Abstract:
BACKGROUND:Early diagnosis of cancer is an important challenge in general practice. Symptoms are the most common starting points. OBJECTIVE:To assess the association between symptoms presented and subsequent cancer. DESIGN:A cohort study of all patients seen consecutively by GPs. Prospective recording of cancer diagnosis, new cancer or new recurrence. SETTING:Two hundred and eighty-three general practice surgeries and 10 working days. METHOD:During patient consultations, GPs registered seven focal symptoms and three general symptoms, commonly considered as warning signs of cancer (WSC). Follow-up 6-11 months later with registration of any subsequent diagnosis of cancer was done. RESULTS:Of 51 073 patients, 6321 (12.4%) had recordings of 7704 WSC. During a median follow-up period of 8 months, 263 patients were diagnosed with cancer and 59 of them with recurrence of a previously diagnosed cancer. Of the cancer patients, 106 (40%) had presented one or more WSC during a preceding consultation. Examined symptoms had likelihood ratios for cancer from 1.5 to 8.2 and positive predictive values (PPVs) from 0.8% to 3.8%. Limited to older age groups, PPVs were a little higher. General symptoms were rarely associated with cancer unless a focal symptom had been recorded as well. Multiple symptoms increased the probability of cancer. CONCLUSION:12.4% of GP patients presented with WSC. A general symptom may have cancer diagnostic value, but usually, only when it occurs along with a focal symptom. PPV of any single symptom is low, and decisions about referral require additional information.
journal_name
Fam Practjournal_title
Family practiceauthors
Ingebrigtsen SG,Scheel BI,Hart B,Thorsen T,Holtedahl Kdoi
10.1093/fampra/cms065subject
Has Abstractpub_date
2013-04-01 00:00:00pages
153-60issue
2eissn
0263-2136issn
1460-2229pii
cms065journal_volume
30pub_type
临床试验,杂志文章相关文献
FAMILY PRACTICE文献大全abstract::The present study was performed to investigate the predictive value of casual blood pressure recordings for mortality in a geographically defined population (n = 1917), for which the primary health care services are responsible. Isotonic regression of blood pressure on age was used to define groups with low, medium an...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/3.1.3
更新日期:1986-03-01 00:00:00
abstract::In November 1991 69% of a random sample of 998 Danish general practitioners (GPs) participated in a survey by anonymously filling in a mailed questionnaire concerning the way in which they use health education in their practices. Among the participating GPs, 97% used health education material. The study showed differe...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/11.1.35
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) is often asymptomatic, and screening is not routinely undertaken. OBJECTIVE:Evaluate the feasibility and effectiveness of a population-based case finding program and to identify the enablers of and/or barriers to its implementation. METHODS:We conducted a cross-sectional study of a...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmaa023
更新日期:2020-09-05 00:00:00
abstract:BACKGROUND:recruitment targets to randomized controlled trials (RCTs) are often not met. Many interventions are used to improve recruitment but there is little empirical evidence on whether these approaches work. OBJECTIVE:to examine whether changes to the design and conduct of a primary care-based RCT were associated...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmq050
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVES:The aim of the study was to validate a new case-finding instrument for common mental disorders (CMDQ). METHODS:A cross-sectional, stratified, two-phase study was carried out in 28 general practices in Aarhus County, Denmark. 1785 consecutive patients, 18-65 years old, consulting 38 GPs with a new health pro...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmi025
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Some studies have demonstrated an association between poor continuity of care, high likelihood of 'inappropriate' use of emergency departments (EDs) and avoidable hospitalization. However, we lack data concerning primary care use after an ED visit. OBJECTIVE:Identify the determinants of a visit to the gener...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmy054
更新日期:2019-03-20 00:00:00
abstract:BACKGROUND:Adolescent pregnancy is an important health issue. Prevention programs are usually aimed at the prevention of repeat pregnancy, ignoring the adolescents at risk of becoming pregnant for the first time. OBJECTIVES:To analyse if socio-economic status, family type and mother's age at first pregnancy are risk f...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmr015
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Medical end-of-life decisions (ELDs) have been discussed for several years in different countries, but little is known about the involvement of GPs in these ELDs. OBJECTIVES:The aim of the present study was to establish the incidence and characteristics of ELDs by GPs. METHOD:We selected 3999 deaths, a 20%...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmh312
更新日期:2004-06-01 00:00:00
abstract::An important pitfall of nutritional guidance in medical practice is how to deal with the prevention paradox: a nutritional advice that is good for the population as a whole is not necessarily proven effective for the individual patient. Evidence-based guidelines are needed to support GPs to translate these advices to ...
journal_title:Family practice
pub_type: 杂志文章,评审
doi:10.1093/fampra/cmn074
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:According to literature, COPD rates are high in spite of decreasing rates of main risk factors smoking and air pollution in developed countries. general practice is a good place to survey unbiased prevalence rates. Ten studies done in general practice over the last 20 years found prevalence rates among smoke...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmn084
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Although practice nurses play an important role in implementing smoking cessation strategies in primary care, relatively little is known of their attitudes and beliefs about giving smoking cessation advice. OBJECTIVES:To describe practice nurses' attitudes towards giving smoking cessation advice. METHODS:1...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmi082
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Regular aspirin is beneficial after myocardial infarction (MI). Community-based surveys appear to show unsatisfactory uptake of aspirin after MI. This could be due to over-the-counter (OTC) use not being recorded. In a pilot study in one practice, 39% of patients on aspirin after MI used OTC preparations. In...
