ABU: Asymptomatic Bacteriuria Guideline Implementation Study
Study Details
Study Description
Brief Summary
Overtreatment of asymptomatic bacteriuria (ABU) is a quality, safety, and cost issue, particularly as unnecessary antibiotics lead to emergence of resistant pathogens. The investigators' proposal to bring clinical practice in line with published guidelines has significant potential to reduce unnecessary antibiotic use for ABU in the VA healthcare system, thus improving the quality and safety of veterans' healthcare. The investigators' study will also provide important insights about how to implement and sustain evidence-based clinical practice within VA hospitals.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Anticipated Impacts on Veterans' Healthcare: Urinary tract infection (UTI) is the single most common hospital-acquired infection. However, the majority of cases of nosocomial catheter-associated urinary tract infection (CAUTI) are really asymptomatic bacteriuria (ABU). ABU is not a clinically significant condition, and treatment is unlikely to confer benefit. Overtreatment of ABU is a quality, safety, and cost issue, particularly as unnecessary antibiotics lead to emergence of resistant flora. The proposal to bring clinical practice in line with published guidelines has significant potential to decrease CAUTI and associated inappropriate antibiotic use in VA hospitals. The study will also provide information about how to maximize effectiveness of audit-feedback to achieve guideline adherence in the inpatient VA setting.
Project Background/Rationale: Evidence-based guidelines recommend that providers neither screen for nor treat ABU in most catheterized patients. However, a significant gap between these guidelines and clinical practice has been documented at the investigators' VA hospital and throughout the world. Since many VA patients in both acute care settings and sub-acute care settings, such as intermediate and long-term care, have a legitimate need for a urinary catheter, the issue of overtreatment of catheter-associated ABU is an active problem for the VA.
Project Objectives: The investigators hypothesize that implementing the existing evidence-based guidelines about non-treatment of ABU will dramatically reduce the unnecessary use of antibiotics to treat ABU and the incidence of incorrectly diagnosed CAUTI. The first objective is to improve quality of care concerning ABU in terms of specific clinical outcomes (inappropriate screening for and treatment of ABU) through implementation of an audit-feedback strategy. The investigators also hypothesize that successful implementation of an audit-feedback strategy will result in measurable changes in clinicians' knowledge and attitudes concerning ABU practice guidelines. The second objective is to assess through surveys the effect of the implementation on clinicians' guideline awareness, familiarity, acceptance, and outcome expectancy.
Project Methods: The investigators' guidelines implementation strategy will employ audit-feedback, applied as a post-prescription antimicrobial review based on established guidelines. The study population for the clinical outcomes is all inpatients on certain wards at the intervention site (Houston VA) and the control site (San Antonio VA). The investigators' study population for the audit-feedback intervention and surveys is the health care providers on these wards. The investigators propose a 3-year study. During the first year the investigators will observe the baseline incidence of inappropriate screening for and treatment of ABU at both sites. Blinded monitoring of clinical outcomes will continue during the next 2 years of the study. During the second year, the investigators will distribute the guidelines at both sites. Clinicians at the intervention site will receive individualized feedback, either by telephone or in person, about whether their management of bacteriuria was guideline-compliant. Unit-level feedback will also be provided. During the third year, individualized feedback will cease, but unit-level feedback will continue as this constitutes a sustainable intervention. Clinicians will complete pre/post surveys of awareness, familiarity, acceptance, and outcome expectancy at the intervention site in year 2 and at both sites in year 3. Differences in outcomes between the individualized intervention in year 2 and the group-level intervention in year 3 will help to determine the necessary intensity of intervention for dissemination and implementation in other VA facilities.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Arm 1- Intervention: Audit-Feedback Baseline surveillance for the clinical outcomes will begin in year 1 at the intervention site and continue for all 3 years of the project. Guideline distribution will begin in year 2 and continue throughout the project. Audit-feedback will occur during year 2 of the study at the intervention site. Feedback will be delivered to individual health care providers at the intervention site during year 2.Unit-level audit feedback will be delivered at the intervention site during years 2 and 3 of the study. Provider surveys of knowledge and attitudes concerning the ABU guidelines will be administered at the intervention site in years 2 and 3 of the project. |
Behavioral: Audit-Feedback
Applied as a post-prescription antimicrobial review based on established guidelines.
