Rethinking the ‘one-stop’ neck lump clinic: a novel pathway beyond coronavirus disease 2019

Autor: A Hariri, S Jawad, S Otero, M Lechner, S Morley, T Beale, J Hughes, P Stimpson, R Dwivedi, F Vaz
Rok vydání: 2023
Předmět:
Zdroj: The Journal of Laryngology & Otology. :1-5
ISSN: 1748-5460
0022-2151
DOI: 10.1017/s002221512300021x
Popis: Objectives UK guidelines advocate ‘one-stop’ neck lump assessment for cancer referrals. This paper reports the pilot of a novel pre-clinic ultrasound pathway, presents outcomes, and discusses strengths and limitations in the context of the coronavirus disease 2019 pandemic. Methods Two-week-wait cancer referral patients with a neck lump were allocated a pre-clinic ultrasound scan followed by a clinic appointment. Demographic, patient journey and outcome data were collected and analysed. Results Ninety-nine patients underwent ultrasound assessment with or without biopsy on average 8 days following referral. Patients were followed up on average 14.1 days (range, 2–26 days) after initial referral. At the first clinic appointment, 45 patients were discharged, 10 were scheduled for surgery, 12 were diagnosed with cancer, 6 were referred to another specialty and cancer was excluded in 19 patients. Retrospectively, four ultrasounds were performed unnecessarily. Conclusion Pre-clinic ultrasound scanning is an alternative to the one-stop neck lump pathway. This study demonstrates fewer clinic visits, faster diagnosis and a low proportion of unnecessary scans, whilst minimising face-to-face consultations and aerosol-generating procedures.
Databáze: OpenAIRE