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Title: Towards improving outcomes in colorectal cancer
Author: Mohammed , Mohammed Amin
Awarding Body: University of Birmingham
Current Institution: University of Birmingham
Date of Award: 2001
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This study aimed to improve outcomes for colorectal cancer (CRC) patients in Greater Birmingham (1996-2000). A two-phase design was adopted. Phase I involved a detailed data collection exercise, which sought to capture the patient's journey from presentation through to primary surgical treatment (n=578). During phase I, it was noted that one of the hospitals showed considerable improvement in the quality of histopathology reporting by adopting a proforma based report. This finding generated the hypothesis that proforma based reporting improved the quality of histopathology reporting. This hypothesis was tested in phase II. A major finding from phase I was that 113 of CRC patients underwent emergency treatment with subsequent poor outcomes. Patient flow analysis showed that half the emergency cases were initially referred by their GP as elective cases, but delays in their pathway of care allowed acute deterioration resulting in emergency admission and treatment. This finding generated the hypothesis that changing GP referral patterns and reducing times to surgical treatment could reduce the number of emergency CRC patients. This hypothesis was also tested in phase II of the study that involved interventions in primary and secondary care to effect a change in referral practice and reduce delays. With reference to emergency CRC patients, the present study challenges two widely held viewpoints - a) that reducing delays is ineffective at improving survival and that b) the emergency CRC is fundamentally different to its elective counterpart. Given that emergency cases account for half the total mortality burden of CRC, the findings of this work merit consideration.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available