|
| No Intervention: Arm 2- Control At the control site, baseline surveillance for the clinical outcomes will begin in year 1 at the and continue for all 3 years of the project. Guideline distribution will begin in year 2 and continue throughout the project. Audit-feedback will not occur at the control site. Provider surveys of knowledge and attitudes concerning the ABU guidelines will be administered at the control site in year 3 of the project. |
Outcome Measures
Primary Outcome Measures
- Number of Cases of ABU That Are Treated Inappropriately With Antibiotics [Years 1, 2, & 3]
- Urine Cultures Ordered [three years]
Number of urine cultures collected per 1000 catheter-days for each unit
- Number of Cases of CAUTI Inappropriately Under-treated (no Antibiotics Given) [Years 1, 2, & 3]
Secondary Outcome Measures
- Number of Days Antibiotics Are Given to Treat ABU [one year]
- Clinicians' Awareness of and Familiarity With the ABU Guidelines. [one year]
- Clinicians Acceptance of and Outcome Expectancy From Following the ABU Guidelines [one year]
The investigators used a previous validated survey to measure this construct, which we termed "risk perception." We asked 5 questions, all exploring whether various patient characteristics (age, type of organism) might increase providers' sense that untreated ASB might be a risk to their patient's health. These questions were scored on a 1-5 scale, from strongly disagree to strongly agree, with 5 being the best answer (compliant with guidelines about ASB treatment), and 1 being the worst answer (least likely to comply with ASB guidelines). Higher scores mean a better answer. Lower scores mean a worse answer. The minimum value was 1, and the maximum value was 5. To create a score for this domain, we added up the score for each of the 5 questions and divided by the number of questions answered (by 5 if all 5 questions were answered; by 4 if only 4 of the 5 questions had been answered; etc).
- Number of Catheter-days of Use Per 1000 Patient Bed Days on Each Unit [One year]
- Patient Level Analysis of Inappropriate Antibiotic Use [three years]
The investigators looked at the percentage of cases of ASB (asymptomatic bacteriuria) that were inappropriately over-treated with antibiotics, and the percentage of cases of CAUTI (catheter-associated UTI) that were not treated with antibiotics (under-treated).
Eligibility Criteria
Criteria
Inclusion Criteria:
-
For Objective 1 (Clinical Outcomes), all inpatients at the MEDVAMC or STVHCS on the units of interest (medicine or ECL) during the 3 year period of the study will be included in the chart review process.
-
For Objective 2, modifying health care provider knowledge and behavior through audit-feedback and surveys, the investigators will attempt to involve all health care providers on rotation at the VA on the targeted wards during the study period.
-
The audit-feedback intervention will be applied to the health care providers on the targeted wards who make the decision to treat CAUTI.
Exclusion Criteria:
-
None.
-
For the chart review component, the investigators want to capture all available data about the clinical outcomes during the study period.
-
review the inpatient rosters on the wards of interest several times per week to determine how many of the patients have urinary catheters, etc.
-
survey as many health care providers as possible who rotate on the wards of interest during the study period.
-
the investigators anticipate that all health care providers who work at the VA hospital will be competent to provide or refuse consent to participate.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Michael E. DeBakey VA Medical Center, Houston, TX | Houston | Texas | United States | 77030 |
Sponsors and Collaborators
- VA Office of Research and Development
Investigators
- Principal Investigator: Barbara Trautner, MD, Michael E. DeBakey VA Medical Center, Houston, TX
Study Documents (Full-Text)
None provided.More Information
Publications
- Gupta K, Trautner BW. Diagnosis and management of recurrent urinary tract infections in non-pregnant women. BMJ. 2013 May 29;346:f3140. doi: 10.1136/bmj.f3140. Review.
- Lin E, Bhusal Y, Horwitz D, Shelburne SA 3rd, Trautner BW. Overtreatment of enterococcal bacteriuria. Arch Intern Med. 2012 Jan 9;172(1):33-8. doi: 10.1001/archinternmed.2011.565.
- Trautner BW. Asymptomatic bacteriuria: when the treatment is worse than the disease. Nat Rev Urol. 2011 Dec 6;9(2):85-93. doi: 10.1038/nrurol.2011.192. Review.
