Title

‘WICKED’ (Wales Interventions and Cancer Knowledge about Early Diagnosis): The development and evaluation of primary care interventions to expedite the diagnosis of symptomatic cancer in Wales. 

Chief Investigators
Co-applicants
  • Ruth Lewis (NWCPCR, Bangor University)
  • Julia Hiscock (NWCPCR, Bangor University)
  • Maggie Hendry (NWCPCR, Bangor University)
  • Nefyn Williams (NWCPCR, Bangor University)
  • Paul Brocklehurst (NWORTH, Bangor University)
  • Zoe Hoare (NWORTH, Bangor University)
  • Rhiannon Tudor Edwards (CHEME, Bangor University)
  • Joanne Rycroft Malone (SHS, Bangor University)
  • Kate Brain (Cardiff University)
  • Andy Carson Stevens (Cardiff University)
  • Sunil Dolwani (Cardiff University)
  • Willie Hamilton (University of Exeter)
  • Fiona Walter (University of Cambridge)
  • Greg Rubin (Durham University)
  • Georgios Lyratzopoulos (University College London)
Research team
Type of study / research design
  • Systematic review of reviews and realist review Survey, DCE, interviews with GPs and practice-based focus groups.
  • Development of intervention, external pilot trial with pilot cost effectiveness analysis & Phase III planning. 
Summary

Wales, like other UK countries, has relatively poor cancer outcomes and late diagnosis is a major contributor. This research programme concentrates on the primary care interval: the time between presentation of symptoms by patients and referral.

Referral is informed by NICE guidance, but GPs in Wales are less likely to refer or investigate, and cancer guideline adherence is lower. There is an evidence gap relating to effective ways of reducing primary care intervals.

WICKED aims to synthesise current evidence, gather new empirical evidence, and use this to develop and evaluate a complex intervention to change primary health care professionals' knowledge, attitudes and clinical behaviour, with the intention of reducing primary care intervals and improving cancer outcomes.

Please describe how the public / patients were involved in the development of the study design, and how they will be involved in the funded study?

Two members of the public were engaged in the study as collaborators during the design stage.  They were recruited through the North Wales Cancer Forum and the NCRI Consumer Forum.  Both have directly relevant experience, and were able to draw on this to comment on drafts of the proposal and make a valuable contribution to the study design.  Unfortunately, due to ill-health, one of them has been unable to make any further contribution, but the other is a very active member of the study management group.  Her ongoing input is invaluable and she is a respected member of the team. 

How could this research potentially benefit patients?

The main outcome of the research will be a complex intervention to promote prompt referral and/or diagnosis of patients presenting in primary care with suspected cancer symptoms.  Earlier diagnosis may lead to faster and potentially less invasive treatment, better survival, and improved quality of life.

Who is the study sponsor?

Bangor University

UKCRN portfolio number

To follow

Funder

Cancer Research Wales Programme Grant

Total grant value

£800,000

Start date

01/07/2016

End date

30/06/2021


Project status

Currently recruiting GPs for qualitative interviews and focus groups which will explore beliefs and experiences about managing the signs and symptoms of cancer. The study team is are especially keen to talk to GPs with 30 or more years of experience as well as GPs working in particularly rural and deprived areas. We will be recruiting practice teams to take part in practice-based focus groups too. 

Email the ‘WICKED’ programme manager for more information or if you would like to take part:
Maggie Hendry m.hendry@bangor.ac.uk

Further information
Outputs generated
  • Maggie Hendry, Rebecca-Jane Law, Sadia Nafees, Andrei Stanciu, Richard Neal, Janice Rose, Ruth Lewis. ‘WICKED’ (Wales Interventions and Cancer Knowledge about Early Diagnosis): Review of reviews and realist review to inform the development and evaluation of primary care interventions to expedite the diagnosis of symptomatic cancer in Wales. PROSPERO 2017:CRD42017054896.
    Available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42017054896