Evidence map›Paper›PMID 34896294›Full record

ArticleContemporary clinical trials2022

Design of Behavioral Economic Applications to Geriatrics Leveraging Electronic Health Records (BEAGLE): A pragmatic cluster randomized controlled trial.

Tiffany Brown, Theresa A Rowe, Ji Young Lee, Lucia C Petito, Ryan Chmiel, Jody D Ciolino, Jason N Doctor, Craig R Fox, Noah J Goldstein, Darren Kaiser and 4 more

Open access · greenAbstract readClinical Trial Protocol
In one paragraph

Article in Contemporary clinical trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 9% of its field
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. 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

14 authors at 4 institutions in 1 country.

Tiffany BrownDepartment of Medicine, Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Theresa A RoweDepartment of Medicine, Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Ji Young LeeDepartment of Medicine, Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Lucia C PetitoDepartment of Preventive Medicine, Division of Biostatistics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Ryan ChmielNorthwestern Memorial HealthCare, Chicago, IL, USA.
Jody D CiolinoDepartment of Preventive Medicine, Division of Biostatistics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Jason N DoctorSchaeffer Center for Health Economics and Policy, University of Southern California, Los Angeles, CA, USA.
Craig R FoxAnderson School of Management, University of California at Los Angeles, Los Angeles, CA, USA.
Noah J GoldsteinAnderson School of Management, University of California at Los Angeles, Los Angeles, CA, USA.
Darren KaiserNorthwestern Memorial HealthCare, Chicago, IL, USA.
Jeffrey A LinderDepartment of Medicine, Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Daniella MeekerSchaeffer Center for Health Economics and Policy, University of Southern California, Los Angeles, CA, USA.
Yaw PeprahDepartment of Medicine, Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Stephen D PersellDepartment of Medicine, Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Center for Primary Care Innovation, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: spersell@nm.org.
Northwestern University · USNorthwestern Medicine · USUniversity of California, Los Angeles · USUniversity of Southern California · US

Funding

Northwestern University Clinical and Translational Science Institute (NUCATS)UL1TR001422 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI D'AQUILA, RICHARD · 2015 to 2023
$56.8M
Behavioral Economics Applications to Geriatrics Leveraging EHRs (BEAGLE)R33AG057383 · NIA · NORTHWESTERN UNIVERSITY AT CHICAGO · PI PERSELL, STEPHEN · 2019 to 2021
$2.1M
NCATS NIH HHS UL1 TR001422NIA NIH HHS R33 AG057383
6 · The paper itself

Abstract

backgroundOvertesting and treatment of older patients is common and may lead to harms. The Choosing Wisely campaign has provided recommendations to reduce overtesting and overtreatment of older adults. Behavioral economics-informed interventions embedded within the electronic health record (EHR) have been shown to reduce overuse in several areas. Our objective is to conduct a parallel arm, pragmatic cluster-randomized trial to evaluate the effectiveness of behavioral-economics-informed clinical decision support (CDS) interventions previously piloted in primary care clinics and designed to reduce overtesting and overtreatment in older adults. METHODS/

designThis trial has two parallel arms: clinician education alone vs. clinician education plus behavioral-economics-informed CDS. There are three co-primary outcomes for this trial: (1) prostate-specific antigen (PSA) screening in older men, (2) urine testing for non-specific reasons in older women, and (3) overtreatment of diabetes in older adults. All eligible primary care clinics from a large regional health system were randomized using a modified constrained randomization process and their attributed clinicians were included. Clinicians were recruited to complete a survey and educational module. We randomized 60 primary care clinics with 374 primary care clinicians and achieved adequate balance between the study arms for prespecified constrained variables. Baseline annual overuse rates for the three co-primary outcomes were 25%, 23%, and 17% for the PSA, urine, and diabetes measures, respectively. DISCUSSION: This trial is evaluating behavioral-economics-informed EHR-embedded interventions to reduce overuse of specific tests and treatments for older adults. The study will evaluate the effectiveness and safety of these interventions.

Indexed as

Decision Support Systems, ClinicalDiabetes MellitusGeriatricsAgedEconomics, BehavioralElectronic Health RecordsFemaleHumansMalePragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicBehavioral economicsDiabetes mellitusElectronic health recordsOveruseProstate cancer screeningUrinary tract infections

Identifiers

PMID34896294
PMCPMC8724916
OpenAlexW4200605050

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.