Neoplasms

Digestive System Diseases

All Conditions

Rare Diseases

Esophageal Neoplasms

Gastroesophageal Reflux

Barrett Esophagus

Gastrointestinal Neoplasms

Digestive System Neoplasms

Head and Neck Neoplasms

Gastrointestinal Diseases

Esophageal Diseases

Precancerous Conditions

Esophageal Cancer

All participants will receive the breath test with the eNose in the general practice, followed by the uTNE in the hospital.

Breath test (eNose) followed by uTNE.

Peter D. Siersema, Prof.dr.

In the Netherlands, the incidence of esophageal adenocarcinoma (EAC) is increasing. In addition, EAC has a dismal prognosis. Therefore, screening for Barrett's Esophagus (BE) has stimulated interest. Although BE is a known precursor of EAC, a minority of patients with EAC are known with a previous diagnosis of BE. A non-invasive screening tool, such as breath testing, could select patients at risk for BE, after which unsedated transnasal endoscopy (uTNE) can confirm or exclude the diagnosis. The objective is to determine the accuracy and acceptability of a non-invasive screening strategy i.e. breath testing followed by uTNE for BE and EAC.

The ongoing increasing incidence of esophageal adenocarcinoma (EAC) in the Netherlands during the last few decades and the still dismal prognosis has stimulated interest in screening for Barrett's esophagus (BE). Although BE is a known precursor of EAC, a minority of patients with EAC (\<10%) are known with a previous diagnosis of BE, and hence, most cases of BE are undiagnosed. Screening programs to detect BE followed by endoscopic surveillance and treatment of dysplasia or early neoplasia seem able to reduce the incidence of EAC and improve survival. A non-invasive screening tool, such as breath testing, could select patients at risk for BE, after which unsedated transnasal endoscopy (uTNE) can confirm or exclude the diagnosis. uTNE offers the possibility of a more acceptable and accurate endoscopic assessment of the esophagus with almost neglectable risks and lower costs compared to conventional endoscopy. The objective is to determine the accuracy and acceptability of a non-invasive screening strategy i.e. breath testing followed by uTNE for BE and EAC.

The study design is a multi-site prospective cohort study in eight general practices. All participants will receive the breath test with the eNose in the general practice, followed by the uTNE in the hospital.

Early Detection of Barrett's Esophagus in Participants With Reflux Symptoms in Primary Care

Early Detection of Barrett's Esophagus and Esophageal Cancer: Accuracy and Acceptability of a Novel Screening Strategy in Primary Care

PPV of the eNose for detecting confirmed BE with the diagnosis made by transnasal endoscopy and upper endoscopy as the reference standard in primary care.

NPV of the eNose for detecting confirmed BE with the diagnosis made by transnasal endoscopy and upper endoscopy as the reference standard in primary care.

Sensitivity of the eNose for detecting confirmed BE with the diagnosis made by transnasal endoscopy and upper endoscopy as the reference standard in primary care.

Specificity of the eNose for detecting confirmed BE with the diagnosis made by transnasal endoscopy and upper endoscopy as the reference standard in primary care.

Patient acceptability consists of two questions regarding discomfort and overall experience of the eNose. Discomfort is measured on a Numeric Pain Rating Scale (NPRS) with 0 being 'none' and 10 being 'severe'. Overall experience is measured on a Numeric Pain Rating Scale (NPRS) with 0 being 'the worst experience', 5 being 'neither pleasant nor unpleasant' and 10 being 'the best experience'.

Patient acceptability consists of two questions regarding discomfort and overall experience of uTNE. Discomfort is measured on a Numeric Pain Rating Scale (NPRS) with 0 being 'none' and 10 being 'severe'. Overall experience is measured on a Numeric Pain Rating Scale (NPRS) with 0 being 'the worst experience', 5 being 'neither pleasant nor unpleasant' and 10 being 'the best experience'.

Patient acceptability consists of two questions regarding discomfort and overall experience of conventional endoscopy. Discomfort is measured on a Numeric Pain Rating Scale (NPRS) with 0 being 'none' and 10 being 'severe'. Overall experience is measured on a Numeric Pain Rating Scale (NPRS) with 0 being 'the worst experience', 5 being 'neither pleasant nor unpleasant' and 10 being 'the best experience'.

