Electronic reminders for pathologists promote recognition of patients at risk for Lynch syndrome: cluster-randomised controlled trial
We investigated success factors for the introduction of a guideline on recognition of Lynch syndrome in patients recently diagnosed with colorectal cancer (CRC) below age 50 or a second CRC below age 70. Pathologists were asked to start microsatellite instability (MSI) testing and report to surgeons...
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| Veröffentlicht in: | Virchows Archiv : an international journal of pathology 2010-06, Vol.456 (6), p.653-659 |
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| container_title | Virchows Archiv : an international journal of pathology |
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| creator | Overbeek, L. I. Hermens, R. P. van Krieken, J. H. Adang, E. M. Casparie, M. Nagengast, F. M. Ligtenberg, M. J. Hoogerbrugge, N. |
| description | We investigated success factors for the introduction of a guideline on recognition of Lynch syndrome in patients recently diagnosed with colorectal cancer (CRC) below age 50 or a second CRC below age 70. Pathologists were asked to start microsatellite instability (MSI) testing and report to surgeons with the advice to consider genetic counselling when MSI test or family history was positive. A multicentre cluster-randomised controlled trial (ClinicalTrials.gov, number NCT00141466) was performed in 12 pathology laboratories (clusters), serving 29 community hospitals. All received an introduction to the new guideline. In the intervention group, surgeons received education and tumour test result reminders; pathologists were provided with inclusion criteria cards, an electronic patient inclusion reminder system and feedback on inclusion. Two hundred sixty-six CRC patients were eligible for recognition as at risk for Lynch syndrome. The actual recognition was 18% more successful in the intervention as compared to the control arm (77% (120 of 156) compared to 59% (65 of 110)), with an adjusted odds ratio (OR) = 2.8 (95% confidence interval (CI) 1.1–7.0). The electronic reminder system for pathologists was most strongly associated with recognition of high-risk patients, OR = 4.2 (95% CI 1.7–10.1). An electronic reminder system for pathologists appeared effective for adherence to a new complex guideline and will enhance the recognition of Lynch syndrome. |
| doi_str_mv | 10.1007/s00428-010-0907-7 |
| format | Article |
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I. ; Hermens, R. P. ; van Krieken, J. H. ; Adang, E. M. ; Casparie, M. ; Nagengast, F. M. ; Ligtenberg, M. J. ; Hoogerbrugge, N.</creator><creatorcontrib>Overbeek, L. I. ; Hermens, R. P. ; van Krieken, J. H. ; Adang, E. M. ; Casparie, M. ; Nagengast, F. M. ; Ligtenberg, M. J. ; Hoogerbrugge, N. ; MIPA study group</creatorcontrib><description>We investigated success factors for the introduction of a guideline on recognition of Lynch syndrome in patients recently diagnosed with colorectal cancer (CRC) below age 50 or a second CRC below age 70. Pathologists were asked to start microsatellite instability (MSI) testing and report to surgeons with the advice to consider genetic counselling when MSI test or family history was positive. A multicentre cluster-randomised controlled trial (ClinicalTrials.gov, number NCT00141466) was performed in 12 pathology laboratories (clusters), serving 29 community hospitals. All received an introduction to the new guideline. In the intervention group, surgeons received education and tumour test result reminders; pathologists were provided with inclusion criteria cards, an electronic patient inclusion reminder system and feedback on inclusion. Two hundred sixty-six CRC patients were eligible for recognition as at risk for Lynch syndrome. The actual recognition was 18% more successful in the intervention as compared to the control arm (77% (120 of 156) compared to 59% (65 of 110)), with an adjusted odds ratio (OR) = 2.8 (95% confidence interval (CI) 1.1–7.0). The electronic reminder system for pathologists was most strongly associated with recognition of high-risk patients, OR = 4.2 (95% CI 1.7–10.1). An electronic reminder system for pathologists appeared effective for adherence to a new complex guideline and will enhance the recognition of Lynch syndrome.</description><identifier>ISSN: 0945-6317</identifier><identifier>EISSN: 1432-2307</identifier><identifier>DOI: 10.1007/s00428-010-0907-7</identifier><identifier>PMID: 20379742</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Biological and medical sciences ; Colorectal carcinoma ; Colorectal Neoplasms - genetics ; Colorectal Neoplasms, Hereditary Nonpolyposis - etiology ; Colorectal Neoplasms, Hereditary Nonpolyposis - genetics ; Colorectal Neoplasms, Hereditary Nonpolyposis - pathology ; Gastroenterology. Liver. Pancreas. Abdomen ; Genetic screening ; Genetics ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Medical sciences ; Medicine ; Medicine & Public Health ; Microsatellite Instability ; Middle Aged ; Original ; Original Article ; Pathology ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; Practice Guidelines as Topic ; Reminder Systems ; Risk ; Stomach. Duodenum. Small intestine. Colon. Rectum. 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I.</creatorcontrib><creatorcontrib>Hermens, R. P.</creatorcontrib><creatorcontrib>van Krieken, J. H.</creatorcontrib><creatorcontrib>Adang, E. M.