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Clinical Decision Support Tool for Early Pancreatic Cancer Detection in Primary Care: Simulation Study
Javiera Martinez-Gutierrez1,2,3, Kaleswari Somasundaram1, Christina Maresch Bernardes4,5
1Department of General Practice, Medicine, Dentristry and Health Services, The University of Melbourne, Melbourne, Australia.
JMIR Formative Research
|February 6, 2026
Summary
General practitioners found a clinical decision support system (CDSS) helpful for identifying potential pancreatic cancer symptoms. However, concerns about overtesting and cost-effectiveness need addressing before widespread adoption in primary care.
Area of Science:
- Digital Health Interventions
- Primary Care Medicine
- Oncology Decision Support
Background:
- Early pancreatic cancer detection in primary care is challenged by low prevalence, non-specific symptoms, and high GP workload.
- Australia's National Pancreatic Cancer Roadmap prioritizes improving outcomes through earlier diagnosis.
- Computerized clinical decision support systems (CDSSs) show potential for timely cancer diagnosis but face adoption barriers like mistrust and workflow integration issues.
Purpose of the Study:
- To evaluate the acceptability and feasibility of a CDSS for identifying patients with pancreatic cancer symptoms within a simulated primary care setting.
- To assess general practitioners' (GPs) perceptions of a CDSS designed to flag potential pancreatic cancer indicators.
Main Methods:
- A CDSS was developed to interact with electronic health records, identifying patients with symptoms like unintended weight loss or new-onset diabetes.
- Eleven GPs participated in a simulation, using the CDSS with patient actors presenting specific clinical scenarios.
- GP interviews were conducted, and data were analyzed using thematic analysis and relevant frameworks to gauge acceptability and feasibility.
Main Results:
- GPs found the CDSS user-friendly, non-obstructive, and effective in prompting consideration of investigations for at-risk patients.
- Concerns were raised regarding potential overtesting, associated financial costs, and patient anxiety from low-probability findings.
- The system was perceived as compatible with clinical workflows, but GPs favored a stepwise investigative approach over immediate imaging.
Conclusions:
- The CDSS demonstrated acceptability and workflow compatibility among GPs for identifying potential pancreatic cancer indicators.
- Barriers to implementation include concerns about overtesting, evidence base, and cost-effectiveness.
- Further evidence is required to support clinical recommendations before integrating this specific CDSS into primary care for pancreatic cancer diagnosis.
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