Evaluation of the use of decision-support software in carcino-embryonic antigen (CEA)-based follow-up of patients with colorectal cancer

Verberne, C.; Nijboer, Cornelis H; Bock, Geertruida H. de; Grossmann, I; Wiggers, Theo; Havenga, Klaas

doi:10.1186/1472-6947-12-14

Cited by 15 publications

(17 citation statements)

References 8 publications

(9 reference statements)

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“…To help improve the reliability of follow-up of the high volume of test results, electronic result managers have been created—both comprehensive systems98 99 as well as test-specific systems such as tools related to cancer screening or follow-up 100 101. Other approaches target test result follow-up for specific high-risk scenarios such as microbiology cultures pending at the time of discharge from the hospital102 or automatic gastroenterology consultations for positive faecal occult blood tests 103.…”

Section: Resultsmentioning

confidence: 99%

Use of health information technology to reduce diagnostic errors

2013

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BackgroundHealth information technology (HIT) systems have the potential to reduce delayed, missed or incorrect diagnoses. We describe and classify the current state of diagnostic HIT and identify future research directions.Methods A multi-pronged literature search was conducted using PubMed, Web of Science, backwards and forwards reference searches and contributions from domain experts. We included HIT systems evaluated in clinical and experimental settings as well as previous reviews, and excluded radiology computer-aided diagnosis, monitor alerts and alarms, and studies focused on disease staging and prognosis. Articles were organised within a conceptual framework of the diagnostic process and areas requiring further investigation were identified.ResultsHIT approaches, tools and algorithms were identified and organised into 10 categories related to those assisting: (1) information gathering; (2) information organisation and display; (3) differential diagnosis generation; (4) weighing of diagnoses; (5) generation of diagnostic plan; (6) access to diagnostic reference information; (7) facilitating follow-up; (8) screening for early detection in asymptomatic patients; (9) collaborative diagnosis; and (10) facilitating diagnostic feedback to clinicians. We found many studies characterising potential interventions, but relatively few evaluating the interventions in actual clinical settings and even fewer demonstrating clinical impact.ConclusionsDiagnostic HIT research is still in its early stages with few demonstrations of measurable clinical impact. Future efforts need to focus on: (1) improving methods and criteria for measurement of the diagnostic process using electronic data; (2) better usability and interfaces in electronic health records; (3) more meaningful incorporation of evidence-based diagnostic protocols within clinical workflows; and (4) systematic feedback of diagnostic performance.

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Section: Resultsmentioning

confidence: 99%

Use of health information technology to reduce diagnostic errors

2013

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“…The software support has been shown to be safe and efficient. 22 Internationally, CT scanning is common practice and ultrasound with thoracic X-ray which seem a bit oldfashioned. However this study is performed to compare the usual follow-up with a new schedule; the study was performed during the time that the 2008 Dutch national guideline was used and this guideline advised X-ray and ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Intensified follow-up in colorectal cancer patients using frequent Carcino-Embryonic Antigen (CEA) measurements and CEA-triggered imaging: Results of the randomized “CEAwatch” trial

Verberne

Zhan

Heuvel

et al. 2015

European Journal of Surgical Oncology (EJSO)

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“…Six studies targeted multiple specialisms; the others focused on one specialism. CDSSs of included studies focused on risk assessment or therapy options to support informed decisions [26][27][28][29][30][31][32], as well as statistical methods and data mining to generate patient-specific recommendations [33,34]. For most studies (7/9), clinical guidelines formed the knowledge base of the CDSS.…”

Section: Eligible Studiesmentioning

confidence: 99%

“…Six studies reported process outcomes ( Table 2). The issues addressed included: use of CSF to control chemotherapy-induced febrile neutropenia [26,27], physician-prescribing behavior [32], clinical trial rate [32], attainment of analgesia [28], time to analgesia [28], frequency of pharmaceutic intervention and pain assessment [28], costs [33] and workload [31]. Comparators included usual care, based on either MDT decisions or clinical guidelines.…”

Section: Process Outcomesmentioning

confidence: 99%

The Effect of Higher Level Computerized Clinical Decision Support Systems on Oncology Care: A Systematic Review

Klarenbeek¹,

Weekenstroo²,

Sedelaar³

et al. 2020

Cancers

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Background: To deal with complexity in cancer care, computerized clinical decision support systems (CDSSs) are developed to support quality of care and improve decision-making. We performed a systematic review to explore the value of CDSSs using automated clinical guidelines, Artificial Intelligence, datamining or statistical methods (higher level CDSSs) on the quality of care in oncology. Materials and Methods: The search strategy combined synonyms for 'CDSS' and 'cancer.' Pubmed, Embase, The Cochrane Library, Institute of Electrical and Electronics Engineers, Association of Computing Machinery digital library and Web of Science were systematically searched from January 2000 to December 2019. Included studies evaluated the impact of higher level CDSSs on process outcomes, guideline adherence and clinical outcomes. Results: 11,397 studies were selected for screening, after which 61 full-text articles were assessed for eligibility. Finally, nine studies were included in the final analysis with a total population size of 7985 patients. Types of cancer included breast cancer (63.1%), lung cancer (27.8%), prostate cancer (4.1%), colorectal cancer (3.1%) and other cancer types (1.9%). The included studies demonstrated significant improvements of higher level CDSSs on process outcomes and guideline adherence across diverse settings in oncology. No significant differences were reported for clinical outcomes. Conclusion: Higher level CDSSs seem to improve process outcomes and guidelines adherence but not clinical outcomes. It should be noticed that the included studies primarily focused on breast and lung cancer. To further explore the impact of higher level CDSSs on quality of care, high-quality research is required.

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Evaluation of the use of decision-support software in carcino-embryonic antigen (CEA)-based follow-up of patients with colorectal cancer

Cited by 15 publications

References 8 publications

Use of health information technology to reduce diagnostic errors

Use of health information technology to reduce diagnostic errors

Intensified follow-up in colorectal cancer patients using frequent Carcino-Embryonic Antigen (CEA) measurements and CEA-triggered imaging: Results of the randomized “CEAwatch” trial

The Effect of Higher Level Computerized Clinical Decision Support Systems on Oncology Care: A Systematic Review

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