🧵We ran a randomised trial within a trial to test two text-message #nudges on #PatientReportedOutcome response rates. Both beat standard invitations (+3.9% prosocial framing, +6.9% prize draw). Published in @jclinepi.bsky.social
Gemma Altinger
@gemmaaltinger.bsky.social
PhD Candidate investigating the use of behavioural economics to improve healthcare
Our systematic review on Default Nudges is one of BMJ Quality and Safety Top 10 papers of 2025! 🏆 Blog post here blogs.bmj.com/qualitysafet... Paper here qualitysafety.bmj.com/content/earl... @jefflinder.bsky.social @wiserhealthcare.bsky.social
Effectiveness of clinician-directed default nudges on reducing overuse of tests and treatments in healthcare: a systematic review of randomised controlled trials
Objective To evaluate the effectiveness of clinician-directed default nudges for reducing overuse of tests and treatments. Design A systematic review was conducted to synthesise evidence from randomi...
qualitysafety.bmj.com
SAY WHAT NOW?! @jamanetworkopen.com published a study of what?! Did I miss something over the last 30 years about there being equipoise in the use of antibiotics for <rereads paper title> low back pain!?? jamanetwork.com/journals/jam...
Efficacy of Antibiotics for Chronic Low Back Pain With Disc Herniation
This randomized clinical trial examines whether amoxicillin-clavulanate is effective in a subgroup of individuals who have chronic low back pain with disc herniation and bone changes detected on magne...
jamanetwork.com
Antibiotic overprescribing is not a microbiological problem. It is a sociobehavioral problem. jamanetwork.com/journals/jam...
We wrote this in response to a great study from Alistair Hay and colleagues at @capcbristol.bsky.social. They found that modern, rapid, point-of-care tests that identified 23 pathogens had no impact on antibiotic prescribng.
For antibiotic overuse, I've heard for YEARS about how we just need better tests. But it's not that simple. Julie Szymczak and I have a new editorial in @jamainternalmed.com on modern microbiological testing failing to reduce antibiotic prescribing. jamanetwork.com/journals/jam...
Very proud to have been part of this team. Please see full thread from @gemmaaltinger.bsky.social!!
Gemma Altinger@gemmaaltinger.bsky.social · 6mo ago🚨 New Research: The NUDG-ED trial, published in @CMAJ, found that behavioral #nudges were not enough to reduce #lowvaluecare for patients with #backpain in high-pressure #emergencycare settings 🏥 Read the study: doi.org/10.1503/cmaj... #BehavioralEconomics #ChoosingWisely
🚨 New Research: The NUDG-ED trial, published in @CMAJ, found that behavioral #nudges were not enough to reduce #lowvaluecare for patients with #backpain in high-pressure #emergencycare settings 🏥 Read the study: doi.org/10.1503/cmaj... #BehavioralEconomics #ChoosingWisely
🚨 New Research: The NUDG-ED trial, published in @CMAJ, found that behavioral #nudges were not enough to reduce #lowvaluecare for patients with #backpain in high-pressure #emergencycare settings 🏥 Read the study: doi.org/10.1503/cmaj... #BehavioralEconomics #ChoosingWisely
Congrats to first author @gemmaaltinger.bsky.social and the team on an Oustanding Publication Award from Sydney Health Partners Musculoskeletal Clinical Academic Group. #MedSky #BehavioralScience #Nudges @nufeinbergmed.bsky.social @nuintmed.bsky.social qualitysafety.bmj.com/content/earl...
Effectiveness of clinician-directed default nudges on reducing overuse of tests and treatments in healthcare: a systematic review of randomised controlled trials
Objective To evaluate the effectiveness of clinician-directed default nudges for reducing overuse of tests and treatments. Design A systematic review was conducted to synthesise evidence from randomi...
