Thames Valley Cancer Research Network, Nuffield Orthopaedic Centre NHS Trust, Oxford, UK.
Colorectal Dis. 2012 Nov;14(11):1351-6. doi: 10.1111/j.1463-1318.2012.03010.x.
To facilitate implementation of National Institute for Health and Clinical Excellence (NICE) guidelines for urgent colorectal cancer referral, local cancer networks have promoted the use of standardized proformas in primary care. This clinical audit assessed use of the proforma within the Thames Valley Cancer Network (TVCN) to see whether increased proforma use was associated with higher compliance to NICE guidelines and higher cancer detection rates.
All 2-week wait referrals for lower bowel cancer to the six Acute NHS Trusts in the TVCN received during the month of June 2010 were identified, anonymized and analysed in relation to colorectal cancer detection rates.
Of the 586 referrals audited, proforma usage varied significantly across the six Acute NHS Trusts from 18% to 96%. Referral letters from primary care had NICE compliance ranging from 30 to 50%. In those which received a referral protocol, 50-90% were NICE compliant. Proforma use was associated with higher cancer detection rates (P = 0.03).
These results have wide-ranging implications since they suggest that the adoption of a simple proforma in primary care can improve the effectiveness of referral for suspected cancer.
为了促进实施国家卫生与临床优化研究所（NICE）关于紧急结直肠癌转诊的指南，当地癌症网络提倡在初级保健中使用标准化的预填式表格。本临床审计评估了泰晤士河谷癌症网络（TVCN）中使用预填式表格的情况，以了解增加预填式表格的使用是否与更高的 NICE 指南遵从率和更高的癌症检出率相关。
在 2010 年 6 月期间，鉴定了 TVCN 内的 6 家急性 NHS 信托机构中所有 2 周等待下消化道癌症的转诊，对其进行匿名分析，并与结直肠癌检出率相关联。
在审核的 586 例转诊中，6 家急性 NHS 信托机构之间的预填式表格使用率差异显著，从 18%到 96%不等。初级保健转诊信的 NICE 遵从率在 30%至 50%之间。在那些收到转诊方案的患者中，50-90%符合 NICE 标准。预填式表格的使用与更高的癌症检出率相关（P=0.03）。
这些结果具有广泛的意义，因为它们表明在初级保健中采用简单的预填式表格可以提高疑似癌症转诊的效果。
