Impact of an Electronic Health Record Maintenance Alert on PSA Screening Rates in a 10-Hospital Integrated Health System
Washington University School of Medicine
Summary
\- 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.
Eligibility
- Age range
- 40–75 years
- Sex
- Male
- Healthy volunteers
- Yes
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)
Interventions
- OtherAnnual PSA Health Maintenance Reminder
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.
Location
- Washington University School of MedicineSt Louis, Missouri