Trial reportJournal of general internal medicine2018
Effect of Social Comparison Feedback on Laboratory Test Ordering for Hospitalized Patients: A Randomized Controlled Trial.
Trial report in Journal of general internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02330289 (The Effect of Norms on Laboratory and Imaging Testing), which is not on this map. Cited by 9 papers, 5 of them syntheses that pooled it.
What it found
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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.
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.
The Effect of Norms on Laboratory and Imaging Testing (ENLITen): a Pragmatic Randomized Controlled Trial
Who cites it
9 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025Pooled it
- Effectiveness of clinical dashboards as audit and feedback or clinical decision support tools on medication use and test ordering: a systematic review of randomized controlled trials.Journal of the American Medical Informatics Association : JAMIA · 2022Pooled it
- Systematic review and narrative synthesis of computerized audit and feedback systems in healthcare.Journal of the American Medical Informatics Association : JAMIA · 2022Pooled it
- Pooled it
- The effectiveness of behavioral economics-informed interventions on physician behavioral change: A systematic literature review.PloS one · 2020Pooled it
- Development, Implementation, and Evaluation Methods for Dashboards in Health Care: Scoping Review.JMIR medical informatics · 2024Article
- The impact of performance feedback reports on physician ordering behavior in the use of computed tomography pulmonary angiography (CTPA).Emergency radiology · 2023Article
- Characteristics promoting behaviour change: physician experience with a coalition-led quality improvement initiative to reduce excessive laboratory test ordering.BMJ open quality · 2023Article
- Research to Change Health Delivery Systems: On the Outside Looking in?Journal of general internal medicine · 2018Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundSocial comparison feedback is an increasingly popular strategy that uses performance report cards to modify physician behavior. Our objective was to test the effect of such feedback on the ordering of routine laboratory tests for hospitalized patients, a practice considered overused.
methodsThis was a single-blinded randomized controlled trial. Between January and June 2016, physicians on six general medicine teams at the Hospital of the University of Pennsylvania were cluster randomized with equal allocation to two arms: (1) those e-mailed a summary of their routine laboratory test ordering vs. the service average for the prior week, linked to a continuously updated personalized dashboard containing patient-level details, and snapshot of the dashboard and (2) those who did not receive the intervention. The primary outcome was the count of routine laboratory test orders placed by a physician per patient-day. We modeled the count of orders by each physician per patient-day after the intervention as a function of trial arm and the physician's order count before the intervention. The count outcome was modeled using negative binomial models with adjustment for clustering within teams.
resultsOne hundred and fourteen interns and residents participated. We did not observe a statistically significant difference in adjusted reduction in routine laboratory ordering between the intervention and control physicians (physicians in the intervention group ordered 0.14 fewer tests per patient-day than physicians in the control group, 95% CI - 0.56 to 0.27, p = 0.50). Physicians whose absolute ordering rate deviated from the peer rate by more than 1.0 laboratory test per patient-day reduced their laboratory ordering by 0.80 orders per patient-day (95% CI - 1.58 to - 0.02, p = 0.04).
conclusionsPersonalized social comparison feedback on routine laboratory ordering did not change targeted behavior among physicians, although there was a significant decrease in orders among participants who deviated more from the peer rate.
trial registrationClinicaltrials.gov registration: #NCT02330289.
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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.