Home - News ( United States | United Kingdom | Italy | Germany ) - Football scores

Showing content from https://pubmed.ncbi.nlm.nih.gov/26304875/ below:

Electronic Trigger-Based Intervention to Reduce Delays in Diagnostic Evaluation for Cancer: A Cluster Randomized Controlled Trial

Randomized Controlled Trial

Affiliations

• ¹ Daniel R. Murphy, Louis Wu, Ashley N.D. Meyer, and Hardeep Singh, Houston Veterans Affairs Health Services Research and Development, Michael E. DeBakey Veterans Affairs Medical Center, and Section of Health Services Research, Baylor College of Medicine; Eric J. Thomas, University of Texas Houston Medical School and University of Texas Houston-Memorial Hermann Center for Healthcare Quality and Safety, Houston; and Samuel N. Forjuoh, Scott and White Healthcare, Texas A&M Health Science Center, College of Medicine, Temple, TX.
• ² Daniel R. Murphy, Louis Wu, Ashley N.D. Meyer, and Hardeep Singh, Houston Veterans Affairs Health Services Research and Development, Michael E. DeBakey Veterans Affairs Medical Center, and Section of Health Services Research, Baylor College of Medicine; Eric J. Thomas, University of Texas Houston Medical School and University of Texas Houston-Memorial Hermann Center for Healthcare Quality and Safety, Houston; and Samuel N. Forjuoh, Scott and White Healthcare, Texas A&M Health Science Center, College of Medicine, Temple, TX. hardeeps@bcm.edu.

• PMID: 26304875
• PMCID: PMC4622097
• DOI: 10.1200/JCO.2015.61.1301

Item in Clipboard

Randomized Controlled Trial

Daniel R Murphy et al. J Clin Oncol. 2015.

• ¹ Daniel R. Murphy, Louis Wu, Ashley N.D. Meyer, and Hardeep Singh, Houston Veterans Affairs Health Services Research and Development, Michael E. DeBakey Veterans Affairs Medical Center, and Section of Health Services Research, Baylor College of Medicine; Eric J. Thomas, University of Texas Houston Medical School and University of Texas Houston-Memorial Hermann Center for Healthcare Quality and Safety, Houston; and Samuel N. Forjuoh, Scott and White Healthcare, Texas A&M Health Science Center, College of Medicine, Temple, TX.
• ² Daniel R. Murphy, Louis Wu, Ashley N.D. Meyer, and Hardeep Singh, Houston Veterans Affairs Health Services Research and Development, Michael E. DeBakey Veterans Affairs Medical Center, and Section of Health Services Research, Baylor College of Medicine; Eric J. Thomas, University of Texas Houston Medical School and University of Texas Houston-Memorial Hermann Center for Healthcare Quality and Safety, Houston; and Samuel N. Forjuoh, Scott and White Healthcare, Texas A&M Health Science Center, College of Medicine, Temple, TX. hardeeps@bcm.edu.

• PMID: 26304875
• PMCID: PMC4622097
• DOI: 10.1200/JCO.2015.61.1301

Item in Clipboard

Purpose: We tested whether prospective use of electronic health record-based trigger algorithms to identify patients at risk of diagnostic delays could prevent delays in diagnostic evaluation for cancer.

Methods: We performed a cluster randomized controlled trial of primary care providers (PCPs) at two sites to test whether triggers that prospectively identify patients with potential delays in diagnostic evaluation for lung, colorectal, or prostate cancer can reduce time to follow-up diagnostic evaluation. Intervention steps included queries of the electronic health record repository for patients with abnormal findings and lack of associated follow-up actions, manual review of triggered records, and communication of this information to PCPs via secure e-mail and, if needed, phone calls to ensure message receipt. We compared times to diagnostic evaluation and proportions of patients followed up between intervention and control cohorts based on final review at 7 months.

Results: We recruited 72 PCPs (36 in the intervention group and 36 in the control group) and applied the trigger to all patients under their care from April 20, 2011, to July 19, 2012. Of 10,673 patients with abnormal findings, the trigger flagged 1,256 patients (11.8%) as high risk for delayed diagnostic evaluation. Times to diagnostic evaluation were significantly lower in intervention patients compared with control patients flagged by the colorectal trigger (median, 104 v 200 days, respectively; n = 557; P < .001) and prostate trigger (40% received evaluation at 144 v 192 days, respectively; n = 157; P < .001) but not the lung trigger (median, 65 v 93 days, respectively; n = 19; P = .59). More intervention patients than control patients received diagnostic evaluation by final review (73.4% v 52.2%, respectively; relative risk, 1.41; 95% CI, 1.25 to 1.58).

Conclusion: Electronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up. Similar interventions could improve timeliness of diagnosis of other serious conditions.

Trial registration: ClinicalTrials.gov NCT01346839.

© 2015 by American Society of Clinical Oncology.

PubMed Disclaimer

Authors' disclosures of potential conflicts of interest are found in the article online at www.jco.org . Author contributions are found at the end of this article.

Study flow diagram. (*) Seven…

Study flow diagram. (*) Seven of the 72 providers left their respective facilities…

Study flow diagram. (*) Seven of the 72 providers left their respective facilities during the study period, and triggers were immediately modified to cease evaluating data of their patients.

Effect of trigger-based intervention on…

Effect of trigger-based intervention on time to diagnostic evaluation for (A) colorectal cancer,…

Effect of trigger-based intervention on time to diagnostic evaluation for (A) colorectal cancer, (B) prostate cancer, and (C) lung cancer.

• Electronic health record-based triggers to detect potential delays in cancer diagnosis.

