ArticleClinical epidemiology2016
Development of an algorithm to identify urgent referrals for suspected cancer from the Danish Primary Care Referral Database.
Article in Clinical epidemiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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1 citing paper in PubMed, 2 citations in OpenAlex.
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6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccurate identification of specific patient populations is a crucial tool in health care. A prerequisite for exploring the actions taken by general practitioners (GPs) on symptoms of cancer is being able to identify patients urgently referred for suspected cancer. Such system is not available in Denmark; however, all referrals are electronically stored. This study aimed to develop and test an algorithm based on referral text to identify urgent cancer referrals from general practice.
methodsTwo urgently referred reference populations were extracted from a research database and linked with the Primary Care Referral (PCR) database through the unique Danish civil registration number to identify the corresponding electronic referrals. The PCR database included GP referrals directed to private specialists and hospital departments, and these referrals were scrutinized. The most frequently used words were integrated in the first version of the algorithm, which was further refined by an iterative process involving two population samples from the PCR database. The performance was finally evaluated for two other PCR population samples against manual assessment as the gold standard for urgent cancer referral.
resultsThe final algorithm had a sensitivity of 0.939 (95% confidence intervals [CI]: 0.905-0.963) and a specificity of 0.937 (95% CI: 0.925-0.963) compared to the gold standard. The positive and negative predictive values were 69.8% (95% CI: 65.0-74.3) and 99.0% (95% CI: 98.4-99.4), respectively. When applying the algorithm on referrals for a population without earlier cancer diagnoses, the positive predictive value increased to 83.6% (95% CI: 78.7-87.7) and the specificity to 97.3% (95% CI: 96.4-98.0).
conclusionThe final algorithm identified 94% of the patients urgently referred for suspected cancer; less than 3% of the patients were incorrectly identified. It is now possible to identify patients urgently referred on cancer suspicion from general practice by applying an algorithm for populations in the PCR database.
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