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NCT Number: NCT06934564

De-Implementation of Low-value Testing in Patients Undergoing Low-Risk Surgery

This trial aims to evaluate the effectiveness of a multi-level, multi-component de-implementation strategy to reduce unnecessary preoperative testing. Sixteen Michigan Value Collaborative (MVC)/Michigan Surgical Quality Collaborative (MSQC) sites in Michigan will implement several tools that have been proven to reduce unnecessary testing at a single site, including clinician education, a decision aid, audit and feedback on performance, and a pay-for-performance incentive. The researchers believe that, through the use of these strategies, there will be a significant reduction in unnecessary preoperative testing during the intervention.

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Key information

Conditions

Breast Lumpectomy Inguinal Hernia Repair Laparoscopic Cholecystectomy

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Michigan and other Michigan Surgical Quality Collaborative sites

Ann Arbor, Michigan, 48109, United States

Location status: Recruiting

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Site

Inclusion criteria

  • Over 30% of testing rates on at least one of the three index procedures (breast lumpectomy, laparoscopic cholecystectomy, and inguinal hernia repair)

Exclusion criteria

  • none

Surgical participants must be over 18 years old.

Treatment and study plan

Active de-Implementation

Behavioral

During active de-implementation (3 months), the local team will distribute the strategy components (i.e., clinician education, decision support, evaluation, consensus building around perioperative testing pathways, facility-specific feedback, and a pay-for-performance incentive) at the local site.

Primary outcomes

  1. Number of tests within 30 days of surgery not associated with an emergency department visit

    Time frame: Within 30 days of surgery

    Only tests relating to three index procedures; breast lumpectomy, laparoscopic cholecystectomy, and inguinal hernia repair

    Data collected using MVC/MSQC database

Secondary outcomes

  1. Number of unnecessary preoperative testing before low-risk surgery at MVC/MSQC sites not participating in the trial

    Time frame: Up to year 2, quarter 4

    Example related operations: laparoscopic hysterectomy, knee arthroscopy

  2. 30-day episode-based spending

    Time frame: Up to Year 2, Quarter 2

    Using the MVC claims data for total spending amounts

  3. Number of unnecessary preoperative testing before low-risk surgery at trial sites

    Time frame: Up to year 2, quarter 4

    Example related operations: laparoscopic hysterectomy, knee arthroscopy

  4. Number of intraoperative complications

    Time frame: Up to year 2, quarter 4

    Examples: myocardial infarction, stroke

  5. Number of same-day case cancellations

    Time frame: Up to year 2, quarter 4

Interested in participating?

Recruiting

Interested in participating?

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Sponsors and collaborators

Lead sponsor

University of Michigan

Other

Collaborators

  • Agency for Healthcare Research and Quality (AHRQ)
  • Blue Cross Blue Shield of Michigan Foundation

Registry information

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Apr 18, 2025
Registry last updated
May 8, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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