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Epidemiology and policy
P1-164 Effectiveness of a clinical decision support system for breast cancer screening: preliminary results in mammogram performance
  1. A M G Saldaño1,
  2. D Borbolla1,
  3. C Otero1,
  4. K Kawamoto2,
  5. J Vicens1,
  6. K Kopitowski1,
  7. D Lobach2,
  8. F G B de Quiros1
  1. 1Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina
  2. 2Duke University, Durham, North Carolina, USA

Abstract

Introduction A decision support system that identifies women lacking results from previous mammograms in their electronic medical record (EMR) and enables immediate corrective intervention was developed. The purpose of this study was to determine if this system increased mammography rates.

Methods In an ongoing cluster randomised pragmatic controlled trial, primary care physicians (PCPs) were allocated to either receive breast cancer screening decision support recommendations in patient's EMR or usual care. PCPs belonging to a Health Maintenance Organization with 150 000 members from Buenos Aires and having panels in which at least 100 women were eligible for routine breast cancer screening (no mammogram or a mammogram with BIRADS 0 within the past 2 years). Preliminary results of subjects' characteristics and mammograms performed are shown in percentages and compared by χ2 test.

Results A total of 9872 women were eligible, with a mean age of 60.4 (SD 0.57) and were similar in: stroke (1.64%, p 0.06), coronary disease (4.78%, p 0.867), hypertension (39.17%, p 0.51), congestive heart failure (0.71%, p 0.987), chronic renal failure (0.49%, p 0.596), tobacco use (26.65%, p 0.307) and number of consultations in the previous year (mean 0.53, SD 0.01, p 0.19). A total of 4237 visited their PCPs from 1 January 2010 to 26 August 2010. Patients cared for by clinicians randomised to the intervention group had significantly more mammograms performed (18.8% vs 15.9% p=0.047).

Conclusion We credit the decision support system with promoting completion of almost 30 delinquent mammograms per 1000 women who consulted their PCPs during an eight-month period.

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