Decision support tools to improve cancer diagnostic decision making in primary care: a systematic review

Due to the complex & challenging nature of diagnosing cancer in primary care, electronic clinical decision support tools (eCDSTs) have been proposed as an approach to improve GP decision making. This systematic review (conducted by PC4 researchers) aimed to investigate whether eCDSTs improve diagnostic decision making for cancer in primary care and to determine which elements influence successful implementation. The results from included studies indicated evidence for improved decision making for cancer diagnosis, and positive effects on secondary clinical or health service outcomes (e.g. prescribing, quality of referrals, cost-effectiveness). One study found a reduction in time to cancer diagnosis. Barriers to implementation of eCDSTs included trust, the compatibility of the support tool’s recommendations with the GP’s role as a gatekeeper, and impact on workflow. Overall, this review suggests that  eCDSTs have the capacity to improve decision making for a cancer diagnosis, but the optimal mode of delivery remains unclear.

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