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Implementing a QCancer risk tool into general practice consultations: an exploratory study using simulated

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  • 1General Practice and Primary Health Care Academic Centre, University of Melbourne, 200 Berkeley Street, Carlton, Victoria 3053, Australia.

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Summary

Cancer risk assessment tools show promise for primary care, but implementation faces challenges. GPs found them useful for complex cases but were wary of conflicting outputs, highlighting barriers to widespread adoption.

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Area of Science:

  • Primary Care Medicine
  • Oncology
  • Health Informatics

Background:

  • Diagnostic delays in primary care negatively impact cancer outcomes.
  • Symptom risk assessment tools offer potential to improve cancer diagnosis.
  • The QCancer model is a tool for assessing cancer risk.

Purpose of the Study:

  • To explore the implementation of a cancer risk tool (QCancer model) in primary care consultations.
  • To assess the potential impact of the tool on clinical decision-making.
  • To identify barriers and facilitators to the use of electronic cancer risk assessment tools.

Main Methods:

  • An exploratory 'action design' research method was used.
  • 15 general practitioners (GPs) in Victoria, Australia, participated.
  • Simulated consultations and semi-structured interviews informed by normalisation process theory were conducted.

Main Results:

  • The risk tool was perceived as useful for patients with complex medical histories.
  • Experienced GPs showed distrust in risk outputs conflicting with their clinical judgment.
  • Variability in symptom interpretation led to inconsistent risk assessments.
  • High numerical risk outputs presented challenges during consultations.

Conclusions:

  • Barriers to implementing electronic cancer risk assessment tools in primary care consultations exist.
  • These barriers include tool design, integration, variable interpretation of clinical data, and reliance on clinician intuition.
  • Addressing these issues is crucial for the successful uptake of such tools.