Why did we do this study?
Diffuse large B-cell lymphoma (DLBCL) is newly diagnosed in around 2,700 people in the UK each year. It is more common in men than women and can be diagnosed at any age, although it is often seen in older people. A YHHN audit noted that patients with DLBCL who were treated at one of the hospitals in the area had poorer survival than the others. We used our data to check if all patients across the study had been treated according to local and national guidance, meaning they were able to access the best possible care.
What did we do?
Disease-specific information is collected from the NHS medical records of all YHHN patients in the study area. Data for patients with DLBCL were checked and compared between each treating hospital to look for differences that might explain the poorer outcomes seen in the audit.
What did we find?
The hospital in question was a specialist centre, providing expert treatment for patients with complex/severe disease (e.g., affecting the brain). We concluded that the differences were due to this hospital taking additional referrals for patients who were very ill, who are known to have poorer outcomes. This information was important to the clinical team, as it reassured them that the variations were due to the type of patients they treated, not differences in care. Also, after checking how poorly patients were in each hospital at diagnosis and/or referral, no differences were seen. We were only able to understand this because we collect information from each patient in the study about the stage of their disease, including the number of sites affected.