News
New Discovery Research publication
The SYMPTOM Study team's research into symptom appraisal for colorectal cancer has been published in BMJ Open. This is a unique piece of research which compares the appraisal and help seeking experiences of patients with colorectal cancer symptoms who go on to have cancer and those who turn out to have non-cancer conditions. The research did not identify any clear differences between the two groups but did identify important barriers to presentation around the ‘private nature’ of colorectal symptoms which will prove useful to policy makers and the design of awareness campaigns. To read more about the research paper see the results section here.
Discovery conference slides available & new research publications
The Discovery Programme held its research conference at the Royal College of General Practitioners on June 2nd 2015. The team presented their research findings and outlined the impact of the programme to a wide range of patient groups, clinicians, policy makers, researchers and journalists. The PowerPoint slides used during the presentation have been uploaded to this website and can be viewed below.
The Discovery Programme 2nd June 2015 – Conference PowerPoint slides
To view the slides from the conference click on the talk titles in the timetable below
The Discovery delegates programme can be viewed here.
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10:30-11:00 |
Registration & Coffee |
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11:00-11:05 |
Welcome and introduction |
Willie Hamilton |
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11:05-11:20 |
Introduction to the Royal College of General Practitioners |
Maureen Baker |
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11:20-11:35 |
Diagnosing cancer early: challenges for patients and general practitioners |
Sara Hiom |
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11:35 -12:40 |
The Discovery Programme of research
PANEL - discussion |
The Discovery Team |
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12:40-1:30 |
Lunch and informal discussions with research team |
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1:30-2:00 |
'What do we now know about early diagnosis of symptomatic cancer, and how has the Discovery Programme contributed to this?'
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The Discovery Team |
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2:00-2:45 |
Key messages…
PANEL - discussion |
Roger Jones (chair), |
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2:45-3:00 |
Cancer research in the UK - the future |
Willie Hamilton |
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3:00-3:15 |
Closing event - Prof Roger Jones, BJGP editor & chair of Discovery steering committee. |
Roger Jones |
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3:15-3:30 |
Further opportunity for informal discussions with research team |
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There are also 2 new research papers to report. Chantal Balasooriya-Smeekens has published the literature review of her PhD in Psycho-Oncology, "The role of emotions in time to presentation for symptoms suggestive of cancer: a systematic review of quantitative studies". Abstract and publication details are here and further papers from Chantal's PhD will be published soon.
Nafees Din has published a new paper under the Discovery related research umbrella. The paper uses Discovery data drawn from the CAPER (theme 2) studies and considers "Age and Gender Variations in Cancer Diagnostic Intervals in 15 Cancers". Full publication details and abstract can be found here.
New Discovery research publications
There are 2 new Discovery research papers in the recent edition of the British Journal of General Practice along with a third paper that uses the discovery programme data drawn from the General Practice Research database. Liz Shephard's is lead author on 2 papers which identify the risk profile of symptoms associated with Hodgkins and Non-Hodgkins Lymphoma. The research confirms lymphadenopathy as the symptom with the highest risk. The Hodgkins paper suggests that current NICE guidance advising a 6 week wait may be too long. The results from these papers should aid GPs in selecting patients for referral and further investigation. Full details on the results page.
There is a new Discovery related research paper also published in the BJGP. Matthew Ridd and researchers at the Universities of Bristol and Exeter looked at data from the Discovery Programme to see whether there is a relationship between time to diagnosis and continuity of GP care. The team found that seeing a known doctor in the 2 years before diagnosis may delay the diagnosis of colorectal cancer, yet following up cancer-related symptoms with the same doctor may speed up the time to diagnosis for colorectal and lung cancer. For more details go to the results page.
Discovery conference draft timetable and guest speakers
We are really pleased to announce our guest speakers and draft timetable for the Discovery Programme conference on June 2nd 2015.
Our guest speakers are:
- Professor Maureen Baker, Chair of the Royal College of General Practitioners
- Dr Sara Hiom, Director of Early Diagnosis and Cancer Intelligence at Cancer Research UK
- Professor Roger Jones, Editor of British Journal of General Practice, Emeritus Professor of General Practice, King's College, London
To book your place click here.