Willingness to undergo repeat procedure consists of one question with answer options 'Yes' and 'No'.

The Cancer Worry Scale (CWS-8) is used to measure cancer worry. Scores are ranging from 8 to 32, and higher scores indicate more cancer worry.

The State-Trait Anxiety Inventory (STAI-6) is used to measure anxiety. Scores are ranging from 6 to 24, and higher scores indicate more anxiety.

The Impact of Event Scale (IES-15) is used to measure impact of event. Scores are ranging from 0 to 75, and higher scores indicate more impact of event.

The rate of successful intubation and complete evaluation will be measured.

The safety will be measured based on reported Adverse Events.

Dutch Digestive Diseases Foundation

Radboud University Medical Center

Skin and Connective Tissue Diseases

Breast Neoplasms

CDSS (MedicBK) captures the patient-specific data required to determine appropriate care decisions from the EMR and then presents relevant data alongside treatment suggestions to clinicians. MedicBK uses algorithms for presenting treatment suggestions framed by guideline-based therapy and personalized personalized evidence-based therapy. MedicBK consists of three main blocks: database, network meta-analysis, and heterogeneity of treatment effects assessment.

Neoadjuvant Chemotherapy by CDSS (MedicBK)

General practice

Evgeny Pokushalov, Prof. MD PhD

Irina Ostanina, MD

This study compares two approaches of upfront chemotherapy in breast cancer.

A Decision Support System (DSS) is an information system that supports business, medical, educational or organisational decision-making activities. DSSs fuse human knowledge and technology to support and improve decision-making.

The area of precision oncology that supports the treatment of breast cancer has not only seen an increase in the availability of different treatment choices but also genomic tools to support the decision-making process. CDSSs have been available for use in clinical oncology practice for over a decade. However, there has been some criticism around the utility of CDSS in personalised medicine decision-making of breast cancer, with these systems often viewed as aids better suited to support the 'average' patient's requirements rather than personalised treatment for the individual patient.

The purpose of the current study is to evaluate an innovative CDSS (MedicBK) platform based on the comparison of multiple treatments simultaneously in making care decisions taking into account the individual characteristics of patients, i.e., based on personalized evidence-based medicine.

Neoadjuvant Chemotherapy in Breast Cancer

Optimizing Neoadjuvant Systemic Treatment for Breast Cancer by Clinical Decision Support System

To compare the efficacy of Neoadjuvant Chemotherapy in general practice and by CDSS

to describe the safety of the various regimens toxicity is compared between the two arms

To identify prognostic and predictive for pathological complete response after neoadjuvant treatment

Center for New Medical Technologies, Novosibirsk, Russia

I.M. Sechenov First Moscow State Medical University

Novosibirsk Oncology Center

Center of Personalized Medicine, Pirogova

Director for research and development

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Gland and Hormone Related Diseases

Ovarian Neoplasms

Carcinoma, Ovarian Epithelial

Carcinoma

Endocrine Gland Neoplasms

Ovarian Diseases

Adnexal Diseases

Genital Diseases, Female

Genital Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Genital Neoplasms, Female

Urogenital Neoplasms

Endocrine System Diseases

Gonadal Disorders

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Ovarian Cancer

Ovarian Epithelial Cancer

All GPs in Central Denmark Region, are planned to be enrolled in the study during the one year study period.

Access to fast transvaginal ultrasound through general practice Develop and conduct training for general practicioners in the latest knowledge of ovarian cancer symptomatology

Transvaginal ultrasound

Marie-Louise L Baun, MD

Peter Vedsted, Professor

Margit Dueholm, As.Professor

Lone Kjeld Petersen, As.Professor

Background

Ovarian cancer (OC) is a disease with a poor prognosis due to diagnosis at late stage. Early-stage OC presents with non-specific and vague symptoms and therefore OC usually is not detected until reaching an advanced stage. From 2008, Danish general practitioners (GPs) could urgently refer patients suspected of having OC to standardized cancer patient pathways (CPPs). The CPP is designed for women presenting specific signs and alarm symptoms, and is supposed to shorten the pathway from suspicion to treatment.

