{ "standard": "FactUnion Standard v1", "checkedAt": "2026-10-20T09:50:11.929Z", "title": "The Text That Failed the Right Way", "date": "2026-10-20", "facts": [ { "n": 1, "claim": "The Behavioural Insights Team's blog of 22 Oct 2015 says it worked with the Department of Health and Imperial College London, testing reminder messages on patients at five clinics at Barts NHS Trust.", "sources": [ { "url": "https://www.bi.team/blogs/reducing-missed-appointments/", "title": "Reducing Missed Appointments" } ], "verdict": "verified", "note": "Kept on a lower-weight source (bi.team); nothing we found says otherwise.", "quote": false, "usedInEpisode": true }, { "n": 2, "claim": "The clear winner was a message that pointed out the approximate cost of the missed appointment to the NHS (£160).", "sources": [ { "url": "https://www.bi.team/blogs/reducing-missed-appointments/", "title": "Reducing Missed Appointments" } ], "verdict": "verified", "note": "Kept on a lower-weight source (bi.team); nothing we found says otherwise.", "quote": false, "usedInEpisode": true }, { "n": 3, "claim": "BIT's blog says a more general version of the cost message, without a specific cost, was less effective.", "sources": [ { "url": "https://www.bi.team/blogs/reducing-missed-appointments/", "title": "Reducing Missed Appointments" } ], "verdict": "verified", "note": "Kept on a lower-weight source (bi.team); nothing we found says otherwise.", "quote": false, "usedInEpisode": true }, { "n": 4, "claim": "The project reduced missed appointments from 11.1% to 8.4%, a relative reduction of 23%.", "sources": [ { "url": "https://www.cambridge.org/core/product/identifier/S2398063X2610030X/type/journal_article", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.gov.uk/government/publications/reducing-missed-hospital-appointments-using-text-messages/a-zero-cost-way-to-reduce-missed-hospital-appointments", "title": "A zero cost way to reduce missed hospital appointments" } ], "verdict": "corrected", "note": "Wrong: 25% reduction, 8.5% figure, and no-extra-cost claim. Right: government and academic sources report 11.1% to 8.4%, a 23% relative reduction.", "quote": false, "usedInEpisode": true }, { "n": 5, "claim": "The PLOS ONE paper reports two randomised trials: Trial One with 10,111 participants (November 2013 to January 2014) and Trial Two with 9,848 participants (March to May 2014), each testing four reminder messages sent five days before the appointment.", "sources": [ { "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137306", "title": "Stating Appointment Costs in SMS Reminders Reduces Missed Hospital Appointments: Findings from Two Randomised Controlled Trials" }, { "url": "https://www.ncbi.nlm.nih.gov/pubmed/26366885", "title": "Checking your browser" }, { "url": "https://doi.org/10.1371/journal.pone.0137306", "title": "Stating Appointment Costs in SMS Reminders Reduces Missed Hospital Appointments: Findings from Two Randomised Controlled Trials" } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 6, "claim": "In Trial One, 8.4% of patients sent the specific-cost message missed their appointment, against 11.1% sent the existing reminder (odds ratio 0.74, 95% CI 0.61 to 0.89).", "sources": [ { "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137306", "title": "Stating Appointment Costs in SMS Reminders Reduces Missed Hospital Appointments: Findings from Two Randomised Controlled Trials" }, { "url": "https://www.ncbi.nlm.nih.gov/pubmed/26366885", "title": "Checking your browser" }, { "url": "https://www.cambridge.org/core/journals/behavioural-public-policy/article/replicating-behavioural-insights-in-health-a-quasiexperimental-phase-2-trial-of-integrating-descriptive-social-norms-and-institutional-cost-in-sms-reminders-to-reduce-missed-hospital-appointments/10770DAE0A45CFB426783CF96729A598", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 7, "claim": "In Trial Two, 8.2% of patients sent the specific-cost message missed their appointment, against 9.9% sent a message describing costs in general terms (odds ratio 1.22).", "sources": [ { "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137306", "title": "Stating Appointment Costs in SMS Reminders Reduces Missed Hospital Appointments: Findings from Two Randomised Controlled Trials" }, { "url": "https://www.ncbi.nlm.nih.gov/pubmed/26366885", "title": "Checking your browser" }, { "url": "https://doi.org/10.1371/journal.pone.0137306", "title": "Stating Appointment Costs in SMS Reminders Reduces Missed Hospital Appointments: Findings from Two Randomised Controlled Trials" } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 8, "claim": "A Danish team including Pelle Guldborg Hansen retested the idea at South-western Jutland Hospital across 20,867 appointments in cardiology, endocrinology and pulmonology, published online in Behavioural Public Policy on 23 April 2026.", "sources": [ { "url": "https://doi.org/10.1017/bpp.2026.10030", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/journals/behavioural-public-policy/article/replicating-behavioural-insights-in-health-a-quasiexperimental-phase-2-trial-of-integrating-descriptive-social-norms-and-institutional-cost-in-sms-reminders-to-reduce-missed-hospital-appointments/10770DAE0A45CFB426783CF96729A598", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/product/identifier/S2398063X2610030X/type/journal_article", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 9, "claim": "The Danish trial was a quasi-experimental, time-blocked design that rotated a standard SMS, a descriptive social norm SMS and a specific institutional cost SMS every two months.", "sources": [ { "url": "https://doi.org/10.1017/bpp.2026.10030", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/journals/behavioural-public-policy/article/replicating-behavioural-insights-in-health-a-quasiexperimental-phase-2-trial-of-integrating-descriptive-social-norms-and-institutional-cost-in-sms-reminders-to-reduce-missed-hospital-appointments/10770DAE0A45CFB426783CF96729A598", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/product/identifier/S2398063X2610030X/type/journal_article", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 10, "claim": "The Danish social-norm message told patients that more than nine in ten patients turn up or cancel in good time.", "sources": [ { "url": "https://inudgeyou.com/en/news-about-nudging-and-behavioural-insights/sms-reminders-missed-hospital-appointments/", "title": "Nudging no-shows in hospital appointments: Phase 2 trial in health fails to replicate well-known behavioural insight" } ], "verdict": "verified", "note": "Kept on a lower-weight source (inudgeyou.com); nothing we found says otherwise.", "quote": false, "usedInEpisode": true }, { "n": 11, "claim": "Neither DSN nor SIC reduced DNAs overall.", "sources": [ { "url": "https://doi.org/10.1017/bpp.2026.10030", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/journals/behavioural-public-policy/article/replicating-behavioural-insights-in-health-a-quasiexperimental-phase-2-trial-of-integrating-descriptive-social-norms-and-institutional-cost-in-sms-reminders-to-reduce-missed-hospital-appointments/10770DAE0A45CFB426783CF96729A598", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/product/identifier/S2398063X2610030X/type/journal_article", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " } ], "verdict": "corrected", "note": "The original omits the qualifier \"overall.\" The evidence supports only that neither DSN nor SIC reduced DNAs overall, not in every case.", "quote": false, "usedInEpisode": true }, { "n": 12, "claim": "In the Danish trial, the specific-cost message increased advance cancellations (OR = 1.41, p < 0.001) but not attendance.", "sources": [ { "url": "https://doi.org/10.1017/bpp.2026.10030", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/journals/behavioural-public-policy/article/replicating-behavioural-insights-in-health-a-quasiexperimental-phase-2-trial-of-integrating-descriptive-social-norms-and-institutional-cost-in-sms-reminders-to-reduce-missed-hospital-appointments/10770DAE0A45CFB426783CF96729A598", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/product/identifier/S2398063X2610030X/type/journal_article", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 13, "claim": "In endocrinology the specific-cost message increased missed appointments (OR = 1.31, p = 0.021), while the social-norm message reduced them in cardiology (OR = 0.76, p = 0.027).", "sources": [ { "url": "https://doi.org/10.1017/bpp.2026.10030", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/journals/behavioural-public-policy/article/replicating-behavioural-insights-in-health-a-quasiexperimental-phase-2-trial-of-integrating-descriptive-social-norms-and-institutional-cost-in-sms-reminders-to-reduce-missed-hospital-appointments/10770DAE0A45CFB426783CF96729A598", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/product/identifier/S2398063X2610030X/type/journal_article", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 14, "claim": "subsequent similar interventions have reported heterogeneous findings", "sources": [ { "url": "https://doi.org/10.1017/bpp.2026.10030", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/journals/behavioural-public-policy/article/replicating-behavioural-insights-in-health-a-quasiexperimental-phase-2-trial-of-integrating-descriptive-social-norms-and-institutional-cost-in-sms-reminders-to-reduce-missed-hospital-appointments/10770DAE0A45CFB426783CF96729A598", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/product/identifier/S2398063X2610030X/type/journal_article", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 15, "claim": "We did not replicate", "sources": [ { "url": "https://inudgeyou.com/en/news-about-nudging-and-behavioural-insights/sms-reminders-missed-hospital-appointments/", "title": "Nudging no-shows in hospital appointments: Phase 2 trial in health fails to replicate well-known behavioural insight" } ], "verdict": "verified", "note": "Kept on a lower-weight source (inudgeyou.com); nothing we found says