Trial reportPostgraduate medical journal2002
Investigation and management of iron deficiency anaemia in general practice: a cluster randomised controlled trial of a simple management prompt.
Trial report in Postgraduate medical journal, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Decision support tools to improve cancer diagnostic decision making in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Pooled it
- Approach to gastroenterological diseases in primary care.Acta bio-medica : Atenei Parmensis · 2018Pooled it
- Interventions to reduce primary care delay in cancer referral: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Pooled it
- Positive predictive values of ≥5% in primary care for cancer: systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Pooled it
- Electronic clinical decision support tool for assessing stomach symptoms in primary care (ECASS): a feasibility study.BMJ open · 2021Trial
- Prevalence and patterns of testing for anaemia in primary care in England: a cohort study using an electronic health records database.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Associations between red blood cell indices and iron status and neurocognitive function in young adults: Evidence from memory and executive function tests and event-related potentials.Annals of the New York Academy of Sciences · 2022Article
- Chronic Kidney Disease Prevalence in Patients with Colorectal Cancer Undergoing Surgery.Diagnostics (Basel, Switzerland) · 2022Article
- Optimization of a Quality Improvement Tool for Cancer Diagnosis in Primary Care: Qualitative Study.JMIR formative research · 2022Article
- Cancer risk in persons with new-onset anaemia: a population-based cohort study in Denmark.BMC cancer · 2022Observational
- Diagnostic workup of cancer in patients with new-onset anaemia: a Danish cohort study in general practice.Scandinavian journal of primary health care · 2021Observational
- Insufficient classification of anaemia in general practice: a Danish register-based observational study.Scandinavian journal of primary health care · 2021Observational
- Article
- The evaluation of anaemia in an older primary care population: retrospective population-based study.BJGP open · 2018Article
- Curative resectability of gastrointestinal cancer identified from iron deficiency anemia.Oncology letters · 2017Article
- The yield of colorectal cancer among fast track patients with normocytic and microcytic anaemia.Annals of the Royal College of Surgeons of England · 2014Article
- The role of primary care physicians in early diagnosis and treatment of chronic gastrointestinal diseases.International journal of general medicine · 2014Review
- The role of primary care in early detection and follow-up of cancer.Nature reviews. Clinical oncology · 2014Review
- The importance of anaemia in diagnosing colorectal cancer: a case-control study using electronic primary care records.British journal of cancer · 2008Article
- A cluster randomised controlled trial of educational prompts in diabetes care: study protocol.Implementation science : IS · 2007Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIron deficiency anaemia (IDA) remains the most common cause of anaemia and is frequently secondary to occult gastrointestinal blood loss requiring further investigation. The study was designed to prospectively assess the adequacy of investigation of IDA and to establish whether a simple computerised prompt would increase the completeness of investigation of patients presenting to their general practitioners. PATIENTS AND
methodsAll men aged >20 and women aged >50 newly found to have a probable IDA (n=431) in primary care were randomised according to general practice (n=89) to one of two computer generated prompts, by the haematology laboratories in two large district general hospitals. Data were collected 12 months after the index date. The primary outcome measure was the adequacy of investigation of the cause of anaemia. Multiple logistic regression was used to analyse each binary outcome.
resultsTwo hundred and three (47%) of 431 patients presenting to their general practitioner with an IDA were adequately managed and 140/357 (39%) of patients who were otherwise fit for investigation had no tests at all. Twenty one (17%) of 125 patients who did have adequate investigation at the time of presentation were found to have colorectal cancer. Only 30% of patients had a confirmed diagnosis within 12 months. The prompt did not affect the level of investigation (odds ratio 0.88, 95% confidence interval (CI) 0.60 to 1.29, p=0.52). The initial prescribing of oral iron was improved (odds ratio 2.19, 95% CI 1.27 to 3.77, p=0.005), but not the documented prescribing of a full therapeutic course or the use of follow up blood counts.
conclusionsThe investigation and management of IDA presenting in general practice remains inadequate and is not improved by a simple management prompt.
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