- An electronic medical record (EMR)-based clinical decision support system was associated with improved adherence to colonoscopy surveillance guidelines, with fewer overuse and underuse colonoscopy recommendations.
- The system automatically generates guideline-adherent recommendations for the next surveillance colonoscopy after polypectomy, based on findings from colonoscopy and pathology reports.
Why this matters
- Over- or underuse of colonoscopy surveillance is common after polypectomy.
- Outcomes were compared between 1320 patients after the system was deployed and 1822 patients before it was deployed.
- Funding: NIH/National Cancer Institute.
- Guideline-adherent recommendations were more common after the system was implemented (84.6% vs 77.4%; P<.001 even after colonoscopies without surveillance recommendations were excluded vs p>
- After implementation, there was a reduction in underuse (3.1% vs 4.7%) and overuse (10.8% vs 14.4%).
- When the system was used, compared with cases when it was available but was not used, guideline-adherent recommendations were made more often (87.0% vs 63.4%; relative risk, 1.34; 95% CI, 1.24-1.42).
- Conducted at a single, safety net health system.
- Quasi-experimental design is vulnerable to confounders.