... General pr'ii't i tioner. Wintertori. ,\'orth Lincolnshire, UK . Rabi Paes, co... more ... General pr'ii't i tioner. Wintertori. ,\'orth Lincolnshire, UK . Rabi Paes, consultant radiologist, director of radiology. Huddersfield NHS Trust, Huddersfield, UK. Correspondence to: Dr Nicholas Summerton. ... accords with similar findings made by both Graffner et aLY and Steine et al. ...
The British journal of general practice : the journal of the Royal College of General Practitioners, 2002
There is little information available to assist general practitioners (GPs) in deciding which pat... more There is little information available to assist general practitioners (GPs) in deciding which patients with haematuria are likely to have a malignancy. To derive discriminant functions for specific items or clusters of clinical history information in relation to the categorisation of patients presenting to the 'open access' haematuria clinic in Hull. Recruitment of patients via an 'open-access' haematuria clinic. A consecutive series of 363 patients aged between 18 and 80 years who attended the clinic. Between February 1999 and October 1999 clinical history information derived from the participating patients was compared with the patients' diagnoses. Diagnoses were established by a combination of cystoscopy and radiological assessments and rechecked against the patient records and the hospital patient administration system two to three months later. A number of individual variables seemed to be particularly helpful in discriminating malignancies. However, when in...
The British journal of general practice : the journal of the Royal College of General Practitioners, 2003
A case-control study design was used to examine consultation patterns during the three years lead... more A case-control study design was used to examine consultation patterns during the three years leading up to the diagnosis of an internal malignancy, within the context of the registered patient list of a single large general practice at Winterton, North Lincolnshire. Using a combination of matching, consultation subclassification, and conditional logistic regression, account was taken of the major confounders affecting consultation rates. Generally, the odds of cancer rose in tandem with increases in the average time between new consultations. This trend was significant for all breast cancers (at the 5% level) and persisted after adjustment for occupation, smoking, and marital status (P = 0.03), as well as after the exclusion of patients identified by routine screening (P = 0.05).
The NHS needs to form new alliances to address the public health challenges posed by the second W... more The NHS needs to form new alliances to address the public health challenges posed by the second Wanless report and the government's consultation paper on public health. Public health physicians need to return to clinical practice if they are to play a credible leadership role. 'Policy partnerships' could promote issues such as health inequalities.
The British journal of general practice : the journal of the Royal College of General Practitioners, 2000
This discussion paper presents the case for a rigorous diagnostic research agenda within primary ... more This discussion paper presents the case for a rigorous diagnostic research agenda within primary care. In view of unique aspects of primary care medicine and the relatively unselected nature of the populations encountered by general practitioners, it is clear that diagnostic research undertaken in other settings may be inapplicable. Most diagnostic studies adopt designs that seek to compare items, or clusters of items, of clinical information against a gold standard. In order to enhance the feasibility and rigour of such research within primary care, suggestions are made about priorities and specific key methodological issues. It is essential that the information generated by primary care diagnostic research should be reliable, valid, useful, and useable within general practice. The ultimate objective must be the identification of specific items, or small clusters of items, of clinical information of high discriminant ability among the groups of patients encountered in general pract...
Background Currently there is no framework for those involved in the identification, evaluation a... more Background Currently there is no framework for those involved in the identification, evaluation and prioritisation of new diagnostic technologies. Therefore we aimed to develop prioritisation criteria for the assessment of new diagnostic technologies, by gaining international consensus on not only which criteria should be used, but also their relative importance. Methods A two-round Delphi process was used to generate consensus amongst an international panel of twenty-six experts on priority criteria for diagnostic health technology assessment. Participants represented a range of health care and related professions, including government, industry, health services and academia. Results Based on the responses to the first questionnaire 18 criteria were placed into three categories: high, intermediate and moderate priority. For 16 of the 18 criteria, agreement with the categorisation of the criteria into the high, intermediate and moderate categories was high at ≥ 70% (10 had agreement...
