North East London coronavirus disease 2019 protocol for diagnostics in two-week wait head and neck cancer patients.
Aerosols
Betacoronavirus
/ isolation & purification
Biopsy, Fine-Needle
/ instrumentation
COVID-19
Clinical Protocols
Coronavirus Infections
/ epidemiology
Delayed Diagnosis
/ prevention & control
Feasibility Studies
Head and Neck Neoplasms
/ diagnostic imaging
Humans
London
/ epidemiology
Otorhinolaryngologic Surgical Procedures
/ statistics & numerical data
Pandemics
Pneumonia, Viral
/ epidemiology
Positron Emission Tomography Computed Tomography
/ methods
Referral and Consultation
Risk Assessment
SARS-CoV-2
Thyroid Neoplasms
/ diagnostic imaging
Ultrasonography, Interventional
/ methods
COVID-19
Diagnostic Imaging
Head And Neck Neoplasms
Histopathology
Squamous Cell Carcinoma Of Head And Neck
Thyroid Neoplasms
Thyroid Nodule
Journal
The Journal of laryngology and otology
ISSN: 1748-5460
Titre abrégé: J Laryngol Otol
Pays: England
ID NLM: 8706896
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
pubmed:
3
7
2020
medline:
2
10
2020
entrez:
3
7
2020
Statut:
ppublish
Résumé
The coronavirus disease 2019 pandemic requires urgent modification to existing head and neck cancer diagnosis and management practices. A protocol was established that utilises risk stratification, early investigation prior to clinical review and a reduction in aerosol generating procedures to lessen the risk of coronavirus disease 2019 spread. Two-week wait referrals were stratified into low, intermediate and high risk. Low risk patients were referred back to primary care with advice; intermediate and high risk patients underwent investigation. Clinical encounters and aerosol generating procedures were minimised. A combined diagnostic and therapeutic surgical approach was undertaken where possible. Forty-one patients were used to assess feasibility. Thirty-one per cent were low risk, 35 per cent were intermediate and 33 per cent were high risk. Thirty-three per cent were discharged with no imaging. Implementing this protocol reduces the future burden on tertiary services, by empowering primary care physicians to re-refer low risk patients. The protocol is applicable across the UK and avoids diagnostic delay.
Sections du résumé
BACKGROUND
BACKGROUND
The coronavirus disease 2019 pandemic requires urgent modification to existing head and neck cancer diagnosis and management practices. A protocol was established that utilises risk stratification, early investigation prior to clinical review and a reduction in aerosol generating procedures to lessen the risk of coronavirus disease 2019 spread.
METHODS
METHODS
Two-week wait referrals were stratified into low, intermediate and high risk. Low risk patients were referred back to primary care with advice; intermediate and high risk patients underwent investigation. Clinical encounters and aerosol generating procedures were minimised. A combined diagnostic and therapeutic surgical approach was undertaken where possible.
RESULTS
RESULTS
Forty-one patients were used to assess feasibility. Thirty-one per cent were low risk, 35 per cent were intermediate and 33 per cent were high risk. Thirty-three per cent were discharged with no imaging.
CONCLUSION
CONCLUSIONS
Implementing this protocol reduces the future burden on tertiary services, by empowering primary care physicians to re-refer low risk patients. The protocol is applicable across the UK and avoids diagnostic delay.
Identifiants
pubmed: 32613916
doi: 10.1017/S0022215120001267
pii: S0022215120001267
pmc: PMC7399153
doi:
Substances chimiques
Aerosols
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
680-683Références
Mol Imaging Biol. 2009 Jan-Feb;11(1):46-53
pubmed: 18769975
Eur Arch Otorhinolaryngol. 2013 Nov;270(12):3121-6
pubmed: 23536138
Clin Otolaryngol. 2020 May;45(3):380-388
pubmed: 31985180
JAMA Otolaryngol Head Neck Surg. 2020 Jun 1;146(6):579-584
pubmed: 32232423