Colorectal Cancer Control and Prevention, Colorectal Cancer Screening, Decision Aid, Shared Decision Making
Conditions
Keywords
colorectal cancer screening, shared decision making, electronic health record, randomized controlled trial, decision tool
Brief summary
The research question we pose is, Does a colorectal cancer (CRC) screening decision support tool offered in advance of primary care visits increase CRC screening completion rates? Our work aims to answer this question by evaluating the effectiveness of an MGB decision support tool to 1) promote informed decisions about CRC screening for average risk patients ages 45-75, 2) deploy a decision support tool as part of a primary care bundle questionnaire, and 3) support patients in completing their preferred method of CRC screening.
Detailed description
As part of usual care, a CRC screening electronic decision support tool developed by Mass General Brigham has been integrated into Epic. This decision support tool is part of routine clinical care and is sent electronically to patients aged 45-75 who receive the Annual Visit Primary Care Screening Bundled Questionnaire in advance of their annual visit. Patients complete the tool on Patient Gateway prior to the visit or via an iPad at the visit. The decision support tool guides patients through the CRC screening options (e.g., FIT, colonoscopy, Cologuard) to help them select their preferred screening method. As part of routine care, the patient will be prompted to complete the tool as part of the bundled questionnaire, and the results will be available in the Epic encounter in the Screenings tab with the other screening bundle responses. The primary care clinician can then discuss the options and/or screening preference with the patient. Depending on what the patient and clinician decide, a CRC screening test may be ordered for the patient. As a secondary outcome, a random sample of 1000 patients will be surveyed to understand their involvement in the decision making process and 300 providers will be surveyed to understand how the decision tool impacted the conversation with the patient. The IRB to conduct surveys of patients and providers was approved by the Mass General Brigham IRB (Protocol # 2024P002568).
Interventions
OTHERCRC decision tool
CRC decision tool included in the primary care bundle questionnaire
Sponsors
Massachusetts General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Practices will be randomized to receive the decision tool or not receive the decision tool.
Eligibility
Sex/Gender
ALL
Age
45 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
Adults aged 45-75 overdue for CRC screening at average risk of CRC have an annual visit scheduled with participating practices
Exclusion criteria
* high risk of CRC
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| CRC screening completion | 6 months | Assessment of electronic health record data to determine completion of CRC screening by any modality |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Provider Experience | During the 6 month intervention phase | Provider-reported question: Did you feel the CRC screening tool informed or affected your conversations in any way? |
| Shared Decision Making Process Measure | During the 6 month intervention phase | Patient-reported survey question about involvement in the decision making process. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORKaren Blumenthal, MD
Massachusetts General Hospital
STUDY_DIRECTORKaren Sepucha, PhD
MGH
Outcome results
None listed