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Life Expectancy-informed Colorectal Cancer Screening

Improving Colorectal Cancer Screening Decisions Through Consideration of Life Expectancy

Who can join

As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.

Age
76 Years and older
Sex
All sexes
Healthy volunteers
Accepted
Compensation
Not stated

Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.

What to expect

No one can promise a trial will help you personally — that is what the research is trying to find out.

What participation involves

  • Time periods mentioned: 75 years
  • Procedures mentioned: Interviews

Only what the study's summary and detailed description on ClinicalTrials.gov say. Time periods may describe the whole study or a part of it — ask the study team what applies to you.

Show the study's own words
  • "Concurrently with the development and testing of the life expectancy prediction model, the investigators will conduct interviews with clinicians to generate knowledge regarding the optimal way to integrate life expectancy information into decision making about colorectal cancer screening in patients over 75 years."
  • "Concurrently with the development and testing of the life expectancy prediction model, the study team will develop the interview guide, which will be semi-structured; the investigators will use pre-defined questions based on study interest but will also allow for new topics to emerge."
  • "As the investigators want to collect diverse clinician perspectives, unique clinicians will be recruited for each phase of interviews."
  • "Interviews will last between 45 minutes and an hour take place via Microsoft Teams."
  • "Interviews will be audio recorded and transcribed verbatim."
  • "For each phase, following coding of 10 interviews, investigators will share findings with the study team and develop a preliminary coding dictionary."
Compensation
Not stated
  • Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
  • Participants are monitored closely by the research team throughout the study.
  • Some participants may receive access to an investigational treatment, which is still being studied.
  • Your participation helps researchers learn whether this approach could help future patients.

About this study

In plain language

This study tests a notice in electronic health records that tells clinicians how long a patient is likely to live. The goal is to help guide colon and rectal cancer screening for adults over 75. It includes a review of patient records, clinician interviews, and a trial of the notice.

The purpose of this study is to improve life-expectancy concordant colorectal cancer screening for adults over 75 years through design and testing of a life expectancy notification to clinicians delivered via the electronic health record. This study has three components: 1. The investigators will develop a life expectancy prediction model using patient data from the Cleveland Clinic electronic health record (EHR) and test it against two existing life expectancy prediction models to determine which should be used in clinical care. This is an observational cohort study. 2. Concurrently with the development and testing of the life expectancy prediction model, the investigators will conduct interviews with clinicians to generate knowledge regarding the optimal way to integrate life expectancy information into decision making about colorectal cancer screening in patients over 75 years. This is a qualitative study. 3. The investigators will then conduct a cluster randomized trial of a clinical decision support-delivered life expectancy notification on life expectancy-congruent colorectal cancer screening orders by primary care clinicians.

Compensation is read from the study's own description and may be missing — always confirm with the study team.

Eligibility

Who can join

  • Patient record review: Adults over 75 who live in Ohio.
  • Patient record review: At least one Cleveland Clinic internal or family medicine visit from January 1, 2007, to September 1, 2022.
  • Clinician interviews: Internal or family medicine doctors or advanced practice providers at Cleveland Clinic in Northeast Ohio.
  • Clinician interviews: Saw at least 10 patients over 75 who were due or overdue for screening in 2024–2025. Their colonoscopy ordering rate must be in the highest or lowest quarter of eligible clinicians.
  • Notice trial: Cleveland Clinic internal or family medicine sites in Northeast Ohio or Florida.
  • Notice trial clinicians: Currently practicing as attending clinicians in internal or family medicine. They must have seen at least 10 patients over 75 due or overdue for screening in 2024–2025.
  • Notice trial patients: Over 75, with no colonoscopy in the past 10 years and no FOBT/FIT in the past year. A colonoscopy uses a camera to check the colon; FOBT/FIT are stool tests for blood.
  • Notice trial patients: An internal or family medicine visit from January 1, 2026, to January 1, 2028.

Who can't join

  • Patient record review: Age 75 or younger.
  • Patient record review: No follow-up internal or family medicine visit in Ohio within two years of the first visit.
  • Patient record review: Receiving treatment for cancer other than skin cancer.
  • Clinician interviews: Colonoscopy ordering rate is not in the highest or lowest quarter for patients over 75.
  • Clinician interviews: Trainees or residents.
  • Clinician interviews: Saw fewer than 10 eligible patients in 2024–2025.
  • Notice trial patients: Under 75. The inclusion rules require patients to be over 75.
  • Notice trial patients: Up to date on screening—a colonoscopy within 10 years, or a FOBT, FIT, or Cologuard stool test within the past year.

Simplified for readability. The official criteria below are what the study team uses.

Official eligibility criteria

Inclusion Criteria: * Aim 1a: Patients must meet all the inclusion criteria listed below to be included: * \> 75 years of age * Resident of Ohio * Had at least one Internal Medicine or Family Medicine visit at Cleveland Clinic Health System between January 1, 2007, and September 1, 2022. Aim 1b: Clinicians must meet all the inclusion criteria listed below to be included: * Internal Medicine or Family Medicine clinician (MD, DO, or APP) practicing at Cleveland Clinic Health System in Northeast Ohio * Saw ≥10 study-eligible patients, defined as patients aged \>75 years who were due or overdue for colorectal cancer screening, between 2024-2025 * With a colonoscopy ordering rate for patients \>75 years in either the top quarter of the distribution of all eligible clinicians or bottom quarter of all eligible clinicians Aim 2: Clinics must meet all the inclusion criteria listed below to be included: • Internal Medicine or Family Medicine clinical site included in the Cleveland Clinic Health System in Northeast Ohio or Florida Clinicians must meet all the inclusion criteria listed below to be included: * Currently practicing in Internal or Family Medicine as an attending clinician * Saw ≥10 study-eligible patients, defined as patients aged \>75 years who were due or overdue for colorectal cancer screening, between 2024-2025 Patients must meet all the inclusion criteria listed below to be included: * \>75 years of age * Have not received a colonoscopy in the prior 10 years * Have not received a FOBT/FIT in prior year * Had a visit in Internal Medicine or Family Medicine between January 1, 2026 and January 1, 2028 Exclusion Criteria: * All candidates meeting any of the exclusion criteria at baseline will be excluded from study participation. Aim 1a: * Patients aged ≤75 years * Patients who did not have at least one subsequent Internal or Family Medicine visit in Ohio within two years from the date of their baseline visit * Patients being actively treated for non-skin cancer Aim 1b: * Clinicians who are not in the top or bottom quarter of the distribution of colonoscopy orderers for patients aged \>75 years * Trainees/residents * Saw \<10 study-eligible patients between 2024-2025 Aim 2: * Patients aged \<75 years * Patients up to date with colorectal cancer screening (colonoscopy within 10 years or FOBT/FIT/Cologuard within the past year)

Study sites (1)

OH