Rapid implementation of an evidence-based remote triaging system for assessment of suspected head and neck cancer referrals and patients on follow up after treatment during the COVID-19 pandemic: A model for international collaboration

Head and Neck Cancer
07/05/2020

Paleri V, et al. Head Neck 2020.

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 cancer referrals, 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 5,123 follow-up consultations was used. A customised Excel Data Tool was created, trialled 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 centres 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. This article is protected by copyright. All rights reserved.