Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

The failure to follow up abnormal test results associated with undiagnosed prevalent cancer in primary care: a systematic review protocol (#245)

Peter Nguyen 1 , Jeanette Reece 2 , Jennifer McIntosh 1 , Jon Emery 1 3
  1. Centre for Cancer Research and Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
  2. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  3. Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom

Background: Diagnostic errors are relatively common in primary care and many patients will likely experience a diagnostic error in their lifetime. This includes delayed diagnoses such as delays in following up abnormal test results that suggest potential cancer risk.

Aims: To explore evidence surrounding the prevalence of the failure to follow up abnormal test results associated with undiagnosed prevalent cancer in primary care. We will also explore the predictors of failing to follow up abnormal test results and the adverse effects on patient outcomes.

Methods and Analysis: We will search the following electronic databases using a prespecified search strategy: MEDLINE, Embase, The Cochrane Library and CINAHL Complete. Test results include pathology and imaging tests commonly or routinely used in primary care that can be associated with undiagnosed prevalent cancer or potential cancer risk. We will restrict our search to peer-reviewed texts that are in English and have no restriction on publication date. Titles of studies will be screened by one review author while abstract screening, full-text screening, data extraction and analysis will be performed independently by two authors, with disagreements discussed and resolved with a third reviewer. For quantitative studies, information will be extracted based on an adapted version of the Cochrane Effective Practice and Organisation of Care (EPOC) data collection checklist. Themes will be extracted for qualitative studies. The Joanna Briggs Institute Critical Appraisal tools will be used to assess risk of bias of included studies. Segregated methodology will be used to synthesise evidence, maintaining the distinction between quantitative and qualitative research. A meta-analysis will be conducted if appropriate.

Conclusions: This review will synthesise evidence about the prevalence, factors and impact associated with the failures or delays of following up abnormal test results related to undiagnosed prevalent cancer in primary care, and will inform future research, practice and policy.