Survivorship Plan HEalth REcord (SPHERE) Implementation Trial

Colorectal Cancer Surveillance Outcomes

The CRC Surveillance Index (SI) will be extracted from the electronic medical record. For each observation period, every person-month is classified as either "covered" (eligible for the test during the month and covered) or "uncovered" (eligible for the test, but not covered). If a surveillance test (S) is delivered to an eligible patient at a particular time, then all person-months for the following recommended interval fall under a period of coverage (P1). If it is not renewed, then an uncovered portion of the observation period (U) is created. Further, if a second surveillance test (S2) is performed after some uncovered interval (U), additional covered months (P2) may be present during the observation period. For each patient, SI=100\*\[(P1+P2)/(P1+P2+U)\] for each surveillance test.

Preventive Care Outcomes

All preventive care measures will be measured in the electronic medical record based upon U.S. Preventive Services Task Force (USPSTF) or Advisory Committee for Immunization Practices guidelines. Measures are calculated using a methodology similar to the one described for the Surveillance Index, but in this instance, a Prevention Index (PI) is created. The following preventive care is included in the index: influenza vaccine, pneumococcal vaccine, cholesterol screening, blood pressure screening, and HIV screening screening118, tobacco status and counseling119, screening mammography119, and cervical cancer screening

Symptom Measures

The primary symptom outcome measure will be the composite 5-symptom T score from the PROMIS which includes scales for sleep, pain, anxiety, depression, and energy/fatigue (SPADE) via self-report. Conversion tables allow conversion of simple summed raw scores from PROMIS scales into T-score values. The composite Patient-Reported Outcomes Measurement Information System (PROMIS) score is the mean of the 5 symptom scores.