S3246 The Impact of COVID-19 on Colorectal Screening Adherence at a Large Institution

The impact of the Pulmonary Embolism Response Team (PERT) model on trainee physician education and autonomy over the management of high risk pulmonary embolism (PE) is unknown. A resident and fellow questionnaire was administered 1 year after PERT implementation. A total of 122 physicians were surveyed, and 73 responded. Even after 12 months of interacting with the PERT consultative service, and having formal instruction in high risk PE management, 51% and 49% of respondents underestimated the true 3-month mortality for sub-massive and massive PE, respectively, and 44% were unaware of a common physical exam finding in patients with PE. Comparing before and after PERT implementation, physicians perceived enhanced confidence in identifying ( p<0.001), and managing ( p=0.003) sub-massive/massive PE, enhanced confidence in treating patients appropriately with systemic thrombolysis ( p=0.04), and increased knowledge of indications for systemic thrombolysis and surgical embolectomy ( p=0.043 and p<0.001, respectively). Respondents self-reported an increased fund of knowledge of high risk PE pathophysiology (77%), and the perception that a multi-disciplinary team improves the care of patients with high risk PE (89%). Seventy-one percent of respondents favored broad implementation of a PERT similar to an acute myocardial infarction team. Overall, trainee physicians at a large institution perceived an enhanced educational experience while managing PE following PERT implementation, believing the team concept is better for patient care.

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Evaluating a preference-tailored decision tool for increasing colorectal cancer screening.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.34_suppl.10 ◽

2012 ◽

Vol 30 (34_suppl) ◽

pp. 10-10

Author(s):

Sarah T. Hawley ◽

Bruce Ling ◽

Angela Fagerlin ◽

Sally W. Vernon ◽

Sandeep Vijan

Keyword(s):

Occult Blood ◽

Fecal Occult Blood ◽

Primary Care Visit ◽

Decision Tool ◽

Chi Square ◽

Crc Screening ◽

Invasive Test ◽

Screening Adherence ◽

Standard Information ◽

The Impact

10 Background: Incorporating patient preferences into CRC screening decisions has been identified as one method for improving informed decision making and increasing screening adherence, yet the impact of tailoring screening recommendations to patients’ preferences on these outcomes has not been evaluated. Methods: We compared the effect of a web-based preference-tailored decision tool (intervention) to a standard information decision tool (control) through an RCT at two VA sites. Eligible subjects were age 50-77, due for CRC screening, with a scheduled primary care visit. Participants arrived 45 minutes early to complete consent and were randomized online. Telephone surveys were conducted 3-5 days post-enrollment and CRC screening adherence was collected from medical charts 6 months later. We evaluated the effect of the tool on adherence and compared stated test preferences to test recevived through Chi-square tests and regression. Results: 468 subjects were enrolled from two VAs. CRC screening adherence 6-months post-enrollment was 38.6% and was not significantly different between groups (37.4% intervention, 39.7% control). Most were adherent with fecal occult blood test (FOBT) (22.4%), followed by colonoscopy (COL) (16.7%). The most commonly recommended test by physicians was COL (59.2% of tests recommended), though veterans most commonly stated a preference for FOBT (60.1%). The features of tests most important to veterans were nature of the test (32.8%), effectiveness (27.1%), and risk of complications (17%). Participants significantly more often adhered to the test that they stated they preferred after the intervention than with a non-preferred test (30.4% adhered to preferred test vs. 7.6% adhered to non-preferred test, P<0.001). Conclusions: CRC screening adherence in this population of veterans was low and the preference-tailored intervention did not significantly improve adherence relative to standard information. Veterans preferred a non-invasive test (FOBT) despite higher rates of recommendation for COL by their physicians. Improving concordance between physician recommendations and patients’ preference may be one method for improving CRC screening adherence in this population.

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The impact of medical tourism on colorectal screening among Korean Americans: A community-based cross-sectional study

BMC Cancer ◽

10.1186/s12885-016-2965-y ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 4

Author(s):

Linda K. Ko ◽

Victoria M. Taylor ◽

Jihye Yoon ◽

Wade K. Copeland ◽

Joo Ha Hwang ◽

...

Keyword(s):

Medical Tourism ◽

Korean Americans ◽

Cross Sectional Study ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

Colorectal Screening ◽

The Impact

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Impact of the sessile serrated polyp pathway on predicted colorectal cancer outcomes in the CRC-AIM model.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.10545 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 10545-10545

Author(s):

John B. Kisiel ◽

Steven H. Itzkowitz ◽

A. Burak Ozbay ◽

Leila Saoud ◽

Marcus Parton ◽

...

