Evidence map›Paper›PMID 40846308›Full record

ArticleApplied clinical informatics2025

A Mixed-Method Case Study to Evaluate Adoption of Clinical Decision Support for Cancer Symptom Management.

Jennifer L Ridgeway, Deirdre R Pachman, Lila J Finney Rutten, Joan M Griffin, Sarah A Minteer, Jessica D Austin, Linda L Chlan, Cindy Tofthagen, Kyle A Tobin, Veronica Grzegorcyzk and 3 more

Abstract read
In one paragraph

Article in Applied clinical informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Trial
  2. 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

13 authors.

Jennifer L RidgewayRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Division of Health Care Delivery Research, Mayo Clinic, Minnesota, United States.
Deirdre R PachmanDivision of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Minnesota, United States.
Lila J Finney RuttenDivision of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Minnesota, United States.
Joan M GriffinRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Division of Health Care Delivery Research, Mayo Clinic, Minnesota, United States.
Sarah A MinteerDepartment of Physical Medicine and Rehabilitation Research, Mayo Clinic, Minnesota, United States.
Jessica D AustinDivision of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Arizona, United States.
Linda L ChlanDivision of Nursing Research, Department of Nursing, Mayo Clinic, Minnesota, United States.
Cindy TofthagenDivision of Nursing Research, Department of Nursing, Mayo Clinic, Florida, United States.
Kyle A TobinDepartment of Information Technology, Mayo Clinic, Minnesota, United States.
Veronica GrzegorcyzkDepartment of Physical Medicine and Rehabilitation, Mayo Clinic, Minnesota, United States.
Parvez RahmanRobert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Minnesota, United States.
Kathryn J RuddyDivision of Medical Oncology, Mayo Clinic, Minnesota, United States.
Andrea L ChevilleDepartment of Physical Medicine and Rehabilitation, Mayo Clinic, Minnesota, United States.

Funding

Enhanced, EHR-facilitated Cancer Symptom Control (E2C2) Pragmatic Clinical TrialUM1CA233033 · NCI · MAYO CLINIC ROCHESTER · PI CHEVILLE, ANDREA LYNNE · 2018 to 2018
$8.7M
National Cancer Institute of the National Institutes of Health UM1CA233033NCI NIH HHS UM1 CA233033
6 · The paper itself

Abstract

Electronic patient-reported outcome measures (ePROMs) can improve care for people with cancer, but effectiveness hinges on well-supported integration in clinical settings.We evaluated clinician use of specific clinical decision support (CDS) tools in the electronic health record (EHR) designed to facilitate timely, clinically appropriate responses to ePROM scores for six symptoms commonly experienced by cancer patients.The parent pragmatic trial, which took place at Mayo Clinic (Rochester, Minnesota, United States) and its affiliated community health care system between March 2019 and January 2023, evaluated the population-level effectiveness and implementation of an ePROM surveillance and EHR-facilitated collaborative care symptom management intervention. The present evaluation used a case study approach with four data sources: (1) clinician interactions with CDS tools abstracted from the EHR; (2) clinician notes identified with an institution-specific textual search tool; (3) qualitative interviews and group discussions with care teams; and (4) administrative records reviewed to identify training and outreach to care teams.EHR metrics showed very low adoption of CDS tools including alerts and symptom-specific order sets, despite educational outreach and information technology support provided to clinical care teams. Qualitative findings revealed that CDS use was not easy to integrate into busy clinical workflows and highlighted clinician perceptions that the collaborative care intervention provided additional patient support that reduced clinicians' need to utilize CDS tools. They also highlight the importance of contextual factors, including institutional priorities and EHR changes.This pragmatic clinical trial case study found limited adoption of EHR CDS tools that had been developed to increase clinicians' awareness of and responses to ePROM data. Findings suggest the need to align clinician and organizational implementation strategies, simplify CDS tools to fit practice expectations, and identify and address contextual factors that could undercut strategies like education and peer support. This may be especially important for teams who aim to iteratively evaluate and refine CDS and implementation strategies for multicomponent interventions or introduce new strategies that are responsive to barriers while maintaining scalability.

Indexed as

Decision Support Systems, ClinicalNeoplasmsElectronic Health RecordsHumansPatient Reported Outcome Measures

Identifiers

PMID40846308
PMCPMC12373467

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Registered trials

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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.