ArticleBMJ open2020
CASNET2: evaluation of an electronic safety netting cancer toolkit for the primary care electronic health record: protocol for a pragmatic stepped-wedge RCT.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses 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
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Why aren't they used? Systematic review of barriers to implementation of clinical decision support systems for early cancer detection in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Pooled it
- Reported problems and responses during the conduct of stepped-wedge cluster randomized trials in healthcare settings: a qualitative systematic review.International journal of epidemiology · 2026Pooled it
- 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 · 2026Review
- Triaging colorectal urgent referrals in the COVID-19 era using faecal immunochemical testing: a prospective UK real-world multicentre cohort study.BMJ open gastroenterology · 2025Observational
- 'ThinkCancer!': randomised feasibility trial of a novel practice-based early cancer diagnosis intervention.BJGP open · 2024Article
- Electronic safety-netting tool features considered important by UK general practice staff: an interview and Delphi consensus study.BJGP open · 2023Article
- Using an electronic safety netting tool designed to improve safety with respect to cancer referral in primary care: a qualitative service evaluation using rapid appraisal methods.BMJ open quality · 2023Article
- Harnessing the Electronic Health Care Record to Optimize Patient Safety in Primary Care: Framework for Evaluating e-Safety-Netting Tools.JMIR medical informatics · 2022Article
- Primary care practice and cancer suspicion during the first three COVID-19 lockdowns in the UK: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Article
- Optimising GPs' communication of advice to facilitate patients' self-care and prompt follow-up when the diagnosis is uncertain: a realist review of 'safety-netting' in primary care.BMJ quality & safety · 2022Review
- Factors affecting the documentation of spoken safety-netting advice in routine GP consultations: a cross-sectional study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
introductionSafety-netting in primary care is the best practice in cancer diagnosis, ensuring that patients are followed up until symptoms are explained or have resolved. Currently, clinicians use haphazard manual solutions. The ubiquitous use of electronic health records provides an opportunity to standardise safety-netting practices.A new electronic safety-netting toolkit has been introduced to provide systematic ways to track and follow up patients. We will evaluate the effectiveness of this toolkit, which is embedded in a major primary care clinical system in England:Egerton Medical Information System(EMIS)-Web. METHODS AND ANALYSIS: We will conduct a stepped-wedge cluster RCT in 60 general practices within the RCGP Research and Surveillance Centre (RSC) network. Groups of 10 practices will be randomised into the active phase at 2-monthly intervals over 12 months. All practices will be activated for at least 2 months. The primary outcome is the primary care interval measured as days between the first recorded symptom of cancer (within the year prior to diagnosis) and the subsequent referral to secondary care. Other outcomes include referrals rates and rates of direct access cancer investigation.Analysis of the clustered stepped-wedge design will model associations using a fixed effect for intervention condition of the cluster at each time step, a fixed effect for time and other covariates, and then include a random effect for practice and for patient to account for correlation between observations from the same centre and from the same participant. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the North West-Greater Manchester West National Health Service Research Ethics Committee (REC Reference 19/NW/0692). Results will be disseminated in peer-reviewed journals and conferences, and sent to participating practices. They will be published on the University of Oxford Nuffield Department of Primary Care and RCGP RSC websites. TRIAL REGISTRATION NUMBER: ISRCTN15913081; Pre-results.
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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.