To evaluate the interest of primary care clinicians in utilizing CDS for PSA screening. Evidence suggests that electronic clinical decision support (CDS) may decrease low-value prostate-specific antigen (PSA) testing. However, physician attitudes towards CDS for PSA screening are largely unknown.
A survey was sent to 201 primary care clinicians, including both physicians and Advanced Practice Providers (APP), within a large academic health system. Eligible clinicians cared for male patients aged 40 to 80 years and ordered ≥5 PSA tests in the past year. Respondents were stratified into 3 groups, appropriate screeners, low-value screeners, or rare-screeners, based on responses to survey questions assessing PSA screening practices. The degree of interest in electronic CDS was determined via a composite Likert score comprising relevant survey items.
Survey response rate was 29% (59/201) consisting of 85% MD/DO and 15% APP respondents. All clinicians surveyed were interested in CDS (P < 0.001) without significant difference between screener groups. Clinicians agreed most uniformly that CDS be evidence-based. Clinicians disagreed on whether CDS would decrease professional discretion over patient decisions.
Primary care clinicians are interested in CDS for PSA screening regardless of their current screening practices. Prioritizing CDS features that clinicians value, such as ensuring CDS recommendations are evidence-based, may increase the likelihood of successful implementation, whereas perceived threat to autonomy may be a hinderance to utilization.
Urologic oncology. 2023 Jan 05 [Epub ahead of print]
Jonathan Harper, Trevor Hunt, Mouneeb Choudry, Ashley L Kapron, Kathleen A Cooney, Christopher Martin, Jacob Ambrose, Brock O'Neil
Division of Urology, Department of Surgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT., Division of Urology, Department of Surgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Department of Urology, University of Rochester Medical Center, Rochester, NY., Utah Clinical & Translational Science Institute, University of Utah Health, Salt Lake City, UT., Department of Medicine, Duke Cancer Institute, Duke University School of Medicine, Durham, NC., Division of Urology, Department of Surgery, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT. Electronic address: .