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Background

Overtesting and overdiagnosis of Clostridium difficile infection (CDI) are increasingly recognized as potentially avoidable causes for unnecessary treatment and cost. Reducing inappropriate testing through diagnostic stewardship may improve C. difficile test utilization. However, the safety of these interventions is not well understood, despite the potential risk for missed or delayed diagnosis. A computerized clinical decision support (CCDS) tool was implemented at a 619-bed tertiary care hospital as part of a multifaceted effort to reduce inappropriate C. difficile testing. The intervention was associated with reductions in tests (41%) and hospital-onset CDI events (31%). We sought to examine patient outcomes associated with the intervention.

Methods

The CCDS was designed to identify patients with a prevented test if a provider initiated the CCDS and aborted the order. Outcomes of patients with either a …