Decision support tools for pancreatic cancer detection: external validation in Australian primary care — a retrospective cohort study

Background Pancreatic cancer is often diagnosed at an advanced stage with poor survival. Risk assessment tools have been developed to aid early diagnosis of pancreatic cancer in primary care settings (QCancer ® , electronic Risk Assessment Tool [eRAT], and the Queensland Institute of Medical Research [QIMR] Berghofer Pancreatic Cancer Decision Support Tool [QPaC Tool]) but have not been validated in the Australian setting. Aim To estimate and compare the performance of these tools for identifying patients with undiagnosed pancreatic cancer using Australian primary care data. Design and setting A cohort study was conducted using linked primary care and cancer registry data from Victoria, Australia. Method Patients presenting to primary care with signs and/or symptoms included in the tools (recorded in the primary care ‘reason for encounter’) were included. Diagnostic accuracy statistics for each tool (and their individual signs and symptoms) were compared. Results Patients with pancreatic cancer were more likely ( P