

ePrognosis: Cancer Screening decision support app
University of California, San Francisco, School of Medicine
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The free "ePrognosis: Cancer Screening" app aims to help trainees and practicing clinicians guide conversations with elderly patients of whether to start, stop, or continue breast cancer and/or colorectal cancer screening. The app is created around the idea that estimating prognosis is a critical aspect in the decision to recommend for or against cancer screening, as there is a long "lag-time to benefit" for these interventions. The objective is to focus cancer screening on those most likely to benefit from these medical interventions, and conversely, avoid screening in those who are unlikely to live long enough to see a benefit but will be exposed to immediate harms.
The objective is to educate providers in guiding conversations with elderly patients of whether to start, stop, or continue breast cancer and/or colorectal cancer screening. When a user starts the app they will see the start screen asking you whether you are interested in screening for colorectal cancer, breast cancer, or both. Once a selection has been made the app runs the user through 15 health related questions including age, gender, BMI, symptoms, and functional impairment to calculate a mortality risk to estimate life expectancy. Based on the response to these questions, the user will be shown a speedometer like image that can help inform whether cancer screening is more likely to help or harm a patient. The user can also click on the "harms" or "benefits" buttons to learn more about what these may include. Lastly, one can also click the learn more button, which will run the user through a series of pictographs (each pictograph is of 1,000 squares where each square represents one person). These pictographs visually display information on harms and mortality benefits from cancer screening, as well overall mortality risk at 10 years.
Requires iOS 5.1 or later. Compatible with iPhone, iPad, and iPod touch. This app is optimized for iPhone 5. It can be downloaded at the iTunes store via the following link https://itunes.apple.com/us/app/eprognosis-cancer-screening/id714539993?mt=8