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Missing data and chance variation in public reporting of cancer stage at diagnosis: Cross-sectional analysis of population-based data in England

Overview of attention for article published in Cancer Epidemiology, February 2018
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (80th percentile)
  • Good Attention Score compared to outputs of the same age and source (72nd percentile)

Mentioned by

twitter
12 tweeters

Citations

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5 Dimensions

Readers on

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22 Mendeley
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Title
Missing data and chance variation in public reporting of cancer stage at diagnosis: Cross-sectional analysis of population-based data in England
Published in
Cancer Epidemiology, February 2018
DOI 10.1016/j.canep.2017.11.005
Pubmed ID
Authors

Matthew E. Barclay, Georgios Lyratzopoulos, David C. Greenberg, Gary A. Abel

Abstract

The percentage of cancer patients diagnosed at an early stage is reported publicly for geographically-defined populations corresponding to healthcare commissioning organisations in England, and linked to pay-for-performance targets. Given that stage is incompletely recorded, we investigated the extent to which this indicator reflects underlying organisational differences rather than differences in stage completeness and chance variation. We used population-based data on patients diagnosed with one of ten cancer sites in 2013 (bladder, breast, colorectal, endometrial, lung, ovarian, prostate, renal, NHL, and melanoma). We assessed the degree of bias in CCG (Clinical Commissioning Group) indicators introduced by missing-is-late and complete-case specifications compared with an imputed 'gold standard'. We estimated the Spearman-Brown (organisation-level) reliability of the complete-case specification. We assessed probable misclassification rates against current pay-for-performance targets. Under the missing-is-late approach, bias in estimated CCG percentage of tumours diagnosed at an early stage ranged from -2 to -30 percentage points, while bias under the complete-case approach ranged from -2 to +7 percentage points. Using an annual reporting period, indicators based on the least biased complete-case approach would have poor reliability, misclassifying 27/209 (13%) CCGs against a pay-for-performance target in current use; only half (53%) of CCGs apparently exceeding the target would be correctly classified in terms of their underlying performance. Current public reporting schemes for cancer stage at diagnosis in England should use a complete-case specification (i.e. the number of staged cases forming the denominator) and be based on three-year reporting periods. Early stage indicators for the studied geographies should not be used in pay-for-performance schemes.

Twitter Demographics

The data shown below were collected from the profiles of 12 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 22 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 22 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 5 23%
Student > Master 4 18%
Student > Bachelor 3 14%
Student > Postgraduate 3 14%
Unspecified 2 9%
Other 5 23%
Readers by discipline Count As %
Medicine and Dentistry 5 23%
Unspecified 4 18%
Engineering 3 14%
Nursing and Health Professions 3 14%
Pharmacology, Toxicology and Pharmaceutical Science 2 9%
Other 5 23%

Attention Score in Context

This research output has an Altmetric Attention Score of 8. 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 21 June 2018.
All research outputs
#1,950,260
of 13,116,247 outputs
Outputs from Cancer Epidemiology
#114
of 627 outputs
Outputs of similar age
#76,283
of 386,431 outputs
Outputs of similar age from Cancer Epidemiology
#3
of 11 outputs
Altmetric has tracked 13,116,247 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 627 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.5. This one has done well, scoring higher than 81% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 386,431 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 80% of its contemporaries.
We're also able to compare this research output to 11 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.