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RecruitingNCT06993805Updated May 29, 2025

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

An interventional study of OPA in Physician Workflow and Resource Utilization, sponsored by University of California, Los Angeles. Recruiting at 1 site in United States. Per ClinicalTrials.gov, last updated 2025-05-29.

Sponsored by University of California, Los Angeles · Not applicable, Interventional, and Health services research

From the registry’s dates

  • Primary completion was expected by Dec 2025, 10 months ago, but the record still lists the study as recruiting.
  • Started May 2025; still recruiting 1 year 5 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
384
Allocation
Randomized
Sex
All
01

Study summary

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.

Read the detailed description

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.

02

Conditions studied

  • Physician Workflow
  • Resource Utilization

Keywords

  • Clinical Decision Support
  • Laboratory Test Optimization
  • Resource Utilization
  • Our Practice Advisory (OPA)
03

In context

Lead sponsor

University of California, Los Angeles is the lead sponsor of 1,142 studies on the registry; 192 are open to participants now.

Of its 91 completed or terminated interventional studies of FDA-regulated products, 66 (73%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No

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

Exclusion Criteria:

  • Have an A1c or TSH ordered and do not have a result for one of these labs in the prior 30 days
05

Study design

Phase
Not applicable
Primary purpose
Health services research
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Care provider, Investigator)
Enrollment
384 participants (estimated)

Study arms

  • Experimental
    OPA Intervention Group

    Providers in this group will receive a Our Practice Advisory (OPA) through the electronic health record (EHR) system when ordering Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) tests. The OPA will prompt providers to reconsider the test if it was ordered within the previous 30 days, aligning with evidence-based guidelines to reduce unnecessary testing.

    Behavioral: OPA

  • No intervention
    Control Group

    Providers in this group will not receive a Our Practice Advisory (OPA) through the Electronic Health Record (EHR) system when ordering Hemoglobin A1c (A1c) and Thyroid-Stimulating Hormone (TSH) tests. This group represents the current standard of care, with no additional prompts or alerts implemented.

Interventions

  • BehavioralOPA

    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.

06

What researchers measure

Primary outcomes

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

    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.

    Time frame: Study month 6

07

Study locations

1 of 1 sites recruiting
  • UCLA Health System
    Los Angeles, California 90024, United States
    Recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 29, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06993805
Lead sponsor
University of California, Los Angeles
Responsible party
Catherine A. Sarkisian (Associate Professor of Medicine, University of California, Los Angeles) — Principal investigator
First posted
May 29, 2025
Start date
May 6, 2025
Primary completion
Dec 2025 (estimated)
Completion
Feb 2026 (estimated)
Last update
May 29, 2025

Study contacts

Katelyn Clinical Research Coordinator
Contact
katenguyen@mednet.ucla.edu
310-267-5250

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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