{
  "abstract": "Objective We calculate positive predictive values (PPVs) of patients presenting with unexpected weight loss (UWL) being diagnosed with cancer within 6 months, using data from a population of Australian primary care patients to replicate results from a previous UK study.Design A diagnostic accuracy study involving calculation of the PPV for any cancer using retrospective data from routinely collected electronic healthcare records. The index date is defined as the first recorded UWL presentation and the reference standard is cancer diagnosis within 6 months of the index date.Setting This study uses primary care data from the Patron primary care database, linked to hospital admissions data and the Victorian Cancer Registry. We include only patients who presented to their General Practitioners (GPs) at least once between 1 July 2007 and 1 February 2022.Participant Patients were included if they were at least 18 years of age at the index date, had no previous diagnosis of cancer or previous weight loss intervention, including being prescribed medications for weight loss. 13 306 patients out of a primary care population of 1 791 051 patients were identified that met the eligibility criteria.Results When stratified by age, sex and smoking status, we found PPVs lower than those derived in a previous UK primary care study, though still above 3% for male non-smokers over 60, female smokers over 70 and all males over 70. Patients from ages 60–79 with at least one abnormal blood test result had PPVs consistently above 3%, while overall, patients with abnormal blood test results have PPVs of up to 35%.Conclusion We confirmed that many PPVs, while consistently below those derived in the UK study, are above clinically significant thresholds and increasing with age and the number of different abnormal blood test results.",
  "authors": [
    {
      "affiliations": [
        "Department of General Practice and Primary Care, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia"
      ],
      "name": "Alex Lee"
    },
    {
      "affiliations": [
        "Department of General Practice and Primary Care, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia"
      ],
      "name": "Lucas de Mendonça"
    },
    {
      "affiliations": [
        "Department of General Practice and Primary Care, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia"
      ],
      "name": "Damien McCarthy"
    },
    {
      "affiliations": [
        "Department of Medicine, Western Health, Footscray, Victoria, Australia",
        "Western Health Chronic Disease Alliance, Western Health, Footscray, Victoria, Australia"
      ],
      "name": "Craig Nelson"
    },
    {
      "affiliations": [
        "Department of General Practice and Primary Care, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia",
        "University College of London Epidemiology of Cancer and Health Outcomes, London, UK"
      ],
      "name": "Meena Rafiq"
    },
    {
      "affiliations": [
        "Department of General Practice and Primary Care, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia",
        "The University of Melbourne Centre for Cancer Research, Parkville, Victoria, Australia"
      ],
      "name": "Brent Venning"
    },
    {
      "affiliations": [
        "Department of General Practice and Primary Care, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia"
      ],
      "name": "Sophie Chima"
    },
    {
      "affiliations": [
        "Department of General Practice and Primary Care, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia"
      ],
      "name": "Deborah Daly"
    },
    {
      "affiliations": [
        "The University of Melbourne, Melbourne, Victoria, Australia"
      ],
      "name": "George Fishman"
    },
    {
      "affiliations": [
        "The Peter Doherty Institute Clinical Trials, Melbourne, Victoria, Australia"
      ],
      "name": "Chris Kearney"
    },
    {
      "affiliations": [
        "Department of General Practice and Primary Care, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia"
      ],
      "name": "Barbara Hunter"
    },
    {
      "affiliations": [
        "National University Polyclinics, Singapore"
      ],
      "name": "Fong Seng Lim"
    },
    {
      "affiliations": [
        "Department of General Practice and Primary Care, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia",
        "Primary Care and Family Medicine Department, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore"
      ],
      "name": "Jo-Anne Manski-Nankervis"
    },
    {
      "affiliations": [
        "Nuffield Department Primary Care Health Sciences, University of Oxford, Oxford, UK"
      ],
      "name": "Brian D Nicholson"
    },
    {
      "affiliations": [
        "Department of General Practice and Primary Care, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia"
      ],
      "name": "Jon Emery"
    },
    {
      "affiliations": [
        "Department of General Practice and Primary Care, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia",
        "Family Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile"
      ],
      "name": "Javiera Martinez-Gutierrez"
    }
  ],
  "title": "Primary care patients presenting with unexpected weight loss in Australian general practices: replication of a diagnostic accuracy study",
  "uid": "bc7875a3-706d-5757-905a-78b157f04f35"
}