@article {Pricee437, author = {Sarah Price and Anne Spencer and Antonieta Medina-Lara and Willie Hamilton}, title = {Availability and use of cancer decision-support tools: a cross-sectional survey of UK primary care}, volume = {69}, number = {684}, pages = {e437--e443}, year = {2019}, doi = {10.3399/bjgp19X703745}, publisher = {Royal College of General Practitioners}, abstract = {Background Decision-support tools quantify the risk of undiagnosed cancer in symptomatic patients, and may help GPs when making referrals.Aim To quantify the availability and use of cancer decision-support tools (QCancer{\textregistered} and risk assessment tools) and to explore the association between tool availability and 2-week-wait (2WW) referrals for suspected cancer.Design and setting A cross-sectional postal survey in UK primary care.Methods Out of 975 UK randomly selected general practices, 4600 GPs and registrars were invited to participate. Outcome measures included the proportions of UK general practices where cancer decision-support tools are available and at least one GP uses the tool. Weighted least-squares linear regression with robust errors tested the association between tool availability and number of 2WW referrals, adjusting for practice size, sex, age, and Index of Multiple Deprivation.Results In total, 476 GPs in 227 practices responded (response rates: practitioner, 10.3\%; practice, 23.3\%). At the practice level, 83/227 (36.6\%, 95\% confidence interval [CI] = 30.3 to 43.1) practices had at least one GP or registrar with access to cancer decision-support tools. Tools were available and likely to be used in 38/227 (16.7\%, 95\% CI = 12.1 to 22.2) practices. In subgroup analyses of 172 English practices, there was no difference in mean 2WW referral rate between practices with tools and those without (mean adjusted difference in referrals per 100 000: 3.1, 95\% CI = -5.5 to 11.7).Conclusion This is the first survey of cancer decision-support tool availability and use. It suggests that the tools are an underused resource in the UK. Given the cost of cancer investigation, a randomised controlled trial of such clinical decision-support aids would be appropriate.}, issn = {0960-1643}, URL = {https://bjgp.org/content/69/684/e437}, eprint = {https://bjgp.org/content/69/684/e437.full.pdf}, journal = {British Journal of General Practice} }