Hypothesis

Direct access to fast transvaginal ultrasound (TVU) through general practice is feasible in earlier diagnosis of OC.

Aim

The aim of this study is to assess the implementation and clinical implications of direct referral access to fast TVU through general practice.

Materials and methods

The study is a feasibility study and GPs from in Central Denmark Region are offered direct access to fast TVU for women aged 40 years or more who present symptoms that could origin from OC, but which are not classified as alarm symptoms. The GPs will receive education about updated knowledge on OC symptoms and the use of the guideline for earlier diagnosis of OC in general practice. The study period is 1 year.

Perspectives

There is a great need to test rational strategies for diagnosing OC at an earlier stage in order to improve survival. For women who do not fulfil access criteria for the CPP, and for whom the main prospect for earlier diagnosis is improved identification of symptomatic OC, this study may provide important new knowledge of how to facilitate the diagnostics of OC in the future and reduce time to diagnosis and improve survival.

Background

Around 550 ovarian cancers (OCs) are diagnosed yearly in Denmark. Still, OC is the fourth commonest cause of cancer death amongst women in Denmark. Epithelial ovarian cancers (carcinomas) account for more than 90% of all OCs and Denmark has the second highest incidence in the world (15 per 100.000 women) with a life-time risk around 2%. The mean age at diagnosis is 63 years, and 80% are postmenopausal. In Denmark, 74% are diagnosed in FIGO stage III-IV and therefore at the time of diagnosis have regional or metastatic spread. Five-year survival with FIGO stage I is 83%, stage II 62%, stage III 23% and stage IV 11%. Thus, OC is detected at advanced stages with a very poor prognosis.

In 2008, a national fast-track system for cancer patients was established to ensure fast diagnosis and initiation of treatment. The fast-track system or cancer patient pathway (CPP) implies that patients presenting 'alarm' symptoms of e.g. OC will be referred immediately for diagnostic workup; no more than 14 days must pass from referral to initiation of treatment. Only about one quarter of the women with OC are referred primarily through this route. Therefore, additional accelerated routes are needed for the majority of women with OC.

A possibility could be access to fast TVU through general practice for women presenting with vague and non-specific symptoms that may represent underlying OC.

Aim

Develop and conduct training for general practitioners (GPs) in the latest knowledge of OC symptomatology. And at the same time investigate the feasibility and clinical implications in general practice of direct referral access to fast TVU, intended for women presenting with vague and non-specific symptoms.

Material and methods

GPs in Central Denmark Region are offered direct access to fast TVU for women aged 40 years or more who present vague and non-specific symptoms that could origin from OC, but which are not classified as alarm symptoms. Shortly afterwards all the GPs are offered a short lecture on OC symptomatology and instructions for the use of TVU for earlier diagnosis of OC through general practice. The lecture will be conducted by researchers from the research group.

Prior to investigation, all women who are referred to TVU will receive a consent form and a symptom-questionnaire. The symptom questionnaire focuses on the experienced symptoms during the past year.

After finished investigation, the TVU test results will return electronically to the referring GP.

The study period is one year. Data analysis will focus on the frequency of TVU use in general practice, action taken on test results and patient-reported symptoms prior to TVU.

Perspectives

The project will provide important new knowledge of the GPs referral practice when they suspect OC. For women presenting with vague and non-specific symptoms that may origin from OC, the introduction of TVU through general practice will provide new possibilities for evaluating the symptoms. Therefor introduction of TVU is a corner stone in the identification of more efficient ways to evaluate women at risk of developing OC.

This study will contribute with important knowledge of how to improve the diagnostics of OC in the future and may reduce time to diagnosis.

A Trial of Fast Access to Transvaginal Ultrasound Through General Practice for Earlier Diagnosis of Ovarian Cancer

Access to Fast Transvaginal Ultrasound Through General Practice for Earlier Diagnosis of Ovarian Cancer

TVU will be requested electronically through an online referral-system used by Danish GPs.

This outcome will be evaluated descriptively by illustrating the relation between time and use of TVU.

