ArticleHealthcare (Amsterdam, Netherlands)2016
Using active choice within the electronic health record to increase physician ordering and patient completion of high-value cancer screening tests.
Article in Healthcare (Amsterdam, Netherlands), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Pooled it
- The effectiveness of behavioral economics-informed interventions on physician behavioral change: A systematic literature review.PloS one · 2020Pooled it
- Health information technology tools to accelerate gastrointestinal evaluation in patients with iron deficiency anaemia: a cluster randomised controlled trial.BMJ open quality · 2024Trial
- Architecting Process of Care: A randomized controlled study evaluating the impact of providing nonadherence information and pharmacist assistance to physicians.Health services research · 2020Trial
- Effect of an Automated Patient Dashboard Using Active Choice and Peer Comparison Performance Feedback to Physicians on Statin Prescribing: The PRESCRIBE Cluster Randomized Clinical Trial.JAMA network open · 2018Trial
- Electronic Health Record Integration of a Calculator for Cesarean Risk During Labor Induction.Learning health systems · 2026Article
- Hepatocellular Carcinoma in Southeast Asian Americans: Epidemiologic Trends, Screening Challenges, and Policy Implications.Healthcare (Basel, Switzerland) · 2026Review
- Machine Learning Prediction and Reducing Overdoses With Electronic Health Record Nudges (mPROVEN) in the Primary Care Setting: Protocol for a Cluster Randomized Controlled Trial.JMIR research protocols · 2026Article
- Increasing screening for breast cancer using a randomized evaluation of electronic health record nudges: Design and rationale of the I-screen clinical trial.Contemporary clinical trials · 2025Article
- A Framework for Integrating Telehealth Equitably across the cancer care continuum.Journal of the National Cancer Institute. Monographs · 2024Article
- Association of Electronic Self-Scheduling and Screening Mammogram Completion.American journal of preventive medicine · 2024Article
- Behavioral "nudges" in the electronic health record to reduce waste and misuse: 3 interventions.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Choice Architecture in Opioid Safety Alerting.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2023Article
- Behavioral Economics Interventions to Improve Medical Decision-Making.Deutsches Arzteblatt international · 2022Article
- A Behavioral Economics-Electronic Health Record Module to Promote Appropriate Diabetes Management in Older Adults: Protocol for a Pragmatic Cluster Randomized Controlled Trial.JMIR research protocols · 2021Article
- Implementation of a Behavioral Economics Electronic Health Record (BE-EHR) Module to Reduce Overtreatment of Diabetes in Older Adults.Journal of general internal medicine · 2020Article
- Identifying End Users' Preferences about Structuring Pharmacogenetic Test Orders in an Electronic Health Record System.The Journal of molecular diagnostics : JMD · 2020Article
- Development and Validation of a Clinical Prediction Tool for Seasonal Influenza Vaccination in England.JAMA network open · 2020Article
- Using Behavioral Economics and Technology to Improve Outcomes in Cardio-Oncology.JACC. CardioOncology · 2020Review
- Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundHigh value screening tests such as colonoscopy and mammography can improve early cancer detection but are often underutilized.
methodsWe evaluated an active choice intervention using the electronic health record (EHR) to confirm patient eligibility for colonoscopy or mammography during the patient's clinic visit and prompt the physician and his/her medical assistant to actively choose to "accept" or "cancel" an order for it. We fit multivariate logistic regression models using a difference-in-differences approach to evaluate changes in physician ordering and patient completion of colonoscopy and mammography at the intervention practice compared to two control practices, adjusting for time trends, patient and clinic visit characteristics.
resultsThe sample comprised 7560 patients due for colonoscopy and 8337 patients due for mammography. Pre-intervention trends between practices did not differ. In the adjusted models, compared to the control group over time, the intervention practice had a significant increase in ordering of colonoscopy (11.8% points, 95% CI: 8.0-15.6, P<0.001) and mammography (12.4% points, 95% CI: 8.7-16.2, P<0.001). There was a significant increase in patient completion of colonoscopy (3.5% points, 95% CI: 1.1-5.9, P<0.01), but no change in mammography (2.2% points, 95% CI: -1.0 to 5.5, P=0.18).
conclusionsActive choice through the EHR was associated with an increase in physician ordering of colonoscopy and mammography. The intervention was also associated with an increase in patient completion of colonoscopy but no change in patient completion of mammography.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.