Risk reduction using remote triaging for new referrals and
follow ups
To break the chain of transmission, several healthcare jurisdictions are
recommending reduced footfall in hospitals. Thus, structured telephone
triaging can be used to separate low-risk from high-risk patients, with
the latter cohort being seen sooner. Using one such risk calculator
generated iteratively from over 10,000 patients in the UK, the risk of
missing cancer in low-risk patients who do not undergo a face-to-face
consultation is under
2%.34 Such
patients can be reassessed at a later time when the acute pandemic
associated issues are resolved. This approach has been supported by
ENTUK, the British Association of Otolaryngology-Head and Neck Surgery.
Similarly, it has been well recognized that the detection of recurrent
cancers is low in the population of asymptomatic patients after
treatment. These patients need support with functional problems. They
should be offered remote consultation; only those with new symptoms
should be offered face-to-face consultation for the duration of the
pandemic.35