| Title |
Impact of rurality on processes and outcomes in melanoma care: results from a whole-Scotland melanoma cohort in primary and secondary care
|
|---|---|
| Published in |
British Journal of General Practice, June 2018
|
| DOI | 10.3399/bjgp18x697901 |
| Pubmed ID | |
| Authors |
Peter Murchie, Rosalind Adam, Wei L Khor, Edwin A Raja, Lisa Iversen, David H Brewster, Amanda J Lee |
| Abstract |
Those living in rural areas have poorer cancer outcomes, but current evidence on how rurality impacts melanoma care and survival is contradictory. To investigate the impact of rurality on setting of melanoma excision and mortality in a whole-nation cohort. Analysis of linked routine healthcare data comprising every individual in Scotland diagnosed with melanoma, January 2005-December 2013, in primary and secondary care. Multivariate binary logistic regression was used to explore the relationship between rurality and setting of melanoma excision; Cox proportional hazards regression between rurality and mortality was used, with adjustments for key confounders. In total 9519 patients were included (54.3% [n = 5167] female, mean age 60.2 years [SD 17.5]). Of melanomas where setting of excision was known, 90.3% (n = 8598) were in secondary care and 8.1% (n = 771) in primary care. Odds of primary care excision increased with increasing rurality/remoteness. Compared with those in urban areas, those in the most remote rural locations had almost twice the odds of melanoma excision in primary care (adjusted odds ratio [aOR] 1.92; 95% confidence interval [CI] = 1.33 to 2.77). No significant association was found between urban or rural residency and all-cause mortality. Melanoma-specific mortality was significantly lower in individuals residing in accessible small towns than in large urban areas (adjusted hazards ratio [HR] 0.53; 95% CI = 0.33 to 0.87) with no trend towards poorer survival with increasing rurality. Patients in Scottish rural locations were more likely to have a melanoma excised in primary care. However, those in rural areas did not have significantly increased mortality from melanoma. Together these findings suggest that current UK melanoma management guidelines could be revised to be more realistic by recognising the role of primary care in the prompt diagnosis and treatment of those in rural locations. |
X Demographics
The data shown below were collected from the profiles of 18 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 11 | 61% |
| New Zealand | 1 | 6% |
| United States | 1 | 6% |
| Unknown | 5 | 28% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 8 | 44% |
| Scientists | 5 | 28% |
| Practitioners (doctors, other healthcare professionals) | 4 | 22% |
| Science communicators (journalists, bloggers, editors) | 1 | 6% |
Mendeley readers
The data shown below were compiled from readership statistics for 31 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 31 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 5 | 16% |
| Student > Master | 4 | 13% |
| Student > Doctoral Student | 3 | 10% |
| Student > Bachelor | 3 | 10% |
| Student > Ph. D. Student | 2 | 6% |
| Other | 3 | 10% |
| Unknown | 11 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 12 | 39% |
| Nursing and Health Professions | 2 | 6% |
| Biochemistry, Genetics and Molecular Biology | 1 | 3% |
| Unspecified | 1 | 3% |
| Psychology | 1 | 3% |
| Other | 3 | 10% |
| Unknown | 11 | 35% |
Attention Score in Context
This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 August 2018.
All research outputs
#2,761,011
of 24,775,802 outputs
Outputs from British Journal of General Practice
#1,285
of 4,611 outputs
Outputs of similar age
#55,112
of 334,064 outputs
Outputs of similar age from British Journal of General Practice
#33
of 115 outputs
Altmetric has tracked 24,775,802 research outputs across all sources so far. Compared to these this one has done well and is in the 88th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,611 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 19.7. This one has gotten more attention than average, scoring higher than 72% of its peers.
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We're also able to compare this research output to 115 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.