After all TVU investigations, a discharge summary will be send electronically to the referring GP.

If indicated, instructions for follow-up investigations is stated in the discharge summary. To evaluate if GPs follow these instructions, data on discharge summary recommended follow-up are compared to data on follow-up referrals made by the GPs. This outcome will be evaluated descriptively.

All women who are referred to TVU will receive a questionnaire prior to investigation, regarding experienced symptoms during the past year.

GPs refer women to TVU electronically. Information about indications for the investigation, is required in the referral. These informations will be used to evaluate the GPs reasons for referring the women to TVU and will be evaluated descriptively.

An overview of all findings by TVU will be provided, and possible side effects will be assessed.

An algorithm for the use of TVU has been developed, and the principal investigator will tick a box specifying what has been discovered during the investigation. Findings by TVU is identified in the algorithm used for TVU and by ICD-10 codes.

Number of OC diagnosed in each cancer stage (FIGO I-IV)

University of Aarhus

Symptoms and General Pathology

Melanoma

Pigmentation Disorders

Nevus, Pigmented

Nevus

Neuroendocrine Tumors

Neuroectodermal Tumors

Neuroectodermal Tumors, Primitive

Neoplasms, Germ Cell and Embryonal

Neoplasms, Nerve Tissue

Nevi and Melanomas

Skin Neoplasms

Skin Diseases

Neuroendocrine Tumor

Neuroepithelioma

Use of Nevus doctor program to assess the diagnostic category of pigmented skin lesions

The Nevus doctor program supplies a diagnostic category of pigmented skin lesions based on dermatoscopy images.

Nevus doctor program

Thomas R Schopf, Ph.D.

The "Nevus doctor" is a dermatoscopy based computer decision support tool to assist general practitioners (GPs) in the classification of pigmented skin lesions (PSLs). The aim of the program "Nevus doctor" is to help GPs increase their diagnostic accuracy, in particular regarding the selection of suspicious PSLs that need biopsy or referral to specialist health care for further assessment. The aim of this study is to investigate the diagnostic performance of the decision support tool in a primary care setting in Norway. We hypothesize that the diagnostic accuracy of the computer program "Nevus doctor" is better than the performance of the GPs.

In the trial GPs examine patients who attend a primary health care center. A given PSL is first assessed clinically by the GP and afterwards photographed. A clinical photograph as well as a dermatoscopic photograph is taken, the latter using a dermatoscope attached to the lens of the camera. The dermatoscopic image is then processed by the computer program. The performance of "Nevus doctor" is compared with the GPs' assessment. A dermatologist reviews all cases based on the clinical and dermatoscopic photographs and this assessment serves as the reference standard.

Nevus Doctor Clinical Decision Support

Nevus Doctor Clinical Decision Support Program for Pigmented Skin Lesions and Melanoma

Participating GPs are invited to interviews

The computer program tests whether the appearance of a skin lesion is suggestive of skin cancer. There are two possible test outcomes: "suspicious" or "not suspicious". The reference standard is the assessment done by a dermatologist. The number (and percentage) of skin lesions correctly classified as "suspicious" or "not suspicious" is reported. Furthermore sensitivity, specificity, positive and negative predictive values are calculated.

All cases with false test results are described in order to identify any pattern that can help to explain the false test result: correlation with specific types of skin lesions, poor image quality, gender and age of the patients.

University of Tromso

The Research Council of Norway

University Hospital of North Norway

Dermatologic Agents

All Drugs and Chemicals

The aim of the first part of the study is to evaluate patients' skin monitoring habits, their knowledge of skin cancer, and their preconceptions about new telemedicine tools such as teledermoscopy. This is a written quantitative questionnaire with answers to tick.

An explanatory folder will be given to patients and they will be asked to read it beforehand in order to allow a good understanding of the terms used and the goal of the project. This part will include 70 to 100 patients.

The second part of the study is a qualitative study and the aim of it is to evaluate the satisfaction, acceptance and future expectations of those who have benefited from teledermoscopy. Individual and anonymous interviews, lasting 15 to 20 minutes, intended for patients who have benefit of teledermoscopy at the office. An explanatory folder will also be given to the patients concerned in order to explain to them the procedure of the interview. This part will include 8 to 10 patients.

