About this tool. The Recall Engine is a free clinical decision support tool for gastroenterologists managing post-colonoscopy surveillance. It combines USMSTF 2020 surveillance logic with pathway-aware interval calculation and patient-facing recall letter generation. Built by a practicing gastroenterologist. Made freely available by the team behind DropCharge — a voice-to-billing platform for procedural physicians.

Disclaimer. This tool is a clinical decision support aid for gastroenterologists. It is not a substitute for independent clinical judgment, is not FDA-cleared, and has not been independently validated. All recommendations should be verified against current society guidelines and adapted to the individual patient. The treating physician is solely responsible for final recall interval decisions and patient communications.

Privacy. The Recall Engine does not collect, transmit, or store patient-identifiable information. There is no name, MRN, or identifier field in the tool. All processing runs locally in the browser. The tool makes no network requests, uses no analytics, and saves no cookies. Your letter customization settings are stored only in your browser's local storage on this device. The generated letter uses *** as a fill-in marker for the patient's name; the physician replaces *** with the name before sending (in Epic, F2 navigates between *** wildcards). The tool never sees or stores the name.

Scope. Surveillance intervals are based primarily on the 2020 US Multi-Society Task Force (USMSTF) recommendations, with pathway logic for piecemeal resection follow-up, APC I1307K, serrated polyposis syndrome, and family history. Patients with IBD, personal history of CRC, or hereditary CRC syndromes (FAP, Lynch, MUTYH-associated polyposis) require individualized surveillance plans beyond the scope of this tool.

Key References

• Gupta S, Lieberman D, Anderson JC, et al. Recommendations for follow-up after colonoscopy and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology 2020;158(4):1131–1153. doi:10.1053/j.gastro.2019.10.026
• Gupta S, Lieberman D, Anderson JC, et al. Recommendations for follow-up after colonoscopy and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer. Gastrointest Endosc 2020;91(3):463–485.e5. doi:10.1016/j.gie.2020.01.014
• Davidson KW, Barry MJ, Mangione CM, et al. US Preventive Services Task Force. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 2021;325(19):1965–1977. doi:10.1001/jama.2021.6238
• Shaukat A, Kahi CJ, Burke CA, Rabeneck L, Sauer BG, Rex DK. ACG Clinical Guidelines: Colorectal Cancer Screening 2021. Am J Gastroenterol 2021;116(3):458–479. doi:10.14309/ajg.0000000000001122
• Dekker E, Bleijenberg A, Balaguer F, et al. Update on the World Health Organization Criteria for Diagnosis of Serrated Polyposis Syndrome. Gastroenterology 2020;158(6):1520–1523. doi:10.1053/j.gastro.2019.11.310
• Mankaney G, Rouphael C, Burke CA. Serrated Polyposis Syndrome. Clin Gastroenterol Hepatol 2020;18(4):777–779. doi:10.1016/j.cgh.2019.09.006
• Bleijenberg AGC, IJspeert JEG, van Herwaarden YJ, et al. Personalised surveillance for serrated polyposis syndrome: results from a prospective 5-year international cohort study. Gut 2020;69(1):112–121. doi:10.1136/gutjnl-2018-318134
• National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Genetic/Familial High-Risk Assessment: Colorectal, Endometrial, and Gastric. Version 3.2024 — APC I1307K surveillance recommendation (colonoscopy every 5 years from age 40).
• Valle L, Katz LH, Latchford A, et al. Position statement of the International Society for Gastrointestinal Hereditary Tumours (InSiGHT) on APC I1307K and cancer risk. J Med Genet 2023;60(11):1035–1043. doi:10.1136/jmg-2022-108984
• CMS Quality Measure #185: Colonoscopy Interval for Patients with a History of Adenomatous Polyps – Avoidance of Inappropriate Use (2024 specifications).

Feedback. Issues, errors, or suggestions welcome at admin@dropcharge.app.