Quantitative analysis of 'virtual' SSP assessment clinics in the NHS bowel cancer screening programme in England.

Claire Nickerson, Suzanne Wright, Lucy Pickering, Lee Adams, Nagamani Mandli, Nick Hex, Cameron Collins, Anne Webb, Jeffery Rayment, Karen Emery-Downing, Rebecca Maclean
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Abstract

Background: Bowel cancer screening in England is initially carried out using a home testing kit, with those who require further testing first being referred to an assessment clinic. During COVID-19, these assessment clinics became 'virtual' (telephone or video-call) where previously they had only been held face-to-face.

Methodology: A before and after study design was constructed to examine the impact of this change in clinic type on key programme metrics.

Results and conclusions: The data showed fewer people changed their specialist screening practitioner appointments when the modality was virtual, with the virtual group also having higher clinic uptake and shorter times to first offered and first attended clinics.Despite clinical opinion that not being able to physically see a patient would negatively impact diagnostic test quality, suggesting that incomplete tests would rise, referrals to colonoscopy would fall, and bowel preparation quality would suffer, the data did not support any of these suppositions.Whilst the data indicated that diagnostic test uptake was lower in the virtual group, the presence of COVID-19 is likely to have skewed findings.The IT system is being developed to support virtual clinics, which will aid future data analysis/monitoring and assist staff with clinic management.

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定量分析“虚拟”SSP评估诊所在NHS肠癌筛查计划在英格兰。
背景:在英国,肠癌筛查最初是使用家庭检测试剂盒进行的,那些需要进一步检测的人首先被转介到评估诊所。在2019冠状病毒病期间,这些评估诊所变成了“虚拟”(电话或视频通话),而以前只能面对面进行。方法:构建了前后研究设计,以检查诊所类型变化对关键方案指标的影响。结果和结论:数据显示,当模式是虚拟的时候,很少有人改变他们的专家筛查医生预约,虚拟组也有更高的诊所使用率和更短的时间到第一次提供和第一次参加的诊所。尽管临床观点认为不能亲自见病人会对诊断测试质量产生负面影响,表明不完整的测试会增加,结肠镜检查的转诊会减少,肠道准备的质量会受到影响,但数据并不支持这些假设。虽然数据表明,虚拟组的诊断测试使用率较低,但COVID-19的存在可能会扭曲结果。正在开发的资讯科技系统支援虚拟诊所,有助日后进行数据分析/监察,并协助员工管理诊所。
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