive to variation in prescriber behaviour. The additive index allows a more accurate analysis of deviation while the multiplicative index is simpler to implement and interpret but more sensitive to change.


CONCLUSIONS
The two deviation indices may be used as new tools in surveys or trials dealing with prescribing practices.
Service de Biostatistique, Hospices Civils de Lyon, Lyon, France. catherine.mercier@chu-lyon.fr
Catherine
C
Mercier
Jean-Pierre
JP
Boissel
Jacques
J
Estève
Jean
J
Iwaz
Patrice
P
Nony
D000465:Algorithms; D019317:Evidence-Based Medicine; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000458:organization & administration / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity