Today, we’re speaking to Dr Steve Bradley, GP and Senior Clinical Lecturer based within the School of Medicine and Population Health at the University of Sheffield.

Title of paper: General practice chest X-ray rate is associated with earlier lung cancer diagnosis and reduced all-cause mortality: a retrospective observational study

Available at: https://doi.org/10.3399/BJGP.2024.0466

It is known that there is wide variation in the use of chest X-ray (CXR) by general practices, but previous studies have provided conflicting evidence as to whether greater utilisation of them leads to lung cancer being diagnosed at an earlier stage and improves survival. This observational study analysed data from the English national cancer registry on CXR rates for individual general practices, along with stage and survival outcomes; it found earlier stage at diagnosis and improved survival for patients diagnosed with cancer at practices that used the test more frequently. Increasing use of CXR by GPs for symptomatic patients, particularly by focusing on practices that use the test infrequently, could improve lung cancer outcomes.

Today, we’re speaking to Professor Martijn Schut, Professor of Translational AI in Laboratory Medicine and Professor Henk CPM van Weert, GP and Emeritus Professor of General Practice, both based at Amsterdam University Medical Center.

Title of paper: Artificial intelligence for early detection of lung cancer in GPs’ clinical notes: a retrospective observational cohort study

Available at: https://doi.org/10.3399/BJGP.2023.0489

In most cancers, the prognosis depends substantially on the stage at the start of therapy. Therefore, many methods have been developed to enhance earlier diagnosis, for example, logistic regression models, biomarkers, and electronic-nose technology (exhaled volatile organic compounds). However, as most patients are referred by their GP, who keeps life-long histories of enlisted patients, general practice files might contain hidden information that could be used for earlier case finding. An algorithm was developed to identify patients with lung cancer 4 months earlier, just by analysing their files. Contrary to other methods, all medical information available in general practice was used.

Today, we’re speaking to Dr Afrodita Marcu, a Research Fellow in Cancer Care at the University of Surrey.

Title of paper: Symptom appraisal and help- seeking before a cancer diagnosis during pregnancy: a qualitative study

Available at: https://doi.org/10.3399/BJGP.2024.0208

There is a gap in current understanding about the experiences of women diagnosed with cancer during or around pregnancy including how they appraise and seek help for cancer-related symptoms. This qualitative study found that women and healthcare professionals often interpreted symptoms through the lens of pregnancy, particularly when symptoms were vague. Health professionals need to ensure full assessment of symptoms, timely referral, and effective safety-netting for these women.

Today, we’re speaking to Dr Stephen Gibbons, Consultant Clinical Biochemist at Leeds Teaching Hospitals NHS Trust, and Dr Clare Spencer, GP Partner and Menopause Specialist at the Meanwood Group Practice in Leeds.

Title of paper: Optimising testosterone therapy in patients with hypoactive sexual desire disorder

Available at: https://doi.org/10.3399/bjgp25X741321

Today, we’re going to do something a bit different and take a look back at the recent BJGP Research Conference, which was held on the 21st of March 2025 in Manchester. I’m going to discuss some of the highlights and really focus on what the conference is about and how to get involved in the future.

Here are some of the links I discussed in the podcast:

Links

https://journals.sagepub.com/doi/full/10.1177/1609406918797475

https://bjgplife.com/write-for-bjgp-life/

Today, we’re speaking to Dr Louise Clarke, a GP and researcher based at the University of Nottingham.

Title of paper: Barriers to diagnosing and treating vulval lichen sclerosus: a survey study

Available at: https://doi.org/10.3399/BJGP.2024.0360

Previous research has identified a significant diagnostic delay and misdiagnosis of vulval lichen sclerosus (VLS), a condition most commonly presenting to primary care. Health care professionals (HCPs) in primary care share the concerns of women with VLS citing frequent misdiagnosis, embarrassment and lack of knowledge as barriers to diagnosis. In this survey, 92.6% of HCPs felt further education would be useful with 37.7% never having participated in learning on vulval skin disease, self-directed or otherwise. Key enablers identified to facilitate timely VLS diagnosis and treatment include: a comprehensive education programme for HCPs, implementation of standardised pathways of care and development of a VLS diagnostic criteria to be implemented in primary care workflow.