otherwise.", "quote": false, "usedInEpisode": true }, { "n": 16, "claim": "Neither message moved the no-show rate.", "sources": [ { "url": "https://inudgeyou.com/en/news-about-nudging-and-behavioural-insights/sms-reminders-missed-hospital-appointments/", "title": "Nudging no-shows in hospital appointments: Phase 2 trial in health fails to replicate well-known behavioural insight" }, { "url": "https://www.cambridge.org/core/journals/behavioural-public-policy/article/replicating-behavioural-insights-in-health-a-quasiexperimental-phase-2-trial-of-integrating-descriptive-social-norms-and-institutional-cost-in-sms-reminders-to-reduce-missed-hospital-appointments/10770DAE0A45CFB426783CF96729A598", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " }, { "url": "https://www.cambridge.org/core/product/identifier/S2398063X2610030X/type/journal_article", "title": "Replicating behavioural insights in health: a quasi-experimental Phase 2 trial of integrating descriptive social norms and institutional cost in SMS reminders to reduce missed hospital appointments | " } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 17, "claim": "A 2016 systematic review by McLean et al. found that all reminder types improve attendance and that reminder systems may also increase cancellation and rescheduling of unwanted appointments.", "sources": [ { "url": "https://doi.org/10.2147/ppa.s93046", "title": "Appointment reminder systems are effective but not optimal: results of" }, { "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4831598/", "title": "Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles" }, { "url": "https://www.tandfonline.com/doi/full/10.2147/PPA.S93046", "title": "Full article: Appointment reminder systems are effective but not optimal: results of a systematic review and evidence synthesis employing realist principles" } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 18, "claim": "At a Wrexham GP surgery of about 15,000 patients, missed appointments fell from 5,848 before SMS reminders to 3,343 after (a 43% drop the authors call significant), out of 572,794 booked between 2010 and 2020; the authors say SMS let patients cancel in good time, and the counts are not adjusted for volume.", "sources": [ { "url": "http://preprints.jmir.org/preprint/43894", "title": "http://preprints.jmir.org/preprint/43894" }, { "url": "https://www.sciencedirect.com/org/science/article/pii/S1438887124004187", "title": "Investigating How the Use of Technology Can Reduce Missed Appointments: Quantitative Case Study at a General Practitioner Surgery - ScienceDirect" } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 19, "claim": "Kim (2025) writes that many restaurants hesitate to apply cancellation policies due to customer dissatisfaction and perceived unfairness, and that research on how such policies affect no-shows remains limited.", "sources": [ { "url": "https://doi.org/10.1111/ijcs.70069", "title": "The Effects of Restaurant Cancellation Policies and No‐Show Awareness Campaigns on Reservation Behaviors - Kim - 2025 - International Journal of Consumer Studies - Wiley Online Library" }, { "url": "https://onlinelibrary.wiley.com/doi/10.1111/ijcs.70069", "title": "The Effects of Restaurant Cancellation Policies and No‐Show Awareness Campaigns on Reservation Behaviors - Kim - 2025 - International Journal of Consumer Studies - Wiley Online Library" } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 20, "claim": "Kim (2025) notes earlier research finding fine-dining guests consider non-refundable reservation fees fair, and warns that policies may lead guests to not book at all or to book while still searching for an alternative.", "sources": [ { "url": "https://doi.org/10.1111/ijcs.70069", "title": "The Effects of Restaurant Cancellation Policies and No‐Show Awareness Campaigns on Reservation Behaviors - Kim - 2025 - International Journal of Consumer Studies - Wiley Online Library" }, { "url": "https://onlinelibrary.wiley.com/doi/10.1111/ijcs.70069", "title": "The Effects of Restaurant Cancellation Policies and No‐Show Awareness Campaigns on Reservation Behaviors - Kim - 2025 - International Journal of Consumer Studies - Wiley Online Library" } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 21, "claim": "No-show customers, who were running above ten percent under the traditional reservation systems, dropped to less than one percent.", "sources": [ { "url": "https://www.gq.com/story/dinner-reservations-high-end-dining", "title": "Are Dinner Tickets the Future of Dining?" } ], "verdict": "verified", "quote": false, "usedInEpisode": true }, { "n": 22, "claim": "A 2014 randomised trial at a Geneva youth clinic found plain SMS reminders made no significant difference to missed appointments (16.4% vs 20.0%, p=0.346).", "sources": [ { "url": "https://doi.org/10.1136/jech-2013-202510", "title": "Text-messaging to reduce missed appointment in a youth clinic: a randomised controlled trial" }, { "url": "https://jech.bmj.com/lookup/doi/10.1136/jech-2013-202510", "title": "Text-messaging