• Family practice · May 2019

    Meta Analysis

    General practitioner referrals to one-stop clinics for symptoms that could be indicative of cancer: a systematic review of use and clinical outcomes.

    • Friedemann SmithClaireCNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK., Alice Tompson, Gea A Holtman, Clare Bankhead, Fergus Gleeson, Daniel Lasserson, and Brian D Nicholson.
    • Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
    • Fam Pract. 2019 May 23; 36 (3): 255261255-261.

    BackgroundOne-stop clinics provide comprehensive diagnostic testing in one outpatient appointment. They could benefit patients with conditions, such as cancer, whose outcomes are improved by early diagnosis, and bring efficiency savings for health systems.ObjectiveTo assess the use and outcomes of one-stop clinics for symptoms where cancer is a possible diagnosis.Design And SettingSystematic review of studies reporting use and outcomes of one-stop clinics in primary care patients.MethodWe searched MEDLINE, Embase, and Cochrane Library for studies assessing one-stop clinics for adults referred after presenting to primary care with any symptom that could be indicative of cancer. Study selection was carried out independently in duplicate with disagreements resolved through discussion.ResultsTwenty-nine studies were identified, most were conducted in the UK and observational in design. Few included a comparison arm. A pooled comparison of the cancer conversion rate of one-stop and multi-stop clinics was only possible for breast symptoms, and we found no significant difference. One-stop clinics were associated with significant reductions in the interval from referral to testing (15 versus 75 days) and more patients diagnosed on the same day (79% versus 25%) compared to multi-stop pathways. The majority of patients and GPs found one-stop clinics to be acceptable.ConclusionThis review found one-stop clinics were associated with reduced time from referral to testing, increased same day diagnoses, and were acceptable to patients and GPs. Our conclusions are limited by high levels of heterogeneity, scarcity of comparator groups, and the overwhelmingly observational nature of included studies.© The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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