A study developing a set of questions to help doctors identify problems after pelvic radiotherapy (DESIGNER)

The team developed a screening tool called ALERT-B that doctors could use to identify people who might have problems after pelvic radiotherapy. 

About this study
There were 4 parts in the DESIGNER study. 

In part 1, the researchers developed the ALERT-B screening tool. They searched journals looking for articles about questionnaires already used to identify people with these problems. A panel of 8 people reviewed these questionnaires. The people were:

• 2 cancer specialist doctors who treat cancers that need pelvic radiotherapy
• 2 specialist doctors who treat diseases of the digestive system and have experience of treating long term problems pelvic radiotherapy can cause
• 3 staff members who are involved with research
• 1 patient representative

In part 2, the team wanted to find out:

• how easy ALERT-B was to use
• if it was acceptable for patients 

A total of 12 people took part (6 women and 6 men). Between October 2013 and January 2014, the team interviewed these people. 

Each person completed the ALERT-B questionnaire. They were then asked about how easy it was to understand the instructions and the questions. 

In part 3, a panel of 9 people used what was reported in part 2 to improve the questions in the ALERT-B screening tool. The people were:

• 3 cancer specialist doctors
• 3 specialist doctors who treat diseases of the digestive system
• 2 staff members who were involved with research
• 1 patient representative

In the part 4, the ALERT-B screening tool was tested in a clinical trial .  

Results
3 questions made up the final ALERT-B tool. The researchers found the questionnaire was:

• easy to understand
• easy and quick to fill in 

The questions covered the following:

• bleeding from the back passage
• inability to control bowel movements causing leaking (incontinence)
• going to the toilet during the night
• the impact on quality of life  including mood, relationships and socialising

Conclusion
The study team concluded that ALERT-B is a useful screening tool. Doctors can use it to improve the supportive care after radiotherapy to the area between the hips (pelvis). It can prompt the doctor when to refer the patient to another doctor who specialises in problems with the digestive system. 

A clinical trial called EAGLE has tested and confirmed that ALERT-B is a useful screening tool. 

Where this information comes from    
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.