{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:53:40Z","timestamp":1772610820751,"version":"3.50.1"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,7,30]],"date-time":"2013-07-30T00:00:00Z","timestamp":1375142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"crossref","award":["R01 CA131197"],"award-info":[{"award-number":["R01 CA131197"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Shared decision making (<jats:styled-content style=\"fixed-case\">SDM<\/jats:styled-content>) related to test preference has been advocated as a potentially effective strategy for increasing adherence to colorectal cancer (CRC) screening, yet primary care providers (<jats:styled-content style=\"fixed-case\">PCP<\/jats:styled-content>s) are often reluctant to comply with patient preferences if they differ from their own. Risk stratification advanced colorectal neoplasia (<jats:styled-content style=\"fixed-case\">ACN<\/jats:styled-content>) provides a rational strategy for reconciling these differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the importance of risk stratification in <jats:styled-content style=\"fixed-case\">PCP<\/jats:styled-content> decision making related to test preference for average\u2010risk patients and receptivity to use of an electronic risk assessment tool for <jats:styled-content style=\"fixed-case\">ACN<\/jats:styled-content> to facilitate <jats:styled-content style=\"fixed-case\">SDM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Mixed methods, including qualitative key informant interviews and a cross\u2010sectional survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">PCP<\/jats:styled-content>s at an urban, academic safety\u2010net institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Measures<\/jats:title><jats:p>Screening preferences, factors influencing patient recommendations and receptivity to use of a risk stratification tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Nine <jats:styled-content style=\"fixed-case\">PCP<\/jats:styled-content>s participated in interviews and 57 completed the survey. Despite an overwhelming preference for colonoscopy by 95% of respondents, patient risk (67%) and patient preferences (63%) were more influential in their decision making than patient comorbidities (31%; <jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.001). Age was the single most influential risk factor (excluding family history), with &lt;20% of respondents choosing factors other than age. Most respondents reported that they would be likely to use a risk stratification tool in their practice either \u2018often\u2019 (43%) or sometimes (53%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Risk stratification was perceived to be important in clinical decision making, yet few providers considered risk factors other than age for average\u2010risk patients. Providers were receptive to the use of a risk assessment tool for <jats:styled-content style=\"fixed-case\">ACN<\/jats:styled-content> when recommending an appropriate screening test for select patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.12110","type":"journal-article","created":{"date-parts":[[2013,7,30]],"date-time":"2013-07-30T12:41:13Z","timestamp":1375188073000},"page":"1327-1338","source":"Crossref","is-referenced-by-count":12,"title":["Risk assessment and clinical decision making for colorectal cancer screening"],"prefix":"10.1111","volume":"18","author":[{"suffix":"III","given":"Paul C.","family":"Schroy","sequence":"first","affiliation":[{"name":"Section of Gastroenterology Boston University School of Medicine Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E.","family":"Caron","sequence":"additional","affiliation":[{"name":"Women's Health Unit Section of General Internal Medicine Boston University School of Medicine Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bonnie J.","family":"Sherman","sequence":"additional","affiliation":[{"name":"Women's Health Unit Section of General Internal Medicine Boston University School of Medicine Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy C.","family":"Heeren","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Boston University School of Public Health Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy A.","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Women's Health Unit Section of General Internal Medicine Boston University School of Medicine Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,7,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20138"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-137-2-200207160-00007"},{"key":"e_1_2_8_4_1","first-page":"41","article-title":"Cancer screening \u2010 United States, 2010","volume":"61","author":"Centers for Disease Control and Prevention","year":"2012","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-12-0023"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3322\/CA.2007.0018"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-149-9-200811040-00243"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-5-201203060-00010"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(96)00221-3"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(99)00145-8"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2003.09.012"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2003.09.011"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1369-6513.2000.00093.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2008.07.018"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2006.10.003"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31817dc496"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-009-1108-4"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X10378701"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-012-2045-1"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X10369007"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26551"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1052-5157(03)00053-9"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369\u20107625.2011.00730.x"},{"key":"e_1_2_8_24_1","volume-title":"Basics of Qualitative Research: Grounded Theory Procedures and Techniques","author":"Strauss A","year":"1990"},{"key":"e_1_2_8_25_1","first-page":"35","article-title":"Numeracy and the medical student's ability to interpret data","volume":"5","author":"Sheridan SL","year":"2002","journal-title":"Effective Clinical Practice"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X07307271"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-139-12-200312160-00005"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.221168"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20512"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2009.03.008"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6947-8-4"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-10-0695"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-10-0749"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X11406285"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-06-0143"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-010-9348-0"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-012-2227-x"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.206"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2012.05.026"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2011.05.029"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.104"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2006.04.010"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31817c6100"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-140-7-200404060-00013"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2005.00164.x"},{"key":"e_1_2_8_46_1","volume-title":"Diffusion of Innovations","author":"Rogers EM","year":"2003"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38398.500764.8F"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15430154jce1902_9"}],"container-title":["Health Expectations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhex.12110","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.12110","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T16:29:00Z","timestamp":1696350540000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hex.12110"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,7,30]]},"references-count":47,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2015,10]]}},"alternative-id":["10.1111\/hex.12110"],"URL":"https:\/\/doi.org\/10.1111\/hex.12110","archive":["Portico"],"relation":{},"ISSN":["1369-6513","1369-7625"],"issn-type":[{"value":"1369-6513","type":"print"},{"value":"1369-7625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7,30]]}}}