Improving Concordance Between Clinicians With Australian Guidelines for Bowel Cancer Prevention Using a Digital...

Area of Science:

• Oncology
• Public Health
• Health Informatics

Background:

• Australia's revised bowel cancer prevention guidelines are highly complex, featuring 230 scenarios for screening and surveillance.
• This complexity may hinder clinician adoption and limit the benefits of these crucial guidelines.
• Digital applications (DAs) offer a scalable solution to aid clinicians, but their efficacy for guideline navigation is untested.

Purpose of the Study:

• To evaluate if a DA can enhance clinician adherence to Australia's updated colorectal cancer screening and surveillance guidelines.
• To determine the correlation between the DA's usability and clinician conformance to these guidelines.

Main Methods:

• A randomized controlled crossover study utilized a clinical vignette quiz to compare a DA against a standard resource (SR).
• Clinician adherence was measured by guideline-concordant responses, with higher scores indicating better adherence.
• System Usability Scale assessed the DA's usability, and its correlation with adherence was analyzed.

Main Results:

• Clinician adherence improved by 40% (RR 1.4, P<.001) when using the DA, with median scores rising from 10 (SR) to 14 (DA) out of 18.
• The DA demonstrated high usability (median 90/100) and a moderate correlation with improved adherence (r_s=0.4; P<.001).
• No significant differences in adherence were found between specialists and non-specialists, nor were there associations between lower DA adherence and participant age or experience.

Conclusions:

• Digital applications can substantially improve the uptake of complex Australian bowel cancer prevention guidelines.
• As guidelines become more personalized, DAs are essential for accurate clinical decision-making in cancer screening and surveillance.
• Further research into suboptimal DA performance and usability enhancements is recommended to further optimize guideline concordance.