iiinova — where your digital self keeps evolving

Gemma Altinger @gemmaaltinger.bsky.social · 17/08/2026

🧵We ran a randomised trial within a trial to test two text-message #nudges on #PatientReportedOutcome response rates. Both beat standard invitations (+3.9% prosocial framing, +6.9% prize draw). Published in @jclinepi.bsky.social

110

Reposted by Gemma Altinger

Jeff Linder @jefflinder.bsky.social · 26/05/2026

SAY WHAT NOW?! @jamanetworkopen.com published a study of what?! Did I miss something over the last 30 years about there being equipoise in the use of antibiotics for <rereads paper title> low back pain!?? jamanetwork.com/journals/jam...

jamanetwork.com

Efficacy of Antibiotics for Chronic Low Back Pain With Disc Herniation

This randomized clinical trial examines whether amoxicillin-clavulanate is effective in a subgroup of individuals who have chronic low back pain with disc herniation and bone changes detected on magne...

8134

Reposted by Gemma Altinger

Jeff Linder @jefflinder.bsky.social · 18/05/2026

Antibiotic overprescribing is not a microbiological problem. It is a sociobehavioral problem. jamanetwork.com/journals/jam...

132

Reposted by Gemma Altinger

Jeff Linder @jefflinder.bsky.social · 18/05/2026

We wrote this in response to a great study from Alistair Hay and colleagues at @capcbristol.bsky.social. They found that modern, rapid, point-of-care tests that identified 23 pathogens had no impact on antibiotic prescribng.

121

Reposted by Gemma Altinger

Jeff Linder @jefflinder.bsky.social · 18/05/2026

For antibiotic overuse, I've heard for YEARS about how we just need better tests. But it's not that simple. Julie Szymczak and I have a new editorial in @jamainternalmed.com on modern microbiological testing failing to reduce antibiotic prescribing. jamanetwork.com/journals/jam...

263

Reposted by Gemma Altinger

Jeff Linder @jefflinder.bsky.social · 14/04/2026

A regular reminder that “routine blood work” is not a thing. www.npr.org/2026/04/14/n...

112

Reposted by Gemma Altinger

Jeff Linder @jefflinder.bsky.social · 06/04/2026

Very proud to have been part of this team. Please see full thread from @gemmaaltinger.bsky.social!!

122

Reposted by Gemma Altinger

Gemma Altinger @gemmaaltinger.bsky.social · 06/04/2026

🚨 New Research: The NUDG-ED trial, published in @CMAJ, found that behavioral #nudges were not enough to reduce #lowvaluecare for patients with #backpain in high-pressure #emergencycare settings 🏥 Read the study: doi.org/10.1503/cmaj... #BehavioralEconomics #ChoosingWisely

132

Gemma Altinger @gemmaaltinger.bsky.social · 06/04/2026

132

Reposted by Gemma Altinger

Gemma Altinger @gemmaaltinger.bsky.social · 17/12/2025

Exciting news! 🎉 Our systematic review on clinician-directed default #nudges on #overuse of healthcare has been awarded the Outstanding Publication Award by @SHPartners MSK Clinical Academic Group Here’s why it matters👇 qualitysafety.bmj.com/content/earl... @jefflinder.bsky.social

142

Gemma Altinger @gemmaaltinger.bsky.social · 17/12/2025

142

Reposted by Gemma Altinger

koenfucius @koenfucius.bsky.social · 03/12/2025

RCT by @gemmaaltinger.bsky.social et al suggests that physicians who are offered multiple alternatives to a treatment (vs just one alternative) are more likely to choose a superior one → presenting multiple alternatives may improve clinical decision-making: buff.ly/3aNxJYf

011

Gemma Altinger @gemmaaltinger.bsky.social · 14/11/2025

Simple #design changes in EHR alerts, like presenting two or three good options instead of just one, could help #doctors provide #bettercare. But if these systems rely on outdated evidence, they risk doing more harm than good. #besci #medicine jamanetwork.com/journals/jam...

111

Reposted by Gemma Altinger

Dr Rod Rizzo, PhD @rodrizzo-pain.bsky.social · 10/11/2025

A meta-analysis (137 studies, n = 12,966) found that touch improves pain, mood, anxiety, and cortisol regulation. Although human touch might be more beneficial, even robot-delivered touch showed physical benefits. #PainResearch #MentalHealth #Neuroscience www.nature.com/articles/s41...

031

Reposted by Gemma Altinger

Jeff Linder @jefflinder.bsky.social · 13/11/2025

These findings differ from a classic paper by Donald Redelmeier in which the found and concluded that offering more options increased "decisional difficulty" and led to inertia in decision-making. jamanetwork.com/journals/jam...

jamanetwork.com

Medical Decision Making in Situations That Offer Multiple Alternatives

Objective. —To determine whether situations involving multiple options can paradoxically influence people to choose an option that would have been declined if fewer options were available.Design....

041

Reposted by Gemma Altinger

Jeff Linder @jefflinder.bsky.social · 13/11/2025

This is important as we think about designing nudges, especially in the electronic health record. For example, in an alert to not prescribe opioids for low back pain, physicians were more likely to pick an alternative if at least 2 non-opioid alternatives were offered.

111

Reposted by Gemma Altinger

Jeff Linder @jefflinder.bsky.social · 13/11/2025

Just in time for the @pennchibe.bsky.social meeting, a new paper with @gemmaaltinger.bsky.social in @jamanetworkopen.com. We found that offering physicians MORE alternatives encouraged them to select one of the alternates.

131

Gemma Altinger @gemmaaltinger.bsky.social · 20/12/2024

This week I received the Excellence in Knowledge Translation Award for a video I made communicating concepts from my Journal of Physiotherapy editorial to a wider audience. As a result this video has been adapted to as part of the intervention arm in a trial. Check out my article at lnkd.in/gReuR8k7

000