Table 1.

Three Iterations of FIT Daily Report Criteria—Definitions (D), Parameters (P), and Rationales (R)

First IterationSecond IterationThird Iteration*Definitions, Parameters, and Rationales
AgeAgeAgeD:Age at the time of making the appointment.
P:Range for patients ‘greater than or equal to 50 years and less than or equal to 85 years.’
Appointment ProcedureD:Procedure code designating the specific procedure to be included.
P:Set to equal the scheduling code for the general global colonoscopy procedure ENDO COLONOSCOPY [1685], i.e., ‘equal to 1685.’
R:Used the one procedure code IT provided.
Appointment Procedure (revised)Appointment ProcedureP:Added more colonoscopy procedure codes to include 11 discrete codes for the study.
R:Initially unaware there were 21 procedure codes, used additional appropriate codes to capture all eligible patients.
Appointment StatusD:The patient’s appointment status, e.g., scheduled, cancelled, arrived, was bumped.
P:Set as ‘equal to Scheduled.’
R:Initially unaware could capture appointment changes, such as cancelled.
Appointment Status (deleted)n/aR:FIT Daily Report would output duplicates of the same appointments every time the report was run if the ‘Scheduled’ appointment fell within the specified Date Range. Replaced with Appointment Made on Date and Contact Type (below).
Date RangeD:Range of days from which the algorithm searches for colonoscopy appointments.
P:Set as ‘from W + 3 to W + 12’ (21 to 84 or 85 days out from when the FIT Daily Report was run).
R:This date range was set to send an invitation to eligible patients so stool specimen could be obtained before colonoscopy prep and within 4 months of scheduled colonoscopy.
Date Range (revised)P:Set as ‘from W + 4 to W + 8’ (29 to 56 days out from when the FIT Daily Report was run).
R:The recruitment start timeframe was extended to allow for subject and study mailings.
Date Range (revised)D:Range of days from which the algorithm searches for colonoscopy appointment. Set as ‘from T-1 to Y + 4’ (from the day before the FIT Daily Report was run to 4 years out, the maximum allowed upper bound in Epic Reporting Workbench).
P:The second iteration of the criterion missed appointments that were rescheduled beyond 56 days. Expanding the interval to encompass all reasonable dates on which the colonoscopies could be scheduled ensured that all scheduling changes could be tracked by researchers.
R:Enforcing the recruitment timeframe (where colonoscopy appointment is between W + 4 and W + 8) was relegated to the Tracking Database.
Encounter DepartmentD:Code identifying the department and location of the room where the patient would encounter the colonoscopy.
P:Set as ‘equal to Med GI/Hepatology Procedure Unit [10401129].’
R:IT provided one procedure unit code.
Encounter Department (revised)Encounter DepartmentP:Expanded to include a total of 3 locations where colonoscopies were performed.
R:To increase number of eligible patients.
Appointment Made on Date (added)Appointment Made on DateD:Constrains the algorithm to search for appointments made within a specified date range.
P:Set to ‘equal to T-1’ (or T-3 on Monday), so that only appointments made on the previous business day are captured.
R:Eliminated multiple outputs of the same appointment. Ensured all newly made appointments would be captured.
Appointment Cancel Date (added)D:Constrains the algorithm to search for appointments cancelled within a specified date range.
P:Set to ‘equal to T-1’ (or T-3 on Monday), so that only appointments cancelled on the previous business day are captured.
R:Appointment Cancel Date restricted the FIT Daily Report to only capture cancellations that were made for appointments made and cancelled on T-1 (or T-3 on Monday), missing cancellations for appointments not made on that day. To capture all cancelled appointments a new report “FIT Daily Cancellations Report” was created to be run alongside the FIT Daily Report, where Appointment Cancel Date replaced Appointment Made on Date.
Contact Type (added)D:Type of contact patient had with hospital (115 types, such as ‘Admission,’ ‘Documentation,’ and ‘Nursing Home Visit’).
P:Set to include only ‘Appointment’ to imitate the function of Appointment Status. Epic IT staff recommended this criterion be added to make the algorithm run faster.
R:The FIT Daily Report would have run correctly without this criterion but adding an additional restriction greatly reduced the population of patients to be filtered through the algorithm.
Contact Type (revised)P:Expanded to also include ‘Hospital Encounter.’
R:Some colonoscopy reschedules were not being tracked after cancellation. Scheduling staff at the gastroenterology clinic explained that Contact Type ‘Appointment’ captured only outpatient scheduling of the procedures. Expanding to include ‘Hospital Encounter’ captured the missing colonoscopies that were being scheduled as inpatient procedures.
ICD-10 Codes (added)ICD-10 CodesD:Classification of medical diagnoses.
P:Set to ‘does not contain’.
R:175 values to exclude patients with specific conditions from study, such as colitis.
Patient Type (added)Patient TypeD:Special populations, e.g., prisoners, group home residents, student athletes, etc.
P:Set to ‘does not exist’.
R:Excludes all patients with a Patient Type designation. Nursing home residents were removed after manual review as they did not have a Patient Type code.
  • * All Appointments Report did not include the Appointment Made on/Cancel Date criteria, and the Date Range was set as ‘from T to M + 6.’.

  • T, Today; W, Week; M, Month; Y, Year; n/a, not available; IT, information technology; FIT, fecal immunochemical testing; GI, gastroenterology.