Evidence map›Paper›PMID 34464568›Full record

Observational studyAnnals of the Royal College of Surgeons of England2021

Rapid implementation of triaging system for assessment of breast referrals from primary care centres during the COVID-19 pandemic.

G Shetty, U Datta, I Rea, S Rai, M-J Hwang, F Hoar, M Sintler, M Mirza, A Husain, M Tan

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Annals of the Royal College of Surgeons of England, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 41% 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

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. 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

10 authors at 2 institutions in 2 countries.

G ShettySandwell and West Birmingham NHS Trust, UK.
U DattaSandwell and West Birmingham NHS Trust, UK.
I ReaSandwell and West Birmingham NHS Trust, UK.
S RaiSandwell and West Birmingham NHS Trust, UK.
M-J HwangSandwell and West Birmingham NHS Trust, UK.
F HoarSandwell and West Birmingham NHS Trust, UK.
M SintlerSandwell and West Birmingham NHS Trust, UK.
M MirzaSandwell and West Birmingham NHS Trust, UK.
A HusainSandwell and West Birmingham NHS Trust, UK.
M TanSandwell and West Birmingham NHS Trust, UK.
Sandwell & West Birmingham Hospitals NHS Trust · GBKasturba Medical College, Manipal · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of this study was to establish a triaging system for assessment of breast referrals from primary care to ensure safe and effective breast services without compromising breast cancer management.

backgroundCOVID-19 was officially declared a global pandemic on 11 March 2020, and with no effective treatment available, preventing spread has been paramount. Previously, all referrals from primary care were seen in the rapid-access breast clinic (RABC). Clinic appointments exposed patients and healthcare professionals to risk.

methodInitial triage during the lockdown was in line with national governing body guidance, rejected low risk referrals and streamed remaining patients through a telephone consultation to RABC or discharge. A modified triage pathway streamed all patients through virtual triage to RABC, telephone clinic or discharge with advice and guidance categories. Demographics, reasons for referral and outcomes data were collected and presented as median with range and frequency with percentages.

resultsInitial triage (23 March-23 April 2020) found fewer referrals with a higher percentage of breast cancer diagnoses. Modified triage (22 June-17 July 2020) resulted in a 35.1% (99/282) reduction in RABC attendance. Overall cancer detection rate remained similar at 4.2% of all referrals pre-COVID (18/429) and 4.3% (12/282) during modified triage. After six months follow-up of patients not seen in RABC during the modified triage pathway, 18 patients were re-referred to RABC and none were diagnosed with cancer.

conclusionA modified triage pathway has the potential to improve triage efficiency and prevent unnecessary visits during the COVID-19 pandemic. Further refinement of pathway is feasible in collaboration with primary care.

Indexed as

COVID-19PandemicsReferral and ConsultationAdultBreast DiseasesCohort StudiesCommunicable Disease ControlFemaleHumansMiddle AgedPrimary Health CareRetrospective StudiesTriageUnited KingdomBreastCoronavirusPrimary healthcareReferral and consultationTriage

Identifiers

PMID34464568
PMCPMC10335053
OpenAlexW3198850852

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.