title: Automated recommendation for cervical cancer screening and surveillance.
abstract: Because of the complexity of cervical cancer prevention guidelines, clinicians often fail to follow best-practice recommendations. Moreover, existing clinical decision support (CDS) systems generally recommend a cervical cytology every three years for all female patients, which is inappropriate for patients with abnormal findings that require surveillance at shorter intervals. To address this problem, we developed a decision tree-based CDS system that integrates national guidelines to provide comprehensive guidance to clinicians. Validation was performed in several iterations by comparing recommendations generated by the system with those of clinicians for 333 patients. The CDS system extracted relevant patient information from the electronic health record and applied the guideline model with an overall accuracy of 87%. Providers without CDS assistance needed an average of 1 minute 39 seconds to decide on recommendations for management of abnormal findings. Overall, our work demonstrates the feasibility and potential utility of automated recommendation system for cervical cancer screening and surveillance.
authors.affiliation: Biomedical Statistics and Informatics, Mayo Clinic Rochester, MN, USA.
authors.forename: Kavishwar B
authors.initials: KB
authors.lastname: Wagholikar
authors.affiliation: Family Medicine, Mayo Clinic Rochester, MN, USA.
authors.forename: Kathy L
authors.initials: KL
authors.lastname: MacLaughlin
authors.affiliation: Obstetrics-Gynecology, Mayo Clinic Rochester, MN, USA.
authors.forename: Petra M
authors.initials: PM
authors.lastname: Casey
authors.affiliation: Obstetrics-Gynecology, Mayo Clinic Rochester, MN, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Kastner
authors.affiliation: Anatomic Pathology, Mayo Clinic Rochester, MN, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Henry
authors.affiliation: Population Management Systems, Mayo Clinic Rochester, MN, USA.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Hankey
authors.affiliation: Pulmonary and Critical Care Medicine, Mayo Clinic Rochester, MN, USA.
authors.forename: Steve G
authors.initials: SG
authors.lastname: Peters
authors.affiliation: Biomedical Informatics, Arizona State University, Phoenix, Arizona. ; Health Science Research, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Greenes
authors.affiliation: Biomedical Statistics and Informatics, Mayo Clinic Rochester, MN, USA.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Chute
authors.affiliation: Biomedical Statistics and Informatics, Mayo Clinic Rochester, MN, USA.
authors.forename: Hongfang
authors.initials: H
authors.lastname: Liu
authors.affiliation: Primary Care Internal Medicine and Center for Innovation, Mayo Clinic Rochester, MN, USA.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Chaudhry
keywords: Papanicolaou test; cervical cancer; clinical decision support; colposcopy; natural language processing