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Rapid implementation of an evidence-based remote triaging system for assessment of suspected referrals and patients with head and neck cancer on follow-up after treatment during the COVID-19 pandemic: Model for international collaboration.
Paleri, Vinidh; Hardman, John; Tikka, Theofano; Bradley, Paula; Pracy, Paul; Kerawala, Cyrus.
  • Paleri V; Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London, UK.
  • Hardman J; Institute of Cancer Research, London, UK.
  • Tikka T; ENT UK Head and Neck Society, London, UK.
  • Bradley P; British Association of Head and Neck Oncologists, London, UK.
  • Pracy P; Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London, UK.
  • Kerawala C; Institute of Cancer Research, London, UK.
Head Neck ; 42(7): 1674-1680, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-291714
Semantic information from SemMedBD (by NLM)
1. Malignant Head and Neck Neoplasm PROCESS_OF Patients
Subject
Malignant Head and Neck Neoplasm
Predicate
PROCESS_OF
Object
Patients
2. Malignant Head and Neck Neoplasm COEXISTS_WITH COVID-19
Subject
Malignant Head and Neck Neoplasm
Predicate
COEXISTS_WITH
Object
COVID-19
3. Patient referral USES Metric (substance)
Subject
Patient referral
Predicate
USES
Object
Metric (substance)
4. Malignant Head and Neck Neoplasm PROCESS_OF Patients
Subject
Malignant Head and Neck Neoplasm
Predicate
PROCESS_OF
Object
Patients
5. Malignant Head and Neck Neoplasm COEXISTS_WITH COVID-19
Subject
Malignant Head and Neck Neoplasm
Predicate
COEXISTS_WITH
Object
COVID-19
6. Patient referral USES Metric (substance)
Subject
Patient referral
Predicate
USES
Object
Metric (substance)
ABSTRACT

BACKGROUND:

Outpatient telemedicine consultations are being adopted to triage patients for head and neck cancer. However, there is currently no established structure to frame this consultation.

METHODS:

For suspected referrals with cancer, we adapted the Head and Neck Cancer Risk Calculator (HaNC-RC)-V.2, generated from 10 244 referrals with the following diagnostic efficacy metrics 85% sensitivity, 98.6% negative predictive value, and area under the curve of 0.89. For follow-up patients, a symptom inventory generated from 5123 follow-up consultations was used. A customized Excel Data Tool was created, trialed across professional groups and made freely available for download at www.entintegrate.co.uk/entuk2wwtt, alongside a user guide, protocol, and registration link for the project. Stakeholder support was obtained from national bodies.

RESULTS:

No remote consultations were refused by patients. Preliminary data from 511 triaging episodes at 13 centers show that 77.1% of patients were discharged directly or have had their appointments deferred.

DISCUSSION:

Significant reduction in footfall can be achieved using a structured triaging system. Further refinement of HaNC-RC-V.2 is feasible and the authors welcome international collaboration.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Referral and Consultation / Triage / Coronavirus Infections / Risk Assessment / Continuity of Patient Care / Head and Neck Neoplasms Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal: Head Neck Journal subject: Neoplasms Year: 2020 Document Type: Article Affiliation country: Hed.26219

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Referral and Consultation / Triage / Coronavirus Infections / Risk Assessment / Continuity of Patient Care / Head and Neck Neoplasms Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal: Head Neck Journal subject: Neoplasms Year: 2020 Document Type: Article Affiliation country: Hed.26219