Evidence map›Paper›PMID 36940950›Full record

ArticleBMJ open2023

Protocol for a pragmatic cluster randomised controlled trial assessing the clinical effectiveness and cost-effectiveness of Electronic RIsk-assessment for CAncer for patients in general practice (ERICA).

Willie Hamilton, Luke Mounce, Gary A Abel, Sarah Gerard Dean, John L Campbell, Fiona C Warren, Anne Spencer, Antonieta Medina-Lara, Martin Pitt, Elizabeth Shephard and 4 more

Full text readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
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

14 authors.

Willie HamiltonPrimary Care Diagnostics, University of Exeter, EXETER, GB, UK W.Hamilton@exeter.ac.uk.ORCID 0000-0003-1611-1373
Luke MounceInstitute of Health Research, University of Exeter, Exeter, UK.ORCID 0000-0002-6089-0661
Gary A AbelUniversity of Exeter Medical School (Primary Care), University of Exeter, Exeter, Essex, UK.ORCID 0000-0003-2231-5161
Sarah Gerard DeanPenCLAHRC University of Exeter Medical School, Exeter, UK.ORCID 0000-0002-3682-5149
John L CampbellPrimary Care, University of Exeter, Exeter, UK.
Fiona C WarrenInstitute of Health Research, University of Exeter Medical School, Exeter, UK.ORCID 0000-0002-3833-0182
Anne SpencerHealth Economics, University of Exeter Medical School, Exeter, UK.
Antonieta Medina-LaraHealth Economics Group, University of Exeter Medical School, Exeter, UK.
Martin PittUniversity of Exeter: Medical School, University of Exeter, Exeter, Essex, UK.
Elizabeth ShephardUniversity of Exeter, Exeter, UK.
Marijke ShakespearePrimary Care, University of Exeter Medical School, Exeter, UK.
Emily FletcherPrimary Care Research Group, University of Exeter Medical School, Exeter, Devon, UK.ORCID 0000-0003-1319-3051
Adrian MercerPrimary Care, University of Exeter Medical School, Exeter, UK.
Raff CalitriPrimary Care, University of Exeter Medical School, Exeter, UK.ORCID 0000-0003-0889-4670

Funding

Cancer Research UK C8640/A23385
6 · The paper itself

Abstract

introductionThe UK has worse cancer outcomes than most comparable countries, with a large contribution attributed to diagnostic delay. Electronic risk assessment tools (eRATs) have been developed to identify primary care patients with a ≥2% risk of cancer using features recorded in the electronic record. METHODS AND ANALYSIS: This is a pragmatic cluster randomised controlled trial in English primary care. Individual general practices will be randomised in a 1:1 ratio to intervention (provision of eRATs for six common cancer sites) or to usual care. The primary outcome is cancer stage at diagnosis, dichotomised to stage 1 or 2 (early) or stage 3 or 4 (advanced) for these six cancers, assessed from National Cancer Registry data. Secondary outcomes include stage at diagnosis for a further six cancers without eRATs, use of urgent referral cancer pathways, total practice cancer diagnoses, routes to cancer diagnosis and 30-day and 1-year cancer survival. Economic and process evaluations will be performed along with service delivery modelling. The primary analysis explores the proportion of patients with early-stage cancer at diagnosis. The sample size calculation used an OR of 0.8 for a cancer being diagnosed at an advanced stage in the intervention arm compared with the control arm, equating to an absolute reduction of 4.8% as an incidence-weighted figure across the six cancers. This requires 530 practices overall, with the intervention active from April 2022 for 2 years. ETHICS AND DISSEMINATION: The trial has approval from London City and East Research Ethics Committee, reference number 19/LO/0615; protocol version 5.0, 9 May 2022. It is sponsored by the University of Exeter. Dissemination will be by journal publication, conferences, use of appropriate social media and direct sharing with cancer policymakers. TRIAL REGISTRATION NUMBER: ISRCTN22560297.

Indexed as

General PracticeNeoplasmsCost-Benefit AnalysisDelayed DiagnosisHumansPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicRisk AssessmentTreatment OutcomeClinical trialsHEALTH SERVICES ADMINISTRATION & MANAGEMENTPRIMARY CARERisk management

Identifiers

PMID36940950
PMCPMC10030284

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read26
identifiers read1
Read underepoch 390

Registered trials

None linked

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.