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Articles by Thomas Round
Performance of a multi-cancer early detection test in the randomized controlled NHS-Galleri trial
Abstract The NHS-Galleri trial was a randomized controlled trial evaluating a multi-cancer early detection (MCED) test added to usual care. We reported elsewhere that the primary endpoint of a reduction in the incidence of stage III/IV cancer diagnoses in the intervention arm versus control arm was not met. Here we report prespecified secondary test performance endpoints among evaluable intervention arm participants across three annual screening rounds.
Improving diagnosis and support for people with bipolar in primary care
What is bipolar? Bipolar is a lifelong, severe mental illness characterised by mood swings and fluctuating energy levels. Clinicians may be more familiar with the term ‘bipolar disorder’; however, bipolar is the current favoured term with patient groups1 and will be used throughout this article.
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Use of AI scribes in UK primary care: a survey of general practitioners
Abstract UK general practice is increasingly adopting ambient voice technology (“AI scribes”) for summarising and documenting medical consultations without clear regulation and implementation guidance. The aim of this study was to examine current use and perceptions of AI scribes among UK GPs, and to identify GP, practice, and population factors associated with their adoption.
Sa1081 RULING OUT THE SHORT STUFF: A META-ANALYSIS OF A SPONGE DEVICE FOR SHORT-SEGMENT BARRETT’S ESOPHAGUS IN A BARRETT’S COHORT
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Why aren’t they used? Systematic review of barriers to implementation of clinical decision support systems for early cancer detection in primary care
Abstract Background Early cancer detection is crucial for patient outcomes. Clinical decision support systems (CDSSs) have been developed to assist with decision making about screening or symptomatic assessment in primary care, but implementation remains challenging. Aim To compare barriers to implementation of cancer-specific CDSSs for screening and symptomatic presentation in primary care. Design and setting Systematic mixed-methods literature review.
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Primary care assessment of transient loss of consciousness in adults
Introduction Transient loss of consciousness (TLoC) affects up to half the population at some point in their lives.1 Vasovagal syncope is the most common cause, with a global prevalence of at least 16%, but TLoC may also be the first presentation of a serious underlying pathology.2 Identifying individuals who require further investigation and evaluation is a challenging but important role of primary care clinicians.
Cardiovascular disease - risk assessment and reduction: NICE 2023 update for GPs
Introduction The National Institute for Health and Care Excellence (NICE) guidelines on preventing cardiovascular disease have recently been updated, with significant changes to recommendations on lipid management.1 The new guidance has featured prominently in the national press because of the extended range of patients who are now potentially eligible for lipid-lowering therapy.
What is a full-time GP?
This is a question I’m sure many of us have posed. Ever-increasing workloads, long hours, yet never seeming to get on top of an endless cycle of work. This, in turn, leads to stress and burnout; with analysis showing that UK GPs have higher workload and stress than most comparable countries.1 Yet we are criticised by some of the media as ‘part-time GPs’. Clearly things need to change if we are going to escape a vicious cycle of an overstretched workforce. The latest issue of the BJGP can back up …
A multi-cancer early detection (MCED) test: clinical update for GPs
Introduction Cancer screening can be effective at early-stage detection, but, currently, only around 6% of cancers in the UK are screen-detected with programmes for cervical, colorectal, breast, and more recently targeted lung cancer screening.1 Increasing areas of interest are cancer detection tests based on circulating tumour-derived DNA (ctDNA) and their potential role in cancer screening,2 with multiple blood-based tests being developed.3 These are designed to detect potential cancer...
Text-message reminders to increase participation in colorectal cancer screening
Background Colorectal cancer (CRC) is the fourth most common cancer among both men and women in the UK. Despite advancements, CRC remains a significant cause of mortality and morbidity, accounting for ∼17 000 deaths and ∼43 000 new diagnoses annually.1 The NHS Bowel Cancer Screening programme (BCSP) aims to detect CRC at early stages.
Transforming post pandemic cancer services - British Journal of Cancer
Abstract This paper outlines the impact of the COVID-19 pandemic on cancer services in the UK including screening, symptomatic diagnosis, treatment pathways and projections on clinical outcomes as a result of these care disruptions. A restoration of cancer services to pre-pandemic levels is not likely to mitigate this adverse impact, particularly with an ageing population and increased cancer burden.
Higher risk of cancer following 'all clear' after suspected cancer referral
Patients who were referred to urgent suspected cancer pathways, but were found not to have cancer at that time, have a higher risk of subsequent cancer in the 1-5 years following the ‘all clear’ than those who haven’t been through the referral pathways. The study, published today in Lancet Oncology is the first to examine the risk of cancer in patients in England who entered the urgent suspected cancer pathway but were found not to have cancer at that time.
Uterine adenomyosis: an update for GPs
BACKGROUND Adenomyosis is the presence of endometrial-like tissue and stroma within the myometrium.
