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Gary A. Abel
University of Exeter
182Publications
30H-index
2,745Citations
Publications 182
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#1Annie Herbert (UoB: University of Bristol)H-Index: 13
#2Sam Winters (PHE: Public Health England)H-Index: 1
Last.Gary A. Abel (University of Exeter)H-Index: 30
view all 6 authors...
Abstract Background Diagnosis of cancer through an emergency presentation is associated with worse clinical and patient experience outcomes. The proportion of patients with cancer who are diagnosed through emergency presentations has consequently been introduced as a routine cancer surveillance measure in England. Welcome reductions in this metric have been reported over more than a decade but whether reductions reflect true changes in how patients are diagnosed rather than the changing case-mix...
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#1Fiona M Walter (University of Cambridge)H-Index: 34
#2Matthew Thompson (UW: University of Washington)H-Index: 32
Last.Jon Emery (University of Melbourne)H-Index: 42
view all 15 authors...
Background Novel diagnostic triage and testing strategies to support early detection of cancer could improve clinical outcomes. Most apparently promising diagnostic tests ultimately fail because of inadequate performance in real-world, low prevalence populations such as primary care or general community populations. They should therefore be systematically evaluated before implementation to determine whether they lead to earlier detection, are cost-effective, and improve patient safety and qualit...
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#1Silvia C Mendonca (University of Cambridge)H-Index: 7
#2Gary A. Abel (University of Exeter)H-Index: 30
Last.Georgios Lyratzopoulos (University of Cambridge)H-Index: 35
view all 11 authors...
Cancer Research UK / National Awareness and Early Diagnosis Initiative Project Grant No. C18081/A17854; Cancer Research UK Advanced Clinician Scientist Fellowship No. C18081/A18180
1 CitationsSource
#1Gary A. Abel (University of Exeter)H-Index: 30
#2Marc N. Elliott (AN: RAND Corporation)H-Index: 66
When the degree of variation between healthcare organisations or geographical regions is quantified, there is often a failure to account for the role of chance, which can lead to an overestimation of the true variation. Mixed-effects models account for the role of chance and estimate the true/underlying variation between organisations or regions. In this paper, we explore how a random intercept model can be applied to rate or proportion indicators and how to interpret the estimated variance para...
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#1Tra My Pham (UCL: University College London)H-Index: 2
#2Mayam Gomez-Cano (University of Exeter)H-Index: 1
Last.Georgios Lyratzopoulos (University of Cambridge)H-Index: 35
view all 6 authors...
Abstract Background Whether diagnostic route (e.g. emergency presentation) is associated with cancer care experience independently of tumour stage is unknown. Methods We analysed data on 18 590 patients with breast, prostate, colon, lung, and rectal cancers who responded to the 2014 English Cancer Patient Experience Survey, linked to cancer registration data on diagnostic route and tumour stage at diagnosis. We estimated odds ratios (OR) of reporting a negative experience of overall cancer care ...
1 CitationsSource
#1Gary A. Abel (University of Exeter)H-Index: 30
#2Mayam Gomez-Cano (University of Exeter)H-Index: 1
Last.Georgios Lyratzopoulos (UCL: University College London)H-Index: 35
view all 4 authors...
Objectives To assess the degree to which variations in publicly reported hospital scores arising from the English Cancer Patient Experience Survey (CPES) are subject to chance. Design Secondary analysis of publically reported data. Setting English National Health Service hospitals. Participants 72 756 patients who were recently treated for cancer in one of 146 hospitals and responded to the 2016 English CPES. Main outcome measures Spearman-Brown reliability of hospital scores on 51 evaluative qu...
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#1Carolynn Gildea (PHE: Public Health England)H-Index: 8
#2Georgios Lyratzopoulos (UCL: University College London)H-Index: 35
Last.Gary A. Abel (University of Exeter)H-Index: 30
view all 5 authors...
Background The Cancer Services profiles report indicators of cancer diagnostic activity for all English general practices. A recent study reported that several indicators were dominated by chance, with some practice-level variation explained by the practice’s age-sex profile. Aim To assess the variation explained by patient-level case-mix and whether the practice age-sex profile adequately adjusts for this. Method Five indicators from Cancer Waiting Times (2016/17, 6050 practices) or Routes to D...
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#1Jennifer Newbould (AN: RAND Corporation)H-Index: 6
#2Sarah Ball (AN: RAND Corporation)H-Index: 6
Last.Martin Roland (University of Cambridge)H-Index: 69
view all 17 authors...
Background The increasing difficulty experienced by general practices in meeting patient demand is leading to new approaches being tried, including greater use of telephone consulting. Objectives To evaluate a ‘telephone first’ approach, in which all patients requesting a general practitioner (GP) appointment are asked to speak to a GP on the telephone first. Methods The study used a controlled before-and-after (time-series) approach using national reference data sets; it also incorporated econo...
1 CitationsSource
#1John L. Campbell (University of Exeter)H-Index: 79
#2Emily Fletcher (University of Exeter)H-Index: 10
Last.Chris Salisbury (UoB: University of Bristol)H-Index: 45
view all 19 authors...
Background: UK general practice faces a workforce crisis, with general practitioner (GP) shortages, organisational change, substantial pressures across the whole health-care system and an ageing population with increasingly complex health needs. GPs require lengthy training, so retaining the existing workforce is urgent and important. Objectives: (1) To identify the key policies and strategies that might (i) facilitate the retention of experienced GPs in direct patient care or (ii) support the r...
1 CitationsSource
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