Evaluating a risk assessment tool to improve triaging of patients to colonoscopies

Internal Medicine Journal
Thomas M ElliottLouisa G Gordon

Abstract

Colonoscopy is the gold standard in the diagnosis of significant bowel disease (SBD), including colorectal cancer, high-risk adenoma and inflammatory bowel disease. As the demand for colonoscopy services is placing significant pressure on hospital resources, new solutions are needed to manage patients more efficiently and effectively. We investigated the impact of using a risk assessment tool (RAT) to improve selection of patients for colonoscopy procedures to detect SBD. A hybrid simulation model was constructed to replicate the current patient triage bookings and waiting times in a large metropolitan hospital. The model used data on 327 patients who were retrospectively assessed for risk of SBD. Risk assessment incorporated blood and faecal immunochemical test results, gender and age in addition to patient symptoms. The model was calibrated over 12 months to current outcomes and was compared with the RAT and a third scenario where low-risk patients did not proceed to a colonoscopy. One-way sensitivity analyses were undertaken. Using the RAT was expected to shorten waiting times by 153 days for moderately-urgent patients and 138 days for non-urgent patients. If low-risk patients did not proceed to colonoscopy, waiting times we...Continue Reading

References

Jun 1, 2011·BMC Gastroenterology·Barbara-Ann AdelsteinLes Irwig
Jan 26, 2016·Asia-Pacific Journal of Clinical Oncology·UNKNOWN Australian Institute of Health and Welfare, UNKNOWN Australian Government Department of Health
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Jan 13, 2017·Lancet·Shannon BrownleeDeborah Korenstein
Mar 20, 2018·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·Callum G Fraser

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