Table 2.
Description of the included 227 randomized controlled trials: characteristics, aims, and outcomes
| Characteristics | Aim and rationale | Outcomes | |||
|---|---|---|---|---|---|
| Settinga | n (%) | Aima | n (%) | Outcome categoriesa | n (%) |
| Primary care — outpatient | 149 (66%) | Abandon | 0 (0%) | Health outcomes | 58 (26%) |
| Primary care — inpatient | 3 (1%) | Reduce | 225 (99%) | Low-value care use | 63 (28%) |
| Secondary/tertiary care — outpatient | 28 (12%) | Replace | 42 (19%) | Appropriate care use | 34 (15%) |
| Secondary/tertiary care — inpatient | 40 (18%) | Unclear | 2 (1%) | Total volume of care | 194 (85%) |
| Other | 22 (10%) | Rationalea | Intention to reduce the use of low-value care | ||
| Randomization unit | Evidence suggests little or no benefit from treatment or diagnostic test | 115 (51%) | 17 (7%) | ||
| Cluster | 145 (64%) | Measured costsa | |||
| Individual | 82 (36%) | Evidence suggests another treatment is more effective or less harmful | 13 (6%) | Intervention costs | 20 (9%) |
| Medical interventiona | Healthcare costs | 45 (20%) | |||
| Prevention | 9 (4%) | Evidence suggests more harms than benefits for the patient or community | 145 (64%) | Reported effectiveness | |
| Diagnostic imaging | 29 (13%) | (Some) desired effect | 186 (82%) | ||
| Laboratory tests | 28 (12%) | Cost-effectiveness | 70 (31%) | No desired effect | 41 (18%) |
| Drug treatment | 163 (72%) | Patient(s) do not want the intervention | 2 (1%) | Theoretical basis and tailoringa | |
| Operative treatments | 7 (3%) | Theory-based interventions | 48 (21%) | ||
| Rehabilitation | 2 (1%) | Not reported/unclear | 20 (9%) | Tailored interventions | 40 (18%) |
| Other | 7 (3%) | Intervention complexityb | |||
| Target groupa | Multicomponent | 152 (67%) | |||
| Public | 5 (2%) | Simple | 84 (37%) | ||
| Patients | 42 (19%) | ||||
| Caregivers | 17 (7%) | ||||
| Physicians | 193 (85%) | ||||
| Nurses | 37 (16%) | ||||
| Other | 23 (10%) | ||||
aOne trial could be categorized into several categories, and therefore, the sum of percentages may be over 100%
bNine trials had multiple treatment arms and tested both simple and multicomponent interventions. Simple intervention was defined as having one intervention category with or without tailoring