ArticleBMJ open2019
Diagnostic property of direct referral from general practitioners to contrast-enhanced thoracoabdominal CT in patients with serious but non-specific symptoms or signs of cancer: a retrospective cohort study on cancer prevalence after 12 months.
Article in BMJ open, 2019. 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.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The pathway and characteristics of patients with non-specific symptoms of cancer: a systematic review.BMC cancer · 2022Pooled it
- Diagnostic flow for all patients referred with non-specific symptoms of cancer to a diagnostic centre in Denmark: A descriptive study.The European journal of general practice · 2024Article
- Risk of cancer and serious disease in Danish patients with urgent referral for serious non-specific symptoms and signs of cancer in Funen 2014-2021.British journal of cancer · 2024Article
- Patients from general practice with non-specific cancer symptoms: a retrospective study of symptoms and imaging.BJGP open · 2024Article
- Irish general practitioner (GP) perspectives on impact of direct access radiology on patient care in the community: results from a mixed-methods study.Irish journal of medical science · 2024Article
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- Economic impact of spectral body imaging in diagnosis of patients suspected for occult cancer.Insights into imaging · 2021Article
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Authors and funding
7 authors.
Funding
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Abstract
objectivesTo describe the diagnostic properties of thoracoabdominal contrast-enhanced CT (ceCT), when general practitioners (GPs) managed referral to ceCT through the non-specific symptoms or signs of cancer-cancer patient pathway (NSSC-CPP).
designRetrospective cohort study including patients from a part of Denmark.
settingDepartment of Internal Medicine at a university hospital.
participantsIn total, 529 patients underwent ceCT. PRIMARY AND SECONDARY OUTCOMES: Our primary objective was to estimate the negative and positive likelihood ratios for being diagnosed with cancer within 1 year after ceCT. Our secondary outcomes were prevalence and final diagnoses of malignancy (including temporal trends since implementation of NSSC-CPP in 2012), the prevalence of revision of CT scans and referral patterns based on ceCT results.
resultsIn total, 529 subjects underwent ceCT and malignancy was identified in 104 (19.7%) patients; 101 (97.1%) during initial workup and 3 patients during the subsequent 12 months follow-up.Eleven patients had a false-negative ceCT, and revision classified the ceCT as 'probable/possible malignancy' in eight (73%) patients. The negative predictive value was 98% and positive predictive value 63%. Negative and positive likelihood ratios for malignancy was 0.1 and 7.9, respectively.
conclusionOur study shows that ceCT as part of GP-coordinated workup has a low negative likelihood ratio for identifying malignancy; this is important since identifying patients for further workup is vital.
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