Clinical trials: Low-Value Care
Surgery-Complications, Anesthesia Complication
De-implementing Low Value Preoperative Care Wisely
Low value preoperative testing does not improve patient outcomes or reduce adverse events. Low value preoperative testing costs patients and healthcare systems without benefit.
- Trial name
- NCT05566327
- Testing
- De-implementation Bundle
- Volunteers
- 20 people, healthy volunteers welcome
- Sponsor
- University of Calgary
Alzheimer Disease, Dementia Alzheimers
An Electronic Clinical Decision Support Tool to Reduce Low-value Antipsychotic Prescriptions
The goal of this study will be to design, implement and test the impact of a quality improvement (QI) intervention that uses an EHR CDS tool among physicians newly ordering an antipsychotic medication for older adults with ADRD.
- Conditions
- Alzheimer Disease, Dementia Alzheimers, Dementia of Alzheimer Type
- Trial name
- NCT04851691
- Testing
- EHR CDS, Usual Care
- Where
- United States
- Volunteers
- 158 people
- Sponsor
- University of California, Los Angeles
Preterm Birth, Activity Restriction
DE-RESTRICT: Deimplementing Activity Restriction for Preterm Birth Prevention
DE-RESTRICT is a pilot study testing whether a strategy to reduce the use of activity restriction and bedrest in pregnancy is acceptable, appropriate, and feasible for prenatal care providers, and whether it changes how often…
- Conditions
- Preterm Birth, Activity Restriction, Bed Rest, Low-Value Care
- Trial name
- NCT07698483
- Testing
- Multicomponent deimplementation strategy
- Where
- 2 sites in United States
- Volunteers
- 237 people, healthy volunteers welcome
- Sponsor
- University of Pennsylvania
Cataract
Pre-Operative Testing for Cataract Surgery Among Adults in LA County
A multi-disciplinary intervention will reduce inappropriate preoperative testing for cataract surgery. Despite multiple rigorous randomized controlled trials and meta-analyses showing that pre-operative testing for cataract…
- Trial name
- CW-CATARACT (NCT03253874)
- Testing
- No Pre-Op Testing for Cataract Surgeries
- Volunteers
- 1,798 people, healthy volunteers welcome
- Sponsor
- University of California, Los Angeles
Health Services Misuse, Physician's Practice Patterns
Primary Care Clinician Commitments to Choosing Wisely®
This pragmatic trial examines the uptake and effects of primary care clinician commitments to follow 3 Choosing Wisely® recommendations.
- Conditions
- Health Services Misuse, Physician's Practice Patterns, Guideline Adherence, Unnecessary Procedures
- Trial name
- NCT02247050
- Testing
- Commitment invitation
- Where
- 6 sites in United States
- Volunteers
- 45 people
- Sponsor
- University of Michigan
Chronic Kidney Diseases, Eye Diseases
Smarter Care Virginia, Examining Low-Value Care in Virginia
Low-value care is defined as patient care that provides no net benefit to patients in specific clinical scenarios, and can cause patient harm.
- Conditions
- Chronic Kidney Diseases, Eye Diseases, Cardiac Disease, Surgery
- Trial name
- NCT04053335
- Testing
- Multicomponent Physician Performance Peer-Comparison Feedback Intervention
- Where
- United States
- Volunteers
- 5,000,000 people
- Sponsor
- University of California, Los Angeles
Bronchiolitis
Low-value Care, and Variation in Practice for Children Hospitalized With Bronchiolitis
Low-value care is defined as the use of a health service, such as diagnostics and treatments, for which the harms or costs outweigh the benefits.
- Trial name
- CareBEST (NCT06506474)
- Testing
- Provision of any of six different low-value health services for treatment of bronchiolitis
- Where
- 15 sites in Canada
- Volunteers
- 3,000 people
- Sponsor
- St. Justine's Hospital
Low-Value Care
EVOLV-Rx VA: Evaluating Opportunities to Decrease Low-Value Prescribing in Community Living Centers
The investigators developed EVOLV-Rx (Evaluating Opportunities to Decrease Low-Value Prescribing), a novel clinical support tool to detect 18 evidence-based and clinically useful low-value prescribing practices in older adults.
- Trial name
- NCT07166107
- Testing
- EVOLV-Rx dashboard
- Where
- 3 sites in United States
- Volunteers
- 1,161 people
- Sponsor
- VA Office of Research and Development
Transition of Care
Pharmacy Transitional Team: Evaluating the Value for Patients With Limited English Proficiency
The overall goal of this proposed study is to characterize the experiences, barriers and facilitators related to providing effective care transitions from hospital to post-acute care settings to elucidate the failures that drive…
- Trial name
- NCT07437508
- Where
- United States
- Volunteers
- 17 people
- Sponsor
- University of Washington
Trauma Injury
Reducing Low-value Care for Trauma Admissions
In Canada, injury leads to more potential years of life lost and to greater costs than heart and stroke diseases combined. Furthermore, more than 50% of patients hospitalised following injury do not receive optimal care, 20% of…
- Trial name
- NCT05744154
- Testing
- Audit & feedback with educational outreach and facilitation, Simple audit & feedback (usual practice)
- Where
- Canada
- Volunteers
- 29 people
- Sponsor
- Laval University
Medicaid Expansion
Evaluating Quality and Value of US Ambulatory Care Delivered Among Medicaid Expansion/Non-Expansion States, 2012-2015
Quasi-experimental pre-post analysis of the rate of high-value and low-value care services between states that expanded Medicaid and states that did not expand Medicaid January 1, 2014, for adult ambulatory visits, using…
- Trial name
- NCT05319743
- Testing
- Medicaid Expansion
- Where
- United States
- Volunteers
- 200,000 people, healthy volunteers welcome
- Sponsor
- University of California, Los Angeles
Critical Illness
Critical Care OptimizatIon of Albumin Ordering
Strong evidence suggests that human albumin solutions should not be used for fluid resuscitation except among patients undergoing therapeutic plasmapheresis and select patients with complications of liver cirrhosis (i.e.
