Table 1

WHO trial registration data set

Data categoryInformation
Primary Registry and Trial Identifying NoISRCTN: ISRCTN15913081
Date of Registration in Primary Registry08/11/2019
Secondary Identifying NumbersN/A
Source(s) of Monetary or Material SupportCancer Research UK; Grant Codes: C48270/A27880
Primary SponsorUniversity of Oxford
Secondary Sponsor(s)None
Contact for Public Queriessusannah.fleming@phc.ox.ac.uk
Contact for Scientific Queriesclare.bankhead@phc.ox.ac.uk
Public TitleTesting an electronic safety netting system to help GPs follow-up patients with worrying symptoms
Scientific TitleCASNET2: Evaluation of an e-safety netting cancer template in primary care: a pragmatic stepped-wedge RCT
Countries of RecruitmentUK
Health Condition(s) or Problem(s) StudiedE-safety netting (E-SN) toolkit.
Intervention(s)The researchers will recruit 60 general practices who are not currently using the E-SN toolkit, and randomise them in clusters (groups) of 10. Each cluster will have the E-SN toolkit turned on at a different time during the 12 months of the study. Once the E-SN toolkit is turned on, the GPs in the practice will be able to use it when caring for any patient they think would benefit from it, although it is expected that it will be of most use when treating patients with symptoms that might indicate cancer. The researchers will collect data from the electronic patient record system from the 12 months of the study and the 24 months before the start of the study to understand whether the introduction of the E-SN toolkit makes any difference to the diagnosis of cancer, and in particular to how quickly patients are diagnosed. The researchers will only extract records from patients who are over 18, and who have not opted out of the research.
Key Inclusion and Exclusion CriteriaGP practices will be eligible for inclusion under the following conditions:

  1. They are actively contributing to the RCGP Research and Surveillance Centre database.

  2. They use the EMIS electronic health record system.

  3. They have data available for the previous 24 months.


Within the participating practices, the researchers will seek to extract data from adult patients (aged over 18 years)
Exclusion criteria:

  1. GP practices who are already using the E-SN toolkit will not be eligible for the study.

  2. The researchers will not extract data from any patient under 18, or from any patient who has opted out of data sharing for research purposes.

Study typeOther
Date of First Enrolment25/11/2019
Target Sample Size60
Recruitment StatusNot yet recruiting
Primary Outcome(s)Primary care interval for cancer diagnoses measured as the time between the first recorded symptom of cancer and referral to secondary cancer care, during inactive and active E-SN phases.
Key Secondary Outcomes

  1. Proportion of cancers diagnosed after emergency presentation measured during inactive and active E-SN phases.

  2. Recorded new diagnoses in those who have a template activated, measured by cancer site and stage, and by non-cancer diagnosis, during the active E-SN stage.

  3. Total time to diagnosis measured from first recorded symptom to definitive diagnosis for all cancer diagnoses during the inactive and active E-SN phases and all diagnoses with template activation during the active E-SN phase

  4. No of GP consultations/patient between first record of symptom and cancer referral, measured during the inactive and active E-SN phase

  5. Rates of patients completing direct access cancer investigations measured during the inactive and active E-SN phase

  6. Rates of patients referred measured as 2-week wait, urgent, and routine, during the inactive and active E-SN phase

  7. Timing of template activation within the primary care interval (from first symptom to referral) measured during the active E-SN phase

  8. Template activation rate among consulting patients, both total and stratified by individual GP, measured during the active E-SN phase

  9. The proportion of diary entries completed measured during the active E-SN phase

  10. The reason for template activation measured based on 20 high-level READ codes during the active E-SN phase

  11. Symptoms leading to direct access to investigations measured during the active E-SN phase

  12. Recorded vague symptoms in the template measured during the active E-SN phase

  13. Demographic details of patients with activated templates measured during the active E-SN phase

  14. GP type completing template (eg, partner, locum, trainee) measured during the active E-SN phase

  15. Diagnostic codes in patients with activated templates measured during the active E-SN phase

  • EMIS, Egerton Medical Information System; E-SN, electronic safety-netting; GP, general practitioner.