No intervention effect was detected ( eye exam rates were 31.6 % for patients of control physicians , 31.3 % for the insert , 32.8 % for the outsert , 32.3 % for those who received both , and 31.2 % for those who received both plus the patient reminder with the largest 95 % confidence interval around any effect extending from -1.3 % to 1.1 % ) .