1 From the Houston Veterans Affairs Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center, and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine - both in Houston (H.S.); RTI International, Raleigh-Durham, NC (M.L.G.); the Society to Improve Diagnosis in Medicine, New York (M.L.G.); and SUNY Stony Brook, Stony Brook, NY (M.L.G.).