  Murphy DR, Laxmisan A, Reis BA, Thomas EJ, Esquivel A, Forjuoh SN, Parikh R, Khan MM, Singh H. Murphy DR, et al. BMJ Qual Saf. 2014 Jan;23(1):8-16. doi: 10.1136/bmjqs-2013-001874. Epub 2013 Jul 19. BMJ Qual Saf. 2014. PMID: 23873756

• Communicating Findings of Delayed Diagnostic Evaluation to Primary Care Providers.

  Meyer AN, Murphy DR, Singh H. Meyer AN, et al. J Am Board Fam Med. 2016 Jul-Aug;29(4):469-73. doi: 10.3122/jabfm.2016.04.150363. J Am Board Fam Med. 2016. PMID: 27390378 Clinical Trial.

• A Multilevel Primary Care Intervention to Improve Follow-Up of Overdue Abnormal Cancer Screening Test Results: A Cluster Randomized Clinical Trial.

  Atlas SJ, Tosteson ANA, Wright A, Orav EJ, Burdick TE, Zhao W, Hort SJ, Wint AJ, Smith RE, Chang FY, Aman DG, Thillaiyapillai M, Diamond CJ, Zhou L, Haas JS. Atlas SJ, et al. JAMA. 2023 Oct 10;330(14):1348-1358. doi: 10.1001/jama.2023.18755. JAMA. 2023. PMID: 37815566 Free PMC article. Clinical Trial.

• Interventions for promoting habitual exercise in people living with and beyond cancer.

  Turner RR, Steed L, Quirk H, Greasley RU, Saxton JM, Taylor SJ, Rosario DJ, Thaha MA, Bourke L. Turner RR, et al. Cochrane Database Syst Rev. 2018 Sep 19;9(9):CD010192. doi: 10.1002/14651858.CD010192.pub3. Cochrane Database Syst Rev. 2018. PMID: 30229557 Free PMC article. Review.

• Screening for prostate cancer.

  Ilic D, Neuberger MM, Djulbegovic M, Dahm P. Ilic D, et al. Cochrane Database Syst Rev. 2013 Jan 31;2013(1):CD004720. doi: 10.1002/14651858.CD004720.pub3. Cochrane Database Syst Rev. 2013. PMID: 23440794 Free PMC article. Review.

• The global burden of diagnostic errors in primary care.

  Singh H, Schiff GD, Graber ML, Onakpoya I, Thompson MJ. Singh H, et al. BMJ Qual Saf. 2017 Jun;26(6):484-494. doi: 10.1136/bmjqs-2016-005401. Epub 2016 Aug 16. BMJ Qual Saf. 2017. PMID: 27530239 Free PMC article. Review.

• Strategies to reduce diagnostic errors: a systematic review.

  Abimanyi-Ochom J, Bohingamu Mudiyanselage S, Catchpool M, Firipis M, Wanni Arachchige Dona S, Watts JJ. Abimanyi-Ochom J, et al. BMC Med Inform Decis Mak. 2019 Aug 30;19(1):174. doi: 10.1186/s12911-019-0901-1. BMC Med Inform Decis Mak. 2019. PMID: 31470839 Free PMC article.

• Decision support tools to improve cancer diagnostic decision making in primary care: a systematic review.

  Chima S, Reece JC, Milley K, Milton S, McIntosh JG, Emery JD. Chima S, et al. Br J Gen Pract. 2019 Nov 28;69(689):e809-e818. doi: 10.3399/bjgp19X706745. Print 2019 Dec. Br J Gen Pract. 2019. PMID: 31740460 Free PMC article.

• Methods for reducing delays in the diagnosis of multiple myeloma.

  Koshiaris C. Koshiaris C. Int J Hematol Oncol. 2019 Feb 26;8(1):IJH13. doi: 10.2217/ijh-2018-0014. eCollection 2019 Feb. Int J Hematol Oncol. 2019. PMID: 30863530 Free PMC article. No abstract available.

• Understanding the roles of three academic communities in a prospective learning health ecosystem for diagnostic excellence.

  Satterfield K, Rubin JC, Yang D, Friedman CP. Satterfield K, et al. Learn Health Syst. 2019 Dec 2;4(1):e210204. doi: 10.1002/lrh2.10204. eCollection 2020. Learn Health Syst. 2019. PMID: 31989032 Free PMC article.

1. 1. Markides GA, Newman CM. Medical malpractice claims in relation to colorectal malignancy in the National Health Service. Colorectal Dis. 2014;16:48–56. - PubMed
2. 1. Gandhi TK, Kachalia A, Thomas EJ, et al. Missed and delayed diagnoses in the ambulatory setting: A study of closed malpractice claims. Ann Intern Med. 2006;145:488–496. - PubMed
3. 1. Phillips RL, Jr, Bartholomew LA, Dovey SM, et al. Learning from malpractice claims about negligent, adverse events in primary care in the United States. Qual Saf Health Care. 2004;13:121–126. - PMC - PubMed
4. 1. Schiff GD, Puopolo AL, Huben-Kearney A, et al. Primary care closed claims experience of Massachusetts malpractice insurers. JAMA Intern Med. 2013;173:2063–2068. - PubMed
5. 1. Savage JR, Weiner GM. Litigation in otolaryngology: Trends and recommendations. J Laryngol Otol. 2006;120:1001–1004. - PubMed

RetroSearch is an open source project built by @garambo | Open a GitHub Issue

Search and Browse the WWW like it's 1997 | Search results from DuckDuckGo

HTML: 3.2 | Encoding: UTF-8 | Version: 0.7.3