. 2012 Aug 22;20(2):388–400. doi: 10.1136/amiajnl-2012-000892

Table 4.

Summary of primary research on CDS systems for cancer-related GPM: CDS for other cancers

Citation and name of system (if applicable)	Manuscript summary and trial details (if applicable)	Users and study location	Genetic information used	Integrated with primary clinical information system	CDS purpose and clinical focus	Manuscript type	Notable informatics aspect
Evans, 1995³²	Description of a FHx CDS system developed for a hereditary cancer consulting service. The system collected FHx information, evaluated the FHx for familial risk patterns, and produced preliminary risk assessment and management recommendations. The system resulted in a significant reduction in time spent on cases	Hereditary cancer consulting service in USA	FHx	No	Assessment of patient risk and provision of management recommendations for hereditary cancer	System description; impact observation	Expert rule-based system that modeled the pattern recognition capabilities of clinical geneticists
Bianchi, 2007³³; CRCAPRO	Evaluation of CRCAPRO, which used FHx of colorectal and endometrial cancers to identify patients with Lynch syndrome. This study showed that CRCAPRO has low sensitivity and specificity	Clinicians in UK	FHx	No	Assessment of patient risk for colorectal cancer	System validation	Probability calculated using Bayesian updating
Overbeek, 2010³⁴	RCT of electronic reminders to pathologists to consider Lynch syndrome genetic testing among newly diagnosed colon cancer patients based on FHx. The CDS reminder intervention in 12 pathology laboratories significantly improved pathologists' recognition of patients at risk for Lynch syndrome (OR 2.8; 95% CI 1.1 to 7.0) and increased use of genetic testing (OR 4.1; 95% CI 1.3 to 13.2)	Pathologists in Europe	FHx	Yes	Provision of management recommendations for colorectal cancer	RCT	Electronic reminders provided through health information system
Picone, 2011³⁵; NeoMark	System description of NeoMark, a web-based tool that combined medical images, genetic markers, and other patient data before and after treatment of oral cavity squamous cell carcinoma to predict reoccurrence	Clinicians in Europe	Genotype	No	Assessment of patient risk for oral cancer	System description	Uses a service-oriented, modular architecture
Hendershot, 2010³⁶	RCT of a web-based genetic feedback intervention involving 200 college students of Asian descent. The system provided personalized alcohol-related health risk information and feedback based on the patient's genotype. The tool resulted in significant reductions in drinking (p=0.02) among participants with the genotype associated with higher risk of alcohol-related cancer	Patients in USA	Genotype	No	Assessment of patient risk; reduction of risky behavior (alcohol consumption) for alcohol-related cancer	RCT	Web-based intervention
Wakefield, 2011³⁷	System description and pilot usability test of an online CDS tool that presented 22 men with age and family history-specific prostate cancer risk information and management recommendations. Most participants preferred this method for receiving prostate cancer information	Patients in Australia/New Zealand	FHx	No	Assessment of patient risk and provision of management recommendations for prostate cancer	System description; pilot usability test	Online decision aid using a Markov model

CDS, clinical decision support; FHx, family health history; GPM, genetically guided personalized medicine; RCT, randomized controlled trial.