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A pilot “Telephone-and-Test” (Modified Straight-to-Test) for ENT two-week wait referrals
  • +2
  • Billy Wong,
  • Maria Kiakou,
  • Leon Fletcher,
  • Madhup Chaurasia,
  • Mark Puvanendran
Billy Wong
Broomfield Hospital
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Maria Kiakou
Broomfield Hospital
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Leon Fletcher
Broomfield Hospital
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Madhup Chaurasia
Broomfield Hospital
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Mark Puvanendran
Broomfield Hospital
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Abstract

Objective To assess the efficacy and outcome of a pilot model in triaging urgent suspected head and neck cancer referrals during the Covid-19 pandemic. Design Prospective observational cohort study Setting Regional Head and Neck Cancer hub, United Kingdom. Participants 84 patients who were referred via the 2 week wait pathway and streamed directly for imaging investigations after initial telephone consultation. Main outcome measures The malignancy detection rate using the telephone-and-test model Results 495 2-week wait referrals were received during the study period. 104 patients were discharged following their initial telephone consultation. 84 (17%) patients were streamed directly for imaging investigations following their telephone consultation. Malignancy was identified in 11.9% of patients which included squamous cell carcinoma, differentiated thyroid carcinoma and lymphoproliferative disease. 51% of patients had other benign pathologies such as benign salivary gland tumour, benign thyroid disease and physiological lymphadenopathy. Following their radiological investigation, 48.8% of patients were discharged without any need for further consultations. Conclusions The telephone-and-test approach is an effective and efficient model for triaging head and neck two-week wait referrals, which could be applicable outside the pandemic times.