Evidence map›Paper›PMID 23564936›Full record

ArticleBMJ open2013

Cost-effectiveness and quality of life in surgeon versus general practitioner-organised colon cancer surveillance: a randomised controlled trial.

Knut Magne Augestad, Jan Norum, Stefan Dehof, Ranveig Aspevik, Unni Ringberg, Torunn Nestvold, Barthold Vonen, Stein Olav Skrøvseth, Rolv-Ole Lindsetmo

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00572143 (Should the Surgeon or the General Practitioner), which is not on this map. Cited by 52 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 11 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.

NCT00572143 nacompletednot on this map

Should the Surgeon or the General Practitioner (GP) Follow up Patients After Surgery for Colon Cancer? A Randomized Controlled Trial Focusing on Quality of Life, Cost-effectiveness and Serious Clinical Events.

TypeinterventionalSponsorUniversity Hospital of North NorwayRan2007 to 2013Enrolled180ConditionsColon CancerArmsca coli follow-up by GP
3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 11 syntheses or guidelines pooled it.

  1. Pooled it
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  5. Survivorship care for cancer patients in primary versus secondary care: a systematic review.Journal of cancer survivorship : research and practice · 2021
    Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. The role of the GP in follow-up cancer care: a systematic literature review.Journal of cancer survivorship : research and practice · 2016
    Pooled it
  10. Pooled it
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  12. Trial
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  15. Quality of early prostate cancer follow-up care from the patients' perspective.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
    Trial
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  18. Cost effectiveness of a web-based decision aid for parents deciding about MMR vaccination: a three-arm cluster randomised controlled trial in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014
    Trial
  19. Trial
  20. Patient-reported outcomes and measures applied in individuals undergoing colonoscopy surveillance for colorectal cancer: a scoping review.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
    Article
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

9 authors.

Knut Magne AugestadNorwegian Center of Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway.
Jan Norum
Stefan Dehof
Ranveig Aspevik
Unni Ringberg
Torunn Nestvold
Barthold Vonen
Stein Olav Skrøvseth
Rolv-Ole Lindsetmo

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess whether colon cancer follow-up can be organised by general practitioners (GPs) without a decline in the patient's quality of life (QoL) and increase in cost or time to cancer diagnoses, compared to hospital follow-up.

designRandomised controlled trial.

settingNorthern Norway Health Authority Trust, 4 trusts, 11 hospitals and 88 local communities.

participantsPatients surgically treated for colon cancer, hospital surgeons and community GPs.

intervention24-month follow-up according to national guidelines at the community GP office. To ensure a high follow-up guideline adherence, a decision support tool for patients and GPs were used.

main outcome measuresPrimary outcomes were QoL, measured by the global health scales of the European Organisation for Research and Treatment of Cancer QoL Questionnaire (EORTC QLQ C-30) and EuroQol-5D (EQ-5D). Secondary outcomes were cost-effectiveness and time to cancer diagnoses.

results110 patients were randomised to intervention (n=55) or control (n=55), and followed by 78 GPs (942 follow-up months) and 70 surgeons (942 follow-up months), respectively. Compared to baseline, there was a significant improvement in postoperative QoL (p=0.003), but no differences between groups were revealed (mean difference at 1, 3, 6, 9, 12, 15, 18, 21 and 24-month follow-up appointments): Global Health; Δ-2.23, p=0.20; EQ-5D index; Δ-0.10, p=0.48, EQ-5D VAS; Δ-1.1, p=0.44. There were no differences in time to recurrent cancer diagnosis (GP 35 days vs surgeon 45 days, p=0.46); 14 recurrences were detected (GP 6 vs surgeon 8) and 7 metastases surgeries performed (GP 3 vs surgeon 4). The follow-up programme initiated 1186 healthcare contacts (GP 678 vs surgeon 508), 1105 diagnostic tests (GP 592 vs surgeon 513) and 778 hospital travels (GP 250 vs surgeon 528). GP organised follow-up was associated with societal cost savings (£8233 vs £9889, p<0.001).

conclusionsGP-organised follow-up was associated with no decline in QoL, no increase in time to recurrent cancer diagnosis and cost savings.

trial registrationClinicalTrials.gov identifier NCT00572143.

Identifiers

PMID23564936
PMCPMC3641467

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Registered trials

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.