eprintid: 10141402
rev_number: 12
eprint_status: archive
userid: 608
dir: disk0/10/14/14/02
datestamp: 2022-01-07 15:45:48
lastmod: 2022-01-07 15:45:48
status_changed: 2022-01-07 15:45:48
type: article
metadata_visibility: show
creators_name: Bradley, SH
creators_name: Barclay, M
creators_name: Cornwell, B
creators_name: Abel, GA
creators_name: Callister, MEJ
creators_name: Gomez-Cano, M
creators_name: Round, T
creators_name: Shinkins, B
creators_name: Neal, R
title: Associations between general practice characteristics and chest X-ray rate: an observational study
ispublished: pub
divisions: UCL
divisions: B02
divisions: D12
divisions: J96
keywords: Science & Technology, Life Sciences & Biomedicine, Primary Health Care, Medicine, General & Internal, General & Internal Medicine, cancer diagnosis, chest X-ray, general practice, lung cancer, outcome assessment, health care, referral and consultation, PRIMARY-CARE, LUNG-CANCER, CONSULTATIONS
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abstract: Background Chest 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.

Aim To explore the associations between characteristics of general practices and frequency of investigation with CXR.

Design and setting Retrospective observational study of English general practices.

Method A 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.

Results There 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.

Conclusion Substantial 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.
date: 2021-12-31
date_type: published
publisher: ROYAL COLL GENERAL PRACTITIONERS
official_url: https://doi.org/10.3399/BJGP.2021.0232
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1911663
doi: 10.3399/BJGP.2021.0232
lyricists_name: Barclay, Matthew
lyricists_id: MBARC71
actors_name: Flynn, Bernadette
actors_id: BFFLY94
actors_role: owner
full_text_status: public
publication: British Journal of General Practice (BJGP)
volume: 72
number: 714
pagerange: e34-e42
pages: 9
citation:        Bradley, SH;    Barclay, M;    Cornwell, B;    Abel, GA;    Callister, MEJ;    Gomez-Cano, M;    Round, T;         ... Neal, R; + view all <#>        Bradley, SH;  Barclay, M;  Cornwell, B;  Abel, GA;  Callister, MEJ;  Gomez-Cano, M;  Round, T;  Shinkins, B;  Neal, R;   - view fewer <#>    (2021)    Associations between general practice characteristics and chest X-ray rate: an observational study.                   British Journal of General Practice (BJGP) , 72  (714)   e34-e42.    10.3399/BJGP.2021.0232 <https://doi.org/10.3399/BJGP.2021.0232>.       Green open access   
 
document_url: https://discovery-pp.ucl.ac.uk/id/eprint/10141402/1/e34.full.pdf