What Influences Physicians' Decisions - Statistics or Stories?

September 10, 2018 updated by: Weill Medical College of Cornell University
The purpose of this study is to test whether physicians change their use of non-recommended tests, procedures, or medications more in response to evidence based-guidelines, price information, or an individual patient's story.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Withdrawn

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

We will perform a randomized controlled trial (RCT) of information presented to physicians to test the hypothesis that an identifiable victim affects physician practice behavior more than a statistical victim.

Specifically, we will answer the following research questions: 1) do physicians order fewer non-recommended tests, procedures, or medications if they are told about a patient or a physician who had a bad outcome from that test, procedure, or medication than if they are simply told the guideline or the cost of the test, procedure or medication, 2) does the effect of learning about the identifiable victim last longer than the effect of learning about the guideline or the cost of a test, procedure, or medication, and 3) does the identifiable victim effect differ if the victim is a patient or a physician? We hypothesize that because of the propensity to respond more to the identifiable victim rather than the statistical victim that physicians will order fewer unnecessary tests when they are told about an individual patient case than if they are simply told about the guideline, that the effect of the identifiable victim will last longer than the effect of the statistical victim, and that a patient as the identifiable victim will have more effect than a physician as the identifiable victim.

The identifiable victim effect refers to the tendency to offer more aid to a specific, identifiable victim rather than a vaguely defined group of people with the same need. In the this study, the identifiable victim is a fictional patient who experience a negative consequence as a result of an unnecessary test. The identifiable victim effect is described and studied in the following articles:

Small D. Sympathy and callousness: The impact of deliberative thought on donations to identifiable and statistical victims. Organizational Behavior and Human Decision Processes 2007;102:143-53.

George Loewenstein, Deborah A. Small, and Jeff Strand. "Statistical, identifiable, and iconic victims" in Edward J. McCaffery, Joel Slemrod (2006). Behavioral public finance. Russell Sage Foundation; pp. 32-35.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • New York
      • New York, New York, United States, 10065
        • Weill Cornell Medical College

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Primary care physicians in the Weill Cornell Physicians Organization

Exclusion Criteria:

  • None

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Guideline and Cost
The Choosing Wisely guideline and the cost of the test at our institution: $60.35 for a basic metabolic panel.
Behavioral: Guideline
Physicians will receive information on the Choosing Wisely Guideline
Behavioral: Cost
Physicians will receive cost information.
Placebo Comparator: Guideline
The Choosing Wisely guideline: "Don't perform blood chemistry panels in asymptomatic, healthy adults."
Behavioral: Guideline
Physicians will receive information on the Choosing Wisely Guideline
Active Comparator: Guideline and Victim
The Choosing Wisely Guideline and a clinical scenario with a patient as an identifiable victim who suffered harm from having an unnecessary test done
Behavioral: Guideline
Physicians will receive information on the Choosing Wisely Guideline
Behavioral: Victim
Physicians will receive information on an identifiable victim.
Experimental: Guideline, Cost, and Victim
The Choosing Wisely guideline and a clinical scenario with a physician as an identifiable victim who suffered harm when he ordered an unnecessary test.
Behavioral: Guideline
Physicians will receive information on the Choosing Wisely Guideline
Behavioral: Cost
Physicians will receive cost information.
Behavioral: Victim
Physicians will receive information on an identifiable victim.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Time Frame
Percentage of blood chemistry tests among visits by adult patients under 65
Time Frame: Within 1 week of receiving the intervention
Within 1 week of receiving the intervention
Percentage of blood chemistry tests among visits by adult patients under 65
Time Frame: Within 1 month of receiving the scenario
Within 1 month of receiving the scenario

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Time Frame
Physicians' attitudes and perceived practice immediately after reading the scenario
Time Frame: Immediate (up to 5 min)
Immediate (up to 5 min)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Weill Medical College of Cornell University

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Duke University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 1, 2014

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 1, 2015

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2015

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 27, 2014

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 28, 2014

First Posted (Estimate)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
January 29, 2014

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 12, 2018

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 10, 2018

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2018

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • Bishop_stats_stories

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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Conditions

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