Evidence map›Paper›PMID 41519765›Full record

ArticleTrials2026

E-health supported referral for patients with breast abnormalities at primary healthcare facilities in Ethiopia: protocol for a cluster-randomised controlled trial.

Eyerusalem Getachew, Muluken Gizaw, Endale Anberber, Abel Shita, Alemnew Destaw, Sarah Sophie Rossner, Aragaw Tesfaw, Adamu Addissie, Eva Johanna Kantelhardt, Eric Sven Kroeber and 1 more

Abstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Eyerusalem GetachewGlobal and Planetary Health Working Group, Center of Health Sciences, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Muluken GizawGlobal and Planetary Health Working Group, Center of Health Sciences, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Endale AnberberDepartment of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Abel ShitaGlobal and Planetary Health Working Group, Center of Health Sciences, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Alemnew DestawGlobal and Planetary Health Working Group, Center of Health Sciences, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Sarah Sophie RossnerGlobal and Planetary Health Working Group, Center of Health Sciences, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Aragaw TesfawGlobal and Planetary Health Working Group, Center of Health Sciences, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Adamu AddissieGlobal and Planetary Health Working Group, Center of Health Sciences, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Eva Johanna KantelhardtGlobal and Planetary Health Working Group, Center of Health Sciences, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Eric Sven Kroeber *Global and Planetary Health Working Group, Center of Health Sciences, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany. eric.kroeber@uk-halle.de.ORCID http://orcid.org/0000-0002-7201-6023
Sefonias Getachew *Global and Planetary Health Working Group, Center of Health Sciences, Medical Faculty of Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.

Funding

Deutsche Gesellschaft für Internationale Zusammenarbeit ID 81281915Else Kröner-Fresenius-Stiftung (Grant No. 2018_HA31SP).German Federal Ministry of Education and Research (Grant No. 01KA2220B)Science for Africa Foundation through the Developing Excellence in Leadership, Training and Science in Africa (DELTAS Africa) programme [Del-22-008]
6 · The paper itself

Abstract

backgroundA weak referral system combined with limited diagnostic facilities is among the key systemic barriers to the early detection of breast cancer. Strengthening patient pathways is essential to improve follow-up and reduce delays in cancer diagnosis and care. This study aims to assess the effectiveness of the DINKNESH referral and follow-up app, a digital, app-based patient referral system linking early detection of breast-related abnormalities at primary healthcare settings with diagnostic facilities in Ethiopia.

methodsA two-arm cluster randomised trial with an embedded qualitative study is being conducted at eight primary health facilities and affiliated satellite hospitals in Ethiopia. The study includes women aged ≥18 years presenting with breast abnormalities, as well as women aged ≥30 years with positive findings on clinical breast examination. In intervention cluster facilities, the referral process for further diagnosis is supported by the DINKNESH referral and follow-up app, which facilitates patient registration, data transfer, and reminder services. This is compared with the routine paper-based referral process in the control clusters. The primary outcome is the proportion of completed referrals. All outcome measures will be analysed using IBM SPSS Statistics 25.0. A mixed-effects logistic regression model will be applied, adjusting for potential confounders and accounting for clustering at the facility level. At the end of the intervention period, qualitative interviews will be conducted using the RE-AIM framework to explore the acceptability, challenges, sustainability, and scalability of the intervention. DISCUSSION: This study will provide robust evidence on whether app-based referral systems for women with breast symptoms can improve follow-up and facilitate early breast cancer detection in low-resource settings such as Ethiopia. The findings will support the WHO Global Breast Cancer Initiative's goal of diagnosing more than 60% of breast cancer cases at an early stage.

trial registrationPACTR202411893209747. Registered on 25 November 2024, https://pactr.samrc.ac.za/.

Indexed as

Breast NeoplasmsEarly Detection of CancerMobile ApplicationsPrimary Health CareReferral and ConsultationTelemedicineAdultEthiopiaFemaleHumansMulticenter Studies as TopicRandomized Controlled Trials as TopicBreast abnormalitiesEarly detectionE-healthFollow-upReferral

Identifiers

PMID41519765
PMCPMC12849283

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.