journal_title:Family practice
pub_type: 杂志文章,多中心研究
doi:
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:Patient experience and satisfaction are important indicators of quality in health care. Little is known about where to prioritize efforts to improve patient satisfaction. OBJECTIVES:To investigate patient satisfaction with primary care, as part of the Quality and Costs of Primary Care in Europe study in Eng...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmw004
更新日期:2016-04-01 00:00:00
abstract::Much of diabetes care needs to be carried out by patients between office visits with their health care providers. Yet, many patients face difficulties carrying out these tasks. In addition, many adults with diabetes cannot count on effective support from their families and friends to help them with their self-manageme...
journal_title:Family practice
pub_type: 杂志文章,收录出版,评审
doi:10.1093/fampra/cmp003
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Co-morbid diabetes and chronic kidney disease (CKD) are common in primary care but health care can be suboptimal. OBJECTIVE:In this multi-centre mixed-methods study, we investigated GPs' perspectives on health service barriers in managing diabetes and CKD as an initial step towards health care improvement. ...
journal_title:Family practice
pub_type: 杂志文章,多中心研究
doi:10.1093/fampra/cmw041
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Little is known about the frequency with which information from the Internet is presented by patients within primary care consultations or the subsequent impact that it may have on those consultations. OBJECTIVES:The aims of this study were to describe the frequency with which Internet information was prese...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmh215
更新日期:2004-04-01 00:00:00
abstract::The electronic version of the second edition of the International Classification of Primary Care, ICPC-2-E, available on the website of Family Practice since 2000, needed an update of the mapping with ICD-10 as a nomenclature and, consequently, of some of its criteria. This is now being made available, together with t...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/19.5.543
更新日期:2002-10-01 00:00:00
abstract::General practitioners' perceptions of low back pain (LBP) patients were investigated through a series of in-depth semi-structured interviews, as part of a wider study which also investigated patient perceptions. An exhaustive analysis of the interview transcripts revealed six principal ways in which GPs distinguished ...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/12.1.44
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVES:The aim of this study is to understand in depth the experience of the family physician faced with the patient that he perceives as 'difficult'. This was done by means of the 'long interview' as a method of qualitative research. METHOD:We interviewed 15 randomly selected Board-certified family physicians, wi...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/18.5.495
更新日期:2001-10-01 00:00:00
abstract::Doctors in different countries completed a questionnaire relating to the importance they attributed to eight possible sources of information about a new drug, their estimation of patients' expectations of the doctor prescribing drugs under specific circumstances and their therapeutic response to common clinical genera...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/4.2.123
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND:The existing scales to measure patient experience of primary care for adults tend to be with many items and difficult to use outside of the research setting. OBJECTIVE:To develop a Japanese version of Primary Care Assessment Tool Short Form as a concise scale for assessing patient experience of primary care...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmz038
更新日期:2020-02-19 00:00:00
abstract:BACKGROUND:Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients' social position. OBJECTIVE:To investigate associations between patients' gender and educational status combined and GP depression ...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmaa120
更新日期:2020-11-05 00:00:00
abstract:OBJECTIVE:In-depth knowledge of existing practice is required to inform interventions aimed at antibiotic prescribing quality improvement. We set out to describe the presentation, antimicrobial management and associated outcome of adults presenting in general practice with acute cough/lower respiratory tract infection ...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmr019
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:There has been a continued trend towards undertaking primary care-based research but the characteristics and generalizability of practices that participate in such research are not well known. OBJECTIVE:To compare research active and non-active practices in terms of practice demographics, disease prevalence...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmm065
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Uncomplicated lower urinary tract infection (LUTI) is one of the most common infections treated in general practice. Although nationwide treatment guidelines for LUTI are increasingly available, most European countries, including Slovenia, have not yet set such guidelines. OBJECTIVES:Our aim was to describe...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmg421
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Influenza (flu) is an acute viral infection of the respiratory tract, which can lead to serious complications for individuals within at-risk groups. Evidence indicates that aspects of organization and delivery within GP practices can have an influence on the rates of flu vaccination uptake. Positive deviance...
journal_title:Family practice
pub_type: 杂志文章,多中心研究
doi:10.1093/fampra/cmw016
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Antibiotics are over-prescribed for lower respiratory tract infection (LRTI). The influence of clinicians' history and examination findings on antibiotic prescribing for LRTI has not been directly assessed, and the extent to which these clinical findings predict appropriate antibiotic prescribing is unknown....
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmi100
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:General practice is person-focused. Contextual information influences the clinical decision-making process in primary care. Currently, person-related information (PeRI) is neither recorded in a systematic way nor coded in the electronic medical record (EMR), and therefore not usable for scientific use. AIM:...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmv099
更新日期:2016-02-01 00:00:00
abstract:Background:Little is known about respiratory tract infection (RTI) severity in children following consultation. Objectives:To investigate post-consultation symptom trajectories in children with acute cough and RTI and whether baseline characteristics predict trajectory group. Methods:Prospective cohort study of 2296 ...
journal_title:Family practice
pub_type: 杂志文章,多中心研究
doi:10.1093/fampra/cmy021
更新日期:2018-12-12 00:00:00
abstract:INTRODUCTION:Walk-in clinics aim to be highly accessible facilities, in particular for urgent primary care cases. A perceived increase of walk-in clinic visits in Canada could put this accessibility at risk. We aimed to study the appropriateness of walk-in clinic visits in Québec, Canada. METHODS:We performed a cross-...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmt069
更新日期:2014-02-01 00:00:00