ObjectiveThe incidence of colorectal cancer (CRC) in people aged <50 years has been increasing dramatically in the past three decades and such patients are known to face difficulties in diagnosis. The objective of this study was to better understand the diagnostic experiences of patients with CRC and explore age-related differences in the proportion with positive experiences.MethodA secondary analysis of the English National Cancer Patient Experience Survey (CPES) 2017 was conducted on the responses of patients with CRC, restricted to those likely to have been diagnosed in the preceding 12 months via pathways other than routine screening. Ten diagnosis-related experience questions were identified, with responses to them categorised as positive, negative or uninformative. Age group-related difference in positive experiences were described and ORs estimated, both raw and adjusted for selected characteristics. Sensitivity analysis was performed by weighting survey responses to 2017 cancer registrations by strata defined by age group, sex and cancer site, to assess whether differential response patterns by these characteristics affected the estimated proportion of positive experiences.ResultsThe reported experiences of 3889 patients with CRC were analysed. There was a significant linear trend (p<0.0001) for 9 of 10 experience items, with older patients consistently displaying higher rates of positive experiences and patients aged 55–64 showing rates of positive experience intermediate between younger and older age groups. This was unaffected by differences in patient characteristics or CPES response rates.ConclusionThe highest rates of positive diagnosis-related experiences were reported by patients aged 65–74 or 75 years and older, and this is robust.
BackgroundRepeat Rapid Response Team (RRT) calls are associated with increased mortality risk to patients and pose a resource burden to organisations. Use of Non-Technical Skills (NTS) at calls has the potential to reduce potentially preventable repeat calling. NTS are usually improved through training, however this consumes time and financial resources. Modifications to the Rapid Response System (RRS) that promote use of NTS are worth exploring as a cost-effective alternative.MethodsA pre-post observational study of a RRS re-design on proportion of admissions each month subject to repeat RRT calling and number of calls per admission, with univariate and multivariable interrupted time series analyses comparing outcomes between study phases.ResultsThe proportion of admissions with repeat calls each month increased across both phases of the study period, but the increase was lower in the post re-design phase (change in adjusted regression slope -0.12 (standard error 0.07) post versus pre re-design). The multivariable model showed an estimated 6.0% reduction (P=0.19) in the proportion of admissions having repeat calls at the end of the study versus that predicted had the re-design not occurred.For the number of calls per the multivariable model predicted a reduction of 0.07 calls per admission at the end of the post re-design phase (95% confidence interval -0.23 – 0.08, P=0.35), equating to one fewer repeat call per 14 patients having RRT calls.ConclusionThis study showed no observed statistically significant effect on rates of repeat calling or numbers of repeat calls per admission from the implementation of a RRS re-design. However, the results demonstrate, at an organisational level, the feasibility of a low-cost initiative to improve NTS use by the RRS.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.