Evidence map›Paper›PMID 39158957›Full record

ArticleJMIR formative research2024

Degenerative Cervical Myelopathy Awareness in Primary Care: UK National Cross-Sectional Survey of General Practitioners.

Remi M Rufus-Toye, Amir Rafati Fard, Oliver D Mowforth, Luke V McCarron, Kayen Chan, Yuri Hirayama, Emma K Smith, Munashe Veremu, Benjamin M Davies, Jamie F M Brannigan

Abstract read
In one paragraph

Article in JMIR formative research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

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

  1. Pooled it
  2. Article
  3. Review
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

10 authors.

Remi M Rufus-ToyeDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.ORCID https://orcid.org/0000-0001-5452-9397
Amir Rafati FardDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.ORCID https://orcid.org/0000-0003-1804-2586
Oliver D MowforthDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.ORCID https://orcid.org/0000-0001-6788-745X
Luke V McCarronDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.ORCID https://orcid.org/0000-0003-0253-0868
Kayen ChanDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.ORCID https://orcid.org/0000-0002-2775-1133
Yuri HirayamaUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.ORCID https://orcid.org/0000-0003-2366-2915
Emma K SmithSchool of General Practice, NHS Health Education East of England, Cambirdgeshire, United Kingdom.ORCID https://orcid.org/0009-0008-7111-7309
Munashe VeremuDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.ORCID https://orcid.org/0000-0001-5138-7565
Benjamin M DaviesDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.ORCID https://orcid.org/0000-0003-0591-5069
Jamie F M BranniganNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0003-1697-403X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDegenerative cervical myelopathy (DCM) is a progressive neurological condition, characterized by spinal cord injury secondary to degenerative changes in the spine. Misdiagnosis in primary care forms part of a complex picture leading to an average diagnostic delay of 2 years. This leads to potentially preventable and permanent disability. A lack of awareness secondary to deficits in postgraduate education may contribute to these delays.

objectiveThis study aims to assess the awareness of DCM in the setting of general practice.

methodsGeneral practitioners completed a quantitative web-based cross-sectional questionnaire. The 17-item questionnaire captured data regarding demographics, subjective awareness, and objective knowledge. The questionnaire was disseminated via professional networks, including via practice managers and senior practice partners. Incentivization was provided via a bespoke DCM fact sheet for those that completed the survey.

resultsA total of 54 general practitioners representing all 4 UK nations responded to the survey. General practitioners most commonly self-assessed that they had "limited awareness" of DCM (n=24, 51%). General practitioners felt most commonly "moderately able" to recognize a case of DCM (n=21, 46%). In total, 13% (n=6) of respondents reported that they would not be at all able to recognize a patient with DCM. Respondents most commonly reported that they were "moderately confident" in their ability to triage a patient with DCM (n=19, 41%). A quarter of respondents reported no prior introduction to DCM throughout their medical training (n=13, 25%). The mean score for knowledge-based questions was 42.6% (SD 3.96%) with the lowest performance observed in patient demographic and clinical recognition items.

conclusionsGeneral practitioners lack confidence in the recognition and management of DCM. These findings are consistent with the diagnostic delays previously described in the literature at the primary care level. Further work to develop and implement educational interventions to general practitioner practices is a crucial step to improving patient outcomes in DCM.

Indexed as

cervical myelopathycervical spinedegenerationgeneral practicemedical educationmisdiagnosismyelopathyneurologyneurosurgeryprimary care

Identifiers

PMID39158957
PMCPMC11369528

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.