Clinical trial NCT06993805: Evaluating a Our Practice Advisory (OPA) to Optimize Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) Test Orders
Official title: Evaluation of Our Practice Advisory (OPA) Interventions on Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) Short Interval Ordering
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Physician Workflow
Resource Utilization
Keywords: Clinical Decision Support
Laboratory Test Optimization
Resource Utilization
Our Practice Advisory (OPA)
Lead sponsor: University of California, Los Angeles
Sponsor class: OTHER
First posted: 2025-05-29
Enrollment: 384
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

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.

Detailed description: The purpose of this Quality Improvement (QI) initiative is to evaluate the impact of a randomized Our Practice Advisory (OPA) intervention on physician ordering behavior of Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) tests within a 30-day interval from the prior test. The OPA will fire when an A1c or TSH are ordered within 30 days of a prior result (these short-interval tests are widely considered unnecessary) and will ask providers to reconsider the order. This study will evaluate the effectiveness of this intervention by randomizing patients 1:1 such that physicians caring for the patient will either (1) receive the OPA or (2) not receive the OPA if the providers order a short-interval test. This study is being conducted for a primary QI intent, as the results will (1) dictate if the short-interval OPA should be implemented across all patients, and (2) if this short-interval OPA should be applied to other labs aside from A1c and TSH. In these ways, the purpose of this study is to directly inform health system operations.

Eligibility criteria: Inclusion Criteria:

* 18 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

Exclusion Criteria:

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

Primary outcomes:
measure: Change in Frequency of Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) Ordered within 30 days of Prior Results
timeFrame: Study month 6
Secondary outcomes:
Other outcomes:
Locations:
city: Los Angeles
country: United States
facility: UCLA Health System
state: California
Study officials:
References: