British Journal of General Practice最新文献

{"title":"Digital maturity: towards a strategic approach.","authors":"Trisha Greenhalgh, Rebecca Payne","doi":"10.3399/bjgp25X741357","DOIUrl":"https://doi.org/10.3399/bjgp25X741357","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"200-202"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of cancer recurrence: a clinical update for GPs.","authors":"Rosie Mew, Richard D Neal","doi":"10.3399/bjgp25X741549","DOIUrl":"https://doi.org/10.3399/bjgp25X741549","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"231-233"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"For the attention of Doctor Nemo.","authors":"Andrew Papanikitas","doi":"10.3399/bjgp25X741441","DOIUrl":"https://doi.org/10.3399/bjgp25X741441","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"218"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How long does general practice take?","authors":"Tim Senior","doi":"10.3399/bjgp25X741537","DOIUrl":"https://doi.org/10.3399/bjgp25X741537","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"230"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative failure.","authors":"Ben Hoban","doi":"10.3399/bjgp25X741501","DOIUrl":"https://doi.org/10.3399/bjgp25X741501","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"225"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Yonder: Extended access, GP retention, registrar wellbeing interventions, and contacts post-paediatric admission.","authors":"Alex Burrell","doi":"10.3399/bjgp25X741489","DOIUrl":"https://doi.org/10.3399/bjgp25X741489","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"224"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General practice chest X-ray rate is associated with earlier lung cancer diagnosis and reduced all-cause mortality: a retrospective observational study.","authors":"Stephen H Bradley, Richard D Neal, Matthew Ej Callister, Benjamin Cornwell, William T Hamilton, Gary A Abel, Bethany Shinkins, Richard B Hubbard, Matthew E Barclay","doi":"10.3399/BJGP.2024.0466","DOIUrl":"10.3399/BJGP.2024.0466","url":null,"abstract":"<p><strong>Background: </strong>Evidence is equivocal on whether general practice rates of investigation in symptomatic patients using chest X-ray (CXR) affect outcomes.</p><p><strong>Aim: </strong>To determine whether there is an association between rates of CXR requested in general practice and lung cancer outcomes.</p><p><strong>Design and setting: </strong>Observational study using data on English general practices.</p><p><strong>Method: </strong>Cancer registry data for patients diagnosed with lung cancer in 2014-2018 were linked to data on general practice CXRs from 2013 until 2017. Cancer stage at diagnosis (I/II versus III/IV) and 1-year and 5-year survival rates (conditional on survival to 1 year) post-diagnosis were reported by general practice quintile of CXR rate, with adjustment for population differences (age, smoking, prevalence of chronic obstructive pulmonary disease and heart failure, ethnicity, and deprivation) and by unadjusted category (low, medium, and high).</p><p><strong>Results: </strong>In total, 192 631 patient records and CXR rates for 7409 practices were obtained. Practices in the highest quintile of CXR rate had fewer cancers diagnosed at stage III/IV compared with those in the lowest quintile (odds ratio [OR] 0.87, 95% confidence interval [CI] = 0.83 to 0.92, <i>P</i><0.001). The association was weaker for the high unadjusted CXR category (OR 0.94, 95% CI = 0.91 to 0.97). For the highest adjusted quintile, hazard ratios (HRs) for death within 1 year and 5 years were 0.92 (95% CI = 0.90 to 0.95, <i>P</i><0.001) and 0.95 (95% CI = 0.91 to 0.99, <i>P</i> = 0.023), respectively. For the high unadjusted CXR category, the HR for 1-year survival was 0.98 (95% CI = 0.96 to 0.99, <i>P</i> = 0.004), with no association demonstrated for 5-year survival.</p><p><strong>Conclusion: </strong>Patients registered at general practices with higher CXR use have a favourable stage distribution and slightly better survival. This supports the use of CXR in promoting earlier diagnosis of symptomatic lung cancer in general practice.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e323-e332"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cancer risk assessment tool use and GP consultation duration: an observational study.","authors":"Emily Fletcher, John L Campbell, Emma Pitchforth, Luke Mounce, Willie Hamilton, Gary Abel","doi":"10.3399/BJGP.2024.0135","DOIUrl":"10.3399/BJGP.2024.0135","url":null,"abstract":"<p><strong>Background: </strong>England is short of GPs, and GP consultation rates, consultation duration, and workload are increasing. Electronic clinical decision support tools assist decision making for screening, diagnosis, and risk management. Cancer detection is one area in which tools are designed to support GPs, with some electronic risk assessment tools (eRATs) estimating the risk of current cancer based on symptoms.