Predictive value of signs and symptoms for colorectal cancer in patients with rectal bleeding in general practice.

Abstract:

:The aim of the study is to determine the diagnostic value of (combinations of) signs, symptoms and simple laboratory test results for colorectal cancer in patients with rectal bleeding presenting in general practice. Initial complaints and findings were compared with the final diagnoses based on clinical follow-up after at least 1 year. Patients studied were those presenting overt rectal bleeding to the general practitioner (83 GPs in the South of the Netherlands). Outcome measures are sensitivity, specificity, predictive values, odds ratios and a prediction model derived from multiple logistic regression analysis. Age, change in bowel habit and blood mixed with or on stool show a statistically significant independent value in the discrimination between patients with a low and those with a high probability of colorectal cancer. Many other variables did not show predictive value. The prediction model has a sensitivitiy of 100% and a specificity of 90%. Although the number of patients with colorectal cancer is small (n = 9) it was possible to identify three characteristics which can be helpful in the prediction of presence or absence of colorectal cancer in general practice. Application of the model presented might prevent 90% of 'unnecessary' invasive diagnostic procedures for patients with rectal bleeding who do not have colorectal cancer (true negative). Testing the performance of the model in other general practice populations is recommended.

journal_name

Fam Pract

journal_title

Family practice

authors

Fijten GH,Starmans R,Muris JW,Schouten HJ,Blijham GH,Knottnerus JA

doi

10.1093/fampra/12.3.279

subject

Has Abstract

pub_date

1995-09-01 00:00:00

pages

279-86

issue

3

eissn

0263-2136

issn

1460-2229

journal_volume

12

pub_type

临床试验,杂志文章
  • How do GPs diagnose and manage acute infective conjunctivitis? A GP survey.

    abstract:OBJECTIVE:To determine GPs' diagnosis and management of acute infective conjunctivitis (AIC)-one of the commonest but least researched acute infections seen in primary care. METHODS:A postal questionnaire survey of 300 GPs from two Health Authorities in Southern England. RESULTS:236 (78%) GPs returned the questionnai...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/19.6.658

    authors: Everitt H,Little P

    更新日期:2002-12-01 00:00:00

  • Diagnosing skin disease in primary care: a qualitative study of GPs' approaches.

    abstract:BACKGROUND:Skin diseases are a common reason for consulting a GP. This regular occurrence happens despite most GPs' lack of knowledge and training in skin disease. OBJECTIVES:We aimed to explore different diagnostic approaches of GPs in patients presenting with a dermatological problem. In addition, we aimed to identi...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmv056

    authors: Rübsam ML,Esch M,Baum E,Bösner S

    更新日期:2015-10-01 00:00:00

  • Shared care in gastroenterology: GPs' views of open access to out-patient follow-up for patients with inflammatory bowel disease.

    abstract:OBJECTIVE:The aim of this study was to ascertain GPs' views about open access to out-patient follow-up for patients with inflammatory bowel disease (IBD). METHODS:Semi-structured interviews and a postal survey were carried out in general practices in West Glamorgan UK, each with at least one IBD patient taking part in...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/19.1.53

    authors: Cheung WY,Dove J,Lervy B,Russell IT,Williams JG

    更新日期:2002-02-01 00:00:00

  • Measuring general practitioners' attitudes towards medical care.

    abstract::The construction and development of a questionnaire which measures the attitudes of general practitioners towards their role in the medical care system is described. Factor analytic procedures identified seven reliable factor-based subscales. The subscales measured attitudes towards: a psychological orientation to pat...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/4.3.192

    authors: Cockburn J,Killer D,Campbell E,Sanson-Fisher RW

    更新日期:1987-09-01 00:00:00

  • Effectiveness of behavioural weight loss interventions delivered in a primary care setting: a systematic review and meta-analysis.

    abstract:BACKGROUND:Overweight and obesity have negative health effects. Primary care clinicians are best placed to intervene in weight management. Previous reviews of weight loss interventions have included studies from specialist settings. The aim of this review was to estimate the effect of behavioural interventions delivere...

