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An electronic family health history tool to identify and manage patients at increased risk for colorectal cancer: protocol for a randomized controlled trial.

Publication ,  Journal Article
Goldstein, KM; Fisher, DA; Wu, RR; Orlando, LA; Coffman, CJ; Grubber, JM; Rakhra-Burris, T; Wang, V; Scheuner, MT; Sperber, N; Datta, SK ...
Published in: Trials
October 7, 2019

BACKGROUND: Colorectal cancer is the fourth most commonly diagnosed cancer in the United States. Approximately 3-10% of the population has an increased risk for colorectal cancer due to family history and warrants more frequent or intensive screening. Yet, < 50% of that high-risk population receives guideline-concordant care. Systematic collection of family health history and decision support may improve guideline-concordant screening for patients at increased risk of colorectal cancer. We seek to test the effectiveness of a web-based, systematic family health history collection tool and decision support platform (MeTree) to improve risk assessment and appropriate management of colorectal cancer risk among patients in the Department of Veterans Affairs primary care practices. METHODS: In this ongoing randomized controlled trial, primary care providers at the Durham Veterans Affairs Health Care System and the Madison VA Medical Center are randomized to immediate intervention or wait-list control. Veterans are eligible if assigned to enrolled providers, have an upcoming primary care appointment, and have no conditions that would place them at increased risk for colorectal cancer (such as personal history, adenomatous polyps, or inflammatory bowel disease). Those with a recent lower endoscopy (e.g. colonoscopy, sigmoidoscopy) are excluded. Immediate intervention patients put their family health history information into a web-based platform, MeTree, which provides both patient- and provider-facing decision support reports. Wait-list control patients access MeTree 12 months post-consent. The primary outcome is the risk-concordant colorectal cancer screening referral rate obtained via chart review. Secondary outcomes include patient completion of risk management recommendations (e.g. colonoscopy) and referral for genetic consultation. We will also conduct an economic analysis and an assessment of providers' experience with MeTree clinical decision support recommendations to inform future implementation efforts if the intervention is found to be effective. DISCUSSION: This trial will assess the feasibility and effectiveness of patient-collected family health history linked to decision support to promote risk-appropriate screening in a large healthcare system such as the Department of Veterans Affairs. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02247336 . Registered on 25 September 2014.

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Published In

Trials

DOI

EISSN

1745-6215

Publication Date

October 7, 2019

Volume

20

Issue

1

Start / End Page

576

Location

England

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Risk Factors
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Prognosis
  • Predictive Value of Tests
  • Multicenter Studies as Topic
  • Middle Aged
  • Medical History Taking
 

Citation

APA
Chicago
ICMJE
MLA
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Goldstein, K. M., Fisher, D. A., Wu, R. R., Orlando, L. A., Coffman, C. J., Grubber, J. M., … Voils, C. I. (2019). An electronic family health history tool to identify and manage patients at increased risk for colorectal cancer: protocol for a randomized controlled trial. Trials, 20(1), 576. https://doi.org/10.1186/s13063-019-3659-y
Goldstein, Karen M., Deborah A. Fisher, R Ryanne Wu, Lori A. Orlando, Cynthia J. Coffman, Janet M. Grubber, Tejinder Rakhra-Burris, et al. “An electronic family health history tool to identify and manage patients at increased risk for colorectal cancer: protocol for a randomized controlled trial.Trials 20, no. 1 (October 7, 2019): 576. https://doi.org/10.1186/s13063-019-3659-y.
Goldstein KM, Fisher DA, Wu RR, Orlando LA, Coffman CJ, Grubber JM, et al. An electronic family health history tool to identify and manage patients at increased risk for colorectal cancer: protocol for a randomized controlled trial. Trials. 2019 Oct 7;20(1):576.
Goldstein, Karen M., et al. “An electronic family health history tool to identify and manage patients at increased risk for colorectal cancer: protocol for a randomized controlled trial.Trials, vol. 20, no. 1, Oct. 2019, p. 576. Pubmed, doi:10.1186/s13063-019-3659-y.
Goldstein KM, Fisher DA, Wu RR, Orlando LA, Coffman CJ, Grubber JM, Rakhra-Burris T, Wang V, Scheuner MT, Sperber N, Datta SK, Nelson RE, Strawbridge E, Provenzale D, Hauser ER, Voils CI. An electronic family health history tool to identify and manage patients at increased risk for colorectal cancer: protocol for a randomized controlled trial. Trials. 2019 Oct 7;20(1):576.
Journal cover image

Published In

Trials

DOI

EISSN

1745-6215

Publication Date

October 7, 2019

Volume

20

Issue

1

Start / End Page

576

Location

England

Related Subject Headings

  • United States Department of Veterans Affairs
  • United States
  • Risk Factors
  • Risk Assessment
  • Randomized Controlled Trials as Topic
  • Prognosis
  • Predictive Value of Tests
  • Multicenter Studies as Topic
  • Middle Aged
  • Medical History Taking