In the United Kingdom, the main routes to diagnosis are screen detected, urgent wait (2WW) Adidas Gazelle Og Leather Blue
referral, routine general practitioner (GP) referral, onward referral from another speciality and emergency presentation (EP). In the 2WW pathway (Department of Health, 2000), patients are referred urgently by their GP and can expect to be seen by a specialist within 2 weeks. This is considered to be the gold standard in diagnosis and for many cancers (such as breast, bladder and ovary) results in higher survival compared with presentation by other routes, with the exception of screen detected cancers (National Cancer Intelligence Network, 2013). Conversely, diagnosis within the context of an EP results in poorer outcomes (McPhail et al, 2013). Between 2006 and 2010, 24 of all cancers in England were diagnosed via the emergency route, although there was considerable variation across cancer types (National Cancer Intelligence Network, 2013). Improving the pathway to diagnosis for patients diagnosed during an EP should improve outcomes, not only for this patient group but also in terms of the United Kingdom as a whole, which is known to have poorer cancer survival than that of comparable countries (Sant .
poorer outcomes. It is often assumed that such patients present to the emergency department without consulting their general practitioner (GP). Little work has been done to identify primary care involvement before hospital attendance. Methods: Participating primary care practices completed a significant event audit (SEA) report for the last patient diagnosed with cancer as a result of an EP. Accounts were synthesised and a qualitative approach to analysis undertaken. Results: SEAs for 222 patients were analysed.
G Rubin2, L Merriman3 and U Macleod4Top of pageAbstractBackground: Methods: Results: Conclusions: Materials and methods Results Discussion Conflict of interest References Acknowledgements Figures and TablesBackground: Patients diagnosed with cancer in the context of an emergency presentation (EP) have Buy Adidas Gazelle Uk
t require disclosure of speculative activities or because firms do not implement the rules properly, the end result is that the financial statements do not provide an accurate picture of the firm speculative activities. The role of primary care in cancer diagnosis via emergency presentation: qualitative synthesis of significant event reportsE D Mitchell1, Adidas Gazelle Og Trainers In Aluminium Grey/White
A range of cancers were included, the most common being lung (32. 4 and upper gastrointestinal (19. 8 In most cases, patients had contact with their practice before diagnosis, primarily in the period immediately before admission. In only eight cases had there been no input from primary care. Accounts of protracted primary care contact generally demonstrated complexity, often related to comorbidity, patient mediated factors or reassurance provided by negative investigations. Learning points identified by practices Adidas Gazelle Buy Online Uk centred on the themes of presentation and diagnosis, consultation and safety netting, communication and system issues, patient factors and referral guidelines.
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