Comparison with existing literature
asthma, wheeze
ASTHMA, STILL
Presently, GPs’ risk assessments were aligned with STARWAVe roughly half of the time, though degree of alignment varied by risk response mode (sliding scale 53% versus category selection 58%). Interestingly, risk-response mode also influenced GPs’ deviations from STARWAVe: the sliding-scale group tended to overestimate (versus underestimate) risk, while the category-selection group did both. In a previous study,The prescribing rate was low in the present study (13%), with GPs preferring further assessment (review/referral) to immediate prescribing. Still, many prescriptions were unnecessary relative to GPs’ own risk assessments (51%) and STARWAVe’s (69%). These findings were consistent across risk-response modes and consistent with the authors’ previous study,These findings suggest a disconnect between risk assessments and prescribing decisions, which was also apparent in GPs’ interpretation of STARWAVe’s risk factors. Younger patient age and recession increased GPs’ risk assessments (in keeping with STARWAVe) but reduced prescribing odds. Vomiting, asthma, and wheeze likewise increased risk assessments (in keeping with STARWAVe) but did not affect prescribing. Only long illness duration and temperature increased both risk perceptions and prescribing, but the former runs counter to STARWAVe (which posits short illness duration as a risk factor).Notably, the effect of the STARWAVe factors on GPs’ risk assessments was consistent with 1) the authors’ previous study,In very-low-risk cases (level 1), parental concern raised GPs’ risk assessments but not prescribing odds, speaking again to the disconnect between risk assessment and prescribing. The non-association between parental concern and prescribing was somewhat surprising, given that parental pressure for antibiotics is known to increase their likelihood.