A pilot “Telephone-and-Test” (Modified Straight-to-Test) for ENT
two-week wait referrals
Abstract
Objective To assess the efficacy and outcome of a pilot model in
triaging urgent suspected head and neck cancer referrals during the
Covid-19 pandemic. Design Prospective observational cohort study Setting
Regional Head and Neck Cancer hub, United Kingdom. Participants 84
patients who were referred via the 2 week wait pathway and streamed
directly for imaging investigations after initial telephone
consultation. Main outcome measures The malignancy detection rate using
the telephone-and-test model Results 495 2-week wait referrals were
received during the study period. 104 patients were discharged following
their initial telephone consultation. 84 (17%) patients were streamed
directly for imaging investigations following their telephone
consultation. Malignancy was identified in 11.9% of patients which
included squamous cell carcinoma, differentiated thyroid carcinoma and
lymphoproliferative disease. 51% of patients had other benign
pathologies such as benign salivary gland tumour, benign thyroid disease
and physiological lymphadenopathy. Following their radiological
investigation, 48.8% of patients were discharged without any need for
further consultations. Conclusions The telephone-and-test approach is an
effective and efficient model for triaging head and neck two-week wait
referrals, which could be applicable outside the pandemic times.