ReviewJournal of hospital medicine2017
A Practical Framework for Understanding and Reducing Medical Overuse: Conceptualizing Overuse Through the Patient-Clinician Interaction.
Review in Journal of hospital medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04851691 (A Pragmatic Randomized-controlled Trial of a Multi-pronged Electronic Health Record-based Clinical Decision Support Tool to Reduce Low-value Antipsychotic Prescriptions Among Older Adults With Alzheimer's and Related Dementias), which is not on this map. Cited by 57 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
A Pragmatic Randomized-controlled Trial of a Multi-pronged Electronic Health Record-based Clinical Decision Support Tool to Reduce Low-value Antipsychotic Prescriptions Among Older Adults With Alzheimer's and Related Dementias
Who cites it
57 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Pooled it
- De-implementing low-value care in cancer care delivery: a systematic review.Implementation science : IS · 2022Pooled it
- Overuse of diagnostic testing in healthcare: a systematic review.BMJ quality & safety · 2022Pooled it
- Decreasing patient-reported burden of treatment: A systematic review of quantitative interventional studies.PloS one · 2021Pooled it
- Development of a Conceptual Map of Negative Consequences for Patients of Overuse of Medical Tests and Treatments.JAMA internal medicine · 2018Pooled it
- Effect of a Peer Comparison and Educational Intervention on Medical Test Conversation Quality: A Randomized Clinical Trial.JAMA network open · 2023Trial
- Parental Perspectives on Continuous Pulse Oximetry Use in Bronchiolitis Hospitalizations.Pediatrics · 2020Trial
- Underdiagnosis of Health: A Key Driver of Overdiagnosis of Disease.Journal of evaluation in clinical practice · 2026Article
- De-Implementing Low-Value Care in Dentistry: The Case for Choosing Wisely Campaigns.Community dentistry and oral epidemiology · 2026Article
- Management of acute dental pain in adults.Canadian family physician Medecin de famille canadien · 2026Article
- Addressing low-value care (LVC) in Asia: a narrative review of Choosing Wisely and other initiatives across Asia.BMJ open quality · 2026Review
- Adherence With Diagnostic Stewardship Guidance and Sociodemographic Characteristics in the PICU.Hospital pediatrics · 2026Article
- Oxygen Stewardship in Adult Critical Care: A Quality Improvement Initiative.Nursing in critical care · 2026Article
- Addressing the overuse-underuse paradox in healthcare.Medicine, health care, and philosophy · 2025Article
- How limited english proficiency impacts patient engagement with telemedicine: a systematic review.NPJ digital medicine · 2025Article
- GPs' decision-making behaviour in the prescription of aspirin for primary prevention in elderly individuals: a qualitative study using semistructured interviews in France.BMC primary care · 2025Article
- Subtle Differences in Physician Communication and Substantial Impacts on Patient Decision-Making About Low-Value Care: An Experimental Vignette Study.Journal of evaluation in clinical practice · 2025Article
- Improving postoperative care for neurosurgical patients by a standardised protocol for urinary catheter placement: a multicentre before-and-after implementation study.BMJ open quality · 2025Observational
- Shifts in total medical expenses by health coverage changes among the low-income, medically vulnerable population in South Korea.Environmental health and preventive medicine · 2025Article
- Moderating Effect of Coping Strategies on the Association Between the Infodemic-Driven Overuse of Health Care Services and Cyberchondria and Anxiety: Partial Least Squares Structural Equation Modeling Study.Journal of medical Internet research · 2024Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Overuse of medical services is an increasingly recognized driver of poor-quality care and high cost. A practical framework is needed to guide clinical decisions and facilitate concrete actions that can reduce overuse and improve care. We used an iterative, expert-informed, evidence-based process to develop a framework for conceptualizing interventions to reduce medical overuse. Given the complexity of defining and identifying overused care in nuanced clinical situations and the need to define care appropriateness in the context of an individual patient, this framework conceptualizes the patient-clinician interaction as the nexus of decisions regarding inappropriate care. This interaction is influenced by other utilization drivers, including healthcare system factors, the practice environment, the culture of professional medicine, the culture of healthcare consumption, and individual patient and clinician factors. The variable strength of the evidence supporting these domains highlights important areas for further investigation. Journal of Hospital Medicine 2017;12:346-351.
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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.