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. Issue 7 (11th May 2020)

• Record Type: Journal Article
• Authors: Paleri, Vinidh; Hardman, John; Tikka, Theofano; Bradley, Paula; Pracy, Paul; Kerawala, Cyrus
• Is Part Of: Head & neck. Volume 42:Issue 7(2020)
• Page Start: 1674
• Page End: 1680
• Publication Date: 2020-05-11
• Subjects: COVID‐19 -- follow‐up -- new referrals -- outpatient consultation -- triaging; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26219
• Languages: English
• ISSNs: 1043-3074

Abstract

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.