North East London coronavirus disease 2019 protocol for diagnostics in two-week wait head and neck cancer patients

Warner, Elinor; Scholfield, Daniel W.; Adams, Ashok; Richards, P.; Ahmed, Jahangir; Ghufoor, Khalid

doi:10.1017/s0022215120001267

Cited by 13 publications

(9 citation statements)

References 5 publications

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“…We excluded 19 studies after full-text reading, and the reasons for exclusion are presented in the Data Supplement. 24 - 42 Nine studies fully met our inclusion criteria. 43 - 51 The flowchart of the process of study identification and selection is presented in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

Impact of Strategies for Mitigating Delays and Disruptions in Cancer Care Due to COVID-19: Systematic Review

Pacheco

Martimbianco

Roitberg

et al. 2021

JCO Global Oncology

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PURPOSE Delays and disruptions in health systems because of the COVID-19 pandemic were identified by a previous systematic review from our group. For improving the knowledge about the pandemic consequences for cancer care, this article aims to identify the effects of mitigation strategies developed to reduce the impact of such delays and disruptions. METHODS Systematic review with a comprehensive search including formal databases, cancer and COVID-19 data sources, gray literature, and manual search. We considered clinical trials, observational longitudinal studies, cross-sectional studies, before-and-after studies, case series, and case studies. The selection, data extraction, and methodological assessment were performed by two independent reviewers. The methodological quality of the included studies was assessed by specific tools. The mitigation strategies identified were described in detail and their effects were summarized narratively. RESULTS Of 6,692 references reviewed, 28 were deemed eligible, and 9 studies with low to moderate methodological quality were included. Five multiple strategies and four single strategies were reported, and the possible effects of mitigating delays and disruptions in cancer care because of COVID-19 are inconsistent. The only comparative study reported a 48.7% reduction observed in the number of outpatient visits to the hospital accompanied by a small reduction in imaging and an improvement in radiation treatments after the implementation of a multiple organizational strategy. CONCLUSION The findings emphasize the infrequency of measuring and reporting mitigation strategies that specifically address patients' outcomes and thus a scarcity of high-quality evidence to inform program development. This review reinforces the need of adopting standardized measurement methods to monitor the impact of the mitigation strategies proposed to reduce the effects of delays and disruptions in cancer health care because of COVID-19.

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Section: Resultsmentioning

confidence: 99%

Impact of Strategies for Mitigating Delays and Disruptions in Cancer Care Due to COVID-19: Systematic Review

Pacheco

Martimbianco

Roitberg

et al. 2021

JCO Global Oncology

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“…1 The coronavirus disease 2019 (Covid-19) pandemic has had a significant effect on the management of cancer patients in the UK, and otolaryngologists and head and neck surgeons around the world have been forced to make changes to their method of practice. 2 – 5 The two-week wait pathway for the referral of head and neck cancer patients by general physicians was also affected by these changes. An attempt was made to rapidly implement a remote triaging system for the assessment of head and neck cancer referrals utilising the Head and Neck Cancer Risk Calculator version 2 (‘HaNC-RCv2’).…”

Section: Introductionmentioning

confidence: 99%

Telephone triage of suspected head and neck cancer patients during the coronavirus disease 2019 pandemic using the Head and Neck Cancer Risk Calculator version 2

et al. 2021

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Objective Utilisation of the Head and Neck Cancer Risk Calculator version 2 has been recommended during the coronavirus disease 2019 pandemic for the assessment of head and neck cancer referrals. As limited data were available, this study was conducted to analyse the use of the Head and Neck Cancer Risk Calculator version 2 in clinical practice. Method Patients undergoing telephone triage in a two-week wait referral clinic were included. Data were collected and analysed using appropriate methods. Results Sixty-four patients in the study were risk-stratified into low-risk (51.6 per cent, 33 of 64), moderate-risk (14.1 per cent, 9 of 64) and high-risk (34.4 per cent, 22 of 64) groups. Of the patients, 53.1 per cent (34 of 64) avoided an urgent hospital visit, and 96.9 per cent (62 of 64) were cancer free, while 3.1 per cent (2 of 64) were found to have a head and neck malignancy. The sensitivity, specificity, negative predictive value and accuracy were 50.00 per cent, 66.13 per cent, 99.92 per cent and 66.11 per cent, respectively. Conclusion It is reasonable to use the calculator for triaging purposes, but it must always be accompanied by a meticulous clinical thought process.

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“…In ordinary times, physical examination, combined with flexible transnasal endoscopy of the upper aerodigestive tract, where indicated, were considered the mainstay of new patient assessment. However, to control the spread of infection and to protect patients and staff, there was a need for departments to adopt virtual clinics and protocols to minimise direct contact [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Remote triaging of urgent suspected head and neck cancer referrals: our experience during the first wave of the COVID-19 pandemic

Kaddour

Jama

Stagnell

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose In response to the coronavirus disease 2019 (COVID-19) pandemic, otolaryngology departments across the United Kingdom have adopted non-face-to-face clinics with consultations being carried out remotely, via telephone or video calls. By reducing footfall on hospital sites, the aim of this strategy was to limit direct contact and curb the spread of infection. This report outlines our experience of conducting a telephone triage clinic in the assessment of urgent suspected head and neck cancer referrals during the first wave of the COVID-19 pandemic. Methods New patients who were referred on the urgent suspected head and neck cancer pathway were prospectively identified between 1 May 2020 and 31 August 2020. Patients were triaged remotely using telephone consultations. Risk stratification was performed using the ‘Head and Neck Cancer Risk Calculator’ (HaNC-RC v.2). Results Four-hundred and twelve patients were triaged remotely during the 4-month study period. Of these, 248 patients were deemed ‘low risk’ (60.2%), 78 were classed as ‘moderate risk’ (18.9%) and 86 were considered ‘high risk’ (20.9%) according to the HaNC-RC v.2 risk score. Twenty-four patients who were assessed during the study period were diagnosed with head and neck cancer (5.82%). Conclusion The use of teleconsultation, supported by a validated, symptom-based risk calculator, has the potential to provide a viable and effective adjunct in the assessment and management of new suspected head and neck cancer patients and should be considered as part of the inherent re-shaping of clinical service delivery following the ongoing pandemic.

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North East London coronavirus disease 2019 protocol for diagnostics in two-week wait head and neck cancer patients

Cited by 13 publications

References 5 publications

Impact of Strategies for Mitigating Delays and Disruptions in Cancer Care Due to COVID-19: Systematic Review

Impact of Strategies for Mitigating Delays and Disruptions in Cancer Care Due to COVID-19: Systematic Review

Telephone triage of suspected head and neck cancer patients during the coronavirus disease 2019 pandemic using the Head and Neck Cancer Risk Calculator version 2

Remote triaging of urgent suspected head and neck cancer referrals: our experience during the first wave of the COVID-19 pandemic

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