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NCT Number: NCT06993805

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

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.

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Key information

Conditions

Physician Workflow Resource Utilization

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

UCLA Health System

Los Angeles, California, 90024, United States

Location status: Recruiting

Location contact

Katelyn Clinical Research Coodinator

CONTACT

[email protected]

310-267-5250

About this study

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.

Who can participate

Healthy volunteers accepted: No

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

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

Treatment and study plan

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.

Primary outcomes

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

    Time frame: Study month 6

    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 contacts

Contact information is provided by the study sponsor or research team.

Katelyn Clinical Research Coordinator

CONTACT

[email protected]

310-267-5250

Sponsors and collaborators

Lead sponsor

University of California, Los Angeles

Other

Registry information

Official study title

Evaluation of Our Practice Advisory (OPA) Interventions on Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) Short Interval Ordering

Important dates

Study start
2025
Primary completion
2025
Study completion
2026
First posted
May 29, 2025
Registry last updated
May 29, 2025

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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