A comparative study of referral patterns and management of patients with malignant brain tumours in Birmingham, UK, and Toronto, Canada

The management of malignant brain tumours comprises a huge financial burden to any health care system. The referral pattern and initial management of this condition has not been widely investigated. Our main aim was to investigate and compare the referral patterns between two tertiary referral centres in Birmingham, UK, and Toronto, Canada, which have similar health care provision structures, but different financial resources, in order to examine whether there are any significant delays in the pathway of either system. The investigation consisted of a retrospective analysis of case records of patients identified as having malignant brain tumours who had been operated on at the two centres during the period 1997–1998. Data were collected on patient demographics, symptomatology at presentation, referral pattern, and time intervals between presentation, investigations, neurosurgical consultation and operation. Mann–Whitney U-tests of statistical significance were used to compare the two centres. Sixty-eight ...