{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:57:01Z","timestamp":1790517421999,"version":"4.1.0"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Clinical practice guidelines for cancer screening and management are developed by multiple guideline organizations and published in narrative form. However, guideline concordance can be challenging due to several factors: rapid advances in cancer care, increasing complexity of narrative clinical guidelines, and the unstructured nature of information needed for decisions in electronic health records (EHRs). Clinical decision support (CDS) tools, or computer-interpretable versions of clinical practice guidelines, may help address these challenges when provided to clinicians at the point of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>The Centers for Disease Control and Prevention collaborated with MITRE Corporation and subject matter experts to translate current narrative guidelines for cervical, breast, and colorectal cancer screening and management into standards-based computable guidelines and interoperable CDS tools. The tools apply guideline logic in real-time to patient EHR data to assess screening history and risk and generate recommended actions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Computable guidelines and CDS tools were developed for all three cancers. The cervical cancer CDS was integrated into EHRs and underwent a 6-month clinical pilot evaluation. Breast and colorectal cancer CDS tools progressed to executable code tested with synthetic patient data but have not undergone clinical pilot testing. All three CDS tools are open source, with code available for download.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Standards-based computable guidelines can support implementation of complex cancer screening and management recommendations within EHRs. Further development and implementation will require improved structured data capture, interoperable workflows, and sustained support. All three CDS tools require longer-term evaluation to assess usability, acceptability, and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15409996261489070","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:16:16Z","timestamp":1790144176000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Building Computable Guidelines and Clinical Decision Support Tools for Cervical, Breast and Colorectal Cancer Screening and Risk Management: A CDC Initiative Update"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1806-1683","authenticated-orcid":false,"given":"Sun Hee","family":"Rim","sequence":"first","affiliation":[{"name":"Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Colbert","sequence":"additional","affiliation":[{"name":"MITRE Healthcare Federally Funded Research and Development Center, McLean, VA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Kobernik","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4688-1459","authenticated-orcid":false,"given":"Thomas B.","family":"Richards","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline W.","family":"Miller","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sallyann","family":"Coleman King","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Townsend","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Nosal","sequence":"additional","affiliation":[{"name":"MITRE Healthcare Federally Funded Research and Development Center, McLean, VA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3557-226X","authenticated-orcid":false,"given":"Michael","family":"O\u2019Hanlon","sequence":"additional","affiliation":[{"name":"MITRE Healthcare Federally Funded Research and Development Center, McLean, VA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rute","family":"Martins","sequence":"additional","affiliation":[{"name":"MITRE Healthcare Federally Funded Research and Development Center, McLean, VA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelima","family":"Karipineni","sequence":"additional","affiliation":[{"name":"MITRE Healthcare Federally Funded Research and Development Center, McLean, VA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9555-7674","authenticated-orcid":false,"given":"Lisa C.","family":"Richardson","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13187-025-02656-5"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000804"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2025.104908"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-2524-5076"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000484"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2022.0100"},{"key":"e_1_3_3_8_1","unstructured":"7.American Cancer Society. American Cancer Society breast cancer screening guidelines. American Cancer Society: Atlanta Georgia; 2026. Available from: https:\/\/www.cancer.org\/cancer\/types\/breast-cancer\/screening-tests-and-early-detection\/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html"},{"key":"e_1_3_3_9_1","unstructured":"8.American College of Obstetricians and Gynecologists. Breast cancer risk assessment and screening in average-risk women. American College of Obstetricians and Gynecologists: Washington (DC); 2017. Available from: https:\/\/www.acog.org\/clinical\/clinical-guidance\/practice-bulletin\/articles\/2017\/07\/breast-cancer-risk-assessment-and-screening-in-average-risk-women"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i30.4148"},{"key":"e_1_3_3_11_1","unstructured":"10.US