Draft conference timetable
|
10:30-11:00 |
Registration & Coffee |
|
|
11:00-11:05 |
Welcome and introduction |
Willie Hamilton |
|
11:05-11:20 |
Introduction to the Royal College of General Practitioners |
Maureen Baker |
|
11:20-11:35 |
Diagnosing cancer early: challenges for patients and general practitioners |
Sara Hiom |
|
11:35 -12:40 |
The Discovery Programme of research
PANEL - discussion |
The Discovery Team |
|
12:40-1:30 |
Lunch and informal discussions with research team |
|
|
1:30-2:00 |
'What do we now know about early diagnosis of symptomatic cancer, and how has the Discovery Programme contributed to this?'
|
The Discovery Team |
|
2:00-2:45 |
Key messages…
PANEL - discussion |
Roger Jones (chair), |
|
2:45-3:00 |
Cancer research in the UK - the future |
Willie Hamilton |
|
3:00-3:15 |
Closing event - Prof Roger Jones, BJGP editor & chair of Discovery steering committee. |
Roger Jones |
|
3:15-3:30 |
Further opportunity for informal discussions with research team |
|
To book your place click here.
New Discovery research paper from the SYMPTOM Study
We are pleased to announce a new Discovery publication by the SYMPTOM Study team. Efforts to improve the timeliness of diagnosis of cancer can be better informed by a deeper appreciation of the natural history of symptoms in patients with and without cancer. The SYMPTOM-Lung study, which collected data from and about almost 1,000 patients referred from primary care to five hospitals across the north east and east of England, provides a much more refined understanding of the nature and sequence of symptomatic presentations that may be associated with lung cancer and other respiratory conditions. See more details on the results page.
BMJ highlights Discovery research paper
The British Medical Journal's research news highlighted Tanimola Martin's paper on differences between preferences of black and white men for prostate cancer investigation. BMJ article is here and full details of the paper in the news item below dated, 2nd March.
New Discovery research publication - ethnic differences in patients' preferences for prostate cancer investigation
Tanimola Martins has a new paper published in the British Journal of General Practice which examines patient preferences for investigation for prostate cancer among black and white men. The study found that white men were more likely to choose to be investigated for symptoms associated with prostate cancer than black men. We know that black men have worse outcomes for prostate cancer and are more likely to be diagnosed via emergency presentation than white me. This study goes some way in helping us understand why these differences exist.
The paper builds on the vignette methodology developed in the Pivot Study where participants are presented with a range of symptoms associated with cancer and asked whether they would choose investigation in these circumstances. A press release of the study can be found here, details of the study are on the results page. This study was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC) and was adopted on the NIHR portfolio of studies as part of the Discovery Programme.
3 new Discovery research publications
Liz Shephard and the Caper team identify the risk of symptoms associated with multiple myeloma in primary care. The paper, published in the British Journal of General Practice highlights that individual symptoms tend to be low risk. However, when associated with primary care blood tests they can act as important indicators to GPs of the risk of myeloma. For more details see the results page, details of the full publication here.
Mousumi Biswas and the Discovery 3.2 team have a new paper in the British Journal of Cancer. This paper continues to develop research on modelling symptom lead time (SLT) for lung and colorectal cancer. SLT is the time from development of symptoms to diagnosis of cancer. This study offers a different perspective to Symptom based approaches to cancer diagnostics, suggesting that a screening based approach may be more effective in identifying cancer because a significant number of cancer cases have been identified through serendipitous investigation. For more details see our results page and full details of the publication are here.
Linda Birt and the Symptom team have a paper in BMJ Open Respiratory Research which looks at symptom appraisal and help-seeking decisions among patients referred to specialist respiratory services with symptoms suggestive of lung cancer. The findings will inform lung cancer awareness campaigns and highlights the importance of social networks in encouraging patients to seek symptom advice. It also highlights the importance of the GP in monitoring and safety netting those with unremitting symptoms. For more details see the results here, details of the full publication here
16th December 2014
Patients' experiences of being referred for cancer investigation
We have a new research paper published in the British Journal of General Practice which examines patients' experiences of being referred for investigation for symptoms which may indicate cancer. The study found that patients were rarely involved in the decision to be referred and the reasons for referral tended to be couched in non-specific terms rather than 'cancer investigation', even when the patient was on a cancer specific pathway.
Our paper argues that GPs should consider a more overt discussion about the possibility of cancer when referring patients for investigation in line with NICE guidance. More details of the paper can be found on the results page, there is also a press release here, and details of the full publication can be found here.
