General practitioner referrals to one-stop clinics for symptoms that could be indicative of cancer
| Autor: | Brian D Nicholson, Claire Friedemann Smith, Daniel Lasserson, Clare Bankhead, Alice Tompson, Gea A Holtman, Fergus V. Gleeson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Systematic Reviews Referral MEDLINE Primary care Cochrane Library Time-to-Treatment 03 medical and health sciences 0302 clinical medicine General Practitioners Neoplasms Outcome Assessment Health Care Humans Medicine 030212 general & internal medicine Medical diagnosis Referral and Consultation Early Detection of Cancer Randomized Controlled Trials as Topic Primary Health Care business.industry 030503 health policy & services Diagnostic test Cancer medicine.disease Family medicine Observational study 0305 other medical science Family Practice business |
| Zdroj: | Family practice. 36(3):255-261 |
| ISSN: | 0263-2136 |
| Popis: | Background One-stop clinics provide comprehensive diagnostic testing in one outpatient appointment. They could benefit patients with conditions, such as cancer, whose outcomes are improved by early diagnosis, and bring efficiency savings for health systems. Objective To assess the use and outcomes of one-stop clinics for symptoms where cancer is a possible diagnosis. Design and setting Systematic review of studies reporting use and outcomes of one-stop clinics in primary care patients. Method We searched MEDLINE, Embase, and Cochrane Library for studies assessing one-stop clinics for adults referred after presenting to primary care with any symptom that could be indicative of cancer. Study selection was carried out independently in duplicate with disagreements resolved through discussion. Results Twenty-nine studies were identified, most were conducted in the UK and observational in design. Few included a comparison arm. A pooled comparison of the cancer conversion rate of one-stop and multi-stop clinics was only possible for breast symptoms, and we found no significant difference. One-stop clinics were associated with significant reductions in the interval from referral to testing (15 versus 75 days) and more patients diagnosed on the same day (79% versus 25%) compared to multi-stop pathways. The majority of patients and GPs found one-stop clinics to be acceptable. Conclusion This review found one-stop clinics were associated with reduced time from referral to testing, increased same day diagnoses, and were acceptable to patients and GPs. Our conclusions are limited by high levels of heterogeneity, scarcity of comparator groups, and the overwhelmingly observational nature of included studies. |
| Databáze: | OpenAIRE |
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