Cancer and Primary Care; Shifting the Narrative
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Cancer and Primary Care; Shifting the Narrative
In this issue we lead with a cancer theme. For over 10 years some of the BJGP ’s most impactful papers have focused on this area, including developing the evidence base for symptom-based approaches to cancer diagnosis. Many studies have used large primary care electronic record databases to develop positive predictive values (PPV) for cancer from different symptoms and clinical features, such as unexplained anaemia and thrombocytosis.
Guidance on faecal immunochemical testing (FIT) to help diagnose colorectal cancer among symptomatic patients in primary care
Skip to main page content Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation Save citation to file Format: Add to My Bibliography Your saved search Name of saved search: Search terms: Frequency: Which day? Which day? Report format: Send at most: Send even when there aren't any new results Optional text in email: Create a file for external citation management software doi: 10.3399/bjgp23X733173. Affiliations Affiliations 1 Wellcome Trust doctoral research fellow.
Guidance on faecal immunochemical testing (FIT) to help diagnose colorectal cancer among symptomatic patients in primary care
INTRODUCTION The Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG) have published a new guideline around faecal immunochemical testing (FIT) in patients with signs or symptoms of suspected colorectal cancer (CRC).1 The guideline was written by a multidisciplinary team including GPs and patient representatives, and includes recommendations for both primary and secondary care.
Diagnosis; Still Our Achilles Heel?
This is my first Editor’s briefing since joining the BJGP as Associate Editor and it is a pleasure to introduce our theme of diagnosis, such an important part of our role as GPs, and yet an area which has been argued is also our ‘Achilles heel’.
'No Time To Die': A Canonical Incongruence
Thomas Round analyses the legacy of the famed British spy James Bond in the context of his reputation, his origins, and the myths surrounding him. Ever since his first incarnation in Ian Fleming’s Casino Royale in 1953, the name James Bond has been synonymous with suaveness, sophistication, sexuality, and, most importantly, Britishness.
Cervical screening: the evolving landscape
The elimination of cervical cancer is within reach.
Notes on Modern Posters
I was recently commuting on the London Underground and occupying myself, as I usually do, by listening to music. My music taste is broad but thinly spread, reaching almost every genre, though never really delving deeply into one artist or genre in particular. One of my favourite musical styles, though, is film and television scores.
NICE chronic primary pain guidelines: what the busy GP needs to know
ASSESSING CHRONIC PAIN Chronic primary pain occurs without a clear underlying condition or when the pain — including associated emotional distress and functional disability — is disproportionate to observable injury or condition. These conditions, including fibromyalgia, chronic primary headache, and chronic primary pelvic pain, affect between 1% and 6% of people in England.1 The underlying pathophysiology is poorly understood.
Atrial fibrillation: NICE 2021 update and the focus on anticoagulation
Clinical Practice Nicholas R Jones, Thomas Round and Kim Rajappan British Journal of General Practice 2022; 72 (717): 193-195. DOI: https://doi.org/10.3399/bjgp22X719069 INTRODUCTION The National Institute for Health and Care Excellence (NICE) released an updated atrial fibrillation (AF) guideline in April 2021.1 This article provides an overview of the key changes relevant to primary care, which are also covered in RCGP Essential Knowledge Updates (EKU) e-learning.
Cancer detection via primary care urgent referral and association with practice characteristics: a retrospective cross-sectional study in England from 2009/2010 to 2018/2019
Notes Funding Thomas Round is funded by a National Institute for Health Research (NIHR) Doctoral Research Fellowship (DRF) (reference: DRF-2016-09-054) for this research project and supported by a Royal Marsden Partners (RMP) Research Fellowship. The views expressed are those of the author(s) and not necessarily those of the NIHR, NHS, RMP, Public Health England (PHE), or the Department of Health and Social Care.
Cancer detection via primary care urgent referral and association with practice characteristics: a retrospective cross-sectional study in England from 2009/2010 to 2018/2019
Research Thomas Round, Mark Ashworth, Veline L’Esperance and Henrik Møller British Journal of General Practice 20 September 2021; BJGP.2020.1030. DOI: https://doi.org/10.3399/BJGP.2020.1030 Abstract Background There is substantial variation in the use of urgent suspected cancer referral (2-week wait [2WW]) between practices. Aim To examine the change in use of 2WW referrals in England over 10 years (2009/2010 to 2018/2019) and the practice and population factors associated with cancer detection.
Venous thromboembolism management and the new NICE guidance: what the busy GP needs to know
Clinical Practice Nicholas R Jones and Thomas Round British Journal of General Practice 2021; 71 (709): 379-380. DOI: https://doi.org/10.3399/bjgp21X716765 INTRODUCTION This article summarises the 2020 National Institute for Health and Care Excellence (NICE) venous thromboembolism (VTE) guidelines, which are also covered in Royal College of General Practitioners (RCGP) Essential Knowledge Updates (EKU) e-learning.
