Evaluating a Our Practice Advisory (OPA) to Optimize Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) Test Orders

NCT06993805 | Recruiting

• 1 other identifier: IRB-25-0120
• Study Type: interventional
• Target: 384
• Locations: 1 country
• Sites: 1

Brief Summary

Our Practice Advisory (OPA) are essential tools in clinical decision-making. The alerts are designed to guide providers towards evidence-based practices and improve patient outcomes. The focus of this initiative is on Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) testing, with the goal of addressing unnecessary repeat testing within a 30-day timeframe, which rarely yields significant new insights. Although randomization occurs at the patient level, the primary outcome of this study focuses on provider behavior and decision-making. By focusing on this specific intervention, the study aims to optimize resource use, align test ordering with evidence-based guidelines, and support improved patient outcomes. The results of this evaluation will help refine OPAs and guide broader strategies for implementing clinical decision support tools across healthcare systems.

Conditions

Physician Workflow; Resource Utilization

Keywords

Clinical Decision Support; Laboratory Test Optimization; Resource Utilization; Our Practice Advisory (OPA)

Outcome Measures

Primary Outcomes (1)

• Change in Frequency of Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) Ordered within 30 days of Prior Results

  This measure evaluates the impact of a randomized Our Practice Advisory (OPA) intervention on the frequency of Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) tests ordered within 30 days of prior results. Data will be extracted from the UCLA Health Electronic Health Record (EHR) system using a structured query to identify qualifying test orders. Logistic regression will be used to compare the likelihood of A1c or TSH orders within the 30 days between the intervention and control group, adjusting for patient age, sex, and comorbidities. Clustering by providers will be accounted for.

  Study month 6

Study Arms (2)

OPA Intervention Group

EXPERIMENTAL

Providers in this group will receive a Our Practice Advisory (OPA) through the electronic health record (EHR) system when ordering Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) tests. The OPA will prompt providers to reconsider the test if it was ordered within the previous 30 days, aligning with evidence-based guidelines to reduce unnecessary testing.

Behavioral: OPA

Control Group

NO INTERVENTION

Providers in this group will not receive a Our Practice Advisory (OPA) through the Electronic Health Record (EHR) system when ordering Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) tests. This group represents the current standard of care, with no additional prompts or alerts implemented.

Interventions

OPA BEHAVIORAL

The Our Practice Advisory (OPA) intervention is a behavioral nudge integrated into the electronic health record system. It is designed to prompt providers to reconsider ordering Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) tests if a similar test was performed within the previous 30 days. The OPA aligns with evidence-based guidelines to reduce unnecessary testing, improve resource utilization, and optimize patient care by enhancing clinical decision-making at the point of order entry.

OPA Intervention Group

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• years or older
• Inpatient or observation stays within UCLA Health System hospitals
• Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) ordered, AND this lab was ordered and resulted within the prior 30 days

You may not qualify if:

• Have an A1c or TSH ordered and do not have a result for one of these labs in the prior 30 days

Sponsors & Collaborators

• University of California, Los Angeles: lead

Study Sites (1)

UCLA Health System

Los Angeles, California, 90024, United States

RECRUITING

Central Study Contacts

Katelyn Clinical Research Coordinator

CONTACT

310-267-5250; katenguyen@mednet.ucla.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: CARE PROVIDER, INVESTIGATOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Medicine

Study Record Dates

• First Submitted: April 30, 2025
• First Posted: May 29, 2025
• Study Start: May 6, 2025
• Primary Completion: December 1, 2025
• Study Completion: February 1, 2026
• Last Updated: May 29, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)