Testing Cascades—A Call to Move From Descriptive Research to Deimplementation Science

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Timothy S. Anderson and Grace A. Lin
JAMA Intern Med. Published online June 8, 2020.
doi:10.1001/jamainternmed.2020.1588

Over the past decade, attention to overuse of testing has steadily grown, reflected by the addition of low-value care, Choosing Wisely, less is more, and cost-conscious care to the medical vernacular. Despite widespread recognition of this issue, there has been little evidence of large-scale changes in testing practices in the US. There may be many barriers to reducing overuse, including a fee-for-service payment model that disincentivizes physicians and health systems from reducing use of revenue-generating tests, a belief that more testing is beneficial, and framing of the issue as largely a problem of health care costs.

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