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GPs trial electronic cancer risk scores

By Lilian Anekwe

Practices have begun trialling new Framingham-style computer software to predict patients’ risk of cancer, as part of a Government drive to increase early diagnosis by GPs.

The Department of Health has launched six-month pilots of the software, based on research by leading GP academics, in 180 practices that will use the risk assessment tool to calculate the likelihood of a patient’s symptoms being a possible diagnosis of either colon or lung cancers, helping guide referral decisions.

It comes after Pulse revealed that some NICE guidance, including those for the referral of patients with suspected bowel cancers, relies too heavily on ‘typical’ symptoms and performs ‘no better than chance’ in younger patients.

The pilot is based on work by Dr William Hamilton, professor of primary care diagnostics at the Peninsula Medical School in Exeter and a GP in the city.

Researchers at the University of Birmingham will also shortly launch CREDIBLE, a second research study funded by the DH’s national awareness and early diagnosis initiative, which will investigate the use of GP software to identify patients needing urgent referral for suspected colorectal cancer.

The CREDIBLE STUDY will run the software weekly in practices and invite any patients that meet referral criteria for a consultation to decide if there is a genuine need to refer. The researchers will follow up identified patients to find out how many turn out to have cancer, polyps or other diagnoses.

Two software companies, MSDi and CDRIntell have already added the symptom scoring systems to their practice software, which is expected to identify about one patient a week with suspected colorectal cancer in a practice of 6,000.

Dr Tom Marshall, senior clinical lecturer in public health at the University of Birmingham and lead researcher on the CREDIBLE project, appealed for GPs to sign up for the pilots.

He said: ‘Our symptom scoring systems work better but they are too complicated for GPs to apply in a normal consultation. We need to programme these rules so that patients can be identified automatically from electronic medical records.’

Dr Ian Marshall, the DH national clinical lead for primary care, NHS improvement, and a GP in Oldham, said the risk software can be used by GPs to assess cancer risk in the same way as cardiovascular disease.

‘Some GPs might see this as an affront to their knowledge but I see it as an additional tool that GPs can use.

‘GPs are already very familiar with this kind of tool and we use it in assessing cardiovascular risk. I can see GPs using this in the same way as CVD risk tools.’

GPs trial computer-based cancer risk scores