The first UK multidisciplinary diagnostic centre: A novel cancer diagnostic service (Record no. 76403)

MARC details
000 -LEADER
fixed length control field 03165cam a2200157 4500
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control field NMDX7548
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fixed length control field 120401t2016 xxu||||| |||| 00| 0 eng d
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Personal name Millar, A.
240 ## - UNIFORM TITLE
Uniform title <a href="Gut">Gut</a>
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Title The first UK multidisciplinary diagnostic centre: A novel cancer diagnostic service
260 ## - PUBLICATION, DISTRIBUTION, ETC. (IMPRINT)
Date of publication, distribution, etc. 2016
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General note NMUH Staff Publications
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General note 65
520 ## - SUMMARY, ETC.
Summary, etc. &lt;span style="font-size: 10pt;"&gt;Introduction Late diagnosis is thought to be a significant cause of the observed lower cancer survival in UK compared to equivalent countries worldwide. A significant proportion of patients with intra-abdominal cancer are often diagnosed after attending Emergency Departments with late stage disease, highlighting the fact that often symptoms of early upper gastrointestinal (UGI) cancer are nebulous and ill-defined. Methods A pilot Multidisciplinary Diagnostic Centre (MDC) at UCLH was established in June 2015. The MDC is for: (a) patients with severe but non-specific worrying symptoms, warranting rapid diagnosis but not qualifying for a '2 Week Wait' referral; (b) patients with severe symptoms for whom admission to hospital currently offers the only clinically appropriate route to timely care. The Centre aims to provide rapid access to specialist assessment and appropriate diagnostic tests, leading to a defined management plan within 28 days of referral, aligning to the Independent Cancer Taskforce recommendations. Initial assessment is by a clinical nurse specialist (CNS) with consultant support. Once the diagnostic tests are performed, follow up is by face to face consultant assessment. Feedback to the service was elicited by a series of phone calls to a proportion of referring doctors. Results Of the initial 91 patients, the majority of patients (47%, 43) presented with vague abdominal symptoms alone. A further 24% (22) of patients had unexplained weight loss. 93% of patients were offered an initial appointment to MDC within 5 working days. Relevant eventual clinical diagnoses were cancer of unknown primary (1), pancreatic cancer (1), adrenal adenoma (1) and intraductal papillary mucinous neoplasm of pancreas (1). Other non-cancer diagnosis include hiatus hernia (10%), irritable bowel syndrome (8%), and colonic/ rectal polyp (5%). The majority of patients underwent CT scanning (54%) and UGI endoscopy (39%). Primary care feedback (n = 6) highlighted the importance even of non-cancer diagnoses. Conclusion The ability to provide a rapid access diagnostic clinic is feasible and will enable the NHS to achieve the Independent Cancer Taskforce recommendation on providing a definitive cancer diagnosis, or cancer excluded within 28 days. Cancer rates are in keeping with other cancer pathways. Input from CNS and efficient administration support are essential in ensuring the diagnostic journey is centred around the patients. We need to understand more about patient experience in this novel pathway, in particular whether rapid access to diagnostic tests and specialist opinion is being perceived as an excellent service.&amp;nbsp;&lt;/span&gt;
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier <a href="http://gut.bmj.com/content/gutjnl/65/Suppl_1/A202.2.full.pdf">http://gut.bmj.com/content/gutjnl/65/Suppl_1/A202.2.full.pdf</a>
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection code Home library Current library Shelving location Date acquired Total Checkouts Date last seen Price effective from Koha item type
        Staff publications for NMDX Ferriman information and Library Service (North Middlesex) Ferriman information and Library Service (North Middlesex) Shelves 07/06/2022   07/06/2022 07/06/2022 Book
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