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.
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 Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
329
Patients receive a text-message and email with educational materials about medical testing.
Physicians receive an email with feedback on how they compare to their peers in aggregate on test ordering during annual physicals.
Physicians receive reference materials on medical test interpretation and incidental findings.
Brigham and Women's Hospital
Boston, Massachusetts, United States
Shared Decision-Making Process 4 Survey
Composite score of survey items completed by the patient after physician visit. Min 0, Max 4 (higher is better).
Time frame: Within two weeks after visit
Presence of testing discussion
Binary measure from patient post-visit survey (present vs absent)
Time frame: Within two weeks after visit
Satisfaction with testing discussion
Binary measure from patient post-visit survey (high vs low)
Time frame: Within two weeks after visit
Discussion of next steps
Binary measure from patient post-visit survey (present vs absent)
Time frame: Within two weeks after visit
Whether doctor explained tests in a way that was easy to understand
Binary measure from patient post-visit survey (yes completely vs yes a little or no)
Time frame: Within two weeks after visit
Patient knowledge
Composite score of survey items from patient post-visit survey. Min 0, Max 4 (higher is better).
Time frame: Within two weeks after visit
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Patients receive a text-message and email with general visit preparation tips.