</creatorcontrib><creatorcontrib>Casparie, M.</creatorcontrib><creatorcontrib>Nagengast, F. M.</creatorcontrib><creatorcontrib>Ligtenberg, M. J.</creatorcontrib><creatorcontrib>Hoogerbrugge, N.</creatorcontrib><creatorcontrib>MIPA study group</creatorcontrib><title>Electronic reminders for pathologists promote recognition of patients at risk for Lynch syndrome: cluster-randomised controlled trial</title><title>Virchows Archiv : an international journal of pathology</title><addtitle>Virchows Arch</addtitle><addtitle>Virchows Arch</addtitle><description>We investigated success factors for the introduction of a guideline on recognition of Lynch syndrome in patients recently diagnosed with colorectal cancer (CRC) below age 50 or a second CRC below age 70. Pathologists were asked to start microsatellite instability (MSI) testing and report to surgeons with the advice to consider genetic counselling when MSI test or family history was positive. A multicentre cluster-randomised controlled trial (ClinicalTrials.gov, number NCT00141466) was performed in 12 pathology laboratories (clusters), serving 29 community hospitals. All received an introduction to the new guideline. In the intervention group, surgeons received education and tumour test result reminders; pathologists were provided with inclusion criteria cards, an electronic patient inclusion reminder system and feedback on inclusion. Two hundred sixty-six CRC patients were eligible for recognition as at risk for Lynch syndrome. The actual recognition was 18% more successful in the intervention as compared to the control arm (77% (120 of 156) compared to 59% (65 of 110)), with an adjusted odds ratio (OR) = 2.8 (95% confidence interval (CI) 1.1–7.0). The electronic reminder system for pathologists was most strongly associated with recognition of high-risk patients, OR = 4.2 (95% CI 1.7–10.1). An electronic reminder system for pathologists appeared effective for adherence to a new complex guideline and will enhance the recognition of Lynch syndrome.</description><subject>Biological and medical sciences</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - genetics</subject><subject>Colorectal Neoplasms, Hereditary Nonpolyposis - etiology</subject><subject>Colorectal Neoplasms, Hereditary Nonpolyposis - genetics</subject><subject>Colorectal Neoplasms, Hereditary Nonpolyposis - pathology</subject><subject>Gastroenterology. Liver. Pancreas. 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I.</au><au>Hermens, R. P.</au><au>van Krieken, J. H.</au><au>Adang, E. M.</au><au>Casparie, M.</au><au>Nagengast, F. M.</au><au>Ligtenberg, M. J.</au><au>Hoogerbrugge, N.</au><aucorp>MIPA study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Electronic reminders for pathologists promote recognition of patients at risk for Lynch syndrome: cluster-randomised controlled trial</atitle><jtitle>Virchows Archiv : an international journal of pathology</jtitle><stitle>Virchows Arch</stitle><addtitle>Virchows Arch</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>456</volume><issue>6</issue><spage>653</spage><epage>659</epage><pages>653-659</pages><issn>0945-6317</issn><eissn>1432-2307</eissn><abstract>We investigated success factors for the introduction of a guideline on recognition of Lynch syndrome in patients recently diagnosed with colorectal cancer (CRC) below age 50 or a second CRC below age 70. Pathologists were asked to start microsatellite instability (MSI) testing and report to surgeons with the advice to consider genetic counselling when MSI test or family history was positive. A multicentre cluster-randomised controlled trial (ClinicalTrials.gov, number NCT00141466) was performed in 12 pathology laboratories (clusters), serving 29 community hospitals. All received an introduction to the new guideline. In the intervention group, surgeons received education and tumour test result reminders; pathologists were provided with inclusion criteria cards, an electronic patient inclusion reminder system and feedback on inclusion. Two hundred sixty-six CRC patients were eligible for recognition as at risk for Lynch syndrome. The actual recognition was 18% more successful in the intervention as compared to the control arm (77% (120 of 156) compared to 59% (65 of 110)), with an adjusted odds ratio (OR) = 2.8 (95% confidence interval (CI) 1.1–7.0). 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| ispartof | Virchows Archiv : an international journal of pathology, 2010-06, Vol.456 (6), p.653-659 |
| issn | 0945-6317 1432-2307 |
| language | eng |
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| subjects | Biological and medical sciences Colorectal carcinoma Colorectal Neoplasms - genetics Colorectal Neoplasms, Hereditary Nonpolyposis - etiology Colorectal Neoplasms, Hereditary Nonpolyposis - genetics Colorectal Neoplasms, Hereditary Nonpolyposis - pathology Gastroenterology. Liver. Pancreas. Abdomen Genetic screening Genetics Humans Investigative techniques, diagnostic techniques (general aspects) Medical sciences Medicine Medicine & Public Health Microsatellite Instability Middle Aged Original Original Article Pathology Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Practice Guidelines as Topic Reminder Systems Risk Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Tumors |
| title | Electronic reminders for pathologists promote recognition of patients at risk for Lynch syndrome: cluster-randomised controlled trial |
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