| Title: | The ECASS Trial – Evaluation of a Computer Aid for assessing Stomach Symptoms |
| Principal research question: | To test the effects of a computerised clinical decision support (eCDS) tool to assist GPs in selection of patients for gastroscopy for possible OG cancer, and to collect all the relevant data to inform a phase III trial of such a tool. |
| Background: | Patients with oesophagogastric (OG) cancer often consult their general practitioner (GP) a number of times before referral. Less than a third are referred to hospital using the urgent suspected cancer pathway and over a quarter are diagnosed following emergency admission. These cancers present with symptoms that, apart from dysphagia, are not very predictive of cancer. Practices that investigate more patients have better outcomes. However, gastroscopy is an invasive procedure and has resource implications. Any increase in activity should target those patients most likely to benefit. |
| Methodology description: | A multi-site Phase II cluster randomised controlled trial (RCT) of the electronic Risk Assessment Tool (eRAT) for OG cancer on the BMJ Informatica platform embedded in practice clinical systems, compared to usual care. |
| Sample group description: | Participants are patients aged 55 and over presenting to their GP with upper gastrointestinal symptoms, who are followed up for 6 months using primary and secondary care records. |
| Outcome measure description: | Include practitioner outcomes, service outcomes, length of the diagnostic interval, health economic outcomes and patient outcomes. These will inform our selection of outcome measures and power calculations for a subsequent Phase III trial. Additionally, we will undertake in-depth interviews with GPs and patients to identify and gain an understanding of the facilitators and constraints influencing use of eCDS in clinical practice. We expect the following themes to be explored in the qualitative analysis: patient awareness of eCDS use in consultations and views of acceptability of eCDS use in consultations; as well as practitioner interaction with the eCDS and perceived acceptability of the eCDS, impact of eCDS on clinical decision making, referrals and practitioner consultation experience and reasons for not using the eCDS. |
| UK Cancer Research Number: | 18331 |
| Project organisation | |
| Start date: | 1st January 2015 |
| End date: | 31st December 2017 |
| Contact person: | Dr Fiona Walter |
| Contact Details: | Strangeways Research Laboratory Worts Causeway Cambridge CB1 8RN UK Telephone: (01223) 330323 Fax: E-mail: fmw22@medschl.cam.ac.uk |
| Collaborative: | Lead Investigators: Prof Greg Rubin, Durham University; Prof Fiona Walter, University of Cambridge; Prof Richard Neal, Bangor University Co-Investgators: Dr Juliet Usher-Smith, University of Cambridge; Dr Obioha Ukoummune, Peninsula Medical School, Dr Sophie Whyte University of Sheffield; Rhiannon Whitaker, Bangor University; Jon Emery, University of Melbourne; William Hamilton, University of Exeter Researchers: Dr Anne Kershenbaum; Dr Cath Nixon; Dr Jenny Howse Collaborators: Yoryos Lyratzopoulos, University of Cambridge; Carolynn Gildea, Public Health England; Rebecca Fitzgerald, MRC Cancer Cell Unit, University of Cambridge Patient Lay Representative: Margaret Johnson |
| References and Publications | |
| Moore HJ, Nixon C, Tariq A, et al. Evaluating a computer aid for assessing stomach symptoms (ECASS): study protocol for a randomised controlled trial. Trials. 2016;17:184. doi:10.1186/s13063-016-1307-3. | |