Trial reportBMJ open2021
Electronic clinical decision support tool for assessing stomach symptoms in primary care (ECASS): a feasibility study.
Trial report in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 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
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- 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
- Diagnostic Risk Prediction Models for Upper Gastrointestinal Cancers: A Systematic Review.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Pooled it
- The implementation challenge of computerised clinical decision support systems for the detection of disease in primary care: systematic review and recommendations.Implementation science : IS · 2025Pooled it
- Using the CFIR 2.0 Framework to Assess the Implementation of GARDE: A Population Health Management Tool for Hereditary Cancer Risk.Research square · 2026Article
- 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
- Clinical Decision Support Tool for Early Pancreatic Cancer Detection in Primary Care: Simulation Study.JMIR formative research · 2026Article
- Adoption, acceptance, and use of a decision support tool to promote timely investigations for cancer in primary care.Family practice · 2024Article
- Supporting primary care through symptom checking artificial intelligence: a study of patient and physician attitudes in Italian general practice.BMC primary care · 2023Article
- Article
- Workload and workflow implications associated with the use of electronic clinical decision support tools used by health professionals in general practice: a scoping review.BMC primary care · 2023Article
- Optimization of a Quality Improvement Tool for Cancer Diagnosis in Primary Care: Qualitative Study.JMIR formative research · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 8 institutions in 4 countries.
Funding
Abstract
objectiveTo determine the feasibility of a definitive trial in primary care of electronic clinical decision support (eCDS) for possible oesophago-gastric (O-G) cancer. DESIGN AND
settingFeasibility study in 42 general practices in two regions of England, cluster randomised controlled trial design without blinding, nested qualitative and health economic evaluation.
participantsPatients aged 55 years or older, presenting to their general practitioner (GP) with symptoms associated with O-G cancer. 530 patients (mean age 68 years, 58% female) participated.
interventionPractices randomised 1:1 to usual care (control) or to receive a previously piloted eCDS tool for suspected cancer (intervention), for use at the discretion of the GPs, supported by a theory-based implementation package and ongoing support. We conducted semistructured interviews with GPs in intervention practices. Recruitment lasted 22 months. OUTCOMES: Patient participation rate, use of eCDS, referrals and route to diagnosis, O-G cancer diagnoses; acceptability to GPs; cost-effectiveness. Participants followed up 6 months after index encounter.
resultsFrom control and intervention practices, we screened 3841 and 1303 patients, respectively; 1189 and 434 were eligible, 392 and 138 consented to participate. Ten patients (1.9%) had O-G cancer. eCDS was used eight times in total by five unique users. GPs experienced interoperability problems between the eCDS tool and their clinical system and also found it did not fit with their workflow. Unexpected restrictions on software installation caused major problems with implementation.
conclusionsThe conduct of this study was hampered by technical limitations not evident during an earlier pilot of the eCDS tool, and by regulatory controls on software installation introduced by primary care trusts early in the study. This eCDS tool needed to integrate better with clinical workflow; even then, its use for suspected cancer may be infrequent. Any definitive trial of eCDS for cancer diagnosis should only proceed after addressing these constraints. TRIAL REGISTRATION NUMBER: ISRCTN125595588.
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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.