If there is any diagnostic doubt about a skin lesion, teledermoscopy will be used, if the patient agrees.

* A table containing the useful information about the patient for the lesion's analysis will be completed.
* The pictures will be taken with a Fotofinder Handyscope. The photos will be integrated into the patient's electronic medical record (CareConnect program).
* The photo is anonymized via a serial number assigned by the "Handyscope" application.
* Sending photos and information via a secure email address to the dermatologists.
* Response from the dermatologist (Prof. Tromme or Dr Harkemanne) in the following days also via email.
* Contact (consultation or telephone call depending on the diagnosis) with the patient to communicate the results and the procedure to be followed.
* This information (emails containing the dermatological report) will be saved in the patient's computerized medical file (CareConnect program) then deleted from the mailbox

taking macroscopic and dermoscopic pictures of suspicious skin lesions

Odile MAGOTTEAUX, Dr

Isabelle Tromme, Dr

The aim objective of this work is to assess the characteristics of patients for whom teledermoscopy could be suitable for the detection of potential skin cancers, within a population of rural general medicine in the South of Hainaut, by means of a mixed quantitative and qualitative study corresponding respectively:

* To identify patients' knowledge of skin cancers, their skin monitoring habits, and their acceptability of new telemedicine tools such as teledermoscopy ("Part 1").
* To evaluate the satisfaction and expectations of those who benefit from teledermoscopy ("Part 2").

Patient Acceptance And Satisfaction of Teledermoscopy In General Practice In a Belgian Rural Area

Evaluation of Patients Acceptance and Satisfaction With Teledermoscopy at the General Practionner's Office for the Detection of Skin Cancer in a Rural Area.

Using a quantitative survey-type questionnaire

* Determination of the patients ' skin monitoring habits
* Determination of patients' knowledge of skin cancers and their prevention
* Determine their acceptance of new technologies such as teledermoscopy in the context of skin cancer screening
* And finally, determination of a target population for whom teledermoscopy could be suitable for the detection of skin cancers (percentage of patients accepting teledermoscopy etc)

Assessment of the satisfaction and future expectations of patients who have benefited from teledermoscopy in general practice, using a qualitative study in the form of semi-structured, individual and anonymous interviews

Cliniques universitaires Saint-Luc- Université Catholique de Louvain

Colorectal Neoplasms

Intestinal Neoplasms

Colonic Diseases

Intestinal Diseases

Rectal Diseases

GPs in this group have not yet received intervention.

GPs in this group have received the intervention.

Intervention

Background

Colorectal cancer (CRC) is common, and a leading cause of cancer death. The evaluation of patients suspected to have CRC is difficult due to poorly predictive alarm symptoms and many patients present with uncharacteristic or vague symptoms. The faecal marker of human globin, iFOBT, could play an important role in aiding the general practitioner in detecting CRC.

Hypothesis

It will be possible to implement iFOBT in general practice as a test performed on patients who do not fulfill the criteria for fast-track referral for colorectal cancer, but whose symptoms could indicate an undiagnosed colorectal cancer.

Aim

To implement iFOBT in general practice and evaluate the uptake and clinical use of the test. Furthermore, we want to investigate the performance of iFOBT when used on patients presenting with uncharacteristic symptoms of CRC, and the clinical implications.

Materials and methods

The study uses a cluster randomised stepped wedge design. Clusters are constituted by the 18 municipalities in the central Denmark Region, and these are randomised when to receive a continuous medical education (CME). The date of inclusion is defined as the first working day in the month the CME is planned to be conducted. The CME is part of an intervention aimed to facilitate the implementation of iFOBT in general practice. Besides a CME, the intervention consist of a start package (iFOBT kits, a guideline and online educational material) that is sent to GPs when they are included in the study, and a status mail that GPs receive approx. one month after inclusion. The inclusion period is during the first 7 month of the study period, the study lasts for one year.

Perspectives

This study will provide important knowledge on how to improve CRC diagnostics in general practice.

