Evidence map›Paper›PMID 17700548›Full record

Trial reportBritish journal of cancer2007

The GRAIDS Trial: a cluster randomised controlled trial of computer decision support for the management of familial cancer risk in primary care.

J Emery, H Morris, R Goodchild, T Fanshawe, A T Prevost, M Bobrow, A L Kinmonth

Open access · hybridAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in British journal of cancer, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 16 pooled it
4.2field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 16 syntheses or guidelines pooled it, 110 citations in OpenAlex.

  1. Pooled it
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  3. Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024
    Pooled it
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  5. Effect of genetics clinical decision support tools on health-care providers' decision making: a mixed-methods systematic review.Genetics in medicine : official journal of the American College of Medical Genetics · 2021
    Pooled it
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  7. Genetic cancer risk assessment in general practice: systematic review of tools available, clinician attitudes, and patient outcomes.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019
    Pooled it
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  9. Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2017
    Pooled it
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  12. Referral interventions from primary to specialist care: a systematic review of international evidence.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014
    Pooled it
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  16. Clinical decision support for genetically guided personalized medicine: a systematic review.Journal of the American Medical Informatics Association : JAMIA
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

J EmeryGeneral Practice, School of Primary, Aboriginal and Rural Health Care, University of Western Australia, 328 Stirling Highway, Claremont, Western Australia 6010, Australia. jon.emery@uwa.edu.au
H Morris
R Goodchild
T Fanshawe
A T Prevost
M Bobrow
A L Kinmonth
University of Cambridge · GBUniversity of Western Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The objective was to evaluate the effect of an assessment strategy using the computer decision support system (the GRAIDS software), on the management of familial cancer risk in British general practice in comparison with best current practice. The design included cluster randomised controlled trial, and involved forty-five general practice teams in East Anglia, UK. Randomised to GRAIDS (Genetic Risk Assessment on the Internet with Decision Support) support (intervention n=23) or comparison (n=22). Training in the new assessment strategy and access to the GRAIDS software (GRAIDS arm) was conducted, compared with an educational session and guidelines about managing familial breast and colorectal cancer risk (comparison) were mailed. Outcomes were measured at practice, practitioner and patient levels. The primary outcome measure, at practice level, was the proportion of referrals made to the Regional Genetics Clinic for familial breast or colorectal cancer that were consistent with referral guidelines. Other measures included practitioner confidence in managing familial cancer (GRAIDS arm only) and, in patients: cancer worry, risk perception and knowledge about familial cancer. There were more referrals to the Regional Genetics Clinic from GRAIDS than comparison practices (mean 6.2 and 3.2 referrals per 10 000 registered patients per year; mean difference 3.0 referrals; 95% confidence interval (CI) 1.2-4.8; P=0.001); referrals from GRAIDS practices were more likely to be consistent with referral guidelines (odds ratio (OR)=5.2; 95% CI 1.7-15.8, P=0.006). Patients referred from GRAIDS practices had lower cancer worry scores at the point of referral (mean difference -1.44 95% CI -2.64 to -0.23, P=0.02). There were no differences in patient knowledge about familial cancer. The intervention increased GPs' confidence in managing familial cancer. Compared with education and mailed guidelines, assessment including computer decision support increased the number and quality of referrals to the Regional Genetics Clinic for familial cancer risk, improved practitioner confidence and had no adverse psychological effects in patients. Trials are registered under N0181144343 in the UK National Research Register.

Indexed as

Decision Making, Computer-AssistedAdultAlgorithmsCluster AnalysisDecision Support Systems, ClinicalEnglandFamily PracticeHealth Knowledge, Attitudes, PracticeHumansMiddle AgedNeoplasmsPractice Patterns, Physicians'Primary Health CareRisk Assessment

Identifiers

PMID17700548
PMCPMC2360348
OpenAlexW2030990782

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.