Search

Background: A two-phase 'respiratory symptoms' mass media campaign was conducted in 2016 and 2017 in England raising awareness of cough and worsening shortness of breath as symptoms warranting a general practitioner (GP) visit.Method: A prospectively planned pre-post evaluation was done using routinely collected data on 15 metrics, including GP attendance, GP referral, emergency presentations, cancers diagnosed (five metrics), cancer stage, investigations (two metrics), outpatient attendances, inpatient admissions, major lung resections and 1-year survival. The primary analysis compared 2015 with 2017. Trends in metrics over the whole period were also considered. The effects of the campaign on awareness of lung cancer symptoms were evaluated using bespoke surveys.Results: There were small favourable statistically significant and clinically important changes over 2 years in 11 of the 15 metrics measured, including a 2.11% (95% confidence interval 1.02-3.20, p < 0.001) improvement in the percentage of lung cancers diagnosed at an early stage. However, these changes were not accompanied by increases in GP attendances. Furthermore, the time trends showed a gradual change in the metrics rather than steep changes occurring during or after the campaigns.Conclusion: There were small positive changes in most metrics relating to lung cancer diagnosis after this campaign. However, the pattern over time challenges whether the improvements are wholly attributable to the campaign. Given the importance of education on cancer in its own right, raising awareness of symptoms should remain important. However further research is needed to maximise the effect on health outcomes. [ABSTRACT FROM AUTHOR]

Objective: A regional 'Be Clear on Cancer' (BCoC) campaign developed by Public Health England aimed to promote public awareness of key abdominal cancer symptoms in people aged 50 years and over. Methods: Data were analysed for metrics at different stages in the patient care pathway including public awareness, GP attendance and referrals, to cancer diagnosis. Results: There was significantly higher recognition of the BCoC abdominal campaign in the campaign region compared to the control area (Post Campaign/Control, n = 401/406; 35% vs. 24%, p < 0.05). The campaign significantly improved knowledge of 'bloating' as a symptom (p = 0.03) compared to pre‐campaign levels. GP attendances for abdominal symptoms increased significantly by 5.8% (p = 0. 03), although the actual increase per practice was small (average 16.8 visits per week in 2016 to 17.7 in 2017). Urgent GP referrals for suspected abdominal cancer increased by 7.6%, compared to a non‐significant change (0.05%) in the control area. For specific abdominal cancers, the number diagnosed were similar to or higher than the median in the campaign area but not in the control area in people aged 50 and over: colorectal (additional n = 61 cancers), pancreatic (additional n = 102) and stomach cancers (additional n = 17). Conclusions: This campaign had a modest impact on public awareness of abdominal cancer symptoms, GP attendances and cancers diagnosed. [ABSTRACT FROM AUTHOR]

Objective: To examine the intra-rater reliability of sitting symmetry and weight-shift activity measurements in poststroke adults. Design: An intra-rater reliability study. Setting: A community setting. Subjects: Adult stroke survivors attending stroke support groups within the community of Nottingham (UK). Main measures: The Balance Performance Monitor used to measure sitting symmetry and weight-shift activity. Intraclass correlation coefficients (ICCs) and their 95% confidence intervals (95% CI) were calculated. The Bland–Altman method for assessing agreement is also presented. Results: We tested 49 participants (median age 73 years; interquartile range 68–81 years). Between-test reliability for sitting symmetry was high: ICC (1,1) = 0.93 (95% CI 0.87 ≤ ICC ≤ 0.96). The mean difference between the measures (d)was -0.08 (95% CI -0.48 ≤ d ≤ 0.31); the standard deviation of the differences (SDdiff) was 1.383. The coefficient of repeatability was 2.76; the 95% limits of agreement were -2.850 and 2.682. Between-test reliability for weight-shift activity was also high: ICC (1,1) = 0.86 (95% CI 0.77 ≤ ICC ≤ 0.92). Bland–Altman d = -0.08 (95%CI -0.19 ≤ d ≤ 0.35), SDdiff = 0.936. The coefficient of repeatability was 1.87; the 95% limits of agreement were -1.792 and 1.952. Conclusions: The 95% CI for d for both parameters crossed zero, indicating that between-test bias is unlikely. Sitting symmetry and weight-shift activity measures demonstrated acceptable levels of reliability. [ABSTRACT FROM AUTHOR]