Using Re-aim to Identify Implementation Determinants of Cardiovascular Risk Stratification Score for Patients With Prostate Cancer
Year: 2025
Type: preprint
Study design: Observational Study
Abstract: Background Cardiovascular disease (CVD) remains the leading cause of death among patients with prostate cancer. While the American Heart Association’s PREVENT Score offers a comprehensive lab-based CVD risk prediction model, its integration into oncology workflows is hindered by logistical barriers. To address this gap, the GUHA-STABELLINI Score was developed as a simplified, lab-independent tool tailored for use in specialty care settings. Objective To evaluate physician preferences, implementation feasibility, and contextual fit of the GUHA-STABELLINI versus PREVENT Score using the RE-AIM (i.e., Reach, Effectiveness, Adoption, Implementation, and Maintenance) model. Methods A cross-sectional survey was administered to 45 oncology-specialized physicians across academic and community settings. The survey, structured around RE-AIM domains, assessed preferences, implementation perceptions, and perceived effectiveness of each tool. Quantitative responses were analyzed descriptively, and qualitative comments were thematically coded. Results A significant majority (93%) of respondents preferred the GUHA-STABELLINI Score over PREVENT, citing its ease of use and alignment with clinical workflows. Across RE-AIM domains, GUHA-STABELLINI scored highly in adaptability (71%), cost/resource feasibility (65%), perceived effectiveness (87%), and equity of reach and outcomes (75% and 73%, respectively). Respondents emphasized the tool’s real-time usability, low resource dependency, and ability to facilitate shared decision-making without laboratory input. Conclusions Despite marginally lower predictive precision, the GUHA-STABELLINI Score demonstrates superior feasibility, reach, and clinical utility within oncology clinics. Findings highlight the importance of implementation-informed design in developing decision support tools. Future research should focus on validating clinical outcomes and expanding use across specialties. The GUHA-STABELLINI Score serves as a model for pragmatic, specialty-integrated preventive care solutions in resource-constrained environments. Question Among oncology-specialized physicians, does the simplified and laboratory-independent GUHA-STABELLINI cardiovascular risk score offer superior perceived implementability and clinical utility compared with the AHA PREVENT Score for prostate cancer patients on androgen deprivation therapy? Findings In this cross-sectional survey of 45 physicians, 93% preferred the GUHA-STABELLINI Score over the AHA PREVENT Score. Respondents rated GUHA-STABELLINI as highly adaptable to workflow (71%), cost- and resource-feasible (65%), and likely to be effective (87%) and equitable in reach (75%), despite its slightly lower predictive precision. Meaning A context-aligned, low-burden cardiovascular risk tool such as GUHA-STABELLINI may achieve greater clinical uptake in oncology settings than more complex laboratory-dependent models, highlighting the central role of implementation-informed design in successful adoption.
Source: medRxiv
Authors: Harikrishnan Hyma Kunhiraman, Aaron J Kruse-Diehr, Phillip J Koo, Pedro Barata, Sagar A Patel, Andrew John Armstrong, Umang Swami, Alicia K. Morgans, Joshi Alumkal, Andrew W. Hahn, Ganesh Palapattu, Zachary Klaassen, Himisha Beltran, Irbaz B. Riaz, Soumyajit Roy, Kelvin Moses, Ashanda R Esdaille, Michael R. Harrison, Neeraj Agarwal, Avirup Guha
Institutions: Augusta University, Augusta University Health, Prostate Cancer Foundation, University Hospitals Seidman Cancer Center, Emory University, Winship Cancer Institute, Duke University, Duke Medical Center, University of Utah, Huntsman Cancer Institute, Harvard University, Dana-Farber Cancer Institute, University of Michigan, U-M Rogel Cancer Center, The University of Texas MD Anderson Cancer Center, Michigan Medicine, Mayo Clinic Hospital, Mayo Clinic Comprehensive Cancer Center (Arizona), Rush University, Vanderbilt University, Vanderbilt University Medical Center, Duke University Hospital, Duke Cancer Institute
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7116404192