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Grant Details

Grant Number: 5R01CA211723-02 Interpret this number
Primary Investigator: Rahm, Alanna
Organization: Geisinger Clinic
Project Title: Implementing Universal Lynch Syndrome Screening Across Multiple Healthcare Systems: Identifying Strategies to Facilitate and Maintain Programs in Different Organizational Contexts
Fiscal Year: 2018
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Project Summary/Abstract Lynch syndrome (LS) is the most common form of inherited colorectal cancer risk. People with Lynch syndrome are also at increased risk for endometrial, ovarian, gastric, small bowel, and renal cancers. Importantly, well-established clinical guidelines with strong evidence exist for cancer treatment, screening, and prevention in individuals with LS. Identification of individuals with LS is accomplished through a variety of techniques, including family and medical history evaluation, computational models, or tumor testing. The systematic screening of all colorectal tumors for LS was first recommended by the Evaluation of Genetic Application in Practice and Prevention (EGAPP) working group in 2009 and has been designated high priority by the National Academies of Science, Engineering, and Medicine working group and by the Blue Ribbon Panel. The potential public health impact to reduce cancer morbidity and mortality of this intervention supports this priority, as effective implementation of LS screening will help meet the goals of the Cancer Moonshot as well as demonstrate the promise of precision medicine. Currently, implementation of LS screening in healthcare systems remains suboptimal for a variety of reasons. LS screening involves the coordination of multiple departments and individuals across an organization, which is often difficult in large, complex, healthcare systems. Therefore, the overarching goal of this project is to utilize tools from implementation science to describe, explain, and compare decision making and other variations in LS screening implementation across multiple healthcare systems to create and evaluate in a real world setting an organizational toolkit to facilitate implementation of LS screening. Our specific aims are to (1) Describe variation in LS screening implementation across multiple healthcare systems; then (2) Explain practice variation and determine factors associated with optimal implementation; and (3) Determine the relative effectiveness, efficiency, and costs of different LS screening protocols by healthcare system; and finally to (4) Develop and test in a natural environment an organizational toolkit for LS screening. This toolkit will enable effective implementation of LS screening programs; ultimately preventing needless suffering of patients and their family members from preventable cancers, decreasing waste in healthcare system costs, and informing strategies to facilitate the promise of precision medicine.

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Cascading After Peridiagnostic Cancer Genetic Testing: An Alternative to Population-Based Screening.
Authors: Offit K. , Tkachuk K.A. , Stadler Z.K. , Walsh M.F. , Diaz-Zabala H. , Levin J.D. , Steinsnyder Z. , Ravichandran V. , Sharaf R.N. , Frey M.K. , et al. .
Source: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2020-05-01; 38(13), p. 1398-1408.
EPub date: 2020-01-10.
PMID: 31922925
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Health Technology Assessment Centers-an Infrastructure for Health Systems to Translate Evidence into Practice.
Authors: Sharaf R.N. , Khullar D. , Umscheid C.A. .
Source: Journal of general internal medicine, 2020 Apr; 35(4), p. 1296-1299.
EPub date: 2020-01-03.
PMID: 31900729
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Implementing universal cancer screening programs can help sustain genomic medicine programs.
Authors: Rahm A.K. , Bellcross C. , Cragun D. , Duquette D. , Hampel H. , Heald B. .
Source: Personalized medicine, 2020 01; 17(1), p. 9-13.
EPub date: 2019-12-04.
PMID: 31797715
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Somatic and germline sequencing in genitourinary oncology: genetics for the clinician.
Authors: Shoag J.E. , Wise D.R. , Sharaf R.N. , Sternberg C.N. .
Source: Current opinion in urology, 2019 07; 29(4), p. 315-318.
PMID: 31158105
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The Healthcare Systems Research Network (HCSRN) as an Environment for Dissemination and Implementation Research: A Case Study of Developing a Multi-Site Research Study in Precision Medicine.
Authors: Rahm A.K. , Ladd I. , Burnett-Hartman A.N. , Epstein M.M. , Lowery J.T. , Lu C.Y. , Pawloski P.A. , Sharaf R.N. , Liang S.Y. , Hunter J.E. .
Source: EGEMS (Washington, DC), 2019-04-12; 7(1), p. 16.
EPub date: 2019-04-12.
PMID: 30984796
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Increased risk of colon cancer and osteogenic sarcoma in Diamond-Blackfan anemia.
Authors: Vlachos A. , Rosenberg P.S. , Atsidaftos E. , Kang J. , Onel K. , Sharaf R.N. , Alter B.P. , Lipton J.M. .
Source: Blood, 2018-11-15; 132(20), p. 2205-2208.
EPub date: 2018-09-28.
PMID: 30266775
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Implementing universal Lynch syndrome screening (IMPULSS): protocol for a multi-site study to identify strategies to implement, adapt, and sustain genomic medicine programs in different organizational contexts.
Authors: Rahm A.K. , Cragun D. , Hunter J.E. , Epstein M.M. , Lowery J. , Lu C.Y. , Pawloski P.A. , Sharaf R.N. , Liang S.Y. , Burnett-Hartman A.N. , et al. .
Source: BMC health services research, 2018-10-30; 18(1), p. 824.
EPub date: 2018-10-30.
PMID: 30376847
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