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Impact of investigations in general practice on timeliness of referral for patients subsequently diagnosed with cancer: analysis of national primary care audit data

Overview of attention for article published in British Journal of Cancer, January 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (93rd percentile)
  • High Attention Score compared to outputs of the same age and source (85th percentile)

Mentioned by

news
1 news outlet
twitter
13 tweeters

Citations

dimensions_citation
23 Dimensions

Readers on

mendeley
75 Mendeley
Title
Impact of investigations in general practice on timeliness of referral for patients subsequently diagnosed with cancer: analysis of national primary care audit data
Published in
British Journal of Cancer, January 2015
DOI 10.1038/bjc.2014.634
Pubmed ID
Authors

G P Rubin, C L Saunders, G A Abel, S McPhail, G Lyratzopoulos, R D Neal

Abstract

Background:For patients with symptoms of possible cancer who do not fulfil the criteria for urgent referral, initial investigation in primary care has been advocated in the United Kingdom and supported by additional resources. The consequence of this strategy for the timeliness of diagnosis is unknown.Methods:We analysed data from the English National Audit of Cancer Diagnosis in Primary Care on patients with lung (1494), colorectal (2111), stomach (246), oesophagus (513), pancreas (327), and ovarian (345) cancer relating to the ordering of investigations by the General Practitioner and their nature. Presenting symptoms were categorised according to National Institute for Health and Care Excellence (NICE) guidance on referral for suspected cancer. We used linear regression to estimate the mean difference in primary-care interval by cancer, after adjustment for age, gender, and the symptomatic presentation category.Results:Primary-care investigations were undertaken in 3198/5036 (64%) of cases. The median primary-care interval was 16 days (IQR 5-45) for patients undergoing investigation and 0 days (IQR 0-10) for those not investigated. Among patients whose symptoms mandated urgent referral to secondary care according to NICE guidelines, between 37% (oesophagus) and 75% (pancreas) were first investigated in primary care. In multivariable linear regression analyses stratified by cancer site, adjustment for age, sex, and NICE referral category explained little of the observed prolongation associated with investigation.Interpretation:For six specified cancers, investigation in primary care was associated with later referral for specialist assessment. This effect was independent of the nature of symptoms. Some patients for whom urgent referral is mandated by NICE guidance are nevertheless investigated before referral. Reducing the intervals between test order, test performance, and reporting can help reduce the prolongation of primary-care intervals associated with investigation use. Alternative models of assessment should be considered.British Journal of Cancer advance online publication, 20 January 2015; doi:10.1038/bjc.2014.634 www.bjcancer.com.

Twitter Demographics

The data shown below were collected from the profiles of 13 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 75 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Unknown 74 99%

Demographic breakdown

Readers by professional status Count As %
Researcher 17 23%
Student > Ph. D. Student 12 16%
Unspecified 10 13%
Other 9 12%
Student > Bachelor 9 12%
Other 18 24%
Readers by discipline Count As %
Medicine and Dentistry 33 44%
Unspecified 20 27%
Nursing and Health Professions 5 7%
Social Sciences 4 5%
Agricultural and Biological Sciences 3 4%
Other 10 13%

Attention Score in Context

This research output has an Altmetric Attention Score of 20. 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 08 October 2015.
All research outputs
#313,471
of 6,647,546 outputs
Outputs from British Journal of Cancer
#216
of 3,112 outputs
Outputs of similar age
#14,579
of 228,868 outputs
Outputs of similar age from British Journal of Cancer
#20
of 135 outputs
Altmetric has tracked 6,647,546 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,112 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.9. This one has done particularly well, scoring higher than 93% 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 228,868 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 135 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 85% of its contemporaries.