Information Signals and Medical Diagnoses: Audit-Study Evidence from Georgia

Last registered on August 25, 2022
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Pre-Trial

Trial Information

General Information

Title
Information Signals and Medical Diagnoses: Audit-Study Evidence from Georgia
RCT ID
AEARCTR-0009967
Initial registration date
August 22, 2022

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
August 25, 2022, 3:05 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

Country
Georgia
Region

Primary Investigator

Name
Renate Hartwig
Affiliation
University of Goettingen
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Other Primary Investigator(s)

PI Name
Dimitry Japaridze
PI Affiliation
Ilia state University
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PI Name
Nana Nana Khetsuriani
PI Affiliation
Ilia State University
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PI Name
Sebastian Vollmer
PI Affiliation
University of Goettingen
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Additional Trial Information

Status
On going
Start date
2022-02-01
End date
2022-08-31
Keywords
Health
Additional Keywords
Health Care, Standardized Patient, Diabetes
JEL code(s)
H42, I11, I18, O15
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Evidence on how digital technologies, such as online health information platforms, affect the doctor-patient relationship in general, and the diagnosis and treatment of doctors in particular, is still limited. Both, theoretically and empirically. In this study, we explore the effects of an information signal, on the diagnosis and treatment behavior of doctors in Georgia. The information signal consists of the patient mentioning that they sought advice from an internet platform on their symptoms. We use an audit study design (standardized patient method) on the clinical case of diabetes type II, a disease which is widespread and on the rise in Georgia in order to test doctor’s response to this signal. The study is conducted with 100 randomly selected doctors in Tbilisi from February to May 2022. The audit study is complemented with a doctor survey collecting background information on the socio-economic profile and experience of the doctors subject to this study.
External Link(s)

Registration Citation

Citation
Hartwig, Renate et al. 2022. "Information Signals and Medical Diagnoses: Audit-Study Evidence from Georgia." AEA RCT Registry. August 25. https://doi.org/10.1257/rct.9967-1.0
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Experimental Details

Interventions

Intervention(s)
We employ an audit study in which standardized patients (SP) – male and female – portray a clinical case of diabetes type II. The audit study comprises of one treatment in which the SPs point the general practitioner to the information they obtained from an online platform.
The audit study is complemented by an online survey with the general practitioners. The survey, in form of an online questionnaire, collects further information on the education, social preferences and background of the doctors, and their current practice.
Intervention Start Date
2022-02-15
Intervention End Date
2022-07-15

Primary Outcomes

Primary Outcomes (end points)
Primary outcomes are: Quality of care - (a) indicator of correct diagnosis (binary), and (b) adherence to the correct checklist items (count of the recommended anamneses and diagnostics) and (c) duration spent with the doctor (continuous). We use three different measures of the quality of care.
Primary Outcomes (explanation)
First, we measure the quality of care based on the diagnosis, i.e. if the provider provided the correct diagnosis of the clinical case presented. Second, we measure the quality of care based on quality of the medical consultation. We assess this by compiling information on the time spent with the health professional, the questions and examinations conducted and the treatment and medication instructions obtained.

Secondary Outcomes

Secondary Outcomes (end points)
Secondary outcomes are related to the features of the intervention: (a) gender (patient characteristic), and (b) provider characteristics such as education, experience, and social preferences.
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
We employ an audit study in which standardized patients (SP).
Experimental Design Details
Randomization Method
Randomization is done by a computer.
Randomization Unit
The unit of randomization is the SP visit.
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
N/A.
Sample size: planned number of observations
400
Sample size (or number of clusters) by treatment arms
200 SP visits for treatment and 200 for control
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
In a basic group means comparison with 80% power, a significance level of 0.05, and unit standard deviations, the MDE is 0.14 for the total sample of 400 standardized patient visits (Assumption: Baseline mean of 0.6 & 1 treatment vs. 1 control group comparison).
Supporting Documents and Materials
IRB

Institutional Review Boards (IRBs)

IRB Name
University of Göttingen, Ethics Committee
IRB Approval Date
2021-09-22
IRB Approval Number
06/2021
IRB Name
Ilia State University, Ethics Committee
IRB Approval Date
2021-12-16
IRB Approval Number
R/377-21
Analysis Plan

Post-Trial

Post Trial Information

Study Withdrawal

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Intervention

Is the intervention completed?
No
Data Collection Complete
Data Publication

Data Publication

Is public data available?
No

Program Files

Program Files
Reports, Papers & Other Materials

Relevant Paper(s)

Reports & Other Materials