Evidence map›Paper›PMID 31042431›Full record

ArticleAnnals of the Royal College of Surgeons of England2019

Straight-to-test for the two-week-wait colorectal cancer pathway under the updated NICE guidelines reduces time to cancer diagnosis and treatment.

J Christopher, T R Flint, H Ahmed, N Dhir, R Li, K Macfarland, Dzs Ng, Jmk Ng, C O'Neill, A Te Water Naudé and 3 more

Open access · greenAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of the Royal College of Surgeons of England, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.2field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 18 citations in OpenAlex.

  1. Article
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  9. Review
  10. Patient experiences of the urgent cancer referral pathway-Can the NHS do better? Semi-structured interviews with patients with upper gastrointestinal cancer.Health expectations : an international journal of public participation in health care and health policy · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 1 country.

J ChristopherBedford Hospital NHS Trust, Bedford, UK.
T R FlintQueen Elizabeth Hospital, King's Lynn NHS Trust, King's Lynn, Norfolk, UK.
H AhmedUniversity of Cambridge School of Clinical Medicine, Cambridge, UK.
N DhirUniversity of Cambridge School of Clinical Medicine, Cambridge, UK.
R LiUniversity of Cambridge School of Clinical Medicine, Cambridge, UK.
K MacfarlandUniversity College London Hospitals, London, UK.
Dzs NgHinchingbrooke Hospital, Huntingdon, Cambridgeshire, UK.
Jmk NgRoyal Free Hospital, London, UK.
C O'NeillStoke Mandeville Hospital, Aylesbury, Buckinghamshire, UK.
A Te Water NaudéJohn Radcliffe Hospital, Oxford, UK.
K SloanColorectal Unit, Cambridge University Hospitals NHS Trust, Cambridge, UK.
N R HallColorectal Unit, Cambridge University Hospitals NHS Trust, Cambridge, UK.
M P PowarColorectal Unit, Cambridge University Hospitals NHS Trust, Cambridge, UK.
Cambridge University Hospitals NHS Foundation Trust · GBUniversity of Cambridge · GBUniversity College London · GBBedford Hospital NHS Trust · GBHinchingbrooke Hospital · GBJohn Radcliffe Hospital · GBQueen Elizabeth Hospital King's Lynn NHS Foundation Trust · GBStoke Mandeville Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe 2015 National Institute for Health and Care Excellence guidelines widened the referral criteria for the two-week-wait pathway for suspected lower gastrointestinal cancer. We implemented a straight-to-test protocol to accommodate the anticipated increase in referrals. We evaluated the impact of these changes for relevant pathway metrics and clinical outcomes using a retrospective cohort study with historic controls. MATERIALS AND

methodsWe analysed data from all patients referred to a teaching hospital via the two-week-wait pathway for suspected lower gastrointestinal cancer under the previous guidelines between 1 March and 31 August 2015 compared with the same period in 2016, when the updated guidelines and straight-to-test protocol had been implemented.

resultsIn the 2015 cohort, there were 64 cancer diagnoses from 664 referrals (9.6% pick-up) compared with 58 cancer diagnoses from 954 referrals in the 2016 cohort (6.1% pick-up). Our straight-to-test protocol reduced the median time to cancer diagnosis by 12.5 days ( DISCUSSION AND

conclusionOur straight-to-test protocol has resulted in a reduction in times to cancer diagnosis and cancer treatment, despite an increase in the number of referrals. The new referral criteria have considerable resource implications, but their implementation did not result in an increase in the total number of cancers diagnosed.

Indexed as

AdenomaAdultAgedClinical ProtocolsColorectal NeoplasmsEarly Detection of CancerFemaleHumansMaleMiddle AgedPractice Guidelines as TopicReferral and ConsultationRetrospective StudiesTime FactorsUnited KingdomWaiting ListsColonoscopyDiagnosisGastrointestinal neoplasmsNeoplasmsSurgery

Identifiers

PMID31042431
PMCPMC6513371
OpenAlexW2943690581

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.