Clinical activity in general practice prior to sarcoma diagnosis : Australian cohort study
Copyright © 2024, The Authors..
Background Increased time-to-diagnosis in sarcoma is associated with poor prognosis and patient outcomes. Research is needed to identify if opportunities to expedite the diagnosis of sarcoma in general practice (GP) exist. Aim To examine pre-diagnostic GP clinical activity prior to sarcoma diagnosis. Design and Setting An Australian retrospective cohort study using hospital registry data (Australian Comprehensive Cancer Outcomes and Research Database) linked to two primary care datasets (Patron and MedicineInsight). Method The frequency of GP healthcare utilisation events (GP attendances, prescriptions, blood test and imaging requests) were compared in 377 soft tissue sarcoma (STS) and 64 bone sarcoma (BS) patients in the year pre-diagnosis. Poisson regression models were used to calculate monthly incidence rates and rate ratios (IRR) for the 24 months pre-diagnosis and estimate inflection points for when healthcare use starts to increase from baseline. Results In the six months pre-diagnosis sarcoma patients had a median of 3-4 GP attendances, a third had a GP imaging request (33% BS and 36% STS), and one in five had multiple imaging requests (19% BS and 21% STS). GP imaging requests progressively increased up to 8-fold from 6 months prior to sarcoma diagnosis (IRR 8.43 95%CI 3.92-18.15, p<0.001) and GP attendances increased from 3 months pre-diagnosis. Conclusion Sarcoma patients have increased GP clinical activity from 6 months pre-diagnosis, indicating a diagnostic window where potential opportunities exist for earlier diagnosis. Interventions to help identify patients and promote appropriate use of imaging and direct specialist centre referrals could improve earlier diagnosis and patient outcomes.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2024 |
---|---|
Erschienen: |
2024 |
Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
---|---|
Enthalten in: |
The British journal of general practice : the journal of the Royal College of General Practitioners - (2024) vom: 25. März |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Rafiq, Meena [VerfasserIn] |
---|
Links: |
---|
Themen: |
---|
Anmerkungen: |
Date Revised 25.03.2024 published: Print-Electronic Citation Status Publisher |
---|
doi: |
10.3399/BJGP.2023.0610 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM370173481 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM370173481 | ||
003 | DE-627 | ||
005 | 20240327000548.0 | ||
007 | cr uuu---uuuuu | ||
008 | 240327s2024 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.3399/BJGP.2023.0610 |2 doi | |
028 | 5 | 2 | |a pubmed24n1349.xml |
035 | |a (DE-627)NLM370173481 | ||
035 | |a (NLM)38527792 | ||
035 | |a (PII)BJGP.2023.0610 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Rafiq, Meena |e verfasserin |4 aut | |
245 | 1 | 0 | |a Clinical activity in general practice prior to sarcoma diagnosis |b Australian cohort study |
264 | 1 | |c 2024 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Revised 25.03.2024 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status Publisher | ||
520 | |a Copyright © 2024, The Authors. | ||
520 | |a Background Increased time-to-diagnosis in sarcoma is associated with poor prognosis and patient outcomes. Research is needed to identify if opportunities to expedite the diagnosis of sarcoma in general practice (GP) exist. Aim To examine pre-diagnostic GP clinical activity prior to sarcoma diagnosis. Design and Setting An Australian retrospective cohort study using hospital registry data (Australian Comprehensive Cancer Outcomes and Research Database) linked to two primary care datasets (Patron and MedicineInsight). Method The frequency of GP healthcare utilisation events (GP attendances, prescriptions, blood test and imaging requests) were compared in 377 soft tissue sarcoma (STS) and 64 bone sarcoma (BS) patients in the year pre-diagnosis. Poisson regression models were used to calculate monthly incidence rates and rate ratios (IRR) for the 24 months pre-diagnosis and estimate inflection points for when healthcare use starts to increase from baseline. Results In the six months pre-diagnosis sarcoma patients had a median of 3-4 GP attendances, a third had a GP imaging request (33% BS and 36% STS), and one in five had multiple imaging requests (19% BS and 21% STS). GP imaging requests progressively increased up to 8-fold from 6 months prior to sarcoma diagnosis (IRR 8.43 95%CI 3.92-18.15, p<0.001) and GP attendances increased from 3 months pre-diagnosis. Conclusion Sarcoma patients have increased GP clinical activity from 6 months pre-diagnosis, indicating a diagnostic window where potential opportunities exist for earlier diagnosis. Interventions to help identify patients and promote appropriate use of imaging and direct specialist centre referrals could improve earlier diagnosis and patient outcomes | ||
650 | 4 | |a Journal Article | |
700 | 1 | |a de Boer, Jasper |e verfasserin |4 aut | |
700 | 1 | |a Mar, Jasmine |e verfasserin |4 aut | |
700 | 1 | |a Desai, Jayesh |e verfasserin |4 aut | |
700 | 1 | |a Bae, Susie |e verfasserin |4 aut | |
700 | 1 | |a Gyorki, David E |e verfasserin |4 aut | |
700 | 1 | |a Di Bella, Claudia |e verfasserin |4 aut | |
700 | 1 | |a Lyratzopoulos, Georgios |e verfasserin |4 aut | |
700 | 1 | |a Lewin, Jeremy |e verfasserin |4 aut | |
700 | 1 | |a Emery, Jon |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t The British journal of general practice : the journal of the Royal College of General Practitioners |d 1996 |g (2024) vom: 25. März |w (DE-627)NLM012664286 |x 1478-5242 |7 nnns |
773 | 1 | 8 | |g year:2024 |g day:25 |g month:03 |
856 | 4 | 0 | |u http://dx.doi.org/10.3399/BJGP.2023.0610 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |j 2024 |b 25 |c 03 |