Screening for abdominal aortic aneurysm with electronic clinical reminders

Area of Science:

• Vascular Surgery
• Medical Informatics
• Public Health Screening

Background:

• Ultrasound screening for abdominal aortic aneurysms (AAA) significantly reduces mortality by enabling timely surgical intervention.
• Ultrasound is a validated, cost-effective, and non-invasive screening tool for AAA detection.
• The study investigated the utility of electronic medical record (EMR) prompts to enhance AAA screening.

Purpose of the Study:

• To evaluate the effectiveness of an age-prompted clinical reminder within an EMR system for detecting abdominal aortic aneurysms (AAA).
• To assess the yield of AAA detection in a male veteran population using a computerized reminder system.

Main Methods:

• An AAA risk screening protocol was implemented in May 2007 using EMR prompts for male veterans aged 65-75 who had ever smoked.
• An abbreviated ultrasound examination was performed, measuring the largest infrarenal aortic diameter using a 3.5- to 4-MHz scan head.

Main Results:

• Out of 1437 examinations, 73 cases (5.1%) of AAA (≥3.0 cm), 33 cases (2.3%) of AAA (≥4.0 cm), 15 cases (1.0%) of AAA (≥5.0 cm), and 11 cases (0.77%) of AAA (≥5.5 cm) were identified.
• Abnormal findings led to counseling for 50 individuals (68%).

Conclusions:

• The implementation of electronic clinical reminders successfully identified previously undiagnosed abdominal aortic aneurysms (AAAs).
• This EMR-based approach facilitates the detection of life-threatening AAAs prior to rupture.
• Prompt counseling and vascular intervention are available for individuals with newly diagnosed AAAs.