- Trial name
- RATIONALE (NCT04187534)
- Testing
- Albumin Fluid Resuscitation Optimization Intervention, Usual Practice
- Where
- 15 sites in Canada
- Volunteers
- 50,000 people
- Sponsor
- University of Calgary
Gastrointestinal Diseases
A Personalised Approach Utilising the Frailty Index to Empower Consumers
Frailty is a common clinical syndrome in older adults that may carry an increased risk for poor health outcomes including falls, hospitalisation, and mortality.
- Trial name
- NCT05292989
- Testing
- Frailty Assessment, Standard Care
- Where
- Australia
- Volunteers
- 200 people
- Sponsor
- Princess Alexandra Hospital, Brisbane, Australia
Low-Value Care, Costs and Cost Analysis
Optimization of Low-Value Medical Testing Practices in Hospitalized Patients in Argentina
Overuse of laboratory testing in hospitalized patients is a common form of low-value care and may contribute to patient discomfort, unnecessary downstream testing, inefficient use of healthcare resources, and increased costs.
- Conditions
- Low-Value Care, Costs and Cost Analysis, Implementation Science, Public Health
- Trial name
- OPTIMIZAR (NCT07629219)
- Testing
- OPTIMIZAR Multicomponent Diagnostic Stewardship Bundle
- Where
- 8 sites in Argentina
- Volunteers
- 600 people
- Sponsor
- Hospital Italiano de Buenos Aires
Cardiology, Gastroenterology
Applying the Intention-Action Framework to Specialty Referrals
This is a prospective randomized controlled trial evaluating an EHR-embedded behavioral intervention intended to reduce low-value specialty referrals in cardiology, pulmonology, and gastroenterology.
- Conditions
- Cardiology, Gastroenterology, Pulmonology
- Trial name
- NCT07671976
- Testing
- Information provision, Auditing, Checklist
- Where
- United States
- Volunteers
- 1,600 people
- Sponsor
- University of California, Los Angeles
Pre-Operative Testing for Cataract Surgery
Using Behavioral Economics to Reduce Low-Value Care
There is strong consensus - based on robust randomized trial data - that routine pre-operative (pre-op) testing for cataract surgery is inappropriate.
- Trial name
- NCT04104256
- Testing
- Nudge #1: Alert highlighting the safety/potential harms to patients of undergoing pre-op tests, Nudge #2: Alert highlighting the financial harms to the patient experiencing pre-op tests, Nudge #3: Alert highlighting potential psychological harms to the patient of experiencing pre-op tests
- Where
- United States
- Volunteers
- 1,045 people
- Sponsor
- University of California, Los Angeles
Osteoarthritis, Knee, Hypertension
The Clinical Impact of Diet on Medical Conditions Treated Within Bundled Payment Models: a Pilot Study
Diet interventions (e.g., low-energy diets) are recommended as a treatment for obesity, obese patients with osteoarthritis, hypertension (HTN), and type 2 diabetes (T2D).
- Conditions
- Osteoarthritis, Knee, Hypertension, Type 2 Diabetes, Obesity
- Trial name
- NCT05735873
- Testing
- Low-energy diet
- Volunteers
- healthy volunteers welcome
- Sponsor
- Vanderbilt University Medical Center
Proton Pump Inhibitors
Evaluation of the National Randomized Proton Pump Inhibitor De-prescribing (RaPPID) Program
Proton pump inhibitors (PPIs) are medications used to treat acid-related stomach disorders, such as chronic heartburn. These medications are widely used by Veterans, with over 11 million 30-day prescriptions being filled each…
- Trial name
- RaPPID (NCT03719170)
- Testing
- PPI De-prescribing Program
- Where
- 4 sites in United States
- Volunteers
- 220,306 people
- Sponsor
- VA Office of Research and Development
Inappropriate Prescribing, Implementation Science
Reduction of Low-value Prescribing Through Audit and Feedback
The objective is to estimate the effect attributable to a primary care pharmacist-led audit and feedback (AF) strategy compared to the currently used AF strategy as a management tool to evaluate healthcare performance focusing on…
- Conditions
- Inappropriate Prescribing, Implementation Science, Behavioral Sciences
- Trial name
- AFFAP (NCT07336550)
- Testing
- Usual AF, Facilitated AF
- Where
- Spain
- Volunteers
- 540 people, healthy volunteers welcome
- Sponsor
- Basque Health Service