16th December 2014
Calendar landmarking instruments in cancer symptom research.
The SYMTOM Study team (lead author, Katie Mills) have published a methodological paper looking at the use of calendar landmarking instruments in cancer symptom research. Understanding the time from symptom onset to presentation is crucial in developing effective interventions to facilitate earlier diagnosis. The calendar landmarking instrument uses a number of significant dates linked to public events to prompt people to remember their symptom onset.
The abstract can be found on our results page and full details of the paper can be found here.
14th October 2014
Discovery theme 3.2 – modelling symptom lead time in cancer
We are pleased to announce the first research publication from theme 3.2 of the Discovery Programme, 'Symptom lead time distribution in lung cancer: natural history and prospects for early diagnosis' in the International Journal of Epidemiology. This stream of work led by Professor Tony Ades at the University of Bristol, has developed an exciting and innovative method of statistical modelling which enables us to estimate the length of time from development of symptoms to diagnosis of cancer.
The idea behind this work was to examine the window of opportunity for earlier diagnosis - a longer symptom lead time (SLT) gives more opportunity for earlier diagnosis and improved outcome. This first study, looking at SLT in lung cancer, found that most symptoms only preceded clinical diagnosis by a few months and did not differ by lung cancer stage at diagnosis. In this study we found that identifying cancer earlier based on investigation of key high risk symptoms does lengthen the SLT but only results in earlier diagnosis in a small proportion of cases. Full details of the publication can be found here and further research on SLT and other cancers will follow in the next few weeks.
The Symptom Study conference presentation
Members of the Symptom Study will present results at a number of academic and clinical conferences over the next few months. The results highlight factors that shape patients' decisions to consult their GP when faced with symptoms associated with lung and colorectal cancer; understanding the factors which impact on the time interval from symptom appraisal to consultation is important for improving early cancer diagnosis. Full details of the presentations below.
June 2014: 7th Cancer and Primary Care Research International Network (CaPRI) annual meeting, Winnipeg, Canada. Poster. Presenting author: Dr F Walter
Understanding the appraisal and help-seeking decisions of patients with symptoms suspicious of lung cancer: a qualitative approach
June 2014: 7th Cancer and Primary Care Research International Network (CaPRI) annual meeting, Winnipeg, Canada. Electronic Poster. Presenting author: Dr N Hall
Health-care seeking among people with symptoms suggestive of colorectal cancer: a qualitative interview study.
August 2014: Royal College of General Practitioners annual conference 2014, Liverpool, UK. Oral presentation. Presenting author Dr N Hall. Healthcare factors influencing patients' decisions to consult GPs for symptoms suggestive of lung or colorectal cancer.
September 2014: British Psychological Society Division of Health Psychology (DHP) annual conference, York. Oral presentation. Presenting author: Dr N Hall
Seeking health-care for symptoms suggestive of colorectal cancer: a qualitative study.
The Symptom Study - update
In the East of England we are continuing to recruit patients who are referred to hospital with pancreatic symptoms. We have been recruiting from Addenbrooke's Hospital, Cambridge since November 2010 and West Suffolk Hospital since November 2011. Between June 2013 and January 2014 we set up four additional hospitals: Bedford; Hinchingbrooke; King's Lynn and Peterborough City. To date we have recruited 287 participants into this cohort of the study, 26 of whom have been interviewed in depth about their symptoms and their decision to seek help about them.
27th February 2014
New publication utilising Discovery data
Richard Neal's paper examining the impact of NICE guidelines has been recently published in the British Journal of Cancer. The research utilises Discovery Programme data from the General Practice Research Database. The paper highlights reduction in diagnostic intervals (time between presentation of first symptom and diagnosis) since the introduction of the guidelines but there is considerable scope for further reductions. Further details here and on the results page.
14th October 2013
The Pivot Study
We're very pleased to announce that the results of the Pivot Study are published by Lancet Oncology and are available on-line from the 14th January 2014. The paper is called 'Preferences for cancer investigation: a vignette-based study of primary-care attendees'. This important research is the first of its kind and identifies patient and public preferences for cancer investigation among a large group of GP attenders. The paper is available here (it is freely available but you may need to register to access it) and the press release can be viewed here. The study presented participants with a range of vignettes relating to colorectal, lung and pancreas cancer which depicted symptoms, risk of cancer and associated investigation and asked whether they would choose to be tested in these circumstances. The study found that most people (88%) preferred testing, even at the lowest risk of cancer (1%). There were subtle variations between cancers (fewer people chose testing at lower risk for colorectal) and between age groups with a stronger preference for testing in the 60-69 group. The findings show that participants prefer testing at a lower level of risk than is present in current UK guidelines. The public engagement with the study highlights the potential for greater patient involvement in decision making around cancer investigation at the primary care level.
