Primary care practitioners' diagnostic action when the patient may have cancer: an exploratory vignette study in 20 European countries.
adult oncology
international health services
primary care
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
31 10 2020
31 10 2020
Historique:
entrez:
1
11
2020
pubmed:
2
11
2020
medline:
15
5
2021
Statut:
epublish
Résumé
Cancer survival rates vary widely between European countries, with differences in timeliness of diagnosis thought to be one key reason. There is little evidence on the way in which different healthcare systems influence primary care practitioners' (PCPs) referral decisions in patients who could have cancer.This study aimed to explore PCPs' diagnostic actions (whether or not they perform a key diagnostic test and/or refer to a specialist) in patients with symptoms that could be due to cancer and how they vary across European countries. A primary care survey. PCPs were given vignettes describing patients with symptoms that could indicate cancer and asked how they would manage these patients. The likelihood of taking immediate diagnostic action (a diagnostic test and/or referral) in the different participating countries was analysed. Comparisons between the likelihood of taking immediate diagnostic action and physician characteristics were calculated. Centres in 20 European countries with widely varying cancer survival rates. A total of 2086 PCPs answered the survey question, with a median of 72 PCPs per country. PCPs' likelihood of immediate diagnostic action at the first consultation varied from 50% to 82% between countries. PCPs who were more experienced were more likely to take immediate diagnostic action than their peers. When given vignettes of patients with a low but significant possibility of cancer, more than half of PCPs across Europe would take diagnostic action, most often by ordering diagnostic tests. However, there are substantial between-country variations.
Identifiants
pubmed: 33130560
pii: bmjopen-2019-035678
doi: 10.1136/bmjopen-2019-035678
pmc: PMC7783622
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e035678Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
BMC Fam Pract. 2014 Jun 17;15:122
pubmed: 24938306
Curr Probl Cancer. 2017 Jan - Feb;41(1):71-79
pubmed: 28104314
Br J Gen Pract. 2010 Feb;60(571):127
pubmed: 20132705
Thorax. 2013 Jun;68(6):551-64
pubmed: 23399908
BMC Health Serv Res. 2013 Apr 23;13:147
pubmed: 23617296
Scand J Prim Health Care. 1996 Mar;14(1):13-20
pubmed: 8725089
Br J Cancer. 2017 Jul 25;117(3):439-449
pubmed: 28641316
Lancet. 2011 Jan 8;377(9760):127-38
pubmed: 21183212
Lancet Oncol. 2014 Feb;15(2):232-40
pubmed: 24433682
Ugeskr Laeger. 2008 Sep 22;170(39):3065-9
pubmed: 18822235
BMJ Open. 2018 Sep 5;8(9):e022904
pubmed: 30185577
Med Teach. 2011;33(10):e564-71
pubmed: 21942493
Fam Pract. 2004 Aug;21(4):387-95
pubmed: 15249527
Br J Cancer. 2009 Dec 3;101 Suppl 2:S110-4
pubmed: 19956154
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014 Mar;57(3):318-26
pubmed: 24562707
Acta Oncol. 2013 Jun;52(5):919-32
pubmed: 23581611
Glob Health Sci Pract. 2017 Sep 28;5(3):412-429
pubmed: 28963174
Br J Cancer. 2009 Dec 3;101 Suppl 2:S125-9
pubmed: 19956156
BMJ. 2015 Jan 07;350:g7773
pubmed: 25569206
BMC Health Serv Res. 2018 May 8;18(1):338
pubmed: 29739409
Br J Cancer. 2015 Mar 31;112 Suppl 1:S41-9
pubmed: 25734388
Br J Cancer. 2013 Oct 1;109(7):2014-9
pubmed: 23963144
BMJ. 2011 Jun 09;342:d3399
pubmed: 21659366
J Med Internet Res. 2008 Oct 16;10(4):e30
pubmed: 18926979
Eur J Oncol Nurs. 2018 Jun;34:82-88
pubmed: 29784144
Br J Cancer. 2009 Dec 3;101 Suppl 2:S102-9
pubmed: 19956153
Br J Cancer. 2015 Mar 31;112 Suppl 1:S92-107
pubmed: 25734382
BMJ Open. 2020 Apr 15;10(4):e035799
pubmed: 32300000
Eur J Cancer. 2013 Jun;49(9):2187-98
pubmed: 23453935
Ann Intern Med. 2018 Jul 3;169(1):36-43
pubmed: 29946705
Br J Gen Pract. 2011 Aug;61(589):e508-12
pubmed: 21801563
Lung Cancer. 2017 Oct;112:156-164
pubmed: 29191588
BMC Fam Pract. 2008 Jan 15;9:2
pubmed: 18194578
Lancet. 2018 Mar 17;391(10125):1023-1075
pubmed: 29395269
Scand J Prim Health Care. 2017 Mar;35(1):27-34
pubmed: 28277044
Health Policy. 2013 Sep;112(1-2):148-55
pubmed: 23693117
Hum Resour Health. 2017 Oct 19;15(1):75
pubmed: 29052504
Br J Cancer. 2013 Feb 5;108(2):292-300
pubmed: 23370208
N Engl J Med. 1992 Aug 6;327(6):424-9
pubmed: 1625720
BMJ Open. 2015 May 27;5(5):e007212
pubmed: 26017370
Br J Gen Pract. 2014 Dec;64(629):e788-93
pubmed: 25452544
BMJ. 2009 Aug 25;339:b2998
pubmed: 19706933
Behav Res Methods. 2015 Dec;47(4):1237-1259
pubmed: 25410404
Lancet Oncol. 2014 Jan;15(1):23-34
pubmed: 24314615
Health Expect. 2014 Oct;17(5):637-50
pubmed: 22809132
J R Coll Gen Pract. 1987 Aug;37(301):350-3
pubmed: 3448226
Ann Intern Med. 2004 Nov 16;141(10):771-80
pubmed: 15545677
JAMA. 2000 Apr 5;283(13):1715-22
pubmed: 10755498
Aust Fam Physician. 1998 Jan-Feb;27(1-2):78-82
pubmed: 9503712
Br J Cancer. 2009 Dec 3;101 Suppl 2:S80-6
pubmed: 19956169
Health Policy Plan. 2007 Sep;22(5):294-302
pubmed: 17660225
BMC Med Res Methodol. 2014 Jun 06;14:76
pubmed: 24906492