Improving the diagnosis of cancer in primary care: a feasibility economic analysis of the ThinkCancer! study.
Notice bibliographique
Résumé
BackgroundCancer survival in the UK remains low compared to other Western countries including Australia, Canada and European countries. Delays in cancer diagnosis have an adverse impact on patient well-being and survival. Welsh Government outline a number of challenges with respect to earlier cancer diagnosis, including a lack of awareness of ‘red flag’ symptoms and difficulties among GPs and other healthcare professionals in identifying cancers that present with vague or non-specific symptoms. For some cancers, earlier diagnosis is associated with greater survival, better patient experience and quality of life, and lower healthcare costs. MethodsThe ThinkCancer! intervention is a complex behaviour change intervention, which aims to change the behaviours of primary care practice teams when thinking of and acting on clinical symptoms that could be cancer. From an NHS perspective, we conducted a feasibility economic analysis of the ThinkCancer! intervention. We used micro-costing methodology to determine whether it was feasible to gather sufficient economic data to cost the ThinkCancer! intervention. Due to the Covid-19 pandemic, the intervention was mostly delivered remotely in a digital format. Intervention deliverers completed data collection sheets (including forms recording materials used and intervention deliverer time) and provided information on primary care staff attendance at each of the ThinkCancer! workshops. Budget impact analysis and sensitivity analysis were conducted to explore the costs of face-to-face delivery of the ThinkCancer! intervention as intended pre-COVID-19. FindingsThe total costs of delivering the ThinkCancer! intervention across 19 general practices in Wales was £25,030. Costs per practice ranged from £431 to £2,498, with an average cost per practice of £1,311 (SD: 579.5). The potential budget impact if the intervention were to be delivered face-to-face across the 19 general practices would be £34,630. Sensitivity analysis revealed that if the intervention were to be delivered by one GP educator, the total estimated cost for face-to-face delivery would be £31,232. With the addition of one support role assisting the GP educator with the intervention delivery, the total cost of face-to-face delivery is estimated to be approximately £33,138. ConclusionsResults of this feasibility study are being used to inform a definitive economic evaluation alongside a pragmatic randomised controlled trial. Primary care interventions to expedite the diagnosis of symptomatic cancer have the potential to reduce large costs to the NHS and improve patient and carer outcomes as later stage cancer treatments are often longer, more aggressive to patients, with larger associated healthcare costs compared to earlier stage treatment. http://wicked.bangor.ac.uk/
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,041 | 0,073 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,002 |
| Méta-épidémiologie (sens large) | 0,003 | 0,007 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,002 | 0,004 |
| Intégrité de la recherche | 0,004 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,015 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».