'One stop' clinic for upper gastrointestinal cancer-an alternative to 'straight to test' referrals?
| Autor: | Manfred Lambertz, Ian Chetter, Chitakattil Oommen, Ross Lathan, Marina Yiasemidou |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Referral Specialist nurse Outpatient clinic Upper gastrointestinal cancer Ambulatory Care Facilities 03 medical and health sciences 0302 clinical medicine General Practitioners medicine Humans 030212 general & internal medicine Medical diagnosis Referral and Consultation Aged Gastrointestinal Neoplasms Retrospective Studies medicine.diagnostic_test business.industry General surgery Oesophageal cancer Endoscopy General Medicine Early diagnosis Test (assessment) 030220 oncology & carcinogenesis Case note Original Article business Gastric cancer |
| Zdroj: | Irish Journal of Medical Science |
| ISSN: | 1863-4362 |
| Popis: | Background Patients suspected to have upper gastrointestinal (UGI) cancer can be referred directly for investigation; however, at times this may result to inappropriate referrals. This study explores the model of a “one-stop” clinic as an alternative to the direct referral system. The current study aims to assess the feasibility and outcomes of a one-stop UGI clinic and evaluate sensitivity and specificity of “on-the-day” diagnoses. Methods A retrospective analysis of case notes of patients seen in one-stop clinic, between January 2017 and January 2019, was conducted. All General Practitioner (GP) referrals were screened by a specialist nurse. Results After completion of the post-GP referral screening process, 252 patients (median age 68 years, IQR 58.8–77.3 years; M:F ratio 118:134) were allocated to the one-stop clinic. OGD was not required, contra-indicated or declined in 27 cases (10.7%). The records of three patients could not be found. One patient did not attend. Overall, 221 patients underwent testing and received “on-the-day” diagnoses. Sensitivity was 94% (range 87–100%), and specificity was 92% (88–96%). Ninety-six percent of patients received a diagnosis on the day. Conclusions The one-stop clinic was feasible and had good specificity and sensitivity. The finding of 10.7% of cases not being suitable for OGD indicates that a patient/specialist consultation is necessary to prevent misuse of endoscopy appointments. The authors recommend widespread adoption of one-stop clinics in UGI surgery. |
| Databáze: | OpenAIRE |
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