Evidence map›Paper›PMID 25734392›Full record

ArticleBritish journal of cancer2015

Implementing a QCancer risk tool into general practice consultations: an exploratory study using simulated consultations with Australian general practitioners.

P P-C Chiang, D Glance, J Walker, F M Walter, J D Emery

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of cancer, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 10 pooled it
2.3field-weighted citation impact, top 10% 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

45 citing papers in PubMed, 10 syntheses or guidelines pooled it, 75 citations in OpenAlex.

  1. Why aren't they used? Systematic review of barriers to implementation of clinical decision support systems for early cancer detection in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Pooled it
  2. Diagnostic Risk Prediction Models for Upper Gastrointestinal Cancers: A Systematic Review.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025
    Pooled it
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  8. Decision support tools to improve cancer diagnostic decision making in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019
    Pooled it
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  11. Comparing GPs' antibiotic prescribing decisions to a clinical prediction rule: an online vignette study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
    Trial
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  13. 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
  14. The 'Hippocratic Oath' for AI-based clinical decision support systems.BMC medical informatics and decision making · 2026
    Article
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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

5 authors at 2 institutions in 1 country.

P P-C ChiangGeneral Practice and Primary Health Care Academic Centre, University of Melbourne, 200 Berkeley Street, Carlton, Victoria 3053, Australia.
D GlanceCentre for Software Practice, University of Western Australia, Crawley, Western Australia 6009, Australia.
J WalkerGeneral Practice and Primary Health Care Academic Centre, University of Melbourne, 200 Berkeley Street, Carlton, Victoria 3053, Australia.
F M Walter1] The Primary Care Unit, Institute of Public Health, University of Cambridge School of Clinical Medicine, Box 113, Cambridge Biomedical Campus, Cambridge CB2 0SR, UK [2] General Practice and Primary Health Care Academic Centre, University of Melbourne, 200 Berkeley Street, Carlton, Victoria 3053, Australia [3] General Practice, School of Primary Aboriginal and Rural Health Care, University of Western Australia, Crawley, Western Australia 6009, Australia.
J D Emery1] General Practice and Primary Health Care Academic Centre, University of Melbourne, 200 Berkeley Street, Carlton, Victoria 3053, Australia [2] General Practice, School of Primary Aboriginal and Rural Health Care, University of Western Australia, Crawley, Western Australia 6009, Australia [3] The Primary Care Unit, Institute of Public Health, University of Cambridge School of Clinical Medicine, Box 113, Cambridge Biomedical Campus, Cambridge CB2 0SR, UK.
University of Melbourne · AUUniversity of Western Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReducing diagnostic delays in primary care by improving the assessment of symptoms associated with cancer could have significant impacts on cancer outcomes. Symptom risk assessment tools could improve the diagnostic assessment of patients with symptoms suggestive of cancer in primary care. We aimed to explore the use of a cancer risk tool, which implements the QCancer model, in consultations and its potential impact on clinical decision making.

methodsWe implemented an exploratory 'action design' method with 15 general practitioners (GPs) from Victoria, Australia. General practitioners applied the risk tool in simulated consultations, conducted semi-structured interviews based on the normalisation process theory and explored issues relating to implementation of the tool.

resultsThe risk tool was perceived as being potentially useful for patients with complex histories. More experienced GPs were distrustful of the risk output, especially when it conflicted with their clinical judgement. Variable interpretation of symptoms meant that there was significant variation in risk assessment. When a risk output was high, GPs were confronted with numerical risk outputs creating challenges in consultation.

conclusionsSignificant barriers to implementing electronic cancer risk assessment tools in consultation could limit their uptake. These relate not only to the design and integration of the tool but also to variation in interpretation of clinical histories, and therefore variable risk outputs and strong beliefs in personal clinical intuition.

Indexed as

Attitude of Health PersonnelDecision Support Systems, ClinicalGeneral PracticePrimary Health CareAdultAgedAustraliaFemaleHumansMaleMiddle AgedNeoplasmsPatient SimulationReferral and ConsultationRisk Assessment

Identifiers

PMID25734392
PMCPMC4385980
OpenAlexW1993857339

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.