qualitysafety.bmj.com
Gemma Altinger@gemmaaltinger.bsky.social · 10mo agoExciting news! 🎉 Our systematic review on clinician-directed default #nudges on #overuse of healthcare has been awarded the Outstanding Publication Award by @SHPartners MSK Clinical Academic Group Here’s why it matters👇 qualitysafety.bmj.com/content/earl... @jefflinder.bsky.social
Exciting news! 🎉 Our systematic review on clinician-directed default #nudges on #overuse of healthcare has been awarded the Outstanding Publication Award by @SHPartners MSK Clinical Academic Group Here’s why it matters👇 qualitysafety.bmj.com/content/earl... @jefflinder.bsky.social
Exciting news! 🎉 Our systematic review on clinician-directed default #nudges on #overuse of healthcare has been awarded the Outstanding Publication Award by @SHPartners MSK Clinical Academic Group Here’s why it matters👇 qualitysafety.bmj.com/content/earl... @jefflinder.bsky.social
RCT by @gemmaaltinger.bsky.social et al suggests that physicians who are offered multiple alternatives to a treatment (vs just one alternative) are more likely to choose a superior one → presenting multiple alternatives may improve clinical decision-making: buff.ly/3aNxJYf
Simple #design changes in EHR alerts, like presenting two or three good options instead of just one, could help #doctors provide #bettercare. But if these systems rely on outdated evidence, they risk doing more harm than good. #besci #medicine jamanetwork.com/journals/jam...
Fun to work with @gemmaaltinger.bsky.social, Adrian Traeger, Chris Maher, @caitlin-jones.bsky.social, and others at @sydney.edu.au Institute for Musculoskeletal Health on this! How we present choices to physicians influences their decision-making. jamanetwork.com/journals/jam...
Multiple Suggested Care Alternatives and Decision-Making of PCPs
This randomized clinical trial investigates whether providing primary care physicians (PCPs) with 1 vs 2 or more appropriate treatment alternatives in a choice set has an effect on the odds that they ...
jamanetwork.com
In time for the @pennchibe.bsky.social meeting, our paper about how the number of alternatives influences physician decision-making. #MedSky #BehaviouralScience jamanetwork.com/journals/jam...
Multiple Suggested Care Alternatives and Decision-Making of PCPs
This randomized clinical trial investigates whether providing primary care physicians (PCPs) with 1 vs 2 or more appropriate treatment alternatives in a choice set has an effect on the odds that they ...
jamanetwork.com
A meta-analysis (137 studies, n = 12,966) found that touch improves pain, mood, anxiety, and cortisol regulation. Although human touch might be more beneficial, even robot-delivered touch showed physical benefits. #PainResearch #MentalHealth #Neuroscience www.nature.com/articles/s41...
➡️ More alternatives (suggestions) = higher likelihood of choosing an NSAID over the opioid in a situation of chronic low back pain flare-up. 🔗 jamanetwork.com/journals/jam...
Multiple Suggested Care Alternatives and Decision-Making of PCPs
This randomized clinical trial investigates whether providing primary care physicians (PCPs) with 1 vs 2 or more appropriate treatment alternatives in a choice set has an effect on the odds that they ...
jamanetwork.com
These findings differ from a classic paper by Donald Redelmeier in which the found and concluded that offering more options increased "decisional difficulty" and led to inertia in decision-making. jamanetwork.com/journals/jam...
Medical Decision Making in Situations That Offer Multiple Alternatives
Objective. —To determine whether situations involving multiple options can paradoxically influence people to choose an option that would have been declined if fewer options were available.Design....
jamanetwork.com
We did not find that adding 3 or 4 alternatives made any further difference. @nuintmed.bsky.social @nupress.bsky.social @ipham.bsky.social @nucatsinstitute.bsky.social @nufeinbergmed.bsky.social The full paper is here: jamanetwork.com/journals/jam...
Multiple Suggested Care Alternatives and Decision-Making of PCPs
This randomized clinical trial investigates whether providing primary care physicians (PCPs) with 1 vs 2 or more appropriate treatment alternatives in a choice set has an effect on the odds that they ...
jamanetwork.com
This is important as we think about designing nudges, especially in the electronic health record. For example, in an alert to not prescribe opioids for low back pain, physicians were more likely to pick an alternative if at least 2 non-opioid alternatives were offered.
Just in time for the @pennchibe.bsky.social meeting, a new paper with @gemmaaltinger.bsky.social in @jamanetworkopen.com. We found that offering physicians MORE alternatives encouraged them to select one of the alternates.
Amazing work by my mentor Brooke Nickel and Joshua Zadro! lnkd.in/dtgJ_4mK
We analysed almost 1,000 social media posts about 5 popular medical tests. Most were utterly misleading
87% of posts mentioned the benefits of the tests, while only 15% mentioned potential harms.
theconversation.com
This week I received the Excellence in Knowledge Translation Award for a video I made communicating concepts from my Journal of Physiotherapy editorial to a wider audience. As a result this video has been adapted to as part of the intervention arm in a trial. Check out my article at lnkd.in/gReuR8k7