How To Develop Your Skill For Great Success And Happiness Including Become CPA? | Additional special tips From Admin
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Cancer decision support tools overview
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Cancer decision support tools are designed to support GPs in assessing patients with potential cancer symptoms. The tools do not replace clinical judgement, but give more information that can be used to inform patient management decisions. They tend to be underpinned by algorithms that calculate the risk of a patient having an undiagnosed cancer based on various data inputs. Several algorithms have now been developed.
Some algorithms are based on symptoms alone, whilst others also take into account other factors such as patient age and gender. There’s interest in how the tools in which these algorithms are incorporated can prompt and remind GPs about potential cancer risk that they can draw on in their management of patients
Risk assessment tool (RAT)
RATs are designed to be used in symptomatic populations presenting to primary care. There are currently tools available for 14 different cancer types, which provide risk estimates for patients with single symptoms, pairs of symptoms and repeat attendances with the same symptom. They are traditionally in table format, but have also been incorporated into electronic format.
Qcancer
QCancer have developed risk models which can be used in both symptomatic and asymptomatic populations. The QCancer tool for symptomatic populations provides absolute risk of all cancers combined, as well as a breakdown of risk for 12 different cancer types individually, based on both risk factors (such as age, gender and family history) and symptoms.
Non-web based decision support tools were initially in operation, such as the desk easel and mouse mat versions of the RAT tool. However, electronic versions, known as electronic cancer decision support tools (eCDS), are now more common. As well as functioning as standalone online risk calculators, the software can also be integrated into GP computer systems.
Using either the RAT or QCancer algorithms, eCDS tools calculate the risk that a patient may have cancer based on inputted factors such as symptoms, medical history and demographic data.
General functionalities that may be included within an eCDS tool:
Macmillan have developed an integrated cancer decision support tool in collaboration with BMJ Informatica. The tool makes use of both eRAT and QCancer software.
Other major GP providers are developing integrated versions e.g. EMIS working with QCancer
At the moment there aren’t any published peer-reviewed randomised controlled trials on the use of CDS tools in practice.
The ECASS trial, a phase II randomised controlled trial evaluating use of a computer aid for assessing stomach symptoms in patients with suspected oesophageal cancer is currently in progress.
There are also a number of evaluation and several feasibility studies.
Find out more about evaluation studies for RAT or QCancer
CRUK’s evaluation of eCDS tool
Cancer Research UK coordinated an independent evaluation of the 2013 Macmillian pilot of the eCDS tool, which used the BMJ Informatica platform.
During Macmillan’s pilot GPs from over 400 practices across England had access to the software between March and November 2013.
The GPs were divided into two groups, with one group being presented with results from the Risk Assessment Tool and the other results from QCancer.
Cancer Research UK analysed the data collected and one of the Department of Health’s Policy Research Units also gathered feedback from interviews with patients and GPs, to get qualitative feedback on the use of the eCDS tool.
What are the effects of using the eCDS tool?
Overall, the pilot evaluation suggests that the eCDS can:
In nearly a fifth (19%) of cases where GPs provided feedback, they reported that had they not used the symptom checker, they would not have referred/investigated the patient.
GPs also expressed some concerns:
Limitations of the evaluation
Read the full evaluation report
Read our blog on the results of the eCDS evaluation
Read more on the eCDS tool, work to integrate it with GP systems and the training available from Macmillan Cancer Support
Accelerate Coordinate Evaluate (ACE)
The NHS led ACE programme, which Cancer Research UK is involved in, is also exploring the impact of using eCDS tools on diagnostic decision making for cancer diagnosis.
Read more about the ACE programme
Cancer decision support tools overview
Research & References of Cancer decision support tools overview|A&C Accounting And Tax Services
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