Procedure
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APPENDIX
GPs received an invitation email, with a link to an expression of interest form (see Supplementary Appendix S1). Those who expressed interest were emailed a link to the study website. After providing consent and reading an introduction to the study (see Supplementary Appendix S2), GPs saw 16 vignettes in a random order. Per vignette, they were asked three questions:
‘In your opinion, what is the probability that this child would deteriorate, requiring hospital admission?’ Half of the sample (randomly selected) expressed their answer as a percentage, using a sliding scale (‘In your clinical judgment, what would be the best course of action?’ Three options were provided for patient management: ‘prescribe antibiotics’, ‘arrange to GP review within 24 h’, and ‘admit for paediatric assessment’. GPs could select all that applied (or none). When ‘prescribe antibiotics’ was selected, GPs were asked whether the antibiotic would be ‘immediate’ or ‘delayed’.‘Please enter any additional comments (optional)’.
GPs were emailed a link to a second survey 24 h later, comprising 16 previously unseen vignettes and one parental concern vignette. Response scales were identical to those seen in the first survey. The procedure is presented graphically in Supplementary Figure S1.Surveys were hosted online using Qualtrics. After completing both surveys, GPs received £50 via bank transfer and the National Institute for Health Research Clinical Research Network (NIHR CRN) gave £50 to each GP’s practice. Data were collected April to October 2021. Departures from the approved protocol are reported in Supplementary Appendix S4.