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Research project: Catric Study: Identifying optimal patient-GP communication about safety-netting, direct access tests, and referral for investigation of possible cancer (CI: Brindle)

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Background: Revisions to NICE 2015 cancer referral guidelines reduced the risk level for urgent investigation of symptoms or signs that may indicate cancer, to 3%, and introduced new recommendations for direct-access-tests and safety-netting in primary care.  Although most patients offered direct-access-tests or referred to a specialist following presentation with potential cancer symptoms will not have cancer, being offered investigation(s) may cause patients concern. Little is known about how patients interpret and respond to recommendations for investigation of suspected cancer, or the implications of these discussions for patients’ intentions to attend for tests. The Catric Study is investigating how GP-patient communication might be optimised to effectively convey information about diagnostic tests, cancer risk, and implications of test results, whilst being responsive to patients’ preferences for information and concerns about cancer.

The Catric Study is:

  • Analysing video-recorded GP-patient consultations previously collected for three communication studies at the University of Southampton, University of Bristol and the University College London. We are analysing how GPs recommend and discuss further investigations/referrals with patients using Conversation Analysis (CA).
  • Analysing 79 doctor appointments in primary care, video-recorded for the Catric Study, with patients thought by their doctor to meet safety-netting or direct access test criteria for possible cancer symptoms, or national referral criteria for investigation of suspected cancer. We have interviews with 49 of these patients to find out about their information needs, their understanding of what was said in the consultation, any cancer concerns, and the extent to which their information needs and concerns were addressed.
  • By linking our analyses of video-recordings with what patients say in interviews we are developing recommendations for GP-patient communication about referral, and investigation of suspected cancer.  Recommendations will be developed into a training module for GPs, to promote best communication practices.

Funder: EDAG (Early Diagnosis Advisory Group); CRUK

CI: Dr Lucy Brindle

Related research groups

Complex Healthcare Processes
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