Today, we’re speaking to Dr Victoria Tzortziou Brown, a GP and Reader in Primary Healthcare and Health Policy at Queen Mary University of London, and Vice Chair for External Affairs at the Royal College of General Practitioners.

Title of paper: Language of primary medical qualification and differential MRCGP exam attainment: an observational study

Available at: https://doi.org/10.3399/BJGP.2024.0296

To the authors’ knowledge, this is the first study on the association between the language of the primary medical qualification and attainment in the Membership of the Royal College of General Practitioners (MRCGP) examination. It shows that undertaking undergraduate clinical training in a country where the native language is not English can statistically significantly and negatively affect examination performance in MRCGP exams. The study also shows statistically significant positive correlations between Multi- Specialty Recruitment Assessment, International English Language Testing System, and Professional and Linguistic Assessments Board scores and the MRCGP exam scores; this suggests that past performance in these assessments can help with the identification of those international medical graduate registrars who may find tailored support beneficial. 

Today, we’re speaking to Professor Helen Atherton, Professor of Primary Care Research at the University of Southampton.

Title of paper: Supporting patients to use online services in general practice: focused ethnographic case study

Available at: https://doi.org/10.3399/BJGP.2024.0137

Use of, and access to, online services are increasing within general practice in England. Current approaches to digital facilitation as observed in this study, appeared to be ad hoc and fitted around multiple services. Reception staff were key to supporting patients to use these platforms, but training, resources and support for such staff were not readily available. Enabling patients to have the best chance of using online services requires vision, strategy and investment of time and money. As practices and patients increasingly use online approaches to healthcare provision, practices should be mindful of patient groups who may find accessing services online to be a challenge and who thus require targeted help and support.

Today, we’re speaking to Dr Sam Merriel, a GP, and NIHR Academic Clinical Lecturer in General Practice based at the University of Manchester.

Title of paper: Factors affecting prostate cancer detection through asymptomatic PSA testing in primary care in England: Evidence from the 2018 National Cancer Diagnosis Audit

Available at: https://doi.org/10.3399/BJGP.2024.0376

Asymptomatic, informed choice prostate specific antigen (PSA) testing occurs in primary care in the UK in the absence of a national prostate cancer screening programme. This study shows that four fifths of prostate cancers are diagnosed following symptomatic presentation rather than from asymptomatic PSA testing. There is a 13-fold variation in asymptomatic PSA test detected prostate cancer between English GP practices, without clear explanatory practice-level factors. Patient factors amongst men diagnosed with prostate cancer, including ethnicity, age, deprivation, and multi-morbidity, have a significant impact on the likelihood of being diagnosed following asymptomatic PSA testing.

Today, we’re speaking to Dr Pete Edwards, a GP and NIHR Research Fellow based at the University of Bristol. Pete has published a research article in the February issue of the BJGP titled,’ Safety-netting advice documentation in out-of-hours primary care: a retrospective cohort from 2013 to 2020’ along with an editorial about safety netting that we’re going to discuss today.

Title of paper: Safety-netting advice documentation in out-of-hours primary care: a retrospective cohort from 2013 to 2020

Available at: https://doi.org/10.3399/BJGP.2024.0057

Title of editorial: Safety netting in primary care : managing the low incidence, high uncertainty of severe illness

Available at: https://doi.org/10.3399/bjgp25X740529

Previous research has reported on safety-netting advice (SNA) documented in patient records during in-hours practice but this, to the authors’ knowledge, is the first large-scale (>1000 consultations) longitudinal analysis of the type of safety-netting documented advice during out-of-hours (OOH) primary care. This study demonstrated an increasing frequency of documented SNA in OOH records and increasing utility of specific advice over time. In contrast to previous reports of verbalised safety-netting during in-hours practice, this study found a higher frequency of SNA in records from face-to-face compared with telephone encounters. This study also showed safety-netting advice was more likely to be documented for patients with possible infections, but less frequently for mental health consultations. That is a possible area for improvement, in line with current UK policy for ‘parity of esteem’ between physical and mental health conditions.