The Use of a Mobile Application to Disseminate Guidelines on Cystic Neoplasms of the Pancreas: A Snapshot Study of 1000 Case-Simulations

Abstract

Introduction: The existence of pancreatic cystic neoplasm (PCN) management guidelines is acknowledged by the European scientific community. However, no data exist on their actual application in clinical practice. Our aim is to implement PCN guidelines dissemination through a mobile application. Methods: iCyst is a digital tool providing access to the three main existing guidelines (European evidence-based, IAP, and AGA). Through a case simulation system, for one year, the app prospectively registered users’ guideline choice. Results: During the study period, 276 users downloaded iCyst and entered 1,020 completed simulations. Most users were European (88%) and were either surgeons (69%) or gastroenterologists (29%). Six different representative scenarios were identified among the simulated cases. Overall, the European guidelines were the most commonly preferred guidelines (52%). In 16% of cases, the users did not choose any of the available guidelines. The rate of users not following any of the guidelines markedly increased in scenarios pertaining to unfitness for surgery or cyst growth rate (p < 0.05). Conclusion: Digital apps can be used to disseminate guidelines in clinical practice. Guideline dissemination might serve as the basis for future research lines on specific clinical scenarios that iCyst identifies as critical among practitioners involved in pancreatic cystic neoplasm treatment.