Cluster randomised controlled trial of computer decision support for management of familial cancer in primary care

Study hypothesis: This project applies the Medical Research Council (MRC) framework for evaluation of complex interventions and encompasses an optimisation trial of computer decision support for familial cancer in primary care and an audit of current referral patterns for familial cancers to inform power calculations for a subsequent multi-centre trial. This optimisation trial will pilot procedures for the delivery and assessment of the intervention and will, in addition, seek to optimise and identify the most cost-effective intervention that should be evaluated in a full-scale trial by having a fixed and an adaptive intervention arm.
The underlying hypotheses are that the provision of computer decision support and a family history questionnaire in primary care will lead to more appropriate and cost-effective referrals for familial cancers (i.e. that are in line with regional referral criteria), and will enable patients to make better informed decisions about their familial risk of cancer.
Primary outcome(s): 1. The number of times that the GRAIDS software is used in the GP practices
2. The total number of referrals to secondary care about familial cancer and the proportion that meet regional referral criteria
3. The cost per use of the software and the cost per appropriate referral