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乳腺症状患者自我转诊在线申请。

Online application for self-referral of the patients with breast symptoms.

作者信息

Rao Ahsan, Razzaq Humayun, Panamarenko Ben, Bottle Alex, Majeed Azeem, Gray Emma

机构信息

Department of Surgery, Southend University Hospital NHFT, Southend on Sea Essex, UK.

School of Public Health and Faculty of Medicine, Imperial College London, UK.

出版信息

Ann Med Surg (Lond). 2021 May 8;66:102372. doi: 10.1016/j.amsu.2021.102372. eCollection 2021 Jun.

Abstract

INTRODUCTION

The study aimed to devise a self-referral mobile/web application for patients with new breast symptoms, giving them an outcome, thus bypassing the need for primary care consultation.

METHODS

The online application was designed on the automated algorithm based on evidence-based guidelines for referral to breast onco-plastic units. A retrospective questionnaire-based anonymous survey was carried out at the breast unit in Southend University Hospital (January 2019 to March 2020). The outcome of the patients was recorded, the same data was entered in the software and its outcome was compared with their clinic outcome to assess and validate the software. Chi-square and -test were used in formulating results.

RESULTS

Data was collected for 366 patients who were referred urgently to the clinic. Only 50.5% (n = 186) were appropriately referred, with the main complaint being breast lump (94.1%). 39.6% of referred patients did not require a secondary care referral. Sensitivity and specificity for identifying patients requiring urgent referral was 100% and 98%, respectively.

CONCLUSION

A significant number of urgent referrals to breast units do not require urgent specialist referral, and this results in a big strain on the hospital service. The discussed self-referral pathway is a promising alternative with the potential to reduce workload in primary and secondary care and improve patient satisfaction.

摘要

引言

本研究旨在为有新的乳房症状的患者设计一款自助转诊移动/网络应用程序,直接给出结果,从而无需进行初级保健咨询。

方法

该在线应用程序基于转诊至乳房肿瘤整形科的循证指南,采用自动算法设计。在绍森德大学医院的乳房科进行了一项基于问卷的回顾性匿名调查(2019年1月至2020年3月)。记录患者的结果,将相同数据输入软件,并将其结果与临床结果进行比较,以评估和验证该软件。使用卡方检验和t检验得出结果。

结果

收集了366名紧急转诊至该诊所患者的数据。只有50.5%(n = 186)的转诊是恰当的,主要症状是乳房肿块(94.1%)。39.6%的转诊患者不需要二级护理转诊。识别需要紧急转诊患者的敏感性和特异性分别为100%和98%。

结论

大量紧急转诊至乳房科的患者并不需要紧急专科转诊,这给医院服务带来了巨大压力。所讨论的自助转诊途径是一个有前景的替代方案,有可能减轻初级和二级护理的工作量并提高患者满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b3b/8141459/b4ceb0f68f05/gr1.jpg

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