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This model is proposed for combining overdispersed binomial data across multiple, heterogeneous studies [4]. The upper and lower lines present the control limits, calculated as 2?SD and 3?SD (?95% and ?99.8% prediction limits). Control limits are calculated using the overdispersion factor technique and 20% winsorized data [5]. Any point falling outside the control limits is an outlier, suggesting a special cause for the variation. The funnel plots were prepared based on a funnel plot excel template downloaded from Easter Region Public Health Observatory (ERPHO, http://www.erpho.org.uk/). Analysing the cause for variation of the effect size used subgroup analysis for categorical moderators and meta-regression for continuous [http://www.selleckchem.com/products/VX-809.html see more] variables (Comprehensive Meta-analysis Version 2, Biostat, Englewood, NJ, USA (2005)). Correlation analysis between variables was performed using SPSS (version PASW Statistics 17.0, Release 17.0.2, SPSS Inc., Chicago, IL, USA). The search for potentially eligible studies yielded 1053 references. Eighty-seven studies reporting rate of inappropriate empirical treatment and meeting the inclusion criteria were included (Fig.?1). These publications comprised 92 study groups, which were used to develop the pooled estimate and the funnel plot. The studies are described in Appendix S1 and referenced separately (Appendix S2). The studies included a total of 27?628 patients and [http://www.selleckchem.com/products/carfilzomib-pr-171.html Proteases inhibitor] were published between 1977 and 2007. The studies were carried out in 23 different countries, predominated by Spain with 34 studies and USA with 24 studies (only a few studies were multi-centred, Appendix S1). Forty-one studies (45%) were conducted in an intensive-care unit (ICU) and the remaining studies were carried out exclusively or predominantly in a non-ICU setting. Forty-six studies (50%) assessed bacteraemia, 24 (26%) assessed pneumonia and the remainder assessed a mix of microbiologically documented infections. Most (71, 77%) of the studies evaluated pathogens combined, but 15 (16%) and 6 (7%) focused on gram-negative and gram-positive infections, respectively. The reported [https://en.wikipedia.org/wiki/Cefaloridine Cefaloridine] proportions of inappropriate empirical treatment varied from 1.61% to 77.36%. Significant heterogeneity between studies was observed (I2?=?95.6%, p?