... General pr'ii't i tioner. Wintertori. ,\'orth Lincolnshire, UK . Rabi Paes, co... more ... General pr'ii't i tioner. Wintertori. ,\'orth Lincolnshire, UK . Rabi Paes, consultant radiologist, director of radiology. Huddersfield NHS Trust, Huddersfield, UK. Correspondence to: Dr Nicholas Summerton. ... accords with similar findings made by both Graffner et aLY and Steine et al. ...
The British journal of general practice : the journal of the Royal College of General Practitioners, 2002
There is little information available to assist general practitioners (GPs) in deciding which pat... more There is little information available to assist general practitioners (GPs) in deciding which patients with haematuria are likely to have a malignancy. To derive discriminant functions for specific items or clusters of clinical history information in relation to the categorisation of patients presenting to the 'open access' haematuria clinic in Hull. Recruitment of patients via an 'open-access' haematuria clinic. A consecutive series of 363 patients aged between 18 and 80 years who attended the clinic. Between February 1999 and October 1999 clinical history information derived from the participating patients was compared with the patients' diagnoses. Diagnoses were established by a combination of cystoscopy and radiological assessments and rechecked against the patient records and the hospital patient administration system two to three months later. A number of individual variables seemed to be particularly helpful in discriminating malignancies. However, when in...
The British journal of general practice : the journal of the Royal College of General Practitioners, 2003
A case-control study design was used to examine consultation patterns during the three years lead... more A case-control study design was used to examine consultation patterns during the three years leading up to the diagnosis of an internal malignancy, within the context of the registered patient list of a single large general practice at Winterton, North Lincolnshire. Using a combination of matching, consultation subclassification, and conditional logistic regression, account was taken of the major confounders affecting consultation rates. Generally, the odds of cancer rose in tandem with increases in the average time between new consultations. This trend was significant for all breast cancers (at the 5% level) and persisted after adjustment for occupation, smoking, and marital status (P = 0.03), as well as after the exclusion of patients identified by routine screening (P = 0.05).
The NHS needs to form new alliances to address the public health challenges posed by the second W... more The NHS needs to form new alliances to address the public health challenges posed by the second Wanless report and the government's consultation paper on public health. Public health physicians need to return to clinical practice if they are to play a credible leadership role. 'Policy partnerships' could promote issues such as health inequalities.
The British journal of general practice : the journal of the Royal College of General Practitioners, 2000
This discussion paper presents the case for a rigorous diagnostic research agenda within primary ... more This discussion paper presents the case for a rigorous diagnostic research agenda within primary care. In view of unique aspects of primary care medicine and the relatively unselected nature of the populations encountered by general practitioners, it is clear that diagnostic research undertaken in other settings may be inapplicable. Most diagnostic studies adopt designs that seek to compare items, or clusters of items, of clinical information against a gold standard. In order to enhance the feasibility and rigour of such research within primary care, suggestions are made about priorities and specific key methodological issues. It is essential that the information generated by primary care diagnostic research should be reliable, valid, useful, and useable within general practice. The ultimate objective must be the identification of specific items, or small clusters of items, of clinical information of high discriminant ability among the groups of patients encountered in general pract...
Background Currently there is no framework for those involved in the identification, evaluation a... more Background Currently there is no framework for those involved in the identification, evaluation and prioritisation of new diagnostic technologies. Therefore we aimed to develop prioritisation criteria for the assessment of new diagnostic technologies, by gaining international consensus on not only which criteria should be used, but also their relative importance. Methods A two-round Delphi process was used to generate consensus amongst an international panel of twenty-six experts on priority criteria for diagnostic health technology assessment. Participants represented a range of health care and related professions, including government, industry, health services and academia. Results Based on the responses to the first questionnaire 18 criteria were placed into three categories: high, intermediate and moderate priority. For 16 of the 18 criteria, agreement with the categorisation of the criteria into the high, intermediate and moderate categories was high at ≥ 70% (10 had agreement...
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Papers by Nick Summerton