7th October 2013
The SYMPTOM Study
The Symptom Study team presented a research poster at the recent Royal College of General Practitioners (RCGP) conference in Harrogate. The poster focused on the experience of patients with potential lung cancer symptoms. Patients highlighted a variety of symptoms and time to consultation and the research will help us to understand how people evaluate their symptoms and make the decision to consult their GP for potential lung cancer symptoms. The research is currently being written up for a full research paper for publication later in 2013.
9th August 2013
C-DAPT (cancer diagnostic pathways improvement project)
Work has started on the final part of the Discovery Programme (theme 3.3): C-DAPT (cancer diagnostic pathways improvement project). The study will develop and test modified diagnostic pathways for cancer diagnosis with a particular focus on the primary care section of the pathway. This work will take place in Bristol and Sunderland and has the support of the local clinical commissioning groups. Modified diagnostic pathways for the Discovery exemplar cancers (lung, colorectal and pancreas) will be implemented in these areas and will be based on data collected from the Discovery programme, national and local data and the input of local clinical experts, NHS commissioners and patients. Expert groups have been established in the two areas to map and modify the existing pathways. The first meeting of the Bristol group took place on the 29th July and the Sunderland group will meet on 19th September. Further meetings are scheduled for the autumn and the pathways are scheduled to go live in January 2014.
9th August 2013
The SYMPTOM Study
Recruitment to the lung and colorectal cohorts has now closed. In just over 2 years, we have recruited 995 participants with lung symptoms and 2667 participants with colorectal symptoms. During this time, 17,333 study packs were mailed out, giving an overall recruitment rate of 21%. The final few diagnoses for the participants in the colorectal cohort are being collected, however the analysis for the lung group is well underway.
We are continuing to recruit patients with pancreatic symptoms for a further 12 months at both Addenbrooke's and West Suffolk hospitals. In addition we are setting up 4 new hospital recruitment sites in East Anglia.
14th February 2013
The Caper Studies
The latest research paper from the Discovery programme is published in the British Journal of General Practice. Liz Shepherd is the lead author of 'Clinical features of kidney cancer in primary care: a case-control study using primary care records'. Full details of the paper can be found here and in the results section of this website. Kidney cancer accounts for over 4000 UK deaths annually, and is one of the cancer sites with a poor mortality record compared with Europe. This paper identifies the symptoms that will help GPs select patients for diagnostic examination at an earlier stage of the disease. A range of symptoms were found to be associated with kidney cancer; visible haematuria (blood in urine) proved to be the strongest indicator of kidney cancer particularly when associated with other symptoms.
14th February 2013
The SYMPTOM Study
The SYMPTOM Study has teamed up with Pancreatic Cancer Action to extend the pancreas component of the Symptom Study ensuring that the study will be able to extend our understanding of the symptoms associated with pancreas cancer in its earliest stages. Pancreatic cancer is the UK's fifth deadliest cancer with 90 per cent of all cases being diagnosed too late for potentially curative surgery to be an option. It has only a three per cent five-year survival rate, and this has not improved in over 40 years. The research team hope to be able to identify the clinical demographic and psychosocial factors associated with later presentation to doctors and whether these delays are associated with stage at diagnosis. The press release from Pancreatic Cancer Action can be found here.
14th February 2013
Ca-PRI conference 2013
The Cancer and Primary Care Research International Network (Ca-PRI) conference will be held at University of Cambridge on the 15th and 16th April. Results from a number of Discovery Programme studies will feature at the conference:
- Fiona Walter will present the first results from the lung component of the Symptom Study looking at patient factors which are associated with late presentation and later stage at diagnosis of lung cancer
- Liz Shepherd will outline the clinical features of myeloma in primary care based on a large case-control study of general practice data
- Jon Banks will give the results of the Pivot Study looking at patient preferences in relation to cancer testing and potential risk of cancer
In addition there are two Discovery poster presentations:
- Chantal Smeekens on the role of emotions in medical help seeking around cancer symptoms
- Katie Mills will outline the usefulness of calendar landmarking (used in the SYMPTOM Study) tools to aid patient recall of symptom onset
For full details visit the conference website here.
