Journal Club Summary
Reference: Gágyor I, et al. BMJ. 2015 Dec 23;351:h6544
Methodology Score: 4/5
Usefulness Score: 2.5/5
This multicenter, double blinded, randomized controlled trial assessed the use of ibuprofen versus fosfomycin in uncomplicated UTIs in women aged 18-65. The study assessed antibiotic usage, symptom burden, and complications arising from UTIs. While those patients randomized to ibuprofen had significantly fewer courses of antibiotics, this was “bought” at a greater symptom burden relative to fosfomycin. That being said, approx. ⅔ of women with UTI had symptom resolution without antibiotics and ibuprofen mono-therapy or delayed antibiotic therapy until culture results could be considered with shared decision making with patients.
By: Dr. Matthew Lipinski
Epi lesson: Propensity Score Matching
In the statistical analysis of observational data, propensity score matching is one of a family of multivariate statistical techniques that attempts to estimate the effect of a treatment, policy, or other intervention by accounting for the covariates that predict receiving the treatment. It is often used when there are fewer than 10 outcomes per covariate, as the propensity score can be reduced to one variable. Compared to the gold standard of a randomized controlled trial, any observational analysis and interpretation of the usefulness of an intervention must be viewed with a large degree of healthy skepticism.
By: Dr. Jeffrey Perry