Defining a Roadmap for Patient Engagement in Imaging CER

Project: Research project

Project Details

Description

The transition to comparative effectiveness research (GER) as a framework for the evaluation of diagnostic tests spurred a community of researchers to design studies that link the appropriateness and potential benefit of imaging on patient outcomes. Two areas of need remain to be addressed for the success of these expanded efforts: 1) development and dissemination of state of the art methods linking diagnostic test results, intermediate outcomes, to health outcomes that patients themselves have determined as meaningful; 2) a robust process for engaging patients in the development, conduct, analysis and results dissemination of CER in imaging.

CER in imaging is not limited to the comparison of two tests for a given clinical condition. Broadly constituted, CER in imaging compares two interventions designed to improve health by delivering the right imaging test or imaging service to the right patient in the right order at the right time. Examples of CER in imaging can include comparing 1) combined use of imaging biomarkers with genetic markers to genetic markers alone to determine cancer-free survival; 2) two clinical guidelines for surveillance of incidentally detected pancreatic cysts to decrease unnecessary pancreatic surgery; 3) practice-level use of standardized automated reporting for incidental findings to usual care to increase the likelihood that recommendations for work-up of detected incidental findings agree with current guidelines. Enhancing the development and conduct of CER, particularly within a multi-center imaging trials network such as Eastern Cooperative Oncology Group-American College of Radiology Imaging Network (ECOG-ACRIN) requires disseminating current state of the art research methods, particularly methods that address challenges in CER. These challenges include rapidly evolving imaging technology [1] with large amounts of data such as genetic and imaging biomarkers; and complex multistep care processes that make it difficult to assess the effect of an intermediate outcome, such as a positive test, on a health outcome such as survival [2]. Additional methods need to address interventions to overcome reluctance to implement CER results in clinical practice, for example developing behavior interventions to improve adherence to practice guidelines. Further, engaging patients in CER in imaging requires that dissemination of these methods occur in a format understandable to patients and lay audiences.
StatusFinished
Effective start/end date10/1/169/30/18

Funding

  • ECOG-ACRIN Medical Research Foundation, Inc. (Agmt 9/29/17)
  • Patient-Centered Outcomes Research Institute (Agmt 9/29/17)

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