Electronic health record - based triggers to detect potential delays in cancer diagnosis

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This article focuses on finding triggers to prevent to the delay in the diagnosing of diseases.


The early detection of cancer is something that can be very beneficial to treating cancer. The purpose of this article is to develop and evaluate trigger algorithms to electronically flag medical records of patients. The cancers that were focused on were colorectal cancer and prostate cancer.


Retrospective data was mined from two integrated health systems with comprehensive electronic health records. Using the data mining algorithm, patient records with specific demographics were searched: abnormal prostate-specific antigen, positive fecal occult blood test, iron-deficiency anemia, and hematochezia.


Over 290,000 patients were reviewed using the algorithm between January and December 2009. Overall, over 1564 triggers were found. The study also discovered that there were many triggers that were not found during check-ups were discovered using the algorithm.


Using algorithms like this, cancer triggers can be discovered and, in turn, can help diagnose cancers earlier for treatment. Some limitations of the study include the range of the study. The study was only conducted at two sites. The same methods were used at both sites during this study and they may not be able to be applied at other sites. The study also failed to discover why these triggers were being missed in the first place. Many said the reason was the difficulty getting the appropriate appointments with specialists and patients failing to show up for appointments.

Related Articles

Murphy, D. R., Wu, L., Thomas, E. J., Forjuoh, S. N., Meyer, A. N., & Singh, H. (2015). Electronic trigger-based intervention to reduce delays in diagnostic evaluation for cancer: a cluster randomized controlled trial. Journal of Clinical Oncology, JCO-2015. http://jco.ascopubs.org/content/early/2015/08/21/JCO.2015.61.1301.long

Electronic medical records and quality of cancer care

colorectal screening and EHRs


  1. Murphy, D., Laximisan, A., Reis, B., Thomas, E., Esquivel, A., Forjuoh, S., . . . Singh, H. (n.d.).Electronic health record-based triggers to detect potential delays in cancer diagnosis. BMJ Quality and Safety, 23(1). http://qualitysafety.bmj.com/content/23/1/8.short