The Effect of Financial Incentives on Patient Decisions to Undergo Low‐value Head Computed Tomography Scans

Abstract

After reading the article, participants should be able to discuss the influence of financial incentives, accompanied with information regarding risk and benefit, on patient preferences for diagnostic testing. Activity Disclosures This activity received no commercial support. CME Editor Corey Heitz discloses no relevant financial relationships. This activity underwent peer review in line with standards of editorial integrity and publication ethics. Conflicts of interest have been identified and resolved in accordance with John Wiley and Sons, Inc.'s Policy on Activity Disclosure and Conflict of Interest. Accreditation John Wiley and Sons, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. John Wiley and Sons, Inc. designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit TM. Physicians should only claim credit commensurate with the extent of their participation in the activity. For information on applicability and acceptance of continuing medical education credit for this activity, please consult your professional licensing board. This activity is designed to be completed within 1 hour. To successfully earn credit, participants must complete the activity during the valid credit period, which is up to two years from initial publication. Additionally, up to 3 attempts and a score of 70% or better is needed to pass the post test.

Patient Preferences to Undergo Low-Value CT Coronary Angiography in the Emergency Department

“…Additionally, the results of our current study were congruent with our more recent study that analyzed the effect of test benefit, test risk, and financial incentive on patient preference for low-value diagnostic testing with CT head in a minor TBI scenario. 6 This supports that the relationship between these variables may be observed across multiple clinical situations.…”

“…7, 9 A subsequent study focused solely on patient preferences for CT head in minor TBI showed that a financial incentive for patients to forego low-value diagnostic testing also significantly reduced patient preference for this test. 6 While the influence of test benefit and risk on patient decision-making was of mixed statistical significance in our original work, these variables both achieved statistical significance in our CT head/minor TBI study. 6, 9…”

“…6 While the influence of test benefit and risk on patient decision-making was of mixed statistical significance in our original work, these variables both achieved statistical significance in our CT head/minor TBI study. 6, 9…”

“…We followed methodology that was previously reported in our 2018 and 2019 work analyzing the effect of an additional copayment or financial incentive for a diagnostic test, respectively. 6, 9 Our sample size of 913 conferred approximately 85-90% power to detect a 10% absolute change in the proportion of subjects agreeing to testing from a baseline test acceptance rate of 50% at a 95% level of significance.…”