Evidence map›Paper›PMID 40879504›Full record

ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2025

Process Mapping to Compare and Improve Management of Abnormal Cervical Cancer Screening Results in Two US Healthcare Systems within the PROSPR Consortium.

Robin T Higashi, Lisa Quirk, Gina Kruse, Patricia M Chen, Tin H Dang, Jennifer S Haas, Steven J Atlas, Sarah Feldman, Sarah C Kobrin, Simon Craddock Lee and 2 more

Abstract readComparative Study
In one paragraph

Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

12 authors.

Robin T HigashiDepartment of Social and Behavioral Sciences, Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas.ORCID 0000-0001-5232-6852
Lisa QuirkDepartment of Medicine, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, Texas.ORCID 0000-0001-8959-3815
Gina KruseDivision of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.ORCID 0000-0002-6681-220X
Patricia M ChenDepartment of Social and Behavioral Sciences, Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas.ORCID 0000-0001-6510-3762
Tin H DangDivision of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.ORCID 0000-0001-9212-6193
Jennifer S HaasDivision of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.ORCID 0000-0001-7227-851X
Steven J AtlasDivision of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.ORCID 0000-0002-2297-9614
Sarah FeldmanDivision of Obstetrics Gynecology & Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.ORCID 0000-0002-5582-9401
Sarah C KobrinHealthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland.ORCID 0000-0002-1391-6048
Simon Craddock LeeDepartment of Social and Behavioral Sciences, Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas.ORCID 0000-0001-6345-1237
Noel SantiniParkland Health, Dallas, Texas.ORCID 0000-0002-6517-834X
Jasmin A TiroDepartment of Social and Behavioral Sciences, Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas.ORCID 0000-0001-8300-0441

Funding

PROSPR METRICS CISNET Collaboration Investigating Impact of Structural Racism/Discrimination on Cervical Screening Moonshot SupplementUM1CA221940 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI CHUBAK, JESSICA, HAAS, JENNIFER S · 2018 to 2023
$15.9M
American Cancer Society (ACS) CRP-22-080-01-CTPSNational Cancer Institute (NCI) UM1CA221940NCI NIH HHS UM1 CA221940
6 · The paper itself

Abstract

backgroundGuidelines for management of abnormal cervical cancer screening results have increased in complexity over the past two decades. Little is known about how patient-, clinician-, and organization-level factors influence implementation when guidelines change. Process mapping may offer insights into organizational processes and facilitate visualization for potential intervention opportunities.

methodsWe conducted an iterative multimodal qualitative assessment to compare abnormal cervical cancer screening management between two health systems: a safety-net institution and an integrated health system. We interviewed clinicians and staff to generate (phase I, May 2019-March 2021) and validate (phase II, July-Oct 2022) process maps at both systems. We conducted a rapid and thematic content analysis and engaged clinical and nonclinical stakeholders during interpretation.

resultsAt both health systems, process maps informed by phase I participants (n = 31) identified a gap in care during patients' transition back to primary care following resolution of abnormal tests by gynecologists. In phase II, participants (n = 21) validated and revised maps, noting guideline updates and quality improvement initiatives. Although each system deployed unique strategies to address gaps in care, strategies in common included creating electronic health record-based clinical decision support tools, enabling gynecologists to provide real-time e-consults to primary care clinicians, and engaging patients via the portal.

conclusionsThe complexity of cervical cancer screening management guidelines elevates the importance of identifying system-level tools to support clinician decision-making and coordinate between primary and specialty care teams. IMPACT: Process maps are valuable in generating cross-system comparisons by documenting clinical workflows, identifying care gaps, and engaging participants in formulating potential interventions.

Indexed as

Early Detection of CancerUterine Cervical NeoplasmsAdultFemaleHumansMiddle AgedUnited States

Identifiers

PMID40879504
PMCPMC12451433

What OpenQuestion holds

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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.