Hugh Claridge, Elizabeth A Cooke, Spencer A Thomas, Nan Greenwood, Agnieszka Lemanska
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It also seeks to synthesise the qualitative and quantitative evidence relating to the patient and clinician perspectives and experiences with these tools.</p><p><strong>Results: </strong>Ten studies were included with five risk assessment tools identified: 'QCancer', 'eRATs' (electronic risk assessment tools), 'CaDet', 'Future Health Today' and 'C the Signs'. No tools were found for pancreatic cancer alone. Thematic synthesis of stakeholder perspectives resulted in three themes: impact on clinical decision-making, impact on patient consultations and implementation barriers and facilitators. Overall, experiences and impacts were positive, especially if used by less experienced clinicians.</p><p><strong>Conclusion: </strong>There is little evidence for the inclusion of many developed pancreatic cancer diagnostic prediction models in risk assessment tools in primary care, and limited research into stakeholder perceptions, especially patient perceptions. 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引用次数: 0
摘要
背景:胰腺癌是世界上第12大最常见的癌症,但高死亡率使其成为癌症死亡的第六大原因。诊断往往太晚,无法进行治疗干预。纳入诊断预测模型的风险评估工具可能有助于初级保健临床医生早期胰腺癌检测。目的和方法:本综合评价旨在确定可用于胰腺癌检测的风险评估工具,并已在初级保健中进行了调查。它还寻求综合与这些工具的患者和临床医生的观点和经验有关的定性和定量证据。结果:纳入了10项研究,确定了5种风险评估工具:“QCancer”、“eRATs”(电子风险评估工具)、“CaDet”、“Future Health Today”和“C the Signs”。没有发现单独治疗胰腺癌的工具。利益相关者观点的专题综合产生了三个主题:对临床决策的影响,对患者咨询的影响以及实施障碍和促进者。总的来说,经验和影响是积极的,特别是如果由经验不足的临床医生使用。结论:在初级保健的风险评估工具中纳入许多已开发的胰腺癌诊断预测模型的证据很少,对利益相关者看法,特别是患者看法的研究也很有限。这一综述可以为未来的工具开发提供信息,并且应该进行进一步的研究来评估这些工具的临床有效性,以鼓励临床实践中使用这些工具。研究注册:本研究前瞻性注册号为PROSPERO CRD42024488160。
Pancreatic Cancer Risk Assessment Tools in Primary Care: A Mixed Methods Systematic Review.
Background: Pancreatic cancer is the twelfth most common cancer worldwide, but high mortality rates make it the sixth leading cause of cancer deaths. Diagnosis is frequently too late for curative intervention. Risk assessment tools incorporating diagnostic prediction models may assist early pancreatic cancer detection by primary care clinicians.
Aim and methods: This mixed methods systematic review aims to identify risk assessment tools which can be used for the detection of pancreatic cancer and have been investigated in primary care. It also seeks to synthesise the qualitative and quantitative evidence relating to the patient and clinician perspectives and experiences with these tools.
Results: Ten studies were included with five risk assessment tools identified: 'QCancer', 'eRATs' (electronic risk assessment tools), 'CaDet', 'Future Health Today' and 'C the Signs'. No tools were found for pancreatic cancer alone. Thematic synthesis of stakeholder perspectives resulted in three themes: impact on clinical decision-making, impact on patient consultations and implementation barriers and facilitators. Overall, experiences and impacts were positive, especially if used by less experienced clinicians.
Conclusion: There is little evidence for the inclusion of many developed pancreatic cancer diagnostic prediction models in risk assessment tools in primary care, and limited research into stakeholder perceptions, especially patient perceptions. This review can inform future tool development, and further research should be undertaken assessing these tools' clinical validity to encourage uptake in clinical practice.
Study registration: This study was registered prospectively as PROSPERO CRD42024488160.
期刊介绍:
The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.