Trial reportPloS one2014
Implementing direct access to low-dose computed tomography in general practice--method, adaption and outcome.
Trial report in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01527214 (The Effect of Direct Referral for Fast CT Scan in Early Lung Cancer Detection in General Practice. Clinical, Randomised Trial), which is not on this map. Cited by 18 papers, 3 of them syntheses that pooled 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.
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.
The Effect of Direct Referral for Fast CT Scan in Early Lung Cancer Detection in General Practice. Clinical, Randomised Trial
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- A systematic review of interventions to recognise, refer and diagnose patients with lung cancer symptoms.NPJ primary care respiratory medicine · 2022Pooled it
- Pooled it
- Direct access cancer testing in primary care: a systematic review of use and clinical outcomes.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- Patient understanding and acceptability of an early lung cancer diagnosis trial: a qualitative study.Trials · 2018Trial
- Immediate chest X-ray for patients at risk of lung cancer presenting in primary care: randomised controlled feasibility trial.British journal of cancer · 2017Trial
- The effect of direct access to CT scan in early lung cancer detection: an unblinded, cluster-randomised trial.BMC cancer · 2015Trial
- A geographical cluster randomised stepped wedge study of continuing medical education and cancer diagnosis in general practice.Implementation science : IS · 2014Trial
- Interventions to Improve Timely Detection and Diagnosis of Cancer Among the Adult Population: A Scoping Review.Healthcare (Basel, Switzerland) · 2026Review
- Patient and Healthcare Provider Barriers in the LDCT Lung Cancer Screening Continuum.Diagnostics (Basel, Switzerland) · 2026Review
- Irish general practitioner (GP) perspectives on impact of direct access radiology on patient care in the community: results from a mixed-methods study.Irish journal of medical science · 2024Article
- Article
- Presentation of lung cancer in primary care.NPJ primary care respiratory medicine · 2019Article
- Recognising Lung Cancer in Primary Care.Advances in therapy · 2019Review
- General practice consultations, diagnostic investigations, and prescriptions in the year preceding a lung cancer diagnosis.Cancer medicine · 2017Article
- Impact of continuing medical education in cancer diagnosis on GP knowledge, attitude and readiness to investigate - a before-after study.BMC family practice · 2016Article
- Pre-referral GP consultations in patients subsequently diagnosed with rarer cancers: a study of patient-reported data.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016Article
- A differentiated approach to referrals from general practice to support early cancer diagnosis - the Danish three-legged strategy.British journal of cancer · 2015Article
- Understanding missed opportunities for more timely diagnosis of cancer in symptomatic patients after presentation.British journal of cancer · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly detection of lung cancer is crucial as the prognosis depends on the disease stage. Chest radiographs has been the principal diagnostic tool for general practitioners (GPs), but implies a potential risk of false negative results, while computed tomography (CT) has a higher sensitivity. The aim of this study was to describe the implementation of direct access to low-dose CT (LDCT) from general practice.
methodsWe conducted a cohort study nested in a randomised study. A total of 119 general practices with 266 GPs were randomised into two groups. Intervention GPs were offered direct access to chest LDCT combined with a Continuing Medical Education (CME) meeting on lung cancer diagnosis.
resultsDuring a 19-month period, 648 patients were referred to LDCT (0.18/1000 adults on GP list/month). Half of the patients needed further diagnostic work-up, and 15 (2.3%, 95% CI: 1.3-3.8%) of the patients had lung cancer; 60% (95% CI: 32.3-83.7%) in a localised stage. The GP referral rate was 61% higher for CME participants compared to non-participants.
conclusionOf all patients referred to LDCT, 2.3% were diagnosed with lung cancer with a favourable stage distribution. Half of the referred patients needed additional diagnostic work-up. There was an association between participation in CME and use of CT scan. The proportion of cancers diagnosed through the usual fast-track evaluation was 2.2 times higher in the group of CME-participating GPs. The question remains if primary care case-finding with LDCT is a better option for patients having signs and symptoms indicating lung cancer than a screening program. Whether open access to LDCT may provide earlier diagnosis of lung cancer is yet unknown and a randomised trial is required to assess any effect on outcome.
trial registrationClinicaltrials.gov NCT01527214.
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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.