Nudge for Ovarian Cancer

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: Abramson Cancer Center at Penn Medicine

Disqualifiers: Ovarian cancer, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new method to help doctors quickly refer patients with suspected ovarian cancer to specialists. The goal is to determine if a small nudge, such as a reminder in the doctor's system, can expedite referrals to gynecologic oncology. This could lead to faster specialist appointments for patients following abnormal imaging. Suitable candidates for this trial are those who have recently undergone imaging tests suggesting possible ovarian cancer but have not yet received a diagnosis. As an unphased trial, this study offers patients the chance to contribute to innovative referral processes that could improve early cancer detection and treatment.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this clinician nudge is safe for patients with suspected ovarian cancer?

Research shows that a "nudge" is safe and can effectively increase the number of patients referred to cancer specialists for suspected ovarian cancer. This method uses a simple reminder in the electronic health record (EHR) to prompt doctors to make referrals. Studies indicate that nudges improved referral rates by up to 20 percentage points, increasing them from 55% to 75%.

No reports of negative effects have emerged from using nudges. Since this trial involves a nudge rather than a traditional medical treatment, it does not directly affect physical health. It simply helps ensure timely referrals to the right specialists. ^{1 2 3 4 5}

Why are researchers excited about this trial?

The "Clinician Nudge" approach is unique because it introduces an opt-out default referral system for ovarian cancer evaluation, streamlining the referral process to gynecologic oncology. Unlike traditional practices where clinicians manually place referrals, this method automatically generates a pre-checked referral alongside educational information when imaging results suggest further evaluation. Researchers are excited about this trial because it aims to reduce delays in patient care by simplifying and expediting the referral process, potentially leading to earlier detection and treatment of ovarian cancer.

What evidence suggests that this clinician nudge is effective for increasing referrals to gynecologic oncology in patients with suspected ovarian cancer?

This trial will compare the effectiveness of a "Nudge" intervention with a control group in increasing referrals to specialists for ovarian cancer. Research has shown that gentle reminders to doctors can significantly increase the number of patients referred to specialists. One study found that a reminder system in electronic health records boosted referrals from 55% to 75%. Another study demonstrated a 20% improvement in referral rates with these reminders. This evidence suggests that such reminders can expedite the process of getting patients with suspected ovarian cancer to specialists, potentially leading to earlier diagnosis and treatment. ^{3 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for patients with suspected ovarian cancer based on abnormal imaging results. The key goal is to see if 'nudges' or reminders to clinicians can increase the rate of referrals to gynecologic oncology specialists within two weeks.

Inclusion Criteria

Eligible clinicians include physicians, physician assistants, and nurse practitioners with eligible patient encounters at sites included in the trial during the study.

I visited the ER or was hospitalized and had imaging done suspecting ovarian cancer.

Exclusion Criteria

Imaging ordered by gynecologic oncologist.

I have been diagnosed with ovarian cancer.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Referral Process

Clinicians receive imaging results and a pre-checked referral order to gynecologic oncology appears in the EHR. Patients are contacted by gynecologic oncology's new patient coordinators within 72 hours and offered an appointment within 2 weeks.

2 weeks

Follow-up

Participants are monitored for whether the gynecologic oncology visit occurred within 60 days of abnormal imaging.

8 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Clinician Nudge

Trial Overview The intervention being tested is a 'nudge' system aimed at prompting clinicians to refer patients with potential ovarian cancer more quickly. The study measures how effective these nudges are in speeding up referrals and subsequent specialist visits.

How Is the Trial Designed?

Group I: Nudge Experimental Treatment 1 Intervention

When the clinician who ordered the imaging that led to randomization receives the test results, a pre-checked referral order to gynecologic oncology for surgical evaluation will appear in the EHR alongside a brief educational explanation. This will constitute the opt-out default referral order (Figure 3). Clinicians will have the option to unclick the referral to opt out and will be asked to indicate the reason from a pre-populated list of choices; if they do not opt out, the referral to gynecologic oncology will proceed. Imaging findings and referral will be communicated to the patient in keeping with the clinician's usual practice. In keeping with routine practice, referred patients will be contacted by gynecologic oncology's new patient coordinators within 72 hours and offered an appointment within 2 weeks at their preferred location.

Group II: Control Active Control 1 Intervention

Clinicians will receive imaging reports per usual practice (i.e., imaging reports that include O-RADS score with recommendation for gynecologic oncology referral in the report) and can place referral through the usual EHR-based ordering system. If referred, patients will be contacted and scheduled as described above.

Who Is Running the Clinical Trial?

Abramson Cancer Center at Penn Medicine

Lead Sponsor

Trials

425

Recruited

464,000+

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT07078409

Clinician Nudge to Referral of Adnexal Masses ... The goal of this study is to test the effectiveness of clinician nudges on referrals to gynecologic oncology in patients with suspected ovarian cancer. The ...

2. chibe.upenn.edu chibe.upenn.edu/news/clinician-nudge-at-suspected-ovarian-cancer-diagnosis-improves-oncology-referral-rate/

Clinician nudge at suspected ovarian cancer diagnosis ... This article discusses a study finding that a clinician nudge improved gynecologic oncology referral rates for ovarian cancer by 20 ...

3. ctv.veeva.com ctv.veeva.com/study/clinician-nudge-to-referral-of-adnexal-masses-to-gynecologic-oncology

Clinician Nudge to Referral of Adnexal Masses to Gynecologic ... The primary outcome will be whether or not patients were referred to gynecologic oncology within 14 days of their abnormal imaging results.

4. withpower.com withpower.com/trial/phase-ovarian-neoplasms-6-2025-c9bcc

Nudge for Ovarian Cancer · Info for Participants The goal of this study is to test the effectiveness of clinician nudges on referrals to gynecologic oncology in patients with suspected ovarian cancer.

5. consultant360.com consultant360.com/conference-coverage/ehr-nudge-boosts-gynecologic-oncology-referrals-speeds-diagnosis-early-ovarian

EHR Nudge Boosts Gynecologic Oncology Referrals ... An electronic health record (EHR) nudge to prompt gynecologic oncology referral for suspected ovarian cancer increased referral rates from 55% to 75% and led ...

6. healio.com healio.com/news/hematology-oncology/20250318/clinician-nudge-at-suspected-ovarian-cancer-diagnosis-improves-oncology-referral-rate

Clinician nudge at suspected ovarian cancer diagnosis ... A clinician nudge at the time of a suspected ovarian cancer diagnosis improved gynecologic oncology referral rates by 20 percentage points.

7. chibe.upenn.edu chibe.upenn.edu/news/clinician-nudge-at-suspected-ovarian-cancer-diagnosis-improves-oncology-referral-rate-2/

Clinician nudge at suspected ovarian cancer diagnosis improves ... This study highlights how a clinician nudge improved gynecologic oncology referrals for suspected ovarian cancer using EHR prompts.

8. clinicaltrials.gov clinicaltrials.gov/study/NCT06451263

NCT06451263 | Nudge to Gynecologic Oncology The study consists of one intervention, a clinician nudge to gynecologic oncology referral. Referral to gynecologic oncology is recommended when patients are ...

9. withpower.com withpower.com/trial/phase-fallopian-tubes-cancer-2024-8cf55

Nudge for Ovarian Cancer · Info for Participants Research has shown that a "nudge" can safely increase the number of patients referred to gynecologic cancer specialists for ovarian cancer. A nudge serves as a ...