Evidence map›Paper›PMID 37380218›Full record

ArticleBJGP open2023

Exploring why European primary care physicians sometimes do not think of, or act on, a possible cancer diagnosis. A qualitative study.

Senada Hajdarevic, Cecilia Högberg, Mercè Marzo-Castillejo, Vija Siliņa, Jolanta Sawicka-Powierza, Magadalena Esteva, Tuomas Koskela, Davorina Petek, Sara Contreras-Martos, Marcello Mangione and 18 more

Abstract read
In one paragraph

Article in BJGP open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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

  1. Article
  2. Article
  3. Article
  4. Article
  5. 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

28 authors.

Senada HajdarevicDepartment of Nursing, Umeå University, Umeå, Sweden senada.hajdarevic@umu.se.ORCID http://orcid.org/0000-0003-0661-8269
Cecilia HögbergDepartment of Public Health and Clinical Medicine, Education and Development Östersund, Unit of Research, Umeå University, Umeå, Sweden.
Mercè Marzo-CastillejoResearch Support Unit Metropolitana Sud, University Institute for Primary Health Care Research IDIAPJordi Gol, Catalan Health Institute, Barcelona, Spain.
Vija SiliņaDepartment of Family Medicine, Riga Stradiņš University, Riga, Latvia.
Jolanta Sawicka-PowierzaDepartment of Family Medicine, Medical University of Białystok, Białystok, Poland.
Magadalena EstevaMajorca Primary Care Department, Spain.
Tuomas KoskelaFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Davorina PetekDepartment of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Sara Contreras-MartosResearch Support Unit Metropolitana Sud, University Institute for Primary Health Care Research IDIAPJordi Gol, Catalan Health Institute, Barcelona, Spain.
Marcello MangioneLocal Health Authority Committee, Palermo City, Italy.
Zlata Ožvačić AdžićDepartment of Family Medicine, University of Zagreb, School of Medicine, Zagreb, Croatia.
Radost AsenovaDepartment Urology and General Practice, Medical University of Plovdiv, Plovdiv, Bulgaria.
Svjetlana Gašparović BabićCroatian Health Insurance Fund, Rijeka, Croatia.
Mette BrekkeDepartment of Health and Society, General Practice Research Unit, University of Oslo, Oslo, Norway.
Krzysztof BuczkowskiNicolaus Copernicus University, Toruń, Poland.
Nicola BuonoDepartment of General Practice, National Society of Medical Education in General Practice (SNaMID), Caserta, Italy.
Saliha Serap ÇifçiliFamily Medicine Department, Marmara University Medical School, Istanbul, Turkey.
Geert-Jan DinantDepartment of General Practice, Maastricht University, Maastricht, The Netherlands.
Babette DoornDepartment of General Practice, Maastricht University, Maastricht, The Netherlands.
Robert D HoffmanDepartment of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
George KuodzaDepartment of Family Medicine and Outpatient Care, Medical Faculty #2, Uzhhorod National University, Uzhgorod, Ukraine.
Peter MurchieCentre of Academic Primary Care, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Liina PilvInstitute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
Aida PuiaDepartment of Family Medicine, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Aurimas RapalaviciusFamily Medicine Department, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Emmanouil SmyrnakisLaboratory of Primary Health Care, General Practice and Health Services Research, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Birgitta WeltermannInstitut für Hausarztmedizin, University of Bonn, Bonn, Germany.
Michael HarrisInstitute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0002-7166-2971

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile primary care physicians (PCPs) play a key role in cancer detection, they can find cancer diagnosis challenging, and some patients have considerable delays between presentation and onward referral.

aimTo explore European PCPs' experiences and views on cases where they considered that they had been slow to think of, or act on, a possible cancer diagnosis. DESIGN &

settingA multicentre European qualitative study, based on an online survey with open-ended questions, asking PCPs for their narratives about cases when they had missed a diagnosis of cancer.

methodUsing maximum variation sampling, PCPs in 23 European countries were asked to describe what happened in a case where they were slow to think of a cancer diagnosis, and for their views on why it happened. Thematic analysis was used to analyse the data.

resultsA total of 158 PCPs completed the questionnaire. The main themes were as follows: patients' descriptions did not suggest cancer; distracting factors reduced PCPs' cancer suspicions; patients' hesitancy delayed the diagnosis; system factors not facilitating timely diagnosis; PCPs felt that they had acted wrongly; and problems with communicating adequately.

conclusionThe study identified six overarching themes that need to be addressed. Doing so should reduce morbidity and mortality in the small proportion of patients who have a significant, avoidable delay in their cancer diagnosis. The 'Swiss cheese' model of accident causation showed how the themes related to each other.

Indexed as

cancerdiagnostic errorsEuropephysicians, primary careprimary health carequalitative research

Identifiers

PMID37380218
PMCPMC11176697

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.