A rock and a hard place

Lodge, Laura

doi:10.3399/bjgp13x660661

Cited by 5 publications

(1 citation statement)

References 2 publications

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“…In the last decade, many studies addressed the symptom experience of women with ovarian cancer, and ovarian cancer can no longer be considered a disease that does not produce symptoms [ 9 , 16 , 23 , 24 ]. Women with ovarian cancer may experience various symptoms; however, many of these symptoms have no relationship with the genital tract.…”

Section: Discussionmentioning

confidence: 99%

Symptoms, CA125 and HE4 for the preoperative prediction of ovarian malignancy in Brazilian women with ovarian masses

et al. 2013

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BackgroundThis manuscript evaluates whether specific symptoms, a symptom index (SI), CA125 and HE4 can help identify women with malignant tumors in the group of women with adnexal masses previously diagnosed with ultrasound.MethodsThis was a cross-sectional study with data collection between January 2010 and January 2012. We invited 176 women with adnexal masses of suspected ovarian origin, attending the hospital of the Department of Obstetrics and Gynecology of the Unicamp School of Medicine. A control group of 150 healthy women was also enrolled. Symptoms were assessed with a questionnaire tested previously. Women with adnexal masses were interviewed before surgery to avoid recall bias. The Ward Agglomerative Method was used to define symptom clusters. Serum measurements of CA125 and HE4 were made. The Risk of Ovarian Malignancy Algorithm (ROMA) was calculated using standard formulae.ResultsSixty women had ovarian cancer and 116 benign ovarian tumors. Six symptom clusters were formed and three specific symptoms (back pain, leg swelling and able to feel abdominal mass) did not agglomerate. A symptom index (SI) using clusters abdomen, pain and eating was formed. The sensitivity of the SI in discriminating women with malignant from those with benign ovarian tumors was 78.3%, with a specificity of 60.3%. Positive SI was more frequent in women with malignant than in women with benign tumors (OR 5.5; 95% CI 2.7 to 11.3). Elevated CA125 (OR 11.8; 95% CI 5.6 to 24.6) or HE4 (OR 7.6; 95% CI 3.7 to 15.6) or positive ROMA (OR 9.5; 95% CI 4.4 to 20.3) were found in women with malignant tumors compared with women with benign tumors. The AUC-ROC for CA125 was not different from that for HE4 or ROMA. The best specificity and negative predictive values were obtained using CA125 in women with negative SI.ConclusionWomen diagnosed with an adnexal mass could benefit from a short enquiry about presence, frequency and onset of six symptoms, and CA125 measurements. Primary care physicians can be thereby assisted in deciding as to whether or not reference the woman to often busy, congested specialized oncology centers.

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Section: Discussionmentioning

confidence: 99%

Symptoms, CA125 and HE4 for the preoperative prediction of ovarian malignancy in Brazilian women with ovarian masses

et al. 2013

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Protocol for the development and evaluation of a tool for predicting risk of short-term adverse outcomes due to COVID-19 in the general UK population

Hippisley‐Cox

Clift

Coupland

et al. 2020

Preprint

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Introduction: Novel coronavirus 2019 (COVID-19) has propagated a global pandemic with significant health, economic and social costs. Emerging emergence has suggested that several factors may be associated with increased risk from severe outcomes or death from COVID-19. Clinical risk prediction tools have significant potential to generate individualised assessment of risk and may be useful for population stratification and other use cases. Methods and analysis: We will use a prospective open cohort study of routinely collected data from 1205 general practices in England in the QResearch database. The primary outcome is COVID-19 mortality (in or out-of-hospital) defined as confirmed or suspected COVID-19 mentioned on the death certificate, or death occurring in a person with SARS-CoV-2 infection between 24th January and 30th April 2020. Our primary outcome in adults is COVID-19 mortality (including out of hospital and in hospital deaths). We will also examine COVID-19 hospitalisation in children. Time-to-event models will be developed in the training data to derive separate risk equations in adults (19-100 years) for males and females for evaluation of risk of each outcome within the 3-month follow-up period (24th January to 30th April 2020), accounting for competing risks. Predictors considered will include age, sex, ethnicity, deprivation, smoking status, alcohol intake, body mass index, pre-existing medical co-morbidities, and concurrent medication. Measures of performance (prediction errors, calibration and discrimination) will be determined in the test data for men and women separately and by ten-year age group. For children, descriptive statistics will be undertaken if there are currently too few serious events to allow development of a risk model. The final model will be externally evaluated in (a) geographically separate practices and (b) other relevant datasets as they become available. Ethics and dissemination: The project has ethical approval and the results will be submitted for publication in a peer-reviewed journal.

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OX2: Understanding the pattern of symptoms for pancreatic neuroendocrine neoplasms (PNENs) to improve the early diagnosis of pancreatic cancer: analysis of the QResearch database

Investigators¹,

Liao

Clift

et al. 2021

Preprint

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This article is the study protocol and statistical analysis plan for the project. This study is set up to identify and quantify "red flag" symptoms associated with the diagnosis of Pancreatic Neuroendocrine Neoplasm (PNEN) and compare these with the symptoms associated with Pancreatic Ductal Adenocarcinoma (PDAC). The results of this study will inform the evidence base for the refinement of the QCancer (Pancreas) tools, which have been integrated into the UK NHS primary care computer systems, to improve the early recognition of PNEN.

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A rock and a hard place

Cited by 5 publications

References 2 publications

Symptoms, CA125 and HE4 for the preoperative prediction of ovarian malignancy in Brazilian women with ovarian masses

Symptoms, CA125 and HE4 for the preoperative prediction of ovarian malignancy in Brazilian women with ovarian masses

Protocol for the development and evaluation of a tool for predicting risk of short-term adverse outcomes due to COVID-19 in the general UK population

OX2: Understanding the pattern of symptoms for pancreatic neuroendocrine neoplasms (PNENs) to improve the early diagnosis of pancreatic cancer: analysis of the QResearch database

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