EHR-based 'nudges' reduce breast cancer overtreatment: Study

An EHR reminder, or "nudge," can reduce unnecessary breast cancer surgeries, according to a study published July 17 in JAMA Surgery.

Researchers at the University of Pittsburgh and UPMC Hillman Cancer Center in Pittsburgh created the reminder in the EHRs of 387 breast cancer patients for seven  surgeons in eight clinical settings over a 12-month period. 

The reminder flagged patients who may not benefit from surgery based on their age and type of tumor, allowing the appropriate surgeon to evaluate treatment options. 

Following implementation of the reminder, unnecessary sentinel lymph node biopsies were reduced 49.3%.

"As patients get older, they also have more challenges recovering from surgery and anesthesia, so if a patient isn't likely to benefit from SLNB, we want to avoid it whenever possible," study co-author Neil Carleton, PhD, said in a July 17 news release. "Patients who undergo SLNB are at risk of developing a serious complication called lymphedema, a permanent but treatable swelling of the arm or breast that can greatly impact quality of life."

Researchers said they used artificial intelligence to analyze patient records for lymphedema symptoms. After the health record reminder was implemented, referrals for lymphedema evaluation decreased from 6.2% to 3.6%, indicating the reminder prevented unnecessary surgeries for those patients, according to the study.

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