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Lung Cancer Screening Before and After a Multifaceted Electronic Health Record Intervention: A Nonrandomized
Polina V Kukhareva1, Haojia Li2, Tanner J Caverly3,4,5
1Department of Biomedical Informatics, University of Utah, Salt Lake City.
JAMA Network Open
|June 7, 2024
Summary
A multifaceted intervention improved lung cancer screening (LCS) care gap closure by increasing identification and completion of recommended services. This approach enhances early lung cancer detection through low-dose computed tomography (LDCT).
Area of Science:
- Oncology
- Public Health
- Health Services Research
Background:
- Lung cancer remains a leading cause of cancer-related mortality in the US.
- Early detection through lung cancer screening (LCS) using low-dose computed tomography (LDCT) significantly improves patient outcomes.
- Addressing care gaps in LCS is crucial for maximizing the benefits of screening programs.
Purpose of the Study:
- To evaluate the effectiveness of a multifaceted clinical decision support intervention on lung cancer screening (LCS) care gap closure.
- To assess the impact of clinician-facing and patient-facing reminders on the identification and completion of LCS services.
- To determine the association between the intervention and the rates of low-dose computed tomography (LDCT) completion.
Main Methods:
- A nonrandomized controlled trial with an interrupted time series design was employed.
- The study included patients aged 55-80 years meeting LCS eligibility criteria (30+ pack-year smoking history).
- Interventions included clinician reminders, shared decision-making tools, and patient-facing reminders, with data collected over three periods: baseline, period 1, and period 2.
Main Results:
- The multifaceted intervention was associated with a significant increase in LCS care gap closure rates.
- Clinician-facing interventions increased the monthly trend of care gap closure by 2.6 percentage points.
- The addition of patient-facing reminders in period 2 led to an immediate increase in care gap closure by 2.3 percentage points, with overall closure rates rising from 15.9% to 46.9%.
Conclusions:
- A multifaceted intervention effectively improves lung cancer screening (LCS) care gap closure.
- Integrating clinical decision support tools and patient reminders enhances the identification and completion of recommended LCS services.
- This strategy holds promise for improving early lung cancer detection rates and patient survival.
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