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Open Access 01-06-2010 | Original Article

Electronic reminders for pathologists promote recognition of patients at risk for Lynch syndrome: cluster-randomised controlled trial

Authors: L. I. Overbeek, R. P. Hermens, J. H. van Krieken, E. M. Adang, M. Casparie, F. M. Nagengast, M. J. Ligtenberg, N. Hoogerbrugge, MIPA study group

Published in: Virchows Archiv | Issue 6/2010

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). 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.

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Title: Electronic reminders for pathologists promote recognition of patients at risk for Lynch syndrome: cluster-randomised controlled trial
Authors: L. I. Overbeek
R. P. Hermens
J. H. van Krieken
E. M. Adang
M. Casparie
F. M. Nagengast
M. J. Ligtenberg
N. Hoogerbrugge
MIPA study group
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: Virchows Archiv / Issue 6/2010
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-010-0907-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Electronic reminders for pathologists promote recognition of patients at risk for Lynch syndrome: cluster-randomised controlled trial

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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