</p><p><strong>Aim: </strong>To explore any association between the impact of eRATs and GP workload and workflow during consultations.</p><p><strong>Design and setting: </strong>Observational sub-study.</p><p><strong>Method: </strong>Thirteen practices in England participating in a cluster randomised controlled trial of eRATs were recruited to the study. Using mixed-effects regression models, the average duration of consulting sessions and individual consultations in which eRATs were, or were not, activated were compared.</p><p><strong>Results: </strong>There was no evidence that consulting sessions in which an eRAT was activated were, on average, longer than sessions in which an eRAT had not been activated. However, after adjusting for a range of session and consultation characteristics, individual consultations involving an eRAT were longer, on average, by 3.96 minutes (95% confidence interval = 3.45 to 4.47; <i>P</i><0.001) when compared with consultations with no eRAT.</p><p><strong>Conclusion: </strong>There was no evidence to suggest that eRATs should not be used to support GPs in early cancer diagnosis from a workload perspective. Activation of eRATs was not associated with increased workload across a consulting session, despite a small increase in time observed in individual consultations involving eRATs. Ultimately, therefore, it should be definitive findings regarding the clinical effectiveness of eRATs, not the related workload/workflow implications, that determine whether the use of eRATs should be rolled out more widely.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e349-e356"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GP registrars don't feel confident about their future in the profession.","authors":"Zachary du Toit, Molly Dineen","doi":"10.3399/bjgp25X741429","DOIUrl":"https://doi.org/10.3399/bjgp25X741429","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 754","pages":"205"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding ethnic inequalities in cancer diagnostic intervals: a cohort study of patients presenting suspected cancer symptoms to GPs in England.","authors":"Tanimola Martins, Liz Down, Alfred Samuels, Deepthi Lavu, William Hamilton, Gary Abel, Richard D Neal","doi":"10.3399/BJGP.2024.0518","DOIUrl":"10.3399/BJGP.2024.0518","url":null,"abstract":"<p><strong>Background: </strong>UK Asian and Black patients experience longer cancer diagnostic intervals - the period between initial symptomatic presentation in primary care and cancer diagnosis.</p><p><strong>Aim: </strong>To determine whether the differences in diagnostic intervals are because of prolonged primary care, referral, or secondary care interval.</p><p><strong>Design and setting: </strong>A cohort study was undertaken of 70 971 patients with seven cancers (breast, lung, prostate, colorectal, oesophagogastric, myeloma, ovarian) diagnosed after symptom presentation in English primary care.</p><p><strong>Method: </strong>Data on symptom presentation and diagnosis were extracted from cancer registry-linked primary care and secondary care data. Primary interval was defined as the period between first primary care presentation and secondary care referral, referral interval as the period between referral and first secondary care appointment, and secondary care interval as the period between the first secondary care appointment and diagnosis. Accelerated failure time models were used to investigate ethnic differences across all four intervals.</p><p><strong>Results: </strong>Across all sites, the median diagnostic interval was 46 days, ranging from 13 days for breast cancer to 116 days for lung cancer. It was 14% longer for Black patients (adjusted time ratio [ATR] 1.14, 95% confidence interval [CI] = 1.05 to 1.25) and 13% longer for Asian patients (ATR 1.13, 95% CI = 1.03 to 1.23) compared with White patients. Site-specific analyses showed that, for myeloma, lung, prostate, and colorectal cancer, the secondary care interval was longer in Asian and Black patients, who also had a longer primary care interval in breast and colorectal cancer. There was little evidence of ethnic differences in referral interval.</p><p><strong>Conclusion: </strong>This study found evidence of ethnic differences in diagnostic intervals, with prolonged secondary care intervals for four common cancers and prolonged primary care intervals for two. Although these differences are relatively modest, they are unjustified and may indicate shortcomings in healthcare delivery that disproportionately affect ethnic minorities.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e333-e340"},"PeriodicalIF":5.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}