- Trautner BW. Management of catheter-associated urinary tract infection. Curr Opin Infect Dis. 2010 Feb;23(1):76-82. doi: 10.1097/QCO.0b013e328334dda8. Review.
- IIR 09-104
- H-24180
Study Results
Participant Flow
| Recruitment Details | The investigators reviewed the electronic medical record continuously at both sites to detect urine cultures and antibiotic use. At the intervention site, we reviewed 170,345 bed days over the 3 years of the project, while at the control site, we reviewed 119,409 bed days over the same time period. The intervention was delivered to the providers. |
|---|---|
| Pre-assignment Detail | From the bed days reviewed, we determined which patient had a positive urine culture that was associated with the presence of a urinary catheter. These cases were studied further to determine if antimicrobial use was compliant with guidelines or non-compliant. These cases became the numbers "enrolled" in each arm of this study. |
| Arm/Group Title | Arm 1- Intervention: Audit-Feedback | Arm 2- Control |
|---|---|---|
| Arm/Group Description | Year 1: baseline surveillance at both sites Year 2: case based, individual audit and feedback delivered to providers, a guidelines based diagnostic algorithm for CAUTI versus asymptomatic bacteriuria (ASB) was given to providers and reinforced in the audit and feedback sessions. Year 3: cased based, group audit and feedback delivered to providers, again based on this diagnostic algorithm. Audit-Feedback: Applied as a post-prescription antimicrobial review based on established guidelines. | This was the contemporary control group. Surveillance for the outcomes of interest (urine cultures order and antibiotics used to treat urine cultures) continued for all 3 years. Providers at this site received standard education about the CAUTI and asymptomatic bacteriuria guidelines delivered in a grand rounds format, and they also received a PDF of the full guidelines by email. |
| Period Title: Overall Study | ||
| STARTED | 867 | 731 |
| COMPLETED | 867 | 731 |
| NOT COMPLETED | 0 | 0 |
Baseline Characteristics
| Arm/Group Title | Arm 1-Intervention: Audit-Feedback | Arm 2- Control | Total |
|---|---|---|---|
| Arm/Group Description | Baseline surveillance for the clinical outcomes will begin in year 1 at the intervention site and continue for all 3 years of the project. Guideline distribution will begin in year 2 and continue throughout the project. Audit-feedback will occur during year 2 of the study at the intervention site. Feedback will be delivered to individual health care providers at the intervention site during year 2.Unit-level audit feedback will be delivered at the intervention site during years 2 and 3 of the study. Provider surveys of knowledge and attitudes concerning the ABU guidelines will be administered at the intervention site in years 2 and 3 of the project. Audit-Feedback: Applied as a post-prescription antimicrobial review based on established guidelines. | At the control site, baseline surveillance for the clinical outcomes will begin in year 1 at the and continue for all 3 years of the project. Guideline distribution will begin in year 2 and continue throughout the project. Audit-feedback will not occur at the control site. Provider surveys of knowledge and attitudes concerning the ABU guidelines will be administered at the control site in year 3 of the project. | Total of all reporting groups |
| Overall Participants | 867 | 731 | 1598 |
| Age (years) [Mean (Standard Deviation) ] | |||
| Mean (Standard Deviation) [years] |
72
(12)
|
72
(13)
|
72
(12)
|
| Sex/Gender, Customized (participants) [Number] | |||
| Female |
19
2.2%
|
19
2.6%
|
38
2.4%
|
| Male |
816
94.1%
|
701
95.9%
|
1517
94.9%
|
| Urinary catheter type (participants) [Number] | |||
| Foley |
510
58.8%
|
444
60.7%
|
954
59.7%
|
| Condom |
341
39.3%
|
160
21.9%
|
501
31.4%
|
| other |
15
1.7%
|
126
17.2%
|
141
8.8%
|
| Department (participants) [Number] | |||
| Medicine |
609
70.2%
|
594
81.3%
|
1203
75.3%
|
| Longterm Care |
258
29.8%
|
132
18.1%
|
390
24.4%
|
Outcome Measures
| Title | Number of Cases of ABU That Are Treated Inappropriately With Antibiotics |
|---|---|
| Description | |
| Time Frame | Years 1, 2, & 3 |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Arm 1-Intervention: Audit-Feedback | Arm 2- Control |
|---|---|---|