COVID-19 and the multidisciplinary care of patients with lung cancer: an evidence-based review and commentary
References 1. Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395, 497–506 (2020). CAS PubMed PubMed Central Article Google Scholar 2. World Health Organization (WHO). Global Cancer Statistics (WHO, 2018). 3. Allemani, C., Matsuda, T., Di Carlo, V., Harewood, R., Matz, M., Nikšić, M. et al.
Primary care funding entrenches health inequalities: time for a rethink
Fifty years since the term was first used to describe the mismatch between healthcare provision and healthcare need,1 the inverse care law is alive and well. Coined by Julian Tudor Hart, a GP in a coal-mining community in south Wales, the term was a clever pun on the inverse square law. And it has stuck ever since. Although primary care in 2021 has changed beyond recognition since 1971, one factor remains largely unchanged and it is a factor that perpetuates disparity.
Association between use of urgent suspected cancer referral and mortality and stage at diagnosis: a 5-year national cohort study
Research Thomas Round, Carolynn Gildea, Mark Ashworth and Henrik Møller British Journal of General Practice 2020; 70 (695): e389-e398. DOI: https://doi.org/10.3399/bjgp20X709433 Abstract Background There is considerable variation between GP practices in England in their use of urgent referral pathways for suspected cancer.
Association between use of urgent suspected cancer referral and mortality and stage at diagnosis: a 5-year national cohort study
Research Thomas Round, Carolynn Gildea, Mark Ashworth and Henrik Møller British Journal of General Practice 20 April 2020; bjgp20X709433. DOI: https://doi.org/10.3399/bjgp20X709433 Abstract Background There is considerable variation between GP practices in England in their use of urgent referral pathways for suspected cancer.
Seeing the wood and the trees: the impact of the healthcare system on variation in primary care referrals
Seeing the wood and the trees: the impact of the healthcare system on variation in primary care referrals Free Thomas Round1, Gary Abel2 1 School of Population Health and Environmental Sciences, King's College London, London, UK 2 Medical School (Primary Care), University of Exeter, Exeter, UK Correspondence to Dr Thomas Round, School of Population Health and Environmental Sciences, King's College London, London SE1 1UL, UK; thomas.round{at}kcl.ac.uk Statistics from Altmetric.com...
Seeing the wood and the trees: the impact of the healthcare system on variation in primary care referrals
Seeing the wood and the trees: the impact of the healthcare system on variation in primary care referrals Free Thomas Round1, Gary Abel2 1School of Population Health and Environmental Sciences, King's College London, London, UK 2Medical School (Primary Care), University of Exeter, Exeter, UK Correspondence to Dr Thomas Round, School of Population Health and Environmental Sciences, King's College London, London SE1 1UL, UK; thomas.round{at}kcl.ac.uk Statistics from Altmetric.com accreditation...
Seeing the wood and the trees: the impact of the healthcare system on variation in primary care referrals
Seeing the wood and the trees: the impact of the healthcare system on variation in primary care referrals Free Correspondence to Dr Thomas Round, School of Population Health and Environmental Sciences, King's College London, London SE1 1UL, UK; thomas.round{at}kcl.ac.uk View Full Text Citation Round T, Abel G Seeing the wood and the trees: the impact of the healthcare system on variation in primary care referrals BMJ Quality & Safety Published Online First: 10 December 2019.
Cancer patients and primary care prescribed medications: offering insights into symptoms, polypharmacy and multimorbidity
Cancer patients and primary care prescribed medications: offering insights into symptoms, polypharmacy and multimorbidity Kwok F Wong, Jackie Charman, Thomas Round, Katherine E Henson Br J Gen Pract 2018; 68 (suppl 1): bjgp18X697001. DOI: 10.3399/bjgp18X697001
Impact of primary care funding on secondary care utilisation and patient outcomes: a retrospective cross-sectional study of English general practice
Impact of primary care funding on secondary care utilisation and patient outcomes: a retrospective cross-sectional study of English general practice Veline L’Esperance, Matt Sutton, Peter Schofield, Thomas Round, Umer Malik, Patrick White, Mark Ashworth Br J Gen Pract 2017; 67 (664): e792-e799. DOI: 10.3399/bjgp17X693101
Impact of primary care funding on secondary care utilisation and patient outcomes: a retrospective cross-sectional study of English general practice
Impact of primary care funding on secondary care utilisation and patient outcomes: a retrospective cross-sectional study of English general practice Veline L’Esperance, Matt Sutton, Peter Schofield, Thomas Round, Umer Malik, Patrick White, Mark Ashworth Br J Gen Pract 25 September 2017; bjgp17X693101. DOI: 10.3399/bjgp17X693101
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