Shared Decision-making on Medical Tests and Care Cascades

Not Applicable

Completed

• Conditions: Health Care Utilization; Health Knowledge, Attitudes, Practice

• Registration Number: NCT04902664
• Lead Sponsor: Brigham and Women's Hospital

Brief Summary

The purpose of this randomized controlled trial is to evaluate the impact of patient and provider facing educational materials and peer comparison on medical testing conversations during annual physicals. The investigators hypothesize that education materials and peer comparison will improve conversation quality about medical testing decisions.

Detailed Description

Medical tests may show unexpected findings leading to additional tests, treatments, and visits that cost money and take time but may not have benefits. This is a prevalent issue with major consequences for patients and clinicians. Making informed decisions about when to order medical tests may help avoid unnecessary costs and worry. However, doctors don't always have detailed conversations about medical testing and there are patient gaps in knowledge. The investigators hypothesize that education materials and peer comparison to promote conversations about medical tests will improve conversation quality about medical testing decisions. The investigators have developed patient and provider-facing interventions to educate on and promote conversations about the uses and consequences of medical tests, and the investigators will test the impact of this just-in-time educational and peer comparison intervention on the likelihood of patients having productive conversations about medical tests. The effects of the intervention will be assessed using surveys before and after the study. This work has the potential to help patients feel more supported by their healthcare system, empower patients to participate in shared decision-making, and build trust between patients and clinicians.

Study Timeline

• Study First Submitted: 2021-05-21
• Study First Submitted QC: 2021-05-21
• Study Start: 2021-05-24
• Study First Posted: 2021-05-26
• Primary Completion: 2022-10-06
• Study Completion: 2022-10-29
• Status Verified: 2022-11
• Last Update Submitted: 2022-11-15
• Last Update Posted: 2022-11-17

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 329

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Shared Decision-Making Process 4 Survey	Within two weeks after visit	Composite score of survey items completed by the patient after physician visit. Min 0, Max 4 (higher is better).

Secondary Outcome Measures

Name	Time	Method
Satisfaction with testing discussion	Within two weeks after visit	Binary measure from patient post-visit survey (high vs low)
Patient knowledge	Within two weeks after visit	Composite score of survey items from patient post-visit survey. Min 0, Max 4 (higher is better).
Presence of testing discussion	Within two weeks after visit	Binary measure from patient post-visit survey (present vs absent)
Discussion of next steps	Within two weeks after visit	Binary measure from patient post-visit survey (present vs absent)
Whether doctor explained tests in a way that was easy to understand	Within two weeks after visit	Binary measure from patient post-visit survey (yes completely vs yes a little or no)

Trial Locations

Locations (1)

Brigham and Women's Hospital; 🇺🇸 Boston, Massachusetts, United States