| Arm/Group Description | Baseline surveillance for the clinical outcomes will begin in year 1 at the intervention site and continue for all 3 years of the project. Guideline distribution will begin in year 2 and continue throughout the project. Audit-feedback will occur during year 2 of the study at the intervention site. Feedback will be delivered to individual health care providers at the intervention site during year 2.Unit-level audit feedback will be delivered at the intervention site during years 2 and 3 of the study. Provider surveys of knowledge and attitudes concerning the ABU guidelines will be administered at the intervention site in years 2 and 3 of the project. Audit-Feedback: Applied as a post-prescription antimicrobial review based on established guidelines. | At the control site, baseline surveillance for the clinical outcomes will begin in year 1 at the and continue for all 3 years of the project. Guideline distribution will begin in year 2 and continue throughout the project. Audit-feedback will not occur at the control site. Provider surveys of knowledge and attitudes concerning the ABU guidelines will be administered at the control site in year 3 of the project. |
| Measure Participants | 180 | 65 |
| Year 1 ASB tx |
1.6
|
0.6
|
| Year 2 ASB tx |
0.5
|
0.6
|
| Year 3 ASB tx |
0.4
|
0.5
|
| Title | Urine Cultures Ordered |
|---|---|
| Description | Number of urine cultures collected per 1000 catheter-days for each unit |
| Time Frame | three years |
Outcome Measure Data
| Analysis Population Description |
|---|
| For this outcome measure, the number of participants is the number of patients that had urine cultures ordered. One patient could have multiple cultures ordered. Arm 1=5209 urine cultures ordered. Arm 2=5979 urine cultures ordered. This number was standardized by bed-days. Arm 1=170345 bed-days. Arm 2=119409 bed-days. |
| Arm/Group Title | Intervention Group | Control Group |
|---|---|---|
| Arm/Group Description | Medicine and extended care wards at the intervention site | Medicine and extended care wards at control site |
| Measure Participants | 867 | 731 |
| Year 1 |
41.2
|
49.3
|
| Year 2 |
23.3
|
54.4
|
| Year 3 |
12.0
|
46.6
|
Statistical Analysis 1
| Statistical Analysis Overview | Comparison Group Selection | Arm 1-Intervention: Audit-Feedback, Arm 2- Control |
|---|---|---|
| Comments | ||
| Type of Statistical Test | Superiority or Other | |
| Comments | ||
| Statistical Test of Hypothesis | p-Value | <0.05 |
| Comments | Descriptive statistics were used to estimate the incidence rates per 1,000 bed-days and 95% confidence intervals (CI) for urine cultures ordered, ASB overtreatment and CAUTI under-treatment in each study period. | |
| Method | Regression, Logistic | |
| Comments | to test whether there was a significant difference in monthly urine cultures ordered between the two study sites over time. | |
| Title | Number of Cases of CAUTI Inappropriately Under-treated (no Antibiotics Given) |
|---|---|
| Description | |
| Time Frame | Years 1, 2, & 3 |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Arm 1-Intervention: Audit-Feedback | Arm 2- Control |
|---|---|---|
| Arm/Group Description | Baseline surveillance for the clinical outcomes will begin in year 1 at the intervention site and continue for all 3 years of the project. Guideline distribution will begin in year 2 and continue throughout the project. Audit-feedback will occur during year 2 of the study at the intervention site. Feedback will be delivered to individual health care providers at the intervention site during year 2.Unit-level audit feedback will be delivered at the intervention site during years 2 and 3 of the study. Provider surveys of knowledge and attitudes concerning the ABU guidelines will be administered at the intervention site in years 2 and 3 of the project. Audit-Feedback: Applied as a post-prescription antimicrobial review based on established guidelines. | At the control site, baseline surveillance for the clinical outcomes will begin in year 1 at the and continue for all 3 years of the project. Guideline distribution will begin in year 2 and continue throughout the project. Audit-feedback will not occur at the control site. Provider surveys of knowledge and attitudes concerning the ABU guidelines will be administered at the control site in year 3 of the project. |
| Measure Participants | 27 | 17 |
| Year 1 CAUTI not tx |
0.2
|
0.1
|
