Prescribing TendenciesNCT02048982
What Influences Physicians' Decisions - Statistics or Stories?
A study testing Guideline, Cost and Victim in people with Prescribing Tendencies, run by Weill Medical College of Cornell University at 1 site in United States.
Trial summary
The purpose of this study is to test whether physicians change their use of non-recommended tests, procedures, or medications more in response to evidence based-guidelines, price information, or an individual patient's story. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Prescribing Tendencies
- What is being tested?
- Guideline, Cost and Victim
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 0 participants
- Where
- 1 siteUnited States
- Study dates
- Feb 2014to Dec 2015
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
- Primary care physicians in the Weill Cornell Physicians Organization
Who cannot join
- None
Trial locations and contacts
1 site in 1 country.
United States1 site
Weill Cornell Medical College
New York, New York, 10065
About this study
The purpose of this study is to test whether physicians change their use of non-recommended tests, procedures, or medications more in response to evidence based-guidelines, price information, or an individual patient's story.
Read the detailed description
We will perform a randomized controlled trial (RCT) of information presented to physicians to test the hypothesis that an identifiable victim affects physician practice behavior more than a statistical victim.
Specifically, we will answer the following research questions: 1) do physicians order fewer non-recommended tests, procedures, or medications if they are told about a patient or a physician who had a bad outcome from that test, procedure, or medication than if they are simply told the guideline or the cost of the test, procedure or medication, 2) does the effect of learning about the identifiable victim last longer than the effect of learning about the guideline or the cost of a test, procedure, or medication, and 3) does the identifiable victim effect differ if the victim is a patient or a physician? We hypothesize that because of the propensity to respond more to the identifiable victim rather than the statistical victim that physicians will order fewer unnecessary tests when they are told about an individual patient case than if they are simply told about the guideline, that the effect of the identifiable victim will last longer than the effect of the statistical victim, and that a patient as the identifiable victim will have more effect than a physician as the identifiable victim.
The identifiable victim effect refers to the tendency to offer more aid to a specific, identifiable victim rather than a vaguely defined group of people with the same need. In the this study, the identifiable victim is a fictional patient who experience a negative consequence as a result of an unnecessary test. The identifiable victim effect is described and studied in the following articles:
Small D. Sympathy and callousness: The impact of deliberative thought on donations to identifiable and statistical victims. Organizational Behavior and Human Decision Processes 2007;102:143-53.
George Loewenstein, Deborah A. Small, and Jeff Strand. "Statistical, identifiable, and iconic victims" in Edward J. McCaffery, Joel Slemrod (2006). Behavioral public finance. Russell Sage Foundation; pp. 32-35.
- Conditions
- Prescribing Tendencies
- Being tested
- Guideline, Cost, Victim
- Keywords
- physician prescribing, behavioral economics, primary care practice
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
GuidelineBehavioural
Physicians will receive information on the Choosing Wisely Guideline
CostBehavioural
Physicians will receive cost information.
VictimBehavioural
Physicians will receive information on an identifiable victim.
| Study group | Role | What they receive |
|---|---|---|
| Guideline and Cost | Experimental | The Choosing Wisely guideline and the cost of the test at our institution: $60.35 for a basic metabolic panel. Receives: Behavioral: Guideline; Behavioral: Cost |
| Guideline | Placebo comparator | The Choosing Wisely guideline: "Don't perform blood chemistry panels in asymptomatic, healthy adults." Receives: Behavioral: Guideline |
| Guideline and Victim | Active comparator | The Choosing Wisely Guideline and a clinical scenario with a patient as an identifiable victim who suffered harm from having an unnecessary test done Receives: Behavioral: Guideline; Behavioral: Victim |
| Guideline, Cost, and Victim | Experimental | The Choosing Wisely guideline and a clinical scenario with a physician as an identifiable victim who suffered harm when he ordered an unnecessary test. Receives: Behavioral: Guideline; Behavioral: Cost; Behavioral: Victim |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of blood chemistry tests among visits by adult patients under 65
Measured: Within 1 week of receiving the intervention
Percentage of blood chemistry tests among visits by adult patients under 65
Measured: Within 1 month of receiving the scenario
Secondary outcomes (1)
Physicians' attitudes and perceived practice immediately after reading the scenario
Measured: Immediate (up to 5 min)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Jan 2014 (estimated)
- Study startFeb 2014
- Primary completionSep 2015
- Study completionDec 2015
Why it stopped: Funding
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Prescribing TendenciesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- Weill Medical College of Cornell University
- Sponsor type
- University, hospital or other
- Collaborators
- Duke University
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02048982
- Sponsor's protocol ID
- Bishop_stats_stories
- Status last verified
- Sep 2018
- First submitted
- 27 Jan 2014
- Last updated
- 12 Sep 2018
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 12 Sep 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- What Influences Physicians' Decisions - Statistics or Stories?
