Evidence map›Paper›PMID 30348886›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2018

Identifying patients with a history of ovarian cancer for referral for genetic counselling: non-randomised comparison of two case-finding strategies in primary care.

Charles W Helsper, Liesbeth M Van Vliet, Mary E Velthuizen, Niek J de Wit, Roy Ph Beijaert, Els Butter, Marleen Pl van Gent-Wagemakers, Els O Witteveen, Ronald P Zweemer, Sandra M van Dulmen and 1 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 3 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

5 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. 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

11 authors.

Charles W HelsperJulius Center for Health Sciences and Primary Care.
Liesbeth M Van VlietDepartment of Genetics, Division of Biomedical Genetics, University Medical Center Utrecht, Utrecht University, the Netherlands; NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands.
Mary E VelthuizenDepartment of Genetics, Division of Biomedical Genetics, University Medical Center Utrecht, Utrecht University, the Netherlands.
Niek J de WitJulius Center for Health Sciences and Primary Care.
Roy Ph BeijaertDutch College of General Practitioners, Utrecht, the Netherlands.
Els ButterDepartment of Gynaecological Oncology, UMC Utrecht Cancer Center, Utrecht University, the Netherlands.
Marleen Pl van Gent-WagemakersHuisartsenpraktijk Kievitstraat, Woerden, the Netherlands.
Els O WitteveenDepartment of Medical Oncology, UMC Utrecht Cancer Center, Utrecht University, the Netherlands.
Ronald P ZweemerDepartment of Gynaecological Oncology, UMC Utrecht Cancer Center, Utrecht University, the Netherlands.
Sandra M van DulmenNIVEL, Utrecht; Radboud University Medical Center, Department of Primary and Community Care, Nijmegen, the Netherlands.
Margreet Gem AusemsDepartment of Genetics, Division of Biomedical Genetics, University Medical Center Utrecht, Utrecht University, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent guidelines recommend genetic counselling and DNA testing (GCT) for patients with ovarian cancer and survivors of ovarian cancer. Finding survivors of ovarian cancer is challenging. Detecting and referring them for GCT via primary care, to allow proper screening recommendations for patients and their family, may be a solution.

aimTo compare the effectiveness and acceptance of two pilot strategies directed at case finding women with a history of ovarian cancer for referral for GCT by their GP. DESIGN AND

settingNon-randomised comparison of the pilot implementation of two case-finding strategies for women with a history of ovarian cancer in Dutch primary care from May 2016 to April 2017.

methodStrategy A (unsupported) asked GPs to identify and refer eligible patients with a history of ovarian cancer. Strategy B (ICT-supported) provided GPs with information and communication technology (ICT) support to identify patients with a history of ovarian cancer electronically. The effectiveness of each strategy was assessed as the proportion of patients who were approached, referred for GCT, and seen by the clinical geneticist. Acceptance of each strategy was assessed by the intervention uptake of GP practices and GP and patient questionnaires.

resultsNineteen out of 30 (63%) patients identified with a history of ovarian cancer were deemed eligible for referral for strategy A, and 39 out of 94 (41%) for strategy B. For each strategy, eight patients were referred and five (63%) were seen for GCT. The intervention uptake by GP practices was 31% (11 out of 36) for strategy A and 46% (21 out of 46) for strategy B. GPs considered 'relevance' and 'workability' as facilitators across both strategies whereas, for strategy B, technical barriers hindered implementation.

conclusionThe effectiveness and acceptance of both strategies for case finding of survivors of ovarian cancer in primary care for GCT is promising, but larger studies are required before wide-scale implementation is warranted.

Indexed as

FamilyGenetic CounselingGenetic TestingPrimary Health CareBRCA2 ProteinEarly Detection of CancerFemaleHumansOvarian NeoplasmsPractice Guidelines as TopicReferral and ConsultationSurvivorsUbiquitin-Protein LigasesBRAP protein, humanBRCA2 ProteinBRCA2 protein, humanUbiquitin-Protein Ligasescase findingDNA testinggenetic counsellingovarian cancerprimary carereferral

Identifiers

PMID30348886
PMCPMC6193781

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Registered trials

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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.