N/A
Completed N=1,045
Using Behavioral Economics to Reduce Low-Value Care
Pre-Operative Testing for Cataract Surgery
Source: ClinicalTrials.gov NCT04104256 ↗
Enrolled (actual)
1,045
Serious AEs
3.0%
Results posted
Sep 2024
Primary outcomePrimary: Pre-Operative Testing Change — 87.4; 85.0; 86.1; 85.4 Percentage of patients with orders
Summary
There is strong consensus - based on robust randomized trial data - that routine pre-operative (pre-op) testing for cataract surgery is inappropriate. Despite these widely endorsed evidence-based recommendations, most seniors undergoing cataract surgery still receive unnecessary blood testing, EKGs, and chest X-rays (CXRs); another substantial percentage even undergo nonindicated cardiac stress tests. We will integrate three new best practice alert (BPA) nudges into the University of California, Los Angeles (UCLA) Health electronic health record (EHR). The nudges are informed by behavioral economic theory and are designed to alter the choice architecture for physicians to decrease the rate of pre-op test ordering while still preserving clinician autonomy. We will conduct a pragmatic trial to evaluate whether these BPA nudges reduce low-value pre-op testing for cataract surgery.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Pre-Operative Testing Change |
— | — |
| SECONDARY Pre-Operative Testing Change |
— | — |
| SECONDARY Pre-Operative Testing Change for Specific Categories of Tests |
— | — |
| SECONDARY Physician Experience Survey Results |
— | — |
| SECONDARY System-level Change - Surgery Cancellations |
— | — |
| SECONDARY System-level Change - Cost Savings |
— | — |
| SECONDARY System-level Change - Return on Investment |
— | — |
Eligibility Criteria
Inclusion Criteria
- Patient at UCLA undergoing cataract surgery, and receives pre-operative evaluation at UCLA Health
Exclusion Criteria
- Cataract surgery patients who get their pre-operative evaluation from non-UCLA physicians
Data sourced from ClinicalTrials.gov (NCT04104256). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.