| Year 2 CAUTI not tx |
0.1
|
0.2
|
| Year 3 CAUTI not tx |
0.05
|
0.07
|
| Title | Number of Days Antibiotics Are Given to Treat ABU |
|---|---|
| Description | |
| Time Frame | one year |
Outcome Measure Data
| Analysis Population Description |
|---|
| This data was not collected and is therefore not available. |
| Arm/Group Title | Arm 1 | Arm 2 |
|---|---|---|
| Arm/Group Description | Baseline surveillance for the clinical outcomes will begin in year 1 at the intervention site and continue for all 3 years of the project. Guideline distribution will begin in year 2 and continue throughout the project. Audit-feedback will occur during year 2 of the study at the intervention site. Feedback will be delivered to individual health care providers at the intervention site during year 2.Unit-level audit feedback will be delivered at the intervention site during years 2 and 3 of the study. Provider surveys of knowledge and attitudes concerning the ABU guidelines will be administered at the intervention site in years 2 and 3 of the project. Audit-Feedback: Applied as a post-prescription antimicrobial review based on established guidelines. | At the control site, baseline surveillance for the clinical outcomes will begin in year 1 at the and continue for all 3 years of the project. Guideline distribution will begin in year 2 and continue throughout the project. Audit-feedback will not occur at the control site. Provider surveys of knowledge and attitudes concerning the ABU guidelines will be administered at the control site in year 3 of the project. |
| Measure Participants | 0 | 0 |
| Title | Clinicians' Awareness of and Familiarity With the ABU Guidelines. |
|---|---|
| Description | |
| Time Frame | one year |
Outcome Measure Data
| Analysis Population Description |
|---|
| health care practitioners |
| Arm/Group Title | Pre-Intervention Group | Control Group- Post-Intervention | Post-intervention Group |
|---|---|---|---|
| Arm/Group Description | Medicine and extended care wards at the intervention site | Medicine and extended care wards at control site | Medicine and extended care wards at the intervention site |
| Measure Participants | 169 | 65 | 157 |
| Count of Participants [Participants] |
151
17.4%
|
62
8.5%
|
150
9.4%
|
| Title | Clinicians Acceptance of and Outcome Expectancy From Following the ABU Guidelines |
|---|---|
| Description | The investigators used a previous validated survey to measure this construct, which we termed "risk perception." We asked 5 questions, all exploring whether various patient characteristics (age, type of organism) might increase providers' sense that untreated ASB might be a risk to their patient's health. These questions were scored on a 1-5 scale, from strongly disagree to strongly agree, with 5 being the best answer (compliant with guidelines about ASB treatment), and 1 being the worst answer (least likely to comply with ASB guidelines). Higher scores mean a better answer. Lower scores mean a worse answer. The minimum value was 1, and the maximum value was 5. To create a score for this domain, we added up the score for each of the 5 questions and divided by the number of questions answered (by 5 if all 5 questions were answered; by 4 if only 4 of the 5 questions had been answered; etc). |
| Time Frame | one year |
Outcome Measure Data
| Analysis Population Description |
|---|
| health care practitioners |
| Arm/Group Title | Pre-Intervention Group | Control Group - Postintervention | Post-intervention Group |
|---|---|---|---|
| Arm/Group Description | Medicine and extended care wards at the intervention site | Medicine and extended care wards at control site | Medicine and extended care wards at the intervention site |
| Measure Participants | 169 | 65 | 157 |
| Mean (Standard Deviation) [score on a scale] |
3.0
(0.6)
|
3.2
(0.5)
|
3.3
(0.6)
|
| Title | Number of Catheter-days of Use Per 1000 Patient Bed Days on Each Unit |
|---|---|
| Description | |
| Time Frame | One year |
Outcome Measure Data
| Analysis Population Description |
|---|
| inpatient-days on acute and extended care wards - aggregate numbers did not look at individual patients |
| Arm/Group Title | Preintervention Acute Medical Care Line | Preintervention Extended Care Line |
|---|---|---|
| Arm/Group Description | Patients in acute medical care wards during the preintervention period | Patients in the extended care (nursing home) wards during the preintervention period |
