Management of the Two-Week Wait Pathway for Skin Cancer Patients, before and during the Pandemic: Is Virtual Consultation an Option?
Background: Although telemedicine emerged more than 100 years ago, the recent pandemic underlined the role of remote assessment of different diseases. The diagnoses of cutaneous conditions, especially malignant lesions, have placed significant stress on the fast-track pathway for general practitione...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/8/1258 |
| _version_ | 1797409427539623936 |
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| author | Maria-Roxana Chiru Sandip Hindocha Ekaterina Burova Gabriel-Cristian Bejan Laura-Maria Manea Liviu-Nicolae Ghilencea |
| author_facet | Maria-Roxana Chiru Sandip Hindocha Ekaterina Burova Gabriel-Cristian Bejan Laura-Maria Manea Liviu-Nicolae Ghilencea |
| author_sort | Maria-Roxana Chiru |
| collection | DOAJ |
| description | Background: Although telemedicine emerged more than 100 years ago, the recent pandemic underlined the role of remote assessment of different diseases. The diagnoses of cutaneous conditions, especially malignant lesions, have placed significant stress on the fast-track pathway for general practitioners (GPs), dermatologists, and plastic surgeons. The aim of the study was to compare (pre- and during the pandemic) the ability of professionals to face the challenge. Methods: The study was composed of 1943 consecutive patients (mean age 61.9 ± 18.3, 53.8% female) assessed by GPs, face-to-face (988 patients, 50.8%, between October 2019 and March 2020) and by virtual (video/photo) visits (955 patients, 49.2%, between March 2020 and October 2020) for skin lesions, and referred to secondary care via the two-week wait pathway for suspected skin malignancy. Results: The two groups had similar primary skin malignancies identification rates (24.3% vs. 22.1%, <i>p</i> = 0.25). The virtual visits identified squamous cell carcinoma (SCC) better than face-to-face consultations (<i>p</i> = 0.04), but identified basal cell carcinoma less-well (BCC, <i>p</i> = 0.02), whereas malignant melanoma (MM) was equally identified in the two groups (<i>p</i> = 0.13). There was no difference in the median breach time (days) of the two-week wait pathway (12, IQR = 6 vs. 12, IQR = 5, <i>p</i> = 0.16) in the two groups. Virtual assessments (by GPs) of skin lesions suspected of malignancy, and referred via the two-week wait pathway, increased the probability of diagnosing SCC by 42.9% (<i>p</i> = 0.03), while for malignant melanomas, face-to-face and virtual consultations were alike (<i>p</i> = 0.12). Conclusions: The equivalent outcomes in the management of skin cancers (SCC, MM) via the two-week pathway through virtual consultations and face-to-face appointments underline the role of telemedicine as a reliable alternative to face-to-face assessments. |
| first_indexed | 2024-03-09T04:15:27Z |
| format | Article |
| id | doaj.art-d9be4a4cebaf41f6b5267988622cbfaa |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T04:15:27Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-d9be4a4cebaf41f6b5267988622cbfaa2023-12-03T13:56:00ZengMDPI AGJournal of Personalized Medicine2075-44262022-07-01128125810.3390/jpm12081258Management of the Two-Week Wait Pathway for Skin Cancer Patients, before and during the Pandemic: Is Virtual Consultation an Option?Maria-Roxana Chiru0Sandip Hindocha1Ekaterina Burova2Gabriel-Cristian Bejan3Laura-Maria Manea4Liviu-Nicolae Ghilencea5Department of Plastic Surgery, Bedford Hospital NHS Foundation Trust, Bedford MK42 9DJ, UKDepartment of Plastic Surgery, Bedford Hospital NHS Foundation Trust, Bedford MK42 9DJ, UKDepartment of Dermatology, Bedford Hospital NHS Foundation Trust, Bedford MK42 9DJ, UKDepartment 5 of Internal Medicine, Carol Davila University of Medicine and Pharmacy, 020022 Bucharest, RomaniaDepartment of Internal Medicine and Cardiology, Coltea University Hospital, 030171 Bucharest, RomaniaDepartment 5 of Internal Medicine, Carol Davila University of Medicine and Pharmacy, 020022 Bucharest, RomaniaBackground: Although telemedicine emerged more than 100 years ago, the recent pandemic underlined the role of remote assessment of different diseases. The diagnoses of cutaneous conditions, especially malignant lesions, have placed significant stress on the fast-track pathway for general practitioners (GPs), dermatologists, and plastic surgeons. The aim of the study was to compare (pre- and during the pandemic) the ability of professionals to face the challenge. Methods: The study was composed of 1943 consecutive patients (mean age 61.9 ± 18.3, 53.8% female) assessed by GPs, face-to-face (988 patients, 50.8%, between October 2019 and March 2020) and by virtual (video/photo) visits (955 patients, 49.2%, between March 2020 and October 2020) for skin lesions, and referred to secondary care via the two-week wait pathway for suspected skin malignancy. Results: The two groups had similar primary skin malignancies identification rates (24.3% vs. 22.1%, <i>p</i> = 0.25). The virtual visits identified squamous cell carcinoma (SCC) better than face-to-face consultations (<i>p</i> = 0.04), but identified basal cell carcinoma less-well (BCC, <i>p</i> = 0.02), whereas malignant melanoma (MM) was equally identified in the two groups (<i>p</i> = 0.13). There was no difference in the median breach time (days) of the two-week wait pathway (12, IQR = 6 vs. 12, IQR = 5, <i>p</i> = 0.16) in the two groups. Virtual assessments (by GPs) of skin lesions suspected of malignancy, and referred via the two-week wait pathway, increased the probability of diagnosing SCC by 42.9% (<i>p</i> = 0.03), while for malignant melanomas, face-to-face and virtual consultations were alike (<i>p</i> = 0.12). Conclusions: The equivalent outcomes in the management of skin cancers (SCC, MM) via the two-week pathway through virtual consultations and face-to-face appointments underline the role of telemedicine as a reliable alternative to face-to-face assessments.https://www.mdpi.com/2075-4426/12/8/1258telemedicinevideo consultationskin cancersquamous cell carcinomabasal cell carcinomamalignant melanoma |
| spellingShingle | Maria-Roxana Chiru Sandip Hindocha Ekaterina Burova Gabriel-Cristian Bejan Laura-Maria Manea Liviu-Nicolae Ghilencea Management of the Two-Week Wait Pathway for Skin Cancer Patients, before and during the Pandemic: Is Virtual Consultation an Option? Journal of Personalized Medicine telemedicine video consultation skin cancer squamous cell carcinoma basal cell carcinoma malignant melanoma |
| title | Management of the Two-Week Wait Pathway for Skin Cancer Patients, before and during the Pandemic: Is Virtual Consultation an Option? |
| title_full | Management of the Two-Week Wait Pathway for Skin Cancer Patients, before and during the Pandemic: Is Virtual Consultation an Option? |
| title_fullStr | Management of the Two-Week Wait Pathway for Skin Cancer Patients, before and during the Pandemic: Is Virtual Consultation an Option? |
| title_full_unstemmed | Management of the Two-Week Wait Pathway for Skin Cancer Patients, before and during the Pandemic: Is Virtual Consultation an Option? |
| title_short | Management of the Two-Week Wait Pathway for Skin Cancer Patients, before and during the Pandemic: Is Virtual Consultation an Option? |
| title_sort | management of the two week wait pathway for skin cancer patients before and during the pandemic is virtual consultation an option |
| topic | telemedicine video consultation skin cancer squamous cell carcinoma basal cell carcinoma malignant melanoma |
| url | https://www.mdpi.com/2075-4426/12/8/1258 |
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