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Dr. Catherine Sarkisian, co-leader of the UCLA CTSI Integrating Special Populations Program and a professor in residence, geriatrician and health services researcher in the UCLA Division of Geriatrics, has received a $1.65 million NIH National Institute on Aging R01 award to test the hypothesis that an interdisciplinary electronic health record (EHR)-based intervention that applies behavioral economics approaches (i.e., “nudges”) will dramatically reduce pre-op testing for cataract surgery in a real-world clinical setting.

Even though substantial scientific evidence shows that there is no benefit to pre-op testing before cataract surgery, most patients still undergo this wasteful testing. A pragmatic randomized trial will implement the intervention at the Ronald Reagan UCLA Medical Center where approximately 3,200 cataract surgeries are performed each year. The goals of the study are to integrate a two-pronged behavioral economics intervention into the UCLA Health electronic health record system and to randomize cataract surgery patients over a one-year period to one of four types of pre-operative visits (normal pre-op care, nudge #1, nudge #2, or both) and measure and compare the efficacy of each intervention. Outcomes will be measured 12 months after the start of the intervention, including the change in percentage of patients undergoing pre-op testing and secondary patient-, physician- and system-level outcomes. If the intervention succeeds at stopping pre-op testing, it can be used as a model for preventing other wasteful unnecessary (and potentially harmful) medical care.

Co-investigators include Drs. John Bartlett, Victor Duval, Noah Goldstein, Joseph Ladapo, John Mafi, Suzanne Shu, Ira Hofer, James Moore, Antonio Pessegueiro, Eric Cheng, Samuel Skootsky, Sitaram Vangala and David Elashoff.


Image source: UCLA

Image caption:  Catherine Sarkisian, M.D., of UCLA.