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Table 2 Summary of the prediction models, their stages of development, the cancer sites covered and study designs

From: Development, validation and effectiveness of diagnostic prediction tools for colorectal cancer in primary care: a systematic review

Prediction model Number and category of descriptors Stage of development Study design Country Population Source
Colorectal cancer
 Bristol-Birmingham equation 8
Symptoms, Test results
External validation Retrospective Case-control UK Derivation cohort: THIN
Validation cohort: CAPER
Marshall 2011 [29]
   External validation Prospective cohort The Netherlands CEDAR study: Patients referred to endoscopy centres by participating Dutch primary care practices. 2009–2012 Elias 2017 [27]
 Netherlands model 3
Symptoms, Patient demographics
Apparent performance Prospective cohort The Netherlands 290 consecutive patients with rectal bleeding presenting to 83 GPs in Limburg (Netherlands) September 1988 to April 1990Predictors: Questionnaires completed by GPs and patients, and laboratory test results. Fijten 1995 [28]
   External validation Prospective cohort UK patients referred from primary care with colorectal symptoms over a 3-yr period to the Leighton Hospital, Crewe, Cheshire, UK Hodder 2005 [40]
   External validation Prospective cohort Netherlands CEDAR study: Patients referred to endoscopy centres by participating Dutch primary care practices. 2009–2012 Elias 2017 [27]
 Machine learning algorithm Numerous models are reported
Patient demographics, Symptoms, Medical history, Test results
Apparent performance Case-control The Netherlands anonymised electronic records from two GP database systems from the Utrecht region, Netherlands, between 01 and 07-2006 and 31-12-2011 Kop 2015 [41]; Kop 2016 [32]; Hoogendoorn 2015 [42]
 Danish model 2
Patient demographics
Symptoms
Apparent performance Prospective cohort Denmark Patients presenting to GPs with first episode of rectal bleeding.
Study 1: 750 GPs 1989–1991
Study 2: 450 GPs 1991–1992
Nørrelund 1996 [31]
   External validation Prospective cohort The Netherlands CEDAR study: Patients referred to endoscopy centres by participating Dutch primary care practices.
2009–2012
Elias 2017 [27]
 Qcancer 6 (females)
7 (males)
Symptoms, Medical history, Test results
Internal validation open Prospective cohort UK QResearch database Hippisley-Cox 2012c [22]
   External validation Prospective cohort UK THIN database Collins 2012 [23]
 RAT (2005) 10
Symptoms, Test results
Apparent performance Case-control UK Patients attending all 21 general practices in Exeter, Devon, UKCases identified from the cancer registry at the Royal Devon and Exeter Hospital Hamilton 2005 [33]
   External validation Prospective cohort The Netherlands CEDAR study: Patients referred to endoscopy centres by participating Dutch primary care practices.
2009–2012
Elias 2017 [27]
 RAT (2009) 8
Symptoms, Test results
Apparent performance Case-control UK THIN database Hamilton 2009 [43]
 RAT (bowel) 10
Symptoms, Test results
Apparent performance Case-control UK GPRD (currently called the CPRD) Stapley 2017 [35]
Metastatic cancer
 RAT 7
Symptoms, Test results
Apparent performance Case-control UK Patients attending 11 general practices in Devon, UK Hamilton 2015 [36]
Multiple cancer sites
Qcancer (female) 7 (uterine)
10 (breast, blood)
11 (ovarian, renal)
12 (cervical)
13 (colorectal, gastro-oesophageal)
14 (pancreatic)
15 (lung)
22 (other cancers)
Medical history, Symptoms, Test results, Patient demographics
Internal validation Open prospective cohort UK QResearch database Hippisley-Cox 2013 [38]
QCancer (male) 3 (testicular)
8 (renal tract)
12 (colorectal)
13 (gastro-oesophageal)
14 (prostate, blood)
15 (pancreatic)
17 (lung)
20 (other cancers)
Medical history, Symptoms, Test results, Patient demographics
Internal validation Open prospective cohort UK QResearch database Hippisley-Cox 2013b [37]
Muris abdominal complaints model 5
Symptoms
Patient demographics
Test results
Apparent performance Prospective cohort The Netherlands Patients presenting to GPs for new abdominal complaints. 1989 Muris 1995 [30]
(Netherlands)   External validation Prospective cohort The Netherlands CEDAR study: Patients referred to endoscopy centres by participating Dutch primary care practices.
2009–2012
Elias 2017 [27]
Abdominal model, Holtedahl and colleagues (2018) 4
Symptoms, Patient demographics
Apparent performance Prospective cohort Norway, Denmark, Sweden, Scotland, Belgium, Netherlands GP records from the participating countries Holtedahl, 2018 [39]
  1. Abbreviation: RAT(s) Risk assessment tool(s)