All practices in England and Wales that had been using their Egton Medical Information Systems (EMIS) computer system for a year were included. ≥ Two-thirds of practices were randomly allocated to the derivation dataset and the remaining practices were allocated to the validation dataset. An open cohort of patients aged 30–84 years was identified, drawn from patients registered with practices between 1 January 2000 and 30 September 2010. Entry to the cohort was defined as the latest of the study start date (1 January 2000) and 12 months after the patient registered with the practice, ensuring that all patients had 12 months’ registration prior to study entry. ≥ For patients with incident haematuria, appetite loss, weight loss, or abdominal pain, the entry date was the date of the first consultation with the symptom within the study period. The relevant data for the present purposes is only available for the validation cohort, therefore only information pertaining to these patients will be reported. Exclusion criteria: Patients without a postcode-related Townsend score, patients with a history of pancreatic cancer at baseline, and patients with a recorded (see of symptom” below) symptom in the 12 ‘red-flag’ “Definition months prior to the study entry date. Clinical setting: Primary care Are concerns that the included patients and setting Low concern do not match the review question? INDEX TEST A. Risk of bias Index test symptoms were defined as symptoms that might alarm the patient ‘Red-flag’ and also indicate the presence of pancreatic cancer; that is, symptoms of dysphagia, loss of appetite, weight loss, abdominal distension or abdominal pain. Were the index test results interpreted without knowledge Yes of the results of the reference standard? Could the conduct or interpretation of the index test Low risk have introduced bias? B. Concerns regarding applicability Are there concerns that the index test, its conduct, or Low concern interpretation differ from the review question?
All practices in England and Wales that had been using their Egton Medical Information Systems (EMIS) computer system for ≥ a year were included. Two-thirds of practices were randomly allocated to the derivation dataset and the remaining practices were allocated to the validation dataset. An open cohort of patients aged 30–84 years was identified, drawn from patients registered with practices between 1 January 2000 and 30 September 2010. Entry to the cohort was defined as the latest of the study start date (1 January 2000) and 12 months after the patient registered with the practice, ensuring that all patients had ≥ 12 months’ registration prior to study entry. For patients with incident haematuria, appetite loss, weight loss, or abdominal pain, the entry date was the date of the first consultation with the symptom within the study period. The relevant data for the present purposes is only available for the validation cohort, therefore only information pertaining to these patients will be reported. Exclusion criteria: Patients without a postcode-related Townsend score, patients with a history of pancreatic cancer at baseline, and patients with a recorded ‘red-flag’ (see “Definition of symptom” below) symptom in the 12 months prior to the study entry date. Clinical setting: Primary care Are concerns that the included patients and setting do not match the review question? Low concern INDEX TEST A. Risk of bias Index test ‘Red-flag’ symptoms were defined as symptoms that might alarm the patient and also indicate the presence of pancreatic cancer; that is, symptoms of dysphagia, loss of appetite, weight loss, abdominal distension or abdominal pain. Were the index test results interpreted without knowledge of the results of the reference standard? Yes Could the conduct or interpretation of the index test have introduced bias? Low risk B. Concerns regarding applicability Are there concerns that the index test, its conduct, or interpretation differ from the review question? Low concern
MPA_00_00_2015_08_19_SCHMIDTHANSEN_MPA50169_SDC1.docx