ArticleScandinavian journal of primary health care2017
How the probability of presentation to a primary care clinician correlates with cancer survival rates: a European survey using vignettes.
Article in Scandinavian journal of primary health care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of GP gatekeeping on quality of care, and health outcomes, use, and expenditure: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Pooled it
- General practitioners' clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countries.Scandinavian journal of primary health care · 2025Article
- Primary Care System Factors and Clinical Decision-making in Patients that Could Have Lung Cancer: a Vignette Study in Five Balkan Region Countries.Zdravstveno varstvo · 2022Article
- Primary care practitioners' diagnostic action when the patient may have cancer: an exploratory vignette study in 20 European countries.BMJ open · 2020Article
- Relationship based care - how general practice developed and why it is undermined within contemporary healthcare systems.Scandinavian journal of primary health care · 2019Article
- Article
- How health system factors affect primary care practitioners' decisions to refer patients for further investigation: protocol for a pan-European ecological study.BMC health services research · 2018Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveEuropean cancer survival rates vary widely. System factors, including whether or not primary care physicians (PCPs) are gatekeepers, may account for some of these differences. This study explores where patients who may have cancer are likely to present for medical care in different European countries, and how probability of presentation to a primary care clinician correlates with cancer survival rates.
designSeventy-eight PCPs in a range of European countries assessed four vignettes representing patients who might have cancer, and consensus groups agreed how likely those patients were to present to different clinicians in their own countries. These data were compared with national cancer survival rates.
settingA total of 14 countries. SUBJECTS: Consensus groups of PCPs.
main outcome measuresProbability of initial presentation to a PCP for four clinical vignettes.
resultsThere was no significant correlation between overall national 1-year relative cancer survival rates and the probability of initial presentation to a PCP (r = -0.16, 95% CI -0.39 to 0.08). Within that there was large variation depending on the type of cancer, with a significantly poorer lung cancer survival in countries where patients were more likely to initially consult a PCP (lung r = -0.57, 95% CI -0.83 to -0.12; ovary: r = -0.13, 95% CI -0.57 to 0.38; breast r = 0.14, 95% CI -0.36 to 0.58; bowel: r = 0.20, 95% CI -0.31 to 0.62).
conclusionsThere were wide variations in the degree of gatekeeping between countries, with no simple binary model as to whether or not a country has a "PCP-as-gatekeeper" system. While there was case-by-case variation, there was no overall evidence of a link between a higher probability of initial consultation with a PCP and poorer cancer survival. KEY POINTS European cancer survival rates vary widely, and health system factors may account for some of these differences. The data from 14 European countries show a wide variation in the probability of initial presentation to a PCP. The degree to which PCPs act as gatekeepers varies considerably from country to country. There is no overall evidence of a link between a higher probability of initial presentation to a PCP and poorer cancer survival.
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