Background

Colorectal cancer (CRC) is the second most common type of cancer in Denmark and is a leading cause of cancer death. Since 2000, the incidence has been increasing by 1-1.5% each year. The estimated 5-year survival rate is currently 80% for stage I cancer, 50% for stages II and III, and \<5 % for stage IV cancer. These figures emphasize the importance of detecting the disease in early stages and underline the current challenge of diagnosing CRC in general practice.

In 2008, a national fast-track system for cancer patients was established to ensure fast diagnosis and initiation of treatment. The fast-track system implies that patients presenting 'alarm' symptoms of e.g. CRC will be referred immediately for diagnostic workup; no more than 14 days must pass from referral to initiation of treatment. Several studies have shown that the positive predictive values (PPV) of the symptoms regarding CRC are fairly low (4-8%). In addition, approximately 50% of new CRC incidents will present with other vague and uncharacteristic symptoms than alarm symptoms.

In addition, a screening programme for CRC has been implemented. It is suggested that this will increase survival rate of CRC, however, it is estimated that approximately 75% of yearly CRC still have to be diagnosed through general practice.

A huge load is, consequently, still placed on general practice in the quest for earlier diagnosis of CRC, and better methods to aid the general practitioner in the diagnostic process are needed.

One tool could be the use of iFOBT in general practice for patients who present with symptoms that could origin from an underlying CRC, but without being alarm symptoms.

Aim

To implement iFOBT in general practice and evaluate the uptake and clinical use of the test. Furthermore, we want to investigate the performance of iFOBT when used on patients presenting with uncharacteristic symptoms of CRC, and the clinical implications.

Materials and methods

We will develop a guideline for the use of iFOBT in general practice. The guideline is aimed at men and women aged 30 years and above who present symptoms that could origin from a CRC, but are not classified as alarm symptoms. The guideline will contain a list of symptoms for which it is recommended to perform iFOBT and suggested actions for positive and negative test result. A value of \<49µg/L will be considered 'negative' and \>50µg/L as 'positive'.

The study uses a cluster randomised stepped wedge design, and is executed in the Central Denmark Region. Municipalities of the region are randomised when to receive a CME, and are included sequentially in the study during the first seven month of the study period. The CME are arranged on scheduled GP-meetings in each municipality and will consist of a 45 minutes lecture on CRC diagnosis and use of iFOBT. Besides a CME, the intervention consist of a start package (10 iFOBT kits, a guideline and online educational material) that is sent to GPs when they are included in the study, and a status mail that GPs receive approx. one month after inclusion. The study period is one year. Data analysis will focus on the uptake and clinical use of iFOBT in general practice, the performance of iFOBT when used on patients presenting with uncharacteristic symptoms of CRC and the clinical implications.

Perspectives

This study will investigate iFOBT and explore its role in general practice. To our knowledge, this study will be one of the first and most thorough investigations of this test in a primary care setting. The results will bring important knowledge of how to improve the diagnostics of colorectal cancer in the future and hopefully reduce time to diagnosis. Especially for patients who do not meet the traditional Danish criteria for fast-track referral, this study will be a corner stone in the identification of more efficient ways to locate patients at risk of developing CRC. At both national and international level, this project will contribute with important knowledge that may provide better planning of CRC diagnostics in the future.

A Trial of the Implementation of iFOBT in General Practice

The Use of Immunochemical Faecal Occult Blood Test (iFOBT) in General Practice. A Randomised Trial of the Implementation of iFOBT.

The risk of having CRC when the iFOBT is positive

The risk of having CRC at different iFOBT values.

The risk of having CRC when iFOBT is positive and specific symptoms. When requesting FIT, the GP register the patients' symptoms.

The relation between number of general practices started using iFOBT and time.

The relation between number of requested iFOBTs and time.

The relation between number of positive iFOBTs and time.

Behaviors and Mental Disorders

Quality of Life

Intervention group: The intervention consists of an extended information routine from hospital to GP based on individual interviews with the patients in the intervention group about their rehabilitation needs and a specific encouragement of the patients' GP to play a proactive role in the patients' rehabilitation course. The individual needs concerning the different types of consequences of the disease and following rehabilitation needs will be brought into focus.

