Leveraging an electronic medical record infrastructure to identify primary care patients eligible for genetic testing for hereditary cancer and evaluate novel cancer genetics service delivery models
利用电子病历基础设施来识别有资格接受遗传性癌症基因检测的初级保健患者,并评估新型癌症遗传学服务提供模式
基本信息
- 批准号:10241936
- 负责人:
- 金额:$ 102.48万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2018
- 资助国家:美国
- 起止时间:2018-09-18 至 2023-08-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdherenceAffectiveCancer PatientCategoriesCharacteristicsClinicClinical InformaticsCognitiveCollectionCommunicationComprehensionComputerized Medical RecordDevelopmentDistressEffectivenessElectronic Health RecordEthnic OriginEthnic groupEvaluationFamilyFamily history ofGenetic CounselingGenetic ModelsGenetic Models for CancerGenetic RiskGenetic ServicesHealth PersonnelHealth Services AccessibilityHealthcare SystemsHereditary Malignant NeoplasmImprove AccessIndividualInfrastructureInheritedMalignant NeoplasmsMethodsMinority GroupsModelingNew YorkPatient CarePatient-Focused OutcomesPatientsPopulationPopulation SciencesPredispositionPrimary Health CareProviderRaceRandomizedRandomized Controlled TrialsReactionRecommendationRecording of previous eventsRegretsResourcesService delivery modelSubgroupTestingTranslational ResearchUncertaintyUnderserved PopulationUniversitiesUtahbasecancer diagnosiscancer geneticscancer preventioncancer riskcare providersclinical careclinical decision supportclinically significantdesigneducation resourcesgenetic counselorgenetic risk assessmentgenetic testingimplementation frameworkimplementation studyinnovationmeetingsnovelopen sourcepatient portalpatient responsepopulation basedracial and ethnicracial minorityrandomized trialresponserisk perceptionrural arearuralityscreeningservice deliverystandard of caretooltreatment strategytrial designuptake
项目摘要
PROJECT SUMMARY
Identifying individuals with inherited cancer susceptibility is critical for targeted cancer prevention, screening,
and treatment. Strategies to assess the genetic risk of unaffected individuals are needed. Scalable and
sustainable methods to automatically extract and analyze family history information routinely captured in the
electronic health record (EHR) can identify primary care patients appropriate for cancer genetic services.
Increased patient ascertainment needs to be paired with implementation studies to compare models of
delivering genetic services, including patient-directed models. Because access to services continues to be a
barrier for those from minority racial and ethnic groups and rural areas, examining responses to different
delivery models across population subgroups is essential. This study will employ an implementation science
framework to test a replicable EHR-based clinical decision support (CDS) infrastructure to: (i) automatically
identify unaffected patients from 48 primary care clinics in two healthcare systems, University of Utah and New
York University, who qualify for cancer genetic services (Aim 1); and (ii) compare two models of genetic
services delivery for 1,920 primary care patients using a randomized trial design with clinic-level randomization
(Aims 2 and 3). We hypothesize that the CDS infrastructure will identify additional patients who have not been
previously referred (Aim 1) and that uptake of genetic testing (Aim 2) and adherence to management
recommendations (Aim 3) will be equivalent between the models. To address Aim 1, we will evaluate whether
the CDS approach identifies patients who have not previously been referred, and whether this varies by
race/ethnicity and rurality. To address Aim 2, we will compare: a patient-directed model in which those
identified by the CDS infrastructure as meeting testing criteria will be informed of their cancer risks, provided
with educational resources, and offered the option to select genetic testing through a patient portal to an
enhanced standard of care model in which providers and patients are notified through CDS when criteria are
met and of the availability of standard of care genetic counseling. We will compare uptake of genetic testing by
model and whether this differs by race/ethnicity and rurality. In Aim 3, we will compare the effects of the two
delivery models on adherence to recommendations 12 months after return of results, examining differences in
effects by race/ethnicity and rurality. Innovative features include implementation of population-based CDS
assessment of family history information available in the EHR; comparison of outcomes of patient-directed and
enhanced standard of care delivery models; and focus on impact of race/ethnicity and rurality. This highly
impactful translational research builds on our unique strengths in cancer genetics, clinical informatics, and
population sciences, and addresses issues of immediate clinical significance, including increasing hereditary
cancer genetic testing in appropriate patients and improving access for underserved groups.
项目总结
项目成果
期刊论文数量(0)
专著数量(0)
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会议论文数量(0)
专利数量(0)
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KIMBERLY A KAPHINGST其他文献
KIMBERLY A KAPHINGST的其他文献
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{{ truncateString('KIMBERLY A KAPHINGST', 18)}}的其他基金
Using Nudges to Recruit Human Subjects in Clinical & Translational Research
在临床中利用助推来招募人类受试者
- 批准号:
10505241 - 财政年份:2022
- 资助金额:
$ 102.48万 - 项目类别:
Using Nudges to Recruit Human Subjects in Clinical & Translational Research
在临床中利用助推来招募人类受试者
- 批准号:
10677859 - 财政年份:2022
- 资助金额:
$ 102.48万 - 项目类别:
Leveraging an electronic medical record infrastructure to identify primary care patients eligible for genetic testing for hereditary cancer and evaluate novel cancer genetics service delivery models
利用电子病历基础设施来识别有资格接受遗传性癌症基因检测的初级保健患者,并评估新型癌症遗传学服务提供模式
- 批准号:
10594168 - 财政年份:2018
- 资助金额:
$ 102.48万 - 项目类别:
Leveraging an electronic medical record infrastructure to identify primary care patients eligible for genetic testing for hereditary cancer and evaluate novel cancer genetics service delivery models
利用电子病历基础设施来识别有资格接受遗传性癌症基因检测的初级保健患者,并评估新型癌症遗传学服务提供模式
- 批准号:
10468229 - 财政年份:2018
- 资助金额:
$ 102.48万 - 项目类别:
COMMUNICATION PREFERENCES FOR GENOME SEQUENCING RESULTS IN BREAST CANCER PATIENTS
乳腺癌患者基因组测序结果的交流偏好
- 批准号:
8539481 - 财政年份:2012
- 资助金额:
$ 102.48万 - 项目类别:
COMMUNICATION PREFERENCES FOR GENOME SEQUENCING RESULTS IN BREAST CANCER PATIENTS
乳腺癌患者基因组测序结果的交流偏好
- 批准号:
8339840 - 财政年份:2012
- 资助金额:
$ 102.48万 - 项目类别:
Communication of Genetic and Genomic Information to Lay
遗传和基因组信息的交流
- 批准号:
7147998 - 财政年份:
- 资助金额:
$ 102.48万 - 项目类别:
Communication of Genetic and Genomic Information to Lay
遗传和基因组信息的交流
- 批准号:
7316059 - 财政年份:
- 资助金额:
$ 102.48万 - 项目类别:
Communication of Genetic and Genomic Information to Lay Audiences
向非专业观众传达遗传和基因组信息
- 批准号:
7594330 - 财政年份:
- 资助金额:
$ 102.48万 - 项目类别:
Communication of Genetic and Genomic Information to Lay Audiences
向非专业观众传达遗传和基因组信息
- 批准号:
7968901 - 财政年份:
- 资助金额:
$ 102.48万 - 项目类别:
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