Gardendale

Researchers are evaluating the effectiveness and implementation of the Spotfire RST multiplex respiratory PCR test in urgent care settings for patients presenting with acute respiratory infections. These infections often lead to high rates of unnecessary antibiotic use, which contributes to antimicrobial resistance and adverse events. The study focuses on how this rapid diagnostic test can influence antibiotic prescribing and patient outcomes while also exploring challenges and facilitators to adopting the test in real-world urgent care clinics. The study compares two groups patients at an intervention site where respiratory samples are tested using the Spotfire RST Panel and results guide clinical decisions, and patients at a control site where standard respiratory antigen tests are used. The Spotfire test detects multiple viral and bacterial targets from nasopharyngeal or throat swabs, providing results in about 15 minutes. Patients at both sites complete a patient satisfaction survey, and providers at the intervention site participate in antimicrobial stewardship and implementation science activities designed before the study began. Participants will have their respiratory samples collected and tested, followed by evaluation of antibiotic use and patient satisfaction. Researchers will monitor antibiotic prescribing rates, antiviral use, patient visit length, and implementation outcomes over approximately 16 weeks from enrollment. The primary outcome is antibiotic utilization for respiratory conditions measured by a validated quality measure. The study includes data collection on workflow and reach, as well as adoption outcomes, to understand the tests impact and integration into urgent care practice.

Researchers are comparing the rates of surgical and minimally invasive interventions, as well as any harms, in Medicare beneficiaries treated with the MILD procedure versus those treated with interspinous process decompression IPD for lumbar spinal stenosis with neurogenic claudication. This observational study uses Medicare claims data to follow patients for 24 months after their initial procedure starting from January 1, 2017. The purpose is to evaluate outcomes between these two types of procedures without requiring prior patient enrollment or consent. The study includes two groups patients who received MILD, which is a percutaneous image-guided lumbar decompression performed under fluoroscopic guidance through a dorsal approach to the spine, and patients who received IPD, a different device-based decompression procedure. Data on reoperations and complications will be collected for both groups over a 24-month follow-up period using Medicare claims. Enrollment continues until the sponsor decides to stop. Participants involvement is passive as the study uses existing Medicare claims data. Researchers will monitor rates of harms related to the initial procedure and subsequent surgical or minimally invasive interventions over two years. No direct patient visits or interventions are conducted, and the study is exempt from institutional review board oversight. The total study duration extends to December 2026, covering cases treated since early 2017.