Frequency and Characteristics of Responders to an Educational Intervention to Reduce Inappropriate Heart Testing: A Sub-study of the Echo WISELY Trial
Bibliographic record
Abstract
Introduction:The Echo WISELY Trial is a controlled randomized multicenter investigator-blinded study that evaluated an educational intervention based on the criteria for appropriate use of echocardiography to reduce the proportion of rarely appropriate outpatient echocardiograms performed.Objective: To describe the prevalence and identify predictors of the responsiveness of responding physicians subjected to an educational intervention in the Echo WISELY Trial.Methods: The intervention group physicians received a multifaceted educational program.A responding physician was defined as one who had a >2.5% reduction in the proportional mean of rarely appropriate tests requested between the first trimester (baseline) and any of the following trimesters (second to sixth).Physician characteristics (sex, time since graduation, medical specialty, and workplace) were compared to the echocardiogram ratings (appropriate, maybe appropriate, and rarely appropriate) and clinical reasons for the requested echocardiograms using the chi-square test.Statistical significance was indicated by a two-tailed p < 0.05.Results: A total of 4,605 tests requested at the six participating hospitals in Ontario were analyzed and randomized for the intervention arm.Of the 36 included physicians, 26 (72%) were classified as responders.Of the variables analyzed, there was no significant difference in the outcomes of the responders versus non-responders to the educational intervention.The number of rarely appropriate tests requested by the responders was significantly lower than that of the non-responders (234 [8.67%] versus 261 [13.8%]; p < 0.0001). Conclusion:The prevalence of responder physicians was high, but predictors of responsiveness to educational intervention were not identified among the analyzed variables.This may be a result of the psychological aspects and personal characteristics of the physicians, which were not included in this research.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".