The ethics of setting national antibiotic policies using financial incentives
Bibliographic record
Abstract
<p>Antimicrobial resistance (AMR) is an increasingly urgent global public health issue. Data from Public Health England- English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) - quantifies the scale of antibiotic resistance in key bacterial pathogens. </p> <br/> <p>The Department of Health’s 5 year strategy to reduce morbidity and mortality associated with AMR (2013-2018) focused on optimising antibiotic prescribing and improving infection prevention and control. In April 2015 NHS England introduced a Quality Premium (QP) focussing on reducing antibiotics. QPs are financial rewards, with a maximal value equivalent to £5 per patient, intended to reward clinical commissioning groups (CCGs) for improvements in the quality of the services that they commission and for associated improvements in health outcomes and reducing inequalities. The AMR QP provided commissioners with financial incentives to reduce antibiotic prescribing; 80% linked to primary care quality measures (reduction in absolute number of antibiotic prescriptions by 1%, decrease in use of broad spectrum antibiotics by 10%) and 20% linked to improving availability of antibiotic prescribing data from secondary care.</p>
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".