Keyword(s):

Sensitivity Analyses ◽

Base Case ◽

Screening Methods ◽

Average Risk ◽

Mortality Reduction ◽

Serrated Polyps ◽

Serrated Polyp ◽

Life Years ◽

Screening Adherence ◽

The Impact

10545 Background: Approximately 20–30% of colorectal cancers (CRC) arise from the serrated polyp pathway. The multitarget stool DNA (mt-sDNA) test has greater sensitivity to detect sessile serrated polyps (SSPs) than a leading fecal immunochemical test (FIT). However, most modeling analyses do not account for the contribution of the SSP pathway to risk of CRC. We used the CRC-AIM model to assess the impact of the SSP pathway on predicted CRC outcomes with mt-sDNA or FIT screening. Methods: A simulated cohort of average-risk US patients underwent triennial mt-sDNA or annual FIT screening from ages 50–75. The percentage of CRCs arising from the SSP pathway were modeled at 0% (base case), 20%, and 30%, with stool screening adherence based on theoretical (100%) or previously reported (mt-sDNA 71%; FIT 43%) rates. Published SSP sensitivities for mt-sDNA and FIT were used. All other model inputs were identical to CISNET models. Sensitivity analyses used screening adherence rates of 40–70%. Key outcomes were life-years gained (LYG), CRC incidence and CRC mortality per 1000 patients. Results: Including SSPs in the model demonstrated a greater loss of LYG with FIT than mt-sDNA (Table). At 100% adherence, compared with base case, modeling 20% or 30% SSP pathway CRCs resulted in a decrease of 9–15 LYG with FIT and 2–4 LYG with mt-sDNA, a decrease in CRC incidence reduction of 3.9–6.1% with FIT and 0.7–1.1% with mt-sDNA, and a decrease in CRC mortality reduction of 2.6–4.0% with FIT and 0.4–0.8% with mt-sDNA. Using previously reported adherence, compared with base case, modeling 20% or 30% SSP pathway CRCs resulted in a decrease of 13–20 LYG with FIT and 2–5 LYG with mt-sDNA, a decrease in CRC incidence reduction of 4.4–6.9% with FIT and 0.6–1.1% with mt-sDNA, and a decrease in CRC mortality reduction of 3.5–5.4% with FIT and 0.4–0.9% with mt-sDNA. Assuming reported adherence and 30% SSP pathway CRCs, mt-sDNA had 48 more LYG, 14.6% greater CRC incidence reduction, and 12.4% greater CRC mortality reduction than FIT. Assuming 30% SSP pathway CRCs, outcomes favored mt-sDNA vs FIT even after modeling equivalent adherence rates ranging from 40–70%. Conclusions: After incorporating the SSP pathway into the model, outcomes with mt-sDNA neared those of FIT at 100% screening adherence rates and surpassed FIT at more realistic reported screening adherence rates.[Table: see text]

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But How Will We Measure It? Co-Creating Assessments of Outcomes in Age-Friendly Care, PA

Innovation in Aging ◽

10.1093/geroni/igab046.1224 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 315-316

Author(s):

Diane Berish

Keyword(s):

Cognitive Assessment ◽

Care Management ◽

Quantitative Measurement ◽

Opioid Misuse ◽

Outcome Indicators ◽

Vaccination Rates ◽

Reporting Requirements ◽

Goal Tracking ◽

Colorectal Screening ◽

The Impact

Abstract Moving from concept to quantitative measurement can be complex. There were several challenges in co-designing measures to assess the impact of Age-Friendly Care, PA, a geriatric workforce enhancement program. First as a FQHC, our clinical partner had not captured the metrics of interest. Second, the co-developed operational definitions for our metrics should be feasible, relevant, and useful for all project members. Third, funder reporting requirements must also be addressed. Working within this context, we co-created 11 outcome indicators structured around the 4Ms (IHI) now with 9 months of data. EMR changes to make data reportable included measuring opioid misuse mitigation, high-risk medication elimination, cognitive assessment and dementia care management, advanced care planning, care partner presence, annual wellness visit completion, pneumonia vaccination rates, colorectal screening rates, mobility goal tracking, and presence of a caregiver. Work continues around formulating themes to create a reportable mechanism for assessing What Matters.

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The impact of an educational workshop on colorectal screening practices

Journal of Cancer Education ◽

10.1080/08858198709527855 ◽

1987 ◽

Vol 2 (1) ◽

pp. 27-30

Author(s):

Wei Li Fang ◽

A. Scott Mills ◽

Harold Wanebo ◽

Alvin Zfass

Keyword(s):

Screening Practices ◽

Colorectal Screening ◽

The Impact ◽

Educational Workshop

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