Table 2

Outcomes, measures and time periods of measurement for primary and secondary outcomes

OutcomeMeasureInactive study periodActive study periodTemplate activations only
Primary outcome
Primary care interval for cancer diagnosesMeasured as the no of days between first recorded symptoms of cancer (within the year prior to diagnosis) and subsequent referral for secondary cancer careXX
Secondary outcomes
Proportion of cancers diagnosed after emergency presentationProportion of cancers for which diagnosis is made prior to referral, including following A&E or inpatient episodes. Where there is uncertainty regarding the route of diagnosis, the RCGP RSC network will contact the practice in an attempt to augment the data. Algorithms will also be developed to identify emergency presentations of cancer.XX
Recorded new diagnoses in those who have a template activatedBy cancer site and stage, and non-cancer diagnoses. Coded entries for all alternative diagnoses where the E-SN toolkit has been activated will be identified.XX
Total time to diagnosis (from first recorded symptom to definitive diagnosis)Measured from first recorded symptom of cancer (within the previous year) to definitive diagnosis for all cancers diagnosed, and for all patients with an activated templateXXX (for non-cancer diagnoses)
No of GP consultations/patient between first record of symptom and cancer referralMeasured as no of primary care consultations between the first recorded symptoms (within the year prior to diagnosis) and subsequent referral, per patient.XX
Rates of patients completing direct access cancer investigationsMeasured as the no of patients undergoing direct access cancer investigations (according to those specified in referral guidelines NG12) in each period divided by the person years of observation for that period.XX
Rates of patients referred for cancerReferrals rates via 2-week wait, urgent, and routine routes for all patients referred for specialist opinion to a secondary care cancer specialistXX
Timing of template activationMeasured as the no of days between first recorded symptoms (within the year prior to diagnosis), and template activation and the no of days between template activation and subsequent referral.XX
Template activation rate among consulting patientsMeasured as the number of patients with an activated template divided by the no of patients consulting, in each time period.
Both total rate and rate stratified by individual GP will be measured.
Proportion of diary entries that were completedMeasured as the no of diary entries that were completed divided by the number of diary entries that were opened.XX
Reason for template activationThe coded reasons for activating the template,
Based on 20 high level READ codes
Symptoms leading to direct access to investigationAll symptoms recorded in patients undergoing direct access cancer investigationsXX
Recorded vague symptoms in the templateAll symptoms recorded within the template.XX
Demographic details of patients with activated templatesAge and sex of patients that had a template activated during the course of the trial.XX
GP type completing templatesDescriptive data on the type of GP that first activated the template (eg, partner, locum, trainee)XX
Diagnostic codes in patients with activated templatesDiagnoses recorded after the activation of template.XX
  • E-SN, electronic safety-netting; GP, general practitioner; RSC, Research and Surveillance Centre; RSC, Research and Surveillance Centre.