The delay in the follow up of abnormal test results associated with undiagnosed prevalent cancer in primary care
Professor Jon Emery
Patients with early prevalent cancer can present with non-specific symptoms or a combination of symptoms. There is evidence to suggest that when associated with a failure to follow up abnormal pathology tests and/or imaging test results, a cancer diagnosis can be delayed or missed. Although cancer diagnoses are uncommon in primary care, missed or delayed diagnoses can be associated with serious health consequences for patients. As general practitioners (GPs) have a significant role as gatekeepers to specialist care in Australia, this presents challenges for GPs to make appropriate and timely actions and potential diagnoses for cancer.
This study aims to determine the prevalence of abnormal test results and the delay or failure to follow-up these results that are associated with undiagnosed prevalent cancer in primary care. This will be explored through a systematic review of existing literature, and secondary analysis of the Australian NPS MedicineInsight dataset, a longitudinal, de-identified primary care dataset.
We will also develop a clinical audit and decision support tool ab initio that aims to assist in the follow-up and management of abnormal test results associated with undiagnosed prevalent cancer. The tool will aim to provide robust and tailored guidance for test result management for patients with a potential and early cancer diagnosis. Simulation testing of the tool using clinical case studies and simulated patients will be conducted with GPs and practice nurses to determine the usability, feasibility and acceptability of the tool, prior to potential pilot testing and implementation in general practice clinics.
Peter Nguyen, PhD Candidate
Professor Jon Emery, Herman Professor of Primary Care Cancer Research
Dr Jennifer McIntosh, Senior Research Fellow, Cancer in Primary Care
Dr Jeanette Reece, NHMRC Research Fellow, Centre for Epidemiology and Biostatistics
Associate Professor Jo-Anne Manski-Nankervis, Department of General Practice
Associate Professor Douglas Boyle, Health and Biomedical Informatics Centre, Department of General Practice
Dr Fiona Walter, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
Professor Hardeep Singh, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs (VA) Medical Center and Baylor College of Medicine, Houston, USA
Assistant Professor Ashley Meyer, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs (VA) Medical Center and Baylor College of Medicine, Houston, USA
Peter Nguyen is funded by the Australian Government Research Training Program, Fay Marles Graduate Research Access Scholarship and the Margaret and Irene Stewardson Fund Scholarship.
This program of research is funded and supported by CanTest.