Preventive Services Task Force. Breast cancer: Screening. Recommendation statement. U.S. Preventive Services Task Force: Washington (DC); 2024. Available from: https:\/\/www.uspreventiveservicestaskforce.org\/uspstf\/recommendation\/breast-cancer-screening"},{"key":"e_1_3_3_12_1","unstructured":"11.US Preventive Services Task Force. Colorectal cancer: Screening. Recommendation statement. U.S. Preventive Services Task Force: Washington (DC); 2025. Available from: https:\/\/www.uspreventiveservicestaskforce.org\/uspstf\/recommendation\/colorectal-cancer-screening"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.04.001"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.01.014"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.174"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.57.2.75"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.435"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2011-000334"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000525"},{"key":"e_1_3_3_20_1","unstructured":"19.National Cancer Institute. Enduring consensus cervical cancer screening and management guidelines. National Cancer Institute: Bethesda (MD); 2024. Available from: https:\/\/dceg.cancer.gov\/research\/cancer-types\/cervix\/enduring-guidelines"},{"key":"e_1_3_3_21_1","unstructured":"20.HL7 International. Clinical practice guidelines 2.0.0 STU2 implementation guide. HL7 International: Ann Arbor Michigan; 2024. Available from: https:\/\/build.fhir.org\/ig\/HL7\/cqf-recommendations\/"},{"key":"e_1_3_3_22_1","unstructured":"21.American College of Obstetricians and Gynecologists. Hereditary cancer syndromes and risk assessment. ACOG: Washington (DC); 2019. Available from: https:\/\/www.acog.org\/clinical\/clinical-guidance\/committee-opinion\/articles\/2019\/12\/hereditary-cancer-syndromes-and-risk-assessment"},{"key":"e_1_3_3_23_1","unstructured":"22.Centers for Disease Control and Prevention. CDC breast cancer screening CDS L2. CDC: Atlanta Georgia; 2024. Available from: https:\/\/cancerscreeningcds.github.io\/CDC-Breast-Cancer-Screening-CDS-L2\/"},{"key":"e_1_3_3_24_1","unstructured":"23.Centers for Disease Control and Prevention. Breast cancer screening and management (BCSM) clinical decision support (CDS) implementation guide. CDC: Atlanta (GA); 2025. Available from: https:\/\/cancerscreeningcds.github.io\/bcsm-cds\/"},{"key":"e_1_3_3_25_1","unstructured":"24.Centers for Disease Control and Prevention. CDC colorectal cancer screening CDS L2. Centers for Disease Control and Prevention: Atlanta (GA); 2024. Available from: https:\/\/cancerscreeningcds.github.io\/CDC-Colorectal-Cancer-Screening-CDS-L2\/"},{"key":"e_1_3_3_26_1","unstructured":"25.Centers for Disease Control and Prevention. Colorectal cancer screening and management (CRCSM) clinical decision support (CDS) implementation guide. CDC: Atlanta (GA); 2025. Available from: https:\/\/cancerscreeningcds.github.io\/crcsm-cds\/"},{"key":"e_1_3_3_27_1","unstructured":"26.Brooks C. Academia industry and government can create innovative partnerships and help secure our digital future. Forbes: Jersey City New Jersey; 2023. Available from: https:\/\/www.forbes.com\/sites\/chuckbrooks\/2023\/07\/13\/academia-industry-and-government-can-create-innovative-partnerships-and-help-secure-our-digital-future\/"},{"key":"e_1_3_3_28_1","doi-asserted-by":"publisher","DOI":"10.4258\/hir.2019.25.1.1"},{"key":"e_1_3_3_29_1","unstructured":"28.HealthIT.gov. Clinical decision support. HealthIT.gov: Washington (DC); 2026. Available from: https:\/\/healthit.gov\/clinical-quality-and-safety\/clinical-decision-support\/"},{"key":"e_1_3_3_30_1","unstructured":"29.eCQI Resource Center. Standards-based clinical practice guidelines for the digital age. eCQI Resource Center: Washington (DC); 2026. Available from: https:\/\/ecqi.healthit.gov\/standards-based-clinical-practice-guidelines-digital-age\/clinical-quality-standards"},{"key":"e_1_3_3_31_1","unstructured":"30.eCQI Resource Center. Clinical decision support. eCQI Resource Center: Washington (DC); 2026. Available from: https:\/\/ecqi.healthit.gov\/cds"},{"key":"e_1_3_3_32_1","unstructured":"31.eCQI Resource Center. CDS tools & resources. eCQI Resource Center: Washington (DC); 2026. Available from: https:\/\/ecqi.healthit.gov\/cds\/tools-resources"},{"key":"e_1_3_3_33_1","unstructured":"32.U.S. Department of Health and Human Services. HHS priorities. HHS: Washington (DC); 2026. Available from: https:\/\/www.hhs.gov\/about\/priorities\/index.html"}],"container-title":["Journal of Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15409996261489070","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15409996261489070","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15409996261489070","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:18:38Z","timestamp":1790515118000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15409996261489070"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":32,"alternative-id":["10.1177\/15409996261489070"],"URL":"https:\/\/doi.org\/10.1177\/15409996261489070","relation":{},"ISSN":["1540-9996","1931-843X"],"issn-type":[{"value":"1540-9996","type":"print"},{"value":"1931-843X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"article-number":"15409996261489070"}}