Evidence map›Paper›PMID 37532232›Full record

ArticleApplied clinical informatics2023

Uptake of a Cervical Cancer Clinical Decision Support Tool: A Mixed-Methods Study.

Nathalie Huguet, David Ezekiel-Herrera, Rose Gunn, Alison Pierce, Jean O'Malley, Matthew Jones, Miguel Marino, Rachel Gold

Open access · hybridAbstract read
In one paragraph

Article in Applied clinical informatics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Impacts of pragmatic implementation science in a primary care laboratory.Journal of clinical and translational science · 2025
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Nathalie HuguetDepartment of Family Medicine, Oregon Health and Science University, Portland, Oregon, United States.
David Ezekiel-HerreraDepartment of Family Medicine, Oregon Health and Science University, Portland, Oregon, United States.
Rose GunnOCHIN Inc., Portland, Oregon, United States.
Alison PierceOCHIN Inc., Portland, Oregon, United States.
Jean O'MalleyOCHIN Inc., Portland, Oregon, United States.
Matthew JonesOCHIN Inc., Portland, Oregon, United States.
Miguel MarinoDepartment of Family Medicine, Oregon Health and Science University, Portland, Oregon, United States.
Rachel GoldOCHIN Inc., Portland, Oregon, United States.
Ochin · USOregon Health & Science University · US

Funding

Research ProgramP50CA244289 · NCI · OREGON HEALTH & SCIENCE UNIVERSITY · PI GOLD, RACHEL · 2019 to 2023
$7.6M
NCI NIH HHS P50 CA244289
6 · The paper itself

Abstract

objectivesClinical decision support (CDS) tools that provide point-of-care reminders of patients' care needs may improve rates of guideline-concordant cervical cancer screening. However, uptake of such electronic health record (EHR)-based tools in primary care practices is often low. This study describes the frequency of factors associated with, and barriers and facilitators to adoption of a cervical cancer screening CDS tool (CC-tool) implemented in a network of community health centers.

methodsThis mixed-methods sequential explanatory study reports on CC-tool use among 480 community-based clinics, located across 18 states. Adoption of the CC-tool was measured as any instance of tool use (i.e., entry of cervical cancer screening results or follow-up plan) and as monthly tool use rates from November 1, 2018 (tool release date) to December 31, 2020. Adjusted odds and rates of tool use were evaluated using logistic and negative-binomial regression. Feedback from nine clinic staff representing six clinics during user-centered design sessions and semi-structured interviews with eight clinic staff from two additional clinics were conducted to assess barriers and facilitators to tool adoption.

resultsThe CC-tool was used ≥1 time in 41% of study clinics during the analysis period. Clinics that ever used the tool and those with greater monthly tool use had, on average, more encounters, more patients from households at >138% federal poverty level, fewer pediatric encounters, higher up-to-date cervical cancer screening rates, and higher rates of abnormal cervical cancer screening results. Qualitative data indicated barriers to tool adoption, including lack of knowledge of the tool's existence, understanding of its functionalities, and training on its use.

conclusionWithout effective systems for informing users about new EHR functions, new or updated EHR tools are unlikely to be widely adopted, reducing their potential to improve health care quality and outcomes.

Indexed as

Decision Support Systems, ClinicalUterine Cervical NeoplasmsAmbulatory Care FacilitiesCommunity Health CentersElectronic Health RecordsFemaleHealth Knowledge, Attitudes, PracticeHumansSurveys and Questionnaires

Identifiers

PMID37532232
PMCPMC10411153
OpenAlexW4385485540

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.