Preliminary results of a feasibility study of the use of information technology for identification of suspected colorectal cancer in primary care: the CREDIBLE study.
BACKGROUND
We report the findings of a feasibility study using information technology to search electronic primary care records and to identify patients with possible colorectal cancer.


METHODS
An algorithm to flag up patients meeting National Institute for Health and Care Excellence (NICE) urgent referral criteria for suspected colorectal cancer was developed and incorporated into clinical audit software. This periodically flagged up such patients aged 60 to 79 years. General practitioners (GPs) reviewed flagged-up patients and decided on further clinical management. We report the numbers of patients identified and the numbers that GPs judged to need further review, investigations or referral to secondary care and the final diagnoses.


RESULTS
Between January 2012 and March 2014, 19,580 records of patients aged 60 to 79 years were searched in 20 UK general practices, flagging up 809 patients who met urgent referral criteria. The majority of the patients had microcytic anaemia (236 (29%)) or rectal bleeding (205 (25%)). A total of 274 (34%) patients needed further clinical review of their records; 199 (73%) of these were invited for GP consultation, and 116 attended, of whom 42 were referred to secondary care. Colon cancer was diagnosed in 10 out of 809 (1.2%) flagged-up patients and polyps in a further 28 out of 809 (3.5%).


CONCLUSIONS
It is technically possible to identify patients with colorectal cancer by searching electronic patient records.
Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, West Midlands B15 2TT, UK.
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E
Kidney
Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, West Midlands B15 2TT, UK.
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L
Berkman
Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, West Midlands B15 2TT, UK.
A
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Macherianakis
Department of Surgery, School of Cancer Sciences, Queen Elizabeth Hospital Birmingham (old), University of Birmingham, Room 29, 4th Floor, Edgbaston, Birmingham B15 2TT, UK.
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Morton
Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, West Midlands B15 2TT, UK.
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Dowswell
College House, University of Exeter Medical School, St Luke's Campus, Exeter EX1 2LU, UK.
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W
Hamilton
Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, West Midlands B15 2TT, UK.
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R
Ryan
Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, West Midlands B15 2TT, UK.
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H
Awbery
Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, West Midlands B15 2TT, UK.
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Greenfield
Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, West Midlands B15 2TT, UK.
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T
Marshall
D000368:Aged; D000465:Algorithms; D000740:Anemia / Q000209:etiology; D002277:Carcinoma / Q000150:complications / Q000175:diagnosis*; D015179:Colorectal Neoplasms / Q000150:complications / Q000175:diagnosis*; D003967:Diarrhea / Q000209:etiology; D057286:Electronic Health Records; D005240:Feasibility Studies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007417:Intestinal Polyps / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008485:Medical Audit; D008490:Medical Informatics / Q000379:methods*; D008875:Middle Aged; D011320:Primary Health Care; D012007:Rectum; D012017:Referral and Consultation; D012984:Software