ArticleImplementation science : IS2022
Randomized controlled trials in de-implementation research: a systematic scoping review.
Article in Implementation science : IS, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Low-value interventions to deimplement: A secondary analysis of a systematic review of low back pain clinical practice guidelines.PM & R : the journal of injury, function, and rehabilitation · 2025Pooled it
- Deimplementation of inappropriate feeding practices in early care and education: a Hybrid Type 3 cluster-randomized trial.Implementation science : IS · 2026Trial
- Effectiveness of a clinical decision support algorithm (CDSA) on reducing unnecessary antibiotic prescriptions for upper respiratory tract infections among ambulatory HIV-infected adults in Mozambique: a cluster randomized controlled trial.BMC infectious diseases · 2026Trial
- De-Implementing Low-Value Care in Dentistry: The Case for Choosing Wisely Campaigns.Community dentistry and oral epidemiology · 2026Article
- From CXR to ultrasound: a multi-framework approach to advancing De-implementation in acute care.Implementation science communications · 2026Article
- Innovation Deimplementation in Emergency Departments During the COVID-19 Pandemic: Qualitative Study of Clinicians' Decision-Making.Interactive journal of medical research · 2026Article
- De-implementation of unnecessary antibiotic use for upper respiratory tract infections in ambulatory HIV care in Mozambique: a two-arm parallel cluster-randomized controlled hybrid type II trial.Implementation science communications · 2026Article
- Physician-suggested strategies for deimplementing low-value care in Swedish primary care: a qualitative analysis across system levels.Implementation science communications · 2026Article
- Designing complex health system interventions: an integrated theory-informed approach.Frontiers in health services · 2026Review
- Mapping the de-implementation of traditional diagnostic tests in pediatric acute lymphoblastic leukemia.Frontiers in oncology · 2026Article
- Advancing the Field of Deimplementation: Perspectives on Low-Value Clinical Preventive Services.AJPM focus · 2025Article
- Management Patterns of Croup in Korean Emergency Departments: A Nationwide Cohort Study.Children (Basel, Switzerland) · 2025Article
- Evidence categories in systematic assessment of cancer overdiagnosis.BMJ evidence-based medicine · 2025Review
- Article
- Effectiveness of different de-implementation strategies in primary care: systematic review and meta-analysis.BMJ medicine · 2025Article
- Effectiveness of de-implementation of low-value healthcare practices: an overview of systematic reviews.Implementation science : IS · 2024Review
- De-implementation strategy to reduce unnecessary antibiotic prescriptions for ambulatory HIV-infected patients with upper respiratory tract infections in Mozambique: a study protocol of a cluster randomized controlled trial.Implementation science : IS · 2024Article
- Reconceptualizing the approach to supporting students with attention-deficit/hyperactivity disorder in school settings.Journal of school psychology · 2024Review
- Perspectives on low-value care and barriers to de-implementation among primary care physicians: a multinational survey.BMC primary care · 2024Article
- Methodological progress note: De-implementation of low-value care.Journal of hospital medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 13 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHealthcare costs are rising, and a substantial proportion of medical care is of little value. De-implementation of low-value practices is important for improving overall health outcomes and reducing costs. We aimed to identify and synthesize randomized controlled trials (RCTs) on de-implementation interventions and to provide guidance to improve future research.
methodsMEDLINE and Scopus up to May 24, 2021, for individual and cluster RCTs comparing de-implementation interventions to usual care, another intervention, or placebo. We applied independent duplicate assessment of eligibility, study characteristics, outcomes, intervention categories, implementation theories, and risk of bias.
resultsOf the 227 eligible trials, 145 (64%) were cluster randomized trials (median 24 clusters; median follow-up time 305 days), and 82 (36%) were individually randomized trials (median follow-up time 274 days). Of the trials, 118 (52%) were published after 2010, 149 (66%) were conducted in a primary care setting, 163 (72%) aimed to reduce the use of drug treatment, 194 (85%) measured the total volume of care, and 64 (28%) low-value care use as outcomes. Of the trials, 48 (21%) described a theoretical basis for the intervention, and 40 (18%) had the study tailored by context-specific factors. Of the de-implementation interventions, 193 (85%) were targeted at physicians, 115 (51%) tested educational sessions, and 152 (67%) multicomponent interventions. Missing data led to high risk of bias in 137 (60%) trials, followed by baseline imbalances in 99 (44%), and deficiencies in allocation concealment in 56 (25%).
conclusionsDe-implementation trials were mainly conducted in primary care and typically aimed to reduce low-value drug treatments. Limitations of current de-implementation research may have led to unreliable effect estimates and decreased clinical applicability of studied de-implementation strategies. We identified potential research gaps, including de-implementation in secondary and tertiary care settings, and interventions targeted at other than physicians. Future trials could be improved by favoring simpler intervention designs, better control of potential confounders, larger number of clusters in cluster trials, considering context-specific factors when planning the intervention (tailoring), and using a theoretical basis in intervention design. REGISTRATION: OSF Open Science Framework hk4b2.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.