Availability of cancer decision-support tools: A cross-sectional survey of UK primary care
Price, SJ; Spencer, A; Medina-Lara, A; et al.Hamilton, W
Date: 7 May 2019
Journal
British Journal of General Practice
Publisher
Royal College of General Practitioners
Publisher DOI
Abstract
Background Decision-support tools quantify the risk of undiagnosed cancer in symptomatic patients, and may help general practitioners (GPs) when making referrals.
Aims: To quantify the availability and use of cancer decision-support tools (QCancer® and Risk Assessment Tools). To explore the association between tool availability and ...
Background Decision-support tools quantify the risk of undiagnosed cancer in symptomatic patients, and may help general practitioners (GPs) when making referrals.
Aims: To quantify the availability and use of cancer decision-support tools (QCancer® and Risk Assessment Tools). To explore the association between tool availability and two-week-wait referrals for suspected cancer.
Design and setting: Cross-sectional postal survey in UK primary care.
Methods: 4,600 GPs from a random sample of 975 UK general practices were invited to participate. Outcome measures included the proportions of UK general practices where: (1) cancer decision-support tools are available, and (2) at least one GP uses the tool. Weighted least-squares linear regression with robust errors tested the association between tool availability and number of two-week-wait referrals, adjusting for practice size, sex, age and index of multiple deprivation.
Results: 476 GPs in 227 practices responded (response rates: practitioner, 10.3%; practice, 23.3%). Cancer decision-support tools were available in 83/227 (36.6%, 95% confidence interval 30.3% to 43.1%) practices. Tools were available and likely to be used in 38/227 (16.7%, 12.1% to 22.2%) practices. In sub-group analyses of 172 English practices, there was no difference in mean two-week-wait referral rate between practices with tools and those without (mean adjusted difference in referrals per 100,000: 3.1, -5.5 to +11.7).
Conclusions: This is the first survey of cancer decision-support tool availability and use. It suggests that the tools are an underused resource in the UK. Given the cost of cancer investigation, a randomised controlled trial of such clinical decision-support aids would be appropriate.
Institute of Health Research
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