14th February 2013
The Pivot Study
The Pivot Study, which looked at patient preferences for cancer testing in relation to risk of cancer, is now being written up for publication. Sandra Hollinghurst will present the results will at the South West Society for Academic Primary Care conference held at Southampton on 7th & 8th March.
14th February 2013
The Caper Studies
The latest research paper from the Discovery programme was published in the January edition of the British Journal of Cancer. Sally Stapely is the lead author of 'The risk of oesophago-gastric cancer in symptomatic patients in primary care: a large case-control study using electronic records.' Full details of the paper can be found here and in the results section of this website. Over 15,000 new cases of oesopho-gastric cancer are diagnosed every year many of these are at an advanced stage at diagnosis. This paper identifies the symptoms that will help GPs select patients for diagnostic examination at an earlier stage of the disease. A range of symptoms were found to be associated with oesophago-gastric cancer with dysphagia (difficulty swallowing) in those over 55 being the strongest indicator of the disease.
14th November 2012
We recently completed a 'test re-test' evaluation exercise for the PIVOT Study electronic questionnaire in one GP practice. Patients completing the questionnaire were asked to return after a period of 2 weeks to complete the questionnaire a second time. This exercise will enable us to compare responses between each visit and evaluate the reliability of the questionnaire. A total of 48 participants returned to complete the questionnaire twice which was in line with our target recruitment.
14th November 2012
The Pivot-Q Study
Jon Banks presented the initial findings from the Pivot qualitative study at the Society for Academic Primary Care conference which took place in Glasgow on the 3rd & 4th October. The presentation focused on patients' experiences of being referred for diagnostic testing for lung, colorectal and pancreas cancer and comparisons were made with the current NICE guidelines for referral.
14th November 2012
The Caper Studies
The 2nd full research paper from the Discovery Programme was published in the September issue of the British Journal of General Practice. Liz Shephard is the lead author of 'clinical features of bladder cancer in primary care'. Full details of the paper can be found here and in the results section of this website. The paper quantifies the risks of symptoms associated with bladder cancer. Haematuria (blood in the urine) proved to be the most significant symptom and whilst other symptoms indicated association with bladder cancer they were of low predictive value. This highlights the need to develop effective diagnostic tests for patients with bladder cancer who do not present with visible haematuria.
14th November 2012
The SYMPTOM Study
The team has recruited 3182 participants in total from all referral sites and conducted 77 participant interviews. Secondary care medical record searching is continuing; so far 2151 patient records have been reviewed.
We have started sending out the follow-up questionnaire to some of the participants who agreed to receive it when they completed their consent form for the main study. We are pleased to report that the response rate for this questionnaire is about 80%.
15th August 2012
The Pivot Study
Recruitment to the Pivot Study was completed on August 2nd 2012, a total of 3997 people participated in the study by completing the electronic questionnaire. This exceeded the study recruitment target and is testament to the work of the Pivot research staff in Bristol and Devon and the East of England primary care network research staff. The Discovery programme would like to thank everyone who participated and we look forward to analysing and publishing our results over the next few months. A further piece of research will take place in September to look at how people respond to the questionnaire when asked to complete it a second time following an interval of 2 weeks.
15th August 2012
The SYMPTOM Study
The team has recruited 2560 participants in total from all referral sites and conducted 64 participant interviews. Secondary care medical record searching is continuing: so far 1482 patient records have been reviewed. We are delighted that the recruitment rate has been maintained during the summer holiday period.
After being piloted with patient representatives and some participants, the follow-up questionnaire has been amended to incorporate their feedback. The amended version was approved by ethics committee on 30th July, so this phase of the study will begin within the next few weeks.
19th June 2012
The CAPER Studies
The CAPER team have produced the first Discovery programme publication. Sally Stapley is the lead author of 'The risk of pancreatic cancer in primary care: a large case-control study using electronic records' which has been published in the British Journal of Cancer. Details of the paper can be found here and on the results section of this website. The paper quantifies the risks of symptoms associated with pancreatic cancer. Jaundice proved to be the most significant symptom whilst abdominal pain, nausea/vomiting, back pain, constipation, diarrhoea, weight loss, malaise and new onset diabetes also showed evidence of association with pancreatic cancer.
