| 1. |
|
|
| 2. |
- Högberg, Cecilia, et al.
(författare)
-
Diagnosing colorectal cancer in primary care : cohort study in Sweden of qualitative faecal immunochemical tests, haemoglobin levels, and platelet counts
- 2020
-
Ingår i: British Journal of General Practice. - London : Royal College of General Practitioners. - 0960-1643 .- 1478-5242. ; 70:701, s. E843-E851
-
Tidskriftsartikel (refereegranskat)abstract
- Background Colorectal cancer (CRC) diagnostics are challenging in primary care and reliable diagnostic aids are desired. Qualitative faecal immunochemical tests (FITs) have been used for suspected CRC in Sweden since the mid-2000s, but evidence regarding their effectiveness is scarce. Anaemia and thrombocytosis are both associated with CRC. Aim To evaluate the usefulness of qualitative FITs requested for symptomatic patients in primary care, atone and combined with findings of anaemia and thrombocytosis, in the diagnosis of CRC. Design and setting A population-based cohort study using electronic health records and data from the Swedish Cancer Register, covering five Swedish regions. Method Patients aged >= 18 years in the five regions who had provided FITs requested by primary care practitioners from 1 January 2015 to 31 December 2015 were identified. FIT and blood-count data were registered and all CRC diagnoses made within 2 years were retrieved. Diagnostic measurements were calculated. Results In total, 15 789 patients provided FITs (four different brands); of these patients, 304 were later diagnosed with CRC. Haemoglobin levels were available for 13 863 patients, and platelet counts for 10 973 patients. Calculated for the different FIT brands only, the sensitivities for CRC were 81.6%-100%; specificities 65.7%-79.5%: positive predictive values 4.7%-8.1%; and negative predictive values 99.5%-100%. Calculated for the finding of either a positive FIT or anaemia, the sensitivities increased to 88.9-100%. Adding thrombocytosis did not further increase the diagnostic performance. Conclusion Qualitative FITs requested in primary care seem to be useful as rule in tests for referral when CRC is suspected. A negative FIT and no anaemia indicate a low risk of CRC.
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
- Wanat, M., et al.
(författare)
-
Transformation of primary care during the COVID-19 pandemic: experiences of healthcare professionals in eight European countries
- 2021
-
Ingår i: British Journal of General Practice. - : Royal College of General Practitioners. - 0960-1643 .- 1478-5242. ; 71:709
-
Tidskriftsartikel (refereegranskat)abstract
- Background I'm Tian/care has a crucial role in responding to the COVID-19 pandemic as the first point of patient care and gatekeeper to secondary care. Qualitative studies exploring the experiences of healthcare professionals during the COVID-19 pandemic have mainly focused on secondary care. Aim To gain an understanding of the experiences of European primary care professionals (PCPs) working during the first peak of the COVID-19 pandemic. Design and setting An exploratory qualitative study, using semi structured interviews in primary care in England, Belgium, the Netherlands. Ireland. Germany, Poland, Greece, and Sweden, between April and July 7020. Method Interviews were audiorecorded, transcribed, and analysed using a combination of inductive and deductive thematic analysis techniques. Results Fighty interviews were conducted with PCPs. PCPs had to make their own decisions on how to rapidly transform services in relation to COVID-19 and non-COVID-19 care. Despite being overwhelmed with guidance. they often lacked access to practical training. Consequently. PCPs turned to their colleagues for moral support and information to try to quickly adjust to new ways of working, including remote care. arid to deal with uncertainty. Conclusion PCPs rapidly transformed primary care delivery despite a number of challenges. Representation of primary care at policy level and engagement with local primary care champions are needed to facilitate easy and coordinated access to practical information on how to adapt services, ongoing training, and access to appropriate mental health support services for PCPs. Preservation of autonomy and responsiveness of primary care are critical to preserve the ability for rapid transformation in any future crisis of care delivery.
|
|
