PMID- 29543399
STAT- Publisher
LR  - 20180410
IS  - 1749-4486 (Electronic)
IS  - 1749-4478 (Linking)
DP  - 2018 Mar 15
TI  - A web-based prediction score for head and neck cancer referrals.
LID - 10.1111/coa.13098 [doi]
AB  - OBJECTIVE: Following the announcement of the NHS Cancer Plan in 2000, anyone
      suspected of having cancer has to be seen by a specialist within 2 weeks of
      referral. Since this introduction, studies have shown that only 6.3%-14.6% of
      2-week referrals were diagnosed with a head and neck cancer and that majority of 
      the cancer diagnoses were via other referral routes. These studies suggest that
      the referral scheme is not currently cost-effective. Our aim is to develop a
      scoring system that determines the risk of head and neck cancer in a patient,
      which can then be used to aid GP referrals. DESIGN: Retrospective data were
      collected from 1075 patients with 2-week head and neck cancer referrals from
      general practitioners. The retrospective data collected included patients'
      demographics, risk factors and relevant investigations. The data were used as
      input into a logistic regression to arrive at our model. Our approach included
      data analysis, machine learning techniques, statistical inference and model
      validation metrics to arrive at the best performing model. The model was then
      tested with more data from 235 prospective patients. RESULTS: Using our results
      from the logistic regression, we created a web-based tool that GPs can use to
      calculate their patient's probability of cancer and use this result to assist in 
      their decision regarding referral. Our prototype can be seen in Figure 2.
      CONCLUSION: We have created a prototype scoring system that can be hosted online 
      to assist GPs with their referrals with a sensitivity of 31% and specificity of
      92%. While we acknowledge that there are several limitations to our model, we
      believe we have created a novel preliminary scoring system that has the potential
      to be improved dramatically with further data and be very helpful for GPs in a
      long run.
CI  - (c) 2018 John Wiley & Sons Ltd.
FAU - Lau, K
AU  - Lau K
AD  - Wexham Park Hospital, Slough, UK.
FAU - Wilkinson, J
AU  - Wilkinson J
AD  - Gain Theory, London, UK.
FAU - Moorthy, R
AU  - Moorthy R
AD  - Wexham Park Hospital, Slough, UK.
LA  - eng
PT  - Journal Article
DEP - 20180315
PL  - England
TA  - Clin Otolaryngol
JT  - Clinical otolaryngology : official journal of ENT-UK ; official journal of
      Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
JID - 101247023
OT  - head and neck cancer
OT  - head and neck surgery
OT  - health services research
OT  - internet
OT  - research
EDAT- 2018/03/16 06:00
MHDA- 2018/03/16 06:00
CRDT- 2018/03/16 06:00
PHST- 2018/03/06 00:00 [accepted]
PHST- 2018/03/16 06:00 [pubmed]
PHST- 2018/03/16 06:00 [medline]
PHST- 2018/03/16 06:00 [entrez]
AID - 10.1111/coa.13098 [doi]
PST - aheadofprint
SO  - Clin Otolaryngol. 2018 Mar 15. doi: 10.1111/coa.13098.