Evidence map›Paper›PMID 25734393›Full record

ReviewBritish journal of cancer2015

Understanding missed opportunities for more timely diagnosis of cancer in symptomatic patients after presentation.

G Lyratzopoulos, P Vedsted, H Singh

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review 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 93 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
93citing papers in PubMed, 2 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

93 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Impact of GP gatekeeping on quality of care, and health outcomes, use, and expenditure: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019
    Pooled it
  2. Patient involvement in diagnosing cancer in primary care: a systematic review of current interventions.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018
    Pooled it
  3. Trial
  4. Electronic Trigger-Based Intervention to Reduce Delays in Diagnostic Evaluation for Cancer: A Cluster Randomized Controlled Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2015
    Trial
  5. Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Reframing prevention: A clinician's perspective.The European journal of general practice · 2025
    Article
  11. Article
  12. Article
  13. Observational
  14. Article
  15. Review
  16. Article
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  19. Review
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33 more citing papers are in PubMed but not listed here.

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

3 authors.

G Lyratzopoulos1] Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK [2] Department of Public Health and Primary Care, Cambridge Centre for Health Services Research, University of Cambridge, Institute of Public Health, Forvie Site, Robinson Way, Cambridge CB2 0SR, UK.
P VedstedDepartment of Public Health, Research Unit for General Practice, Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, DK-Bartholins Allé, 8000 Aarhus, Denmark.
H SinghHouston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston TX 77030, US.

Funding

Decision Making and Clinical Work of Test Result Follow-up in Health IT SettingsR01HS022087 · AHRQ · BAYLOR COLLEGE OF MEDICINE · PI SINGH, HARDEEP · 2013 to 2016
$2.0M
AHRQ HHS R01 HS022087AHRQ HHS R01HS022087Cancer Research UK 18180Cancer Research UK A18180Department of Health PDF-2011-04-047
6 · The paper itself

Abstract

The diagnosis of cancer is a complex, multi-step process. In this paper, we highlight factors involved in missed opportunities to diagnose cancer more promptly in symptomatic patients and discuss responsible mechanisms and potential strategies to shorten intervals from presentation to diagnosis. Missed opportunities are instances in which post-hoc judgement indicates that alternative decisions or actions could have led to more timely diagnosis. They can occur in any of the three phases of the diagnostic process (initial diagnostic assessment; diagnostic test performance and interpretation; and diagnostic follow-up and coordination) and can involve patient, doctor/care team, and health-care system factors, often in combination. In this perspective article, we consider epidemiological 'signals' suggestive of missed opportunities and draw on evidence from retrospective case reviews of cancer patient cohorts to summarise factors that contribute to missed opportunities. Multi-disciplinary research targeting such factors is important to shorten diagnostic intervals post presentation. Insights from the fields of organisational and cognitive psychology, human factors science and informatics can be extremely valuable in this emerging research agenda. We provide a conceptual foundation for the development of future interventions to minimise the occurrence of missed opportunities in cancer diagnosis, enriching current approaches that chiefly focus on clinical decision support or on widening access to investigations.

Indexed as

Delayed DiagnosisHumansNeoplasmsReferral and Consultation

Identifiers

PMID25734393
PMCPMC4385981

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.