How Clinical and Personal Information Shape Physicians' Risk Judgments

NCT07162376 | Completed

• 1 other identifier: 2281657-2
• Study Type: interventional
• Target: 300
• Locations: 1 country
• Sites: 1

Brief Summary

Physicians often form quick judgments about the risk for serious disease when interacting with patients. Underestimating risk can lead to underuse of diagnostic testing and untreated illness, which can worsen patient outcomes. On the other hand, overestimating risk can lead to overuse of diagnostic testing, which is costly for health systems. To form judgments of risk, physicians should attend to a host of validated factors that are predictive of disease. However, research suggests that physicians may rely on demographic factors-such as race and gender. Physicians' judgments could also be influenced by non-health-related, personal information about their patients (e.g., hobbies, nicknames), which may moderate the impact of demographics on those judgments. The investigators examine these dynamics in the context of heart disease. The History, Electrocardiogram, Age, Risk factors and Troponin (HEART) Score is a validated model that specifies a correspondence between certain risk factors and the likelihood of Major Adverse Cardiac Event (MACE). Importantly, there are substantially different diagnostic tests (e.g., noninvasive stress test versus coronary angiogram) that should be used depending on a patient's MACE likelihood. Specifically, the investigators have three research questions:

• Research Question 1 (RQ1): How accurate are physicians relative to the benchmarks from the HEART score model?
• Research Question 2 (RQ2): How do clinically-relevant risk factors (e.g., smoking history), race, gender, and personal information disclosure influence risk judgments?
• Research Question 3 (RQ3): Does personal information disclosure moderate the effects of race and gender on risk judgments? Note that when the investigators discuss accuracy and error, they are referring to the comparison of physician judgments to the HEART score model benchmarks.

Conditions

Major Adverse Cardiac Event (MACE)

Keywords

Major Adverse Cardiac Event (MACE); Physician Perception; Risk Judgment; HEART Score; Diagnostic Testing; Cardiology; Personal Information

Outcome Measures

Primary Outcomes (1)

• Absolute Error in Perceived Risk of MACE

  For each patient profile, all participants will be asked about their perceived risk of MACE: What is the likelihood that this patient experiences a major adverse cardiac event in the six weeks following the visit? \[0-100\]. The paradigm uses two levels of risk factors, each associated with a specific risk of MACE range as defined by the HEART score model: low risk factors = 0.9-1.7% (midpoint = 1.3%); and medium risk factors = 12-16.6% (midpoint = 14.3%). To calculate each participant's directional error, the investigators will take the difference between participants' perceived risk of MACE and the midpoint of the risk of MACE range from the HEART score model at each patient's corresponding risk level. The absolute error is calculated by taking the absolute value of the directional error.

  At the time of survey completion, within approximately 2 weeks

Secondary Outcomes (5)

• Perceived Risk of MACE

  At the time of survey completion, within approximately 2 weeks

• Directional Error

  At the time of survey completion, within approximately 2 weeks

• Categorical Error

  At the time of survey completion, within approximately 2 weeks

• Diagnostic Test Decision

  At the time of survey completion, within approximately 2 weeks

• Overconfidence

  At the time of survey completion, within approximately 2 weeks

Study Arms (2)

No Personal Information Disclosure

NO INTERVENTION

Participants rate 8 patient profiles of patients with chest pain. The profiles each contain info about the patient's race, gender, and risk factors associated with MACE.

Personal Information Disclosure

EXPERIMENTAL

Participants rate 8 patient profiles of patients with chest pain. The profiles each contain info about the patient's race, gender, and risk factors associated with MACE. Each profile also contains non-health related personal information that the patient has disclosed (e.g., nickname, hobbies).

Behavioral: Personal Information Disclosure

Interventions

Personal Information Disclosure BEHAVIORAL

Each profile also contains non-health related personal information that the patient has disclosed (e.g., nickname, hobbies).

Personal Information Disclosure

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Emergency medicine physicians
• Cardiologists
• Hospitalists (i.e., internists whose practice is primarily in the hospital)
• If there are duplicate participant IDs in the data, only the first response will be included in the analysis

You may not qualify if:

• Participants who indicate they are retired
• Participants who write gibberish in the open-ended items
• Incomplete responses

Sponsors & Collaborators

• University of Maryland, College Park: lead

Study Sites (1)

Van Munching Hall

College Park, Maryland, 20742, United States

Location

Study Officials

• Joseph Reiff, PhD

  University of Maryland Robert H. Smith School of Business

  PRINCIPAL INVESTIGATOR

• Aneesh Rai, PhD

  University of Maryland Robert H. Smith School of Business

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Marketing

Model Details: Parallel randomized trial at the physician level.

Study Record Dates

• First Submitted: August 25, 2025
• First Posted: September 9, 2025
• Study Start: September 16, 2025
• Primary Completion: September 26, 2025
• Study Completion: September 26, 2025
• Last Updated: January 16, 2026

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: Indefinitely upon the study concluding.
• Access Criteria: The investigators will post the data, code, and materials on Researchbox.org. The investigators will create a unique page for our project. Any interested reader can access this page.

Locations

US (1)