Evidence map›Paper›PMID 20360221›Full record

SynthesisBMJ (Clinical research ed.)2010

Value of symptoms and additional diagnostic tests for colorectal cancer in primary care: systematic review and meta-analysis.

Petra Jellema, Daniëlle A W M van der Windt, David J Bruinvels, Christian D Mallen, Stijn J B van Weyenberg, Chris J Mulder, Henrica C W de Vet

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
77citing papers in PubMed, 14 pooled it
–field-weighted citation impact
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

77 citing papers in PubMed, 14 syntheses or guidelines pooled it.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Weight loss as a predictor of cancer in primary care: a systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018
    Pooled it
  6. Pooled it
  7. Pooled it
  8. Guideline
  9. Pooled it
  10. Systematic review of clinical features of suspected colorectal cancer in primary care.Canadian family physician Medecin de famille canadien · 2014
    Pooled it
  11. Pooled it
  12. Pooled it
  13. The diagnostic value of symptoms for colorectal cancer in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011
    Pooled it
  14. 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 · 2010
    Pooled it
  15. Trial
  16. Trial
  17. Trial
  18. Identifying patients with suspected colorectal cancer in primary care: derivation and validation of an algorithm.The British journal of general practice : the journal of the Royal College of General Practitioners · 2012
    Trial
  19. Article
  20. Observational

17 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Petra JellemaDepartment of General Practice, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands.
Daniëlle A W M van der Windt
David J Bruinvels
Christian D Mallen
Stijn J B van Weyenberg
Chris J Mulder
Henrica C W de Vet

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo summarise available evidence on diagnostic tests that might help primary care physicians to identify patients with an increased risk for colorectal cancer among those consulting for non-acute lower abdominal symptoms. DATA SOURCES: PubMed, Embase, and reference screening. Study eligibility criteria Studies were selected if the design was a diagnostic study; the patients were adults consulting because of non-acute lower abdominal symptoms; tests included signs, symptoms, blood tests, or faecal tests. Study appraisal and synthesis methods Two reviewers independently assessed quality with a modified version of the QUADAS tool and extracted data. We present diagnostic two by two tables and pooled estimates of sensitivity and specificity. We refrained from pooling when there was considerable clinical or statistical heterogeneity.

results47 primary diagnostic studies were included. Sensitivity was consistently high for age >or=50 (range 0.81-0.96, median 0.91), a referral guideline (0.80-0.94, 0.92), and immunochemical faeces tests (0.70-1.00, 0.95). Of these, only specificity of the faeces tests was good. Specificity was consistently high for family history (0.75-0.98, 0.91), weight loss (0.72-0.96, 0.89), and iron deficiency anaemia (0.83-0.95, 0.92), but all tests lacked sensitivity. None of these six tests was (sufficiently) studied in primary care.

conclusionsAlthough combinations of symptom and results of immunochemical faeces tests showed good diagnostic performance for colorectal cancer, evidence from primary care is lacking. High quality studies on their role in the diagnostic investigation of colorectal cancer in primary care are urgently needed.

Indexed as

AdultAgedColorectal NeoplasmsGastrointestinal HemorrhageHumansMiddle AgedOccult BloodPedigreeQuality Assurance, Health CareRectal DiseasesReferral and ConsultationRisk AssessmentRisk FactorsSensitivity and SpecificityWeight Loss

Identifiers

PMID20360221
PMCPMC2848719

What OpenQuestion holds

Textmetadata
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.