Default Options: Opportunities to Improve Quality and Value in Oncology

Evaluation of Use of Shorter Radiation Regimens for Breast and Prostate Cancer in the US, 2015-2017

“…Development, testing, and scaling of strategies to achieve this goal, such as default options, audit and feedback and patient engagement, is warranted. 6 This study has limitations. Because the Centers for Medicare & Medicaid Services data set is missing cancer stage and radiation field, these results underestimate the absolute proportion of beneficiaries receiving shorter regimens.…”

Initiative to reduce bone scans for low-risk prostate cancer patients: A quasi-experimental before-and-after study in a Veterans Affairs hospital

“… 12 Although attractive, these minimally intrusive interventions may yield only modest behavioral changes. 21 More intrusive strategies such as financial incentives 19 or default options 22 might have a greater effect. 20 Alternatively, our modest BS reduction could reflect the limitations of a one-time intervention.…”

Effect of Introducing a Default Order in the Electronic Medical Record on Unnecessary Daily Imaging During Palliative Radiotherapy for Adults With Cancer

“…There is evidence to support the hypothesis that stromatous components of malignant tumors stimulate growth and prolifera-tion of malignant components of invasive tumors 2 ; higher stromal content, referred to as high tumor-stroma proportion, has been associated with worse prognosis in many epithelial cancers. [3][4][5] We report the results of a prospective observational study examining tumor-stroma proportion as a predictive biomarker of chemoresistance in women diagnosed with ovarian cancer.…”

“…Default options, which leverage insights from behavioral economics, can change physician behavior but have focused less on deadoption of unnecessary care. 3,4 We conducted a stepped-wedge cluster randomized clinical trial to test the effectiveness of introducing a default imaging order in the electronic health record (EHR) vs usual practice to reduce unnecessary daily imaging during palliative radiotherapy.…”