    journal_title:Family practice

    pub_type: 杂志文章,meta分析,评审

    doi:10.1093/fampra/cmu064

    authors: Booth HP,Prevost TA,Wright AJ,Gulliford MC

    更新日期:2014-12-01 00:00:00

  • 'Advise yes, dictate no'. Patients' views on health promotion in the consultation.

    abstract::Interviews with 130 mothers of lower social class provided the basis for studying their views on the desirability of general practitioner intervention in their lifestyle habits; the study used both quantitative (questionnaire) and qualitative (interview) techniques. The majority of women were in favour of counselling ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/7.2.125

    authors: Stott NC,Pill RM

    更新日期:1990-06-01 00:00:00

  • Variation in general practitioners' depression care following certification of sickness absence: a registry-based cohort study.

    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

    authors: Riiser S,Haukenes I,Baste V,Smith-Sivertsen T,Hetlevik Ø,Ruths S

    更新日期:2020-11-05 00:00:00

  • Acute bronchitis: aetiology, symptoms and treatment.

    abstract::There is much discussion about the aetiology, definition and treatment of acute bronchitis. This paper reviews the main issues in the debate. It concludes that bronchitis should be regarded as a collective name for a wide range of syndromes. Whether further differentiation of the clinical diagnosis is meaningful depen...

    journal_title:Family practice

    pub_type: 杂志文章,评审

    doi:10.1093/fampra/6.1.66

    authors: Verheij TJ,Kaptein AA,Mulder JD

    更新日期:1989-03-01 00:00:00

  • Incidence, patient characteristics and treatment initiated for GP-diagnosed depression in general practice: results of a 1-year nationwide surveillance study.

    abstract:BACKGROUND:Despite its public health significance, data about depression in general practice are often unavailable. OBJECTIVE:To study (i) the incidence of GP-diagnosed depression during 2008, (ii) associations between patient characteristics, appraised severity and initiated treatment, (iii) GPs' usual care compared ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cms024

    authors: Boffin N,Bossuyt N,Declercq T,Vanthomme K,Van Casteren V

    更新日期:2012-12-01 00:00:00

  • A cross-sectional study of United States family medicine residency programme director burnout: implications for mitigation efforts and future research.

    abstract:BACKGROUND:Academic physician burnout is concerning. Too little is known about factors associated with residency programme director burnout. Continued uncertainty risks adverse outcomes including graduate medical education leadership turnover and negative impact on recruiting and retaining under-represented minority re...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmaa075

    authors: Psenka TM,Freedy JR,Mims LD,DeCastro AO,Berini CR,Diaz VA,Jarrett JB,Steyer TE

    更新日期:2020-11-28 00:00:00

  • Effectiveness of a learner-centred training programme for primary care physicians in using a patient-centred consultation style.

    abstract:OBJECTIVE:The aim of the present study was to find out if a training programme adapted to family physicians with several years of clinical experience changes their behaviour when they deal with fibromyalgic patients in the sense of introducing the communication skills that define the 'patient-centred' approach. METHOD...

    journal_title:Family practice

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/fampra/18.1.60

    authors: Moral RR,Alamo MM,Jurado MA,de Torres LP

    更新日期:2001-02-01 00:00:00

  • Climacteric complaints in the community.

    abstract:BACKGROUND:At the onset of the climacteric, healthy middle-aged women present with a variety of complaints, especially in general practice. In these first years of entering the menopause, vaginal blood loss alters from irregular periods to complete amenorrhoea. According to these different menstrual patterns, we can di...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/18.2.189

    authors: Maartens LW,Leusink GL,Knottnerus JA,Smeets CG,Pop VJ

    更新日期:2001-04-01 00:00:00

  • Aspects of diagnosis of acute otitis media.

    abstract:BACKGROUND:Acute otitis media is a common disease, particularly among children. The importance of a correct diagnosis is crucial, especially as unjustified prescription of antibiotics has become a major problem in clinical praxis. OBJECTIVES:Our aim was to evaluate the predictive value of different otological findings...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/15.2.133

    authors: Hemlin C,Hassler E,Hultcrantz M,Papatziamos G,Krakau I

    更新日期:1998-04-01 00:00:00

  • The search for person-related information in general practice: a qualitative study.

