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Evaluating a computer aid for assessing stomach symptoms (ECASS): study protocol for a randomised controlled trial.

Helen J Moore1, Catherine Nixon1, Anisah Tariq1

  • 1School of Medicine, Pharmacy & Health, Durham University, Wolfson Research Institute, Queens Campus, Thornaby, TS17 6BH, UK.

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Summary

This study evaluates an electronic clinical decision-support tool for gastro-oesophageal cancer detection in primary care. It aims to optimize the tool and assess its feasibility for a larger trial.

Keywords:
Electronic clinical decision supportGastric cancerGeneral practiceOesophageal cancerPrimary care

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Area of Science:

  • Oncology
  • Primary Care Medicine
  • Health Informatics

Background:

  • Gastro-oesophageal cancers often present with non-specific symptoms, delaying diagnosis.
  • Current referral guidelines for urgent cancer diagnosis are met by a minority of patients.
  • Electronic clinical decision-support tools offer potential for improving early cancer detection in primary care.

Purpose of the Study:

  • To optimize an electronic clinical decision-support tool for gastro-oesophageal cancer detection.
  • To assess the acceptability and feasibility of the tool and its randomized controlled trial design.
  • To inform the design of a definitive phase III trial.

Main Methods:

  • A two-arm, multi-centre, cluster-randomised controlled phase II trial.
  • 60 general practices recruited 3000 adults presenting with symptoms suggestive of gastro-oesophageal cancer.
  • Process measures, including practitioner, service, diagnostic intervals, and health economic outcomes, were assessed. Qualitative interviews explored patient and GP experiences.

Main Results:

  • Preliminary data on process measures, resource utilization, and healthcare costs were collected.
  • Qualitative data provided insights into the facilitators and constraints of implementing the decision-support tool.
  • The study design and outcome measures were confirmed as suitable for a phase III trial.

Conclusions:

  • The study generated knowledge on the use of electronic decision-support tools in primary care.
  • Findings will inform the design and implementation of a definitive phase III trial for gastro-oesophageal cancer.
  • Preliminary economic data on the tool's impact on resource utilization were obtained.