| Measure Participants | NA | NA |
| Measure bed-days | 64699 | 63568 |
| Number [catheter-days of use/1000 pt bed days] |
347.2
|
392.1
|
| Title | Patient Level Analysis of Inappropriate Antibiotic Use |
|---|---|
| Description | The investigators looked at the percentage of cases of ASB (asymptomatic bacteriuria) that were inappropriately over-treated with antibiotics, and the percentage of cases of CAUTI (catheter-associated UTI) that were not treated with antibiotics (under-treated). |
| Time Frame | three years |
Outcome Measure Data
| Analysis Population Description |
|---|
| All patients on acute medical care wards or extended care wards during the three year study project who had a positive urine culture associated with the presence of a urinary catheter. |
| Arm/Group Title | Intervention Group | Control Group |
|---|---|---|
| Arm/Group Description | Cases of positive urine cultures on medicine and extended care wards at the intervention site | Cases of positive urine cultures on medicine and extended care wards at the control site |
| Measure Participants | 867 | 731 |
| Year 1 ASB tx |
38
|
20
|
| Year 2 ASB tx |
22
|
25
|
| Year 3 ASB tx |
29
|
17
|
| Year 1 CAUTI not tx |
8
|
4
|
| Year 2 CAUTI not tx |
9
|
7
|
| Year 3 CAUTI not tx |
7
|
2
|
Statistical Analysis 1
| Statistical Analysis Overview | Comparison Group Selection | Arm 1-Intervention: Audit-Feedback, Arm 2- Control |
|---|---|---|
| Comments | ||
| Type of Statistical Test | Superiority or Other | |
| Comments | ||
| Statistical Test of Hypothesis | p-Value | <0.05 |
| Comments | We used χ2 test, Fisher's exact test and one-way ANOVA to determine if patient-level covariates differed between the baseline, intervention and maintenance periods at each study site. | |
| Method | Regression, Logistic | |
| Comments | ||
Adverse Events
| Time Frame | All 3 years | |||
|---|---|---|---|---|
| Adverse Event Reporting Description | Only the under-treatment of CAUTI (failure to use antimicrobials when indicated) was collected/assessed/measured as an adverse event. | |||
| Arm/Group Title | Arm 1-Intervention: Audit-Feedback | Arm 2- Control | ||
| Arm/Group Description | Baseline surveillance for the clinical outcomes will begin in year 1 at the intervention site and continue for all 3 years of the project. Guideline distribution will begin in year 2 and continue throughout the project. Audit-feedback will occur during year 2 of the study at the intervention site. Feedback will be delivered to individual health care providers at the intervention site during year 2.Unit-level audit feedback will be delivered at the intervention site during years 2 and 3 of the study. Provider surveys of knowledge and attitudes concerning the ABU guidelines will be administered at the intervention site in years 2 and 3 of the project. Audit-Feedback: Applied as a post-prescription antimicrobial review based on established guidelines. | At the control site, baseline surveillance for the clinical outcomes will begin in year 1 at the and continue for all 3 years of the project. Guideline distribution will begin in year 2 and continue throughout the project. Audit-feedback will not occur at the control site. Provider surveys of knowledge and attitudes concerning the ABU guidelines will be administered at the control site in year 3 of the project. | ||
All Cause Mortality |
||||
| Arm 1-Intervention: Audit-Feedback | Arm 2- Control | |||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | / (NaN) | / (NaN) | ||
Serious Adverse Events |
||||
| Arm 1-Intervention: Audit-Feedback | Arm 2- Control | |||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 0/0 (NaN) | 0/0 (NaN) | ||
Other (Not Including Serious) Adverse Events |
||||
| Arm 1-Intervention: Audit-Feedback | Arm 2- Control | |||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 27/867 (3.1%) | 17/731 (2.3%) | ||
| Renal and urinary disorders | ||||
| Incidence of under-treatment of CAUTI | 27/867 (3.1%) | 27 | 17/731 (2.3%) | 17 |
Limitations/Caveats
More Information
Certain Agreements
All Principal Investigators ARE employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
| Name/Title | Barbara Trautner, MD, PhD |
|---|---|
| Organization | Michael E. DeBakey VA Medical Center |
| Phone | 713-440-4438 |
| barbar.trautner@va.gov |
- IIR 09-104
- H-24180