Background Patient facing online triage tools potentially offer GPs a way to recognise cancer related symptoms and features to facilitate appropriate suspected cancer referrals. Little is known about their impact on cancer diagnostic process and outcomes. Aim To describe patterns of cancer outcome and process indicators associated with the use of online triage tools in primary care. Design and setting Publicly reported data on 3,053 English general practices using an online triage tool, linked to practice level data on 31,233,594 triage forms in 2022/2023. Method Cross-sectional analysis (mixed-effects regression) of the association between the annual rate of eConsult forms received (weighted to practice registrations) and various cancer diagnosis process and outcome measures. Results Increased use of online triage forms was associated with higher rates of Urgent Suspected Cancer (USC) referrals and investigations, for example there was a 7.75% difference in colonoscopy rate (95%CI: 3.83% to 8.98%) across the 90% mid-range of practices. Despite this, there was no evidence of an association with USC referrals resulting in diagnosis or emergency presentations. Conclusion Greater use of online triage forms is associated with more investigations and referrals for suspected cancer, but not associated with better diagnostic outcomes. This may indicate that any additional referrals are of lower quality and overall there is an increase in inappropriate use of USC referrals. Research is needed to understand how this impacts investigations and referrals for individual patients.
Paule et al. (Mon,) studied this question.