Novel diagrammatical analyses of turnover of patients with cancer

Abstract

Background/Aims The Inverted Nomogramma di Gandy is a diagrammatical method for evaluating staff turnover in large organisations. This exploratory research investigated whether it could be applied to cohorts of ‘active’ patients with cancer (those within the first 5 years of diagnosis) and provide additional insights into the underlying dynamics of cancer incidence and prevalence. Methods The Inverted Nomogramma di Gandy method was applied using relevant data for all clinical commissioning groups in England in 2017. This article details the data and results for breast and lung cancer. To evaluate the method's usefulness to healthcare practitioners, a report was circulated throughout the Cheshire and Merseyside Cancer Alliance, with readers asked to respond to a 15-item survey about their perceptions of the method and its usefulness. Results were analysed using descriptive statistics. Results There were wide variations in incidence and prevalence of breast and lung cancer across England. The diagram showed dispersed patterns for cancer alliances and identified the locations of individual outliers, revealing the underlying dynamics. The patterns for breast cancer and lung cancer were very different; even within the Cheshire and Merseyside Cancer Alliance there were some marked variations between locations. Survey respondents were generally neutral or positive about the method. Conclusions This diagrammatical method provided useful analyses that were complementary to incidence and prevalence data, and potentially useful for practitioners. Because the method uses existing available data, it could be rapidly introduced to services.