NG12 Cancer Recognition - PSA Radar (HP197)

NG12 Cancer Recognition - PSA Radar (HP197)

NG12 Cancer Recognition - PSA Radar (HP197)


Overview/Purpose

The Prostate Specific Antigen (PSA) radar is designed to improve the detection of prostate cancer and to spot progression of established prostate cancer. The alert informs a user when loading the record (via the red protocol alert box), about the status of this patient's PSA testing. It aims to quickly draw attention to potential risks associated with raised PSA results, providing recommendations about a 2 week-wait referral or involving current urology teams.

Resource type:

Base
Optional
Localised


Product

This protocol is part of the PCIT toolset product

What does it do?

  • Runs when loading the medical notes.
  • Corrects the PSA by doubling the value if a man is also on a 5-Alpha-Reductase-Inhibitor, ensuring the risk isn't overlooked.
  • In patients without established cancer,
    • alerts are shown if the corrected PSA is raised (3-20) or over 20,
    • a check is made for coded urology input and referenced in the alert,
    • NICE guidance is referenced and recommendations made in line with this,
    • Reminds the practitioner about the other signs, symptoms and scenarios where prostate cancer needs to be considered
    • Both age linked reference ranges (NICE & British Association of Urological Surgeons) and absolute values (CtheSigns), are used to make recommendations about 2 week wait referral. This acknowledges regional variations around referral thresholds.
  • In patients with established prostate cancer,
    • A history of PSA results is presented in the alert itself, allowing the practitioner to quickly spot the trend and act on recommendations,
    • Cancer date and diagnosis is shown,
    • Latest significant intervention dates and procedure codes are shown, including radiotherapy and prostatectomy,
    • If treatment intent has been coded, this is presented in the alert, for example "watchful waiting",
    • If bone pain symptoms have been recently coded, this is shown in the alert, to raise the possibility of metastatic disease

Why is it important?

This is designed to improve the detection of prostate cancer and spot progression of established prostate cancer.  The alert informs a user about the status of the patients PSA testing.   It aims to quickly draw attention to potential risks associated with PSA results, making recommendations about 2 week wait referrals or involving current urology team.  

What does it look like?

See below screenshot displaying an example of the protocol alert:



If you double click on the alert it will take you to a template where you can add structured and useful information that may be relevant to the patients needs and care:


How to get it

You can request this resource in the PCIT Hub in the optional handy protocol section. Alternatively you can click here to submit a ticket to request it.


System Dependencies

This protocol is dependent on accurate coded information within EMIS web, especially PSA levels and diagnoses of prostate related issues as well as contemporaneously recording medication issues. 


System Triggers

System trigger: Load patient record
Run mode: Always run
Enable trigger for: All job categories, unless you wish for this protocol alert to only show for specific team members.



Change management considerations

Prior to activating this protocol alert, we would advise that your team are aware that this alert will show for patients who have had prostate cancer previously, or appear to be at risk of prostate related issues. It may be worth the relevant team members reading this support article to fully understand the protocol alert.


HP current version number: 8.0.2

Published 10/11/2022.
Initial release




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