Evidence map›Paper›PMID 27044367›Full record

Trial reportTrials2016

Evaluating a computer aid for assessing stomach symptoms (ECASS): study protocol for a randomised controlled trial.

Helen J Moore, Catherine Nixon, Anisah Tariq, Jon Emery, Willie Hamilton, Zoë Hoare, Anne Kershenbaum, Richard D Neal, Obioha C Ukoumunne, Juliet Usher-Smith and 3 more

Open access · goldAbstract readClinical Trial, Phase IIMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Trials, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 7% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. 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
  5. Article
  6. Electronic patient records research to aid diagnostic reasoning for possible cancer in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018
    Article
  7. Reimagining the diagnostic pathway for gastrointestinal cancer.Nature reviews. Gastroenterology & hepatology · 2018
    Review
  8. Improving early diagnosis of symptomatic cancer.Nature reviews. Clinical oncology · 2016
    Review
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.

Helen J MooreSchool of Medicine, Pharmacy & Health, Durham University, Wolfson Research Institute, Queens Campus, Thornaby, TS17 6BH, UK.
Catherine NixonSchool of Medicine, Pharmacy & Health, Durham University, Wolfson Research Institute, Queens Campus, Thornaby, TS17 6BH, UK.
Anisah TariqSchool of Medicine, Pharmacy & Health, Durham University, Wolfson Research Institute, Queens Campus, Thornaby, TS17 6BH, UK.
Jon EmeryGeneral Practice and Primary Health Care Academic Centre, The University of Melbourne, 200 Berkeley St, Carlton, VIC, 3053, Australia.
Willie HamiltonThe Veysey Building, University of Exeter, College House, Exeter, EX1 2LU, UK.
Zoë HoareNWORTH Clinical Trials Unit, Bangor University, Y Wern, Normal Site, Holyhead Road, Bangor, LL57 2PZ, UK.
Anne KershenbaumPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, 2 Worts Causeway, Cambridge, CB1 8RN, UK.
Richard D NealNorth Wales Centre for Primary Care Research, Bangor University, Gwenfro Units 4-8, Wrexham Technology Park, Wrexham, LL13 7YP, UK.
Obioha C UkoumunneNIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter, South Cloisters Building, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
Juliet Usher-SmithPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, 2 Worts Causeway, Cambridge, CB1 8RN, UK.
Fiona M WalterPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, 2 Worts Causeway, Cambridge, CB1 8RN, UK.
Sophie WhyteSchool of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
Greg RubinSchool of Medicine, Pharmacy & Health, Durham University, Wolfson Research Institute, Queens Campus, Thornaby, TS17 6BH, UK. g.p.rubin@durham.ac.uk.
Durham University · GBUniversity of Cambridge · GBBangor University · GBUniversity of Exeter · GBUniversity of Melbourne · AUUniversity of Sheffield · GB

Funding

Cancer Research UK 17940Cancer Research UK C6971/A17940
6 · The paper itself

Abstract

backgroundFor most cancers, only a minority of patients have symptoms meeting the National Institute for Health and Clinical Excellence guidance for urgent referral. For gastro-oesophageal cancers, the 'alarm' symptoms of dysphagia and weight loss are reported by only 32 and 8 % of patients, respectively, and their presence correlates with advanced-stage disease. Electronic clinical decision-support tools that integrate with clinical computer systems have been developed for general practice, although uncertainty remains concerning their effectiveness. The objectives of this trial are to optimise the intervention and establish the acceptability of both the intervention and randomisation, confirm the suitability and selection of outcome measures, finalise the design for the phase III definitive trial, and obtain preliminary estimates of the intervention effect. METHODS/

designThis is a two-arm, multi-centre, cluster-randomised, controlled phase II trial design, which will extend over a 16-month period, across 60 general practices within the North East and North Cumbria and the Eastern Local Clinical Research Network areas. Practices will be randomised to receive either the intervention (the electronic clinical decision-support tool) or to act as a control (usual care). From these practices, we will recruit 3000 adults who meet the trial eligibility criteria and present to their GP with symptoms suggestive of gastro-oesophageal cancer. The main measures are the process data, which include the practitioner outcomes, service outcomes, diagnostic intervals, health economic outcomes, and patient outcomes. One-on-one interviews in a sub-sample of 30 patient-GP dyads will be undertaken to understand the impact of the use or non-use of the electronic clinical decision-support tool in the consultation. A further 10-15 GPs will be interviewed to identify and gain an understanding of the facilitators and constraints influencing implementation of the electronic clinical decision-support tool in practice. DISCUSSION: We aim to generate new knowledge on the process measures regarding the use of electronic clinical decision-support tools in primary care in general and to inform a subsequent definitive phase III trial. Preliminary data on the impact of the support tool on resource utilisation and health care costs will also be collected.

trial registrationISRCTN Registry, ISRCTN12595588 .

Indexed as

Decision Support Systems, ClinicalDecision Support TechniquesDiagnosis, Computer-AssistedClinical ProtocolsCost-Benefit AnalysisEnglandEsophageal NeoplasmsGeneral PractitionersHealth Care CostsHealth ResourcesHumansPredictive Value of TestsPrognosisResearch DesignRisk AssessmentRisk FactorsElectronic clinical decision supportGastric cancerGeneral practiceOesophageal cancerPrimary care

Identifiers

PMID27044367
PMCPMC4820978
OpenAlexW2339280166

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.