Evidence map›Paper›PMID 26462713›Full record

ArticleBMJ (Clinical research ed.)2015

Use of the English urgent referral pathway for suspected cancer and mortality in patients with cancer: cohort study.

Henrik Møller, Carolynn Gildea, David Meechan, Greg Rubin, Thomas Round, Peter Vedsted

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 4 pooled it
6.6field-weighted citation impact, top 2% of its field
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

54 citing papers in PubMed, 4 syntheses or guidelines pooled it, 104 citations in OpenAlex.

  1. A Bibliometric Analysis and Visualization of Decision Support Systems for Healthcare Referral Strategies.International journal of environmental research and public health · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 2 countries.

Henrik MøllerCancer Epidemiology and Population Health, King's College London, London SE1 9RT, UK Research Unit for General Practice, Centre for Cancer Diagnosis in Primary Care, Department of Public Health, Aarhus University, Aarhus, Denmark henrik.moller@kcl.ac.uk.
Carolynn GildeaPublic Health England, Knowledge & Intelligence Team (East Midlands), Sheffield, UK.
David MeechanPublic Health England, Knowledge & Intelligence Team (East Midlands), Sheffield, UK.
Greg RubinSchool of Medicine, Pharmacy and Health, University of Durham, Stockton on Tees, UK.
Thomas RoundDivision of Health and Social Care, King's College London.
Peter VedstedResearch Unit for General Practice, Centre for Cancer Diagnosis in Primary Care, Department of Public Health, Aarhus University, Aarhus, Denmark.
Aarhus University · DKPublic Health England · GBKing's College London · GBUniversity Hospital of North Tees · GB

Funding

Cancer Research UK
6 · The paper itself

Abstract

objectiveTo assess the overall effect of the English urgent referral pathway on cancer survival.

setting8049 general practices in England.

designCohort study. Linked information from the national Cancer Waiting Times database, NHS Exeter database, and National Cancer Register was used to estimate mortality in patients in relation to the propensity of their general practice to use the urgent referral pathway.

participants215,284 patients with cancer, diagnosed or first treated in England in 2009 and followed up to 2013. OUTCOME MEASURE: Hazard ratios for death from any cause, as estimated from a Cox proportional hazards regression.

resultsDuring four years of follow-up, 91,620 deaths occurred, of which 51,606 (56%) occurred within the first year after diagnosis. Two measures of the propensity to use urgent referral, the standardised referral ratio and the detection rate, were associated with reduced mortality. The hazard ratio for the combination of high referral ratio and high detection rate was 0.96 (95% confidence interval 0.94 to 0.99), applying to 16% (n=34,758) of the study population. Patients with cancer who were registered with general practices with the lowest use of urgent referral had an excess mortality (hazard ratio 1.07 (95% confidence interval 1.05 to 1.08); 37% (n=79,416) of the study population). The comparator group for these two hazard ratios was the remaining 47% (n=101,110) of the study population. This result in mortality was consistent for different types of cancer (apart from breast cancer) and with other stratifications of the dataset, and was not sensitive to adjustment for potential confounders and other details of the statistical model.

conclusionsUse of the urgent referral pathway could be efficacious. General practices that consistently have a low propensity to use urgent referrals could consider increasing the use of this pathway to improve the survival of their patients with cancer.

Indexed as

Referral and ConsultationCause of DeathEarly Detection of CancerEnglandGeneral PracticeHumansNeoplasmsRetrospective StudiesSurvival Rate

Identifiers

PMID26462713
PMCPMC4604216
OpenAlexW2166865228

What OpenQuestion holds

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Registered trials

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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 OpenQuestion graph.