OBJECTIVES: To test the feasibility of using an electronic medical record (EMR)-based @entity262 ( @entity262 ) that incorporates morbidity and frailty information to individualize @entity14 ( @entity14 ) screening recommendations. STUDY DESIGN: Our framework used the payoff time, defined as the minimum time until the benefits of screening exceed the harms. METHODS: Subjects were 24 @entity1 eligible for @entity14 screening and 22 primary care providers (PCPs). Measures included @entity4426 satisfaction with existing reminder systems and with decision support. RESULTS: The run-in phase, during which the intervention was inactive but its performance was verified, had 14 @entity1 enrolled. The intervention phase, during which payoff time and life expectancy calculations were used to recommend for or against @entity14 screening, had 10 @entity1 enrolled. Of the 10 @entity1 enrolled in the intervention phase, the @entity262 recommended in favor of @entity14 screening for 6 @entity1 . (The PCPs also recommended it for those 6 @entity1 , although 3 refused the screening.) The @entity262 recommended against @entity14 screening for 4 @entity1 , while the PCPs recommended against it for 3 of those 4 and ordered the screening for 1 @entity1 . PCPs who had @entity1 enrolled in the intervention phase indicated interest in having payoff time information for all @entity1 eligible for @entity14 screening. This pilot study was small and was not powered to determine the effect of the intervention on screening behavior. CONCLUSIONS: @entity14 screening involves balancing immediate harms with longer-term benefits; EMR decision support may facilitate personalized benefit/harm assessment. The payoff time framework is feasible for implementation in EMR decision support.

Pilot of decision support to individualize XXXX screening recommendations.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity4426 :: ('D010622', 'Chemical') :: ['PCP'] @entity262 :: ('MESH:D034721', 'Disease') :: ['DSS', 'decision support system'] @entity14 :: ('MESH:D015179', 'Disease') :: ['Colorectal cancer', 'CRC', 'colorectal cancer']
@entity14 :: (MESH:D015179,Disease) :: ['colorectal cancer']