The intervention consists of an extended information routine from hospital to GP based on individual interviews with the patients in the intervention group and a specific encouragement of the patients' GP to play a proactive role in the patients' rehabilitation course. The individual needs concerning the different types of consequences of the disease and following rehabilitation needs will be brought into focus. The control group is assigned to usual procedures.

Two step intervention including patient interview followed by an extended information routine to the patients' GP about the patients' rehabilitation needs

The aim of this study is to investigate the impact of a joint effort towards intensifying the collaboration and communication between hospital and general practice.

Background

In recent years an increasing focus has been on the unfulfilled needs of cancer patients for an individual rehabilitation taking into consideration the physical, psychological, social, economic, as well as work-related consequences of the cancer disease. Furthermore, there is a great need for ongoing adjustments of the organisation and procurement of rehabilitation offers and for optimizing the continuity of care, especially regarding transfer between sectors.

Research question

The aim of this study is to investigate whether a joint effort towards intensifying the collaboration and communication between hospital and general practice and encouraging the GP to take an active and prominent part in the rehabilitation process on actual patients has any effect on:

1. Health Related Quality of Life
2. The rehabilitation of cancer patients
3. The experience of continuity of care among cancer patients
4. How the GP act with regard to rehabilitation among cancer patients

Material and methods

The study uses a randomised, controlled design and is carried out as a PhD project. At Vejle Hospital approximately 1000 patients (500 in the intervention group and 500 in the control group) was included at the initiation of treatment. The intervention consists of an extended information routine from hospital to GP based on individual interviews with the patients in the intervention group and a specific encouragement of the patients' GP to play a proactive role in the patients' rehabilitation course. The individual needs concerning the different types of consequences of the disease and following rehabilitation needs will be brought into focus. The data will be obtained from public health registers and questionnaires to patients 6 and 14 months after the time of diagnosis (measuring Health Related Quality of Life, satisfaction with and use of rehabilitation activities, perceived continuity of care and satisfaction with their GP) and to GPs after 12 months (measuring satisfaction with the information from the hospital and activities to meet the patients' rehabilitation needs).

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Early Detection of Barrett's Esophagus in Participants With Reflux Symptoms in Primary Care	NCT04656392	Barrett Esophag... Esophageal Canc...	Breath test (eN...	50 Years - 75 Years	Radboud University Medical Center
Neoadjuvant Chemotherapy in Breast Cancer	NCT04802941	Decision Suppor...	Neoadjuvant Che... General practic...	18 Years -	Center of Personalized Medicine, Pirogova
A Trial of Fast Access to Transvaginal Ultrasound Through General Practice for Earlier Diagnosis of Ovarian Cancer	NCT03069872	Ovarian Cancer	Transvaginal ul...	40 Years -	University of Aarhus
Nevus Doctor Clinical Decision Support	NCT02012751	Nevus Melanoma	Nevus doctor pr...	18 Years -	University Hospital of North Norway
A Trial of Fast Access to Transvaginal Ultrasound Through General Practice for Earlier Diagnosis of Ovarian Cancer	NCT03069872	Ovarian Cancer	Transvaginal ul...	40 Years -	University of Aarhus
Patient Acceptance And Satisfaction of Teledermoscopy In General Practice In a Belgian Rural Area	NCT04534868	Skin Cancer Patient Accepta... Patient Satisfa...	taking macrosco...	18 Years -	Cliniques universitaires Saint-Luc- Université Catholique de Louvain
Early Detection of Barrett's Esophagus in Participants With Reflux Symptoms in Primary Care	NCT04656392	Barrett Esophag... Esophageal Canc...	Breath test (eN...	50 Years - 75 Years	Radboud University Medical Center
A Trial of the Implementation of iFOBT in General Practice	NCT02308384	Colorectal Canc...	Intervention	-	University of Aarhus
The GP's Role in Cancer Rehabilitation: a Randomised, Controlled Study.	NCT01021371	HRQOL (Health R...	Two step interv...	18 Years -	University of Southern Denmark

Spots Global Cancer Trial Database for general practice