Observational studyThe British journal of general practice : the journal of the Royal College of General Practitioners2022
Associations between general practice characteristics and chest X-ray rate: an observational study.
Observational study in The British journal of general practice : the journal of the Royal College of General Practitioners, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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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.
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Who cites it
4 citing papers in PubMed.
- 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
- Clinical decision-making on lung cancer investigations in primary care: a vignette study.BMJ open · 2024Article
- A Narrative Review of the Use of Artificial Intelligence in Breast, Lung, and Prostate Cancer.Life (Basel, Switzerland) · 2023Review
- General practice characteristics and chest X-ray rate.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
Corrections and comments
- Commented on byAuthor response.2022
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9 authors.
Funding
Abstract
backgroundChest X-ray (CXR) is the first-line test for lung cancer in many settings. Previous research has suggested that higher utilisation of CXR is associated with improved outcomes.
aimTo explore the associations between characteristics of general practices and frequency of investigation with CXR. DESIGN AND
settingRetrospective observational study of English general practices.
methodA database was constructed of English general practices containing number of CXRs requested and data on practices for 2018, including patient and staff demographics, smoking prevalence, deprivation, and patient satisfaction indicators. Mixed-effects Poisson modelling was used to account for variation because of chance and to estimate the amount of remaining variation that could be attributed to practice and population characteristics.
resultsThere was substantial variation in GP CXR rates (median 34 per 1000 patients, interquartile range 26-43). Only 18% of between-practice variance in CXR rate was accounted for by recorded characteristics. Higher practice scores for continuity and communication skills, and higher proportions of smokers, Asian and mixed ethnic groups, and patients aged >65 years were associated with increased CXR rates. Higher patient satisfaction scores for access and greater proportions of male patients and patients of Black ethnicity were associated with lower CXR rates.
conclusionSubstantial variation was found in CXR rates beyond that expected by chance, which could not be accounted for by practices' recorded characteristics. As other research has indicated that increasing CXR rates can lead to earlier detection, supporting practices that currently investigate infrequently could be an effective strategy to improve lung cancer outcomes.
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