A study looking at a computer aid to help GPs decide who needs further tests for stomach symptoms (ECASS)

Cancer type:

Oesophageal cancer
Stomach cancer





This study was done to see if a computerised decision tool could help GPs decide who to refer for more tests or to see a specialist. It was for people with possible symptoms of stomach or oesophageal cancer. 

The study was open for people to join between 2015 and 2017. The team published the results in 2021.

More about this trial

Many people have stomach problems such as pain, feeling full or indigestion now and then. Only a very small number of these will be caused by stomach cancer or cancer of the food pipe (oesophagus).

The GPs participating in this study used a computer aided tool. It’s called the electronic clinical decision support (eCDS) tool.

The tool collects information about symptoms and then gives a score. This score helps GPs work out someone’s risk of possibly having cancer. The researchers hoped it would help them decide which patients to refer for further tests or to a specialist.

The main aims of the study were to find out whether the computer aid can:

  • help GPs decide who to refer for further tests
  • help GPs make decisions more quickly
  • be looked at in a larger study

Summary of results

Study design
A total of 530 people from 42 GP practices joined this study. 

The GP practices taking part were put into two groups:

  • half used usual guidelines to refer people for more tests
  • half could use the electronic decision tool if they wanted to

The results were similar in both groups:

  • about half the people (50%) were referred for more tests
  • about 2 out of 100 people (2%) were diagnosed with stomach or oesophageal cancer  

But the computer aided tool was not used as often as the research team would have liked.

There were problems with it which meant that many GPs chose not to use it. The issues included:

  • the eCDS tool was slow to load and to use
  • there were problems linking it to their existing computer systems
  • there were restrictions on what programmes they were allowed to use on their computers

The team concluded that any eCDS tool has to be easy to use and link easily to existing systems. But even then, they suggest GPs may not use a decision making tool like this very often.

More detailed information
There is more information about this research in the reference below. 

Please note, this article is not in plain English. It has been written for health care professionals and researchers.

Electronic clinical decision support tool for assessing stomach symptoms in primary care (ECASS): a feasibility study 
G Rubin and others
BMJ Open, 2021. Volume 11, Issue 3.

Where this information comes from    
We have based this summary on the information in the article above. This has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Greg Rubin

Supported by

Bangor University
Cancer Research UK
Durham University
Peninsula Medical School
Public Health England
University of Cambridge
University of Exeter
University of Melbourne
University of Sheffield

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Charlie took part in a trial to try new treatments

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“I think it’s really important that people keep signing up to these type of trials to push research forward.”

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