19th June 2012
The SYMPTOM Study
The team has recruited 2249 participants in total from all referral sites and conducted 57 participant interviews. Secondary care medical record searching is continuing: so far 1076 patient records have been reviewed.
On 19th April we received ethics committee approval for a follow-up questionnaire, which will be mailed to participants who have agreed to receive it. This aims to find out about the emotions people feel when they have certain symptoms and when deciding whether or not to consult their GP.
5th April 2012
The PIVOT Study
The Pivot Study gained full research governance approval to recruit participants in NHS Bedfordshire, NHS Hertfordshire, NHS Mid Essex and NHS South East Essex. The study is being administered by researchers from the East of England Primary Care Research Network. Recruitment started in mid March and is progressing well with over 300 questionnaires completed so far.
5th April 2012
The CAPER Studies
The first Discovery research paper, 'Clinical features of bladder cancer in primary care' has been accepted for publication in the British Journal of General Practice. The paper's authors are Liz Shepherd, Sally Stapely, Richard Neal, Peter Rose, Fiona Walter and Willie Hamilton. Full publication details will follow.
The other main research paper to come from the CAPER Studies team so far, 'The risk of pancreatic cancer in symptomatic patients in primary care' has been submitted to the British Journal of Cancer and we expect a decision soon.
10th April 2012
The SYMPTOM Study
The team has recruited 1779 participants in total from all referral sites and conducted 44 participant interviews. Secondary care medical record searching has been taking place in Addenbrooke's, Papworth, North Tees and Hartlepool Hospitals: so far 830 patient records have been reviewed.
We are delighted to announce the safe arrival of our first study team baby. Katie Mills gave birth to Imogen Beth on 27th February. Both mother and baby are doing really well. This week Linda Birt has joined the team to lead the qualitative part of the study in Cambridge during Katie's maternity leave. She will be conducting interviews and contributing to the early analyses.
15th February 2012
The SYMPTOM Study
Congratulations to June Battram and Nicky Bateman on becoming the first research nurses at North Tees and Hartlepool NHS Foundation Trust to pass the Accredited Researcher Programme. June and Nicky, who work in the respiratory clinic, have been working hard to recruit patients to the SYMPTOM Study since it started in November 2010, as well as working on a number of other clinical trials and research projects.
We are delighted to welcome Linda Birt to the team in Cambridge. Linda is an experienced qualitative researcher who will be conducting some of the interviews with participants from April to December, during Katie Mills' maternity leave.
20th January 2012
The PIVOT Study
The Pivot Study started full recruitment at the beginning of December 2011 in Bristol and Devon. The Pivot researchers have been asking patients in GP waiting rooms to complete the survey on iPads (touch screen hand held computers). Recruitment to date has been very good with most people approached agreeing to participate. The iPad is proving to be a very user friendly device for all those participating.
20th January 2012
The CAPER Studies
Three of the CAPER studies will be presented at the conference of the Society of Academic primary care. The conference is being held in Torquay in March and this will be the first 'official' airing of the studies. The presentations will be on the risk of symptoms associated with: bladder, pancreas and uterus cancer. The abstracts from the conference will be available on this website after the conference.
20th January 2012
The SYMPTOM Study
Three new hospital sites started recruitment on 21st November 2011: University Hospital of North Durham; Darlington Memorial Hospital and West Suffolk Hospital, Bury St Edmunds. Recruitment is progressing well in these new sites as well as the established ones: Addenbrooke's, Papworth, North Tees and Hartlepool Hospitals.
The team has recruited 1309 participants in total from all referral sites and conducted 44 participant interviews.
Katie Mills, Research Associate in Cambridge, is now on maternity leave and the team wishes her well at this exciting time.
20th January 2012
The CAPER Studies
Methodological developments for the CAPER team … as the team are doing so many studies within the CAPER umbrella, they have spent two months deriving agreed lists of symptoms and blood tests which can be used across ALL cancer sites. This sounds simple, but wasn't. The GPRD contains over 100,000 codes, and a single symptom - for example headache - can have many different codes, such as 'persistent headache' 'pain in the head' etc. We have compiled long lists of the codes that we think reasonable equate to a single symptom. This also involved writing long sequences of computer code to allow the researchers to identify these symptoms. A similar process had to be done for the tests. The upside of this hiatus/diversion is that all future CAPER studies using GPRD data will be quicker to perform, and more reproducible.
