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Title: The evaluation of 'Lower Gastrointestinal e-Referral Protocol' at the Primary care-Secondary care interface : a prospective study
Author: John, Solomon
Awarding Body: University of Southampton
Current Institution: University of Southampton
Date of Award: 2011
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The rationale for this study was born out of the need to streamline referral mechanisms for suspected colorectal cancer referrals from primary care, and also to process patients with lower gastrointestinal symptoms and suspected iron deficiency anaemia adequately. There is limited guidance on how to decide which patients need investigations and no clear guidance in primary care on where patients with various colorectal symptoms should be seen in secondary care. We hypothesized that a validated electronic referral protocol (e -RP) addressing the full spectrum of lower gastrointestinal symptoms and suspected or proven iron deficiency anaemia would help General Practitioners in making correct referral decisions. This prospective, parallel, non-randomised trial looking at the benefits of a dedicated Lower Gastrointestinal e-Referral Protocol was carried out in one secondary care hospital and surrounding general practices in the Bournemouth and South & East Dorset Primary Care Trusts. My aim was to assess the yield of CRC, whilst filtering less serious pathology, from the TWW and urgent referral system. I measured the time periods from referral by GP through first appointment/investigation to definitive diagnosis in groups of patients who were referred using the e-RP or through traditional referral methods. The use of e-RP was associated with a statistically significant increase in yield of CRC, difference in time to definitive diagnosis for colorectal cancer and a sensitivity of 100%, compared with 75% for non-use of e-RP. There were several other changes which support the use of e-RP but which did not reach statistical significance, probably due to Type II error.
Supervisor: Primrose, John ; George, Stephen ; Fozard, Basil Sponsor: Not available
Qualification Name: Thesis (D.M.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RC Internal medicine