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Clinical utility of a Web-enabled risk-assessment and clinical decision support program.

Publication ,  Journal Article
Orlando, LA; Wu, RR; Myers, RA; Buchanan, AH; Henrich, VC; Hauser, ER; Ginsburg, GS
Published in: Genet Med
October 2016

PURPOSE: Risk-stratified guidelines can improve quality of care and cost-effectiveness, but their uptake in primary care has been limited. MeTree, a Web-based, patient-facing risk-assessment and clinical decision support tool, is designed to facilitate uptake of risk-stratified guidelines. METHODS: A hybrid implementation-effectiveness trial of three clinics (two intervention, one control). PARTICIPANTS: consentable nonadopted adults with upcoming appointments. PRIMARY OUTCOME: agreement between patient risk level and risk management for those meeting evidence-based criteria for increased-risk risk-management strategies (increased risk) and those who do not (average risk) before MeTree and after. MEASURES: chart abstraction was used to identify risk management related to colon, breast, and ovarian cancer, hereditary cancer, and thrombosis. RESULTS: Participants = 488, female = 284 (58.2%), white = 411 (85.7%), mean age = 58.7 (SD = 12.3). Agreement between risk management and risk level for all conditions for each participant, except for colon cancer, which was limited to those <50 years of age, was (i) 1.1% (N = 2/174) for the increased-risk group before MeTree and 16.1% (N = 28/174) after and (ii) 99.2% (N = 2,125/2,142) for the average-risk group before MeTree and 99.5% (N = 2,131/2,142) after. Of those receiving increased-risk risk-management strategies at baseline, 10.5% (N = 2/19) met criteria for increased risk. After MeTree, 80.7% (N = 46/57) met criteria. CONCLUSION: MeTree integration into primary care can improve uptake of risk-stratified guidelines and potentially reduce "overuse" and "underuse" of increased-risk services.Genet Med 18 10, 1020-1028.

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Published In

Genet Med

DOI

EISSN

1530-0366

Publication Date

October 2016

Volume

18

Issue

10

Start / End Page

1020 / 1028

Location

United States

Related Subject Headings

  • Risk Management
  • Risk Assessment
  • Primary Health Care
  • Neoplasms
  • Middle Aged
  • Medical History Taking
  • Male
  • Humans
  • Genetics & Heredity
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Orlando, L. A., Wu, R. R., Myers, R. A., Buchanan, A. H., Henrich, V. C., Hauser, E. R., & Ginsburg, G. S. (2016). Clinical utility of a Web-enabled risk-assessment and clinical decision support program. Genet Med, 18(10), 1020–1028. https://doi.org/10.1038/gim.2015.210
Orlando, Lori A., R Ryanne Wu, Rachel A. Myers, Adam H. Buchanan, Vincent C. Henrich, Elizabeth R. Hauser, and Geoffrey S. Ginsburg. “Clinical utility of a Web-enabled risk-assessment and clinical decision support program.Genet Med 18, no. 10 (October 2016): 1020–28. https://doi.org/10.1038/gim.2015.210.
Orlando LA, Wu RR, Myers RA, Buchanan AH, Henrich VC, Hauser ER, et al. Clinical utility of a Web-enabled risk-assessment and clinical decision support program. Genet Med. 2016 Oct;18(10):1020–8.
Orlando, Lori A., et al. “Clinical utility of a Web-enabled risk-assessment and clinical decision support program.Genet Med, vol. 18, no. 10, Oct. 2016, pp. 1020–28. Pubmed, doi:10.1038/gim.2015.210.
Orlando LA, Wu RR, Myers RA, Buchanan AH, Henrich VC, Hauser ER, Ginsburg GS. Clinical utility of a Web-enabled risk-assessment and clinical decision support program. Genet Med. 2016 Oct;18(10):1020–1028.

Published In

Genet Med

DOI

EISSN

1530-0366

Publication Date

October 2016

Volume

18

Issue

10

Start / End Page

1020 / 1028

Location

United States

Related Subject Headings

  • Risk Management
  • Risk Assessment
  • Primary Health Care
  • Neoplasms
  • Middle Aged
  • Medical History Taking
  • Male
  • Humans
  • Genetics & Heredity
  • Female