To test or not: a registry-based observational study of an online decision support for prostate-specific antigen tests

Int J Med Inform. 2013 Oct;82(10):973-9. doi: 10.1016/j.ijmedinf.2013.06.010. Epub 2013 Jul 11.


Background: Watchful waiting is an essential part in the handling of patients with prostate cancer (PC). More effective disease management may be achieved by this strategy. Correct use of prostate-specific antigen (PSA) test is crucial and the general practitioner (GP) may therefore benefit from access to a clinical decision support system (CDSS) that focuses on this challenge. There are many barriers to the use of CDSSs. The aim of the present paper is to study if such barriers may be overcome by granting GPs easier access to a web-based CDSS via a hyperlink in the GPs' electronic medical record system (EMR).

Methods: In the present population-based observational registry study with an intervention and control group, we created a web-based CDSS that was made accessible to GPs via hyperlink inserted into the EMR medical chart contents. The intervention was introduced 1 January 2011. Our outcome measure was the number of age-standardised PSA test rates per 1000 men per practice during three equally sized periods of 6 months within the study period from 1 January 2010 to 30 June 2011.

Results: We found that none of the differences between intervention and control groups were statistically significant.

Conclusions: Providing GPs with access to a CDSS to aid their decision to use the PSA, had no measurable effect on the GPs' PSA testing behaviour.

Keywords: CDSS; EMR; PSA-testing; Prostate cancer.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged, 80 and over
  • Biomarkers, Tumor / blood*
  • Decision Support Systems, Clinical / statistics & numerical data*
  • Denmark / epidemiology
  • Electronic Health Records / statistics & numerical data
  • General Practice / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Online Systems
  • Prevalence
  • Prostate-Specific Antigen / blood*
  • Prostatic Neoplasms / blood*
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / epidemiology*
  • Registries*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Utilization Review


  • Biomarkers, Tumor
  • Prostate-Specific Antigen