    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

    authors: Schrans D,Avonts D,Christiaens T,Willems S,de Smet K,van Boven K,Boeckxstaens P,Kühlein T

    更新日期:2016-02-01 00:00:00

  • General practitioner consultation after a visit to the emergency department: an observational study.

    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

    authors: Rotival J,Yordanov Y,Thiebaud PC,Pelletier-Fleury N,Jacquet E,Debuc E,Pateron D,Naouri D

    更新日期:2019-03-20 00:00:00

  • The BeweegKuur programme: a qualitative study of promoting and impeding factors for successful implementation of a primary health care lifestyle intervention for overweight and obese people.

    abstract:BACKGROUND:The aim of the study was to identify promoting and impeding factors for successful implementation of a Dutch primary health care-based lifestyle programme called 'BeweegKuur'. BeweegKuur aims to increase the physical activity and change the diet of people at increased health risk due to overweight or obesity...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmr056

    authors: Helmink JH,Kremers SP,Van Boekel LC,Van Brussel-Visser FN,Preller L,De Vries NK

    更新日期:2012-04-01 00:00:00

  • A multinational study of the factorial structure and other characteristics of the Dartmouth COOP Functional Health Assessment Charts/WONCA.

    abstract:BACKGROUND:The 'Dartmouth COOP Functional Health Assessment Charts/WONCA' constitute a relatively new derived instrument for assessing health status that is specifically intended for use in primary care on a world-wide basis. It needs further validation in its special area of use. OBJECTIVES:Over a range of countries,...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/14.6.478

    authors: Westbury RC,Rogers TB,Briggs TE,Allison DJ,Gérvas J,Shigemoto H,Elford W

    更新日期:1997-12-01 00:00:00

  • The diagnostic value of rectal examination.

    abstract::The rectal examination is a much advocated procedure for assessing abdominal and urinary symptoms. A Medline literature search yielded only a few studies, not one of them in a general practice setting. The sensitivity of the rectal examination to rectal carcinoma and appendicitis is low, while it is high for prostate ...

    journal_title:Family practice

    pub_type: 杂志文章,meta分析

    doi:10.1093/fampra/10.1.34

    authors: Muris JW,Starmans R,Wolfs GG,Pop P,Knottnerus JA

    更新日期:1993-03-01 00:00:00

  • The importance of measuring self-efficacy in patients with diabetes.

    abstract:OBJECTIVES:Self-efficacy is an important factor influencing diabetes self-management behaviours. Previous studies have examined self-efficacy as a general measure in diabetes care for all self-care treatment recommendations together. This current study was designed to examine if low self-efficacy in each of the measure...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmq086

    authors: Mishali M,Omer H,Heymann AD

    更新日期:2011-02-01 00:00:00

  • Consultations involving people with congenital disabilities: factors that help or hinder giving care.

    abstract:BACKGROUND:Previous studies have suggested that the attitudes of health professionals towards people with disability may be as negative as those of society. Further, even positive attitudes may not always be reflected in the health professional's behaviour. OBJECTIVE:The aim of this study was to examine GPs' (registra...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/18.4.419

    authors: Muir EH,Ogden J

    更新日期:2001-08-01 00:00:00

  • Is statistician involvement as co-author associated with reduced time to publication of quantitative research in general medical journals? A bibliometric study.

    abstract:OBJECTIVE:We aimed to compare the number of submissions until acceptance and the time to publication between articles co-authored and articles not co-authored by statisticians. METHODS:We randomly selected 781 articles published in 2016 in 18 high impact factor journals of general internal medicine and primary care. F...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmy115

    authors: Sebo P,Fournier JP,Maisonneuve H

    更新日期:2019-07-31 00:00:00

  • Relevance and practical use of the Consultation and Relational Empathy (CARE) Measure in general practice.

    abstract:BACKGROUND:The Consultation and Relational Empathy (CARE) Measure has been developed as a tool for assessing the patients' perceptions of relational empathy in the consultation. OBJECTIVES:The present paper provides performance data on the CARE measure in a large sample of general practice consultations in areas of hi...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmh730

    authors: Mercer SW,McConnachie A,Maxwell M,Heaney D,Watt GC

    更新日期:2005-06-01 00:00:00

  • Doing randomized controlled trials in a developing country: some practical realities.

