{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:01:15Z","timestamp":1790420475969,"version":"4.1.0"},"posted":{"date-parts":[[2026,9,23]]},"group-title":"Gastroenterology","reference-count":22,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nd\/4.0\/"}],"funder":[{"name":"National Cancer Institute of the National Institutes of Health","award":["R01CA230442"],"award-info":[{"award-number":["R01CA230442"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background &amp; Aims<\/jats:title>\n                  <jats:p>We previously developed multiple machine-learning and regression-based risk prediction models using retrospective electronic health records (EHR) to estimate near-term risk of pancreatic cancer (PC). This pilot study aimed to assess the feasibility of an early detection strategy combining initial EHR-based risk prediction with downstream imaging and blood-based testing.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This prospective study included adults aged 50\u201384 years with an estimated \u22651% 18-month risk of PC, identified between January 2021 and March 2023 using four previously validated models. Patients with a history or active suspicion of PC were excluded. Participants completed cross-sectional imaging and CA19-9 labs at baseline and again at 18 months. Outcomes included enrollment rates, test completion rate, and burden of incidental findings.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 1,251 eligible patients, 102 (8.2%) enrolled (median age 69 years [IQR 62-75]; 58% women; 48% Hispanic, 34% White, 11% Black, and 7% Asian). At baseline, 89 (87%) completed imaging and 98 (96%) completed CA19-9. At 18 months, 79% completed both imaging and CA19-9. Ten (10%) participants underwent additional clinical evaluations triggered by imaging findings. Evaluations included an endoscopic ultrasound, renal imaging, and FibroScan. CA19-9 results were normal in most participants, though 18% had elevated levels at baseline.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Real-time EHR-based ML algorithms can be combined with blood- and imaging-based surveillance for early detection of PC with acceptable burden of incidental findings. However, improved patient engagement is a key aspect that will need to be addressed in order to successfully scale an AI-guided strategy for early detection.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.09.22.26363704","type":"posted-content","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:55:11Z","timestamp":1790222111000},"source":"Crossref","is-referenced-by-count":0,"title":["Implementation of risk prediction models using electronic health data for early detection of pancreatic cancer: a prospective pilot feasibility study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3304-2704","authenticated-orcid":false,"given":"Bechien U.","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA"},{"name":"Department of Gastroenterology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5825-9248","authenticated-orcid":false,"given":"Tiffany Q.","family":"Luong","sequence":"additional","affiliation":[{"name":"Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6719-6090","authenticated-orcid":false,"given":"Eva","family":"Lustigova","sequence":"additional","affiliation":[{"name":"Tulane Center for Clinical Research, Tulane University School of Medicine, New Orleans, LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5739-2477","authenticated-orcid":false,"given":"Christie","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Puttock","sequence":"additional","affiliation":[{"name":"Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca H.","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes A.","family":"Munis","sequence":"additional","affiliation":[{"name":"Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3486-7468","authenticated-orcid":false,"given":"Wansu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Research & Evaluation, Southern California Permanente Medical Group, Pasadena, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026092603300659000_2026.09.22.26363704v1.1","unstructured":"National Cancer Institute Surveillance, Epidemiology and End Results Program. Cancer Stat Facts: Pancreatic Cancer. 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