The Impact of Pop-Up Clinical Electronic Health Record Decision Tools on Ordering Pulmonary Embolism Studies in the Emergency Department

Redinger, Kathryn; Rozin, Emily; Schiller, Timothy; Zhen, Andrew; Vos, Duncan

doi:10.1016/j.jemermed.2021.09.014

Cited by 2 publications

(4 citation statements)

References 9 publications

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“…26 As there are also patients who can present themselves via other routes than the GP, additional RWD sources should be considered. 27…”

Section: Diagnostic Phasementioning

confidence: 99%

“…26 As there are also patients who can present themselves via other routes than the GP, additional RWD sources should be considered. 27 The challenging recognition of sarcoma can, among others, lead to a prolonged diagnostic interval. 4,20 Quantifying the potential negative impact of a prolonged diagnostic trajectory on patient outcomes through the integration of EHR data (eg, clinical outcomes such as overall survival [OS]) with the growing collection of PRO data (eg, diaries or social media platforms) in daily clinical practice can provide valuable insights into groups at risk.…”

Section: Diagnostic Phasementioning

confidence: 99%

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Improving Diagnosis and Care for Patients With Sarcoma: Do Real-World General Practitioners Data and Prospective Data Collections Have a Place Next to Clinical Trials?

Holthuis,

Heins,

van Houdt

et al. 2024

JCO Clin Cancer Inform

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There has been growing interest in the use of real-world data (RWD) to address clinically and policy-relevant (research) questions that cannot be answered with data from randomized controlled trials (RCTs) alone. This is, for example, the case in rare malignancies such as sarcomas as limited patient numbers pose challenges in conducting RCTs within feasible timeliness, a manageable number of collaborators, and statistical power. This narrative review explores the potential of RWD to generate real-world evidence (RWE) in sarcoma research, elucidating its application across different phases of the patient journey, from prediagnosis to the follow-up/survivorship phase. For instance, examining electronic health records (EHRs) from general practitioners (GPs) enables the exploration of consultation frequency and presenting symptoms in primary care before a sarcoma diagnosis. In addition, alternative study designs that integrate RWD with well-designed observational RCTs may offer relevant information on the effectiveness of clinical treatments. As, especially in cases of ultrarare sarcomas, it can be an extreme challenge to perform well-powered randomized prospective studies. Therefore, it is crucial to support the adaptation of novel study designs. Regarding the follow-up/survivorship phase, examining EHR from primary and secondary care can provide valuable insights into identifying the short- and long-term effects of treatment over an extended follow-up period. The utilization of RWD also comes with several challenges, including issues related to data quality and privacy, as described in this study. Notwithstanding these challenges, this study underscores the potential of RWD to bridge, at least partially, gaps between evidence and practice and holds promise in contributing to the improvement of sarcoma care.

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“…26 As there are also patients who can present themselves via other routes than the GP, additional RWD sources should be considered. 27…”

Section: Diagnostic Phasementioning

confidence: 99%

Section: Diagnostic Phasementioning

confidence: 99%

Improving Diagnosis and Care for Patients With Sarcoma: Do Real-World General Practitioners Data and Prospective Data Collections Have a Place Next to Clinical Trials?

Holthuis,

Heins,

van Houdt

et al. 2024

JCO Clin Cancer Inform

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“…29 Integrating decision rules into electronic medical records improves appropriate test ordering. 30 Computerised tools can generate plausible differential diagnoses that promote more appropriate lines of investigation 31 as well as context-aware warnings of lurking diagnostic pitfalls, including test limitations, 32 in uncertain or serious clinical scenarios. However, optimal use of these tools requires easy to use interfaces, seamless integration into clinical workflows, and compatibility with clinicians' cognitive processing.…”

Section: Using Diagnostic Decision Support Toolsmentioning

confidence: 99%

“…Related to overuse, using rule‐out algorithms and D‐dimer testing in suspected pulmonary thromboembolism limits unnecessary computed tomography pulmonary artery imaging and overinvestigation of incidental findings 29 . Integrating decision rules into electronic medical records improves appropriate test ordering 30 . Computerised tools can generate plausible differential diagnoses that promote more appropriate lines of investigation 31 as well as context‐aware warnings of lurking diagnostic pitfalls, including test limitations, 32 in uncertain or serious clinical scenarios.…”

Section: Using Diagnostic Decision Support Toolsmentioning

confidence: 99%

Too much versus too little: looking for the “sweet spot” in optimal use of diagnostic investigations

Scott,

Crock,

Twining

2023

Medical Journal of Australia

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The Impact of Pop-Up Clinical Electronic Health Record Decision Tools on Ordering Pulmonary Embolism Studies in the Emergency Department

Cited by 2 publications

References 9 publications

Improving Diagnosis and Care for Patients With Sarcoma: Do Real-World General Practitioners Data and Prospective Data Collections Have a Place Next to Clinical Trials?

Improving Diagnosis and Care for Patients With Sarcoma: Do Real-World General Practitioners Data and Prospective Data Collections Have a Place Next to Clinical Trials?

Too much versus too little: looking for the “sweet spot” in optimal use of diagnostic investigations

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