{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T22:34:24Z","timestamp":1785191664309,"version":"3.55.0"},"reference-count":17,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"12","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>Less than half of the patients with newly diagnosed metastatic non\u2013small cell lung cancer (NSCLC) undergo comprehensive molecular testing. We designed an electronic medical record (EMR)\u2013based \u201cnudge intervention\u201d to prompt plasma-based molecular testing at the time of initial medical oncology consultation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>\n              A nonrandomized prospective trial was conducted at the University of Pennsylvania's academic practice and two affiliated community practices. Molecular genotyping was performed by tissue- and\/or plasma-based next generation sequencing methods. Comprehensive testing was defined as testing for\n              <jats:italic>EGFR<\/jats:italic>\n              ,\n              <jats:italic>ALK<\/jats:italic>\n              ,\n              <jats:italic>BRAF<\/jats:italic>\n              ,\n              <jats:italic>ROS1<\/jats:italic>\n              ,\n              <jats:italic>MET<\/jats:italic>\n              ,\n              <jats:italic>RET<\/jats:italic>\n              ,\n              <jats:italic>KRAS<\/jats:italic>\n              , and\n              <jats:italic>NTRK<\/jats:italic>\n              . Guideline-concordant treatment was defined as the use of the appropriate first-line (1L) therapy as per the National Comprehensive Cancer Network (NCCN) guidelines. Proportion of patients with comprehensive molecular genotyping results available at any time, molecular results available before 1L therapy, and guideline-concordant 1L treatment were compared between the preintervention and postintervention cohorts using Fisher's exact test or Pearson's chi-squared test.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>\n              Five hundred and thirty-three patients were included, 376 in the preintervention cohort and 157 in the postintervention cohort. After implementation of the EMR-based nudge, a higher proportion of patients underwent comprehensive molecular testing in the postintervention versus the preintervention cohort (100%\n              <jats:italic>v<\/jats:italic>\n              88%,\n              <jats:italic>P<\/jats:italic>\n              = &lt;.001), had results of comprehensive molecular testing available before initiating 1L treatment (97.3%\n              <jats:italic>v<\/jats:italic>\n              91.6%,\n              <jats:italic>P<\/jats:italic>\n              = .026), and received NCCN guideline-concordant care (89.8%\n              <jats:italic>v<\/jats:italic>\n              78.2%,\n              <jats:italic>P<\/jats:italic>\n              = .035).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>Across three practice sites in a large health system, implementation of a provider team\u2013focused EMR-based nudge intervention was feasible, and led to a higher number of patients with NSCLC undergoing comprehensive molecular genotyping. These findings demonstrate that behavioral nudges can promote molecular testing and should be studied further as a tool to improve guideline-concordant care in both community and academic sites.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/op.24.00070","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T19:59:41Z","timestamp":1720036781000},"page":"1620-1628","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":7,"title":["Electronic Medical Record\u2013Based Nudge Intervention to Increase Comprehensive Molecular Genotyping in Patients With Metastatic Non\u2013Small Cell Lung Cancer: Results From a Prospective Clinical Trial"],"prefix":"10.1200","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2187-3583","authenticated-orcid":true,"given":"Melina E.","family":"Marmarelis","sequence":"first","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan G.","family":"Scholes","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Penn Center for Cancer Care Innovation, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2332-0256","authenticated-orcid":true,"given":"Tara L.","family":"McWilliams","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA"},{"name":"Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2829-2167","authenticated-orcid":true,"given":"Wei-Ting","family":"Hwang","sequence":"additional","affiliation":[{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"},{"name":"Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA"},{"name":"Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kosteva","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Costello","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5015-2964","authenticated-orcid":true,"given":"Lova","family":"Sun","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditi P.","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8854-224X","authenticated-orcid":true,"given":"Kelsey S.","family":"Lau-Min","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Massachusetts General Cancer Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6646-433X","authenticated-orcid":true,"given":"Abigail","family":"Doucette","sequence":"additional","affiliation":[{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"},{"name":"Penn Center for Cancer Care Innovation, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3772-9669","authenticated-orcid":true,"given":"Peter E.","family":"Gabriel","sequence":"additional","affiliation":[{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"},{"name":"Penn Center for Cancer Care Innovation, University of Pennsylvania, Philadelphia, PA"},{"name":"Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7757-6649","authenticated-orcid":true,"given":"Anthony O.","family":"Martella","sequence":"additional","affiliation":[{"name":"Penn Center for Cancer Care Innovation, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0432-7600","authenticated-orcid":true,"given":"Megan A.","family":"Roy","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5734-0004","authenticated-orcid":true,"given":"Jeffrey C.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"},{"name":"Department of Pulmonary Medicine and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger B.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Dougherty","sequence":"additional","affiliation":[{"name":"Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA"},{"name":"Abramson Cancer Center, University of Pennsylvania, Philadelphia, 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