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Referral Pathways (referral + pathway)

Distribution by Scientific Domains
Medical Sciences85%

Selected Abstracts

Referral pathways and diagnosis: UK government actions fail to recognize complexity of lymphoma

EUROPEAN JOURNAL OF CANCER CARE, Issue 6 2007
D.A. HOWELL rgn
Referral pathways and diagnosis: UK government actions fail to recognise complexity of lymphoma To gain survival advantages potentially associated with prompt diagnosis, the UK government introduced identical waiting-time targets for all cancers, and guidelines to ensure that general practitioners make appropriate hospital referrals. For lymphoma, the evidence guiding these actions is limited. This study examined referral pathways in patients with lymphoma and variations in time to diagnosis by discipline of first referral. A case series study was conducted including all patients aged over 25 years, newly diagnosed with lymphoma in the UK county of West Yorkshire, during 2000. Data were extracted from primary care and hospital records of 189 patients. Referral pathways were described, and the number of days between first referral and diagnosis calculated. A distinct referral pathway did not exist; patients were initially referred to many disciplines. Surgical referrals predominated, and only 12% of patients were sent directly to haematology. Time to diagnosis varied by discipline and was shorter for patients sent to haematology than for most other common disciplines. UK government actions to ensure the prompt diagnosis of patients with lymphoma are not evidence-based. The complexity of the referral pathway in patients with lymphoma, which affects time to diagnosis, has been underestimated. Further government actions should be evidence-based, ensuring prompt diagnosis of lymphoma from whatever discipline patients originate. [source]

Psychiatric disorders and the use of mental health services among children involved in bullying

AGGRESSIVE BEHAVIOR, Issue 2 2001
Kirsti Kumpulainen
Abstract This study had two aims: to evaluate the relationship between bullying and psychiatric disorders and to study the probability of using mental health services among children involved in bully/victim problems. The data consisted of interviews with 423 parents and 420 children. Diagnostic measures were based on the Isle of Wight Interview. Children involved in bullying as bullies, bully-victims, and victims were compared with other children. Children involved in bully/victim problems were more prone to have psychiatric disorders than noninvolved children. The probability of being disturbed was highest among male bullies, followed by male bully-victims and female victims (9.5-fold, 7.9-fold, and 4.3-fold, respectively) compared with noninvolved same-sex children. The most common diagnoses among children involved in bully/victim problems were attention deficit disorder, oppositional/conduct disorder, and depression. Furthermore, children involved in bully/victim problems were more likely to have used mental health services at some time during their lives and also during the previous 3 months. Special attention should be paid to children's mental health when dealing with bullying problems at school. Referral pathways to mental health services and factors affecting the referral processes among children should be further studied. Aggr. Behav. 27:102,110, 2001. © 2001 Wiley-Liss, Inc. [source]

Referral pathways and diagnosis: UK government actions fail to recognize complexity of lymphoma

EUROPEAN JOURNAL OF CANCER CARE, Issue 6 2007
D.A. HOWELL rgn
Referral pathways and diagnosis: UK government actions fail to recognise complexity of lymphoma To gain survival advantages potentially associated with prompt diagnosis, the UK government introduced identical waiting-time targets for all cancers, and guidelines to ensure that general practitioners make appropriate hospital referrals. For lymphoma, the evidence guiding these actions is limited. This study examined referral pathways in patients with lymphoma and variations in time to diagnosis by discipline of first referral. A case series study was conducted including all patients aged over 25 years, newly diagnosed with lymphoma in the UK county of West Yorkshire, during 2000. Data were extracted from primary care and hospital records of 189 patients. Referral pathways were described, and the number of days between first referral and diagnosis calculated. A distinct referral pathway did not exist; patients were initially referred to many disciplines. Surgical referrals predominated, and only 12% of patients were sent directly to haematology. Time to diagnosis varied by discipline and was shorter for patients sent to haematology than for most other common disciplines. UK government actions to ensure the prompt diagnosis of patients with lymphoma are not evidence-based. The complexity of the referral pathway in patients with lymphoma, which affects time to diagnosis, has been underestimated. Further government actions should be evidence-based, ensuring prompt diagnosis of lymphoma from whatever discipline patients originate. [source]

Inter general practice variability in use of referral guidelines for colorectal cancer

COLORECTAL DISEASE, Issue 8 2007
S. K. P. John
Abstract Objective, The Two-Week Wait (TWW) referral system for suspected colorectal cancers has a low yield. To examine this, we assessed the referral pattern of general practices within four primary care trusts and looked at the variability of yield of colorectal cancer amongst all TWW referrals and assessed the reasons for variability. Method, A prospectively collected database of all colorectal cancers was examined for new cases diagnosed in the 12 months from April 1st 2004. Patients were cross-referenced via general practitioner (GP) codes to identify the referral origin. Reasons for the variability in referral patterns from each general practice were assessed in relation to TWW referrals, population demographics and through postal questionnaire of GPs. Results, A total of 175 patients diagnosed with colorectal cancer were referred from 49 general practices. Whilst there was a positive correlation between the number of TWW referrals and colorectal cancer per 1000-practice population (P = 0.001; Spearman correlation coefficient rs=0.447, two-tailed), there was a big discrepancy between referrals and cancer diagnosed in many general practices. Twenty-six general practices (53%) had no colorectal cancer diagnosed via the TWW route and these practices had significantly lower utilization of the TWW referral pathway. In the postal survey, 22% of GPs were unaware of TWW clinics or colorectal cancer referral guidelines and only 8% of GPs knew the number of referral criteria. Conclusion, This study demonstrates wide variability within primary care, in the appropriate use of colorectal cancer referral guidelines. General practices should be targeted for education. [source]

Referral pathways and diagnosis: UK government actions fail to recognize complexity of lymphoma

EUROPEAN JOURNAL OF CANCER CARE, Issue 6 2007
D.A. HOWELL rgn
Referral pathways and diagnosis: UK government actions fail to recognise complexity of lymphoma To gain survival advantages potentially associated with prompt diagnosis, the UK government introduced identical waiting-time targets for all cancers, and guidelines to ensure that general practitioners make appropriate hospital referrals. For lymphoma, the evidence guiding these actions is limited. This study examined referral pathways in patients with lymphoma and variations in time to diagnosis by discipline of first referral. A case series study was conducted including all patients aged over 25 years, newly diagnosed with lymphoma in the UK county of West Yorkshire, during 2000. Data were extracted from primary care and hospital records of 189 patients. Referral pathways were described, and the number of days between first referral and diagnosis calculated. A distinct referral pathway did not exist; patients were initially referred to many disciplines. Surgical referrals predominated, and only 12% of patients were sent directly to haematology. Time to diagnosis varied by discipline and was shorter for patients sent to haematology than for most other common disciplines. UK government actions to ensure the prompt diagnosis of patients with lymphoma are not evidence-based. The complexity of the referral pathway in patients with lymphoma, which affects time to diagnosis, has been underestimated. Further government actions should be evidence-based, ensuring prompt diagnosis of lymphoma from whatever discipline patients originate. [source]