Known Biomarkers, Better Care: Optimizing a CDS Tool to Guide Personalized Cancer Treatment

A study, presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting by Daniel Rubin, PharmD, investigated how a clinical decision support (CDS) tool can improve the documentation of biomarker results in cancer care.

Previously, many biomarker results were documented as "unknown" in the CDS tool, potentially due to results not being available yet. The researchers redesigned the tool's prompts to better align with the typical timeline for receiving biomarker results for different cancer types. For instance, some prompts were moved to later stages in the treatment selection process when results are more likely to be available. Additionally, the tool would reprompt for unknown biomarkers during subsequent therapy selections.

The improvements led to a significant increase in the documentation of known biomarkers. In non–small cell lung cancer, the percentage of known biomarkers documented jumped from around 60% to nearly 80%. Similar improvements were seen in metastatic castration-resistant prostate cancer, where known biomarkers increased from 34% to 61%.

These findings suggest that tailoring CDS tool prompts to the specific context of each cancer type can significantly improve the capture of essential biomarker data. This allows healthcare providers to make more informed treatment decisions based on a patient's unique biological profile. The researchers plan to implement similar adjustments for other cancer types within the CDS tool.

Here, Rubin, pharmacist with McKesson supporting The US Oncology Network, discusses the key takeaways from this study.

Transcription:

0:05 | I think the key takeaways are that decision support tools can really aid in helping to navigate the treatment landscape as it greatly changes with the increase in precision medicine. But that doesn't have to come with a burden of click fatigue and a challenge of using another electronic tool. It can be done in a way that fits the clinical flow; it can be designed with a careful attention to the questions themselves, and so that this is really meant to be a tool and not another computer program run awry.

0:36 | Until there's a situation setup for more of a automatic interoperable flow of data from all our vendors, and everywhere throughout the health system, that we can navigate guideline treatments and help have a better understanding of what documentation has been done, and what values are available to us, especially from the biomarker standpoint. And from pharmacists, it's really important that documentation is well kept together, because as far as the validation and the verification of any sort of orders that are done, having that available in a discreet, well-met, well-captured area is really important.

Transcription created with AI and edited for clarity.