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It should be noted that unlike the start of the primary care interval, which is based on the recorded first consultation date, the start of the patient interval was inferred using information in the free text of the patient records.
Follow-up time was defined as the length of time (in years) between study entry (1st January 1999 or first consultation date, whichever occurred last) and the first recorded diagnosis of cancer (before or on 31st December 2008, or date of transfer out of the practice or death, whichever occurred first).
Eligible patients were those who had a first-ever cancer diagnosis recorded in general practice records or secondary care (HES) between 1st January 1999 (or first consultation date, whichever occurred last) and 31st December 2008 (or date of transfer out of the practice or death, whichever occurred first).
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If the patients were unable to recall the exact date of symptoms experienced and date of first consultation with HCP, such dates were approximated by probing the exact week of the respective month and year of symptoms experienced and first consultation with HCP.
For each patient three time-points had been recorded: date of first symptoms, date of first consultation of a medical doctor, date of first specific treatment.
Dates used for estimating delays were date of symptoms experienced, date of first consultation with health care provider (HCP), date of final referral to cancer diagnostic center by HCP, date of first visit to cancer diagnostic center and date of confirmed diagnosis.
Study researchers extracted data from hospital medical records, including date of referral and route (urgent, routine, emergency, other); date of first consultation; investigations and findings; and diagnosis and date (histological, clinical, MDT meetings).
Information was also available on the referral interval (the period from the date of first consultation to the first hospital appointment for specialist assessment).
The mid-point of that week was approximated as date of symptoms experienced and date of first consultation with HCP accordingly.
Collecting information regarding date of onset of symptoms and date of first consultation is probably more reliable than asking patients directly about length of delay and also more accurate than using data based on hospital records which are often obtained in a non standardised manner.
In both sets of interviews the participants were asked about the date of onset of the first symptom and the date of first consultation with a health care professional, using a calendar landmarking instrument to aid recall of their pathways towards diagnosis and the start of treatment.
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CEO of Professional Science Editing for Scientists @ prosciediting.com