# De-implementation of Low-Value Testing in Patients Undergoing Low-Risk Surgery

> **NIH AHRQ R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $373,189

## Abstract

PROJECT SUMMARY/ABSTRACT
 Unnecessary tests and treatments represent two of the greatest sources of preventable patient harm and
excess healthcare spending in the United States. Robust evidence demonstrates routine preoperative tests
such as electrocardiograms, blood and urine tests, and chest radiographs before low-risk surgery do not
prevent adverse events or improve outcomes. In addition, unnecessary preoperative testing can trigger care
cascades leading to additional specialty consultations and invasive procedures, potentially resulting in
significant patient harm, delays in surgery, and patient financial toxicity. Numerous professional societies
recommend against routine preoperative testing prior to low-risk surgery but eliminating use has proven
difficult. In the US, few investigators have moved beyond describing the prevalence of low value testing or
testing limited strategies targeting a single procedure (i.e., cataract surgery) or hospital. As a result, there are
no broadly scalable de-implementation strategies and unnecessary, wasteful, and harmful testing remains
commonplace. This research will test a theory-informed and broadly scalable multi-level, multi-component de-
implementation strategy to reduce unnecessary preoperative testing before low-risk surgery across diverse
procedures and practice types. In the Michigan Value Collaborative (MVC), a consortium of 87 Michigan
hospitals, routine preoperative testing occurs before low-risk surgery in more than 52% of patients with inter-
facility variation ranging from 8% to 85%. Our preliminary data has identified important, yet modifiable
determinants of unnecessary testing. Based on these findings, we will test a multi-level, multi-component de-
implementation strategy across Michigan hospitals. Using facilities jointly participating in the Michigan Surgical
Quality Collaborative (MSQC), the largest surgical collaborative quality improvement program in the United
States, we will evaluate the effectiveness of our intervention through a stepped wedge cluster randomized trial.

## Key facts

- **NIH application ID:** 10916512
- **Project number:** 5R01HS029306-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** LESLY A DOSSETT
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $373,189
- **Award type:** 5
- **Project period:** 2023-09-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10916512

## Citation

> US National Institutes of Health, RePORTER application 10916512, De-implementation of Low-Value Testing in Patients Undergoing Low-Risk Surgery (5R01HS029306-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10916512. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*