to reduce missed appointment in a youth clinic: a randomised controlled trial" } ], "verdict": "verified", "quote": false, "usedInEpisode": true } ], "removed": [ { "claim": "We got the same result when we ran the trial again, which makes us confident it's a real result.", "reason": "Only one source states this: bi.team." }, { "claim": "A 2025 restaurant study cites OpenTable data showing 28% of US restaurant reservations made in the past year were not honored.", "reason": "Reliable sources disagree about this." }, { "claim": "A June 2014 MassLive column describes Chicago restaurateur Nick Kokonas replacing reservations with prepaid tickets, first at Next (opened 2011), with the payment serving as a deposit against the final check.", "reason": "Sources only partly back this: Chicago Tribune." }, { "claim": "The column reports revenue and customer counts each rose about 20 percent, while noting the results came from three high-end, high demand operations.", "reason": "Couldn't be checked: a key record would not open." }, { "claim": "RepuClinic, citing Mangomint 2025 data, reports that 77.49% of barbershop appointments are booked online.", "reason": "Only one source states this: repuclinic.com." } ], "audioCheck": { "lines": 167, "matched": 167 }, "corrections": [], "verify": { "method": "1.3", "llmMode": "testing", "models": { "summary": "claude-haiku-5-5", "extract": "claude-haiku-5-5", "consolidate": "claude-haiku-5-5", "query": "claude-haiku-5-5", "read": "claude-haiku-5-5", "read_second": "claude-sonnet-5-5", "compare": "claude-haiku-5-5", "classify": "claude-haiku-5-5", "explain": "claude-haiku-5-5", "undash": "claude-haiku-5-5", "correct": "claude-haiku-5-5" }, "preScript": { "jobId": "job_5JW47BZRRHVFZVTSS6SC", "checkedAt": "2026-10-20T09:50:11.929Z", "counts": { "verified": 20, "corrected": 2, "removed": 5 } }, "episode": { "jobId": "job_DN0AJDYC3C5XSNF66BSE", "checkRef": "chk_YVZG3BWPQNB5NS8J2D6T", "trustPageUrl": null, "checkedAt": "2026-10-20T12:48:37.848Z", "score": null, "outcome": "not_rated", "counts": { "verified": 36, "not_verified": 0, "questionable": 14, "unable_to_determine": 23 }, "stability": { "spread": 7, "unstableClaims": 4, "pass": false }, "notVerified": [], "questionable": [ { "k": 1, "claim": "A reminder trial ran in November 2013 across five specialities at Barts Health NHS Trust.", "reasonText": "Reliable sources disagree about this." }, { "k": 11, "claim": "In the Danish study, neither new text reduced the no-show rate overall, and the number of missed appointments did not change with the cost text.", "reasonText": "Only one source states this: inudgeyou.com." }, { "k": 12, "claim": "In the Danish study, more people cancelled their appointments ahead of time with the cost reminder text, while the no-show rate did not change.", "reasonText": "Only one source states this: inudgeyou.com." }, { "k": 21, "claim": "The Behavioural Insights Team, working with Imperial College London and the Department of Health, ran both London hospital reminder-text trials.", "reasonText": "Only lower-weight sources state this: buildingbetterhealthcare.com and 1 more." }, { "k": 24, "claim": "The two London reminder-text trials were randomised, each with about 10,000 people.", "reasonText": "Sources only partly back this: PLOS." }, { "k": 31, "claim": "Researcher Pelle Guldborg Hansen, working at Southwestern Jutland Hospital, is part of the Danish study team.", "reasonText": "Sources only partly back this: Cambridge University Press." }, { "k": 33, "claim": "The Danish study was published online on 23 April 2026 in the journal Behavioural Public Policy.", "reasonText": "Reliable sources disagree about this." }, { "k": 35, "claim": "The third Danish text told patients that more than 90 percent of people turn up or cancel in good time.", "reasonText": "Only one source states this: inudgeyou.com." }, { "k": 40, "claim": "The Danish paper carries a correction, and some of its figures may have been changed.", "reasonText": "Sources only partly back this: MedPage Today." }, { "k": 46, "claim": "The Danish team counted patients who contacted them ahead of time to cancel, as well as people who walked in.", "reasonText": "Sources only partly back this: Cambridge University Press." }, { "k": 49, "claim": "In the Danish study, the same number of people attended while more of them called ahead to cancel.", "reasonText": "Sources only partly back this: Cambridge University Press." }, { "k": 55, "claim": "The Wrexham GP surgery's appointment counts cover more than 500,000 bookings made over ten years.", "reasonText": "Only one source states this: preprints.jmir.org." }, { "k": 56, "claim": "Missed appointments at the Wrexham GP surgery fell by 43 percent after text reminders were introduced.", "reasonText": "Only one source states this: preprints.jmir.org." }, { "k": 59, "claim": "The Wrexham before-and-after counts were not adjusted for how many appointments were booked in each period.", "reasonText": "Sources only partly back this: Elsevier." } ] } } }