Evidence map›Paper›PMID 37605243›Full record

ArticleImplementation science : IS2023

Reporting of costs and economic impacts in randomized trials of de-implementation interventions for low-value care: a systematic scoping review.

Petra Falkenbach, Aleksi J Raudasoja, Robin W M Vernooij, Jussi M J Mustonen, Arnav Agarwal, Yoshitaka Aoki, Marco H Blanker, Rufus Cartwright, Herney A Garcia-Perdomo, Tuomas P Kilpeläinen and 10 more

Registry-linked trialOpen access · goldAbstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in Implementation science : IS, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06896474 (SDM POSSIBLE), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.6field-weighted citation impact, top 10% 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.

NCT06896474 narecruitingnot on this mapstarted 2026, after this paper: background citation

SDM POSSIBLE: A Cluster RCT of a Breast Cancer Treatment Decision Aid for Women 70+ With Low-Risk Stage I Breast Cancers

TypeinterventionalSponsorBeth Israel Deaconess Medical CenterRan2026 to 2033Enrolled402ConditionsBreast CancerArmsShared Decision-Making Training and Decision Aid
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. A Surgeon's Field Guide to Value-Based Specialty Care.Laryngoscope investigative otolaryngology · 2025
    Review
  4. 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

20 authors at 13 institutions in 6 countries.

Petra FalkenbachFinnish Coordinating Center for Health Technology Assessment, Oulu University Hospital, University of Oulu, Oulu, Finland. petra.falkenbach@pohde.fi.ORCID http://orcid.org/0000-0003-3541-5313
Aleksi J RaudasojaFinnish Medical Society Duodecim, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Robin W M VernooijDepartment of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands.
Jussi M J MustonenMehiläinen Oy, Helsinki, Finland.
Arnav AgarwalDepartment of Medicine, Division of General Internal Medicine, McMaster University, Hamilton, ON, Canada.
Yoshitaka AokiDepartment of Urology, University of Fukui Faculty of Medical Sciences, Fukui, Japan.
Marco H BlankerDepartment of General Practice and Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Rufus CartwrightDepartment of Gynaecology, Chelsea and Westminster NHS Foundation Trust, London, UK.
Herney A Garcia-PerdomoDepartment of Surgery, Division of Urology/Uro-Oncology, School of Medicine, Universidad del Valle, Cali, Colombia.
Tuomas P KilpeläinenDepartment of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Olli LainialaDepartment of Radiology, Faculty of Medicine and Health Technologies, Imaging Centre, Tampere University Hospital, Tampere University, Tampere, Finland.
Tiina LambergFinnish Medical Society Duodecim, Helsinki, Finland.
Olli P O NevalainenWellbeing Services County of Pirkanmaa, Unit of Health Sciences, Faculty of Social Sciences, Hatanpää Health Center, Tampere University, Tampere, Finland.
Eero RaittioDepartment of Dentistry and Oral Health, Oral Health Care, Institute of Dentistry, Aarhus University, University of Eastern, Kuopio, Finland.
Patrick O RichardDivision of Urology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada.
Philippe D VioletteDepartments of Surgery and Health Research Methods Evidence and Impact, McMaster University, Hamilton, Canada.
Kari A O TikkinenDepartment of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Raija SipiläFinnish Medical Society Duodecim, Helsinki, Finland.
Miia TurpeinenOulu University Hospital, University of Oulu, Oulu, Finland.
Jorma KomulainenFinnish Medical Society Duodecim, Helsinki, Finland.
Finnish Medical Society Duodecim · FIUniversity of Helsinki · FIImpact · CAOulu University Hospital · FICentre Hospitalier Universitaire de Sherbrooke · CAChelsea and Westminster Hospital NHS Foundation Trust · GBTampere University · FITampere University Hospital · FIUniversidad del Valle · COUniversity Medical Center Groningen · NLUniversity of Eastern Finland · FIUniversity of Fukui · JPUtrecht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDe-implementation of low-value care can increase health care sustainability. We evaluated the reporting of direct costs of de-implementation and subsequent change (increase or decrease) in health care costs in randomized trials of de-implementation research.

methodsWe searched MEDLINE and Scopus databases without any language restrictions up to May 2021. We conducted study screening and data extraction independently and in duplicate. We extracted information related to study characteristics, types and characteristics of interventions, de-implementation costs, and impacts on health care costs. We assessed risk of bias using a modified Cochrane risk-of-bias tool.

resultsWe screened 10,733 articles, with 227 studies meeting the inclusion criteria, of which 50 included information on direct cost of de-implementation or impact of de-implementation on health care costs. Studies were mostly conducted in North America (36%) or Europe (32%) and in the primary care context (70%). The most common practice of interest was reduction in the use of antibiotics or other medications (74%). Most studies used education strategies (meetings, materials) (64%). Studies used either a single strategy (52%) or were multifaceted (48%). Of the 227 eligible studies, 18 (8%) reported on direct costs of the used de-implementation strategy; of which, 13 reported total costs, and 12 reported per unit costs (7 reported both). The costs of de-implementation strategies varied considerably. Of the 227 eligible studies, 43 (19%) reported on impact of de-implementation on health care costs. Health care costs decreased in 27 studies (63%), increased in 2 (5%), and were unchanged in 14 (33%).

conclusionDe-implementation randomized controlled trials typically did not report direct costs of the de-implementation strategies (92%) or the impacts of de-implementation on health care costs (81%). Lack of cost information may limit the value of de-implementation trials to decision-makers.

trial registrationOSF (Open Science Framework): https://osf.io/ueq32 .

Indexed as

Health Care CostsLow-Value CareAnti-Bacterial AgentsDatabases, FactualHumansRandomized Controlled Trials as TopicAnti-Bacterial AgentsCostDe-implementationDe-implementation strategyHealth care costsSystematic scoping review

Identifiers

PMID37605243
PMCPMC10440866
OpenAlexW4386028743

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.