    abstract:BACKGROUND:Formal randomized controlled trial results are often reported. The difficulties of doing such trial are not. Developing countries represent a new field in which trials can be undertaken. In this context even less is known about the practicalities involved. METHOD AND RESULTS:A randomized, double-blind, para...

    journal_title:Family practice

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/fampra/13.1.98

    authors: Glasgow NJ,Murdoch JC,Baynouna L,al Sabosy MM,al Jabiri ON,Harron DW

    更新日期:1996-02-01 00:00:00

  • The assessment of genetic risk of breast cancer: a set of GP guidelines.

    abstract:BACKGROUND:Assessing a genetic risk for developing breast cancer is not an easy task for a GP. Current expert guidelines for referring and counselling women with a family history positive for breast cancer are complex and difficult to apply in general practice, and have only two strategies (to refer or not to refer for...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/16.1.71

    authors: de Bock GH,Vliet Vlieland TP,Hageman GC,Oosterwijk JC,Springer MP,Kievit J

    更新日期:1999-02-01 00:00:00

  • The social impact of asthma.

    abstract::While much research has examined the aetiology and treatment of asthma, little work has been done on its social impact. Yet asthma, like any disease, has a social as well as a medical dimension and it is increasingly being recognized that these two dimensions are interlinked. This paper describes a study into the soci...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/8.1.37

    authors: Nocon A,Booth T

    更新日期:1991-03-01 00:00:00

  • Late-life depression and the association with multimorbidity and polypharmacy: a cross-sectional study.

    abstract:Background:Late-life depression often coincides with chronic somatic diseases and, consequently, with polypharmacy, which may complicate medical treatment. Objective:To determine the associations between patients diagnosed with late-life depression in primary care and multimorbidity and polypharmacy. Methods:This cro...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmx018

    authors: Holvast F,van Hattem BA,Sinnige J,Schellevis F,Taxis K,Burger H,Verhaak PFM

    更新日期:2017-09-01 00:00:00

  • Paired interviews of shared experiences around chronic low back pain: classic mismatch between patients and their doctors.

    abstract:BACKGROUND:current treatments for chronic low back pain (LBP) appear to be inadequate and there are growing calls for new approaches. This study explores the paired interviews of shared experiences among chronic LBP patients and their physicians with the ultimate goal of improving doctor-patient communication and clini...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmq063

    authors: Allegretti A,Borkan J,Reis S,Griffiths F

    更新日期:2010-12-01 00:00:00

  • Selections from current literature: hormone therapy in postmenopausal women.

    abstract::The articles reviewed for this issue of 'Selections' concern potential therapies to prevent osteoporosis and cardiovascular disease in postmenopausal women. Each therapy is controversial and provokes more questions than answers. The most benign intervention is the administration of calcium to postmenopausal women whos...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/8.3.288

    authors: Froom J

    更新日期:1991-09-01 00:00:00

  • Long-term prognosis of acute otitis media in infancy: determinants of recurrent acute otitis media and persistent middle ear effusion.

    abstract:OBJECTIVES:Children under 2 years of age with acute otitis media are known to have a relatively poor prognosis. The objective of this study was to assess whether known determinants for recurrent acute otitis media and persistent middle ear effusion after an episode of acute otitis media during childhood also apply to c...

    journal_title:Family practice

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/fampra/cmi083

    authors: Damoiseaux RA,Rovers MM,Van Balen FA,Hoes AW,de Melker RA

    更新日期:2006-02-01 00:00:00

  • The differential blood pressure sign in general practice: prevalence and prognostic value.

    abstract:BACKGROUND:Patients sometimes have differences of > or =20/10 mmHg in their blood pressure depending on which arm is measured. The prevalence and prognostic value of this finding in general practice are unknown. If these differences are due to peripheral vascular disease, these patients may be at increased risk of card...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/19.5.439

    authors: Clark CE,Powell RJ

    更新日期:2002-10-01 00:00:00