What are the limitations of current research in this field and what areas require further study?
Included studies rarely reported important measures of the potential harms of the intervention. These include the potential for increased use of health services (e.g., return visits due to persistent symptoms) and adverse clinical consequences (e.g., increasing rates of serious infections due to undertreatment). Patient satisfaction does not appear to be affected in the limited number of studies that did report this outcome. More importantly, very few of the included studies (and none of the US-based treatment studies) documented the resources required for completion of the intervention and measurements. Only four 102, 121, 143, 144 studies reported the cost savings resulting from changing prescribing behavior. Thus, although an active clinician education intervention may be more effective than a passive intervention, we are unable to make any statement regarding the cost-effectiveness of such an intervention. Given the apparent benefit of other, potentially less resource-intensive int
