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Cited by 91Healthcare cost, quality, practicesClinical Laboratory Practices and Quality ControlClinical Reasoning and Diagnostic Skills

Modifying Test-Ordering Behavior in the Outpatient Medical Clinic: A Controlled Trial of Two Educational Interventions

Marton, Keith I.·1985·Archives of Internal Medicine
DOI 10.1001/archinte.1985.00360050060009
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Abstract

Education is an effective tool for modifying physician use of the laboratory. We compared two interventions by assigning 56 medical house officers into four groups: control group; feedback group, which received feedback concerning its use of tests; manual group, which received a manual concerning cost-effective laboratory use; and manual plus feedback group, which received both interventions. All intervention groups experienced significant decreases in test use. When we controlled for diagnosis, the manual plus feedback group had the most profound decrease (42%) in laboratory use, followed by the manual group. The feedback and control groups had no change. Attitudes and knowledge did not change. We conclude that one can, via simple techniques, modify house staff use of the outpatient laboratory. The less-expensive intervention was a cost-oriented manual, which may have a "sensitizing" rather than educational effect.

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  • Marton 1985 found that offering a manual outlining laboratory costs reduced laboratory test utilisation compared to feedback alone (adjusted change relative to baseline performance in the audit and feedback alone arm = 33%; no P value reported).

    “Marton 1985 also found that offering a manual outlining laboratory costs reduced laboratory test utilisation compared to feedback alone (adjusted change relative to baseline performance in the audit and feedback alone arm = 33%; no P value reported).”

    From Audit and feedback: effects on professional practice and healthcare outcomes (2012) · cites this paper as Marton 1985

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Authors
Marton, K. I.
Corresponding author
Marton, Keith I.
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
1985-05-01
Volume
145
Issue
5
Pages
816
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinte.1985.00360050060009
OpenAlex
W2032077175
Cited by
91
References
18
Citations by year
2026: 1 · 2025: 1 · 2023: 1 · 2021: 2 · 2018: 1 · 2017: 1 · 2016: 3 · 2014: 1 · 2012: 4
FWCI
16.57
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Keywords
laboratory test ordering, physician behavior change, feedback interventions, cost sensitivity, physician training, medical education intervention
MeSH terms
Ambulatory Care, Attitude, Behavior Therapy, Biofeedback, Psychology, Clinical Trials as Topic, Consumer Behavior, Costs and Cost Analysis, Diagnostic Tests, Routine, Humans, Knowledge of Results, Psychological, Medical Staff, Hospital, Random Allocation, Time Factors

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