Table 7 Key Findings for the influence of designated Acute Trust of treatment and access to chemotherapy
From: A systematic review of geographical variation in access to chemotherapy
Study | Un-adjusted OR (CI) | Adjusted OR for receipt of chemotherapy (CI) | P-value |
|---|---|---|---|
Monkhouse ‘12 [32] | Not clearly presented. A table presents time to definitive oncology by cancer site for hib and spoke hospitals, however it is not entirely clear what the P value pertains to. The authors also note that “some different chemotherapy regimes take variable lengths of time so Table 4 is for illustrative purposes only”. | No evidence of adjustment | - |
McLeod ‘99 [41] | Not quoted. Text states: “Without adjusting for patient, area and hospital level characteristics there was significant variation between both area of residence and hospital of first admission. Variation between hospitals was over six times that observed between areas.” | 58 Scottish Hospital point estimates (with 95 % CI) for probability of receipt of chemotherapy presented in a figure. | Not stated |
OR of receipt chemotherapy by hospital (from figure): range ~ OR 0.55 to 7.5. | |||
NLCA* ‘13 [28] | Numbers and percent of patients receiving chemo-therapy per acute trust. Range (in trusts treating >10 SCLC cases): SCLC 20.8 % to 92.9 %, NSCLC 9.3 % to 45.9 % | Adjusted odds ratios for receipt of chemotherapy in SCLC by each acute trust (for trusts with >10 SCLC cases), compared with the whole NLCA population, showed a range of 0.24 (95 % CI 0.09 to 0.67) [18 cases] to 8.44 (95 % CI 1.79 to 39.80) [12 cases] with 14 trusts having statistically significant odds ratios demonstrating difference from the null- NLCA overall population estimate. Adjusted odds ratios for NSCLC by trust demonstrated a range of OR 0.20 (95 % CI 0.08-0.54) [25 cases] to 7.51 (95 % CI 1.69 to 33.4)[19 cases]. 27 trusts had statistically significant different odds of chemotherapy compared to the whole NLCA population for NSCLC. | Not stated |
Rich ‘11 [39] | Not stated | Overall proportion receiving chemotherapy across NHS trusts was 0.61. | P < 0.001 |
Range 0.14 to 0.86 (interquartile range 0.53 to 0.71). Adjusting for all patient features there was significant variation (P < 0.001)Trust odds ratios ranged from 0.03 (0.014 to 0.07) to 4.47 (1.46 to 13.72) with an interquartile range of 0.42 to 1.0.2 |