TABLE 2.

Factors Associated With Reporting Greater Adherence to Evidence-Based Management and Less Use of Therapies/Tests of Unproven Benefit

OR (95% CI)
Hospitalist Versus Community PediatricianAcademic Setting Versus Community HospitalaTime Attending (>90 d/y Versus ≤90 d/y)bTime Out of Residency (≤10 y Versus >10 y)cGraduate/Fellowship Training Versus No Graduate/Fellowship Trainingd
UTIe
    Renal ultrasound4.17 (1.39–12.47)f3.17 (1.06–9.51)f0.93 (0.40–2.16)1.16 (0.50–2.70)0.81 (0.34–1.93)
    VCUG3.24 (1.56–6.73)f2.12 (1.04–4.32)f1.03 (0.55–1.94)1.64 (0.86–3.13)0.95 (0.50–1.81)
Asthma
    Albuterole3.51 (1.57–7.85)f2.25 (1.04–4.89)f1.33 (0.67–2.26)1.34 (0.68–2.67)3.21 (1.31–7.87)f
    Ipratropium in first 24 he3.61 (2.38–5.47)f1.23 (0.82–1.83)1.77 (1.19–2.67)f2.69 (1.79–4.03)f1.36 (0.90–2.05)
    Steroidse2.03 (0.82–5.02)0.60 (0.26–1.36)0.98 (0.43–2.24)1.27 (0.55–2.94)0.72 (0.31–1.66)
    No ipratropium after 24 hg1.61 (1.08–2.42)f1.30 (0.86–1.97)1.49 (0.99–2.24)0.71 (0.47–1.05)0.73 (0.48–1.10)
Bronchiolitisg
    Levalbuterol5.61 (3.60–8.73)f2.75 (1.79–4.23)f2.65 (1.75–4.01)f1.24 (0.84–1.85)1.50 (0.98–2.27)
    Inhaled steroid therapy6.33 (3.82–10.47)f2.62 (1.64–4.16)f2.95 (1.88–4.63)f1.22 (0.80–1.86)1.44 (0.92–2.25)
    Oral steroid therapy5.88 (3.76–9.21)f2.68 (1.75–4.12)f2.81 (1.85–4.26)f1.11 (0.74–1.65)1.23 (0.81–1.87)
    Albuterol2.17 (1.21–3.89)f1.73 (0.97–3.07)3.00 (1.63–5.54)f0.86 (0.48–1.55)0.85 (0.46–1.56)
Gastroenteritisg
    Stool culture3.57 (2.22–5.75)f1.72 (1.09–2.73)f2.28 (1.43–3.62)f1.78 (1.13–2.81)f1.76 (1.11–2.79)f
    Rotavirus test2.19 (1.11–4.31)f1.20 (0.61–2.37)0.98 (0.50–1.92)1.33 (0.69–2.58)1.06 (0.53–2.11)
  • VCUG indicates voiding cystourethrogram.

  • a Physicians who practiced in an academic center were compared with those who practiced in a community hospital setting.

  • b Physicians who attended >90 days in the past year were compared with those who attended ≤90 days.

  • c Physicians who were ≤10 years out of residency were compared with those who were >10 years out of residency.

  • d Physicians who had completed graduate training (eg, masters in public health) and/or fellowship training were compared with those who had not.

  • e OR of reporting often or almost always using the given evidence-based test or therapy.

  • f Therapy/test for which the reported management decisions were significantly different between the 2 groups.

  • g OR of reporting rarely or never using the given test or therapy of unproven benefit.