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Impact of continuing medical education in cancer diagnosis on GP knowledge, attitude and readiness to investigate – a before-after study

机译：癌症诊断中继续医学教育对全科医生的知识，态度和调查准备的影响–前后研究

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Background Continuing medical education (CME) in earlier cancer diagnosis was launched in Denmark in 2012 as part of the Danish National Cancer Plan. The CME programme was introduced to improve the recognition among general practitioners (GPs) of symptoms suggestive of cancer and improve the selection of patients requiring urgent investigation. This study aims to explore the effect of CME on GP knowledge about cancer diagnosis, attitude towards own role in cancer detection, self-assessed readiness to investigate and cancer risk assessment of urgently referred patients. Methods We conducted a before-after study in the Central Denmark Region including 831 GPs assigned to one of eight geographical clusters. All GPs were invited to participate in the CME at three-week intervals between clusters. A questionnaire focusing on knowledge, attitude and clinical vignettes was sent to each GP one month before and seven months after the CME. The GPs were also asked to assess the risk of cancer in patients urgently referred to a fast-track cancer pathway during an eight-month period. CME-participating GPs were compared with reference (non-participating) GPs by analysing before-after differences. Results One quarter of all GPs participated in the CME. 202 GPs (24.3?%) completed both the baseline and the follow-up questionnaires. 532 GPs (64.0?%) assessed the risk of cancer before the CME and 524 GPs (63.1?%) assessed the risk of cancer after the CME in urgently referred consecutive patients. Compared to the reference group, CME-participating GPs statistically significantly improved their understanding of a rational probability of diagnosing cancer among patients urgently referred for suspected cancer, increased their knowledge of cancer likelihood in a 50-year-old referred patient and lowered the assessed risk of cancer in urgently referred patients. Conclusions The standardised CME lowered the GP-assessed cancer risk of urgently referred patients, whereas the effect on knowledge about cancer diagnosis and attitude towards own role in cancer detection was limited. No effect was found on the GPs’ readiness to investigate. CME may be effective for optimising the interpretation of cancer symptoms and thereby improve the selection of patients for urgent cancer referral. Trial registration NCT02069470 on ClinicalTrials.gov. Retrospectively registered, 1/29/2014.
机译：背景技术作为丹麦国家癌症计划的一部分，2012年在丹麦启动了早期癌症诊断的继续医学教育（CME）。引入了CME程序，以提高全科医生（GPs）对暗示癌症的症状的认识，并改善需要紧急调查的患者的选择。本研究旨在探讨CME对GP的癌症诊断知识，对自身在癌症检测中的作用的态度，自我评估的调查准备程度以及对急诊患者的癌症风险评估的影响。方法我们在丹麦中部地区进行了一项前后研究，其中包括分配给八个地理集群之一的831个GP。所有GP均应每两周间隔三周参加CME。在CME的一个月前和七个月后，向每个GP发送了一份针对知识，态度和临床渐晕的问卷。还要求全科医生评估在八个月内紧急转诊为快速通道癌症患者的癌症风险。通过分析前后差异，将参加CME的GP与参考（未参加）的GP进​​行比较。结果所有GP中有四分之一参加了CME。 202名GP（24.3％）完成了基线调查表和后续调查表。紧急转诊的连续患者中，有532名GPs（64.0％）评估了CME之前的癌症风险，有524名GPs（63.1％）评估了CME之后的CME之后的癌症风险。与参考组相比，参加CME的GP在统计学上显着提高了他们对急诊可疑癌症急诊患者的合理诊断癌症概率的理解，增加了他们对50岁转诊患者癌症可能性的了解，并降低了评估风险急诊患者的癌症结论标准化的CME降低了GP评估的急诊患者的癌症风险，而对癌症诊断知识和对自己在癌症检测中的作用的态度的影响有限。对全科医生的调查准备没有发现任何影响。 CME可能有效地优化了对癌症症状的解释，从而改善了紧急转诊患者的选择。在ClinicalTrials.gov上进行的试验注册NCT02069470。追溯注册，2014年1月29日。

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