Choosing Tests Wisely in Rheumatology

SLE Clinical Trial

Official title:

Choosing Tests Wisely in Rheumatology

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03240536
• Other study ID #: 109363
• Status: Completed
• Phase: N/A
• Start date: May 15, 2018
• Est. completion date: September 8, 2021

Study information

• Verified date: April 2022
• Source: Lawson Health Research Institute
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a randomized study intended to produce a reduction in ordering of inappropriate tests by general practitioners as determined by recommendations from the CRA's Choosing Wisely guidelines. This reduction of inappropriate testing is expected in referrals to the rheumatologists randomized to the intervention group. This study will further explore which recommendations from the Canadian Rheumatology Association (CRA)/Canada Choosing Wisely campaign have the most impact on regional referring physicians to the Rheumatology clinic at St. Joseph's Hospital, London.

Description:

This a randomized study in that 6 rheumatologists (30 referrals each) will be randomized to one of two groups: intervention or control. Referring physicians to the intervention group will be faxed a brief Choosing Wisely form (intervention) based upon the recommendations of the Canadian Rheumatology Association's (CRA) Canada Choosing Wisely campaign, while referring physicians from the control group will not receive the form (non intervention). Analysis will be based upon the results of a three question survey faxed to all referring physicians at year one and at year two and on future referrals from the referring physicians to determine if there is a reduction in the group of ordering physicians that received the intervention (Choosing Wisely form).

Recruitment information / eligibility

• Status: Completed
• Enrollment: 638
• Est. completion date: September 8, 2021
• Est. primary completion date: September 8, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Ordering physicians who recently made a referral to the Rheumatology clinic at St. Joseph's Health Care.

Exclusion Criteria:

• N/A, all recent referrals will be included.

Related Conditions & MeSH terms

• SLE

Intervention

Other:
• Choosing Wisely form
The investigators will fax a "Choosing Wisely form" to ordering physicians that will include information from the Canadian Rheumatology Association Canada Choosing Wisely Guidelines. Three points will be included with some additional explanation of why these are important. The three guidelines included will be: Don't order an ANA as a screening test in patients without specific signs or symptoms of systemic lupus erythematous (SLE) or another connective tissue disorder (CTD). Don't routinely image patients with low back pain regardless of the duration of symptoms unless that are clinical reasons to suspect serious underlying pathology Don' routinely order a shoulder ultrasound as it is likely to indicate a tear in many people over the age of 50 years and will not change the initial management.

Locations

Country	Name	City	State
Canada	St. Joseph's Health Care London	London	Ontario

Sponsors (1)

Lead Sponsor	Collaborator
Lawson Health Research Institute

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Assessing the change in the number of the total number of ANA tests, back CT's and shoulder ultrasounds in rheumatology referrals	-collecting the total number of ANA tests, back CT's and shoulder ultrasounds	Change from baseline number of tests at year one, year two