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Cost Analysis of Computerized Clinical Decision Support and Trainee Financial Incentive for Clostridioides difficile Testing

  • Gregory R. Madden (a1), Heather L. Cox (a1) (a2), Melinda D. Poulter (a3), Jason A. Lyman (a4), Kyle B. Enfield (a5) and Costi D. Sifri (a1) (a6)...


Corresponding author

Author for correspondence: Costi D. Sifri, Division of Infectious Diseases & International Health, University of Virginia Health System, PO Box 800473, Charlottesville, VA 22908–0473. E-mail:


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PREVIOUS PRESENTATION: Data from this study were presented in part as an abstract at the 2018 Society for Healthcare Epidemiology of America meeting on April 19, 2018, in Portland, Oregon (abstract #327).

Cite this article: Madden GR et al. (2019) Cost analysis of computerized clinical decision support and trainee financial incentive for Clostridioides difficile testing. Infection Control & Hospital Epidemiology 2019, 40, 242–244. doi: 10.1017/ice.2018.300



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2. Desai, K, Gupta, SB, Dubberke, ER, Prabhu, VS, Browne, C, Mast, TC. Epidemiological and economic burden of Clostridium difficile in the United States: estimates from a modeling approach. BMC Infect Dis 2016;16:303.
3. Polage, CR, Gyorke, CE, Kennedy, MA, et al. Overdiagnosis of Clostridium difficile infection in the molecular test era. JAMA Intern Med 2015;175:17921801.
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5. CDC/NHSN Surveillance definitions for specific types of infections. Centers for Disease Control and Prevention website. Published January 2017. Accessed April 26, 2017.
6. Madden, GR, German Mesner, I, Cox, HL, et al. Reduced Clostridium difficile tests and laboratory-identified events with a computerized clinical decision support tool and financial incentive. Infect Control Hosp Epidemiol 2018;39:737740.
7. McGlone, SM, Bailey, RR, Zimmer, SM, et al. The economic burden of Clostridium difficile . Clin Microbiol Infect 2012;18:282289.
8. Song, X, Bartlett, JG, Speck, K, Naegeli, A, Carroll, K, Perl, TM. Rising economic impact of clostridium difficile-associated disease in adult hospitalized patient population. Infect Control Hosp Epidemiol 2008;29:823828.
9. Zhang, D, Prabhu, VS, Marcella, SW. Attributable healthcare resource utilization and costs for patients with primary and recurrent Clostridium difficile infection in the United States. Clin Infect Dis 2018;359:13261332.
10. Mathers, AJ, Poulter, M, Dirks, D, Carroll, J, Sifri, CD, Hazen, KC. Clinical microbiology costs for methods of active surveillance for Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae. Infect Control Hosp Epidemiol 2014;35:350355.


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