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Evaluation of a nudge intervention providing simple feedback to clinicians of the consequence of radiation exposure on demand for computerised tomography scans: a prospective, controlled study

Lewis, Sarah; Shaw, Dominick; Langley, Tessa; Fogarty, Andrew; Young, Ben; Cranwell, O.

Authors

Sarah Lewis

Dominick Shaw

Tessa Langley

Andrew Fogarty

Ben Young

O. Cranwell



Abstract

Computerised tomography (CT) is readily available in developed countries. As one of the side-effects includes an increased risk of cancer, interventions that may encourage more judicious use of CT scans are important. Behavioural economics theory includes the use of nudges that aim to help more informed decisions to be made, although these have been rarely used in hospitals to date. We aimed to evaluate the impact of a simple educational message appended to the CT scan report on subsequent numbers of CT scans completed using a controlled interrupted time series design based in two teaching hospitals in X. The intervention was the addition of a non-directional educational message on the risk of ionising radiation to all CT scan reports. There was a statistically significant reduction in the number of CT scans requested in the intervention hospital compared to the control hospital (-4.6%, 95% confidence intervals -7.4 to -1.7, p = 0.002) in the 12 months after the intervention was implemented. We conclude that a simple, non-directional nudge intervention has the capacity to modify clinician use of CT scans. This approach is cheap, and has potential in helping support doctors make informed decisions.

Journal Article Type Article
Publication Date Jul 1, 2019
Print ISSN 1470-2118
Publisher Royal College of Physicians
Peer Reviewed Peer Reviewed
Volume 19
Issue 4
Pages 290-293
APA6 Citation Lewis, S., Shaw, D., Langley, T., Fogarty, A., Young, B., & Cranwell, O. (2019). Evaluation of a nudge intervention providing simple feedback to clinicians of the consequence of radiation exposure on demand for computerised tomography scans: a prospective, controlled study. Clinical Medicine, 19(4), 290-293. doi:10.7861/clinmedicine.19-4-290
DOI https://doi.org/10.7861/clinmedicine.19-4-290
Publisher URL http://www.clinmed.rcpjournal.org/content/19/4/290

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