Electronic Risk Assessment System as an Appropriate Tool for the Prevention of Cancer: a Qualitative Study

  • Amoli, Amir hossein Javan (Islamic Azad University) ;
  • Maserat, Elham (School of Allied Medical Sciences, Tehran University of Medical Sciences) ;
  • Safdari, Reza (School of Allied Medical Sciences, Tehran University of Medical Sciences) ;
  • Zali, Mohammad Reza (Research Center of Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science)
  • Published : 2016.01.11


Background: Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. Materials and Methods: A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi-structured interview. Results: Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. Conclusions: The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.


Electronic risk assessment system;prevention;cancer screening;colorectal


Supported by : Shahid Beheshti University of Medical Science


  1. Angus RM, Thompson EB, Davies L, et al (2012). Feasibility and impact of a computer-guided consultation on guidelinebased management of COPD in general practice. Prim Care Respir J, 21, 425-30.
  2. Atkinson W (2008). Study aims to improve colorectal cancer screening participation. AHIP Cover, 42, 46-8.
  3. Bouaud J, Blaszka-Jaulerry B, Zelek L, et al (2014). Health information technology: use it well, or don't! Findings from the use of a decision support system for breast cancer management. AMIA Annu Symp Proc, 14, 315-24.
  4. Boxwala AA, Peleg M, Tu S, et al (2004). GLIF3: a representation format for sharable computer-interpretable clinical practice guidelines. J Biomed Inform, 37, 147-61.
  5. Collado Martin R, Garcia Palomo A, de la Cruz Merino L, Borrega Garcia P, Baron Duarte FJ (2014). Clinical guideline SEOM: cancer of unknown primary site. Clin Translational Oncology, 16, 1091-7.
  6. Dekker A, Vinod S, Holloway L, et al (2014). Rapid learning in practice: a lung cancer survival decision support system in routine patient care data, Radiother Oncol, 113, 47-53.
  7. Eccher C, Seyfang A, Ferro A (2014).Implementation and evaluation of an Asbru-based decision support system for adjuvant treatment in breast cancer. Comput Methods Programs Biomed, 117, 308-21.
  8. Eriksson H, Tu SW, Musen M. Semantic clinical guideline documents (2005). AMIA Annu Symp Proc, 236-40.
  9. Glaser B, Strauss A (1967). The Discovery of Grounded Theory. Chicago, IL: Aldine.
  10. Heselmans A, Van de Velde S, Donceel P, Aertgeerts B, Ramaekers D (2009). Effectiveness of electronic guidelinebased implementation systems in ambulatory care settings - a systematic review. Implement Sci, 30.
  11. Lobach DF, Hammond WE (1994). Development and evaluation of a computer-assisted management protocol (CAMP): improved compliance with care guidelines for diabetes mellitus. Proc Annu Symp Comput Appl Med Care,787-91.
  12. Jimbo M, Rana GK, Hawley S, et al (2013). What is lacking in current decision aids on cancer screening? CA: A Cancer Journal for Clinicians, 63, 193-214.
  13. Maserat E, Reza S, Elnaz M, Mohamad Reza Zali (2012). Endoscopic electronic record: A new approach for improving management of colorectal cancer prevention. World J Gastrointest Oncol, 4, 76-81.
  14. Maserat Elham, Reza Fatemi, Mohamad Reza Zali (2009). New perspective for integrated information management in national colorectal cancer screening in Iran. Asian Pac J Cancer Prev, 10.
  15. Navid G, Shima A, Elham M, Masoume S, Reza FS (2010). The role of information systems in cancer prevention. Gastroenterology and Hepatology From Bed to Bench, 3, 164-168.
  16. Peleg M (2013). Computer-interpretable clinical guidelines: a methodological review. J Biomed Inform, 46, 744-63.
  17. Safaee A, Moghimi-Dehkordi B, Fatemi SR, et al (2008). Colorectal cancer in Iran. Asian Pac J Cancer Prev, 9, 123-6.
  18. Shiffman RN1, Brandt CA, Liaw Y, Corb GJ (1999). A design model for computer-based guideline implementation based on information management services. J Am Med Inform Assoc, 6, 99-103.
  19. Steele SR, Bilchik A, Johnson EK, et al (2014). Time-dependent estimates of recurrence and survival in colon cancer: clinical decision support system tool development for adjuvant therapy and oncological outcome assessment. Am Surg, 80, 441-53.
  20. Tomaszewski W (2012). Computer-based medical decision support system based on guidelines, clinical pathways and decision nodes. Acta Bioeng Biomech, 14, 107-16.
  21. Unertl KM, Weinger MB, Johnson KB, Lorenzi NM (2009). Describing and modeling workflow and information flow in chronic disease care. J Am Med Inform Assoc, 16, 826-36.
  22. Yilmaz AA, Ozdemir L (2015). Development and implementation of the clinical decision support system for patients with cancer and nurses' experiences regarding the system. Int J Nurs Knowl.