ArticlePostgraduate medical journal2002
Guidelines, compliance, and effectiveness: a 12 months' audit in an acute district general healthcare trust on the two week rule for suspected colorectal cancer.
Article in Postgraduate medical journal, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Value of symptoms and additional diagnostic tests for colorectal cancer in primary care: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2010Pooled it
- Influences on pre-hospital delay in the diagnosis of colorectal cancer: a systematic review.British journal of cancer · 2008Pooled it
- The effects of the Two-Week Rule on NHS colorectal cancer diagnostic services: a systematic literature review.BMC health services research · 2006Pooled it
- Article
- Anaemia as a risk stratification tool for symptomatic patients referred via the two-week wait pathway for colorectal cancer.Annals of the Royal College of Surgeons of England · 2018Article
- Colorectal cancer diagnosis: Pitfalls and opportunities.World journal of gastrointestinal oncology · 2015Review
- The Two-Week Referral System for colorectal cancer--not fit for purpose.International journal of colorectal disease · 2013Article
- Is the "red flag" referral pathway effective in diagnosing colorectal carcinoma?The Ulster medical journal · 2012Article
- Risk profiles of prostate cancers identified from UK primary care using national referral guidelines.British journal of cancer · 2012Article
- The interface of primary and oncology specialty care: from symptoms to diagnosis.Journal of the National Cancer Institute. Monographs · 2010Review
- The gap between practice and guidelines in the choice of first-line disease modifying antirheumatic drug in early rheumatoid arthritis: results from the ESPOIR cohort.The Journal of rheumatology · 2009Article
- Audit of two-week rule referrals for suspected testicular cancer in Cornwall, 2003-2005.Annals of the Royal College of Surgeons of England · 2009Article
- A prospective study of peri-diagnostic and surgical wait times for patients with presumptive colorectal, lung, or prostate cancer.British journal of cancer · 2009Article
- Prospective evaluation of a novel one-stop testicular clinic.Annals of the Royal College of Surgeons of England · 2008Article
- Prospective analysis of scrotal pathology referrals - are referrals appropriate and accurate?Annals of the Royal College of Surgeons of England · 2006Article
- Urgent GP referrals for suspected lung, colorectal, prostate and ovarian cancer.The British journal of general practice : the journal of the Royal College of General Practitioners · 2006Article
- The effectiveness of a rapid-access flexible sigmoidoscopy clinic in a district hospital.International surgeryArticle
- Promoting colorectal cancer screening among Haitian Americans.Journal of the Georgia Public Health AssociationArticle
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe Department of Health had recently introduced guidelines so that all suspected colorectal cancer patients could be seen by a specialist within two weeks of referral by their general practitioners. The usefulness and practicality of such a decision had been questioned. The aims of this study were to measure the compliance to the guidelines and evaluate the effectiveness of such referrals.
methodsAll patients who were referred to the rapid access colorectal clinic between August 2000 and July 2001 were included. SETTINGS: Darlington Memorial Hospital and Bishop Auckland General Hospital, both under South Durham Health Care Trust, were considered for the study. MEASURES: Date of referral, referring practitioner, time of appointment, reasons for referral, and diagnosis.
resultsA total of 239 referrals were made; 96.2% of patients were given appointments within two weeks. Rectal bleed was the commonest (32%) cause for referral. Diverticular disease was the most frequent (29%) condition diagnosed. Altogether 97.4% of referrals were incomplete and 37.6% did not comply with the guidelines. Twenty one colorectal cancers (8.9%) were diagnosed. The early cancer detection rate was 4.6%.
conclusionsThis audit showed that compliance to the guidelines was associated with a higher cancer detection rate. The majority of patients received appointments within two weeks. Contrary to some speculations, the number of referrals was not limitless. However a high number of referrals failed to adhere to the guidelines. The cancer (particularly early cancer) detection rate was disappointingly low. This does not reflect an efficient system of referral and potential benefits to patients remain questionable.
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