To account for data

clustering

To account for data

clustering calcitriol?hormone within GP practice, we used a multilevel regression model with the practice identifier entered as a random effect. All p values were two-tailed and a value of less than 5% (≤0.05) was considered statistically significant. All analyses were done using Stata V.12.1. Results Read code analysis of a subgroup 296 patients with PDAC The Read codes of 10% of randomly selected patients with PDAC (296 cases) were reviewed in their entirety. In this group, symptoms were common (table 1); 91% (268/296) had relevant symptoms in the 2 years prior to diagnosis. Patients attended their GP on a median of 3 occasions with alarm symptoms (range 0–22) during this period but visits did cluster nearest to the time of diagnosis (figure 1A, B). In those who were symptomatic, 51% (136/268) reattended with the same symptom during the 2-year time period and 75% (202/268) reattended with an alternative alarm symptom. Common alarm symptoms that prompted reattendance included abdominal, back, chest or shoulder pain, dyspepsia and change in bowel habit. 11% (32/296) of patients had previously been diagnosed with another cancer. The length of time a symptom had been present for was measured from first presentation to time of diagnosis. All prediagnosis serum measurements of bilirubin (345 tests),

glucose (188 tests) and haemoglobin (335 tests)

were also obtained for this cohort. A rising trend in glucose and bilirubin nearest to the time of diagnosis was observed (figure 2). Figure 2 Trends in commonly performed blood tests in the year prior to diagnosis (bilirubin N=345 blood tests from 192 patients, glucose N=188 blood tests from 118 patients, haemoglobin N=335 blood tests from 195 patients). Very few biologically plausible symptoms were reported more than 1 year prior to diagnosis (table 1 and figure 1A, B). The limit of the study period was therefore set at 2 years, for the subsequent case–control study. Case–control study In total, 2773 patients with PDAC, 848 patients with BTC and 15 395 controls were included in this study (table 2). In the year prior to diagnosis, patients Cilengitide with PDAC visited their GP on a median of 18 (IQR 11–27) occasions and patients with BTC visited their GP on a median of 22 (IQR 12–22) occasions. This is compared with control patients who visited their GP on a median of 14 occasions (IQR 8–21). In PDAC a median of three of these visits were with alarm symptoms and a quarter visited their GP on more than four occasions with alarm symptoms in the year prior to diagnosis. Table 2 Patient characteristics In the 2 years prior to diagnosis, alarm symptoms were more common in patients with PDAC or BTC compared with controls (table 3). For example, 43.

Leave a Reply

Your email address will not be published. Required fields are marked *

*

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>