Observational studyFamily practice2019
Associations between general practice characteristics with use of urgent referrals for suspected cancer and endoscopies: a cross-sectional ecological study.
Observational study in Family practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- A Bibliometric Analysis and Visualization of Decision Support Systems for Healthcare Referral Strategies.International journal of environmental research and public health · 2022Pooled it
- Pooled it
- Variations in the investigation of colorectal cancer-related symptoms in Australian primary care: a retrospective cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Correlates of the Stage of Esophageal Cancer at Diagnosis Among Patients: A Mixed-Methods Cross-Sectional Study.Cancer management and research · 2026Article
- Variation in the use of primary care-led investigations prior to a cancer diagnosis: analysis of the National Cancer Diagnosis Audit.BMJ quality & safety · 2025Article
- Inequalities in cancer 2-week-wait referrals: a cross-sectional study in English general practice.BJGP open · 2025Article
- Mental Health Morbidities and Time to Cancer Diagnosis Among Adults With Colon Cancer in England.JAMA network open · 2022Article
- Assessing Ethnic Inequalities in Diagnostic Interval of Common Cancers: A Population-Based UK Cohort Study.Cancers · 2022Article
- Do presenting symptoms, use of pre-diagnostic endoscopy and risk of emergency cancer diagnosis vary by comorbidity burden and type in patients with colorectal cancer?British journal of cancer · 2022Article
- Associations between general practice characteristics and chest X-ray rate: an observational study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Observational
- Disentangling the Relationship between Physician and Organizational Performance: A Signal Detection Approach.Medical decision making : an international journal of the Society for Medical Decision Making · 2020Article
- Association between use of urgent suspected cancer referral and mortality and stage at diagnosis: a 5-year national cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundLarge variation in measures of diagnostic activity has been described previously between English general practices, but related predictors remain understudied.
objectiveTo examine associations between general practice population and characteristics, with the use of urgent referrals for suspected cancer, and use of endoscopy.
methodsCross-sectional observational study of English general practices. We examined practice-level use (/1000 patients/year) of urgent referrals for suspected cancer, gastroscopy, flexible sigmoidoscopy and colonoscopy. We used mixed-effects Poisson regression to examine associations with the sociodemographic profile of practice populations and other practice attributes, including the average age, sex and country of qualification of practice doctors.
resultsThe sociodemographic characteristics of registered patients explained much of the between-practice variance in use of urgent referrals (32%) and endoscopic investigations (18-25%), all being higher in practices with older and more socioeconomically deprived patients. Practice-level attributes explained a substantial amount of between-practice variance in urgent referral (19%) but little of the variance in endoscopy (3%-4%). Adjusted urgent referral rates were higher in training practices and those with younger GPs. Practices with mean doctor ages of 41 and 57 years (at the 10th/90th centiles of the national distribution) would have urgent referral rates of 24.1 and 19.1/1000 registered patients, P < 0.001.
conclusionMost between-practice variation in use of urgent referrals and endoscopies seems to reflect health need. Some practice characteristics, such as the mean age of GPs, are associated with appreciable variation in use of urgent referrals, though these associations do not seem strong enough to justify targeted interventions.
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Registered trials
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.