Evidence map›Paper›PMID 25231496›Full record

Trial reportBMJ open2014

The Improving Rural Cancer Outcomes (IRCO) Trial: a factorial cluster-randomised controlled trial of a complex intervention to reduce time to diagnosis in rural patients with cancer in Western Australia: a study protocol.

Jon D Emery, Victoria Gray, Fiona M Walter, Shelley Cheetham, Emma J Croager, Terry Slevin, Christobel Saunders, Tim Threlfall, Kirsten Auret, Anna K Nowak and 3 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
1.2field-weighted citation impact, top 20% 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

11 citing papers in PubMed, 22 citations in OpenAlex.

  1. Trial
  2. Educational Interventions to Reduce Cancer Diagnostic Delays in Primary Care: A Scoping Review.Journal of cancer education : the official journal of the American Association for Cancer Education · 2026
    Review
  3. Article
  4. Regionalization of esophagectomy: where are we now?Journal of thoracic disease · 2019
    Review
  5. Article
  6. Availability and use of cancer decision-support tools: a cross-sectional survey of UK primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019
    Article
  7. Article
  8. Frontiers in public health · 2018
    Review
  9. Article
  10. Improving early diagnosis of symptomatic cancer.Nature reviews. Clinical oncology · 2016
    Review
  11. 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

13 authors at 6 institutions in 2 countries.

Jon D EmeryGeneral Practice and Primary Health Care Academic Centre, Melbourne Medical School, The University of Melbourne, Melbourne, Australia School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Crawley, Australia.ORCID http://orcid.org/0000-0002-5274-6336
Victoria GraySchool of Primary, Aboriginal and Rural Health Cancer, The University of Western Australia, Crawley, Australia School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia Education and Research Division, Cancer Council Western Australia, Perth, Western Australia, Australia.
Fiona M WalterThe Primary Care Unit, Department of Public Health & Primary Care, University of Cambridge, Cambridge, UK.
Shelley CheethamSchool of Primary, Aboriginal and Rural Health Cancer, The University of Western Australia, Crawley, Australia.
Emma J CroagerEducation and Research Division, Cancer Council Western Australia, Perth, Western Australia, Australia Centre for Behavioural Research in Cancer Control, Curtin University, Perth, Western Australia, Australia.
Terry SlevinEducation and Research Division, Cancer Council Western Australia, Perth, Western Australia, Australia Centre for Behavioural Research in Cancer Control, Curtin University, Perth, Western Australia, Australia.
Christobel SaundersSchool of Surgery, The University of Western Australia, Perth, Western Australia, Australia.
Tim ThrelfallThe Department of Health of Western Australia, Western Australia Cancer Registry, Australia.
Kirsten AuretRural Clinical School of WA, The University of Western Australia, Perth, Western Australia, Australia.
Anna K NowakSchool of Medicine and Pharmacology, The University of Western Australia, Crawley, Australia.
Elizabeth GeelhoedSchool of Population Health, The University of Western Australia, Crawley, Western Australia, Australia.
Max BulsaraInstitute of Health and Rehabilitation Research, Notre Dame University, Freemantle, Australia.
C D'Arcy J HolmanSchool of Population Health, The University of Western Australia, Crawley, Western Australia, Australia.
The University of Western Australia · AUCurtin University · AUGovernment of Western Australia Department of Health · AUThe University of Melbourne · AUThe University of Notre Dame Australia · AUUniversity of Cambridge · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWhile overall survival for most common cancers in Australia is improving, the rural-urban differential has been widening, with significant excess deaths due to lung, colorectal, breast and prostate cancer in regional Australia. Internationally a major focus on understanding variations in cancer outcomes has been later presentation to healthcare and later diagnosis. Approaches to reducing time to diagnosis of symptomatic cancer include public symptom awareness campaigns and interventions in primary care to improve early cancer detection. This paper reports the protocol of a factorial cluster-randomised trial of community and general practice (GP) level interventions to reduce the time to diagnosis of cancer in rural Western Australia (WA). METHODS AND ANALYSIS: The community intervention is a symptom awareness campaign tailored for rural Australians delivered through a community engagement model. The GP intervention includes a resource card with symptom risk assessment charts and local referral pathways implemented through multiple academic detailing visits and case studies. Participants are eligible if recently diagnosed with breast, colorectal, lung or prostate cancer who reside in specific regions of rural WA with a planned sample size of 1350. The primary outcome is the Total Diagnostic Interval, defined as the duration from first symptom (or date of cancer screening test) to cancer diagnosis. Secondary outcomes include cancer stage, healthcare utilisation, disease-free status, survival at 2 and 5 years and cost-effectiveness. ETHICS AND DISSEMINATION: Ethics approval has been granted by the University of Western Australia and from all relevant hospital recruitment sites in WA.

resultsResults of this trial will be reported in peer-reviewed publications and in conference presentations. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12610000872033.

Indexed as

AdultCost-Benefit AnalysisEarly DiagnosisGeneral PractitionersHumansNeoplasmsQuality ImprovementRisk FactorsRural Health ServicesSurveys and QuestionnairesSurvival AnalysisTime FactorsWestern AustraliaMEDICAL EDUCATION & TRAININGPRIMARY CAREPUBLIC HEALTH

Identifiers

PMID25231496
PMCPMC4166137
OpenAlexW2096114669

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.