Evidence map›Paper›PMID 33827838›Full record

ArticleBMJ open2021

Processes of care and survival associated with treatment in specialist teenage and young adult cancer centres: results from the BRIGHTLIGHT cohort study.

Lorna A Fern, Rachel M Taylor, Julie Barber, Javier Alvarez-Galvez, Richard Feltbower, Sarah Lea, Ana Martins, Stephen Morris, Louise Hooker, Faith Gibson and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.0field-weighted citation impact, top 14% 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

7 citing papers in PubMed, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 7 institutions in 2 countries.

Lorna A FernOncology, University College London Hospitals NHS Foundation Trust, London, UK.
Rachel M TaylorCentre for Nurse, Midwife and AHP Led Research (CNMAR), University College London Hospitals NHS Foundation Trust, London, UK rtaylor13@nhs.net.ORCID 0000-0002-0853-0925
Julie BarberDepartment of Statistical Science, University College London, London, UK.
Javier Alvarez-GalvezDepartment of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cadiz, Spain.ORCID 0000-0001-9512-7853
Richard FeltbowerSchool of Medicine, University of Leeds, Leeds, UK.
Sarah LeaCancer Service, University College London Hospitals NHS Foundation Trust, London, UK.
Ana MartinsCancer Clinical Trials, University College London Hospitals NHS Foundation Trust, London, UK.
Stephen MorrisPrimary Care Unit, University of Cambridge, Cambridge, UK.ORCID 0000-0002-5828-3563
Louise HookerWessex Teenage and Young Adult Cancer Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Faith GibsonFaculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
Rosalind RaineInstitute of Epidemiology & Health, University College London, London, UK.
Dan P StarkLeeds Insitute of Molecular Medicine, University of Leeds, Leeds, UK.
Jeremy WhelanCancer Service, University College London Hospitals NHS Foundation Trust, London, UK.ORCID 0000-0001-6793-5722
University College London Hospitals NHS Foundation Trust · GBUniversity College London · GBUniversity of Leeds · GBGreat Ormond Street Hospital for Children NHS Foundation Trust · GBUniversidad de Cádiz · ESUniversity Hospital Southampton NHS Foundation Trust · GBUniversity of Cambridge · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSurvival gains in teenagers and young adults (TYA) are reported to be lower than children and adults for some cancers. Place of care is implicated, influencing access to specialist TYA professionals and research.Consequently, age-appropriate specialist cancer care is advocated for TYA although systematic investigation of associated outcomes is lacking. In England, age-appropriate care is delivered through 13 Principal Treatment Centres (TYA-PTC). BRIGHTLIGHT is the national evaluation of TYA cancer services to examine outcomes associated with differing places and levels of care. We aimed to examine the association between exposure to TYA-PTC care, survival and documentation of clinical processes of care.

designProspective cohort study.

setting109 National Health Service (NHS) hospitals across England.

participants1114 TYA, aged 13-24, newly diagnosed with cancer between 2012 and 2014.

interventionParticipants were assigned a TYA-PTC category dependent on the proportion of care delivered in a TYA-PTC in the first year after diagnosis: all care in a TYA-PTC (ALL-TYA-PTC, n=270), no care in a TYA-PTC (NO-TYA-PTC, n=359), and some care in a TYA-PTC with additional care in a children's/adult unit (SOME-TYA-PTC, n=419). PRIMARY OUTCOME: Data were collected on documented processes indicative of age-appropriate care using clinical report forms, and survival through linkage to NHS databases.

resultsTYA receiving NO-TYA-PTC care were less likely to have documentation of molecular diagnosis, be reviewed by a children's or TYA multidisciplinary team, be assessed by supportive care services or have a fertility discussion. There was no significant difference in survival according to category of care. There was weak evidence that the association between care category and survival differed by age (p=0.08) with higher HRs for those over 19 receiving ALL or SOME-TYA-PTC compared with NO-TYA-PTC.

conclusionTYA-PTC care was associated with better documentation of clinical processes associated with age-appropriate care but not improved survival.

Indexed as

NeoplasmsState MedicineAdolescentAdultChildCohort StudiesEnglandHumansProspective StudiesYoung Adultoncologyorganisational developmentquality in health care

Identifiers

PMID33827838
PMCPMC8031022
OpenAlexW3148936254

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.