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Clinician-identified problems and solutions for delayed diagnosis in primary care: a PRIORITIZE study

Overview of attention for article published in BMC Family Practice, September 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (90th percentile)
  • Good Attention Score compared to outputs of the same age and source (74th percentile)

Mentioned by

blogs
1 blog
twitter
19 tweeters
facebook
3 Facebook pages

Citations

dimensions_citation
15 Dimensions

Readers on

mendeley
75 Mendeley
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Title
Clinician-identified problems and solutions for delayed diagnosis in primary care: a PRIORITIZE study
Published in
BMC Family Practice, September 2016
DOI 10.1186/s12875-016-0530-z
Pubmed ID
Authors

Lorainne Tudor Car, Nikolaos Papachristou, Adrian Bull, Azeem Majeed, Joseph Gallagher, Mona El-Khatib, Paul Aylin, Igor Rudan, Rifat Atun, Josip Car, Charles Vincent

Abstract

Delayed diagnosis in primary care is a common, harmful and costly patient safety incident. Its measurement and monitoring are underdeveloped and underutilised. We created and implemented a novel approach to identify problems leading to and solutions for delayed diagnosis in primary care. We developed a novel priority-setting method for patient safety problems and solutions called PRIORITIZE. We invited more than 500 NW London clinicians via an open-ended questionnaire to identify three main problems and solutions relating to delayed diagnosis in primary care. 113 clinicians submitted their suggestions which were thematically grouped and synthesized into a composite list of 33 distinct problems and 27 solutions. A random group of 75 clinicians from the initial cohort scored these and an overall ranking was derived. The agreement between the clinicians' scores was presented using the Average Expert Agreement. The top ranked problems were poor communication between secondary and primary care and the inverse care law, i.e. a mismatch between patients' medical needs and healthcare supply. The highest ranked solutions included: a more rigorous system of communicating abnormal results of investigations to patients, direct hotlines to specialists for GPs to discuss patient problems and better training of primary care clinicians in relevant areas. A priority highlighted throughout the findings is a need to improve communication between clinicians as well as with patients. The highest ranked suggestions had the highest consensus between experts. The novel method we have developed is highly feasible, informative and scalable, and merits wider exploration with a view of becoming part of a routine pro-active and preventative system for patient safety assessment. Clinicians proposed a range of concrete suggestions with an emphasis on improving communication among clinicians and with patients and better GP training. In their view, delayed diagnosis can be largely prevented with interventions requiring relatively minor investment. Rankings of identified problems and solutions can serve as an aid to policy makers and commissioners of care in prioritization of scarce healthcare resources.

Twitter Demographics

The data shown below were collected from the profiles of 19 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 75 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
United States 1 1%
Unknown 73 97%

Demographic breakdown

Readers by professional status Count As %
Researcher 13 17%
Student > Ph. D. Student 9 12%
Student > Master 8 11%
Student > Bachelor 8 11%
Student > Doctoral Student 4 5%
Other 12 16%
Unknown 21 28%
Readers by discipline Count As %
Medicine and Dentistry 24 32%
Nursing and Health Professions 8 11%
Arts and Humanities 3 4%
Psychology 3 4%
Agricultural and Biological Sciences 2 3%
Other 8 11%
Unknown 27 36%

Attention Score in Context

This research output has an Altmetric Attention Score of 20. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 October 2016.
All research outputs
#1,620,716
of 22,886,568 outputs
Outputs from BMC Family Practice
#148
of 1,857 outputs
Outputs of similar age
#30,681
of 330,061 outputs
Outputs of similar age from BMC Family Practice
#10
of 39 outputs
Altmetric has tracked 22,886,568 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,857 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.6. This one has done particularly well, scoring higher than 91% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 330,061 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 90% of its contemporaries.
We're also able to compare this research output to 39 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 74% of its contemporaries.