21st November 2011
Discovery team poster wins award at research event in South West
The Peninsula College of Medicine and Dentistry's Annual Academic Research Event in Plymouth on 8th November, 2011, showcased over 80 posters from researchers based in the South West. The Discovery team's poster, 'Clinical Features of Bladder Cancer in Primary Care' won the prize for best poster. The results have also been submitted for publication in a peer review journal.
31st October 2011
The SYMPTOM Study
By the end of October, the SYMPTOM Study team had recruited 1000 participants from their referrals to Addenbrooke's, Papworth, North Tees and Hartlepool Hospitals.
In early November the study will also be set up to recruit from University Hospital of North Durham, Darlington Memorial Hospital and West Suffolk Hospital, Bury St Edmunds.
By the end of June, 38 participants had been interviewed about how they recognised symptoms. An interim analysis of these has been conducted and the next phase of interviews will begin in November.
27th October 2011
The Caper Studies
The Caper team have completed analysis of bladder and pancreas and the results have been submitted for peer review publication.
The results from the analysis of bladder cancer will be presented as a research poster at the annual Peninsula College of Medicine and Dentistry research event and lecture on the 8th November by Liz Shepherd.
Analysis has started on the next cancer sites: uterus, oesophagus and kidney. Initial results are expected in approximately 6 months time.
27th October 2011
The Pivot Study – Pilot phase complete
The Pivot Study has undertaken 2 phases of pilot research to test and develop the electronic questionnaire and the main phase of data collection will start in November.
The first pilot phase consisted of 18 verbal probing interviews to test the iPad based questionnaire and vignettes for comprehension and acceptability. We initially did 13 interviews, changed the questionnaire in light of the feedback and tested the changes in a further 5 interviews.
The second pilot phase consisted of a full simulation of the planned data collection process over 4 days in a GP practice waiting room. This enabled us to test the data collection process and the acceptability of the iPad. Over 80 people completed the questionnaire which is above our projected recruitment rate.
The amended questionnaire has been submitted to the local ethics committee for approval. The target date for the main phase of data collection is November 7th in Bristol. Data collection in Devon will be approximately 2-3 weeks behind this date.
19th July 2011
The SYMPTOM Study - pilot phase complete
The 5-month pilot phase of The SYMPTOM Study was completed in April 2011, achieving an overall response rate for the return of study questionnaires of 21% (608 completed questionnaires returned from a total of 2869 study recruitment packs sent out).
The study team have used data and feedback from participants along with input from consumer representatives to introduce measures that aim to improve the recruitment rate for the main study. These include:
- Simplifying the study invitation letter and information sheet so that they are easier for participants to understand;
- Clarifying parts of the questionnaire;
- Slightly modifying the inclusion and exclusion criteria for eligibility to be approached to participate in the study;
- Approaching additional hospitals to help with recruitment.
The revised study documents have been approved by NHS ethics committee and were implemented on 1st August 2011.
A sample of 38 participants who completed the study questionnaire have been interviewed; 19 in the North East of England and 19 in East Anglia. The interviews are designed to provide detailed data on how participants recognise the symptoms associated with cancer and what influences their decision to visit their GP or not.
19th July 2011
The Pivot Study - approvals complete, pilot phase starting soon
The governance approvals (NHS research governance and NHS ethics committee) are now in place and the pilot phase of the study will be starting soon.
The pilot phase of the study will use cognitive interviewing techniques with a small sample of participants to test the validity and reliability of the electronic questionnaire. During this initial phase we will also trial the acceptability of completing the questionnaire in GP waiting rooms.
Lin Bigwood is the research associate for the study in Bristol and Cath Stabb in Exeter.
19th July 2011
The Caper studies
These are progressing well. By the end of summer 2011, we had largely completed analysis of two cancer sites: bladder and pancreas. The plan is for submission to journals for publication shortly. The results are helpful, and we are hopeful that they will be suitable for quite a high-profile journal.
The pathways studies are also progressing well. As Jackie Barrett, the researcher, is part-time the first study (of colorectal cancer) will be available in late 2011. It is too early to predict the results, but watch this space...