Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2015
Electronic Trigger-Based Intervention to Reduce Delays in Diagnostic Evaluation for Cancer: A Cluster Randomized Controlled Trial.
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 7 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Digital patient safety interventions in primary care: a systematic review and meta-analysis.BMC medicine · 2026Pooled it
- Why aren't they used? Systematic review of barriers to implementation of clinical decision support systems for early cancer detection in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Pooled it
- Decision support tools to improve cancer diagnostic decision making in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Pooled it
- Quality of the diagnostic process in patients presenting with symptoms suggestive of bladder or kidney cancer: a systematic review.BMJ open · 2019Pooled it
- Strategies to reduce diagnostic errors: a systematic review.BMC medical informatics and decision making · 2019Pooled it
- The impact of health information technology on the management and follow-up of test results - a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2019Pooled it
- Interventions to Improve Follow-up of Positive Results on Fecal Blood Tests: A Systematic Review.Annals of internal medicine · 2017Pooled it
- Implementation of a Quality Improvement and Clinical Decision Support Tool for Cancer Diagnosis in Primary Care: Process Evaluation.JMIR cancer · 2025Trial
- A Virtual Breakthrough Series Collaborative for Missed Test Results: A Stepped-Wedge Cluster-Randomized Clinical Trial.JAMA network open · 2024Trial
- Effect of an Antiracism Intervention on Racial Disparities in Time to Lung Cancer Surgery.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022Trial
- Electronic clinical decision support tool for assessing stomach symptoms in primary care (ECASS): a feasibility study.BMJ open · 2021Trial
- Digital quality measure of potentially avoidable emergency presentations among patients with colorectal cancer.BMJ quality & safety · 2026Article
- A digital quality measure for emergency presentation of pancreatic cancer.British journal of cancer · 2026Article
- Interventions to improve timely cancer diagnosis: an integrative review.Diagnosis (Berlin, Germany) · 2025Review
- An intervention mapping approach to the development and evaluation of a community-based prostate cancer early detection programme in Nigeria.PLOS global public health · 2025Article
- Negative spillover due to constraints on care delivery: a potential source of bias in pragmatic clinical trials.Trials · 2024Article
- Adoption, acceptance, and use of a decision support tool to promote timely investigations for cancer in primary care.Family practice · 2024Article
- Computable phenotype for diagnostic error: developing the data schema for application of symptom-disease pair analysis of diagnostic error (SPADE).Diagnosis (Berlin, Germany) · 2024Article
- Medical Home Implementation and Follow-Up of Cancer-Related Abnormal Test Results in the Veterans Health Administration.JAMA network open · 2024Article
- Time duration and health care resource use during cancer diagnoses in the United States: A large claims database analysis.Journal of managed care & specialty pharmacy · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
purposeWe tested whether prospective use of electronic health record-based trigger algorithms to identify patients at risk of diagnostic delays could prevent delays in diagnostic evaluation for cancer.
methodsWe performed a cluster randomized controlled trial of primary care providers (PCPs) at two sites to test whether triggers that prospectively identify patients with potential delays in diagnostic evaluation for lung, colorectal, or prostate cancer can reduce time to follow-up diagnostic evaluation. Intervention steps included queries of the electronic health record repository for patients with abnormal findings and lack of associated follow-up actions, manual review of triggered records, and communication of this information to PCPs via secure e-mail and, if needed, phone calls to ensure message receipt. We compared times to diagnostic evaluation and proportions of patients followed up between intervention and control cohorts based on final review at 7 months.
resultsWe recruited 72 PCPs (36 in the intervention group and 36 in the control group) and applied the trigger to all patients under their care from April 20, 2011, to July 19, 2012. Of 10,673 patients with abnormal findings, the trigger flagged 1,256 patients (11.8%) as high risk for delayed diagnostic evaluation. Times to diagnostic evaluation were significantly lower in intervention patients compared with control patients flagged by the colorectal trigger (median, 104 v 200 days, respectively; n = 557; P < .001) and prostate trigger (40% received evaluation at 144 v 192 days, respectively; n = 157; P < .001) but not the lung trigger (median, 65 v 93 days, respectively; n = 19; P = .59). More intervention patients than control patients received diagnostic evaluation by final review (73.4% v 52.2%, respectively; relative risk, 1.41; 95% CI, 1.25 to 1.58).
conclusionElectronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up. Similar interventions could improve timeliness of diagnosis of other serious conditions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.