ArticleCancer2021
Remote triage incorporating symptom-based risk stratification for suspected head and neck cancer referrals: A prospective population-based study.
Article in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 43 citations in OpenAlex.
- Telephone and 'Straight-to-Test' Model in Triaging Urgent Suspected Cancer Referrals in a Head and Neck Clinic.Cureus · 2026Article
- Patient-specific variables predicting triage outcomes of ear, nose, throat referrals from primary care for dysphonia.BMC primary care · 2026Article
- Remote triage and virtual urgent care services: A qualitative assessment of factors that impact triage decisions and outcomes.Journal of telemedicine and telecare · 2026Article
- Hybrid Care Modifications in the Delivery of Nonpandemic Care During the COVID-19 Pandemic: Scoping Review.Journal of medical Internet research · 2026Article
- A nurse-led telephone clinic can safely triage suspected head and neck cancer referrals using the head and neck risk calculator.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- Service Evaluation of a "Straight to Scan" Pathway for Neck Lumps Referred as Urgent Suspected Head and Neck Cancer.Laryngoscope investigative otolaryngology · 2026Article
- Feasibility and Safety of Allied Health Professional Delivered Clinics for Suspected Head and Neck Cancers: A Scoping Review.Laryngoscope investigative otolaryngology · 2026Review
- Challenges in Developing a Patient-Reported Symptom-Based Risk Stratification System for Suspected Head and Neck Cancer: Protocol for a Qualitative Case Study.JMIR research protocols · 2025Article
- Remote Consultations in England During COVID-19: Challenges in Data Quality, Linkage, and Research Validity.Online journal of public health informatics · 2025Article
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- A novel remote assessment pathway to streamline the management of two-week-wait suspected head and neck cancer referrals: a prospective analysis of 660 patients.The Journal of laryngology and otology · 2024Article
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- Nomenclature of the symptoms of head and neck cancer: a systematic scoping review.Frontiers in oncology · 2024Article
- Patient perceptions of a remote assessment pathway in otology: a qualitative descriptive analysis.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2023Article
- Telephone triage for 2-week-wait cancer clinics: a viable alternative to face-to-face clinics?Annals of the Royal College of Surgeons of England · 2023Article
- A retrospective cohort study of telephone versus face-to-face clinics for the management of new otology referrals.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2023Article
- "Shopping around" for treatment is not a solution to cancer backlog.BMJ (Clinical research ed.) · 2022Article
- Methodology for the development of National Multidisciplinary Management Recommendations using a multi-stage meta-consensus initiative.BMC medical research methodology · 2022Article
- Remote triaging of urgent suspected head and neck cancer referrals: our experience during the first wave of the COVID-19 pandemic.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRemote triage for suspected head and neck cancer (HNC) referrals was adopted by many institutions during the initial peak of the coronavirus disease 2019 pandemic. Its safety in this population has not been established.
methodsA 16-week, prospective, multicenter national service evaluation was started on March 23, 2020. Suspected HNC referrals undergoing remote triage in UK secondary care centers were identified and followed up for a minimum of 6 months to record the cancer status. Triage was supported by risk stratification using a validated calculator.
resultsData for 4568 cases were submitted by 41 centers serving a population of approximately 26 million. These represented 14.1% of the predicted maximum referrals for this population outside of pandemic times, and this gave the study a margin of error of 1.34% at 95% confidence. Completed 6-month follow-up data were available for 99.8% with an overall cancer rate of 5.6% (254 of 4557). The rates of triage were as follows: urgent imaging investigation, 25.4% (n = 1156); urgent face-to-face review, 27.8%; (n = 1268); assessment deferral, 30.3% (n = 1382); and discharge, 16.4% (n = 749). The corresponding missed cancers rates were 0.5% (5 of 1048), 0.3% (3 of 1149), 0.9% (12 of 1382), and 0.9% (7 of 747; P = .15). The negative predictive value for a nonurgent triage outcome and no cancer diagnosis was 99.1%. Overall harm was reported in 0.24% (11 of 4557) and was highest for deferred assessments (0.58%; 8 of 1382).
conclusionsRemote triage, incorporating risk stratification, may facilitate targeted investigations for higher risk patients and prevent unnecessary hospital attendance for lower risk patients. The risk of harm is low and may be reduced further with appropriate safety netting of deferred appointments. LAY SUMMARY: This large national study observed the widespread adoption of telephone assessment (supported by a risk calculator) of patients referred to hospital specialists with suspected head and neck cancer during the initial peak of the coronavirus disease 2019 pandemic. The authors identified 4568 patients from 41 UK centers (serving a population of more than 26 million people) who were followed up for a minimum of 6 months. Late cancers were identified, whether reviewed or investigated urgently (0.4%) or nonurgently (0.9%), but the overall rate of harm was low (0.2%), with the highest rate being seen with deferred appointments (0.6%).
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