Evidence map›Paper›PMID 30446909›Full record

ArticleJournal of general internal medicine2019

Improving Patients' Choice of Clinician by Including Roll-up Measures in Public Healthcare Quality Reports: an Online Experiment.

Jennifer L Cerully, Andrew M Parker, Lise Rybowski, Mark Schlesinger, Dale Shaller, Rachel Grob, Melissa L Finucane, Steven C Martino

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jennifer L CerullyRAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, USA. jcerully@rand.org.
Andrew M ParkerRAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, USA.
Lise RybowskiSeveryn Group, Ashburn, VA, USA.
Mark SchlesingerYale University, New Haven, CT, USA.
Dale ShallerShaller Consulting Group, Chesterfield, MI, USA.
Rachel GrobUniversity of Wisconsin-Madison, Madison, WI, USA.
Melissa L FinucaneRAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, USA.
Steven C MartinoRAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, USA.

Funding

Consumer Assessment of Healthcare Providers and Systems CAHPS VU18HS016978 · AHRQ · YALE UNIVERSITY · PI CLEARY, PAUL D · 2007 to 2021
$20.3M
Continuation of Consumer Assessment of Healthcare Providers and Systems CAHPS IVU18HS016980 · AHRQ · RAND CORPORATION · PI HAYS, RONALD DALE · 2007 to 2016
$14.7M
AHRQ HHS U18 HS016978AHRQ HHS U18 HS016980
6 · The paper itself

Abstract

backgroundPublic reports on healthcare quality typically include complex data. To lower the cognitive burden of interpreting these data, some report designers create summary, or roll-up, measures combining multiple indicators of quality into one score. Little is known about how the availability of roll-ups affects clinician choice.

objectiveTo determine how presenting quality scores at different levels of aggregation affects patients' clinician choices.

designWe conducted a simulated clinician-choice experiment, randomizing participants to three versions of a public reporting website and comparing their clinician choices. One version aggregated all clinician-level quality measures into roll-ups, the second provided disaggregated (drill-down) scores only, and the third offered both roll-ups and drill-downs.

participantsFive hundred fifty panelists drawn from a probability-based Internet panel. MAIN MEASURES: We assessed the amount of effort participants exerted by tracking the length of time spent on the website and the number of concrete actions taken on the website (e.g., clicking items). We evaluated decision quality by measuring whether participants selected a clinician who performed more poorly than others and incongruence between participants' stated preferences for dimensions of quality and their chosen clinician's performance on those dimensions. KEY

resultsParticipants seeing drill-downs alone (mean = 14.9) or with roll-ups (mean = 19.2) took more actions than those who saw roll-ups alone (mean = 10.5) (ps < 0.05). However, participants seeing only drill-downs made poorer choices than those who saw roll-ups alone or with drill-downs. More participants seeing drill-downs chose a clinician who was outperformed (36.3% versus 23.4% [roll-up] and 25.6% [drill-down + roll-up], ps < 0.05) and made choices incongruent with stated preferences (51.2% versus 45.6% [roll-up] and 47.5% [drill-down + roll-up], ps < 0.05). The distinction between roll-up and drill-down was somewhat stronger for sicker participants.

conclusionsOur results suggest that roll-ups in healthcare quality reports, alone or as a complement to drill-downs, can help patients make better decisions for themselves.

Indexed as

Choice BehaviorAdolescentAdultFemaleHumansMaleMiddle AgedPatient PreferencePhysician-Patient RelationsPhysiciansPublic HealthQuality of Health CareResearch ReportYoung Adultcomposite measurehealthcare qualitypatient experiencepatient satisfactionsummary score

Identifiers

PMID30446909
PMCPMC6374266

What OpenQuestion holds

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Registered trials

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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.