SynthesisFamily practice2015
Symptomatic diagnosis of cancer of the brain and central nervous system in primary care: a systematic review.
Synthesis in Family practice, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Interventions to reduce the time to diagnosis of brain tumours.The Cochrane database of systematic reviews · 2020Pooled it
- Development of high-throughput ATR-FTIR technology for rapid triage of brain cancer.Nature communications · 2019Trial
- Construction and validation of a risk prediction model for symptom cluster distress in brain tumor patients: a cross-sectional study.BMC cancer · 2025Article
- Analytical Validation and Clinical Sensitivity of the Belay Summit Assay for the Detection of DNA Variants in Cerebrospinal Fluid of Primary and Metastatic Central Nervous System Cancer.The Journal of molecular diagnostics : JMD · 2025Article
- Neuropsychiatric symptoms as early indicators of brain tumors.Archive of clinical cases · 2024Review
- Clinical Presentation and Prognosis.Advances in experimental medicine and biology · 2023Article
- Development and validation of nomograms to predict early death for elderly lung cancer patients.Frontiers in surgery · 2023Article
- Classification and Diagnosis of Adult Glioma: A Scoping Review.Brain & NeuroRehabilitation · 2022Article
- Verbal fluency as a quick and simple tool to help in deciding when to refer patients with a possible brain tumour.BMC neurology · 2022Article
- Article
- Prediagnostic symptoms and signs of adult glioma: the patients' view.Journal of neuro-oncology · 2020Article
- Article
- Missed opportunities for diagnosing brain tumours in primary care: a qualitative study of patient experiences.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Article
- Symptoms in primary care with time to diagnosis of brain tumours.Family practice · 2018Article
- Brain tumor research in the United Kingdom: current perspective and future challenges. A strategy document from the NCRI Brain Tumor CSG.Neuro-oncology practice · 2018Review
- Health care use before a diagnosis of primary intracranial tumor: a Danish nationwide register study.Clinical epidemiology · 2018Article
- Epidemiology of glioma: clinical characteristics, symptoms, and predictors of glioma patients grade I-IV in the the Danish Neuro-Oncology Registry.Journal of neuro-oncology · 2017Article
- Evaluation of matrix metalloproteinase type IV-collagenases in serum of patients with tumors of the central nervous system.Journal of neuro-oncology · 2017Observational
- Nanocarriers Call the Last Shot in the Treatment of Brain Cancers.Technology in cancer research & treatmentReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe performed a systematic review of diagnostic studies of symptomatic patients in primary care to quantify the risk of brain/central nervous system (CNS) cancer in patients presenting in primary care with symptoms that may indicate brain/CNS cancer.
objectiveTo quantify the risk of brain/CNS cancer in symptomatic patients presenting in primary care.
methodsWe searched Medline, Premedline, Embase, the Cochrane Library, Web of Science and ISI Proceedings (1980 to August 2014) and PsychInfo (1980 to February 2013) for diagnostic studies of symptomatic adult patients in primary care. Study quality was assessed using QUADAS-II and data were extracted to calculate the positive predictive values (PPVs) of symptoms, singly or in combination, for brain/CNS cancer.
resultsSix studies with 159938 patients were included. The PPVs of single symptoms were very low with only 'new-onset seizure' being above 1% in patients aged 18 years and above, rising to 2.3% in patients aged 60-69 years. In patients aged 15-24 years, the PPVs for the individual symptoms were also very low, with the highest, also for seizure, being 0.024%, similar to that in children aged 0-14 years of 0.02%. For symptom combinations, none of the PPVs were above 0.39%.
conclusionsAll the symptoms of brain tumours are individually low risk, apart from new-onset epilepsy. This provides a real diagnostic problem, as brain tumours have all the expected features seen with cancer diagnostic delay, with high proportions presenting as an emergency and having had multiple primary care consultations before referral, and the prognosis is poor. Improving these metrics can only be done by liberalizing investigation, although the health economics of that strategy is undetermined.
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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.