Impact of an Electronic Health Record Maintenance Alert on PSA Screening Rates in a 10-Hospital Integrated Health System
Status
RECRUITING
Phase
NA
Age
40 - 75 Years
Enrollments
40000Conditions
Prostate Cancer, Cancer of the ProstateSummary
- The investigators propose a clinical trial to evaluate the impact of annual shared decision making for PSA screening, supported by system-level enhancements to promote evidence-based care:* Defined referral thresholds within the health maintenance reminder, aligned with clinical risk stratification per NCCN guidelines. * Enhanced clinical decision support (CDS) tools to reduce provider variation and ensure guideline-concordant screening and referral practices. * The goal is to reduce late-stage presentation without increasing overdiagnosis-ensuring that prostate cancer screening is both accessible and clinically effective.
Locations
1 location Found with status Recruiting
Status
- RECRUITING
Contact Person
- Lannis Hall, M.D., MPH
- 636-916-9947
- [email protected]
Principal Investigator
- Lannis Hall, M.D., MPH
Eligibility Criteria
Eligibility Criteria:
* Receive care within the BJC Health System
* Have had at least one primary care physician appointment in the calendar year of PSA screening (primary care)
* Be male
* Not have a history of prostate cancer
* Meet one of the following risk criteria:
* High Risk for Prostate Cancer
* African American, between the ages of 40 and 75 (inclusive), or
* Family history of prostate, breast, ovarian, and/or pancreatic cancer, or
* Known familial germline mutation OR
* Average Risk for Prostate Cancer
* Between the ages of 50 and 75 (inclusive)
Study Plan
Annual PSA Health Maintenance Reminder
EXPERIMENTAL
An annual health maintenance reminder will be implemented for all men who meet the American Cancer Society guidelines for average- and high-risk eligibility criteria. The goal is to encourage their primary care provider (PCP) to engage in a shared decision-making discussion with the patient about the benefits and risks of prostate cancer screening.nnThis alert will appear in the health maintenance reminder section of the electronic health record (EHR).nnAlthough all providers with access to EPIC can view the alert, it is typically the PCPs who review and take action on alerts in the health maintenance reminder section.
OTHER:
Annual PSA Health Maintenance ReminderDescription:
The annual health maintenance reminder does not mandate PSA screening for eligible patients. Instead, it recommends that primary care providers (PCPs) initiate a shared decision-making discussion with their patients. As part of this conversation, patients will be informed of their individual risk factors-including race, family history, and germline mutations-and can then make an informed choice about whether to proceed with PSA screening.
Outcome Measures
Primary Outcome Measures
Change in PSA screening completion rates in the BJC East Health System
Secondary Outcome Measures
Proportion of men diagnosed with clinically significant prostate cancer (Gleason score u2265 7)
Incidence of advanced and metastatic disease at diagnosis of prostate cancer
Incidence of early-stage prostate cancer
Stage distribution of prostate cancer diagnoses
Biopsy rates
Percent of PSA screening ordered but not completed
Median PSA at time of diagnosis
Evaluate the agreement between 3T MRI and biomarker test results
PSA screening rate by age group
PSA screening rate by race
PSA screening rate by comorbidity burden
PSA screening rate by insurance coverage
PSA screening rate by provider
Timeline
Last Updated
August 17, 2025Start Date
August 7, 2025Today
November 9, 2025Completion Date ( Estimated )
August 31, 2031
Sponsors of this trial
Lead Sponsor
Washington University School of Medicine
RECRUITING 
≥ 18 Years