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Fig 1.

Final version of ALERT-B screening tool questions [18].

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Fig 2.

Desired impact of the new specialised gastroenterology service.

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Fig 3.

Centres and patients.

All three centres set-up a specialist PRD service; two with the nurse-led model (Cardiff and Brighton) and one with a consultant led-model (Sheffield).

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Table 1.

Baseline data from participants referred to the gastroenterology service.

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Fig 4.

Results for the EPIC bowel subscale and the EORTC QLQ PR25 bowel symptoms scale.

4a) EPIC Bowel subscale. The results are presented on a scale of 0 (= Extremely Poor QoL) to 100 (= Extremely Good QoL). A statistically significant (6 months versus baseline, P = 0.005; 12 months versus baseline, P = 0.013) increase occurs in bowel QoL (i.e., a reduction in symptoms). The left-hand axis indicates percentages for the stacked bar chart, whereas means and medians are interpreted via the scale on the shown right-hand axis. As the size of the rectangle for 80 to 100 increased substantially for 6 months and 12 months compared to baseline, this indicates that quality of life increased with time (as expected) as EPIC measures QoL on a positive scale. This is also reflected in the mean and median QoL scores (w.r.t. the right-hand axis), which increased in magnitude with time also. 4b) EORTC Bowel subscale. The results are presented on a scale of 0 (= Extremely Good QoL) to 100 (= Extremely Poor QoL). A statistically significant (6 months versus baseline, P = 0.021; 12 months versus baseline, P = 0.009) increase occurs in bowel QoL (i.e., a reduction in symptoms). The left-hand axis indicates percentages for the stacked bar chart, whereas means and medians are interpreted via the scale on the shown right-hand axis. As the size of the rectangle for 0 to 20 increased substantially for 6 months and 12 months compared to baseline, this indicates that quality of life increased with time (as expected) as EORTC measures QoL on a negative scale. This is also reflected in the mean and median QoL scores (w.r.t. the right-hand axis), which decreased in magnitude with time also.

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Table 2.

Selected results as the standardized difference from baseline.

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Table 3.

Breakdown of participants interviewed for the qualitative analysis, over three time points.

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