- ClinicalTrials.gov ID
- NCT02048982
- Acronym / sponsor ID
- Bishop_stats_stories
- Conditions
- Prescribing Tendencies
- Keywords
- physician prescribing, behavioral economics, primary care practice
- Study type
- Interventional
- Recruitment status
- WithdrawnReason stopped: Funding
- Enrolment
- 0 participants (actual)
- Lead sponsor
- Weill Medical College of Cornell UniversityUniversity, hospital or other
- Collaborators
- Duke University
- Study start
- Feb 2014
- Primary completion
- Sep 2015 (actual)
- Study completion
- Dec 2015 (actual)
- First posted
- 29 Jan 2014 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to test whether physicians change their use of non-recommended tests, procedures, or medications more in response to evidence based-guidelines, price information, or an individual patient's story.
Detailed description
We will perform a randomized controlled trial (RCT) of information presented to physicians to test the hypothesis that an identifiable victim affects physician practice behavior more than a statistical victim.
Specifically, we will answer the following research questions: 1) do physicians order fewer non-recommended tests, procedures, or medications if they are told about a patient or a physician who had a bad outcome from that test, procedure, or medication than if they are simply told the guideline or the cost of the test, procedure or medication, 2) does the effect of learning about the identifiable victim last longer than the effect of learning about the guideline or the cost of a test, procedure, or medication, and 3) does the identifiable victim effect differ if the victim is a patient or a physician? We hypothesize that because of the propensity to respond more to the identifiable victim rather than the statistical victim that physicians will order fewer unnecessary tests when they are told about an individual patient case than if they are simply told about the guideline, that the effect of the identifiable victim will last longer than the effect of the statistical victim, and that a patient as the identifiable victim will have more effect than a physician as the identifiable victim.
The identifiable victim effect refers to the tendency to offer more aid to a specific, identifiable victim rather than a vaguely defined group of people with the same need. In the this study, the identifiable victim is a fictional patient who experience a negative consequence as a result of an unnecessary test. The identifiable victim effect is described and studied in the following articles:
Small D. Sympathy and callousness: The impact of deliberative thought on donations to identifiable and statistical victims. Organizational Behavior and Human Decision Processes 2007;102:143-53.
George Loewenstein, Deborah A. Small, and Jeff Strand. "Statistical, identifiable, and iconic victims" in Edward J. McCaffery, Joel Slemrod (2006). Behavioral public finance. Russell Sage Foundation; pp. 32-35.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Guideline and Cost | Experimental | Behavioral: Guideline, Behavioral: CostThe Choosing Wisely guideline and the cost of the test at our institution: $60.35 for a basic metabolic panel. |
| Guideline | Placebo comparator | Behavioral: GuidelineThe Choosing Wisely guideline: "Don't perform blood chemistry panels in asymptomatic, healthy adults." |
| Guideline and Victim | Active comparator | Behavioral: Guideline, Behavioral: VictimThe Choosing Wisely Guideline and a clinical scenario with a patient as an identifiable victim who suffered harm from having an unnecessary test done |
| Guideline, Cost, and Victim | Experimental | Behavioral: Guideline, Behavioral: Cost, Behavioral: VictimThe Choosing Wisely guideline and a clinical scenario with a physician as an identifiable victim who suffered harm when he ordered an unnecessary test. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- Primary care physicians in the Weill Cornell Physicians Organization
Key exclusion criteria (1 listed)
- None
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| GuidelinePhysicians will receive information on the Choosing Wisely Guideline | Behavioural | Guideline, Guideline and Cost, Guideline and Victim, Guideline, Cost, and Victim |
| CostPhysicians will receive cost information. | Behavioural | Guideline and Cost, Guideline, Cost, and Victim |
| VictimPhysicians will receive information on an identifiable victim. | Behavioural | Guideline and Victim, Guideline, Cost, and Victim |
Primary outcome
Percentage of blood chemistry tests among visits by adult patients under 65
Time frame: Within 1 week of receiving the intervention
Percentage of blood chemistry tests among visits by adult patients under 65
Time frame: Within 1 month of receiving the scenario
1 secondary outcome
Physicians' attitudes and perceived practice immediately after reading the scenario
Time frame: Immediate (up to 5 min)
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Sep 2018.
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Guideline, Cost and Victim in people with Prescribing Tendencies, run by Weill Medical College of Cornell University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: withdrawn, as of the sponsor's last update on 12 Sep 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study was withdrawn before enrolling participants, so there are no results.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percentage of blood chemistry tests among visits by adult patients under 65 (time frame: Within 1 week of receiving the intervention). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Sep 2018.